Narrativa gerada: StructureDefinition br-core-servicerequest Nome Bandeiras Card. Tipo Descrição e condicionalismos ServiceRequest 0..* ServiceRequest A request for a service to be performed #xD; id 0..1 id Identificador lógico deste artefato #xD; meta 0..1 Meta Metadados sobre o recurso #xD; implicitRules 0..1 uri Um conjunto de regras sob as quais este conteúdo foi criado #xD; language 0..1 code Idioma do recurso #xD; text 0..1 Narrative Resumo do texto do recurso em linguagem natural #xD; contained 0..* Resource Contained, inline Resources #xD; extension 0..* Extension Extension #xD; modifierExtension 0..* Extension Extensões adicionais que não podem ser ignoradas, mesmo que não reconhecidas #xD; identifier 0..* Identifier Identificadores externos para este recurso #xD; instantiatesCanonical 0..* canonical(ActivityDefinition | PlanDefinition) Instancia o protocolo ou definição FHIR #xD; instantiatesUri 0..* uri Instancia protocolo externo ou definição #xD; basedOn 0..* Reference(BRCoreCarePlan | BRCoreServiceRequest | br-core-medicationrequest) Referência aos planos de cuidado/solicitações/medicamentos associados a esta requisição #xD; replaces 0..* Reference(ServiceRequest) Referência à requisição a ser substituida #xD; requisition 0..1 Identifier Identificador da requisição #xD; status 1..1 code Status da requisição #xD; intent 1..1 code Código da intencionalidade desta requisição #xD; category 1..1 CodeableConcept Categoria desta requisição Vínculo: BR Categoria Procedimento (example) #xD; priority 1..1 code Prioridade desta requisição Vínculo: BR Carater Atendimento MIRA (required) #xD; doNotPerform 0..1 boolean Verdadeiro se o serviço/procedimento não deve ser executado #xD; code 1..1 CodeableConcept Código do procedimento solicitado Vínculo: BR Procedimentos Nacionais (example) #xD; orderDetail 0..* CodeableConcept Informações adicionais da requesição #xD; quantity[x] 0..1 Quantity, Ratio, Range Quantidade de procedimento solicitados #xD; subject 1..1 Reference(BRCorePatient | Group | br-core-location | Device) Referência ao paciente/grupo/localidade/dispositivo associado a esta requisição #xD; encounter 0..1 Reference(Encounter) Referência ao atendimento relacionado a esta requisição #xD; occurrence[x] 0..1 dateTime, Period, Timing Quando o procedimento deve ocorrer #xD; asNeeded[x] 0..1 boolean, CodeableConcept Pré-condições para a realização do procedimento #xD; authoredOn 0..1 dateTime Data de assinatura da requisição #xD; requester 1..1 Reference(BRCorePractitioner | BRCorePractitionerRole | BRCoreOrganization | BRCorePatient | Device | BRCoreRelatedPerson) Referência ao profissional/organização/paciente/dispotivo/pessoa relacionada que está solicitando o procedimento #xD; performerType 0..1 CodeableConcept Função do profissional executante solicitado #xD; performer 0..1 Reference(BRCorePractitioner | BRCorePractitionerRole | BRCoreOrganization | CareTeam | br-core-healthcareservice | BRCorePatient | Device | BRCoreRelatedPerson) Referência ao profissional executante solicitado #xD; locationCode 0..* CodeableConcept Localização solicitada #xD; locationReference 0..* Reference(br-core-location) ReferÇencia à localização solicitada #xD; reasonCode 0..* CodeableConcept Explicação/Justificativa para procedimento ou serviço #xD; reasonReference 0..* Reference(BRCoreCondition | BRCoreObservation | BRCoreDiagnosticReport | DocumentReference) Referência à explicação/justificativa para serviço ou procedimento #xD; insurance 0..* Reference(Coverage | ClaimResponse) Referência às coberturas associadas #xD; supportingInfo 0..* Reference(Resource) Referência às informações adicionais #xD; specimen 0..* Reference(Specimen) Referência à amostras associadas #xD; bodySite 0..* CodeableConcept Local anatômico associado ao procedimento Vínculo: SNOMEDCTBodyStructures (example) #xD; note 0..* Annotation Comentários #xD; patientInstruction 0..1 string Instruções para o paciente #xD; relevantHistory 0..* Reference(Provenance) Referência ao recurso Provenance #xD; Documentação para este formato
Este recurso restringe o recurso [ServiceRequest](https://hl7.org/fhir/R4/servicerequest.html) que registra uma solicitação de serviço, como investigações diagnósticas, tratamentos ou operações a serem realizadas
Quality Improvement and Clinical Knowledge (QUICK)
A record of a request for service such as diagnostic investigations, treatments, or operations to be performed.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
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()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
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()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
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.
A resource should have narrative for robust management
orderDetail SHALL only be present if code is present
exists(f:code) or not(exists(f:orderDetail))
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Um conjunto de regras sob as quais este conteúdo foi criado
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.
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
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).
Resumo do texto do recurso em linguagem natural
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.
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.
Extensões adicionais que não fazem parte do modelo base
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
Extensões adicionais que não podem ser ignoradas, mesmo que não reconhecidas
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Identificadores externos para este recurso
The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.
Note: This is a business identifier, not a resource identifier (see [discussion](http://hl7.org/fhir/R4/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.
Instancia protocolo externo ou definição
This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
Referência aos planos de cuidado/solicitações/medicamentos associados a esta requisição
Referência à requisição a ser substituida
Handled by message location of ORC (ORC.1=RO or RU)
Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.
Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes.
The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see [Event Pattern](http://hl7.org/fhir/R4/event.html) for general discussion) or using the [Task](http://hl7.org/fhir/R4/task.html) resource.
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
Código da intencionalidade desta requisição
This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.
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
.moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.
Used for filtering what service request are retrieved and displayed.
.outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="INT"].code
If missing, this task should be performed with normal priority
Verdadeiro se o serviço/procedimento não deve ser executado
In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.
Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.
If missing, the request is a positive request e.g. "do perform"
If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.
Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code.
For information from the medical record intended to support the delivery of the requested services, use the `supportingInformation` element.
Codified order entry details which are based on order context.
When ordering a service the number of service items may need to be specified separately from the the service item.
Referência ao paciente/grupo/localidade/dispositivo associado a esta requisição
Referência ao atendimento relacionado a esta requisição
.inboundRelationship(typeCode=COMP].source[classCode<=PCPR, moodCode=EVN]
Pré-condições para a realização do procedimento
A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
boolean: precondition.negationInd (inversed - so negationInd = true means asNeeded=false CodeableConcept: precondition.observationEventCriterion[code="Assertion"].value
Referência ao profissional/organização/paciente/dispotivo/pessoa relacionada que está solicitando o procedimento
This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource.
Função do profissional executante solicitado
This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”.
Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
Referência ao profissional executante solicitado
If multiple performers are present, it is interpreted as a list of *alternative* performers without any preference regardless of order. If order of preference is needed use the [request-performerOrder extension](http://hl7.org/fhir/R4/extension-request-performerorder.html). Use CareTeam to represent a group of performers (for example, Practitioner A *and* Practitioner B).
PRT, Practitioner: PRD-2/PRD-7 where PRD-3 = RT; Organization: PRD-10 where PRD-3 = RT
A location type where services are delivered.
Explicação/Justificativa para procedimento ou serviço
This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use `CodeableConcept.text` element if the data is free (uncoded) text as shown in the [CT Scan example](http://hl7.org/fhir/R4/servicerequest-example-di.html).
Diagnosis or problem codes justifying the reason for requesting the service investigation.
Referência à explicação/justificativa para serviço ou procedimento
This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to *Observation* or *Condition* should be used if available. Otherwise when referencing *DiagnosticReport* it should contain a finding in `DiagnosticReport.conclusion` and/or `DiagnosticReport.conclusionCode`. When using a reference to *DocumentReference*, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in `ServiceRequest.reasonCode` if the data is free (uncoded) text as shown in the [CT Scan example](http://hl7.org/fhir/R4/servicerequest-example-di.html).
To represent information about how the services are to be delivered use the `instructions` element.
Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the [Specimen](http://hl7.org/fhir/R4/specimen.html) resource points to the ServiceRequest.
Local anatômico associado ao procedimento
Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension [procedure-targetBodyStructure](http://hl7.org/fhir/R4/extension-procedure-targetbodystructure.html).
Knowing where the procedure is performed is important for tracking if multiple sites are possible.
.inboundRelationship(typeCode=SUBJ].source[classCode=ANNGEN, moodCode=EVN].value[xsi:type=ST]
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.
.inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]