ServiceRequest

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

Overview

ServiceRequest is a record of a request for a procedure or diagnostic or other service to be planned, proposed, or performed, as distinguished by the ServiceRequest.intent field value, with or on a patient. The service to be performed would result in a Procedure, Observation, DiagnosticReport, ImagingStudy or similar resource.

This profile is used to define the content that will be returned by the API Server in response to requests to access ServiceRequest resources. All elements described in the Definition and Detailed Definitions below are supported, which means that the API Server is capable of supplying these fields from the product database when they have been populated via the product or its APIs.

Definition

The official URL for this profile is:

https://fhir.athena.io/StructureDefinition/ah-servicerequest

The base definition for this profile is:

ServiceRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. ServiceRequestC0..*ServiceRequestA request for a service to be performed
... idΣ0..1idLogical id of this artifact
... metaΣ0..1MetaMetadata about the resource
... implicitRules?!Σ0..1uriA set of rules under which this content was created
... text0..1NarrativeText summary of the resource, for human interpretation
... contained0..*ResourceContained, inline Resources
... Slices for extension1..*ExtensionExtension
Slice: Unordered, Open by value:url
... ahChartSharingGroup0..1Reference(Organization)athenahealth Chart Sharing Group
URL: https://fhir.athena.io/StructureDefinition/ah-chart-sharing-group
... ahPractice1..1Reference(Organization)athenahealth Practice
URL: https://fhir.athena.io/StructureDefinition/ah-practice
... modifierExtension?!0..*ExtensionExtensions that cannot be ignored
... identifierΣ0..*IdentifierIdentifiers assigned to this order
... status?!Σ1..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.

... intent?!Σ1..1codeproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.

... categoryΣ0..*CodeableConceptClassification of service
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.


... doNotPerform?!Σ0..1booleanTrue if service/procedure should not be performed
... codeΣ0..1CodeableConceptWhat is being requested/ordered
Binding: ProcedureCodes(SNOMEDCT) (example): Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred and a valueset using LOINC Order codes is available here.

... subjectΣ1..1Reference(Patient)Individual or Entity the service is ordered for
... encounterΣ0..1Reference(Encounter)Encounter in which the request was created
... occurrence[x]Σ0..1When service should occur
.... occurrenceDateTimedateTime (YYYY-MM-DDThh:mm:ss+zz:zz)
.... occurrencePeriodPeriod
... authoredOnΣ0..1dateTime (YYYY-MM-DDThh:mm:ss+zz:zz)Date request signed
... requesterΣ0..1Reference(Practitioner)Who/what is requesting service
... performerΣ0..*Reference(Practitioner | Organization)Requested performer
... locationReferenceΣ0..*Reference(Location)Requested location
... reasonCodeΣ0..*CodeableConceptExplanation/Justification for procedure or service
Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation.


... note0..*AnnotationComments

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
ServiceRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
ServiceRequest.statusrequiredRequestStatus
ServiceRequest.intentrequiredRequestIntent
ServiceRequest.categoryexampleServiceRequestCategoryCodes
ServiceRequest.codeexampleProcedureCodes(SNOMEDCT)
ServiceRequest.reasonCodeexampleProcedureReasonCodes

Detailed Definitions


ServiceRequest

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

Cardinality 0..*
Type Root

ServiceRequest.id

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

Cardinality 0..1
Type id
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.

ServiceRequest.meta

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.

Cardinality 0..1
Type Meta

ServiceRequest.implicitRules

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.

Cardinality 0..1
Type uri
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.

ServiceRequest.language

The base language in which the resource is written.

Cardinality 0..1
Type code Binding: CommonLanguages (preferred)
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).

ServiceRequest.text

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.

Cardinality 0..1
Type Narrative
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.

ServiceRequest.contained

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.

Cardinality 0..*
Type Resource
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.

ServiceRequest.extension

An Extension

Cardinality 1..*
Type Extension

ServiceRequest.extension:ahChartSharingGroup

An Extension used to reference a specific athenahealth chart sharing group Organization.

Cardinality 0..1
Type Extension(AthenaChartSharingGroup)

ServiceRequest.extension:ahPractice

An Extension used to reference a specific athenahealth practice Organization.

Cardinality 1..1
Type Extension(AthenaPractice)

ServiceRequest.modifierExtension

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).

Cardinality 0..*
Type Extension
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.
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.

ServiceRequest.identifier

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

Cardinality 0..*
Type Identifier
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.

ServiceRequest.status

The status of the order.

Cardinality 1..1
Type code Binding: RequestStatus (required)
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](event.html) for general discussion) or using the Task resource.

ServiceRequest.intent

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

Cardinality 1..1
Type code Binding: RequestIntent (required)
Comments This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

ServiceRequest.category

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

Cardinality 0..*
Type CodeableConcept Binding: ServiceRequestCategoryCodes (example)
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.
Requirements Used for filtering what service request are retrieved and displayed.

ServiceRequest.doNotPerform

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

Cardinality 0..1
Type boolean
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.
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.

ServiceRequest.code

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

Cardinality 0..1
Type CodeableConcept Binding: ProcedureCodes(SNOMEDCT) (example)
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.

ServiceRequest.subject

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).

Cardinality 1..1
Type Reference(Patient)

ServiceRequest.encounter

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

Cardinality 0..1
Type Reference(Encounter)

ServiceRequest.occurrence[x]

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

Cardinality 0..1
Type dateTime (YYYY-MM-DDThh:mm:ss+zz:zz) | Period

ServiceRequest.authoredOn

When the request transitioned to being actionable.

Cardinality 0..1
Type dateTime (YYYY-MM-DDThh:mm:ss+zz:zz)

ServiceRequest.requester

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

Cardinality 0..1
Type Reference(Practitioner)
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.

ServiceRequest.performer

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

Cardinality 0..*
Type Reference(Practitioner | Organization)
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.

ServiceRequest.locationReference

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

Cardinality 0..*
Type Reference(Location)

ServiceRequest.reasonCode

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`.

Cardinality 0..*
Type CodeableConcept Binding: ProcedureReasonCodes (example)
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](servicerequest-example-di.html).

ServiceRequest.note

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

Cardinality 0..*
Type Annotation

Interactions

READ

Read interactions are executed as specified in the HL7 FHIR RESTful API read specification. To read ServiceRequest resources, an application will perform an HTTP GET specifying the logical ID of the ServiceRequest being retrieved.

The [patient|user|system]/ServiceRequest.read authorization scope is required.

GET
/fhir/r4/ServiceRequest/{logicalId}
Try in Postman

Parameters

required

conditional required

Name Type Description
logicalId string (REQUIRED) The logical ID of the resource (alias: Resource.id). It is specified in the URL path and not as a query parameter.

Response Codes

Response code Description
200 OK The requested ServiceRequest resource was found and is contained within the body of the HTTP response.
400 Bad Request The server could not understand the request due to invalid syntax. The body of the HTTP response will contain an OperationOutcome resource that indicates the invalid request could not be processed.
404 Not Found The requested resource does not exist. The body of the HTTP response will contain an OperationOutcome resource that indicates the resource could not be found.
410 Gone The requested resource has been permanently deleted from server with no forwarding address. The body of the HTTP response will contain an OperationOutcome resource that indicates the resource could not be found.
500 Internal Server Error The server has encountered a situation it doesn't know how to handle. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error.
5xx Server Error The server may return other error codes to indicate other error conditions. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error.

GET SEARCH

Search interactions are executed as specified in the HL7 FHIR RESTful API search specification. To search for ServiceRequest resources using the HTTP GET method, an application will perform the HTTP GET specifying the query parameters associated with the ServiceRequest in the URL.

The [patient|user|system]/ServiceRequest.read authorization scope is required.

The following additional authorization scopes might be required depending on _include and/or _revinclude search parameters used:

  • [patient|user|system]/CareTeam.read
  • [patient|user|system]/Device.read
  • [patient|user|system]/Encounter.read
  • [patient|user|system]/Organization.read
  • [patient|user|system]/Patient.read
  • [patient|user|system]/Practitioner.read
  • [patient|user|system]/Provenance.read

GET
/fhir/r4/ServiceRequest
Try in Postman

Parameters

ServiceRequest search requests conditionally require one of the following search parameters or search parameter combinations in order to match and return a result set:
  • _id
  • patient

required

conditional required

Name Type Description
ah-practice reference Identify the athenahealth Practice Organization (e.g., 'ah-practice=Organization/a-1.Practice-[practiceId]')
_id token (CONDITIONAL REQUIRED) ServiceRequest.id resource reference to FHIR ServiceRequest resource
encounter reference Resource reference to FHIR Encounter resource
patient reference (CONDITIONAL REQUIRED) ServiceRequest.subject resource reference to FHIR Patient resource
_count number The number of ServiceRequest resources to return per page for paged search results.
status token ServiceRequest.status token value.
authored date ServiceRequest.authoredOn is the parameter for searching by authored
cursor token Search by cursor token for first resource to return in a paged search result
performer reference ServiceRequest.performer resource reference to the FHIR Practitioner or Organization resource
requester reference ServiceRequest.requester resource reference to the FHIR Practitioner resource
ah-chart-sharing-group reference Search by athenahealth Chart Sharing Group (e.g., 'ah-chart-sharing-group=Organization/a-[practiceId].CSG-[csgId]') for resources containing the 'Athena Chart Sharing Group' Extension
_include string Requests the server to include the referenced resource(s) in the search results according to the specified search parameter. Additional authorization scope(s) will be required. The supported _include parameter values are:
  • ServiceRequest:ah-chart-sharing-group - Included resource(s) Organization and required scope(s) [patient|user|system]/Organization.read
  • ServiceRequest:ah-practice - Included resource(s) Organization and required scope(s) [patient|user|system]/Organization.read
  • ServiceRequest:encounter - Included resource(s) Encounter and required scope(s) [patient|user|system]/Encounter.read
  • ServiceRequest:patient - Included resource(s) Patient and required scope(s) [patient|user|system]/Patient.read
  • ServiceRequest:performer - Included resource(s) CareTeam, Device, Organization, Patient, Practitioner and required scope(s) [patient|user|system]/CareTeam.read, [patient|user|system]/Device.read, [patient|user|system]/Organization.read, [patient|user|system]/Patient.read, [patient|user|system]/Practitioner.read
  • ServiceRequest:requester - Included resource(s) Device, Organization, Patient, Practitioner and required scope(s) [patient|user|system]/Device.read, [patient|user|system]/Organization.read, [patient|user|system]/Patient.read, [patient|user|system]/Practitioner.read
_revinclude string Requests the server to include the associated resource(s) in the search results according to the specified search parameter. Additional authorization scope(s) will be required. The supported _revinclude parameter values are:
  • Provenance:target - Associated resource(s) Provenance and required scope(s) [patient|user|system]/Provenance.read

Response Codes

Response code Description
200 OK The search request succeeded. The body of the HTTP response will contain a Bundle resource containing the results of the search.
403 Forbidden The server refused to perform the search due to a missing required search parameter. The body of the HTTP response will contain an OperationOutcome resource that includes the required search parameters.
500 Internal Server Error The server has encountered a situation it doesn't know how to handle. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error.
5xx Server Error The server may return other error codes to indicate other error conditions. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error.

POST SEARCH

Search interactions are executed as specified in the HL7 FHIR RESTful API search specification. To search for ServiceRequest resources using the HTTP POST method, an application will perform the HTTP POST specifying the query parameters associated with the ServiceRequest in the request body.

The [patient|user|system]/ServiceRequest.read authorization scope is required.

The following additional authorization scopes might be required depending on _include and/or _revinclude search parameters used:

  • [patient|user|system]/CareTeam.read
  • [patient|user|system]/Device.read
  • [patient|user|system]/Encounter.read
  • [patient|user|system]/Organization.read
  • [patient|user|system]/Patient.read
  • [patient|user|system]/Practitioner.read
  • [patient|user|system]/Provenance.read

POST
/fhir/r4/ServiceRequest/_search
Try in Postman

Request Header

Content-Type: application/x-www-form-urlencoded

Request Body

param1=value1&param2=value2...

Parameters

ServiceRequest search requests conditionally require one of the following search parameters or search parameter combinations in order to match and return a result set:
  • _id
  • patient

required

conditional required

Name Type Description
ah-practice reference Identify the athenahealth Practice Organization (e.g., 'ah-practice=Organization/a-1.Practice-[practiceId]')
_id token (CONDITIONAL REQUIRED) ServiceRequest.id resource reference to FHIR ServiceRequest resource
encounter reference Resource reference to FHIR Encounter resource
patient reference (CONDITIONAL REQUIRED) ServiceRequest.subject resource reference to FHIR Patient resource
_count number The number of ServiceRequest resources to return per page for paged search results.
status token ServiceRequest.status token value.
authored date ServiceRequest.authoredOn is the parameter for searching by authored
cursor token Search by cursor token for first resource to return in a paged search result
performer reference ServiceRequest.performer resource reference to the FHIR Practitioner or Organization resource
requester reference ServiceRequest.requester resource reference to the FHIR Practitioner resource
ah-chart-sharing-group reference Search by athenahealth Chart Sharing Group (e.g., 'ah-chart-sharing-group=Organization/a-[practiceId].CSG-[csgId]') for resources containing the 'Athena Chart Sharing Group' Extension
_include string Requests the server to include the referenced resource(s) in the search results according to the specified search parameter. Additional authorization scope(s) will be required. The supported _include parameter values are:
  • ServiceRequest:ah-chart-sharing-group - Included resource(s) Organization and required scope(s) [patient|user|system]/Organization.read
  • ServiceRequest:ah-practice - Included resource(s) Organization and required scope(s) [patient|user|system]/Organization.read
  • ServiceRequest:encounter - Included resource(s) Encounter and required scope(s) [patient|user|system]/Encounter.read
  • ServiceRequest:patient - Included resource(s) Patient and required scope(s) [patient|user|system]/Patient.read
  • ServiceRequest:performer - Included resource(s) CareTeam, Device, Organization, Patient, Practitioner and required scope(s) [patient|user|system]/CareTeam.read, [patient|user|system]/Device.read, [patient|user|system]/Organization.read, [patient|user|system]/Patient.read, [patient|user|system]/Practitioner.read
  • ServiceRequest:requester - Included resource(s) Device, Organization, Patient, Practitioner and required scope(s) [patient|user|system]/Device.read, [patient|user|system]/Organization.read, [patient|user|system]/Patient.read, [patient|user|system]/Practitioner.read
_revinclude string Requests the server to include the associated resource(s) in the search results according to the specified search parameter. Additional authorization scope(s) will be required. The supported _revinclude parameter values are:
  • Provenance:target - Associated resource(s) Provenance and required scope(s) [patient|user|system]/Provenance.read

Response Codes

Response code Description
200 OK The search request succeeded. The body of the HTTP response will contain a Bundle resource containing the results of the search.
403 Forbidden The server refused to perform the search due to a missing required search parameter. The body of the HTTP response will contain an OperationOutcome resource that includes the required search parameters.
500 Internal Server Error The server has encountered a situation it doesn't know how to handle. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error.
5xx Server Error The server may return other error codes to indicate other error conditions. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error.
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