Codes, extension, profiles and more
1.0.0 - ci-build Norway flag

Codes, extension, profiles and more - Local Development build (v1.0.0). See the Directory of published versions

Resource Profile: HnBasisServiceRequest - Detailed Descriptions

Draft as of 2024-06-12

Definitions for the hn-basis-serviceRequest resource profile.

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

0. ServiceRequest
2. ServiceRequest.identifier
Definition

Identifier er identifikator som identifiserer serviceRequest uavhengig av ressursens id på en FHIR-server. Skal være en UUID. Kan benyttes for å knytte ServiceRequest sammen med eventuelle etterfølgende oppdateringer.

ShortSkal være UUID
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..?
4. ServiceRequest.identifier.system
Control1..?
6. ServiceRequest.identifier.value
Control1..?
8. ServiceRequest.status
Definition

Status active betyr at serviceRequest er sendt fra Helsenorge og status completed betyr at status er oppdatert fra behandler.

ShortDefault status er active
Pattern Valueactive
InvariantsStatusActiveOrCompleted: status må være enten 'active' eller 'completed'. (value='active' or value='completed')
10. ServiceRequest.intent
Pattern Valueorder
InvariantsIntentOrder: intent må være 'order'. (value='order')
12. ServiceRequest.category
ShortHvis category er brukt og det mangler code bør beskrivelse av bestilling være i note
Control1..?
BindingThe codes SHALL be taken from ServiceRequest Category Value Set
14. ServiceRequest.priority
Control1..?
InvariantsPriorityUrgentOrRoutine: priority må være enten 'routine' eller 'urgent'. (value='routine' or value='urgent')
16. ServiceRequest.subject
ShortSubject identifiserer innbygger.
TypeReference(Patient)
18. ServiceRequest.subject.reference
Control0..0
20. ServiceRequest.subject.type
Pattern ValuePatient
22. ServiceRequest.subject.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
24. ServiceRequest.subject.identifier.system
ShortDet skal benyttes fødselsnummer eller d-nummer.
InvariantsValidSubjectSystemURL: system URL må være enten urn:oid:2.16.578.1.12.4.1.4.1' eller 'urn:oid:2.16.578.1.12.4.1.4.2'. (value='urn:oid:2.16.578.1.12.4.1.4.1' or value='urn:oid:2.16.578.1.12.4.1.4.2')
26. ServiceRequest.performerType
BindingThe codes SHALL be taken from ServiceRequest PerformerType Value Set
28. ServiceRequest.supportingInfo
Definition

Hvis det er frykt for smitte eller bevist smitte er slik informasjonen referert fra supportingInformation som ‘contained’ ressurs.

ShortSupporting info kan brukes for å sende informasjon når det er frykt for smitte.

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..*
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-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-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-6: A resource should have narrative for robust management (text.`div`.exists())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
2. ServiceRequest.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

Control0..1
This element is affected by the following invariants: ele-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
Standards StatusNormative (from Trial Use)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. 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..*
This element is affected by the following invariants: ele-1
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Standards StatusNormative (from Trial Use)
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())
SlicingThis element introduces a set of slices on ServiceRequest.modifierExtension. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators:
  • value @ url
6. ServiceRequest.identifier
Definition

Identifier er identifikator som identifiserer serviceRequest uavhengig av ressursens id på en FHIR-server. Skal være en UUID. Kan benyttes for å knytte ServiceRequest sammen med eventuelle etterfølgende oppdateringer.


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

ShortSkal være UUIDIdentifiers 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)
Control10..*
This element is affected by the following invariants: ele-1
TypeIdentifier
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. ServiceRequest.identifier.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
This element is affected by the following invariants: ele-1
BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Standards StatusNormative (from Trial Use)
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

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

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control10..1
This element is affected by the following invariants: ele-1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. ServiceRequest.identifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control10..1
This element is affected by the following invariants: ele-1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. ServiceRequest.status
Definition

Status active betyr at serviceRequest er sendt fra Helsenorge og status completed betyr at status er oppdatert fra behandler.


The status of the order.

ShortDefault status er activedraft | 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.


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
This element is affected by the following invariants: ele-1
BindingThe codes SHALL be taken from RequestStatushttp://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
Summarytrue
Pattern Valueactive
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
StatusActiveOrCompleted: status må være enten 'active' eller 'completed'. (value='active' or value='completed')
16. ServiceRequest.intent
Definition

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

Shortproposal | 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
This element is affected by the following invariants: ele-1
BindingThe codes SHALL be taken from RequestIntenthttp://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 &quot;the time the request is recommended to occur&quot; vs. &quot;the time the request is authorized to occur&quot; or &quot;who is recommended to perform the request&quot; vs. &quot;who is authorized to perform the request
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Pattern Valueorder
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
IntentOrder: intent må være 'order'. (value='order')
18. ServiceRequest.category
Definition

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

ShortHvis category er brukt og det mangler code bør beskrivelse av bestilling være i noteClassification of service
Comments

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

Control10..*
This element is affected by the following invariants: ele-1
BindingThe codes SHALL be taken from For example codes, see ServiceRequest Category Value Sethttp://hl7.org/fhir/ValueSet/servicerequest-category
TypeCodeableConcept
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()))
20. ServiceRequest.priority
Definition

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

Shortroutine | urgent | asap | stat
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Control10..1
This element is affected by the following invariants: ele-1
BindingThe codes SHALL be taken from RequestPriorityhttp://hl7.org/fhir/ValueSet/request-priority|4.0.1

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

Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
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()))
PriorityUrgentOrRoutine: priority må være enten 'routine' eller 'urgent'. (value='routine' or value='urgent')
22. 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
This element is affected by the following invariants: ele-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
Standards StatusNormative (from Trial Use)
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()))
24. 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: ele-1, prr-1
BindingFor example codes, see ServiceRequestOrderDetailsCodeshttp://hl7.org/fhir/ValueSet/servicerequest-orderdetail

Codified order entry details which are based on order context.

TypeCodeableConcept
Standards StatusNormative (from Trial Use)
Summarytrue
Alternate Namesdetailed instructions
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. 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).

ShortSubject identifiserer innbygger.Individual or Entity the service is ordered for
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Control1..1
This element is affected by the following invariants: ele-1
TypeReference(Patient, Group, Location, Device)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
28. ServiceRequest.subject.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

ShortLiteral reference, Relative, internal or absolute URL
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Control0..01
This element is affected by the following invariants: ele-1, ref-1
Typestring
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()))
30. ServiceRequest.subject.type
Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

ShortType the reference refers to (e.g. "Patient")
Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Control0..1
This element is affected by the following invariants: ele-1
BindingUnless not suitable, these codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types

Aa resource (or, for logical models, the URI of the logical model).

Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Pattern ValuePatient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. 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
This element is affected by the following invariants: ele-1
BindingThe codes SHALL be taken from For example codes, see ServiceRequest PerformerType Value Sethttp://hl7.org/fhir/ValueSet/participant-role
TypeCodeableConcept
Summarytrue
Alternate Namesspecialty
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. ServiceRequest.supportingInfo
Definition

Hvis det er frykt for smitte eller bevist smitte er slik informasjonen referert fra supportingInformation som ‘contained’ ressurs.


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.

ShortSupporting info kan brukes for å sende informasjon når det er frykt for smitte.Additional clinical information
Comments

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

Control0..*
This element is affected by the following invariants: ele-1
TypeReference(Resource)
Alternate NamesAsk at order entry question, AOE
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))

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..*
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-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-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-6: A resource should have narrative for robust management (text.`div`.exists())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
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.

Control0..1
Typeid
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
This element is affected by the following invariants: ele-1
TypeMeta
Standards StatusNormative (from Trial Use)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. ServiceRequest.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

Control0..1
This element is affected by the following invariants: ele-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
Standards StatusNormative (from Trial Use)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. ServiceRequest.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

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

Control0..1
This element is affected by the following invariants: ele-1
BindingThe codes SHOULD be taken from CommonLanguages: A human language.
Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Standards StatusNormative (from Trial Use)
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. ServiceRequest.text
Definition

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

ShortText summary of the resource, for human interpretation
Comments

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

Control0..1
This element is affected by the following invariants: ele-1
TypeNarrative
Standards StatusNormative (from Trial Use)
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. ServiceRequest.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, 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
Alternate Namesinline resources, anonymous resources, contained resources
14. ServiceRequest.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and 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..*
This element is affected by the following invariants: ele-1
TypeExtension
Standards StatusNormative (from Trial Use)
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.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators:
  • value @ url
16. ServiceRequest.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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.

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..*
This element is affected by the following invariants: ele-1
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Standards StatusNormative (from Trial Use)
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())
SlicingThis element introduces a set of slices on ServiceRequest.modifierExtension. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators:
  • value @ url
18. ServiceRequest.identifier
Definition

Identifier er identifikator som identifiserer serviceRequest uavhengig av ressursens id på en FHIR-server. Skal være en UUID. Kan benyttes for å knytte ServiceRequest sammen med eventuelle etterfølgende oppdateringer.

ShortSkal være UUID
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)
Control1..*
This element is affected by the following invariants: ele-1
TypeIdentifier
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. ServiceRequest.identifier.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
XML FormatIn the XML format, this property is represented as an attribute.
22. ServiceRequest.identifier.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..*
This element is affected by the following invariants: ele-1
TypeExtension
Standards StatusNormative (from Trial Use)
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.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators:
  • value @ url
24. ServiceRequest.identifier.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
This element is affected by the following invariants: ele-1
BindingThe codes SHALL be taken from IdentifierUse: Identifies the purpose for this identifier, if known .
Typecode
Is Modifiertrue because This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Standards StatusNormative (from Trial Use)
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

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

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

ShortDescription of identifier
Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Control0..1
This element is affected by the following invariants: ele-1
BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes: A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
TypeCodeableConcept
Standards StatusNormative (from Trial Use)
Summarytrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

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

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control1..1
This element is affected by the following invariants: ele-1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. ServiceRequest.identifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control1..1
This element is affected by the following invariants: ele-1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. ServiceRequest.identifier.period
Definition

Time period during which identifier is/was valid for use.

ShortTime period when id is/was valid for use
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Control0..1
This element is affected by the following invariants: ele-1
TypePeriod
Standards StatusNormative (from Trial Use)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
34. ServiceRequest.identifier.assigner
Definition

Organization that issued/manages the identifier.

ShortOrganization that issued id (may be just text)
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control0..1
This element is affected by the following invariants: ele-1
TypeReference(Organization)
Standards StatusNormative (from Trial Use)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
36. 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..*
This element is affected by the following invariants: ele-1
Typecanonical(ActivityDefinition, PlanDefinition)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Standards StatusNormative (from Trial Use)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. 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..*
This element is affected by the following invariants: ele-1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Standards StatusNormative (from Trial Use)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. ServiceRequest.basedOn
Definition

Plan/proposal/order fulfilled by this request.

ShortWhat request fulfills
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Control0..*
This element is affected by the following invariants: ele-1
TypeReference(CarePlan, ServiceRequest, MedicationRequest)
Standards StatusNormative (from Trial Use)
Summarytrue
Alternate Namesfulfills
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
42. ServiceRequest.replaces
Definition

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

ShortWhat request replaces
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Control0..*
This element is affected by the following invariants: ele-1
TypeReference(ServiceRequest)
Standards StatusNormative (from Trial Use)
Summarytrue
Alternate Namessupersedes, prior, renewed order
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
44. 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
This element is affected by the following invariants: ele-1
TypeIdentifier
Standards StatusNormative (from Trial Use)
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()))
46. ServiceRequest.status
Definition

Status active betyr at serviceRequest er sendt fra Helsenorge og status completed betyr at status er oppdatert fra behandler.

ShortDefault status er active
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
This element is affected by the following invariants: ele-1
BindingThe codes SHALL be taken from RequestStatus: 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
Summarytrue
Pattern Valueactive
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
StatusActiveOrCompleted: status må være enten 'active' eller 'completed'. (value='active' or value='completed')
48. ServiceRequest.intent
Definition

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

Shortproposal | 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
This element is affected by the following invariants: ele-1
BindingThe codes SHALL be taken from RequestIntent: The kind of service request.
Typecode
Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example &quot;the time the request is recommended to occur&quot; vs. &quot;the time the request is authorized to occur&quot; or &quot;who is recommended to perform the request&quot; vs. &quot;who is authorized to perform the request
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Pattern Valueorder
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
IntentOrder: intent må være 'order'. (value='order')
50. ServiceRequest.category
Definition

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

ShortHvis category er brukt og det mangler code bør beskrivelse av bestilling være i note
Comments

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

Control1..*
This element is affected by the following invariants: ele-1
BindingThe codes SHALL be taken from ServiceRequest Category Value Set
TypeCodeableConcept
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()))
52. ServiceRequest.priority
Definition

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

Shortroutine | urgent | asap | stat
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Control1..1
This element is affected by the following invariants: ele-1
BindingThe codes SHALL be taken from RequestPriority: Identifies the level of importance to be assigned to actioning the request.
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
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()))
PriorityUrgentOrRoutine: priority må være enten 'routine' eller 'urgent'. (value='routine' or value='urgent')
54. 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
This element is affected by the following invariants: ele-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
Standards StatusNormative (from Trial Use)
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()))
56. 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.

Control0..1
This element is affected by the following invariants: ele-1
BindingFor example codes, see ProcedureCodes(SNOMEDCT): 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.
TypeCodeableConcept
Standards StatusNormative (from Trial Use)
Summarytrue
Alternate Namesservice requested
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. 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: ele-1, prr-1
BindingFor example codes, see ServiceRequestOrderDetailsCodes: Codified order entry details which are based on order context.
TypeCodeableConcept
Standards StatusNormative (from Trial Use)
Summarytrue
Alternate Namesdetailed instructions
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. 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
This element is affected by the following invariants: ele-1
TypeChoice of: Quantity, Ratio, Range
[x] NoteSee Choice of Data Types for further information about how to use [x]
Standards StatusNormative (from Trial Use)
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()))
62. 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).

ShortSubject identifiserer innbygger.
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Control1..1
This element is affected by the following invariants: ele-1
TypeReference(Patient)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
64. ServiceRequest.subject.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
XML FormatIn the XML format, this property is represented as an attribute.
66. ServiceRequest.subject.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..*
This element is affected by the following invariants: ele-1
TypeExtension
Standards StatusNormative (from Trial Use)
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.subject.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators:
  • value @ url
68. ServiceRequest.subject.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

ShortLiteral reference, Relative, internal or absolute URL
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Control0..0
This element is affected by the following invariants: ele-1, ref-1
Typestring
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()))
70. ServiceRequest.subject.type
Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

ShortType the reference refers to (e.g. "Patient")
Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Control0..1
This element is affected by the following invariants: ele-1
BindingUnless not suitable, these codes SHALL be taken from ResourceType: Aa resource (or, for logical models, the URI of the logical model).
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Pattern ValuePatient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. ServiceRequest.subject.identifier
Definition

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

ShortLogical reference, when literal reference is not known
Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
This element is affected by the following invariants: ele-1
TypeIdentifier
Standards StatusNormative (from Trial Use)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. ServiceRequest.subject.identifier.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
XML FormatIn the XML format, this property is represented as an attribute.
76. ServiceRequest.subject.identifier.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..*
This element is affected by the following invariants: ele-1
TypeExtension
Standards StatusNormative (from Trial Use)
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.subject.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: , and can be differentiated using the following discriminators:
  • value @ url
78. ServiceRequest.subject.identifier.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
This element is affected by the following invariants: ele-1
BindingThe codes SHALL be taken from IdentifierUse: Identifies the purpose for this identifier, if known .
Typecode
Is Modifiertrue because This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Standards StatusNormative (from Trial Use)
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

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

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

ShortDescription of identifier
Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Control0..1
This element is affected by the following invariants: ele-1
BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes: A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
TypeCodeableConcept
Standards StatusNormative (from Trial Use)
Summarytrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

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

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortDet skal benyttes fødselsnummer eller d-nummer.
Comments

Identifier.system is always case sensitive.

Control0..1
This element is affected by the following invariants: ele-1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ValidSubjectSystemURL: system URL må være enten urn:oid:2.16.578.1.12.4.1.4.1' eller 'urn:oid:2.16.578.1.12.4.1.4.2'. (value='urn:oid:2.16.578.1.12.4.1.4.1' or value='urn:oid:2.16.578.1.12.4.1.4.2')
84. ServiceRequest.subject.identifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control0..1
This element is affected by the following invariants: ele-1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Standards StatusNormative (from Trial Use)
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
86. ServiceRequest.subject.identifier.period
Definition

Time period during which identifier is/was valid for use.

ShortTime period when id is/was valid for use
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Control0..1
This element is affected by the following invariants: ele-1
TypePeriod
Standards StatusNormative (from Trial Use)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
88. ServiceRequest.subject.identifier.assigner
Definition

Organization that issued/manages the identifier.

ShortOrganization that issued id (may be just text)
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control0..1
This element is affected by the following invariants: ele-1
TypeReference(Organization)
Standards StatusNormative (from Trial Use)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
90. ServiceRequest.subject.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

ShortText alternative for the resource
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Control0..1
This element is affected by the following invariants: ele-1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Standards StatusNormative (from Trial Use)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
92. 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
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Control0..1
This element is affected by the following invariants: ele-1
TypeReference(Encounter)
Standards StatusNormative (from Trial Use)
Summarytrue
Alternate Namescontext
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
94. ServiceRequest.occurrence[x]
Definition

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

ShortWhen service should occur
Control0..1
This element is affected by the following invariants: ele-1
TypeChoice of: dateTime, Period, Timing
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Standards StatusNormative (from Trial Use)
Summarytrue
Alternate Namesschedule
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
96. 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
This element is affected by the following invariants: ele-1
BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes: 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] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Standards StatusNormative (from Trial Use)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
98. ServiceRequest.authoredOn
Definition

When the request transitioned to being actionable.

ShortDate request signed
Control0..1
This element is affected by the following invariants: ele-1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Standards StatusNormative (from Trial Use)
Summarytrue
Alternate NamesorderedOn
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
100. 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
This element is affected by the following invariants: ele-1
TypeReference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
Standards StatusNormative (from Trial Use)
Summarytrue
Alternate Namesauthor, orderer
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
102. 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
This element is affected by the following invariants: ele-1
BindingThe codes SHALL be taken from ServiceRequest PerformerType Value Set
TypeCodeableConcept
Summarytrue
Alternate Namesspecialty
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
104. 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..*
This element is affected by the following invariants: ele-1
TypeReference(Practitioner, PractitionerRole, Organization, CareTeam, HealthcareService, Patient, Device, RelatedPerson)
Standards StatusNormative (from Trial Use)
Summarytrue
Alternate Namesrequest recipient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
106. 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
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Control0..*
This element is affected by the following invariants: ele-1
BindingFor example codes, see ServiceDeliveryLocationRoleType: A location type where services are delivered.
TypeCodeableConcept
Standards StatusNormative (from Trial Use)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
108. 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
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Control0..*
This element is affected by the following invariants: ele-1
TypeReference(Location)
Standards StatusNormative (from Trial Use)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
110. 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..*
This element is affected by the following invariants: ele-1
BindingFor example codes, see ProcedureReasonCodes: Diagnosis or problem codes justifying the reason for requesting the service investigation.
TypeCodeableConcept
Standards StatusNormative (from Trial Use)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
112. 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..*
This element is affected by the following invariants: ele-1
TypeReference(Condition, Observation, DiagnosticReport, DocumentReference)
Standards StatusNormative (from Trial Use)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
114. 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
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Control0..*
This element is affected by the following invariants: ele-1
TypeReference(Coverage, ClaimResponse)
Standards StatusNormative (from Trial Use)
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
116. ServiceRequest.supportingInfo
Definition

Hvis det er frykt for smitte eller bevist smitte er slik informasjonen referert fra supportingInformation som ‘contained’ ressurs.

ShortSupporting info kan brukes for å sende informasjon når det er frykt for smitte.
Comments

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

Control0..*
This element is affected by the following invariants: ele-1
TypeReference(Resource)
Alternate NamesAsk at order entry question, AOE
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
118. 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..*
This element is affected by the following invariants: ele-1
TypeReference(Specimen)
Standards StatusNormative (from Trial Use)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
120. 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..*
This element is affected by the following invariants: ele-1
BindingFor example codes, see SNOMEDCTBodyStructures: Codes describing anatomical locations. May include laterality.
TypeCodeableConcept
Standards StatusNormative (from Trial Use)
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()))
122. ServiceRequest.note
Definition

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

ShortComments
Comments

For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

Control0..*
This element is affected by the following invariants: ele-1
TypeAnnotation
Standards StatusNormative (from Trial Use)
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
124. ServiceRequest.patientInstruction
Definition

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

ShortPatient or consumer-oriented instructions
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Control0..1
This element is affected by the following invariants: ele-1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Standards StatusNormative (from Trial Use)
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
126. 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..*
This element is affected by the following invariants: ele-1
TypeReference(Provenance)
Standards StatusNormative (from Trial Use)
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))