# text.div
Name | Flags | Card. | Type | Description & Constraints

DeviceRequest

TU

DomainResource

Medical device request
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension

identifier

Σ

0..*

Identifier

External Request identifier

instantiatesCanonical

Σ

0..*

canonical( ActivityDefinition | PlanDefinition)

Instantiates FHIR protocol or definition

instantiatesUri

Σ

0..*

uri

Instantiates external protocol or definition

basedOn

Σ

0..*

Reference( Any)

What request fulfills

priorRequest

Σ

0..*

Reference( Any)

What request replaces

groupIdentifier | Σ | 0..1 | Identifier | Identifier of composite request

status

?! Σ

0..1

code

draft | active | suspended | completed | entered-in-error | cancelled
RequestStatus ( Required)

intent

?! Σ

1..1

code

proposal | plan | original-order | encoded | reflex-order
RequestIntent ( Required)

priority

Σ

0..1

code

Indicates how quickly the {{title}} should be addressed with respect to other requests
Request priority ( Required)

code[x]

Σ

1..1

Device requested
FHIR Device Types ( Example)

codeReference | | | Reference( Device) |
codeCodeableConcept | | | CodeableConcept |

parameter

0..*

BackboneElement

Device details

code | | 0..1 | CodeableConcept | Device detail
value[x] | | 0..1 | | Value of detail
valueCodeableConcept | | | CodeableConcept |
valueQuantity | | | Quantity |
valueRange | | | Range |
valueBoolean | | | boolean |
subject | Σ | 1..1 | Reference( Patient | Group | Location | Device) | Focus of request
encounter | Σ | 0..1 | Reference( Encounter) | Encounter motivating request
occurrence[x] | Σ | 0..1 | | Desired time or schedule for use
occurrenceDateTime | | | dateTime |
occurrencePeriod | | | Period |
occurrenceTiming | | | Timing |
authoredOn | Σ | 0..1 | dateTime | When recorded
requester | Σ | 0..1 | Reference( Device | Practitioner | PractitionerRole | Organization) | Who/what is requesting diagnostics

performerType

Σ

0..1

CodeableConcept

Filler role
Participant Roles ( Example)

performer | Σ | 0..1 | Reference( Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) | Requested Filler

reasonCode

Σ

0..*

CodeableConcept

Coded Reason for request
Condition/Problem/Diagnosis Codes ( Example)

reasonReference

Σ

0..*

Reference( Condition | Observation | DiagnosticReport | DocumentReference)

Linked Reason for request

insurance

0..*

Reference( Coverage | ClaimResponse)

Associated insurance coverage

supportingInfo

0..*

Reference( Any)

Additional clinical information

note

0..*

Annotation

Notes or comments

relevantHistory

0..*

Reference( Provenance)

Request provenance

Documentation for this format

# publisher
Health Level Seven International (Orders and Observations)

# description
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.

# mapping[].name
Quality Improvement and Clinical Knowledge (QUICK)

# snapshot.element[].definition
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.

# snapshot.element[].constraint[].human
If the resource is contained in another resource, it SHALL NOT contain nested Resources

# snapshot.element[].constraint[].human
If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated

# snapshot.element[].constraint[].human
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

# snapshot.element[].constraint[].extension[].valueMarkdown
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.

# snapshot.element[].constraint[].human
A resource should have narrative for robust management

# snapshot.element[].constraint[].human
If a resource is contained in another resource, it SHALL NOT have a security label

# snapshot.element[].definition
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

# snapshot.element[].comment
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

# snapshot.element[].definition
The 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.

# snapshot.element[].short
A set of rules under which this content was created

# snapshot.element[].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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

# snapshot.element[].comment
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.

# snapshot.element[].isModifierReason
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

# snapshot.element[].definition
The base language in which the resource is written.

# snapshot.element[].comment
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).

# snapshot.element[].short
Text summary of the resource, for human interpretation

# snapshot.element[].definition
A 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.

# snapshot.element[].comment
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.

# snapshot.element[].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.

# snapshot.element[].comment
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.

# snapshot.element[].short
Additional content defined by implementations

# snapshot.element[].definition
May 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.

# snapshot.element[].comment
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.

# snapshot.element[].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 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).

# snapshot.element[].comment
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.

# snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).

# snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

# snapshot.element[].definition
Identifiers assigned to this order by the orderer or by the receiver.

# snapshot.element[].short
Instantiates FHIR protocol or definition

# snapshot.element[].definition
The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest.

# snapshot.element[].comment
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.

# snapshot.element[].short
Instantiates external protocol or definition

# snapshot.element[].definition
The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest.

# snapshot.element[].comment
This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

# snapshot.element[].definition
Plan/proposal/order fulfilled by this request.

# snapshot.element[].definition
The request takes the place of the referenced completed or terminated request(s).

# snapshot.element[].mapping[].map
Handled by message location of ORC (ORC.1=RO or RU)

# snapshot.element[].short
draft | active | suspended | completed | entered-in-error | cancelled

# snapshot.element[].comment
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.

# snapshot.element[].isModifierReason
This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid

# snapshot.element[].binding.description
Codes representing the status of the request.

# snapshot.element[].short
proposal | plan | original-order | encoded | reflex-order

# snapshot.element[].definition
Whether the request is a proposal, plan, an original order or a reflex order.

# snapshot.element[].isModifierReason
This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request

# snapshot.element[].mapping[].map
.moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)

# snapshot.element[].short
Indicates how quickly the {{title}} should be addressed with respect to other requests

# snapshot.element[].definition
Indicates how quickly the {{title}} should be addressed with respect to other requests.

# snapshot.element[].binding.description
Identifies the level of importance to be assigned to actioning the request.

# snapshot.element[].binding.description
Codes for devices that can be requested.

# snapshot.element[].definition
Specific parameters for the ordered item.  For example, the prism value for lenses.

# snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# snapshot.element[].definition
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

# snapshot.element[].short
Additional content defined by implementations

# snapshot.element[].definition
May 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.

# snapshot.element[].comment
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.

# snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# snapshot.element[].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 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).

# snapshot.element[].comment
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.

# snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).

# snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# snapshot.element[].definition
A code or string that identifies the device detail being asserted.

# snapshot.element[].binding.description
A code that identifies the device detail.

# snapshot.element[].comment
Range means device should have a value that falls somewhere within the specified range.

# snapshot.element[].definition
An encounter that provides additional context in which this request is made.

# snapshot.element[].definition
The 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".

# snapshot.element[].definition
When the request transitioned to being actionable.

# snapshot.element[].definition
The individual who initiated the request and has responsibility for its activation.

# snapshot.element[].definition
Desired type of performer for doing the diagnostic testing.

# snapshot.element[].binding.description
Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

# snapshot.element[].definition
The desired performer for doing the diagnostic testing.

# snapshot.element[].definition
Reason or justification for the use of this device.

# snapshot.element[].binding.description
Diagnosis or problem codes justifying the reason for requesting the device.

# snapshot.element[].definition
Reason or justification for the use of this device.

# snapshot.element[].definition
Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.

# snapshot.element[].definition
Additional 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).

# snapshot.element[].requirements
Knowing where the device is targeted is important for tracking if multiple sites are possible.

# snapshot.element[].definition
Details 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.

# snapshot.element[].definition
Key events in the history of the request.

# snapshot.element[].comment
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.

# differential.element[].definition
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.

# differential.element[].definition
Identifiers assigned to this order by the orderer or by the receiver.

# differential.element[].short
Instantiates FHIR protocol or definition

# differential.element[].definition
The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest.

# differential.element[].comment
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.

# differential.element[].short
Instantiates external protocol or definition

# differential.element[].definition
The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest.

# differential.element[].comment
This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

# differential.element[].definition
Plan/proposal/order fulfilled by this request.

# differential.element[].definition
The request takes the place of the referenced completed or terminated request(s).

# differential.element[].mapping[].map
Handled by message location of ORC (ORC.1=RO or RU)

# differential.element[].short
draft | active | suspended | completed | entered-in-error | cancelled

# differential.element[].comment
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.

# differential.element[].isModifierReason
This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid

# differential.element[].binding.description
Codes representing the status of the request.

# differential.element[].short
proposal | plan | original-order | encoded | reflex-order

# differential.element[].definition
Whether the request is a proposal, plan, an original order or a reflex order.

# differential.element[].isModifierReason
This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request

# differential.element[].mapping[].map
.moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)

# differential.element[].short
Indicates how quickly the {{title}} should be addressed with respect to other requests

# differential.element[].definition
Indicates how quickly the {{title}} should be addressed with respect to other requests.

# differential.element[].binding.description
Identifies the level of importance to be assigned to actioning the request.

# differential.element[].binding.description
Codes for devices that can be requested.

# differential.element[].definition
Specific parameters for the ordered item.  For example, the prism value for lenses.

# differential.element[].definition
A code or string that identifies the device detail being asserted.

# differential.element[].binding.description
A code that identifies the device detail.

# differential.element[].comment
Range means device should have a value that falls somewhere within the specified range.

# differential.element[].definition
An encounter that provides additional context in which this request is made.

# differential.element[].definition
The 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".

# differential.element[].definition
When the request transitioned to being actionable.

# differential.element[].definition
The individual who initiated the request and has responsibility for its activation.

# differential.element[].definition
Desired type of performer for doing the diagnostic testing.

# differential.element[].binding.description
Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

# differential.element[].definition
The desired performer for doing the diagnostic testing.

# differential.element[].definition
Reason or justification for the use of this device.

# differential.element[].binding.description
Diagnosis or problem codes justifying the reason for requesting the device.

# differential.element[].definition
Reason or justification for the use of this device.

# differential.element[].definition
Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.

# differential.element[].definition
Additional 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).

# differential.element[].requirements
Knowing where the device is targeted is important for tracking if multiple sites are possible.

# differential.element[].definition
Details 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.

# differential.element[].definition
Key events in the history of the request.

# differential.element[].comment
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.