Introduction

The CommunicationRequest resource allows for change in the way eHealth automated processing creates Communication (of profile ehealth-message) as a result of a submitted measurement or lack thereof for a particular Patient and context.

Scope and Usage

In the eHealth Infrastructure, automated processing generates Communication (of profile ehealth-message) in the following cases:

• Automated processing has been performed on a submitted measurement - whether zero, one or more Communication are created depends on the automated processing rules involved.
• A measurement is missing, that is, expected measurement has not been submitted
• A measurement has been submitted at unexpected time

By default, the Communication is created with recipient set to the one or more CareTeam associated with the CarePlan referencing the ServiceRequest for which the measurement was made.

The CommunicationRequest is used to customize how and when Communications are created by automated processing:

• For a CareTeam, the CommunicationRequest specifies suppression of setting the CareTeam as recipient of Communication
• For a Patient, the CommunicationRequest specifies additional creation of Communication with the Patient as recipient

If multiple CommunicationRequests for the same recipient are found, then only the newest is considered valid.

Suppression of setting a CareTeam as recipient in Communication

When automated processing creates Communication about a specific ServiceRequest and Patient, the CareTeam is not set as recipient when a CommunicationRequest exists where:

• basedOn references the ServiceRequest
• recipient references the CareTeam
• reasonCode matches the Communication reasonCode (of the Communication created for CareTeam).
• priority matches the Task priority (of the Task created for CareTeam).
• status is ‘suspended’

Setting the status to any other value than ‘suspended’ disables the specified suppression of Communication with the CareTeam as recipient. The Communication is created with recipient set as the remaining one or more CareTeam referenced from the CarePlan referencing the ServiceRequest. In case no remaining CareTeam are referenced from the CarePlan, no Communication is created.

Creation of Communication with Patient as recipient

When automated processing creates Communication about a specific ServiceRequest and Patient, additional Communication with the Patient as recipient is created if a CommunicationRequest exists where:

• basedOn references the ServiceRequest
• recipient references the Patient
• reasonCode matches the Communication reasonCode (of the Communication created for CareTeam).
• priority matches the Task priority (of the Task created for CareTeam).
• status is ‘active’

Setting the status to ‘suspended’ disables the specified creation of Communication with the Patient as recipient.

Override medium and payload

It is possible to use CommunicationRequest to override some default values of the Communication:

• medium of the Communication (created for the Patient or Careteam) overrides the Communication medium (of the Communication created for CareTeam).
• payload of the Communication (created for the Patient) overrides the Communication payload (of the Communication created for CareTeam).

Boundaries and Relationships

A CommunicationRequest is related to Communication (ehealth-message), Task (ehealth-task), and ServiceRequest (ehealth-serviceRequest).

• Text Summary
• Differential Table
• Snapshot Table
• Snapshot Table (Must Support)
• All

This structure is derived from CommunicationRequest

Name	Flags	Card.	Type	Description & Constraints
CommunicationRequest		0..*	CommunicationRequest	A request for information to be sent to a receiver
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
workflow-episodeOfCare		1..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
basedOn		0..1	Reference(Resource)	Fulfills plan or proposal
category		0..*	CodeableConcept	Message category Binding: MessageCategory (required)
priority		0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required)
medium		0..*	CodeableConcept	A channel of communication Binding: MessageMedium (required)
subject		1..1	Reference(Patient)	Focus of message
recipient		0..*	Reference(Patient | CareTeam) {r}	Message recipient
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
CommunicationRequest		0..*	CommunicationRequest	A request for information to be sent to a receiver
id	Σ	0..1	string	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language.
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
workflow-episodeOfCare		1..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Unique identifier
basedOn	Σ	0..1	Reference(Resource)	Fulfills plan or proposal
replaces	Σ	0..*	Reference(CommunicationRequest)	Request(s) replaced by this request
groupIdentifier	Σ	0..1	Identifier	Composite request this is part of
status	?!Σ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request.
statusReason		0..1	CodeableConcept	Reason for current status Binding: (unbound) (example): Codes identifying the reason for the current state of a request.
category		0..*	CodeableConcept	Message category Binding: MessageCategory (required)
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required)
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
medium		0..*	CodeableConcept	A channel of communication Binding: MessageMedium (required)
subject		1..1	Reference(Patient)	Focus of message
about		0..*	Reference(Resource)	Resources that pertain to this communication request
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
payload		0..*	BackboneElement	Message payload
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]		1..1		Message part content
contentString			string
contentAttachment			Attachment
contentReference			Reference(Resource)
occurrence[x]	Σ	0..1		When scheduled
occurrenceDateTime			dateTime
occurrencePeriod			Period
authoredOn	Σ	0..1	dateTime	When request transitioned to being actionable
requester	Σ	0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Who/what is requesting service
recipient		0..*	Reference(Patient | CareTeam) {r}	Message recipient
sender	Σ	0..1	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService)	Message sender
reasonCode	Σ	0..*	CodeableConcept	Why is communication needed? Binding: v3 Code System ActReason (example): Codes for describing reasons for the occurrence of a communication.
reasonReference	Σ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Why is communication needed?
note		0..*	Annotation	Comments made about communication request
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
CommunicationRequest		0..*	CommunicationRequest	A request for information to be sent to a receiver
Documentation for this format

This structure is derived from CommunicationRequest

Summary

Mandatory: 3 elements

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare

Differential View

This structure is derived from CommunicationRequest

Name	Flags	Card.	Type	Description & Constraints
CommunicationRequest		0..*	CommunicationRequest	A request for information to be sent to a receiver
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
workflow-episodeOfCare		1..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
basedOn		0..1	Reference(Resource)	Fulfills plan or proposal
category		0..*	CodeableConcept	Message category Binding: MessageCategory (required)
priority		0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required)
medium		0..*	CodeableConcept	A channel of communication Binding: MessageMedium (required)
subject		1..1	Reference(Patient)	Focus of message
recipient		0..*	Reference(Patient | CareTeam) {r}	Message recipient
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
CommunicationRequest		0..*	CommunicationRequest	A request for information to be sent to a receiver
id	Σ	0..1	string	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language.
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
workflow-episodeOfCare		1..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Unique identifier
basedOn	Σ	0..1	Reference(Resource)	Fulfills plan or proposal
replaces	Σ	0..*	Reference(CommunicationRequest)	Request(s) replaced by this request
groupIdentifier	Σ	0..1	Identifier	Composite request this is part of
status	?!Σ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request.
statusReason		0..1	CodeableConcept	Reason for current status Binding: (unbound) (example): Codes identifying the reason for the current state of a request.
category		0..*	CodeableConcept	Message category Binding: MessageCategory (required)
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required)
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
medium		0..*	CodeableConcept	A channel of communication Binding: MessageMedium (required)
subject		1..1	Reference(Patient)	Focus of message
about		0..*	Reference(Resource)	Resources that pertain to this communication request
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
payload		0..*	BackboneElement	Message payload
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]		1..1		Message part content
contentString			string
contentAttachment			Attachment
contentReference			Reference(Resource)
occurrence[x]	Σ	0..1		When scheduled
occurrenceDateTime			dateTime
occurrencePeriod			Period
authoredOn	Σ	0..1	dateTime	When request transitioned to being actionable
requester	Σ	0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Who/what is requesting service
recipient		0..*	Reference(Patient | CareTeam) {r}	Message recipient
sender	Σ	0..1	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService)	Message sender
reasonCode	Σ	0..*	CodeableConcept	Why is communication needed? Binding: v3 Code System ActReason (example): Codes for describing reasons for the occurrence of a communication.
reasonReference	Σ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Why is communication needed?
note		0..*	Annotation	Comments made about communication request
Documentation for this format