Care Coordination and 360 Referrals (Proof of Concept)
0.1.0 - proof-of-concept
Care Coordination and 360 Referrals (Proof of Concept)
0.1.0 - proof-of-concept
Care Coordination and 360 Referrals (Proof of Concept) - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Official URL: https://fhir.acmeexample.org.uk/PatientCareCoordination/StructureDefinition/ReferralRequest | Version: 0.1.0 | ||||
| Draft as of 2026-11-03 | Computable Name: ReferralRequest | ||||
Referral - the request from the Referral Initiator to the Referral Recipient
(Referral Request [PCC-55]). Equivalent to HL7 v2 OMG^O19 (360X) or
REF_I12 and the eRS ServiceRequest; BaRS referrals are mapped onto it (see
BaRS). Also used
for referrals to a virtual ward.
Equivalent FDP Canonical Data Model (CDM) v1.0.0 objects: Referral, UEC Referral, eRS Service.
Differences:
referralId, sourceUniqueId and ubrn carry no identifier type or assigning organisation, so the Referral Initiator's (placer) Referral ID is not distinguished - this profile slices identifier into the Referral ID (PLAC, assigner ODS) and UBRN.referralLetterContent, referralLetterRid) and notes; this profile references structured information and forms (supportingInfo, reasonReference).basedOn / replaces; redirection is triage outcome text.status); this guide keeps it on the Referral Task.presentingComplaintSnomedCtCode, primaryReferralReasonCode), priority, referrer and provider ODS codes, treatment function, booking dates.The CDM is a downstream persistence model, used here as evidence of what NHS operations record, not as a design source. Mapping by property name - To confirm. See FDP Canonical Data Model Mapping for the full mapping.
Usages:
You can also check for usages in the FHIR IG Statistics
Description Differentials, Snapshots, and other representations.
| Name | Flags | Card. | Type | Description & Constraints Filter:  |
|---|---|---|---|---|
  ServiceRequest |
C | 0..* | ServiceRequest | A request for a service to be performed Constraints: prr-1 |
  implicitRules |
0..1 | uri | A set of rules under which this content was created | |
 modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |
  Slices for identifier |
1..* | Identifier | Identifiers assigned to this order Slice: Unordered, Open by profile:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
   identifier:referralId |
1..1 | ReferralIdentifier | Referral ID assigned by the Referral Initiator (ORC-2 / OBR-2) | |
 identifier:ubrn |
0..1 | UniqueBookingReferenceNumber | eRS Unique Booking Reference Number, if referred through eRS | |
 basedOn |
0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | The care plan this referral carries out (Dynamic Care Planning) | |
| replaces |
0..* | Reference(ServiceRequest) | A declined or cancelled referral this one replaces (a new referral needs a new Referral ID) | |
| status |
1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order. | |
| intent |
1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Fixed Value: order (no extensions allowed) | |
 category |
1..* | CodeableConcept | Classification of service Binding: Referral Category (extensible) | |
| priority |
0..1 | code | routine | urgent | asap | stat - see NHS mapping on the PCC-55 page Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request. | |
| doNotPerform |
0..1 | boolean | True if service/procedure should not be performed | |
| code |
1..1 | CodeableConcept | Service referred to (eRS specialty / clinic type, or a SNOMED CT referral procedure) Binding: Referral Service Type (extensible) | |
| subject |
1..1 | Reference(Patient) | Individual or Entity the service is ordered for | |
 identifier |
0..1 | NHSIdentifier | Logical reference, when literal reference is not known | |
| encounter |
0..1 | Reference(Encounter) | The encounter in which the referral was made | |
 occurrence[x] |
0..1 | When the service should be provided - TQ1-8 expected service provision time; a Period for the referral's validity (TQ1-6) | ||
| occurrenceDateTime |
dateTime | |||
| occurrencePeriod |
Period | |||
| occurrenceTiming |
Timing | |||
| authoredOn |
1..1 | dateTime | Date request signed | |
| requester |
1..1 | Reference(PractitionerRole | Practitioner | Organization) | Referring clinician (ORC-12 / OBR-16) - the Referral Initiator | |
| performer |
0..* | Reference(PractitionerRole | Organization | HealthcareService) | Service or clinician referred to - the Referral Recipient | |
| reasonCode |
0..* | CodeableConcept | Reason(s) for referral (OBR-31) Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation. | |
| reasonReference |
0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | Explanation/Justification for service or service | |
| supportingInfo |
0..* | Reference(Resource) | Clinical information: referral form (QuestionnaireResponse), observations, referral letter, FHIR Document, results | |
| note |
0..* | Annotation | Referral question - the clinical question for the Referral Recipient (OBX with OBX-29 QST) | |
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| ServiceRequest.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std. |
| ServiceRequest.intent | Base | required | RequestIntent | 📍4.0.1 | FHIR Std. |
| ServiceRequest.category | Base | extensible | Referral Category | 📦0.1.0 | This IG |
| ServiceRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std. |
| ServiceRequest.code | Base | extensible | Referral Service Type | 📦0.1.0 | This IG |
| ServiceRequest.reasonCode | Base | example | Procedure Reason Codes | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | ServiceRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | ServiceRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
|
| dom-4 | error | ServiceRequest | 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()
|
| dom-5 | error | ServiceRequest | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | ServiceRequest | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| prr-1 | error | ServiceRequest | orderDetail SHALL only be present if code is present |
orderDetail.empty() or code.exists()
|
This structure is derived from ServiceRequest
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| ServiceRequest |
0..* | ServiceRequest | A request for a service to be performed | |
| Slices for identifier |
1..* | Identifier | Identifiers assigned to this order Slice: Unordered, Open by profile:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| identifier:referralId |
1..1 | ReferralIdentifier | Referral ID assigned by the Referral Initiator (ORC-2 / OBR-2) | |
| identifier:ubrn |
0..1 | UniqueBookingReferenceNumber | eRS Unique Booking Reference Number, if referred through eRS | |
 basedOn |
0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | The care plan this referral carries out (Dynamic Care Planning) | |
| replaces |
0..* | Reference(ServiceRequest) | A declined or cancelled referral this one replaces (a new referral needs a new Referral ID) | |
| status |
1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown | |
| intent |
1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Fixed Value: order (no extensions allowed) | |
| category |
1..* | CodeableConcept | Classification of service Binding: Referral Category (extensible) | |
| priority |
0..1 | code | routine | urgent | asap | stat - see NHS mapping on the PCC-55 page | |
| code |
1..1 | CodeableConcept | Service referred to (eRS specialty / clinic type, or a SNOMED CT referral procedure) Binding: Referral Service Type (extensible) | |
| subject |
1..1 | Reference(Patient) | Individual or Entity the service is ordered for | |
| identifier |
0..1 | NHSIdentifier | Logical reference, when literal reference is not known | |
| encounter |
0..1 | Reference(Encounter) | The encounter in which the referral was made | |
| occurrence[x] |
0..1 | dateTime, Period, Timing | When the service should be provided - TQ1-8 expected service provision time; a Period for the referral's validity (TQ1-6) | |
| authoredOn |
1..1 | dateTime | Date request signed | |
| requester |
1..1 | Reference(PractitionerRole | Practitioner | Organization) | Referring clinician (ORC-12 / OBR-16) - the Referral Initiator | |
| performer |
0..* | Reference(PractitionerRole | Organization | HealthcareService) | Service or clinician referred to - the Referral Recipient | |
| reasonCode |
0..* | CodeableConcept | Reason(s) for referral (OBR-31) | |
| reasonReference |
0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | Explanation/Justification for service or service | |
| supportingInfo |
0..* | Reference(Resource) | Clinical information: referral form (QuestionnaireResponse), observations, referral letter, FHIR Document, results | |
| note |
0..* | Annotation | Referral question - the clinical question for the Referral Recipient (OBX with OBX-29 QST) | |
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| ServiceRequest.category | Base | extensible | Referral Category | 📦0.1.0 | This IG |
| ServiceRequest.code | Base | extensible | Referral Service Type | 📦0.1.0 | This IG |
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| ServiceRequest |
C | 0..* | ServiceRequest | A request for a service to be performed Constraints: prr-1 | ||||
| id |
0..1 | id | Logical id of this artifact | |||||
| meta |
0..1 | Meta | Metadata about the resource | |||||
| implicitRules |
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): A human language.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
 extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |||||
| Slices for identifier |
1..* | Identifier | Identifiers assigned to this order Slice: Unordered, Open by profile:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| identifier:referralId |
1..1 | ReferralIdentifier | Referral ID assigned by the Referral Initiator (ORC-2 / OBR-2) | |||||
| identifier:ubrn |
0..1 | UniqueBookingReferenceNumber | eRS Unique Booking Reference Number, if referred through eRS | |||||
| instantiatesCanonical |
0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition | |||||
| instantiatesUri |
0..* | uri | Instantiates external protocol or definition | |||||
| basedOn |
0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | The care plan this referral carries out (Dynamic Care Planning) | |||||
| replaces |
0..* | Reference(ServiceRequest) | A declined or cancelled referral this one replaces (a new referral needs a new Referral ID) | |||||
| requisition |
0..1 | Identifier | Composite Request ID | |||||
| status |
1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order. | |||||
| intent |
1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Fixed Value: order (no extensions allowed) | |||||
| category |
1..* | CodeableConcept | Classification of service Binding: Referral Category (extensible) | |||||
| priority |
0..1 | code | routine | urgent | asap | stat - see NHS mapping on the PCC-55 page Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request. | |||||
| doNotPerform |
0..1 | boolean | True if service/procedure should not be performed | |||||
| code |
1..1 | CodeableConcept | Service referred to (eRS specialty / clinic type, or a SNOMED CT referral procedure) Binding: Referral Service Type (extensible) | |||||
| orderDetail |
C | 0..* | CodeableConcept | Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context. | ||||
| quantity[x] |
0..1 | Service amount | ||||||
| quantityQuantity |
Quantity | |||||||
| quantityRatio |
Ratio | |||||||
| quantityRange |
Range | |||||||
| subject |
1..1 | Reference(Patient) | Individual or Entity the service is ordered for | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| reference |
C | 0..1 | string | Literal reference, Relative, internal or absolute URL | ||||
| type |
0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | |||||
| identifier |
0..1 | NHSIdentifier | Logical reference, when literal reference is not known | |||||
| display |
0..1 | string | Text alternative for the resource | |||||
| encounter |
0..1 | Reference(Encounter) | The encounter in which the referral was made | |||||
| occurrence[x] |
0..1 | When the service should be provided - TQ1-8 expected service provision time; a Period for the referral's validity (TQ1-6) | ||||||
| occurrenceDateTime |
dateTime | |||||||
| occurrencePeriod |
Period | |||||||
| occurrenceTiming |
Timing | |||||||
| asNeeded[x] |
0..1 | Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. | ||||||
| asNeededBoolean |
boolean | |||||||
| asNeededCodeableConcept |
CodeableConcept | |||||||
| authoredOn |
1..1 | dateTime | Date request signed | |||||
| requester |
1..1 | Reference(PractitionerRole | Practitioner | Organization) | Referring clinician (ORC-12 / OBR-16) - the Referral Initiator | |||||
| performerType |
0..1 | CodeableConcept | Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. | |||||
| performer |
0..* | Reference(PractitionerRole | Organization | HealthcareService) | Service or clinician referred to - the Referral Recipient | |||||
| locationCode |
0..* | CodeableConcept | Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered. | |||||
| locationReference |
0..* | Reference(Location) | Requested location | |||||
| reasonCode |
0..* | CodeableConcept | Reason(s) for referral (OBR-31) Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation. | |||||
| reasonReference |
0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | Explanation/Justification for service or service | |||||
| insurance |
0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage | |||||
| supportingInfo |
0..* | Reference(Resource) | Clinical information: referral form (QuestionnaireResponse), observations, referral letter, FHIR Document, results | |||||
| specimen |
0..* | Reference(Specimen) | Procedure Samples | |||||
| bodySite |
0..* | CodeableConcept | Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. | |||||
| note |
0..* | Annotation | Referral question - the clinical question for the Referral Recipient (OBX with OBX-29 QST) | |||||
| patientInstruction |
0..1 | string | Patient or consumer-oriented instructions | |||||
| relevantHistory |
0..* | Reference(Provenance) | Request provenance | |||||
| Documentation for this format | ||||||||
| Path | Status | Usage | ValueSet | Version | Source |
| ServiceRequest.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| ServiceRequest.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std. |
| ServiceRequest.intent | Base | required | RequestIntent | 📍4.0.1 | FHIR Std. |
| ServiceRequest.category | Base | extensible | Referral Category | 📦0.1.0 | This IG |
| ServiceRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std. |
| ServiceRequest.code | Base | extensible | Referral Service Type | 📦0.1.0 | This IG |
| ServiceRequest.orderDetail | Base | example | Service Request Order Details Codes | 📍4.0.1 | FHIR Std. |
| ServiceRequest.subject.type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std. |
| ServiceRequest.asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std. |
| ServiceRequest.performerType | Base | example | Participant Roles | 📍4.0.1 | FHIR Std. |
| ServiceRequest.locationCode | Base | example | ServiceDeliveryLocationRoleType | 📦3.0.0 | THO v7.5 |
| ServiceRequest.reasonCode | Base | example | Procedure Reason Codes | 📍4.0.1 | FHIR Std. |
| ServiceRequest.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | ServiceRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | ServiceRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
|
| dom-4 | error | ServiceRequest | 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()
|
| dom-5 | error | ServiceRequest | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | ServiceRequest | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| prr-1 | error | ServiceRequest | orderDetail SHALL only be present if code is present |
orderDetail.empty() or code.exists()
|
This structure is derived from ServiceRequest
Summary
Mandatory: 6 elements
Must-Support: 19 elements
Fixed: 1 element
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| ServiceRequest |
C | 0..* | ServiceRequest | A request for a service to be performed Constraints: prr-1 |
| implicitRules |
0..1 | uri | A set of rules under which this content was created | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |
| Slices for identifier |
1..* | Identifier | Identifiers assigned to this order Slice: Unordered, Open by profile:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| identifier:referralId |
1..1 | ReferralIdentifier | Referral ID assigned by the Referral Initiator (ORC-2 / OBR-2) | |
| identifier:ubrn |
0..1 | UniqueBookingReferenceNumber | eRS Unique Booking Reference Number, if referred through eRS | |
| basedOn |
0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | The care plan this referral carries out (Dynamic Care Planning) | |
| replaces |
0..* | Reference(ServiceRequest) | A declined or cancelled referral this one replaces (a new referral needs a new Referral ID) | |
| status |
1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order. | |
| intent |
1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Fixed Value: order (no extensions allowed) | |
| category |
1..* | CodeableConcept | Classification of service Binding: Referral Category (extensible) | |
| priority |
0..1 | code | routine | urgent | asap | stat - see NHS mapping on the PCC-55 page Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request. | |
| doNotPerform |
0..1 | boolean | True if service/procedure should not be performed | |
| code |
1..1 | CodeableConcept | Service referred to (eRS specialty / clinic type, or a SNOMED CT referral procedure) Binding: Referral Service Type (extensible) | |
| subject |
1..1 | Reference(Patient) | Individual or Entity the service is ordered for | |
| identifier |
0..1 | NHSIdentifier | Logical reference, when literal reference is not known | |
| encounter |
0..1 | Reference(Encounter) | The encounter in which the referral was made | |
| occurrence[x] |
0..1 | When the service should be provided - TQ1-8 expected service provision time; a Period for the referral's validity (TQ1-6) | ||
| occurrenceDateTime |
dateTime | |||
| occurrencePeriod |
Period | |||
| occurrenceTiming |
Timing | |||
| authoredOn |
1..1 | dateTime | Date request signed | |
| requester |
1..1 | Reference(PractitionerRole | Practitioner | Organization) | Referring clinician (ORC-12 / OBR-16) - the Referral Initiator | |
| performer |
0..* | Reference(PractitionerRole | Organization | HealthcareService) | Service or clinician referred to - the Referral Recipient | |
| reasonCode |
0..* | CodeableConcept | Reason(s) for referral (OBR-31) Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation. | |
| reasonReference |
0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | Explanation/Justification for service or service | |
| supportingInfo |
0..* | Reference(Resource) | Clinical information: referral form (QuestionnaireResponse), observations, referral letter, FHIR Document, results | |
| note |
0..* | Annotation | Referral question - the clinical question for the Referral Recipient (OBX with OBX-29 QST) | |
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| ServiceRequest.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std. |
| ServiceRequest.intent | Base | required | RequestIntent | 📍4.0.1 | FHIR Std. |
| ServiceRequest.category | Base | extensible | Referral Category | 📦0.1.0 | This IG |
| ServiceRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std. |
| ServiceRequest.code | Base | extensible | Referral Service Type | 📦0.1.0 | This IG |
| ServiceRequest.reasonCode | Base | example | Procedure Reason Codes | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | ServiceRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | ServiceRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
|
| dom-4 | error | ServiceRequest | 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()
|
| dom-5 | error | ServiceRequest | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | ServiceRequest | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| prr-1 | error | ServiceRequest | orderDetail SHALL only be present if code is present |
orderDetail.empty() or code.exists()
|
Differential View
This structure is derived from ServiceRequest
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| ServiceRequest |
0..* | ServiceRequest | A request for a service to be performed | |
| Slices for identifier |
1..* | Identifier | Identifiers assigned to this order Slice: Unordered, Open by profile:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| identifier:referralId |
1..1 | ReferralIdentifier | Referral ID assigned by the Referral Initiator (ORC-2 / OBR-2) | |
| identifier:ubrn |
0..1 | UniqueBookingReferenceNumber | eRS Unique Booking Reference Number, if referred through eRS | |
| basedOn |
0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | The care plan this referral carries out (Dynamic Care Planning) | |
| replaces |
0..* | Reference(ServiceRequest) | A declined or cancelled referral this one replaces (a new referral needs a new Referral ID) | |
| status |
1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown | |
| intent |
1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Fixed Value: order (no extensions allowed) | |
| category |
1..* | CodeableConcept | Classification of service Binding: Referral Category (extensible) | |
| priority |
0..1 | code | routine | urgent | asap | stat - see NHS mapping on the PCC-55 page | |
| code |
1..1 | CodeableConcept | Service referred to (eRS specialty / clinic type, or a SNOMED CT referral procedure) Binding: Referral Service Type (extensible) | |
| subject |
1..1 | Reference(Patient) | Individual or Entity the service is ordered for | |
| identifier |
0..1 | NHSIdentifier | Logical reference, when literal reference is not known | |
| encounter |
0..1 | Reference(Encounter) | The encounter in which the referral was made | |
| occurrence[x] |
0..1 | dateTime, Period, Timing | When the service should be provided - TQ1-8 expected service provision time; a Period for the referral's validity (TQ1-6) | |
| authoredOn |
1..1 | dateTime | Date request signed | |
| requester |
1..1 | Reference(PractitionerRole | Practitioner | Organization) | Referring clinician (ORC-12 / OBR-16) - the Referral Initiator | |
| performer |
0..* | Reference(PractitionerRole | Organization | HealthcareService) | Service or clinician referred to - the Referral Recipient | |
| reasonCode |
0..* | CodeableConcept | Reason(s) for referral (OBR-31) | |
| reasonReference |
0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | Explanation/Justification for service or service | |
| supportingInfo |
0..* | Reference(Resource) | Clinical information: referral form (QuestionnaireResponse), observations, referral letter, FHIR Document, results | |
| note |
0..* | Annotation | Referral question - the clinical question for the Referral Recipient (OBX with OBX-29 QST) | |
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| ServiceRequest.category | Base | extensible | Referral Category | 📦0.1.0 | This IG |
| ServiceRequest.code | Base | extensible | Referral Service Type | 📦0.1.0 | This IG |
Snapshot ViewView
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| ServiceRequest |
C | 0..* | ServiceRequest | A request for a service to be performed Constraints: prr-1 | ||||
| id |
0..1 | id | Logical id of this artifact | |||||
| meta |
0..1 | Meta | Metadata about the resource | |||||
| implicitRules |
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): A human language.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |||||
| Slices for identifier |
1..* | Identifier | Identifiers assigned to this order Slice: Unordered, Open by profile:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| identifier:referralId |
1..1 | ReferralIdentifier | Referral ID assigned by the Referral Initiator (ORC-2 / OBR-2) | |||||
| identifier:ubrn |
0..1 | UniqueBookingReferenceNumber | eRS Unique Booking Reference Number, if referred through eRS | |||||
| instantiatesCanonical |
0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition | |||||
| instantiatesUri |
0..* | uri | Instantiates external protocol or definition | |||||
| basedOn |
0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | The care plan this referral carries out (Dynamic Care Planning) | |||||
| replaces |
0..* | Reference(ServiceRequest) | A declined or cancelled referral this one replaces (a new referral needs a new Referral ID) | |||||
| requisition |
0..1 | Identifier | Composite Request ID | |||||
| status |
1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order. | |||||
| intent |
1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Fixed Value: order (no extensions allowed) | |||||
| category |
1..* | CodeableConcept | Classification of service Binding: Referral Category (extensible) | |||||
| priority |
0..1 | code | routine | urgent | asap | stat - see NHS mapping on the PCC-55 page Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request. | |||||
| doNotPerform |
0..1 | boolean | True if service/procedure should not be performed | |||||
| code |
1..1 | CodeableConcept | Service referred to (eRS specialty / clinic type, or a SNOMED CT referral procedure) Binding: Referral Service Type (extensible) | |||||
| orderDetail |
C | 0..* | CodeableConcept | Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context. | ||||
| quantity[x] |
0..1 | Service amount | ||||||
| quantityQuantity |
Quantity | |||||||
| quantityRatio |
Ratio | |||||||
| quantityRange |
Range | |||||||
| subject |
1..1 | Reference(Patient) | Individual or Entity the service is ordered for | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| reference |
C | 0..1 | string | Literal reference, Relative, internal or absolute URL | ||||
| type |
0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | |||||
| identifier |
0..1 | NHSIdentifier | Logical reference, when literal reference is not known | |||||
| display |
0..1 | string | Text alternative for the resource | |||||
| encounter |
0..1 | Reference(Encounter) | The encounter in which the referral was made | |||||
| occurrence[x] |
0..1 | When the service should be provided - TQ1-8 expected service provision time; a Period for the referral's validity (TQ1-6) | ||||||
| occurrenceDateTime |
dateTime | |||||||
| occurrencePeriod |
Period | |||||||
| occurrenceTiming |
Timing | |||||||
| asNeeded[x] |
0..1 | Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. | ||||||
| asNeededBoolean |
boolean | |||||||
| asNeededCodeableConcept |
CodeableConcept | |||||||
| authoredOn |
1..1 | dateTime | Date request signed | |||||
| requester |
1..1 | Reference(PractitionerRole | Practitioner | Organization) | Referring clinician (ORC-12 / OBR-16) - the Referral Initiator | |||||
| performerType |
0..1 | CodeableConcept | Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. | |||||
| performer |
0..* | Reference(PractitionerRole | Organization | HealthcareService) | Service or clinician referred to - the Referral Recipient | |||||
| locationCode |
0..* | CodeableConcept | Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered. | |||||
| locationReference |
0..* | Reference(Location) | Requested location | |||||
| reasonCode |
0..* | CodeableConcept | Reason(s) for referral (OBR-31) Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation. | |||||
| reasonReference |
0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | Explanation/Justification for service or service | |||||
| insurance |
0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage | |||||
| supportingInfo |
0..* | Reference(Resource) | Clinical information: referral form (QuestionnaireResponse), observations, referral letter, FHIR Document, results | |||||
| specimen |
0..* | Reference(Specimen) | Procedure Samples | |||||
| bodySite |
0..* | CodeableConcept | Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. | |||||
| note |
0..* | Annotation | Referral question - the clinical question for the Referral Recipient (OBX with OBX-29 QST) | |||||
| patientInstruction |
0..1 | string | Patient or consumer-oriented instructions | |||||
| relevantHistory |
0..* | Reference(Provenance) | Request provenance | |||||
| Documentation for this format | ||||||||
| Path | Status | Usage | ValueSet | Version | Source |
| ServiceRequest.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| ServiceRequest.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std. |
| ServiceRequest.intent | Base | required | RequestIntent | 📍4.0.1 | FHIR Std. |
| ServiceRequest.category | Base | extensible | Referral Category | 📦0.1.0 | This IG |
| ServiceRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std. |
| ServiceRequest.code | Base | extensible | Referral Service Type | 📦0.1.0 | This IG |
| ServiceRequest.orderDetail | Base | example | Service Request Order Details Codes | 📍4.0.1 | FHIR Std. |
| ServiceRequest.subject.type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std. |
| ServiceRequest.asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std. |
| ServiceRequest.performerType | Base | example | Participant Roles | 📍4.0.1 | FHIR Std. |
| ServiceRequest.locationCode | Base | example | ServiceDeliveryLocationRoleType | 📦3.0.0 | THO v7.5 |
| ServiceRequest.reasonCode | Base | example | Procedure Reason Codes | 📍4.0.1 | FHIR Std. |
| ServiceRequest.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | ServiceRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | ServiceRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
|
| dom-4 | error | ServiceRequest | 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()
|
| dom-5 | error | ServiceRequest | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | ServiceRequest | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| prr-1 | error | ServiceRequest | orderDetail SHALL only be present if code is present |
orderDetail.empty() or code.exists()
|
This structure is derived from ServiceRequest
Summary
Mandatory: 6 elements
Must-Support: 19 elements
Fixed: 1 element
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Other representations of profile: CSV, Excel, Schematron