FHIR Release 3 (STU) 5 Preview #3
This page is part of the FHIR Specification (v3.0.2: STU 3). The current version which supercedes this version is 4.0.1 . For a full list of available versions, see the Directory of published versions
Patient Care Work Group Maturity Level : 2   Trial Use Security Category : Patient Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson

Detailed Descriptions for the elements in the CommunicationRequest resource.

Alternate Names Alternate Names encounter Invariants Defined on this element cmr-1 : onBehalfOf can only be specified if agent is practitioner or device ( expression : (agent.resolve() is Practitioner) or (agent.resolve() is Device) or onBehalfOf.exists().not(), xpath: contains(f:agent/f:reference/@value, '/Practitioner/') or contains(f:agent/f:reference/@value, '/Device/') or not(exists(f:onBehalfOf))) Invariants Affect this element cmr-1 : onBehalfOf can only be specified if agent is practitioner or device ( expression : (agent.resolve() is Practitioner) or (agent.resolve() is Device) or onBehalfOf.exists().not(), xpath: contains(f:agent/f:reference/@value, '/Practitioner/') or contains(f:agent/f:reference/@value, '/Device/') or not(exists(f:onBehalfOf)))
CommunicationRequest
Element Id CommunicationRequest
Definition

A request to convey information; e.g. the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition.

Control Cardinality 1..1 0..*
Type DomainResource
CommunicationRequest.identifier
Element Id CommunicationRequest.identifier
Definition

A unique ID of Business identifiers assigned to this communication request for reference purposes. It must be provided if user wants it returned as part of any output, otherwise it will be autogenerated, if needed, by CDS system. Does not need to be the actual ID of performer or other systems which remain constant as the source system. resource is updated and propagates from server to server.

Note This is a business identifer, identifier, not a resource identifier (see discussion )
Control Cardinality 0..*
Type Identifier
Requirements

Allows identification of the communication request as it is known by various participating systems and in a way that remains consistent across servers.

Summary true
Comments

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.

CommunicationRequest.basedOn
Element Id CommunicationRequest.basedOn
Definition

A plan or proposal that is fulfilled in whole or in part by this request.

Control Cardinality 0..*
Type Reference ( Any )
Requirements

Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon.

Alternate Names fulfills
Summary true
CommunicationRequest.replaces
Element Id CommunicationRequest.replaces
Definition

Completed or terminated request(s) whose function is taken by this new request.

Control Cardinality 0..*
Type Reference ( CommunicationRequest )
Requirements

Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests.

Alternate Names supersedes; prior
Summary true
Comments

The replacement could be because the initial request was immediately rejected (due to an issue) or because the previous request was completed, but the need for the action described by the request remains ongoing.

CommunicationRequest.groupIdentifier
Element Id CommunicationRequest.groupIdentifier
Definition

A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition, prescription or similar form.

Control Cardinality 0..1
Type Identifier
Alternate Names grouperId
Summary true
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.

CommunicationRequest.status
Element Id CommunicationRequest.status
Definition

The status of the proposal or order.

Control Cardinality 1..1
Terminology Binding RequestStatus ( Required )
Type code
Is Modifier true (Reason: This element is labelled 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.)
Summary true
CommunicationRequest.statusReason
Element Id CommunicationRequest.statusReason
Definition

Captures the reason for the current state of the CommunicationRequest.

Cardinality 0..1
Terminology Binding CommunicationRequest Status Reason ( Example )
Type CodeableConcept
Alternate Names Suspended Reason; Cancelled Reason
Comments

This element is labeled generally only used for "exception" statuses such as a modifier because the status contains the codes cancelled and entered-in-error that mark "on-hold" or "revoked". The reason why the request as CommunicationRequest was created at all is captured in reasonCode, not currently valid. here.

CommunicationRequest.category
Element Id CommunicationRequest.category
Definition

The type of message to be sent such as alert, notification, reminder, instruction, etc.

Control Cardinality 0..*
Terminology Binding CommunicationCategory ( Example )
Type CodeableConcept
Comments

There may be multiple axes of categorization and one communication request may serve multiple purposes.

CommunicationRequest.priority
Element Id CommunicationRequest.priority
Definition

Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine.

Control Cardinality 0..1
Terminology Binding RequestPriority Request priority ( Required )
Type code
Meaning if Missing If missing, this task should be performed with normal priority
Summary true
CommunicationRequest.doNotPerform
Element Id CommunicationRequest.doNotPerform
Definition

If true indicates that the CommunicationRequest is asking for the specified action to not occur.

Cardinality 0..1
Type boolean
Is Modifier true (Reason: If true this element negates the specified action. For Example, instead of a request for a communication, it is a request for the communication to not occur.)
Meaning if Missing If do not perform is not specified, the request is a positive request e.g. "do perform"
Alternate Names prohibited
Summary true
Comments

The attributes provided with the request qualify what is not to be done.

CommunicationRequest.medium
Element Id CommunicationRequest.medium
Definition

A channel that was used for this communication (e.g. email, fax).

Control Cardinality 0..*
Terminology Binding v3 Code System ParticipationMode ( Example )
Type CodeableConcept
CommunicationRequest.subject
Element Id CommunicationRequest.subject
Definition

The patient or group that is the focus of this communication request.

Control Cardinality 0..1
Type Reference ( Patient | Group )
patient Patterns CommunicationRequest.recipient Definition The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication. Control Reference(Patient,Group): Common patterns = Participant 0..*
Alternate Names Type Reference ( Device | Organization | Patient | Practitioner | RelatedPerson | Group | CareTeam ) patient
CommunicationRequest.topic CommunicationRequest.about
Element Id CommunicationRequest.about
Definition

The Other resources which were related that pertain to producing this communication request. request and to which this communication request should be associated.

Control Cardinality 0..*
Type Reference ( Any )
Comments

Don't use CommunicationRequest.about element when a more specific element exists, such as basedOn, reasonReference, or replaces.

CommunicationRequest.context CommunicationRequest.encounter
Element Id CommunicationRequest.encounter
Definition

The encounter Encounter during which this CommunicationRequest was created or episode of care within to which the communication request was created. creation of this record is tightly associated.

Control Cardinality 0..1
Type Reference ( Encounter | EpisodeOfCare )
Summary true
Comments

This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

CommunicationRequest.payload
Element Id CommunicationRequest.payload
Definition

Text, attachment(s), or resource(s) to be communicated to the recipient.

Control Cardinality 0..*
CommunicationRequest.payload.content[x]
Element Id CommunicationRequest.payload.content[x]
Definition

The communicated content (or for multi-part communications, one portion of the communication).

Control Cardinality 1..1
Type string | Attachment | Reference ( Any ) )| CodeableConcept
[x] Note See Choice of Data Types for further information about how to use [x]
Comments

The content can be codified or textual. As an example of codified content, when working with machine generated communications, the payload may be drawn from a finite, terminology defined set of communications, especially for short, status update kinds of communications where more of a natural language approach isn't appropriate.

If the content isn't codified, contentCodeableConcept.text can be used.

When using contentCodeableConcept, the CodeableConcept is what is being communicated and is not a categorization of the content.

CommunicationRequest.occurrence[x]
Element Id CommunicationRequest.occurrence[x]
Definition

The time when this communication is to occur.

Control Cardinality 0..1
Type dateTime | Period
[x] Note See Choice of Data Types for further information about how to use [x]
Alternate Names timing
Summary true
CommunicationRequest.authoredOn
Element Id CommunicationRequest.authoredOn
Definition

For draft requests, indicates the date of initial creation. For requests with other statuses, indicates the date of activation.

Control Cardinality 0..1
Type dateTime
Alternate Names createdOn
Summary true
CommunicationRequest.sender CommunicationRequest.requester
Element Id CommunicationRequest.requester
Definition

The entity (e.g. person, organization, clinical information system, device, individual, or device) which is organization who asks for the information to be the source of the communication. shared.

Control Cardinality 0..1
Type Reference ( Device Practitioner | PractitionerRole | Organization | Patient | Practitioner | RelatedPerson ) | Device CommunicationRequest.requester )
Definition The individual who initiated the request and has responsibility for its activation. Patterns Control Reference(Practitioner,PractitionerRole,Organization,Patient,RelatedPerson,Device): Common patterns = Participant 0..1
Alternate Names author
Summary true
CommunicationRequest.requester.agent CommunicationRequest.recipient
Element Id CommunicationRequest.recipient
Definition

The entity (e.g. person, organization, clinical information system, device, practitioner, etc. who initiated group, or care team) which is the request. intended target of the communication.

Control Cardinality 1..1 0..*
Type Reference ( Practitioner Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Device Group | CareTeam | HealthcareService | Endpoint )
Summary Patterns true Reference(Device,Organization,Patient,Practitioner,PractitionerRole,RelatedPerson,Group,CareTeam,HealthcareService,Endpoint): No common pattern
CommunicationRequest.requester.onBehalfOf CommunicationRequest.informationProvider
Element Id CommunicationRequest.informationProvider
Definition

The organization the device entity (e.g. person, organization, clinical information system, or practitioner was acting on behalf of. device) which is to be the source of the communication.

Control Cardinality 0..1 0..*
Type Reference ( Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService | Endpoint )
Requirements Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when authoring the request. Patterns Reference(Device,Organization,Patient,Practitioner,PractitionerRole,RelatedPerson,HealthcareService,Endpoint): No common pattern
Summary true
CommunicationRequest.reasonCode CommunicationRequest.reason
Element Id CommunicationRequest.reason
Definition

Describes why the request is being made in coded or textual form.

Control Cardinality 0..*
Terminology Binding v3 Code System ActReason ( Example ) CommunicationReason :
Type CodeableConcept CodeableReference ( Any )
Summary true
Comments

Textual reasons can be caprued captured using reasonCode.text.

CommunicationRequest.reasonReference CommunicationRequest.note
Definition Indicates another resource whose existence justifies this request. Control 0..* Type Reference ( Condition | Observation ) Summary Element Id true CommunicationRequest.note
Definition

Comments made about the request by the requester, sender, recipient, subject or other participants.

Control Cardinality 0..*
Type Annotation