DeviceRequest
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.
- Schema
- Usage
- Relationships
- Referenced By
Elements
| Name | Required | Type | Description |
|---|---|---|---|
| identifier | Identifier[] | External Request identifier DetailsIdentifiers assigned to this order by the orderer or by the receiver. | |
| instantiatesCanonical | canonical[] | Instantiates FHIR protocol or definition DetailsThe URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest. Note: This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. | |
| instantiatesUri | uri[] | Instantiates external protocol or definition DetailsThe URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest. This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier. | |
| basedOn | Reference<Resource>[] | What request fulfills DetailsPlan/proposal/order fulfilled by this request. | |
| priorRequest | Reference<Resource>[] | What request replaces DetailsThe request takes the place of the referenced completed or terminated request(s). | |
| groupIdentifier | Identifier | Identifier of composite request DetailsComposite request this is part of. | |
| status | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown DetailsThe status of the request. 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. | |
| intent | ✓ | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option DetailsWhether the request is a proposal, plan, an original order or a reflex order. |
| priority | code | routine | urgent | asap | stat DetailsIndicates how quickly the {{title}} should be addressed with respect to other requests. | |
| code[x] | ✓ | Reference<Device>, CodeableConcept | Device requested DetailsThe details of the device to be used. |
| parameter | DeviceRequestParameter[] | Device details DetailsSpecific parameters for the ordered item. For example, the prism value for lenses. | |
| id | string | Unique id for inter-element referencing DetailsUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | |
| extension | Extension[] | Additional content defined by implementations DetailsMay be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. | |
| modifierExtension | Extension[] | Extensions that cannot be ignored even if unrecognized DetailsMay 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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. | |
| code | CodeableConcept | Device detail DetailsA code or string that identifies the device detail being asserted. | |
| value[x] | CodeableConcept, Quantity, Range, boolean | Value of detail DetailsThe value of the device detail. Range means device should have a value that falls somewhere within the specified range. | |
| subject | ✓ | Reference< Patient | Group | Location | Device > | Focus of request DetailsThe patient who will use the device. |
| encounter | Reference<Encounter> | Encounter motivating request DetailsAn encounter that provides additional context in which this request is made. | |
| occurrence[x] | dateTime, Period, Timing | Desired time or schedule for use DetailsThe 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". | |
| authoredOn | dateTime | When recorded DetailsWhen the request transitioned to being actionable. | |
| requester | Reference< Device | Practitioner | PractitionerRole | Organization > | Who/what is requesting diagnostics DetailsThe individual who initiated the request and has responsibility for its activation. | |
| performerType | CodeableConcept | Filler role DetailsDesired type of performer for doing the diagnostic testing. | |
| performer | Reference< Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson > | Requested Filler DetailsThe desired performer for doing the diagnostic testing. | |
| reasonCode | CodeableConcept[] | Coded Reason for request DetailsReason or justification for the use of this device. | |
| reasonReference | Reference< Condition | Observation | DiagnosticReport | DocumentReference >[] | Linked Reason for request DetailsReason or justification for the use of this device. | |
| insurance | Reference<Coverage | ClaimResponse>[] | Associated insurance coverage DetailsInsurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service. | |
| supportingInfo | Reference<Resource>[] | Additional clinical information DetailsAdditional clinical information about the patient that may influence the request fulfilment. For example, this may include where on the subject's body the device will be used (i.e. the target site). | |
| note | Annotation[] | Notes or comments DetailsDetails 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. | |
| relevantHistory | Reference<Provenance>[] | Request provenance DetailsKey events in the history of the request. This might not include provenances for all versions of the request - only those deemed "relevant" or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a "relevant" change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject. |
Search Parameters
| Name | Type | Description | Expression |
|---|---|---|---|
| code | token | Code for what is being requested/ordered | DeviceRequest.code as CodeableConcept |
| identifier | token | Business identifier for request/order | DeviceRequest.identifier |
| patient | reference | Individual the service is ordered for | DeviceRequest.subject.where(resolve() is Patient) |
| encounter | reference | Encounter during which request was created | DeviceRequest.encounter |
| authored-on | date | When the request transitioned to being actionable | DeviceRequest.authoredOn |
| based-on | reference | Plan/proposal/order fulfilled by this request | DeviceRequest.basedOn |
| device | reference | Reference to resource that is being requested/ordered | DeviceRequest.code as Reference |
| event-date | date | When service should occur | DeviceRequest.occurrence as dateTime | DeviceRequest.occurrence as Period |
| group-identifier | token | Composite request this is part of | DeviceRequest.groupIdentifier |
| instantiates-canonical | reference | Instantiates FHIR protocol or definition | DeviceRequest.instantiatesCanonical |
| instantiates-uri | uri | Instantiates external protocol or definition | DeviceRequest.instantiatesUri |
| insurance | reference | Associated insurance coverage | DeviceRequest.insurance |
| intent | token | proposal | plan | original-order |reflex-order | DeviceRequest.intent |
| performer | reference | Desired performer for service | DeviceRequest.performer |
| prior-request | reference | Request takes the place of referenced completed or terminated requests | DeviceRequest.priorRequest |
| requester | reference | Who/what is requesting service | DeviceRequest.requester |
| status | token | entered-in-error | draft | active |suspended | completed | DeviceRequest.status |
| subject | reference | Individual the service is ordered for | DeviceRequest.subject |
Inherited Elements
| Name | Required | Type | Description |
|---|---|---|---|
| id | string | Logical id of this artifact DetailsThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | |
| meta | Meta | Metadata about the resource DetailsThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. | |
| implicitRules | uri | A set of rules under which this content was created DetailsA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. 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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. | |
| language | code | Language of the resource content DetailsThe base language in which the resource is written. 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). | |
| text | Narrative | Text summary of the resource, for human interpretation DetailsA human-readable narrative that contains a summary of the resource and can 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. 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 information is added later. | |
| contained | Resource[] | Contained, inline Resources DetailsThese 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. 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. | |
| extension | Extension[] | Additional content defined by implementations DetailsMay be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. | |
| modifierExtension | Extension[] | Extensions that cannot be ignored DetailsMay 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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. |
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:
- 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 devices must be implanted via a surgical or other procedure and the implantation or explantation is represented in the Procedure or ServiceRequest 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.