Update Service Request Message
STATUS: draft
This message provides the required information to update previously submitted Service Request (a.k.a., Referral) in Netsmart Referral Manager.
{
// ...
"eventCoding": {
"system": "http://ntst.com/fhir/message-events",
"code": "update-service-request"
}
// ...
}
Authorization
This message will require the application obtain authorization using one of the following custom scopes based on SMART.
- v1:
[patient|user|system]/Messaging.[write|*] - v2: To be determined. (future)
Workflow
Payload
The payload for this message will consist of a Bundle with the type message and additional resources that make up the relevant information for the Service Request.
| Resource | Cardinality | Note |
|---|---|---|
| MessageHeader | 1..1 | Required for all FHIR messages and must be the first entry in the Bundle. |
| ServiceRequest | 1..1 | Details of the ServiceRequest. |
| Patient | 1..1 | Subject of the ServiceRequest. |
| Condition | 0..* | Associated conditions for this ServiceRequest. |
| Coverage | 0..* | Associated insurance coverage for this ServiceRequest. |
| Location | 0..* | Locations reference by the ServiceRequest or PractitionerRoles. |
| Observation | 0..* | Associated Observations for this ServiceRequest. |
| Organization | 0..* | Organizations referenced by the ServiceRequest or other resources. |
| Practitioner | 0..* | Practitioners referenced by the ServiceRequest or other resources. |
| PractitionerRole | 0..* | PractitionerRoles referenced by the ServiceRequest or other resources. |
| QuestionnaireResponse | 0..* | Supporting information for the ServiceRequest. These should be listed in MessageHeader.focus since they are not referenced elsewhere in the Bundle. |
Entity Relationship Diagram
Each resource included in the reference must be referenced by another resource within the Bundle. The diagram below illustrates the relationships and references.
Examples
Sample Request Payload
{
"resourceType": "Bundle",
"id": "607e4728-5d96-43a8-8be0-418313050140",
"type": "message",
"entry": [
{
"fullUrl": "MessageHeader/3641833",
"resource": {
"resourceType": "MessageHeader",
"eventCoding": {
"system": "http://ntst.com/fhir/message-events",
"code": "update-service-request"
},
"focus": [
{
"reference": "ServiceRequest/123456",
"type": "ServiceRequest"
},
{
"reference": "QuestionnaireResponse/ABC-456789",
"type": "QuestionnaireResponse"
}
]
}
},
{
"fullUrl": "ServiceRequest/123456",
"resource": {
"resourceType": "ServiceRequest",
"id": "123456",
"extension": [
// We can support multiple extension data types via the message. However, these will only be read if configured in Referral Manager.
],
"identifier": [
// We can support the exchange of identifiers as well. Configure the Systems in Referral Manager to add to the Referral.
],
"status": "active",
"intent": "proposal",
"subject": {
"reference": "Patient/987654",
"type": "Patient"
},
"requester": {
"reference": "PractitionerRole/45678",
"type": "PractitionerRole"
},
"performer": [
{
"reference": "PractitionerRole/56789",
"type": "PractitionerRole"
},
{
"reference": "Practitioner/888888888",
"type": "Practitioner"
}
],
"locationReference": [
{
"reference": "Location/90456",
"type": "Location"
}
]
}
},
{
"fullUrl": "PractitionerRole/45678",
"resource": {
"resourceType": "PractitionerRole",
"id": "1176",
"practitioner": {
"reference": "Practitioner/444444444"
},
"organization": {
"reference": "Organization/90123"
}
}
},
{
"fullUrl": "PractitionerRole/56789",
"resource": {
"resourceType": "PractitionerRole",
"id": "56789",
"practitioner": {
"reference": "Practitioner/666666666",
"type": "Practitioner"
},
"organization": {
"reference": "Organization/90123",
"type": "Organization"
}
}
},
{
"fullUrl": "Practitioner/444444444",
"resource": {
"resourceType": "Practitioner",
"id": "444444444",
"name": [
{
"family": "Family",
"given": [
"Given"
]
}
],
"telecom": [
{
"system": "phone",
"value": "5551234567"
},
{
"system": "email",
"value": "my.username@org.com"
}
]
}
},
{
"fullUrl": "Practitioner/666666666",
"resource": {
"resourceType": "Practitioner",
"id": "900049",
"extension": [
// Supported
],
"identifier": [
// Supported
],
"name": [
{
"family": "Last",
"given": [
"First"
]
}
]
}
},
{
"fullUrl": "Practitioner/888888888",
"resource": {
"resourceType": "Practitioner",
"id": "8236756",
"extension": [
// Supported
],
"name": [
{
"family": "Another",
"given": [
"Name"
]
}
]
}
},
{
"fullUrl": "Organization/90123",
"resource": {
"resourceType": "Organization",
"id": "90123",
"extension": [
// Supported
],
"identifier": [
{
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "2134567890"
},
],
"active": true,
"type": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/organization-type",
"code": "prov",
"display": "Healthcare Provider"
}
]
}
],
"name": "Hospital Name",
"telecom": [
{
"system": "phone",
"value": "9998887777"
}
],
"address": [
{
"line": [
"123 Main Street",
"Apt B"
],
"city": "Springfield",
"state": "MO",
"postalCode": "65803",
"country": "USA"
}
]
},
{
"fullUrl": "Patient/987654",
"resource": {
"resourceType": "Patient",
"extension": [
{
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race",
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2106-3",
"display": "White"
}
},
{
"url": "detailed",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2106-3",
"display": "White"
}
},
{
"url": "text",
"valueString": "White"
}
]
},
{
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity",
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2186-5",
"display": "Not Hispanic or Latino"
}
},
{
"url": "detailed",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2186-5",
"display": "Not Hispanic or Latino"
}
},
{
"url": "text",
"valueString": "Not Hispanic or Latino"
}
]
},
{
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
"valueCode": "M"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/patient-citizenship",
"extension": [
{
"url": "code",
"valueCodeableConcept": {
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "US"
}
]
}
},
{
"url": "code",
"valuePeriod": {
"start": "2000-03-12T05:00:00+00:00",
"end": "2017-08-31T05:00:00+00:00"
}
}
]
}
],
"identifier": [
// Supported
],
"name": [
{
"text": "First MI Last",
"family": "Last",
"given": [
"First",
"MI"
],
"suffix": "JR"
}
],
"telecom": [
{
"use": "home",
"system": "phone",
"value": "5556667788",
"rank": 1
},
{
"use": "work",
"system": "phone",
"value": "5556321478"
},
{
"use": "home",
"system": "email",
"value": "myemail20004@gmail.com"
}
],
"gender": "male",
"birthDate": "1997-01-16",
"deceasedBoolean": false,
"address": [
{
"use": "home",
"line": [
"4950 College Blvd."
],
"city": "Overland Park",
"state": "KS",
"postalCode": "66211",
"country": "US",
"period": {
"start": "2015-06-22T05:00:00+00:00"
}
}
],
"maritalStatus": {
"coding": [
{
"system": "urn:oid:2.16.840.1.113883.4.642.3.29",
"code": "C",
"display": "Common Law"
}
]
},
"communication": [
{
"language": {
"coding": [
{
"system": "urn:oid:1.0.639.1",
"code": "en",
"display": "English"
}
]
},
"preferred": true
}
]
}
}
},
{
"fullUrl": "QuestionnaireResponse/ABC-456789",
"resource": {
"resourceType": "QuestionnaireResponse",
"identifier": {
"value": "MQ_3641833"
},
"basedOn": [
{
"reference": "ServiceRequest/123456"
}
],
"questionnaire": "Questionnaire/ABC",
"status": "in-progress",
"item": [
{
"linkId": "P-01",
"text": "Text of the first prompt?",
"answer": [
{
"valueString": "Free-text answer"
}
]
},
{
"linkId": "P-02",
"text": "Text the second prompt?",
"answer": [
{
"valueBoolean": false
}
]
}
]
}
},
{
"fullUrl": "Location/90456",
"resource": {
"resourceType": "Location",
"id": "90456",
"extension": [
// Supported
],
"identifier": [
// Supported
],
"status": "active",
"name": "Facility Name",
"description": "Facility description.",
"mode": "instance",
"telecom": [
{
"use": "work",
"system": "phone",
"value": "2328"
},
{
"system": "email",
"value": "facility@domain.com"
}
],
"address": {
"use": "work",
"line": [
"Street 1",
"Street 2"
],
"city": "City",
"postalCode": "12345+6789",
"country": "US"
},
"position": {
"longitude": -83.6945691,
"latitude": 42.25475478,
"altitude": 0
},
"managingOrganization": {
"reference": "Organization/90123"
},
"hoursOfOperation": [
{
"daysOfWeek": [
"mon",
"tue",
"wed",
"thu",
"fri"
],
"allDay": false,
"openingTime": "07:00:00",
"closingTime": "19:00:00"
},
{
"daysOfWeek": [
"sat"
],
"allDay": false,
"openingTime": "09:00:00",
"closingTime": "16:00:00"
}
]
}
},
]
}
Sample Response Payload
{
"resourceType": "Bundle",
"id": "1a124350-e357-4b29-b780-1a4c9064c024",
"type": "message",
"entry": [
{
"fullUrl": "MessageHeader/3641833",
"resource": {
"resourceType": "MessageHeader",
"eventCoding": {
"system": "http://ntst.com/fhir/message-events",
"code": "update-service-request"
},
"response": {
"identifier": "607e4728-5d96-43a8-8be0-418313050140",
"code": "ok"
},
"focus": [
{
"reference": "ServiceRequest/123456",
"type": "ServiceRequest"
},
{
"reference": "QuestionnaireResponse/ABC-456789",
"type": "QuestionnaireResponse"
}
]
}
},
{
"fullUrl": "ServiceRequest/123456",
"resource": {
"resourceType": "ServiceRequest",
"id": "123456",
"extension": [
// We can support multiple extension data types via the message. However, these will only be read if configured in Referral Manager.
],
"identifier": [
// We can support the exchange of identifiers as well. Configure the Systems in Referral Manager to add to the Referral.
],
"status": "active",
"intent": "proposal",
"subject": {
"reference": "Patient/987654",
"type": "Patient"
},
"requester": {
"reference": "PractitionerRole/45678",
"type": "PractitionerRole"
},
"performer": [
{
"reference": "PractitionerRole/56789",
"type": "PractitionerRole"
},
{
"reference": "Practitioner/888888888",
"type": "Practitioner"
}
],
"locationReference": [
{
"reference": "Location/90456",
"type": "Location"
}
]
}
},
{
"fullUrl": "PractitionerRole/45678",
"resource": {
"resourceType": "PractitionerRole",
"id": "1176",
"practitioner": {
"reference": "Practitioner/444444444"
},
"organization": {
"reference": "Organization/90123"
}
}
},
{
"fullUrl": "PractitionerRole/56789",
"resource": {
"resourceType": "PractitionerRole",
"id": "56789",
"practitioner": {
"reference": "Practitioner/666666666",
"type": "Practitioner"
},
"organization": {
"reference": "Organization/90123",
"type": "Organization"
}
}
},
{
"fullUrl": "Practitioner/444444444",
"resource": {
"resourceType": "Practitioner",
"id": "444444444",
"name": [
{
"family": "Family",
"given": [
"Given"
]
}
],
"telecom": [
{
"system": "phone",
"value": "5551234567"
},
{
"system": "email",
"value": "my.username@org.com"
}
]
}
},
{
"fullUrl": "Practitioner/666666666",
"resource": {
"resourceType": "Practitioner",
"id": "900049",
"extension": [
// Supported
],
"identifier": [
// Supported
],
"name": [
{
"family": "Last",
"given": [
"First"
]
}
]
}
},
{
"fullUrl": "Practitioner/888888888",
"resource": {
"resourceType": "Practitioner",
"id": "8236756",
"extension": [
// Supported
],
"name": [
{
"family": "Another",
"given": [
"Name"
]
}
]
}
},
{
"fullUrl": "Organization/90123",
"resource": {
"resourceType": "Organization",
"id": "90123",
"extension": [
// Supported
],
"identifier": [
{
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "2134567890"
},
],
"active": true,
"type": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/organization-type",
"code": "prov",
"display": "Healthcare Provider"
}
]
}
],
"name": "Hospital Name",
"telecom": [
{
"system": "phone",
"value": "9998887777"
}
],
"address": [
{
"line": [
"123 Main Street",
"Apt B"
],
"city": "Springfield",
"state": "MO",
"postalCode": "65803",
"country": "USA"
}
]
},
{
"fullUrl": "Patient/987654",
"resource": {
"resourceType": "Patient",
"extension": [
{
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race",
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2106-3",
"display": "White"
}
},
{
"url": "detailed",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2106-3",
"display": "White"
}
},
{
"url": "text",
"valueString": "White"
}
]
},
{
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity",
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2186-5",
"display": "Not Hispanic or Latino"
}
},
{
"url": "detailed",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2186-5",
"display": "Not Hispanic or Latino"
}
},
{
"url": "text",
"valueString": "Not Hispanic or Latino"
}
]
},
{
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
"valueCode": "M"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/patient-citizenship",
"extension": [
{
"url": "code",
"valueCodeableConcept": {
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "US"
}
]
}
},
{
"url": "code",
"valuePeriod": {
"start": "2000-03-12T05:00:00+00:00",
"end": "2017-08-31T05:00:00+00:00"
}
}
]
}
],
"identifier": [
// Supported
],
"name": [
{
"text": "First MI Last",
"family": "Last",
"given": [
"First",
"MI"
],
"suffix": "JR"
}
],
"telecom": [
{
"use": "home",
"system": "phone",
"value": "5556667788",
"rank": 1
},
{
"use": "work",
"system": "phone",
"value": "5556321478"
},
{
"use": "home",
"system": "email",
"value": "myemail20004@gmail.com"
}
],
"gender": "male",
"birthDate": "1997-01-16",
"deceasedBoolean": false,
"address": [
{
"use": "home",
"line": [
"4950 College Blvd."
],
"city": "Overland Park",
"state": "KS",
"postalCode": "66211",
"country": "US",
"period": {
"start": "2015-06-22T05:00:00+00:00"
}
}
],
"maritalStatus": {
"coding": [
{
"system": "urn:oid:2.16.840.1.113883.4.642.3.29",
"code": "C",
"display": "Common Law"
}
]
},
"communication": [
{
"language": {
"coding": [
{
"system": "urn:oid:1.0.639.1",
"code": "en",
"display": "English"
}
]
},
"preferred": true
}
]
}
}
},
{
"fullUrl": "QuestionnaireResponse/ABC-456789",
"resource": {
"resourceType": "QuestionnaireResponse",
"identifier": {
"value": "MQ_3641833"
},
"basedOn": [
{
"reference": "ServiceRequest/123456"
}
],
"questionnaire": "Questionnaire/ABC",
"status": "in-progress",
"item": [
{
"linkId": "P-01",
"text": "Text of the first prompt?",
"answer": [
{
"valueString": "Free-text answer"
}
]
},
{
"linkId": "P-02",
"text": "Text the second prompt?",
"answer": [
{
"valueBoolean": false
}
]
}
]
}
},
{
"fullUrl": "Location/90456",
"resource": {
"resourceType": "Location",
"id": "90456",
"extension": [
// Supported
],
"identifier": [
// Supported
],
"status": "active",
"name": "Facility Name",
"description": "Facility description.",
"mode": "instance",
"telecom": [
{
"use": "work",
"system": "phone",
"value": "2328"
},
{
"system": "email",
"value": "facility@domain.com"
}
],
"address": {
"use": "work",
"line": [
"Street 1",
"Street 2"
],
"city": "City",
"postalCode": "12345+6789",
"country": "US"
},
"position": {
"longitude": -83.6945691,
"latitude": 42.25475478,
"altitude": 0
},
"managingOrganization": {
"reference": "Organization/90123"
},
"hoursOfOperation": [
{
"daysOfWeek": [
"mon",
"tue",
"wed",
"thu",
"fri"
],
"allDay": false,
"openingTime": "07:00:00",
"closingTime": "19:00:00"
},
{
"daysOfWeek": [
"sat"
],
"allDay": false,
"openingTime": "09:00:00",
"closingTime": "16:00:00"
}
]
}
},
]
}