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12.22 Resource DeviceRequest - Content

Orders and Observations Work Group Maturity Level : 0   Draft Trial Use Security Category : Patient Compartments : Device , Encounter , Patient , Practitioner

Represents a request for a patient to employ a medical device. The device may be an implantable device, or an external assistive device, such as a walker.

Trial-Use Note: In terms of scope and usage, the Orders and Observations workgroups wish to draw the attention of reviewers and implementers to the following issue:

  1. We are seeking input from the implementation community on whether to combine DeviceRequest and VisionPrescription for R4. The parameters element was added to DeviceRequest for representing custom details for ordering devices. With this change, VisionPrescription significantly overlaps DeviceRequest. To illustrate this, the devicerequest-left-lens and devicerequest-right-lens examples are based on the general glasses example in VisionPrescription.

This resource is a request resource from a FHIR workflow perspective - see Workflow .

This resource describes the request for the use of a device by a patient. The device may be any pertinent device specified in the Device resource. Examples of devices that may be requested include wheelchair, hearing aids, or an insulin pump. The request may lead to the dispensing of the device to the patient or for use by the patient.

The device use request may represent an order or a prescription entered by a practitioner in a CPOE system or a proposal made by a clinical decision support (CDS) system based on a patient's clinical record and context of care.

This resource deals with the allocation of a device to a patient and while it may contain instructions on how to use the device, the data about getting the device to the patient is addressed in other resources. For example, Certain certain devices must be implanted via a surgical or other procedure and the implantation or explantation is represented in the [Procedure](procedure.html) or [ProcedureRequest](procedurerequest.html) [ServiceRequest](servicerequest.html) resource.

The SupplyRequest resource is similar in that it deals with requesting a particular item for a specific patient. However, DeviceRequest is concerned with items where there is a patient focus, or instructions regarding their use, whereas SupplyRequest is concerned with inventory management.

This resource is referenced by CarePlan , Claim and Observation .

This resource implements the Request pattern.

Structure

Name Flags Card. Type Description & Constraints doco
. . DeviceRequest TU DomainResource Medical device request
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier External Request identifier
. . . definition instantiatesCanonical Σ 0..* Reference canonical ( ActivityDefinition | PlanDefinition ) Protocol Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
. . . basedOn Σ 0..* Reference ( Any ) What request fulfills
. . . priorRequest Σ 0..* Reference ( Any ) What request replaces
. . . groupIdentifier Σ 0..1 Identifier Identifier of composite request
. . . status ?! Σ 0..1 code draft | active | suspended on-hold | revoked | completed | entered-in-error | cancelled unknown
RequestStatus ( Required )
. . . intent ?! Σ 1..1 CodeableConcept code proposal | plan | original-order directive | encoded order | original-order | reflex-order | filler-order | instance-order | option
RequestIntent ( Required )
. . . priority Σ 0..1 code Indicates how quickly the {{title}} should be addressed with respect to other requests routine | urgent | asap | stat
RequestPriority Request priority ( Required )
. . . code[x] Σ 1..1 Device requested
FHIR Device Types ( Example )
. . . . codeReference Reference ( Device )
. . . . codeCodeableConcept CodeableConcept
. . . parameter 0..* BackboneElement Device details
.... code 0..1 CodeableConcept Device detail
.... value[x] 0..1 Value of detail
..... valueCodeableConcept CodeableConcept
..... valueQuantity Quantity
..... valueRange Range
..... valueBoolean boolean
. . . subject Σ 1..1 Reference ( Patient | Group | Location | Device ) Focus of request
. . . context encounter Σ 0..1 Reference ( Encounter | EpisodeOfCare ) Encounter or Episode motivating request
. . . occurrence[x] Σ 0..1 Desired time or schedule for use
. . . . occurrenceDateTime dateTime
. . . . occurrencePeriod Period
. . . . occurrenceTiming Timing
. . . authoredOn Σ 0..1 dateTime When recorded
. . . requester Σ 0..1 BackboneElement Who/what is requesting diagnostics agent Σ 1..1 0..1 Reference ( Device | Practitioner | Organization ) Individual making the request onBehalfOf Σ 0..1 Reference PractitionerRole ( | Organization ) Organization agent Who/what is acting for requesting diagnostics
. . . performerType Σ 0..1 CodeableConcept Fille Filler role
Participant Roles ( Example )
. . . performer Σ 0..1 Reference ( Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson | HealthcareService ) Requested Filler
. . . reasonCode Σ 0..* CodeableConcept Coded Reason for request
Condition/Problem/Diagnosis Codes ( Example )
. . . reasonReference Σ 0..* Reference ( Any Condition | Observation | DiagnosticReport | DocumentReference ) Linked Reason for request
. . . insurance 0..* Reference ( Coverage | ClaimResponse ) Associated insurance coverage
... supportingInfo 0..* Reference ( Any ) Additional clinical information
. . . note 0..* Annotation Notes or comments
. . . relevantHistory 0..* Reference ( Provenance ) Request provenance

doco Documentation for this format

UML Diagram ( Legend )

DeviceRequest ( DomainResource ) Identifiers assigned to this order by the orderer or by the receiver identifier : Identifier [0..*] Protocol The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition followed that is adhered to in whole or in part by this request. For example: The proposed act must be performed if the indicated conditions occur, e.g.., shortness of breath, SpO2 less than x% DeviceRequest definition instantiatesCanonical : Reference canonical [0..*] « ActivityDefinition | PlanDefinition » The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest instantiatesUri : uri [0..*] Plan/proposal/order fulfilled by this request basedOn : Reference [0..*] « Any » The request takes the place of the referenced completed or terminated request(s) priorRequest : Reference [0..*] « Any » Composite request this is part of groupIdentifier : Identifier [0..1] The status of the request (this element modifies the meaning of other elements) status : code [0..1] « Codes representing the status of the request. (Strength=Required) RequestStatus ! » Whether the request is a proposal, plan, an original order or a reflex order (this element modifies the meaning of other elements) intent : CodeableConcept code [1..1] « The kind of diagnostic request request. (Strength=Required) RequestIntent ! » Indicates how quickly the {{title}} should be addressed with respect to other requests priority : code [0..1] « Identifies the level of importance to be assigned to actioning the request request. (Strength=Required) RequestPriority ! » The details of the device to be used code[x] : Type [1..1] « Reference ( Device )| CodeableConcept ; Codes for devices that can be requested requested. (Strength=Example) FHIR Device Types FHIRDeviceTypes ?? » The patient who will use the device subject : Reference [1..1] « Patient | Group | Location | Device » An encounter that provides additional context in which this request is made context encounter : Reference [0..1] « Encounter | EpisodeOfCare » The timing schedule for the use of the device. The Schedule data type allows many different expressions, for example. "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013" occurrence[x] : Type [0..1] « dateTime | Period | Timing » When the request transitioned to being actionable authoredOn : dateTime [0..1] The individual who initiated the request and has responsibility for its activation requester : Reference [0..1] « Device | Practitioner | PractitionerRole | Organization » Desired type of performer for doing the diagnostic testing performerType : CodeableConcept [0..1] « Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. (Strength=Example) Participant Roles ParticipantRoles ?? » The desired perfomer performer for doing the diagnostic testing performer : Reference [0..1] « Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson | HealthcareService » Reason or justification for the use of this device reasonCode : CodeableConcept [0..*] « Diagnosis or problem codes justifying the reason for requesting the device. (Strength=Example) Condition/Problem/Diagnosis Condition/Problem/DiagnosisCo... ?? » Reason or justification for the use of this device reasonReference : Reference [0..*] Any « Condition | Observation | DiagnosticReport | DocumentReference » Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service insurance : Reference [0..*] « Coverage | ClaimResponse » Additional clinical information about the patient that may influence the request fulfilment. For example, this may includes body include where on the subject's body the device will be used ( i.e. (i.e. the target site) supportingInfo : Reference [0..*] « Any » Details about this request that were not represented at all or sufficiently in one of the attributes provided in a class. These may include for example a comment, an instruction, or a note associated with the statement note : Annotation [0..*] Key events in the history of the request relevantHistory : Reference [0..*] « Provenance » Requester Parameter The device, practitioner, etc. who initiated A code or string that identifies the request device detail being asserted agent code : Reference [1..1] Device | Practitioner | Organization CodeableConcept [0..1] The organization value of the device or practitioner was acting on behalf of detail onBehalfOf value[x] : Reference Type [0..1] Organization « CodeableConcept | Quantity | Range | boolean » The individual who initiated Specific parameters for the request and has responsibility ordered item. For example, the prism value for its activation lenses requester parameter [0..1] [0..*]

XML Template

<DeviceRequest xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Request identifier --></identifier>
 <</definition>

 <instantiatesCanonical><!-- 0..* canonical(ActivityDefinition|PlanDefinition) Instantiates FHIR protocol or definition --></instantiatesCanonical>
 <instantiatesUri value="[uri]"/><!-- 0..* Instantiates external protocol or definition -->

 <basedOn><!-- 0..* Reference(Any) What request fulfills --></basedOn>
 <priorRequest><!-- 0..* Reference(Any) What request replaces --></priorRequest>
 <groupIdentifier><!-- 0..1 Identifier Identifier of composite request --></groupIdentifier>
 <
 <</intent>
 <

 <status value="[code]"/><!-- 0..1 draft | active | on-hold | revoked | completed | entered-in-error | unknown -->
 <intent value="[code]"/><!-- 1..1 proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option -->
 <priority value="[code]"/><!-- 0..1 routine | urgent | asap | stat -->

 <code[x]><!-- 1..1 Reference(Device)|CodeableConcept Device requested --></code[x]>
 <</subject>
 <</context>

 <parameter>  <!-- 0..* Device details -->
  <code><!-- 0..1 CodeableConcept Device detail --></code>
  <value[x]><!-- 0..1 CodeableConcept|Quantity|Range|boolean Value of detail --></value[x]>
 </parameter>
 <subject><!-- 1..1 Reference(Device|Group|Location|Patient) Focus of request --></subject>
 <encounter><!-- 0..1 Reference(Encounter) Encounter motivating request --></encounter>

 <occurrence[x]><!-- 0..1 dateTime|Period|Timing Desired time or schedule for use --></occurrence[x]>
 <authoredOn value="[dateTime]"/><!-- 0..1 When recorded -->
 <
  <</agent>
  <</onBehalfOf>
 </requester>
 <</performerType>
 <|
   </performer>

 <requester><!-- 0..1 Reference(Device|Organization|Practitioner|PractitionerRole) Who/what is requesting diagnostics --></requester>
 <performerType><!-- 0..1 CodeableConcept Filler role --></performerType>
 <performer><!-- 0..1 Reference(CareTeam|Device|HealthcareService|Organization|
   Patient|Practitioner|PractitionerRole|RelatedPerson) Requested Filler --></performer>
 <reasonCode><!-- 0..* CodeableConcept Coded Reason for request --></reasonCode>
 <</reasonReference>
 <</supportingInfo>

 <reasonReference><!-- 0..* Reference(Condition|DiagnosticReport|
   DocumentReference|Observation) Linked Reason for request --></reasonReference>
 <insurance><!-- 0..* Reference(ClaimResponse|Coverage) Associated insurance coverage --></insurance>
 <supportingInfo><!-- 0..* Reference(Any) Additional clinical information --></supportingInfo>

 <note><!-- 0..* Annotation Notes or comments --></note>
 <relevantHistory><!-- 0..* Reference(Provenance) Request provenance --></relevantHistory>
</DeviceRequest>

JSON Template

{doco
  "resourceType" : "DeviceRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External Request identifier
  "

  "instantiatesCanonical" : [{ canonical(ActivityDefinition|PlanDefinition) }], // Instantiates FHIR protocol or definition
  "instantiatesUri" : ["<uri>"], // Instantiates external protocol or definition

  "basedOn" : [{ Reference(Any) }], // What request fulfills
  "priorRequest" : [{ Reference(Any) }], // What request replaces
  "groupIdentifier" : { Identifier }, // Identifier of composite request
  "
  "
  "

  "status" : "<code>", // draft | active | on-hold | revoked | completed | entered-in-error | unknown
  "intent" : "<code>", // R!  proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
  "priority" : "<code>", // routine | urgent | asap | stat

  // code[x]: Device requested. One of these 2:
  "codeReference" : { Reference(Device) },
  "codeCodeableConcept" : { CodeableConcept },
  "
  "

  "parameter" : [{ // Device details
    "code" : { CodeableConcept }, // Device detail
    // value[x]: Value of detail. One of these 4:
    "valueCodeableConcept" : { CodeableConcept }
    "valueQuantity" : { Quantity }
    "valueRange" : { Range }
    "valueBoolean" : <boolean>
  }],
  "subject" : { Reference(Device|Group|Location|Patient) }, // R!  Focus of request
  "encounter" : { Reference(Encounter) }, // Encounter motivating request

  // occurrence[x]: Desired time or schedule for use. One of these 3:
  "occurrenceDateTime" : "<dateTime>",
  "occurrencePeriod" : { Period },
  "occurrenceTiming" : { Timing },
  "authoredOn" : "<dateTime>", // When recorded
  "
    "
    "
  },
  "
  "|
   

  "requester" : { Reference(Device|Organization|Practitioner|PractitionerRole) }, // Who/what is requesting diagnostics
  "performerType" : { CodeableConcept }, // Filler role
  "performer" : { Reference(CareTeam|Device|HealthcareService|Organization|
   Patient|Practitioner|PractitionerRole|RelatedPerson) }, // Requested Filler
  "reasonCode" : [{ CodeableConcept }], // Coded Reason for request
  "
  "

  "reasonReference" : [{ Reference(Condition|DiagnosticReport|
   DocumentReference|Observation) }], // Linked Reason for request
  "insurance" : [{ Reference(ClaimResponse|Coverage) }], // Associated insurance coverage
  "supportingInfo" : [{ Reference(Any) }], // Additional clinical information

  "note" : [{ Annotation }], // Notes or comments
  "relevantHistory" : [{ Reference(Provenance) }] // Request provenance
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco
[ a fhir:DeviceRequest;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root
  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:DeviceRequest.identifier [ Identifier ], ... ; # 0..* External Request identifier
  fhir:

  fhir:DeviceRequest.instantiatesCanonical [ canonical(ActivityDefinition|PlanDefinition) ], ... ; # 0..* Instantiates FHIR protocol or definition
  fhir:DeviceRequest.instantiatesUri [ uri ], ... ; # 0..* Instantiates external protocol or definition

  fhir:DeviceRequest.basedOn [ Reference(Any) ], ... ; # 0..* What request fulfills
  fhir:DeviceRequest.priorRequest [ Reference(Any) ], ... ; # 0..* What request replaces
  fhir:DeviceRequest.groupIdentifier [ Identifier ]; # 0..1 Identifier of composite request
  fhir:
  fhir:
  fhir:

  fhir:DeviceRequest.status [ code ]; # 0..1 draft | active | on-hold | revoked | completed | entered-in-error | unknown
  fhir:DeviceRequest.intent [ code ]; # 1..1 proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
  fhir:DeviceRequest.priority [ code ]; # 0..1 routine | urgent | asap | stat

  # DeviceRequest.code[x] : 1..1 Device requested. One of these 2
    fhir:DeviceRequest.codeReference [ Reference(Device) ]
    fhir:DeviceRequest.codeCodeableConcept [ CodeableConcept ]
  fhir:
  fhir:

  fhir:DeviceRequest.parameter [ # 0..* Device details
    fhir:DeviceRequest.parameter.code [ CodeableConcept ]; # 0..1 Device detail
    # DeviceRequest.parameter.value[x] : 0..1 Value of detail. One of these 4
      fhir:DeviceRequest.parameter.valueCodeableConcept [ CodeableConcept ]
      fhir:DeviceRequest.parameter.valueQuantity [ Quantity ]
      fhir:DeviceRequest.parameter.valueRange [ Range ]
      fhir:DeviceRequest.parameter.valueBoolean [ boolean ]
  ], ...;
  fhir:DeviceRequest.subject [ Reference(Device|Group|Location|Patient) ]; # 1..1 Focus of request
  fhir:DeviceRequest.encounter [ Reference(Encounter) ]; # 0..1 Encounter motivating request

  # DeviceRequest.occurrence[x] : 0..1 Desired time or schedule for use. One of these 3
    fhir:DeviceRequest.occurrenceDateTime [ dateTime ]
    fhir:DeviceRequest.occurrencePeriod [ Period ]
    fhir:DeviceRequest.occurrenceTiming [ Timing ]
  fhir:DeviceRequest.authoredOn [ dateTime ]; # 0..1 When recorded
  fhir:
    fhir:
    fhir:
  ];
  fhir:
  fhir:

  fhir:DeviceRequest.requester [ Reference(Device|Organization|Practitioner|PractitionerRole) ]; # 0..1 Who/what is requesting diagnostics
  fhir:DeviceRequest.performerType [ CodeableConcept ]; # 0..1 Filler role
  fhir:DeviceRequest.performer [ Reference(CareTeam|Device|HealthcareService|Organization|Patient|Practitioner|
  PractitionerRole|RelatedPerson) ]; # 0..1 Requested Filler
  fhir:DeviceRequest.reasonCode [ CodeableConcept ], ... ; # 0..* Coded Reason for request
  fhir:
  fhir:

  fhir:DeviceRequest.reasonReference [ Reference(Condition|DiagnosticReport|DocumentReference|Observation) ], ... ; # 0..* Linked Reason for request
  fhir:DeviceRequest.insurance [ Reference(ClaimResponse|Coverage) ], ... ; # 0..* Associated insurance coverage
  fhir:DeviceRequest.supportingInfo [ Reference(Any) ], ... ; # 0..* Additional clinical information

  fhir:DeviceRequest.note [ Annotation ], ... ; # 0..* Notes or comments
  fhir:DeviceRequest.relevantHistory [ Reference(Provenance) ], ... ; # 0..* Request provenance
]

Changes since DSTU2 R3

DeviceRequest DeviceRequest.definition Added Element DeviceRequest.basedOn Added Element DeviceRequest.priorRequest Added Element DeviceRequest.groupIdentifier Added Element
DeviceRequest.status
  • Change value set from http://hl7.org/fhir/ValueSet/device-use-request-status http://hl7.org/fhir/ValueSet/request-status|4.0.0 to http://hl7.org/fhir/ValueSet/request-status DeviceRequest.intent Added Element http://hl7.org/fhir/ValueSet/request-status|4.1.0
DeviceRequest.priority DeviceRequest.intent
  • Change value set from http://hl7.org/fhir/ValueSet/device-use-request-priority to http://hl7.org/fhir/ValueSet/request-priority Default Value "If missing, normal priority" added DeviceRequest.code[x] Added Element DeviceRequest.subject Add Reference(Group), Add Reference(Location), Add Reference(Device) DeviceRequest.context Renamed from encounter to context Add Reference(EpisodeOfCare) DeviceRequest.occurrence[x] Added Element DeviceRequest.authoredOn Added Element DeviceRequest.requester Added Element DeviceRequest.requester.agent Added Element DeviceRequest.requester.onBehalfOf Added Element DeviceRequest.performerType Added Element DeviceRequest.performer Added Element DeviceRequest.reasonCode Renamed from indication http://hl7.org/fhir/ValueSet/request-intent|4.0.0 to reasonCode DeviceRequest.reasonReference Added Element DeviceRequest.supportingInfo Added Element http://hl7.org/fhir/ValueSet/request-intent|4.1.0
DeviceRequest.note DeviceRequest.priority
  • Renamed from notes to note Type changed Change value set from string http://hl7.org/fhir/ValueSet/request-priority|4.0.0 to Annotation DeviceRequest.relevantHistory Added Element DeviceRequest.bodySite[x] deleted DeviceRequest.device deleted DeviceRequest.prnReason deleted DeviceRequest.orderedOn deleted DeviceRequest.recordedOn deleted DeviceRequest.timing[x] deleted http://hl7.org/fhir/ValueSet/request-priority|4.1.0

See the Full Difference for further information

This analysis is available as XML or JSON .

See R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. 2 fail round-trip testing and 1 r3 resources are invalid (0 errors). )

Structure

Name Flags Card. Type Description & Constraints doco
. . DeviceRequest TU DomainResource Medical device request
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier External Request identifier
. . . definition instantiatesCanonical Σ 0..* Reference canonical ( ActivityDefinition | PlanDefinition ) Protocol Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
. . . basedOn Σ 0..* Reference ( Any ) What request fulfills
. . . priorRequest Σ 0..* Reference ( Any ) What request replaces
. . . groupIdentifier Σ 0..1 Identifier Identifier of composite request
. . . status ?! Σ 0..1 code draft | active | suspended on-hold | revoked | completed | entered-in-error | cancelled unknown
RequestStatus ( Required )
. . . intent ?! Σ 1..1 CodeableConcept code proposal | plan | original-order directive | encoded order | original-order | reflex-order | filler-order | instance-order | option
RequestIntent ( Required )
. . . priority Σ 0..1 code Indicates how quickly the {{title}} should be addressed with respect to other requests routine | urgent | asap | stat
RequestPriority Request priority ( Required )
. . . code[x] Σ 1..1 Device requested
FHIR Device Types ( Example )
. . . . codeReference Reference ( Device )
. . . . codeCodeableConcept CodeableConcept
. . . parameter 0..* BackboneElement Device details
.... code 0..1 CodeableConcept Device detail
.... value[x] 0..1 Value of detail
..... valueCodeableConcept CodeableConcept
..... valueQuantity Quantity
..... valueRange Range
..... valueBoolean boolean
. . . subject Σ 1..1 Reference ( Patient | Group | Location | Device ) Focus of request
. . . context encounter Σ 0..1 Reference ( Encounter | EpisodeOfCare ) Encounter or Episode motivating request
. . . occurrence[x] Σ 0..1 Desired time or schedule for use
. . . . occurrenceDateTime dateTime
. . . . occurrencePeriod Period
. . . . occurrenceTiming Timing
. . . authoredOn Σ 0..1 dateTime When recorded
. . . requester Σ 0..1 BackboneElement Who/what is requesting diagnostics agent Σ 1..1 0..1 Reference ( Device | Practitioner | Organization ) Individual making the request onBehalfOf Σ 0..1 Reference PractitionerRole ( | Organization ) Organization agent Who/what is acting for requesting diagnostics
. . . performerType Σ 0..1 CodeableConcept Fille Filler role
Participant Roles ( Example )
. . . performer Σ 0..1 Reference ( Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson | HealthcareService ) Requested Filler
. . . reasonCode Σ 0..* CodeableConcept Coded Reason for request
Condition/Problem/Diagnosis Codes ( Example )
. . . reasonReference Σ 0..* Reference ( Any Condition | Observation | DiagnosticReport | DocumentReference ) Linked Reason for request
. . . insurance 0..* Reference ( Coverage | ClaimResponse ) Associated insurance coverage
... supportingInfo 0..* Reference ( Any ) Additional clinical information
. . . note 0..* Annotation Notes or comments
. . . relevantHistory 0..* Reference ( Provenance ) Request provenance

doco Documentation for this format

UML Diagram ( Legend )

DeviceRequest ( DomainResource ) Identifiers assigned to this order by the orderer or by the receiver identifier : Identifier [0..*] Protocol The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition followed that is adhered to in whole or in part by this request. For example: The proposed act must be performed if the indicated conditions occur, e.g.., shortness of breath, SpO2 less than x% DeviceRequest definition instantiatesCanonical : Reference canonical [0..*] « ActivityDefinition | PlanDefinition » The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest instantiatesUri : uri [0..*] Plan/proposal/order fulfilled by this request basedOn : Reference [0..*] « Any » The request takes the place of the referenced completed or terminated request(s) priorRequest : Reference [0..*] « Any » Composite request this is part of groupIdentifier : Identifier [0..1] The status of the request (this element modifies the meaning of other elements) status : code [0..1] « Codes representing the status of the request. (Strength=Required) RequestStatus ! » Whether the request is a proposal, plan, an original order or a reflex order (this element modifies the meaning of other elements) intent : CodeableConcept code [1..1] « The kind of diagnostic request request. (Strength=Required) RequestIntent ! » Indicates how quickly the {{title}} should be addressed with respect to other requests priority : code [0..1] « Identifies the level of importance to be assigned to actioning the request request. (Strength=Required) RequestPriority ! » The details of the device to be used code[x] : Type [1..1] « Reference ( Device )| CodeableConcept ; Codes for devices that can be requested requested. (Strength=Example) FHIR Device Types FHIRDeviceTypes ?? » The patient who will use the device subject : Reference [1..1] « Patient | Group | Location | Device » An encounter that provides additional context in which this request is made context encounter : Reference [0..1] « Encounter | EpisodeOfCare » The timing schedule for the use of the device. The Schedule data type allows many different expressions, for example. "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013" occurrence[x] : Type [0..1] « dateTime | Period | Timing » When the request transitioned to being actionable authoredOn : dateTime [0..1] The individual who initiated the request and has responsibility for its activation requester : Reference [0..1] « Device | Practitioner | PractitionerRole | Organization » Desired type of performer for doing the diagnostic testing performerType : CodeableConcept [0..1] « Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. (Strength=Example) Participant Roles ParticipantRoles ?? » The desired perfomer performer for doing the diagnostic testing performer : Reference [0..1] « Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson | HealthcareService » Reason or justification for the use of this device reasonCode : CodeableConcept [0..*] « Diagnosis or problem codes justifying the reason for requesting the device. (Strength=Example) Condition/Problem/Diagnosis Condition/Problem/DiagnosisCo... ?? » Reason or justification for the use of this device reasonReference : Reference [0..*] Any « Condition | Observation | DiagnosticReport | DocumentReference » Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service insurance : Reference [0..*] « Coverage | ClaimResponse » Additional clinical information about the patient that may influence the request fulfilment. For example, this may includes body include where on the subject's body the device will be used ( i.e. (i.e. the target site) supportingInfo : Reference [0..*] « Any » Details about this request that were not represented at all or sufficiently in one of the attributes provided in a class. These may include for example a comment, an instruction, or a note associated with the statement note : Annotation [0..*] Key events in the history of the request relevantHistory : Reference [0..*] « Provenance » Requester Parameter The device, practitioner, etc. who initiated A code or string that identifies the request device detail being asserted agent code : Reference [1..1] Device | Practitioner | Organization CodeableConcept [0..1] The organization value of the device or practitioner was acting on behalf of detail onBehalfOf value[x] : Reference Type [0..1] Organization « CodeableConcept | Quantity | Range | boolean » The individual who initiated Specific parameters for the request and has responsibility ordered item. For example, the prism value for its activation lenses requester parameter [0..1] [0..*]

XML Template

<DeviceRequest xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Request identifier --></identifier>
 <</definition>

 <instantiatesCanonical><!-- 0..* canonical(ActivityDefinition|PlanDefinition) Instantiates FHIR protocol or definition --></instantiatesCanonical>
 <instantiatesUri value="[uri]"/><!-- 0..* Instantiates external protocol or definition -->

 <basedOn><!-- 0..* Reference(Any) What request fulfills --></basedOn>
 <priorRequest><!-- 0..* Reference(Any) What request replaces --></priorRequest>
 <groupIdentifier><!-- 0..1 Identifier Identifier of composite request --></groupIdentifier>
 <
 <</intent>
 <

 <status value="[code]"/><!-- 0..1 draft | active | on-hold | revoked | completed | entered-in-error | unknown -->
 <intent value="[code]"/><!-- 1..1 proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option -->
 <priority value="[code]"/><!-- 0..1 routine | urgent | asap | stat -->

 <code[x]><!-- 1..1 Reference(Device)|CodeableConcept Device requested --></code[x]>
 <</subject>
 <</context>

 <parameter>  <!-- 0..* Device details -->
  <code><!-- 0..1 CodeableConcept Device detail --></code>
  <value[x]><!-- 0..1 CodeableConcept|Quantity|Range|boolean Value of detail --></value[x]>
 </parameter>
 <subject><!-- 1..1 Reference(Device|Group|Location|Patient) Focus of request --></subject>
 <encounter><!-- 0..1 Reference(Encounter) Encounter motivating request --></encounter>

 <occurrence[x]><!-- 0..1 dateTime|Period|Timing Desired time or schedule for use --></occurrence[x]>
 <authoredOn value="[dateTime]"/><!-- 0..1 When recorded -->
 <
  <</agent>
  <</onBehalfOf>
 </requester>
 <</performerType>
 <|
   </performer>

 <requester><!-- 0..1 Reference(Device|Organization|Practitioner|PractitionerRole) Who/what is requesting diagnostics --></requester>
 <performerType><!-- 0..1 CodeableConcept Filler role --></performerType>
 <performer><!-- 0..1 Reference(CareTeam|Device|HealthcareService|Organization|
   Patient|Practitioner|PractitionerRole|RelatedPerson) Requested Filler --></performer>
 <reasonCode><!-- 0..* CodeableConcept Coded Reason for request --></reasonCode>
 <</reasonReference>
 <</supportingInfo>

 <reasonReference><!-- 0..* Reference(Condition|DiagnosticReport|
   DocumentReference|Observation) Linked Reason for request --></reasonReference>
 <insurance><!-- 0..* Reference(ClaimResponse|Coverage) Associated insurance coverage --></insurance>
 <supportingInfo><!-- 0..* Reference(Any) Additional clinical information --></supportingInfo>

 <note><!-- 0..* Annotation Notes or comments --></note>
 <relevantHistory><!-- 0..* Reference(Provenance) Request provenance --></relevantHistory>
</DeviceRequest>

JSON Template

{doco
  "resourceType" : "DeviceRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External Request identifier
  "

  "instantiatesCanonical" : [{ canonical(ActivityDefinition|PlanDefinition) }], // Instantiates FHIR protocol or definition
  "instantiatesUri" : ["<uri>"], // Instantiates external protocol or definition

  "basedOn" : [{ Reference(Any) }], // What request fulfills
  "priorRequest" : [{ Reference(Any) }], // What request replaces
  "groupIdentifier" : { Identifier }, // Identifier of composite request
  "
  "
  "

  "status" : "<code>", // draft | active | on-hold | revoked | completed | entered-in-error | unknown
  "intent" : "<code>", // R!  proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
  "priority" : "<code>", // routine | urgent | asap | stat

  // code[x]: Device requested. One of these 2:
  "codeReference" : { Reference(Device) },
  "codeCodeableConcept" : { CodeableConcept },
  "
  "

  "parameter" : [{ // Device details
    "code" : { CodeableConcept }, // Device detail
    // value[x]: Value of detail. One of these 4:
    "valueCodeableConcept" : { CodeableConcept }
    "valueQuantity" : { Quantity }
    "valueRange" : { Range }
    "valueBoolean" : <boolean>
  }],
  "subject" : { Reference(Device|Group|Location|Patient) }, // R!  Focus of request
  "encounter" : { Reference(Encounter) }, // Encounter motivating request

  // occurrence[x]: Desired time or schedule for use. One of these 3:
  "occurrenceDateTime" : "<dateTime>",
  "occurrencePeriod" : { Period },
  "occurrenceTiming" : { Timing },
  "authoredOn" : "<dateTime>", // When recorded
  "
    "
    "
  },
  "
  "|
   

  "requester" : { Reference(Device|Organization|Practitioner|PractitionerRole) }, // Who/what is requesting diagnostics
  "performerType" : { CodeableConcept }, // Filler role
  "performer" : { Reference(CareTeam|Device|HealthcareService|Organization|
   Patient|Practitioner|PractitionerRole|RelatedPerson) }, // Requested Filler
  "reasonCode" : [{ CodeableConcept }], // Coded Reason for request
  "
  "

  "reasonReference" : [{ Reference(Condition|DiagnosticReport|
   DocumentReference|Observation) }], // Linked Reason for request
  "insurance" : [{ Reference(ClaimResponse|Coverage) }], // Associated insurance coverage
  "supportingInfo" : [{ Reference(Any) }], // Additional clinical information

  "note" : [{ Annotation }], // Notes or comments
  "relevantHistory" : [{ Reference(Provenance) }] // Request provenance
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco
[ a fhir:DeviceRequest;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root
  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:DeviceRequest.identifier [ Identifier ], ... ; # 0..* External Request identifier
  fhir:

  fhir:DeviceRequest.instantiatesCanonical [ canonical(ActivityDefinition|PlanDefinition) ], ... ; # 0..* Instantiates FHIR protocol or definition
  fhir:DeviceRequest.instantiatesUri [ uri ], ... ; # 0..* Instantiates external protocol or definition

  fhir:DeviceRequest.basedOn [ Reference(Any) ], ... ; # 0..* What request fulfills
  fhir:DeviceRequest.priorRequest [ Reference(Any) ], ... ; # 0..* What request replaces
  fhir:DeviceRequest.groupIdentifier [ Identifier ]; # 0..1 Identifier of composite request
  fhir:
  fhir:
  fhir:

  fhir:DeviceRequest.status [ code ]; # 0..1 draft | active | on-hold | revoked | completed | entered-in-error | unknown
  fhir:DeviceRequest.intent [ code ]; # 1..1 proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
  fhir:DeviceRequest.priority [ code ]; # 0..1 routine | urgent | asap | stat

  # DeviceRequest.code[x] : 1..1 Device requested. One of these 2
    fhir:DeviceRequest.codeReference [ Reference(Device) ]
    fhir:DeviceRequest.codeCodeableConcept [ CodeableConcept ]
  fhir:
  fhir:

  fhir:DeviceRequest.parameter [ # 0..* Device details
    fhir:DeviceRequest.parameter.code [ CodeableConcept ]; # 0..1 Device detail
    # DeviceRequest.parameter.value[x] : 0..1 Value of detail. One of these 4
      fhir:DeviceRequest.parameter.valueCodeableConcept [ CodeableConcept ]
      fhir:DeviceRequest.parameter.valueQuantity [ Quantity ]
      fhir:DeviceRequest.parameter.valueRange [ Range ]
      fhir:DeviceRequest.parameter.valueBoolean [ boolean ]
  ], ...;
  fhir:DeviceRequest.subject [ Reference(Device|Group|Location|Patient) ]; # 1..1 Focus of request
  fhir:DeviceRequest.encounter [ Reference(Encounter) ]; # 0..1 Encounter motivating request

  # DeviceRequest.occurrence[x] : 0..1 Desired time or schedule for use. One of these 3
    fhir:DeviceRequest.occurrenceDateTime [ dateTime ]
    fhir:DeviceRequest.occurrencePeriod [ Period ]
    fhir:DeviceRequest.occurrenceTiming [ Timing ]
  fhir:DeviceRequest.authoredOn [ dateTime ]; # 0..1 When recorded
  fhir:
    fhir:
    fhir:
  ];
  fhir:
  fhir:

  fhir:DeviceRequest.requester [ Reference(Device|Organization|Practitioner|PractitionerRole) ]; # 0..1 Who/what is requesting diagnostics
  fhir:DeviceRequest.performerType [ CodeableConcept ]; # 0..1 Filler role
  fhir:DeviceRequest.performer [ Reference(CareTeam|Device|HealthcareService|Organization|Patient|Practitioner|
  PractitionerRole|RelatedPerson) ]; # 0..1 Requested Filler
  fhir:DeviceRequest.reasonCode [ CodeableConcept ], ... ; # 0..* Coded Reason for request
  fhir:
  fhir:

  fhir:DeviceRequest.reasonReference [ Reference(Condition|DiagnosticReport|DocumentReference|Observation) ], ... ; # 0..* Linked Reason for request
  fhir:DeviceRequest.insurance [ Reference(ClaimResponse|Coverage) ], ... ; # 0..* Associated insurance coverage
  fhir:DeviceRequest.supportingInfo [ Reference(Any) ], ... ; # 0..* Additional clinical information

  fhir:DeviceRequest.note [ Annotation ], ... ; # 0..* Notes or comments
  fhir:DeviceRequest.relevantHistory [ Reference(Provenance) ], ... ; # 0..* Request provenance
]

Changes since DSTU2 Release 3

DeviceRequest DeviceRequest.definition Added Element DeviceRequest.basedOn Added Element DeviceRequest.priorRequest Added Element DeviceRequest.groupIdentifier Added Element
DeviceRequest.status
  • Change value set from http://hl7.org/fhir/ValueSet/device-use-request-status http://hl7.org/fhir/ValueSet/request-status|4.0.0 to http://hl7.org/fhir/ValueSet/request-status DeviceRequest.intent Added Element http://hl7.org/fhir/ValueSet/request-status|4.1.0
DeviceRequest.priority DeviceRequest.intent
  • Change value set from http://hl7.org/fhir/ValueSet/device-use-request-priority to http://hl7.org/fhir/ValueSet/request-priority Default Value "If missing, normal priority" added DeviceRequest.code[x] Added Element DeviceRequest.subject Add Reference(Group), Add Reference(Location), Add Reference(Device) DeviceRequest.context Renamed from encounter to context Add Reference(EpisodeOfCare) DeviceRequest.occurrence[x] Added Element DeviceRequest.authoredOn Added Element DeviceRequest.requester Added Element DeviceRequest.requester.agent Added Element DeviceRequest.requester.onBehalfOf Added Element DeviceRequest.performerType Added Element DeviceRequest.performer Added Element DeviceRequest.reasonCode Renamed from indication http://hl7.org/fhir/ValueSet/request-intent|4.0.0 to reasonCode DeviceRequest.reasonReference Added Element DeviceRequest.supportingInfo Added Element http://hl7.org/fhir/ValueSet/request-intent|4.1.0
DeviceRequest.note DeviceRequest.priority
  • Renamed from notes to note Type changed Change value set from string http://hl7.org/fhir/ValueSet/request-priority|4.0.0 to Annotation DeviceRequest.relevantHistory Added Element DeviceRequest.bodySite[x] deleted DeviceRequest.device deleted DeviceRequest.prnReason deleted DeviceRequest.orderedOn deleted DeviceRequest.recordedOn deleted DeviceRequest.timing[x] deleted http://hl7.org/fhir/ValueSet/request-priority|4.1.0

See the Full Difference for further information

This analysis is available as XML or JSON .

See R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. 2 fail round-trip testing and 1 r3 resources are invalid (0 errors). )

 

Alternate See the Profiles & Extensions and the alternate definitions: Master Definition ( XML , + JSON ), , XML Schema / Schematron (for ) + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis a

Path Definition Type Reference
DeviceRequest.status Codes representing the status of the request. Required RequestStatus
DeviceRequest.intent The kind of diagnostic request request. Required valueset-request-intent.html RequestIntent
DeviceRequest.priority Identifies the level of importance to be assigned to actioning the request request. Required RequestPriority
DeviceRequest.code[x] Codes for devices that can be requested requested. Example FHIR Device Types FHIRDeviceTypes
DeviceRequest.parameter.code A code that identifies the device detail. Unknown No details provided yet
DeviceRequest.performerType Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. Example Participant Roles ParticipantRoles
DeviceRequest.reasonCode Diagnosis or problem codes justifying the reason for requesting the device. Example Condition/Problem/Diagnosis Codes Condition/Problem/DiagnosisCodes

Notes to reviewers:

At this time, the code bindings are placeholders to be fleshed out upon further review by the community.

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
authored-on date When the request transitioned to being actionable DeviceRequest.authoredOn
based-on reference Plan/proposal/order fulfilled by this request DeviceRequest.basedOn
(Any)
code token Code for what is being requested/ordered DeviceRequest.code.as(CodeableConcept) (DeviceRequest.code as CodeableConcept) 8 13 Resources
definition reference Protocol or definition followed by this request DeviceRequest.definition ( PlanDefinition , ActivityDefinition ) device reference Reference to resource that is being requested/ordered DeviceRequest.code.as(Reference) (DeviceRequest.code as Reference)
( Device )
encounter reference Encounter or Episode during which request was created DeviceRequest.context DeviceRequest.encounter
( EpisodeOfCare , Encounter )
12 Resources
event-date date When service should occur DeviceRequest.occurrence.as(DateTime) (DeviceRequest.occurrence as dateTime) | DeviceRequest.occurrence.as(Period) (DeviceRequest.occurrence as Period)
group-identifier token Composite request this is part of DeviceRequest.groupIdentifier
identifier token Business identifier for request/order DeviceRequest.identifier 26 30 Resources
instantiates-canonical reference Instantiates FHIR protocol or definition DeviceRequest.instantiatesCanonical
( PlanDefinition , ActivityDefinition )
instantiates-uri uri Instantiates external protocol or definition DeviceRequest.instantiatesUri
insurance reference Associated insurance coverage DeviceRequest.insurance
( ClaimResponse , Coverage )
intent token proposal | plan | original-order |reflex-order DeviceRequest.intent
patient reference Individual the service is ordered for DeviceRequest.subject DeviceRequest.subject.where(resolve() is Patient)
( Patient )
31 33 Resources
performer reference Desired performer for service DeviceRequest.performer
( Practitioner , Organization , CareTeam , Device , Patient , HealthcareService , PractitionerRole , RelatedPerson )
priorrequest prior-request reference Request takes the place of referenced completed or terminated requests DeviceRequest.priorRequest
(Any)
requester reference Who/what is requesting service  service DeviceRequest.requester.agent DeviceRequest.requester
( Practitioner , Organization , Device , PractitionerRole )
status token entered-in-error | draft | active |suspended | completed  completed DeviceRequest.status
subject reference Individual the service is ordered for DeviceRequest.subject
( Group , Device , Patient , Location )