HL7 Europe Imaging Study Report
0.1.0-ballot - ci-build 150

HL7 Europe Imaging Study Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.1.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/oijauregui/ehdsimaging/tree/master and changes regularly. See the Directory of published versions

Resource Profile: ImOrder - Detailed Descriptions

Page standards status: Draft Maturity Level: 1

Definitions for the ImOrder resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. ServiceRequest
Definition

A record of a request for service such as diagnostic investigations, treatments, or operations to be performed.

ShortA request for a service to be performed
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesdiagnostic request, referral, referral request, transfer of care request
Invariantsbdystr-1: bodyStructure SHALL only be present if bodySite is not present (bodySite.exists() implies bodyStructure.empty())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
2. ServiceRequest.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. ServiceRequest.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

Control0..*
This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
TypeResource
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
6. ServiceRequest.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Must Supportfalse
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. ServiceRequest.identifier
Definition

Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

ShortIdentifiers assigned to this order
Comments

The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 V2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 V2). For further discussion and examples see the resource notes section below.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on ServiceRequest.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ type
  • 10. ServiceRequest.identifier:accessionNumber
    Slice NameaccessionNumber
    Definition

    Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

    ShortIdentifiers assigned to this order
    Comments

    The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 V2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 V2). For further discussion and examples see the resource notes section below.

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..1*
    TypeIdentifier(Imaging Accession Number Identifier)
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. ServiceRequest.status
    Definition

    The status of the order.

    Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
    Comments

    The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, revoked or placed on-hold. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.


    The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, revoked or placed on-hold. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.

    Control1..1
    BindingThe codes SHALL be taken from RequestStatushttp://hl7.org/fhir/ValueSet/request-status|5.0.0
    (required to http://hl7.org/fhir/ValueSet/request-status|5.0.0)

    The status of a service order.

    Typecode
    Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. ServiceRequest.intent
    Definition

    Whether the request is a proposal, plan, an original order or a reflex order.

    Shortproposal | plan | directive | order +
    Comments

    This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

    Control1..1
    BindingThe codes SHALL be taken from RequestIntenthttp://hl7.org/fhir/ValueSet/request-intent|5.0.0
    (required to http://hl7.org/fhir/ValueSet/request-intent|5.0.0)

    The kind of service request.

    Typecode
    Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. ServiceRequest.category
    Definition

    A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

    ShortClassification of service
    Comments

    There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

    Control10..*
    BindingFor example codes, see ServiceRequestCategoryCodeshttp://hl7.org/fhir/ValueSet/servicerequest-category
    (example to http://hl7.org/fhir/ValueSet/servicerequest-category)

    Classification of the requested service.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Requirements

    Used for filtering what service request are retrieved and displayed.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on ServiceRequest.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ $this
    • 18. ServiceRequest.category:imaging
      Slice Nameimaging
      Definition

      A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

      ShortClassification of service
      Comments

      There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

      Control10..1*
      BindingFor example codes, see ServiceRequestCategoryCodeshttp://hl7.org/fhir/ValueSet/servicerequest-category
      (example to http://hl7.org/fhir/ValueSet/servicerequest-category)

      Classification of the requested service.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Requirements

      Used for filtering what service request are retrieved and displayed.

      Pattern Value{
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "363679005",
          "display" : "Imaging"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. ServiceRequest.doNotPerform
      Definition

      Set this to true if the record is saying that the service/procedure should NOT be performed.

      ShortTrue if service/procedure should not be performed
      Comments

      In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.

      Control0..1
      Typeboolean
      Is Modifiertrue because If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Requirements

      Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.

      Meaning if MissingIf missing, the request is a positive request e.g. "do perform"
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. ServiceRequest.code
      Definition

      A code or reference that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.

      ShortWhat is being requested/ordered
      Comments

      Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code.

      Control0..1
      This element is affected by the following invariants: prr-1
      BindingFor example codes, see ProcedureCodesSNOMEDCThttp://hl7.org/fhir/ValueSet/procedure-code
      (example to http://hl7.org/fhir/ValueSet/procedure-code)

      Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred and a valueset using LOINC Order codes is available here.


      Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred and a valueset using LOINC Order codes is available here.

      TypeCodeableReference(ActivityDefinition, PlanDefinition)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Alternate Namesservice requested
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. ServiceRequest.subject
      Definition

      On whom or what the service is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans).

      ShortIndividual or Entity the service is ordered for
      Control1..1
      TypeReference(Patient, Group, Location, Device)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. ServiceRequest.supportingInfo
      Definition

      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

      ShortAdditional clinical information
      Comments

      To represent information about how the services are to be delivered use the instructions element.

      Control0..*
      TypeCodeableReference(Resource)
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate NamesAsk at order entry question, AOE
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on ServiceRequest.supportingInfo. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ $this
      • 28. ServiceRequest.supportingInfo:pregnancy
        Slice Namepregnancy
        Definition

        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

        ShortAdditional clinical information
        Comments

        To represent information about how the services are to be delivered use the instructions element.

        Control0..1*
        BindingThe codes SHALL be taken from For codes, see Pregnancy Status - IPS
        (required to http://hl7.org/fhir/uv/ips/ValueSet/pregnancy-status-uv-ips)
        TypeCodeableReference(Resource)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Alternate NamesAsk at order entry question, AOE
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. ServiceRequest.note
        Definition

        Any other notes and comments made about the service request. For example, internal billing notes.

        ShortComments
        Control0..*
        TypeAnnotation
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

        Guidance on how to interpret the contents of this table can be foundhere

        0. ServiceRequest
        2. ServiceRequest.identifier
        NoteThis is a business identifier, not a resource identifier (see discussion)
        SlicingThis element introduces a set of slices on ServiceRequest.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ type
        • 4. ServiceRequest.identifier:accessionNumber
          Slice NameaccessionNumber
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..1
          TypeIdentifier(Imaging Accession Number Identifier)
          6. ServiceRequest.category
          Control1..?
          SlicingThis element introduces a set of slices on ServiceRequest.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ $this
          • 8. ServiceRequest.category:imaging
            Slice Nameimaging
            Control1..1
            Pattern Value{
              "coding" : [{
                "system" : "http://snomed.info/sct",
                "code" : "363679005",
                "display" : "Imaging"
              }]
            }
            10. ServiceRequest.code
            12. ServiceRequest.subject
            14. ServiceRequest.reason
            16. ServiceRequest.reason.concept
            18. ServiceRequest.reason.concept.text
            20. ServiceRequest.supportingInfo
            SlicingThis element introduces a set of slices on ServiceRequest.supportingInfo. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ $this
            • 22. ServiceRequest.supportingInfo:pregnancy
              Slice Namepregnancy
              Control0..1
              BindingThe codes SHALL be taken from Pregnancy Status - IPS
              (required to http://hl7.org/fhir/uv/ips/ValueSet/pregnancy-status-uv-ips)
              24. ServiceRequest.note

              Guidance on how to interpret the contents of this table can be foundhere

              0. ServiceRequest
              Definition

              A record of a request for service such as diagnostic investigations, treatments, or operations to be performed.

              ShortA request for a service to be performed
              Control0..*
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Alternate Namesdiagnostic request, referral, referral request, transfer of care request
              Invariantsbdystr-1: bodyStructure SHALL only be present if bodySite is not present (bodySite.exists() implies bodyStructure.empty())
              dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
              dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
              dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
              dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
              dom-6: A resource should have narrative for robust management (text.`div`.exists())
              prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
              2. ServiceRequest.id
              Definition

              The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

              ShortLogical id of this artifact
              Comments

              Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

              Control0..1
              Typeid
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              4. ServiceRequest.meta
              Definition

              The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

              ShortMetadata about the resource
              Control0..1
              TypeMeta
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              6. ServiceRequest.implicitRules
              Definition

              A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

              ShortA set of rules under which this content was created
              Comments

              Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

              Control0..1
              Typeuri
              Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              8. ServiceRequest.language
              Definition

              The base language in which the resource is written.

              ShortLanguage of the resource content
              Comments

              Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

              Control0..1
              BindingThe codes SHALL be taken from AllLanguages
              (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

              IETF language tag for a human language

              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supportfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              10. ServiceRequest.text
              Definition

              A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

              ShortText summary of the resource, for human interpretation
              Comments

              Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

              Control0..1
              This element is affected by the following invariants: dom-6
              TypeNarrative
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Alternate Namesnarrative, html, xhtml, display
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              12. ServiceRequest.contained
              Definition

              These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

              ShortContained, inline Resources
              Comments

              This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

              Control0..*
              This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
              TypeResource
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Alternate Namesinline resources, anonymous resources, contained resources
              14. ServiceRequest.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Must Supportfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              16. ServiceRequest.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
              Must Supportfalse
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              18. ServiceRequest.identifier
              Definition

              Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

              ShortIdentifiers assigned to this order
              Comments

              The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 V2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 V2). For further discussion and examples see the resource notes section below.

              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..*
              TypeIdentifier
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on ServiceRequest.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ type
              • 20. ServiceRequest.identifier:accessionNumber
                Slice NameaccessionNumber
                Definition

                Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

                ShortIdentifiers assigned to this order
                Comments

                The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 V2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 V2). For further discussion and examples see the resource notes section below.

                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..1
                TypeIdentifier(Imaging Accession Number Identifier)
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                22. ServiceRequest.instantiatesCanonical
                Definition

                The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest.

                ShortInstantiates FHIR protocol or definition
                Comments

                The PlanDefinition resource is used to describe series, sequences, or groups of actions to be taken, while the ActivityDefinition resource is used to define each specific step or activity to be performed. More information can be found in the Boundaries and Relationships section for PlanDefinition.

                Control0..*
                Typecanonical(ActivityDefinition, PlanDefinition)
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                24. ServiceRequest.instantiatesUri
                Definition

                The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest.

                ShortInstantiates external protocol or definition
                Comments

                This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

                Control0..*
                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                26. ServiceRequest.basedOn
                Definition

                Plan/proposal/order fulfilled by this request.

                ShortWhat request fulfills
                Control0..*
                TypeReference(CarePlan, ServiceRequest, MedicationRequest)
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                Alternate Namesfulfills
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                28. ServiceRequest.replaces
                Definition

                The request takes the place of the referenced completed or terminated request(s).

                ShortWhat request replaces
                Control0..*
                TypeReference(ServiceRequest)
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                Alternate Namessupersedes, prior, renewed order
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                30. ServiceRequest.requisition
                Definition

                A shared identifier common to all service requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier.

                ShortComposite Request ID
                Comments

                Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

                Control0..1
                TypeIdentifier
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                Requirements

                Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes.

                Alternate NamesgrouperId, groupIdentifier
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                32. ServiceRequest.status
                Definition

                The status of the order.

                Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
                Comments

                The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, revoked or placed on-hold. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.

                Control1..1
                BindingThe codes SHALL be taken from RequestStatus
                (required to http://hl7.org/fhir/ValueSet/request-status|5.0.0)

                The status of a service order.

                Typecode
                Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                34. ServiceRequest.intent
                Definition

                Whether the request is a proposal, plan, an original order or a reflex order.

                Shortproposal | plan | directive | order +
                Comments

                This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

                Control1..1
                BindingThe codes SHALL be taken from RequestIntent
                (required to http://hl7.org/fhir/ValueSet/request-intent|5.0.0)

                The kind of service request.

                Typecode
                Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                36. ServiceRequest.category
                Definition

                A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

                ShortClassification of service
                Comments

                There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

                Control1..*
                BindingFor example codes, see ServiceRequestCategoryCodes
                (example to http://hl7.org/fhir/ValueSet/servicerequest-category)

                Classification of the requested service.

                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                Requirements

                Used for filtering what service request are retrieved and displayed.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on ServiceRequest.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ $this
                • 38. ServiceRequest.category:imaging
                  Slice Nameimaging
                  Definition

                  A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

                  ShortClassification of service
                  Comments

                  There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

                  Control1..1
                  BindingFor example codes, see ServiceRequestCategoryCodes
                  (example to http://hl7.org/fhir/ValueSet/servicerequest-category)

                  Classification of the requested service.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Requirements

                  Used for filtering what service request are retrieved and displayed.

                  Pattern Value{
                    "coding" : [{
                      "system" : "http://snomed.info/sct",
                      "code" : "363679005",
                      "display" : "Imaging"
                    }]
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  40. ServiceRequest.priority
                  Definition

                  Indicates how quickly the ServiceRequest should be addressed with respect to other requests.

                  Shortroutine | urgent | asap | stat
                  Control0..1
                  BindingThe codes SHALL be taken from RequestPriority
                  (required to http://hl7.org/fhir/ValueSet/request-priority|5.0.0)

                  Identifies the level of importance to be assigned to actioning the request.

                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supportfalse
                  Summarytrue
                  Meaning if MissingIf missing, this task should be performed with normal priority
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  42. ServiceRequest.doNotPerform
                  Definition

                  Set this to true if the record is saying that the service/procedure should NOT be performed.

                  ShortTrue if service/procedure should not be performed
                  Comments

                  In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.

                  Control0..1
                  Typeboolean
                  Is Modifiertrue because If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supportfalse
                  Summarytrue
                  Requirements

                  Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.

                  Meaning if MissingIf missing, the request is a positive request e.g. "do perform"
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  44. ServiceRequest.code
                  Definition

                  A code or reference that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.

                  ShortWhat is being requested/ordered
                  Comments

                  Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code.

                  Control0..1
                  This element is affected by the following invariants: prr-1
                  BindingFor example codes, see ProcedureCodesSNOMEDCT
                  (example to http://hl7.org/fhir/ValueSet/procedure-code)

                  Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred and a valueset using LOINC Order codes is available here.

                  TypeCodeableReference(ActivityDefinition, PlanDefinition)
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Alternate Namesservice requested
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  46. ServiceRequest.orderDetail
                  Definition

                  Additional details and instructions about the how the services are to be delivered. For example, and order for a urinary catheter may have an order detail for an external or indwelling catheter, or an order for a bandage may require additional instructions specifying how the bandage should be applied.

                  ShortAdditional order information
                  Comments

                  For information from the medical record intended to support the delivery of the requested services, use the supportingInformation element.

                  Control0..*
                  This element is affected by the following invariants: prr-1
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Alternate Namesdetailed instructions
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  48. ServiceRequest.orderDetail.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  50. ServiceRequest.orderDetail.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  52. ServiceRequest.orderDetail.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  54. ServiceRequest.orderDetail.parameterFocus
                  Definition

                  Indicates the context of the order details by reference.

                  ShortThe context of the order details by reference
                  Control0..1
                  TypeCodeableReference(Device, DeviceDefinition, DeviceRequest, SupplyRequest, Medication, MedicationRequest, BiologicallyDerivedProduct, Substance)
                  Is Modifierfalse
                  Must Supportfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  56. ServiceRequest.orderDetail.parameter
                  Definition

                  The parameter details for the service being requested.

                  ShortThe parameter details for the service being requested
                  Control1..*
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  58. ServiceRequest.orderDetail.parameter.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  60. ServiceRequest.orderDetail.parameter.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  62. ServiceRequest.orderDetail.parameter.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  64. ServiceRequest.orderDetail.parameter.code
                  Definition

                  A value representing the additional detail or instructions for the order (e.g., catheter insertion, body elevation, descriptive device configuration and/or setting instructions).

                  ShortThe detail of the order being requested
                  Control1..1
                  BindingFor example codes, see ServiceRequestOrderDetailParameterCode
                  (example to http://hl7.org/fhir/ValueSet/servicerequest-orderdetail-parameter-code)

                  Codes for order detail parameters.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  66. ServiceRequest.orderDetail.parameter.value[x]
                  Definition

                  Indicates a value for the order detail.

                  ShortThe value for the order detail
                  Comments

                  CodeableConcept values are indented to express concepts that would normally be coded - when a code is not available for a concept, CodeableConcept.text can be used. When the data is a text or not a single identifiable concept, string should be used.

                  Control1..1
                  TypeChoice of: Quantity, Ratio, Range, boolean, CodeableConcept, string, Period
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  68. ServiceRequest.quantity[x]
                  Definition

                  An amount of service being requested which can be a quantity ( for example $1,500 home modification), a ratio ( for example, 20 half day visits per month), or a range (2.0 to 1.8 Gy per fraction).

                  ShortService amount
                  Control0..1
                  TypeChoice of: Quantity, Ratio, Range
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Requirements

                  When ordering a service the number of service items may need to be specified separately from the the service item.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  70. ServiceRequest.subject
                  Definition

                  On whom or what the service is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans).

                  ShortIndividual or Entity the service is ordered for
                  Control1..1
                  TypeReference(Patient, Group, Location, Device)
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  72. ServiceRequest.focus
                  Definition

                  The actual focus of a service request when it is not the subject of record representing something or someone associated with the subject such as a spouse, parent, fetus, or donor. The focus of a service request could also be an existing condition, an intervention, the subject's diet, another service request on the subject, or a body structure such as tumor or implanted device.

                  ShortWhat the service request is about, when it is not about the subject of record
                  Control0..*
                  TypeReference(Resource)
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  74. ServiceRequest.encounter
                  Definition

                  An encounter that provides additional information about the healthcare context in which this request is made.

                  ShortEncounter in which the request was created
                  Control0..1
                  TypeReference(Encounter)
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Alternate Namescontext
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  76. ServiceRequest.occurrence[x]
                  Definition

                  The date/time at which the requested service should occur.

                  ShortWhen service should occur
                  Control0..1
                  TypeChoice of: dateTime, Period, Timing
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supportfalse
                  Summarytrue
                  Alternate Namesschedule
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  78. ServiceRequest.asNeeded[x]
                  Definition

                  If a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc.

                  ShortPreconditions for service
                  Control0..1
                  BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                  (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

                  A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.

                  TypeChoice of: boolean, CodeableConcept
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  80. ServiceRequest.authoredOn
                  Definition

                  When the request transitioned to being actionable.

                  ShortDate request signed
                  Control0..1
                  TypedateTime
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supportfalse
                  Summarytrue
                  Alternate NamesorderedOn
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  82. ServiceRequest.requester
                  Definition

                  The individual who initiated the request and has responsibility for its activation.

                  ShortWho/what is requesting service
                  Comments

                  This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource.

                  Control0..1
                  TypeReference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Alternate Namesauthor, orderer
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  84. ServiceRequest.performerType
                  Definition

                  Desired type of performer for doing the requested service.

                  ShortPerformer role
                  Comments

                  This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”.

                  Control0..1
                  BindingFor example codes, see ParticipantRoles
                  (example to http://hl7.org/fhir/ValueSet/participant-role)

                  Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Alternate Namesspecialty
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  86. ServiceRequest.performer
                  Definition

                  The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc.

                  ShortRequested performer
                  Comments

                  If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the http://hl7.org/fhir/StructureDefinition/request-performerOrder. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B).

                  Control0..*
                  TypeReference(Practitioner, PractitionerRole, Organization, CareTeam, HealthcareService, Patient, Device, RelatedPerson)
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Alternate Namesrequest recipient
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  88. ServiceRequest.location
                  Definition

                  The preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center.

                  ShortRequested location
                  Control0..*
                  BindingFor example codes, see ServiceDeliveryLocationRoleType
                  (example to http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType)

                  A location type where services are delivered.

                  TypeCodeableReference(Location)
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  90. ServiceRequest.reason
                  Definition

                  An explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in supportingInfo.

                  ShortExplanation/Justification for procedure or service
                  Comments

                  This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise, use concept.text element if the data is free (uncoded) text as shown in the CT Scan example.

                  Control0..*
                  BindingFor example codes, see ProcedureReasonCodes
                  (example to http://hl7.org/fhir/ValueSet/procedure-reason)

                  SNOMED CT Condition/Problem/Diagnosis Codes

                  TypeCodeableReference(Condition, Observation, DiagnosticReport, DocumentReference, DetectedIssue)
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  92. ServiceRequest.reason.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  Typeid
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  94. ServiceRequest.reason.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on ServiceRequest.reason.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 96. ServiceRequest.reason.concept
                    Definition

                    A reference to a concept - e.g. the information is identified by its general class to the degree of precision found in the terminology.

                    ShortReference to a concept (by class)
                    Control0..1
                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    98. ServiceRequest.reason.concept.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typeid
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    100. ServiceRequest.reason.concept.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on ServiceRequest.reason.concept.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 102. ServiceRequest.reason.concept.coding
                      Definition

                      A reference to a code defined by a terminology system.

                      ShortCode defined by a terminology system
                      Comments

                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                      Control0..*
                      TypeCoding
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      Allows for alternative encodings within a code system, and translations to other code systems.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      104. ServiceRequest.reason.concept.text
                      Definition

                      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                      ShortPlain text representation of the concept
                      Comments

                      Very often the text is the same as a displayName of one of the codings.

                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      106. ServiceRequest.reason.reference
                      Definition

                      A reference to a resource the provides exact details about the information being referenced.

                      ShortReference to a resource (by instance)
                      Control0..1
                      TypeReference
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      108. ServiceRequest.insurance
                      Definition

                      Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service.

                      ShortAssociated insurance coverage
                      Control0..*
                      TypeReference(Coverage, ClaimResponse)
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      110. ServiceRequest.supportingInfo
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortAdditional clinical information
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..*
                      TypeCodeableReference(Resource)
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      SlicingThis element introduces a set of slices on ServiceRequest.supportingInfo. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ $this
                      • 112. ServiceRequest.supportingInfo:pregnancy
                        Slice Namepregnancy
                        Definition

                        Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                        ShortAdditional clinical information
                        Comments

                        To represent information about how the services are to be delivered use the instructions element.

                        Control0..1
                        BindingThe codes SHALL be taken from Pregnancy Status - IPS
                        (required to http://hl7.org/fhir/uv/ips/ValueSet/pregnancy-status-uv-ips)
                        TypeCodeableReference(Resource)
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Alternate NamesAsk at order entry question, AOE
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        114. ServiceRequest.specimen
                        Definition

                        One or more specimens that the laboratory procedure will use.

                        ShortProcedure Samples
                        Comments

                        The purpose of the ServiceRequest.specimen is to reflect the actual specimen that the requested test/procedure is asked to be performed on, whether the lab already has it or not. References to specimens for purposes other than to perform a test/procedure on should be made using the ServiceRequest.supportingInfo or the Specimen.parent where the Specimen.parent would enable descendency and ServiceRequest.supportingInfo a general reference for context.

                        Control0..*
                        TypeReference(Specimen)
                        Is Modifierfalse
                        Must Supportfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        116. ServiceRequest.bodySite
                        Definition

                        Anatomic location where the procedure should be performed. This is the target site.

                        ShortCoded location on Body
                        Comments

                        Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension http://hl7.org/fhir/StructureDefinition/procedure-targetBodyStructure.

                        Control0..*
                        This element is affected by the following invariants: bdystr-1
                        BindingFor example codes, see SNOMEDCTBodyStructures
                        (example to http://hl7.org/fhir/ValueSet/body-site)

                        SNOMED CT Body site concepts

                        TypeCodeableConcept
                        Is Modifierfalse
                        Must Supportfalse
                        Summarytrue
                        Requirements

                        Knowing where the procedure is performed is important for tracking if multiple sites are possible.

                        Alternate Nameslocation
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        118. ServiceRequest.bodyStructure
                        Definition

                        Anatomic location where the procedure should be performed. This is the target site.

                        ShortBodyStructure-based location on the body
                        Control0..1
                        This element is affected by the following invariants: bdystr-1
                        TypeReference(BodyStructure)
                        Is Modifierfalse
                        Must Supportfalse
                        Summarytrue
                        Requirements

                        Knowing where the procedure is performed is important for tracking if multiple sites are possible.

                        Alternate NameslocationStructure
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        120. ServiceRequest.note
                        Definition

                        Any other notes and comments made about the service request. For example, internal billing notes.

                        ShortComments
                        Control0..*
                        TypeAnnotation
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        122. ServiceRequest.patientInstruction
                        Definition

                        Instructions in terms that are understood by the patient or consumer.

                        ShortPatient or consumer-oriented instructions
                        Control0..*
                        TypeBackboneElement
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        124. ServiceRequest.patientInstruction.id
                        Definition

                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        ShortUnique id for inter-element referencing
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        126. ServiceRequest.patientInstruction.extension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                        ShortAdditional content defined by implementations
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        128. ServiceRequest.patientInstruction.modifierExtension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                        ShortExtensions that cannot be ignored even if unrecognized
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                        Summarytrue
                        Requirements

                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                        Alternate Namesextensions, user content, modifiers
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        130. ServiceRequest.patientInstruction.instruction[x]
                        Definition

                        Instructions in terms that are understood by the patient or consumer.

                        ShortPatient or consumer-oriented instructions
                        Control0..1
                        TypeChoice of: markdown, Reference(DocumentReference)
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supportfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        132. ServiceRequest.relevantHistory
                        Definition

                        Key events in the history of the request.

                        ShortRequest provenance
                        Comments

                        This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.

                        Control0..*
                        TypeReference(Provenance)
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))