{
  "description": null,
  "_filename": "NHSDigital-ServiceRequest.StructureDefinition.json",
  "package_name": "uk.nhsdigital.r4.test",
  "date": null,
  "derivation": "constraint",
  "publisher": null,
  "fhirVersion": "4.0.1",
  "name": "NHSDigitalServiceRequest",
  "abstract": false,
  "type": "ServiceRequest",
  "experimental": null,
  "resourceType": "StructureDefinition",
  "title": null,
  "package_version": "2.8.7-prerelease",
  "status": "draft",
  "id": "018e0305-2868-4882-9884-2945c5a1ceef",
  "kind": "resource",
  "url": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-ServiceRequest",
  "version": null,
  "differential": {
    "element": [ {
      "id": "ServiceRequest.id",
      "path": "ServiceRequest.id",
      "short": "Local Referral ID"
    }, {
      "id": "ServiceRequest.extension",
      "min": 0,
      "path": "ServiceRequest.extension",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      }
    }, {
      "id": "ServiceRequest.extension:ERSAdviceAndGuidance",
      "min": 0,
      "path": "ServiceRequest.extension",
      "type": [ {
        "code": "Extension",
        "profile": [ "https://fhir.nhs.uk/StructureDefinition/Extension-ERS-Referral" ]
      } ],
      "short": "ERS Advice and Guidance",
      "sliceName": "ERSAdviceAndGuidance",
      "definition": "```json\r\n  \"extension\": [\r\n        {\r\n            \"url\": \"https://fhir.nhs.uk/StructureDefinition/Extension-ERS-Referral\",\r\n            \"extension\": [\r\n                {\r\n                    \"url\": \"sourceSystem\",\r\n                    \"valueCode\": \"ers\"\r\n                },\r\n                {\r\n                    \"url\": \"status\",\r\n                    \"valueCode\": \"unbooked\"\r\n                }\r\n            ]\r\n        },\r\n```",
      "mustSupport": true
    }, {
      "id": "ServiceRequest.extension:ERSServiceRequestState",
      "min": 0,
      "path": "ServiceRequest.extension",
      "type": [ {
        "code": "Extension",
        "profile": [ "https://fhir.nhs.uk/StructureDefinition/Extension-eRS-ServiceRequest-State" ]
      } ],
      "short": "Request Status",
      "sliceName": "ERSServiceRequestState",
      "definition": "e-RS representation of the state of the referral\r\n\r\n```json\r\n\"extension\": [\r\n        {\r\n            \"url\": \"https://fhir.nhs.uk/StructureDefinition/Extension-ERS-Referral\",\r\n            \"extension\": [\r\n                {\r\n                    \"url\": \"sourceSystem\",\r\n                    \"valueCode\": \"ers\"\r\n                },\r\n                {\r\n                    \"url\": \"status\",\r\n                    \"valueCode\": \"unbooked\"\r\n                }\r\n            ]\r\n        }\r\n    ],\r\n```",
      "mustSupport": true
    }, {
      "path": "ServiceRequest.extension",
      "min": 0,
      "definition": "Deep Link into the specific landing page in MYR\r\n\r\n```json\r\n\"extension\": [\r\n        {\r\n            \"url\": \"https://fhir.nhs.uk/StructureDefinition/Extension-Portal-Link\",\r\n            \"valueUrl\": \"https://virtual.nhs.uk/MyPatientRecords\"\r\n        }\r\n    ],\r\n```",
      "short": "Portal Link",
      "type": [ {
        "code": "Extension",
        "profile": [ "https://fhir.nhs.uk/StructureDefinition/Extension-Portal-Link" ]
      } ],
      "mustSupport": true,
      "sliceName": "portalLink",
      "max": "1",
      "id": "ServiceRequest.extension:portalLink"
    }, {
      "id": "ServiceRequest.extension:serviceRequestPriority",
      "max": "1",
      "min": 0,
      "path": "ServiceRequest.extension",
      "type": [ {
        "code": "Extension",
        "profile": [ "https://fhir.nhs.uk/StructureDefinition/Extension-ServiceRequest-Priority" ]
      } ],
      "sliceName": "serviceRequestPriority",
      "mustSupport": true
    }, {
      "id": "ServiceRequest.identifier",
      "min": 1,
      "path": "ServiceRequest.identifier",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "system",
          "type": "value"
        } ]
      },
      "definition": "Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.\r\n\r\n```json\r\n\"identifier\": [\r\n                    {\r\n                        \"system\": \"https://fhir.nhs.uk/Id/UBRN\",\r\n                        \"value\": \"111111111112\"\r\n                    }\r\n                ],\r\n```",
      "mustSupport": true
    }, {
      "id": "ServiceRequest.identifier.value",
      "min": 1,
      "path": "ServiceRequest.identifier.value"
    }, {
      "id": "ServiceRequest.identifier:UBRN",
      "max": "1",
      "path": "ServiceRequest.identifier",
      "short": "Unique Booking Reference Numbe",
      "sliceName": "UBRN",
      "definition": "Unique Booking Reference Number\r\n(12 digit number used as an internal and external identifier of the referral), known as \"Booking Reference\" Patient side",
      "mustSupport": true
    }, {
      "id": "ServiceRequest.identifier:UBRN.system",
      "min": 1,
      "path": "ServiceRequest.identifier.system",
      "fixedUri": "https://fhir.nhs.uk/Id/UBRN"
    }, {
      "id": "ServiceRequest.identifier:UBRN.value",
      "min": 1,
      "path": "ServiceRequest.identifier.value"
    }, {
      "id": "ServiceRequest.basedOn",
      "path": "ServiceRequest.basedOn",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-CarePlan", "https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationRequest", "https://fhir.nhs.uk/StructureDefinition/NHSDigital-ServiceRequest" ]
      } ],
      "mustSupport": true
    }, {
      "id": "ServiceRequest.basedOn.identifier",
      "path": "ServiceRequest.basedOn.identifier",
      "mustSupport": true
    }, {
      "id": "ServiceRequest.basedOn.identifier.system",
      "min": 1,
      "path": "ServiceRequest.basedOn.identifier.system"
    }, {
      "id": "ServiceRequest.basedOn.identifier.value",
      "min": 1,
      "path": "ServiceRequest.basedOn.identifier.value"
    }, {
      "id": "ServiceRequest.intent",
      "path": "ServiceRequest.intent",
      "definition": "In **e-RS** default to `order`"
    }, {
      "id": "ServiceRequest.category",
      "max": "1",
      "min": 1,
      "path": "ServiceRequest.category",
      "definition": "A code that classifies the service for searching, sorting and display purposes (e.g. \"Surgical Procedure\").\r\n\r\nAt present the only code in use is Patient Referral\r\n\r\n```json\r\n \"category\": [\r\n        {\r\n            \"coding\": [\r\n                {\r\n                    \"system\": \"http://snomed.info/sct\",\r\n                    \"code\": \"3457005\",\r\n                    \"display\": \"Patient referral\"\r\n                }\r\n            ]\r\n        }\r\n    ],\r\n```",
      "mustSupport": true
    }, {
      "id": "ServiceRequest.category.coding",
      "min": 1,
      "path": "ServiceRequest.category.coding",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "system",
          "type": "value"
        } ]
      }
    }, {
      "id": "ServiceRequest.category.coding.system",
      "min": 1,
      "path": "ServiceRequest.category.coding.system"
    }, {
      "id": "ServiceRequest.category.coding.code",
      "min": 1,
      "path": "ServiceRequest.category.coding.code"
    }, {
      "id": "ServiceRequest.category.coding:BARSCategory",
      "path": "ServiceRequest.category.coding",
      "binding": {
        "strength": "preferred",
        "valueSet": "https://fhir.nhs.uk/ValueSet/NHSDigital-BARS-message-category"
      },
      "sliceName": "BARSCategory"
    }, {
      "id": "ServiceRequest.category.coding:BARSCategory.system",
      "path": "ServiceRequest.category.coding.system",
      "fixedUri": "https://fhir.nhs.uk/CodeSystem/message-category-servicerequest"
    }, {
      "id": "ServiceRequest.category.coding:NHSDigitalServiceRequestCategory",
      "path": "ServiceRequest.category.coding",
      "binding": {
        "strength": "preferred",
        "valueSet": "https://fhir.nhs.uk/ValueSet/NHSDigital-ServiceRequest-category"
      },
      "sliceName": "NHSDigitalServiceRequestCategory"
    }, {
      "id": "ServiceRequest.category.coding:NHSDigitalServiceRequestCategory.system",
      "path": "ServiceRequest.category.coding.system",
      "fixedUri": "http://snomed.info/sct"
    }, {
      "id": "ServiceRequest.priority",
      "path": "ServiceRequest.priority",
      "definition": "Request Priority Code \r\n\r\nCode for the priority of the referral set by the Referring Clinician\r\n\r\n```json\r\n \"priority\": \"routine\",\r\n```",
      "mustSupport": true
    }, {
      "id": "ServiceRequest.code",
      "path": "ServiceRequest.code",
      "definition": "A code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.\r\n\r\n```json\r\n\"code\": {\r\n        \"coding\":  [\r\n            {\r\n                \"system\": \"http://snomed.info/sct\",\r\n                \"code\": \"73761001\",\r\n                \"display\": \"Colonoscopy\"\r\n            }\r\n        ],\r\n        \"text\": \"Colonoscopy requested\"\r\n    }\r\n```",
      "mustSupport": true
    }, {
      "id": "ServiceRequest.code.coding",
      "path": "ServiceRequest.code.coding",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "system",
          "type": "value"
        } ]
      }
    }, {
      "id": "ServiceRequest.code.coding:SNOMEDProcedureCode",
      "path": "ServiceRequest.code.coding",
      "sliceName": "SNOMEDProcedureCode"
    }, {
      "id": "ServiceRequest.code.coding:SNOMEDProcedureCode.system",
      "min": 1,
      "path": "ServiceRequest.code.coding.system",
      "fixedUri": "http://snomed.info/sct"
    }, {
      "id": "ServiceRequest.code.coding:SNOMEDProcedureCode.code",
      "min": 1,
      "path": "ServiceRequest.code.coding.code"
    }, {
      "id": "ServiceRequest.code.coding:ServiceRequestCode",
      "path": "ServiceRequest.code.coding",
      "sliceName": "ServiceRequestCode"
    }, {
      "id": "ServiceRequest.code.coding:ServiceRequestCode.system",
      "min": 1,
      "path": "ServiceRequest.code.coding.system",
      "fixedUri": "https://fhir.nhs.uk/CodeSystem/ServiceRequest-Code"
    }, {
      "id": "ServiceRequest.code.coding:ServiceRequestCode.code",
      "min": 1,
      "path": "ServiceRequest.code.coding.code"
    }, {
      "id": "ServiceRequest.subject",
      "path": "ServiceRequest.subject",
      "type": [ {
        "code": "Reference",
        "aggregation": [ "referenced" ],
        "targetProfile": [ "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Patient" ]
      } ],
      "constraint": [ {
        "key": "patient-reference",
        "human": "An identifier reference or resource reference must be provided",
        "severity": "error",
        "expression": "(reference.exists() or identifier.exists())"
      }, {
        "key": "patient-nhs",
        "human": "NHS Number must be in the English and Welsh NHS Number range or length of the number is wrong.",
        "severity": "error",
        "expression": "identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists().not() or (identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists()  and identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').value.matches('^([456789]{1}[0-9]{9})$'))"
      } ],
      "definition": "On whom or what the service is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans).\r\n\r\n```json\r\n\"subject\": {\r\n        \"identifier\": {\r\n            \"system\": \"https://fhir.nhs.uk/Id/nhs-number\",\r\n            \"value\": \"9999998887\"\r\n        }\r\n    },\r\n```",
      "mustSupport": true
    }, {
      "id": "ServiceRequest.subject.identifier.system",
      "min": 1,
      "path": "ServiceRequest.subject.identifier.system",
      "fixedUri": "https://fhir.nhs.uk/Id/nhs-number"
    }, {
      "id": "ServiceRequest.subject.identifier.value",
      "min": 1,
      "path": "ServiceRequest.subject.identifier.value"
    }, {
      "id": "ServiceRequest.encounter",
      "path": "ServiceRequest.encounter",
      "type": [ {
        "code": "Reference",
        "aggregation": [ "referenced" ],
        "targetProfile": [ "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Encounter" ]
      } ]
    }, {
      "id": "ServiceRequest.authoredOn",
      "path": "ServiceRequest.authoredOn",
      "short": "Referral Initiated Date",
      "definition": "Date the referral was initiated in e-RS\r\n\r\n```json\r\n\"authoredOn\": \"2022-01-11T16:40:00+00:00\",\r\n```",
      "mustSupport": true
    }, {
      "id": "ServiceRequest.requester",
      "path": "ServiceRequest.requester",
      "type": [ {
        "code": "Reference",
        "aggregation": [ "contained", "referenced" ],
        "targetProfile": [ "https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole-Minimal" ]
      } ],
      "definition": "Who is created the Request or the Event. In NHSDigital API's this **SHOULD** always be a PractitionerRole role reference.\r\n\r\n```json\r\n \"requester\": {\r\n        \"reference\": \"#requester\"\r\n    },\r\n```\r\n\r\nThis will reference a `contained` PractitionerRole (note: this resource only contains limited user metadata such as ODS Code, professional code and SDS User Profile Id). This resource should not hold data which is held in SDS, only enough information to identify the SDS Entry,\r\n\r\n```json\r\n{\r\n    \"resourceType\": \"ServiceRequest\",\r\n    \"id\": \"bd1ca5c4-ff49-4f2a-9db4-f5dda0112084\",\r\n    \"meta\": {\r\n        \"lastUpdated\": \"2016-07-11T11:07:22+00:00\"\r\n    },\r\n    \"contained\": [\r\n        {\r\n            \"resourceType\": \"PractitionerRole\",\r\n            \"id\": \"requester\",\r\n            \"practitioner\": {\r\n                \"identifier\": {\r\n                    \"system\": \"https://fhir.hl7.org.uk/Id/gmp-number\",\r\n                    \"value\": \"G8123456\"\r\n                },\r\n                \"display\": \"DR AA BHATIA\"\r\n            },\r\n            \"organization\": {\r\n                \"identifier\": {\r\n                    \"system\": \"https://fhir.nhs.uk/Id/ods-organization-code\",\r\n                    \"value\": \"C81007\"\r\n                },\r\n                \"display\": \"VERNON STREET MEDICAL CTR\"\r\n            },\r\n        }\r\n    ],\r\n    \"requester\": {\r\n        \"reference\": \"#requester\"\r\n    },\r\n```\r\n\r\n**e-RS**\r\n\r\nThe contained PractitionerRole must contain\r\n\r\n- SDS User ID of the Referrer in `practitioner`\r\n- ODS Code of the Referring Organisation in `organization`",
      "mustSupport": true
    }, {
      "id": "ServiceRequest.performerType",
      "path": "ServiceRequest.performerType",
      "short": "Requested Specialty Name",
      "definition": "**ERS**\r\n\r\nSpecialty used to search for the shortlisted service(s) (if one was used)\r\n\r\n\r\n```json\r\n\"performerType\": {\r\n        \"coding\": [\r\n            {\r\n                \"system\": \"https://fhir.nhs.uk/CodeSystem/eRS-Specialty\",\r\n                \"code\": \"GENERAL_MEDICINE\"\r\n            }\r\n        ]\r\n    },\r\n```\r\n\r\n```json\r\n\"performerType\": {\r\n                    \"coding\": [\r\n                        {\r\n                            \"display\": \"Dermatology\"\r\n                        }\r\n                    ]\r\n                }\r\n```",
      "mustSupport": true
    }, {
      "id": "ServiceRequest.performerType.coding",
      "path": "ServiceRequest.performerType.coding",
      "binding": {
        "strength": "example",
        "valueSet": "https://fhir.nhs.uk/ValueSet/NHSDigital-CareSettingType"
      },
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "system",
          "type": "value"
        } ]
      }
    }, {
      "id": "ServiceRequest.performerType.coding:treatmentFunctionCodes",
      "path": "ServiceRequest.performerType.coding",
      "binding": {
        "strength": "required",
        "valueSet": "https://fhir.nhs.uk/ValueSet/NHSDataModelAndDictionary-treatment-function"
      },
      "sliceName": "treatmentFunctionCodes",
      "mustSupport": true
    }, {
      "id": "ServiceRequest.performerType.coding:treatmentFunctionCodes.system",
      "path": "ServiceRequest.performerType.coding.system",
      "fixedUri": "https://fhir.nhs.uk/CodeSystem/NHSDataModelAndDictionary-treatment-function"
    }, {
      "id": "ServiceRequest.performerType.coding:eRSSpecialty",
      "path": "ServiceRequest.performerType.coding",
      "binding": {
        "strength": "required",
        "valueSet": "https://fhir.nhs.uk/ValueSet/NHSDigital-eRS-Specialty"
      },
      "sliceName": "eRSSpecialty"
    }, {
      "id": "ServiceRequest.performerType.coding:eRSSpecialty.system",
      "path": "ServiceRequest.performerType.coding.system",
      "fixedUri": "https://fhir.nhs.uk/CodeSystem/eRS-Specialty"
    }, {
      "id": "ServiceRequest.performer",
      "path": "ServiceRequest.performer",
      "mustSupport": true
    }, {
      "id": "ServiceRequest.performer.identifier",
      "path": "ServiceRequest.performer.identifier",
      "mustSupport": true
    }, {
      "id": "ServiceRequest.performer.identifier.system",
      "min": 1,
      "path": "ServiceRequest.performer.identifier.system"
    }, {
      "id": "ServiceRequest.performer.identifier.value",
      "min": 1,
      "path": "ServiceRequest.performer.identifier.value"
    }, {
      "id": "ServiceRequest.reasonCode",
      "path": "ServiceRequest.reasonCode",
      "definition": "An explanation or justification for why this service is being requested in coded or textual form.   This is often for billing purposes.  May relate to the resources referred to in `supportingInfo`.\r\n\r\n```json\r\n\"reasonCode\":  [\r\n        {\r\n            \"coding\":  [\r\n                {\r\n                    \"system\": \"http://snomed.info/sct\",\r\n                    \"code\": \"271835004\",\r\n                    \"display\": \"Abdominal distension, gaseous\"\r\n                }\r\n            ],\r\n            \"text\": \"Swollen abdomen\"\r\n        }\r\n    ]\r\n```",
      "mustSupport": true
    }, {
      "id": "ServiceRequest.supportingInfo",
      "path": "ServiceRequest.supportingInfo",
      "type": [ {
        "code": "Reference",
        "aggregation": [ "referenced" ],
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Resource", "https://fhir.nhs.uk/StructureDefinition/NHSDigital-DocumentReference" ]
      } ],
      "definition" : "Additional clinical information about the patient or specimen that may influence the services or their interpretations.     This information includes diagnosis, clinical findings and other observations.  In laboratory ordering these are typically referred to as \"ask at order entry questions (AOEs)\".  This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example,  reporting the amount of inspired oxygen for blood gas measurements.\r\n\r\n```json\r\n\"supportingInfo\": [\r\n        {\r\n            \"type\" : \"DocumentReference\",\r\n            \"reference\": \"DocumentReference/5da894e0-a57e-43e9-a1a1-e283a484003c\"\r\n        },\r\n        {\r\n            \"type\" : \"QuestionnaireResponse\",\r\n            \"reference\": \"QuestionnaireResponse/d9d4cf80-3f9d-4435-9f3b-e6efb09ad654\"\r\n        }\r\n    ],\r\n```",
      "mustSupport": true
    }, {
      "id": "ServiceRequest.note",
      "path": "ServiceRequest.note",
      "comment": "For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time.  This element may need to be included in narrative because of the potential for modifying information.  *Annotations SHOULD NOT* be used to communicate \"modifying\" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).\r\n\r\n```json\r\n\"note\": [\r\n        {\r\n            \"text\": \"Please advise me on this patient who ...(information about patient)\"\r\n        }\r\n    ]\r\n```",
      "mustSupport": true
    } ]
  },
  "baseDefinition": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-ServiceRequest"
}