Implementation Guide
23.0.0 - R4 APIs

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Resource Profile: AthenaServiceRequest - Detailed Descriptions

Active as of 2022-03-01

Definitions for the athena-servicerequest-profile resource profile.

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

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
Invariantsdom-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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(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())
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

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control10..1
Typeidstring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
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.meta.versionId
Definition

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

ShortVersion specific identifier
Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

Control0..1
Typeid
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()))
8. ServiceRequest.meta.lastUpdated
Definition

When the resource last changed - e.g. when the version changed.

ShortWhen the resource version last changed
Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

Control0..1
Typeinstant
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()))
10. ServiceRequest.meta.profile
Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

ShortProfiles this resource claims to conform to
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Control10..*
Typecanonical(StructureDefinition)
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()))
SlicingThis element introduces a set of slices on ServiceRequest.meta.profile. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ uri
  • 12. ServiceRequest.meta.profile:Athena ServiceRequest Profile
    Slice NameAthena ServiceRequest Profile
    Definition

    A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

    ShortProfiles this resource claims to conform to
    Comments

    It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

    Control10..1*
    Typecanonical(StructureDefinition)
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Fixed Valuehttps://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-servicerequest-profile
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. ServiceRequest.meta.profile:US Core Profile
    Slice NameUS Core Profile
    Definition

    A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

    ShortProfiles this resource claims to conform to
    Comments

    It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

    Control0..1*
    Typecanonical(StructureDefinition)
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Fixed Valuehttp://hl7.org/fhir/us/core/StructureDefinition/us-core-servicerequest
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. ServiceRequest.meta.security
    Definition

    Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

    ShortSecurity Labels applied to this resource
    Comments

    The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

    Control0..4*
    BindingUnless not suitable, these codes SHALL be taken from All Security Labelshttp://hl7.org/fhir/ValueSet/security-labels
    (extensible to http://hl7.org/fhir/ValueSet/security-labels)

    Security Labels from the Healthcare Privacy and Security Classification System.

    TypeCoding
    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.meta.security. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ coding
    • 18. ServiceRequest.meta.security:SENSITIVECHART
      Slice NameSENSITIVECHART
      Definition

      Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

      ShortSecurity Labels applied to this resource
      Comments

      The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

      Control0..1*
      BindingUnless not suitable, these codes SHALL be taken from All Security Labelshttp://hl7.org/fhir/ValueSet/security-labels
      (extensible to http://hl7.org/fhir/ValueSet/security-labels)

      Security Labels from the Healthcare Privacy and Security Classification System.

      TypeCoding
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. ServiceRequest.meta.security:CONFABBR
      Slice NameCONFABBR
      Definition

      Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

      ShortSecurity Labels applied to this resource
      Comments

      The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

      Control0..1*
      BindingUnless not suitable, these codes SHALL be taken from All Security Labelshttp://hl7.org/fhir/ValueSet/security-labels
      (extensible to http://hl7.org/fhir/ValueSet/security-labels)

      Security Labels from the Healthcare Privacy and Security Classification System.

      TypeCoding
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. ServiceRequest.meta.security:CONFABBR.system
      Definition

      The identification of the code system that defines the meaning of the symbol in the code.

      ShortIdentity of the terminology system
      Comments

      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

      Control10..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Requirements

      Need to be unambiguous about the source of the definition of the symbol.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. ServiceRequest.meta.security:CONFABBR.code
      Definition

      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

      ShortSymbol in syntax defined by the system
      Control10..1
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Requirements

      Need to refer to a particular code in the system.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. ServiceRequest.meta.security:LOCATION
      Slice NameLOCATION
      Definition

      Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

      ShortSecurity Labels applied to this resource
      Comments

      The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

      Control0..1*
      BindingUnless not suitable, these codes SHALL be taken from All Security Labelshttp://hl7.org/fhir/ValueSet/security-labels
      (extensible to http://hl7.org/fhir/ValueSet/security-labels)

      Security Labels from the Healthcare Privacy and Security Classification System.

      TypeCoding
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. ServiceRequest.meta.security:LOCATION.system
      Definition

      The identification of the code system that defines the meaning of the symbol in the code.

      ShortIdentity of the terminology system
      Comments

      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

      Control10..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Requirements

      Need to be unambiguous about the source of the definition of the symbol.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. ServiceRequest.meta.security:LOCATION.code
      Definition

      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

      ShortSymbol in syntax defined by the system
      Control10..1
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Requirements

      Need to refer to a particular code in the system.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. ServiceRequest.meta.security:CONFTYPEID
      Slice NameCONFTYPEID
      Definition

      Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

      ShortSecurity Labels applied to this resource
      Comments

      The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

      Control0..1*
      BindingUnless not suitable, these codes SHALL be taken from All Security Labelshttp://hl7.org/fhir/ValueSet/security-labels
      (extensible to http://hl7.org/fhir/ValueSet/security-labels)

      Security Labels from the Healthcare Privacy and Security Classification System.

      TypeCoding
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. ServiceRequest.meta.security:CONFTYPEID.system
      Definition

      The identification of the code system that defines the meaning of the symbol in the code.

      ShortIdentity of the terminology system
      Comments

      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

      Control10..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Requirements

      Need to be unambiguous about the source of the definition of the symbol.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. ServiceRequest.meta.security:CONFTYPEID.code
      Definition

      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

      ShortSymbol in syntax defined by the system
      Control10..1
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Requirements

      Need to refer to a particular code in the system.

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

      Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

      ShortTags applied to this resource
      Comments

      The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

      Control10..2*
      BindingFor example codes, see CommonTagshttp://hl7.org/fhir/ValueSet/common-tags
      (example to http://hl7.org/fhir/ValueSet/common-tags)

      Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

      TypeCoding
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. 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 it's 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 it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. 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 manageable, 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
      Summaryfalse
      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())
      44. 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()))
      46. ServiceRequest.status
      Definition

      The status of the order.

      Shortdraft | active | on-hold | revoked | completed | entered-in-errordraft | 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, cancelled or suspended. 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|4.0.1
      (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

      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()))
      48. ServiceRequest.intent
      Definition

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

      Shortplan | orderproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
      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|4.0.1
      (required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

      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()))
      50. ServiceRequest.category
      Definition

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

      Shortservice | referral | testClassification 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.

      Control0..*
      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 @ category
      • 52. ServiceRequest.category:us-core
        Slice Nameus-core
        Definition

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

        ShortSDOH | Functional Status | Disability Status | Cognitive StatusClassification 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.

        Control0..*
        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()))
        54. 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 RequestPriorityhttp://hl7.org/fhir/ValueSet/request-priority|4.0.1
        (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

        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()))
        56. 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
        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()))
        58. ServiceRequest.code
        Definition

        A code 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.

        Control10..1
        BindingFor example codes, see ProcedureCodes(SNOMEDCT)http://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)[http://build.fhir.org/terminologies.html#preferred] and a valueset using LOINC Order codes is available here.

        TypeCodeableConcept
        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()))
        60. 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()))
        62. 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()))
        64. ServiceRequest.occurrence[x]
        Definition

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

        ShortWhen service should occur
        Control0..1
        TypePeriod, dateTime, Timing
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Alternate Namesschedule
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. 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()))
        68. 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()))
        70. 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 request-performerOrder extension. 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()))
        72. ServiceRequest.reasonCode
        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. Use CodeableConcept.text element if the data is free (uncoded) text as shown in the CT Scan example.

        Control0..1*
        BindingFor example codes, see ProcedureReasonCodeshttp://hl7.org/fhir/ValueSet/procedure-reason
        (example to http://hl7.org/fhir/ValueSet/procedure-reason)

        Diagnosis or problem codes justifying the reason for requesting the service investigation.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. 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..1*
        TypeReference(Condition, 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()))
        76. 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 found here

        0. ServiceRequest
        Must Supportfalse
        2. ServiceRequest.id
        Control1..1
        Typeid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        4. ServiceRequest.meta
        Control0..1
        TypeMeta
        Must Supportfalse
        6. ServiceRequest.meta.versionId
        Control0..1
        Typeid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        8. ServiceRequest.meta.lastUpdated
        Control0..1
        Typeinstant
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        10. ServiceRequest.meta.profile
        Control1..*
        Typecanonical
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        SlicingThis element introduces a set of slices on ServiceRequest.meta.profile. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ uri
        • 12. ServiceRequest.meta.profile:Athena ServiceRequest Profile
          Slice NameAthena ServiceRequest Profile
          Control1..1
          Typecanonical
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Fixed Valuehttps://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-servicerequest-profile
          14. ServiceRequest.meta.profile:US Core Profile
          Slice NameUS Core Profile
          Control0..1
          Typecanonical
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Fixed Valuehttp://hl7.org/fhir/us/core/StructureDefinition/us-core-servicerequest
          16. ServiceRequest.meta.security
          Control0..4
          TypeCoding
          Must Supportfalse
          SlicingThis element introduces a set of slices on ServiceRequest.meta.security. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ coding
          • 18. ServiceRequest.meta.security:SENSITIVECHART
            Slice NameSENSITIVECHART
            Control0..1
            TypeCoding
            Must Supportfalse
            20. ServiceRequest.meta.security:CONFABBR
            Slice NameCONFABBR
            Control0..1
            TypeCoding
            Must Supportfalse
            22. ServiceRequest.meta.security:CONFABBR.system
            Control1..1
            Typeuri
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            24. ServiceRequest.meta.security:CONFABBR.code
            Control1..1
            Typecode
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            26. ServiceRequest.meta.security:LOCATION
            Slice NameLOCATION
            Control0..1
            TypeCoding
            Must Supportfalse
            28. ServiceRequest.meta.security:LOCATION.system
            Control1..1
            Typeuri
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            30. ServiceRequest.meta.security:LOCATION.code
            Control1..1
            Typecode
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            32. ServiceRequest.meta.security:CONFTYPEID
            Slice NameCONFTYPEID
            Control0..1
            TypeCoding
            Must Supportfalse
            34. ServiceRequest.meta.security:CONFTYPEID.system
            Control1..1
            Typeuri
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            36. ServiceRequest.meta.security:CONFTYPEID.code
            Control1..1
            Typecode
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            38. ServiceRequest.meta.tag
            Control1..2
            TypeCoding
            Must Supportfalse
            40. ServiceRequest.identifier
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier
            Must Supportfalse
            42. ServiceRequest.status
            Shortdraft | active | on-hold | revoked | completed | entered-in-error
            Control1..1
            Typecode
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            44. ServiceRequest.intent
            Shortplan | order
            Control1..1
            Typecode
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            46. ServiceRequest.category
            Shortservice | referral | test
            Control0..*
            TypeCodeableConcept
            Must Supportfalse
            SlicingThis element introduces a set of slices on ServiceRequest.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ category
            • 48. ServiceRequest.category:us-core
              Slice Nameus-core
              ShortSDOH | Functional Status | Disability Status | Cognitive Status
              Control0..*
              TypeCodeableConcept
              Must Supportfalse
              50. ServiceRequest.priority
              Control0..1
              Typecode
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supportfalse
              52. ServiceRequest.code
              Control1..1
              TypeCodeableConcept
              Must Supportfalse
              54. ServiceRequest.subject
              Control1..1
              TypeReference(Patient)
              Must Supportfalse
              56. ServiceRequest.encounter
              Control0..1
              TypeReference(Encounter)
              Must Supportfalse
              58. ServiceRequest.occurrence[x]
              Control0..1
              TypePeriod, dateTime, Timing
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Must Supportfalse
              60. ServiceRequest.authoredOn
              Control0..1
              TypedateTime
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supportfalse
              62. ServiceRequest.requester
              Control0..1
              TypeReference(Practitioner)
              Must Supportfalse
              64. ServiceRequest.performer
              Control0..*
              TypeReference(Practitioner)
              Must Supportfalse
              66. ServiceRequest.reasonCode
              Control0..1
              TypeCodeableConcept
              Must Supportfalse
              68. ServiceRequest.supportingInfo
              Control0..1
              TypeReference(Condition)
              Must Supportfalse
              70. ServiceRequest.note
              Control0..*
              TypeAnnotation
              Must Supportfalse

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

              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
              Invariantsdom-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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(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

              The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

              Control1..1
              Typeid
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              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.meta.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
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              8. ServiceRequest.meta.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 manageable, 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.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 10. ServiceRequest.meta.versionId
                Definition

                The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

                ShortVersion specific identifier
                Comments

                The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

                Control0..1
                Typeid
                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()))
                12. ServiceRequest.meta.lastUpdated
                Definition

                When the resource last changed - e.g. when the version changed.

                ShortWhen the resource version last changed
                Comments

                This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

                Control0..1
                Typeinstant
                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()))
                14. ServiceRequest.meta.source
                Definition

                A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

                ShortIdentifies where the resource comes from
                Comments

                In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

                This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

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

                A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

                ShortProfiles this resource claims to conform to
                Comments

                It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

                Control1..*
                Typecanonical
                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()))
                SlicingThis element introduces a set of slices on ServiceRequest.meta.profile. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ uri
                • 18. ServiceRequest.meta.profile:Athena ServiceRequest Profile
                  Slice NameAthena ServiceRequest Profile
                  Definition

                  A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

                  ShortProfiles this resource claims to conform to
                  Comments

                  It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

                  Control1..1
                  Typecanonical
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supportfalse
                  Summarytrue
                  Fixed Valuehttps://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-servicerequest-profile
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  20. ServiceRequest.meta.profile:US Core Profile
                  Slice NameUS Core Profile
                  Definition

                  A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

                  ShortProfiles this resource claims to conform to
                  Comments

                  It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

                  Control0..1
                  Typecanonical
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supportfalse
                  Summarytrue
                  Fixed Valuehttp://hl7.org/fhir/us/core/StructureDefinition/us-core-servicerequest
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  22. ServiceRequest.meta.security
                  Definition

                  Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

                  ShortSecurity Labels applied to this resource
                  Comments

                  The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                  Control0..4
                  BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                  (extensible to http://hl7.org/fhir/ValueSet/security-labels)

                  Security Labels from the Healthcare Privacy and Security Classification System.

                  TypeCoding
                  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.meta.security. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ coding
                  • 24. ServiceRequest.meta.security:SENSITIVECHART
                    Slice NameSENSITIVECHART
                    Definition

                    Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

                    ShortSecurity Labels applied to this resource
                    Comments

                    The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                    (extensible to http://hl7.org/fhir/ValueSet/security-labels)

                    Security Labels from the Healthcare Privacy and Security Classification System.

                    TypeCoding
                    Is Modifierfalse
                    Must Supportfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    26. ServiceRequest.meta.security:CONFABBR
                    Slice NameCONFABBR
                    Definition

                    Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

                    ShortSecurity Labels applied to this resource
                    Comments

                    The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                    (extensible to http://hl7.org/fhir/ValueSet/security-labels)

                    Security Labels from the Healthcare Privacy and Security Classification System.

                    TypeCoding
                    Is Modifierfalse
                    Must Supportfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    28. ServiceRequest.meta.security:CONFABBR.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
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    30. ServiceRequest.meta.security:CONFABBR.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 manageable, 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.meta.security.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 32. ServiceRequest.meta.security:CONFABBR.system
                      Definition

                      The identification of the code system that defines the meaning of the symbol in the code.

                      ShortIdentity of the terminology system
                      Comments

                      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                      Control1..1
                      Typeuri
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supportfalse
                      Summarytrue
                      Requirements

                      Need to be unambiguous about the source of the definition of the symbol.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      34. ServiceRequest.meta.security:CONFABBR.version
                      Definition

                      The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                      ShortVersion of the system - if relevant
                      Comments

                      Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                      NoteThis is a business version Id, not a resource version Id (see discussion)
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      36. ServiceRequest.meta.security:CONFABBR.code
                      Definition

                      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                      ShortSymbol in syntax defined by the system
                      Control1..1
                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supportfalse
                      Summarytrue
                      Requirements

                      Need to refer to a particular code in the system.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      38. ServiceRequest.meta.security:CONFABBR.display
                      Definition

                      A representation of the meaning of the code in the system, following the rules of the system.

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

                      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      40. ServiceRequest.meta.security:CONFABBR.userSelected
                      Definition

                      Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                      ShortIf this coding was chosen directly by the user
                      Comments

                      Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                      This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      42. ServiceRequest.meta.security:LOCATION
                      Slice NameLOCATION
                      Definition

                      Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

                      ShortSecurity Labels applied to this resource
                      Comments

                      The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                      Control0..1
                      BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                      (extensible to http://hl7.org/fhir/ValueSet/security-labels)

                      Security Labels from the Healthcare Privacy and Security Classification System.

                      TypeCoding
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      44. ServiceRequest.meta.security:LOCATION.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
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      46. ServiceRequest.meta.security:LOCATION.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 manageable, 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.meta.security.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 48. ServiceRequest.meta.security:LOCATION.system
                        Definition

                        The identification of the code system that defines the meaning of the symbol in the code.

                        ShortIdentity of the terminology system
                        Comments

                        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                        Control1..1
                        Typeuri
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supportfalse
                        Summarytrue
                        Requirements

                        Need to be unambiguous about the source of the definition of the symbol.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        50. ServiceRequest.meta.security:LOCATION.version
                        Definition

                        The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                        ShortVersion of the system - if relevant
                        Comments

                        Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                        NoteThis is a business version Id, not a resource version Id (see discussion)
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        52. ServiceRequest.meta.security:LOCATION.code
                        Definition

                        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                        ShortSymbol in syntax defined by the system
                        Control1..1
                        Typecode
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supportfalse
                        Summarytrue
                        Requirements

                        Need to refer to a particular code in the system.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        54. ServiceRequest.meta.security:LOCATION.display
                        Definition

                        A representation of the meaning of the code in the system, following the rules of the system.

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

                        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        56. ServiceRequest.meta.security:LOCATION.userSelected
                        Definition

                        Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                        ShortIf this coding was chosen directly by the user
                        Comments

                        Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                        This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        58. ServiceRequest.meta.security:CONFTYPEID
                        Slice NameCONFTYPEID
                        Definition

                        Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

                        ShortSecurity Labels applied to this resource
                        Comments

                        The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                        Control0..1
                        BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                        (extensible to http://hl7.org/fhir/ValueSet/security-labels)

                        Security Labels from the Healthcare Privacy and Security Classification System.

                        TypeCoding
                        Is Modifierfalse
                        Must Supportfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        60. ServiceRequest.meta.security:CONFTYPEID.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
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        62. ServiceRequest.meta.security:CONFTYPEID.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 manageable, 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.meta.security.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 64. ServiceRequest.meta.security:CONFTYPEID.system
                          Definition

                          The identification of the code system that defines the meaning of the symbol in the code.

                          ShortIdentity of the terminology system
                          Comments

                          The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                          Control1..1
                          Typeuri
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supportfalse
                          Summarytrue
                          Requirements

                          Need to be unambiguous about the source of the definition of the symbol.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          66. ServiceRequest.meta.security:CONFTYPEID.version
                          Definition

                          The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                          ShortVersion of the system - if relevant
                          Comments

                          Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                          NoteThis is a business version Id, not a resource version Id (see discussion)
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          68. ServiceRequest.meta.security:CONFTYPEID.code
                          Definition

                          A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                          ShortSymbol in syntax defined by the system
                          Control1..1
                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supportfalse
                          Summarytrue
                          Requirements

                          Need to refer to a particular code in the system.

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

                          A representation of the meaning of the code in the system, following the rules of the system.

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

                          Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          72. ServiceRequest.meta.security:CONFTYPEID.userSelected
                          Definition

                          Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                          ShortIf this coding was chosen directly by the user
                          Comments

                          Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                          This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

                          Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

                          ShortTags applied to this resource
                          Comments

                          The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

                          Control1..2
                          BindingFor example codes, see CommonTags
                          (example to http://hl7.org/fhir/ValueSet/common-tags)

                          Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

                          TypeCoding
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          76. 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 it's 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 it's meaning or interpretation
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          78. 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 SHOULD be taken from CommonLanguages
                          (preferred to http://hl7.org/fhir/ValueSet/languages)

                          A human language.

                          Additional BindingsPurpose
                          AllLanguagesMax Binding
                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          80. 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 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
                          TypeNarrative
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesnarrative, html, xhtml, display
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          82. ServiceRequest.contained
                          Definition

                          These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                          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..*
                          TypeResource
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesinline resources, anonymous resources, contained resources
                          84. 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 manageable, 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())
                          86. 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 manageable, 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
                          Summaryfalse
                          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())
                          88. 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()))
                          90. 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

                          Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

                          Control0..*
                          Typecanonical(ActivityDefinition, PlanDefinition)
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          92. 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
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          94. ServiceRequest.basedOn
                          Definition

                          Plan/proposal/order fulfilled by this request.

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

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

                          ShortWhat request replaces
                          Control0..*
                          TypeReference(ServiceRequest)
                          Is Modifierfalse
                          Summarytrue
                          Alternate Namessupersedes, prior, renewed order
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          98. 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
                          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()))
                          100. ServiceRequest.status
                          Definition

                          The status of the order.

                          Shortdraft | active | on-hold | revoked | completed | entered-in-error
                          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, cancelled or suspended. 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|4.0.1)

                          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()))
                          102. ServiceRequest.intent
                          Definition

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

                          Shortplan | 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|4.0.1)

                          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()))
                          104. ServiceRequest.category
                          Definition

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

                          Shortservice | referral | test
                          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.

                          Control0..*
                          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 @ category
                          • 106. ServiceRequest.category:us-core
                            Slice Nameus-core
                            Definition

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

                            ShortSDOH | Functional Status | Disability Status | Cognitive Status
                            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.

                            Control0..*
                            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()))
                            108. 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|4.0.1)

                            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()))
                            110. 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
                            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()))
                            112. ServiceRequest.code
                            Definition

                            A code 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.

                            Control1..1
                            BindingFor example codes, see ProcedureCodes(SNOMEDCT)
                            (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)[http://build.fhir.org/terminologies.html#preferred] and a valueset using LOINC Order codes is available here.

                            TypeCodeableConcept
                            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()))
                            114. 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
                            BindingFor example codes, see ServiceRequestOrderDetailsCodes
                            (example to http://hl7.org/fhir/ValueSet/servicerequest-orderdetail)

                            Codified order entry details which are based on order context.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Alternate Namesdetailed instructions
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            116. 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
                            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()))
                            118. 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)
                            Is Modifierfalse
                            Must Supportfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            120. 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()))
                            122. ServiceRequest.occurrence[x]
                            Definition

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

                            ShortWhen service should occur
                            Control0..1
                            TypePeriod
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Must Supportfalse
                            Summarytrue
                            Alternate Namesschedule
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            124. 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
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            126. 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()))
                            128. 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)
                            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()))
                            130. 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
                            Summarytrue
                            Alternate Namesspecialty
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            132. 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 request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B).

                            Control0..*
                            TypeReference(Practitioner)
                            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()))
                            134. ServiceRequest.locationCode
                            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.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            136. ServiceRequest.locationReference
                            Definition

                            A reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center.

                            ShortRequested location
                            Control0..*
                            TypeReference(Location)
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            138. ServiceRequest.reasonCode
                            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. Use CodeableConcept.text element if the data is free (uncoded) text as shown in the CT Scan example.

                            Control0..1
                            BindingFor example codes, see ProcedureReasonCodes
                            (example to http://hl7.org/fhir/ValueSet/procedure-reason)

                            Diagnosis or problem codes justifying the reason for requesting the service investigation.

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

                            Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in supportingInfo.

                            ShortExplanation/Justification for service 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 when referencing DiagnosticReport it should contain a finding in DiagnosticReport.conclusion and/or DiagnosticReport.conclusionCode. When using a reference to DocumentReference, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in ServiceRequest.reasonCode if the data is free (uncoded) text as shown in the CT Scan example.

                            Control0..*
                            TypeReference(Condition, Observation, DiagnosticReport, DocumentReference)
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            142. 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
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            144. 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..1
                            TypeReference(Condition)
                            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()))
                            146. ServiceRequest.specimen
                            Definition

                            One or more specimens that the laboratory procedure will use.

                            ShortProcedure Samples
                            Comments

                            Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest.

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

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

                            ShortLocation 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 procedure-targetBodyStructure.

                            Control0..*
                            BindingFor example codes, see SNOMEDCTBodyStructures
                            (example to http://hl7.org/fhir/ValueSet/body-site)

                            Codes describing anatomical locations. May include laterality.

                            TypeCodeableConcept
                            Is Modifierfalse
                            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()))
                            150. 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()))
                            152. ServiceRequest.patientInstruction
                            Definition

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

                            ShortPatient or consumer-oriented instructions
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            154. 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
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))