ServiceRequest - FHIR v4.0.1 (2024)

This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU) in it's permanent home (it will always be available at this URL). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions ServiceRequest - FHIR v4.0.1 (1). Page versions: R5 R4B R4

A record of a request for service such as diagnostic investigations, treatments, or operations to be performed.

12.14.1 Scope and Usage

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

ServiceRequest is a record of a request for a procedure or diagnostic or other service to be planned, proposed, or performed, as distinguished by the ServiceRequest.intent field value, with or on a patient. The procedure will lead to either a Procedure or DiagnosticReport, which in turn may reference one or more Observations, which summarize the performance of the procedures and associated documentation such as observations, images, findings that are relevant to the treatment/management of the subject. This resource may be used to share relevant information required to support a referral or a transfer of care request from onepractitioner or organization to another when a patient is required to be referred to another provider for aconsultation/second opinion and/or for short term or longer term management of one or more health issues or problems.

Examples include:

  • diagnostic tests/studies
  • endoscopic procedures
  • counseling
  • biopsies
  • therapies (e.g., physio-, social-, psychological-)
  • (exploratory) surgeries or procedures
  • exercises
  • specialist consultation and assessments
  • community services
  • nursing services
  • pharmacist medication review, and
  • other clinical interventions.

Procedures may be performed by a healthcare professional, a friend or relative or in some cases by the patient themselves.

The principal intention of ServiceRequest is to support ordering procedures for one patient (which includes non-human patients in veterinary medicine). However, in many contexts, healthcare related processes include performing diagnostic investigations on groups of subjects, devices involved in the provision of healthcare, and even environmental locations such as ducts, bodies of water, etc. ServiceRequest supports all these usages. The service request may represent an order that is entered by a practitioner in a CPOE system as well as a proposal made by a clinical decision support (CDS) system based on a patient's clinical record and context of care. Planned procedures referenced by a CarePlan may also be represented by this resource.

The general work flow that this resource facilitates is that a clinical system creates a service request. The service request is then accessed by or exchanged with a system, perhaps via intermediaries, that represents an organization (e.g., diagnostic or imaging service, surgical team, physical therapy department) that can perform the procedure. The organization receiving the service request will, after it accepts the request, update the request as the work is performed, and then finally issue a report that references the requests that it fulfilled.

The ServiceRequest resource allows requesting only a single procedure. If a workflow requires requesting multiple procedures simultaneously, this is done using multiple instances of this resource. These instances can be linked in different ways, depending on the needs of the workflow. For guidance, refer to the Request pattern

12.14.2 Boundaries and Relationships

ServiceRequest is a record of a proposal/plan or order for a service to be performed that would result in a Procedure, Observation, DiagnosticReport, ImagingStudy or similar resource. In contrast to ServiceRequest, Task which spans both intent and event and tracks the execution through to completion and is intended for "administrative" actions like requesting and tracking things to be done to a record, or keeping track of a checklist of steps such to be performed as part of a fulfilment process. A ServiceRequest can be higher-level authorization that triggered the creation of Task, or it can be the "request" resource Task is seeking to fulfill.

ServiceRequest and CommunicationRequest are related. A CommunicationRequest is a request to merely disclose information. Whereas a ServiceRequest would be used to request information as part of training or counseling - i.e. when the process will involve verification of the patient's comprehension or an attempt to change the patient's mental state. In some workflows both may exist. For example, upon receiving a CommunicationRequest a practitioner might initiate a ServiceRequest.

PathDefinitionTypeReference ServiceRequest.status The status of a service order.RequiredRequestStatus ServiceRequest.intent The kind of service request.RequiredRequestIntent ServiceRequest.category Classification of the requested service.ExampleServiceRequestCategoryCodes ServiceRequest.priority Identifies the level of importance to be assigned to actioning the request.RequiredRequestPriority ServiceRequest.code Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is (preferred)[http://build.fhir.org/terminologies.html#preferred] and a valueset using LOINC Order codes is available [here](valueset-diagnostic-requests.html).ExampleProcedureCodes(SNOMEDCT) ServiceRequest.orderDetail Codified order entry details which are based on order context.ExampleServiceRequestOrderDetailsCodes ServiceRequest.asNeeded[x] A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.ExampleSNOMEDCTMedicationAsNeededReasonCodes ServiceRequest.performerType Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.ExampleParticipantRoles ServiceRequest.locationCode A location type where services are delivered.Examplev3.ServiceDeliveryLocationRoleType ServiceRequest.reasonCode Diagnosis or problem codes justifying the reason for requesting the service investigation.ExampleProcedureReasonCodes ServiceRequest.bodySite Codes describing anatomical locations. May include laterality.ExampleSNOMEDCTBodyStructures

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

NameTypeDescriptionExpressionIn Common authoreddateDate request signedServiceRequest.authoredOn based-onreferenceWhat request fulfillsServiceRequest.basedOn
(CarePlan, MedicationRequest, ServiceRequest) body-sitetokenWhere procedure is going to be doneServiceRequest.bodySite categorytokenClassification of serviceServiceRequest.category codetokenWhat is being requested/orderedServiceRequest.code13 Resources encounterreferenceAn encounter in which this request is madeServiceRequest.encounter
(Encounter)11 Resources identifiertokenIdentifiers assigned to this orderServiceRequest.identifier29 Resources instantiates-canonicalreferenceInstantiates FHIR protocol or definitionServiceRequest.instantiatesCanonical
(PlanDefinition, ActivityDefinition) instantiates-uriuriInstantiates external protocol or definitionServiceRequest.instantiatesUri intenttokenproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | optionServiceRequest.intent occurrencedateWhen service should occurServiceRequest.occurrence patientreferenceSearch by subject - a patientServiceRequest.subject.where(resolve() is Patient)
(Patient)32 Resources performerreferenceRequested performerServiceRequest.performer
(Practitioner, Organization, CareTeam, Device, Patient, HealthcareService, PractitionerRole, RelatedPerson) performer-typetokenPerformer roleServiceRequest.performerType prioritytokenroutine | urgent | asap | statServiceRequest.priority replacesreferenceWhat request replacesServiceRequest.replaces
(ServiceRequest) requesterreferenceWho/what is requesting serviceServiceRequest.requester
(Practitioner, Organization, Device, Patient, PractitionerRole, RelatedPerson) requisitiontokenComposite Request IDServiceRequest.requisition specimenreferenceSpecimen to be testedServiceRequest.specimen
(Specimen) statustokendraft | active | on-hold | revoked | completed | entered-in-error | unknownServiceRequest.status subjectreferenceSearch by subjectServiceRequest.subject
(Group, Device, Patient, Location)
ServiceRequest - FHIR v4.0.1 (2024)

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