An appointment may include a visit either in person or remote (by phone, video conference, etc.). All that matter is that the time and usage of one or more individuals, locations and/or pieces of equipment is being fully or partially reserved for a designated period of time. When using a request-response style of appointment this is done using Appointment and AppointmentResponse resources. The request is made in the form of an Appointment with a proposed or pending status, and the list of actors with a participation status of “needs-action”.
The procedure will lead to either a Procedure or DiagnosticReport, which in turn may reference one or more Observations, which summarize the performance of the procedures and associated documentation such as observations, images, findings that are relevant to the treatment/management of the subject. This resource may be used to share relevant information required to support a referral or a transfer of care request from one practitioner or organization to another when a patient is required to be referred to another provider for a consultation /second opinion and/or for short term or longer term management of one or more health issues or problems.
– diagnostic tests/studies
– endoscopic procedures
– therapies (e.g., physio-, social-, psychological-)
– (exploratory) surgeries or procedures
– specialist consultation and assessments
– community services
– nursing services
– pharmacist medication review, and
– other clinical interventions.
– Procedures may be performed by a healthcare professional, a friend or relative or in some cases by the patient themselves.
The principal intention of ServiceRequest is to support ordering procedures for one patient (which includes non-human patients in veterinary medicine). However, in many contexts, healthcare related processes include performing diagnostic investigations on groups of subjects, devices involved in the provision of healthcare, and even environmental locations such as ducts, bodies of water, etc. Service Request supports all these usages. The service request may represent an order that is entered by a practitioner in a Computerized Physician Order Entry (CPOE) system as well as a proposal made by a clinical decision support (CDS) system based on a patient’s clinical record and context of care. Planned procedures referenced by a Care Plan may also be represented by this resource.
The general work flow, that this resource facilitates is that a clinical system creates a service request. The service request is then accessed by or exchanged with a system, perhaps via intermediaries, which represents an organization (e.g., diagnostic or imaging service, surgical team, physical therapy department) that can perform the procedure. The organization receiving the service request will, after it accepts the request, update the request as the work is performed, and then finally issue a report that references the requests that is fulfilled.
The ServiceRequest resource allows requesting only a single procedure. If a workflow requires requesting multiple procedures simultaneously, this is done using multiple instances of this resource. These instances can be linked in different ways, depending on the needs of the workflow.