CommunicationRequest

A request to convey information; e.g. the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition.

Schema

Elements

Name	Required	Type	Description
identifier		Identifier[]	Unique identifier Details Business identifiers assigned to this communication request by the performer or other systems which remain constant as the resource is updated and propagates from server to server. 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.
basedOn		Reference<Resource>[]	Fulfills plan or proposal Details A plan or proposal that is fulfilled in whole or in part by this request.
replaces		Reference<CommunicationRequest>[]	Request(s) replaced by this request Details Completed or terminated request(s) whose function is taken by this new request. The replacement could be because the initial request was immediately rejected (due to an issue) or because the previous request was completed, but the need for the action described by the request remains ongoing.
groupIdentifier		Identifier	Composite request this is part of Details A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition, prescription or similar form. 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.
status	✓	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Details The status of the proposal or order.
statusReason		CodeableConcept	Reason for current status Details Captures the reason for the current state of the CommunicationRequest. This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the CommunicationRequest was created at all is captured in reasonCode, not here. [distinct reason codes for different statuses can be enforced using invariants if they are universal bindings].
category		CodeableConcept[]	Message category Details The type of message to be sent such as alert, notification, reminder, instruction, etc. There may be multiple axes of categorization and one communication request may serve multiple purposes.
priority		code	routine | urgent | asap | stat Details Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine.
doNotPerform		boolean	True if request is prohibiting action Details If true indicates that the CommunicationRequest is asking for the specified action to *not* occur. The attributes provided with the request qualify what is not to be done.
medium		CodeableConcept[]	A channel of communication Details A channel that was used for this communication (e.g. email, fax).
subject		Reference<Patient | Group>	Focus of message Details The patient or group that is the focus of this communication request.
about		Reference<Resource>[]	Resources that pertain to this communication request Details Other resources that pertain to this communication request and to which this communication request should be associated. Don't use CommunicationRequest.about element when a more specific element exists, such as basedOn, reasonReference, or replaces.
encounter		Reference<Encounter>	Encounter created as part of Details The Encounter during which this CommunicationRequest was created or to which the creation of this record is tightly associated. This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.
payload		CommunicationRequestPayload[]	Message payload Details Text, attachment(s), or resource(s) to be communicated to the recipient.
id		string	Unique id for inter-element referencing Details Unique 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 Details 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. 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 Details 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). 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.
content[x]	✓	string, Attachment, Reference<Resource>	Message part content Details The communicated content (or for multi-part communications, one portion of the communication).
occurrence[x]		dateTime, Period	When scheduled Details The time when this communication is to occur.
authoredOn		dateTime	When request transitioned to being actionable Details For draft requests, indicates the date of initial creation. For requests with other statuses, indicates the date of activation.
requester		Reference< Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device >	Who/what is requesting service Details The device, individual, or organization who initiated the request and has responsibility for its activation.
recipient		Reference< Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService >[]	Message recipient Details The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication.
sender		Reference< Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService >	Message sender Details The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication.
reasonCode		CodeableConcept[]	Why is communication needed? Details Describes why the request is being made in coded or textual form. Textual reasons can be captured using reasonCode.text.
reasonReference		Reference< Condition | Observation | DiagnosticReport | DocumentReference >[]	Why is communication needed? Details Indicates another resource whose existence justifies this request.
note		Annotation[]	Comments made about communication request Details Comments made about the request by the requester, sender, recipient, subject or other participants.

Search Parameters

Name	Type	Description	Expression
authored	date	When request transitioned to being actionable	CommunicationRequest.authoredOn
based-on	reference	Fulfills plan or proposal	CommunicationRequest.basedOn
category	token	Message category	CommunicationRequest.category
encounter	reference	Encounter created as part of	CommunicationRequest.encounter
group-identifier	token	Composite request this is part of	CommunicationRequest.groupIdentifier
identifier	token	Unique identifier	CommunicationRequest.identifier
medium	token	A channel of communication	CommunicationRequest.medium
occurrence	date	When scheduled	CommunicationRequest.occurrence as dateTime
patient	reference	Focus of message	CommunicationRequest.subject.where(resolve() is Patient)
priority	token	routine | urgent | asap | stat	CommunicationRequest.priority
recipient	reference	Message recipient	CommunicationRequest.recipient
replaces	reference	Request(s) replaced by this request	CommunicationRequest.replaces
requester	reference	Who/what is requesting service	CommunicationRequest.requester
sender	reference	Message sender	CommunicationRequest.sender
status	token	draft | active | on-hold | revoked | completed | entered-in-error | unknown	CommunicationRequest.status
subject	reference	Focus of message	CommunicationRequest.subject
priority-order	number	Numeric priority order for resource types using http://hl7.org/fhir/ValueSet/request-priority	iif(priority = 'stat', 50, iif(priority = 'asap', 40, iif(priority = 'urgent', 30, iif(priority = 'routine', 20, 10))))

Inherited Elements

Name	Required	Type	Description
id		string	Logical id of this artifact Details The 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 Details 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.
implicitRules		uri	A set of rules under which this content was created Details 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. 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 Details The 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 Details 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. 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 Details 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. 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 Details 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. 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 Details 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). 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.

Usage

CommunicationRequest is one of the request resources in the FHIR workflow specification.

This resource is a record of a request for a communication to be performed. A communication is a conveyance of information from one entity, a sender, to another entity, a receiver. The requester requests the sender to send the payload to the recipient. The sender and receivers may be patients, practitioners, related persons, organizations, and devices. Uses of communication request include:

• A computer-based decision-support system requesting a reminder or alert be delivered to a responsible provider
• A physician requesting notification from the nurse if a patient's temperature exceeds a value
• A monitoring system or a provider requesting a staff member or department to notify a public health agency of a patient presenting with a communicable disease reportable to the public health agency
• A computer-based decision-support system proposes to send educational material to a patient

Relationships

This resource is a record of a request. It does not represent the actual flow of communication.

The use of CommunicationRequest excludes requests for referrals and requests for therapy or counseling which would be handled by the ServiceRequest resource. The performance of a CommunicationRequest may result in a Communication resource.

Referenced By

• CarePlan
• ClaimResponse