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ServiceRequest Profile

Canonical../StructureDefinition/nexus-emr-core-servicerequest
Statusdraft · 1.26.0
BaseServiceRequest (constraint)
SourceFSH · JSON

Defines the Nexus EMR FHIR profile for ORDER-shaped ServiceRequest resources -- laboratory, diagnostic-imaging and procedure orders -- aggregated from multiple EMRs. Referrals are NOT in scope: a referral is intent=proposal and carries the receiving service or specialty in category, neither of which this profile permits. Referrals use NexusCoreReferral (../StructureDefinition/nexus-core-referral).

Overview

Overview

The Nexus EMR Core ServiceRequest profile represents orders for diagnostic tests and procedures within primary care EMR systems. This profile captures the essential elements of service ordering including what is requested, for whom, by whom, and when across the Nexus EMR ecosystem.

Scope: orders, not referrals

This profile is order-shaped. intent is fixed to order, and category is bound (required) to the base FHIR ServiceRequest category value set, which enumerates exactly five concepts and contains no referral concept.

A referral is a different shape: intent = proposal, because the referrer does not control whether the receiving service accepts, and its category carries the receiving service or specialty rather than one of those five. Referrals are profiled separately as NexusCoreReferral; see the Referrals guide page for the relationship to the Ontario eReferral and CA-eReC contracts.

Key Features

  • Flexible Service Coding: Supports SNOMED CT, LOINC, and source EMR order codes
  • Category Classification: Distinguishes laboratory, imaging and procedure orders
  • Status Tracking: Monitors order lifecycle from draft through completion
  • Timing Flexibility: Supports scheduled, urgent, and routine requests
  • Clinical Context: Links to encounters and related clinical information

Service Categories

Common order types include:

  • Laboratory: Blood tests, urinalysis, cultures, pathology
  • Diagnostic Imaging: X-rays, CT, MRI, ultrasound orders
  • Procedures: Minor surgeries, diagnostic procedures

Order Workflow

Service requests progress through states:

  • Draft: Order being prepared
  • Active: Order placed and actionable
  • On-hold: Temporarily suspended
  • Completed: Service has been performed
  • Entered-in-error: Order should be ignored
  • Revoked: Order cancelled before completion

Clinical Decision Support

The profile supports:

  • Order appropriateness checking
  • Duplicate order detection
  • Insurance authorization requirements
  • Clinical guidelines integration
  • Result tracking and follow-up

Relationships

ServiceRequests connect to:

  • DiagnosticReport: Results fulfilling the request
  • Procedure: Procedures performed in response
  • Observation: Observations resulting from the request
  • Encounter: Clinical context when ordered
  • MedicationRequest: Related medication orders

Terminology bindings

Path Strength Value set
ServiceRequest.status required request-status
ServiceRequest.intent required request-intent
ServiceRequest.category required servicerequest-category