Resource type: devicerequest

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.

Elements

PathShortDefinitionComments
Medical device requestRepresents 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.
identifierExternal Request identifierIdentifiers assigned to this order by the orderer or by the receiver.
instantiatesCanonicalInstantiates FHIR protocol or definitionThe 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.
instantiatesUriInstantiates external protocol or definitionThe 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.
basedOnWhat request fulfillsPlan/proposal/order fulfilled by this request.
priorRequestWhat request replacesThe request takes the place of the referenced completed or terminated request(s).
groupIdentifierIdentifier of composite requestComposite request this is part of.
statusdraft | active | suspended | completed | entered-in-error | cancelledThe 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.
intentproposal | plan | original-order | encoded | reflex-orderWhether the request is a proposal, plan, an original order or a reflex order.
priorityIndicates how quickly the {{title}} should be addressed with respect to other requestsIndicates how quickly the {{title}} should be addressed with respect to other requests.
code[x]Device requestedThe details of the device to be used.
parameterDevice detailsSpecific parameters for the ordered item. For example, the prism value for lenses.
parameter.idUnique id for inter-element referencingUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
parameter.extensionAdditional content defined by implementationsMay 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.
parameter.modifierExtensionExtensions that cannot be ignored even if unrecognizedMay 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.
parameter.codeDevice detailA code or string that identifies the device detail being asserted.
parameter.value[x]Value of detailThe value of the device detail.Range means device should have a value that falls somewhere within the specified range.
subjectFocus of requestThe patient who will use the device.
encounterEncounter motivating requestAn encounter that provides additional context in which this request is made.
occurrence[x]Desired time or schedule for useThe 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".
authoredOnWhen recordedWhen the request transitioned to being actionable.
requesterWho/what is requesting diagnosticsThe individual who initiated the request and has responsibility for its activation.
performerTypeFiller roleDesired type of performer for doing the diagnostic testing.
performerRequested FillerThe desired performer for doing the diagnostic testing.
reasonCodeCoded Reason for requestReason or justification for the use of this device.
reasonReferenceLinked Reason for requestReason or justification for the use of this device.
insuranceAssociated insurance coverageInsurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.
supportingInfoAdditional clinical informationAdditional 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).
noteNotes or commentsDetails 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.
relevantHistoryRequest provenanceKey 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.

Scope and Usage

[%stu-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:

  1. 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.
[%end-note-np%]

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.

Boundaries and Relationships

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](procedure.html) or [ServiceRequest](servicerequest.html) 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.

Notes to reviewers:

At this time, the code bindings are placeholders to be fleshed out upon further review by the community.

Search Parameters

authored-onWhen the request transitioned to being actionableDeviceRequest.authoredOn
based-onPlan/proposal/order fulfilled by this requestDeviceRequest.basedOn
deviceReference to resource that is being requested/ordered(DeviceRequest.code as Reference)
event-dateWhen service should occur(DeviceRequest.occurrence as dateTime) | (DeviceRequest.occurrence as Period)
group-identifierComposite request this is part ofDeviceRequest.groupIdentifier
instantiates-canonicalInstantiates FHIR protocol or definitionDeviceRequest.instantiatesCanonical
instantiates-uriInstantiates external protocol or definitionDeviceRequest.instantiatesUri
insuranceAssociated insurance coverageDeviceRequest.insurance
intentproposal | plan | original-order |reflex-orderDeviceRequest.intent
performerDesired performer for serviceDeviceRequest.performer
prior-requestRequest takes the place of referenced completed or terminated requestsDeviceRequest.priorRequest
requesterWho/what is requesting serviceDeviceRequest.requester
statusentered-in-error | draft | active |suspended | completedDeviceRequest.status
subjectIndividual the service is ordered forDeviceRequest.subject

Extension Definitions

These are extension definitions for this resource defined by the spec