eHealth Infrastructure (v2021.2)

StructureDefinition: ehealth-communication-request - Detailed Descriptions

Definitions for the ehealth-communication-request Profile.

1. 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.

Control0..*
InvariantsDefined on this element
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (: contained.text.empty())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (: contained.where(('#'+id in %resource.descendants().reference).not()).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())
2. CommunicationRequest.id
Definition

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

Control0..1
Typeid
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.

3. CommunicationRequest.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

Control0..1
TypeMeta
4. CommunicationRequest.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.

Control0..1
Typeuri
Is Modifiertrue
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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

5. CommunicationRequest.language
Definition

The base language in which the resource is written.

Control0..1
BindingThe codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
Max Binding: All Languages A human language.

Typecode
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).

6. CommunicationRequest.text
Definition

A human-readable narrative that contains a summary of the resource, and may 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.

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
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 in formation is added later.

7. CommunicationRequest.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.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained 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.

8. CommunicationRequest.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

9. CommunicationRequest.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. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content
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.

10. CommunicationRequest.identifier
Definition

A unique ID of this 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 the source system.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
11. CommunicationRequest.basedOn
Definition

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

Control0..1
TypeReference(ProcedureRequest)
Requirements

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

Alternate Namesfulfills
12. CommunicationRequest.replaces
Definition

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

Control0..*
TypeReference(CommunicationRequest)
Requirements

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

Alternate Namessupersedes, prior
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.

13. 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.

Control0..1
TypeIdentifier
Alternate NamesgrouperId
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.

14. CommunicationRequest.status
Definition

The status of the proposal or order.

Control1..1
BindingThe codes SHALL be taken from RequestStatus The status of the communication request.

Typecode
Is Modifiertrue
Comments

This element is labeled as a modifier because the status contains the codes cancelled and entered-in-error that mark the request as not currently valid.

15. CommunicationRequest.category
Definition

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

Control0..*
BindingFor example codes, see MessageCategory
TypeCodeableConcept
Comments

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

16. CommunicationRequest.priority
Definition

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

Control0..1
BindingThe codes SHALL be taken from RequestPriority
Typecode
Meaning if MissingIf missing, this task should be performed with normal priority
17. CommunicationRequest.medium
Definition

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

Control0..*
BindingFor example codes, see MessageMedium
TypeCodeableConcept
18. CommunicationRequest.subject
Definition

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

Control1..1
TypeReference(Patient)
Alternate Namespatient
19. 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.

Control0..*
TypeReference(Patient | CareTeam)
20. CommunicationRequest.topic
Definition

The resources which were related to producing this communication request.

Control0..*
TypeReference(Resource)
21. CommunicationRequest.context
Definition

The encounter or episode of care within which the communication request was created.

Control1..1
TypeReference(EpisodeOfCare)
Alternate Namesencounter
22. CommunicationRequest.payload
Definition

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

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
23. CommunicationRequest.payload.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
24. CommunicationRequest.payload.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

25. CommunicationRequest.payload.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

26. CommunicationRequest.payload.content[x]
Definition

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

Control1..1
TypeChoice of: string, Attachment, Reference(Resource)
[x] NoteSee Choice of Data Types for further information about how to use [x]
27. CommunicationRequest.occurrence[x]
Definition

The time when this communication is to occur.

Control0..1
TypeChoice of: dateTime, Period
[x] NoteSee Choice of Data Types for further information about how to use [x]
Alternate Namestiming
28. CommunicationRequest.authoredOn
Definition

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

Control0..1
TypedateTime
Alternate NamescreatedOn
29. CommunicationRequest.sender
Definition

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

Control0..1
TypeReference(Device | Organization | Patient | Practitioner | RelatedPerson)
30. CommunicationRequest.requester
Definition

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

Control0..1
TypeBackboneElement
Alternate Namesauthor
InvariantsDefined on this element
cmr-1: onBehalfOf can only be specified if agent is practitioner or device (: (agent.resolve() is Practitioner) or (agent.resolve() is Device) or onBehalfOf.exists().not())
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
31. CommunicationRequest.requester.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
32. CommunicationRequest.requester.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

33. CommunicationRequest.requester.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

34. CommunicationRequest.requester.agent
Definition

The device, practitioner, etc. who initiated the request.

Control1..1
TypeReference(Practitioner | Organization | Patient | RelatedPerson | Device)
35. CommunicationRequest.requester.onBehalfOf
Definition

The organization the device or practitioner was acting on behalf of.

Control0..1 This element is affected by the following invariants: cmr-1
TypeReference(Organization)
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.

36. CommunicationRequest.reasonCode
Definition

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

Control0..*
BindingFor example codes, see ActReason Codes for describing reasons for the occurrence of a communication.

TypeCodeableConcept
Comments

Textual reasons can be caprued using reasonCode.text.

37. CommunicationRequest.reasonReference
Definition

Indicates another resource whose existence justifies this request.

Control0..*
TypeReference(Condition | Observation)
38. CommunicationRequest.note
Definition

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

Control0..*
TypeAnnotation