## Profile Comparison between http://hl7.org/fhir/us/core/StructureDefinition/us-core-servicerequest vs http://hl7.org/fhir/us/core/StructureDefinition/us-core-pmo-servicerequest

Left: | US Core ServiceRequest Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-servicerequest)
Right: | US Core PMO ServiceRequest Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-pmo-servicerequest)

### Messages

Error | StructureDefinition.url | Values for url differ: 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-servicerequest' vs 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-pmo-servicerequest'
Error | StructureDefinition.version | Values for version differ: '8.0.0' vs '0.1.0'
Information | StructureDefinition.name | Values for name differ: 'USCoreServiceRequestProfile' vs 'USCorePMOServiceRequestProfile'
Information | StructureDefinition.title | Values for title differ: 'US Core ServiceRequest Profile' vs 'US Core PMO ServiceRequest Profile'
Information | StructureDefinition.status | Values for status differ: 'active' vs 'draft'
Information | StructureDefinition.date | Values for date differ: '2025-04-28' vs '2025-08-26'
Information | StructureDefinition.publisher | Values for publisher differ: 'HL7 International / Cross-Group Projects' vs 'HL7 International / Payer/Provider Information Exchange Work Group'
Information | ServiceRequest.language | Example/preferred bindings differ at ServiceRequest.language using binding from USCoreServiceRequestProfile
Information | StructureDefinition.short | Values for short differ: 'proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option' vs 'Note: To allow for the resource life cycle, no constraint on intent, use 'directive' in PMO document'
Error | ServiceRequest.code | Unable to resolve right value set http://hl7.org/fhir/us/core/ValueSet/us-core-pmo-procedure-code at ServiceRequest.code
Information | StructureDefinition.short | Values for short differ: '𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: The name of the test, procedure, or service to be performed.' vs 'Plain text representation of the PMO procedure or service.'
Warning | ServiceRequest.code.text | Elements differ in definition for mustSupport: 'false' vs 'true'
Warning | ServiceRequest.orderDetail | Elements differ in definition for mustSupport: 'false' vs 'true'
Information | StructureDefinition.short | Values for short differ: 'Individual or Entity the service is ordered for' vs 'limited to Patient'
Information | StructureDefinition.short | Values for short differ: 'Encounter in which the request was created' vs '**NOT USED WHEN PART OF A PMO DOCUMENT**'
Information | StructureDefinition.short | Values for short differ: 'When service should occur' vs 'Often just a start date'
Information | StructureDefinition.short | Values for short differ: 'Date request signed' vs 'Date Order signed vs date of PMO document - same if part of PMO document'
Information | StructureDefinition.short | Values for short differ: 'Who/what is requesting service' vs 'Authored only by Practitioner'
Information | StructureDefinition.short | Values for short differ: '𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Explanation/Justification for procedure or service' vs 'Explanation/Justification for procedure or service'
Warning | ServiceRequest.reasonCode | Elements differ in definition for mustSupport: 'false' vs 'true'
Information | StructureDefinition.short | Values for short differ: '𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profile that supports the requested service' vs 'US Core ADI DocumentReference Profile or other US Core profiles that support the requested PMO service.'
Warning | ServiceRequest.reasonReference | Elements differ in definition for mustSupport: 'false' vs 'true'
Error | ServiceRequest.reasonReference | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/Condition], CanonicalType[http://hl7.org/fhir/StructureDefinition/Observation], CanonicalType[http://hl7.org/fhir/StructureDefinition/DiagnosticReport], CanonicalType[http://hl7.org/fhir/StructureDefinition/DocumentReference]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-adi-documentreference], CanonicalType[http://hl7.org/fhir/StructureDefinition/us-core-condition], CanonicalType[http://hl7.org/fhir/StructureDefinition/us-core-observation], CanonicalType[http://hl7.org/fhir/StructureDefinition/us-core-diagnosticreport]])

### Metadata

Name | Value | Comments
--- | --- | ---
abstract | false |
baseDefinition | http://hl7.org/fhir/StructureDefinition/ServiceRequest |
copyright | Used by permission of HL7 International, all rights reserved Creative Commons License |  | Removed the item 'Used by permission of HL7 International, all rights reserved Creative Commons License'
date | 2025-04-28 | 2025-08-26 | Values Differ
description | The US Core ServiceRequest Profile inherits from the FHIR [ServiceRequest](https://hl7.org/fhir/R4/servicerequest.html) resource; refer to it for scope and usage definitions. This profile sets minimum expectations for recording, searching, and fetching the ServiceRequest information. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption. | The US Core PMO ServiceRequest Profile inherits from the [FHIR ServiceRequest](https://hl7.org/fhir/R4/servicerequest.html) resource; refer to it for scope and usage definitions. This profile represents an order based on a PMO document and references the [US Core ADI DocumentReference Profile](StructureDefinition-us-core-adi-documentreference.html) to communicate the contents of the PMO document, such as POLST, MOLST, or other state-specific forms. PMO documents follow the patient across care settings and are typically stored as scanned images in EMRs/EHRs. Together, these two profiles satisfy the USCDI's PMO Order Data Element's intent to represent orders based on an individual's PMO. The US Core PMO ServiceRequest Profile establishes minimum expectations for recording, searching, and fetching PMO-related ServiceRequest information, specifying core elements, extensions, vocabularies, and value sets that SHALL be present to promote interoperability. | Values Differ
experimental |  |
fhirVersion | 4.0.1 |
jurisdiction |  |
jurisdiction[0] | urn:iso:std:iso:3166#US |
kind | resource |
name | USCoreServiceRequestProfile | USCorePMOServiceRequestProfile | Values Differ
publisher | HL7 International / Cross-Group Projects | HL7 International / Payer/Provider Information Exchange Work Group | Values Differ
purpose |  |
status | active | draft | Values Differ
title | US Core ServiceRequest Profile | US Core PMO ServiceRequest Profile | Values Differ
type | ServiceRequest |
url | http://hl7.org/fhir/us/core/StructureDefinition/us-core-servicerequest | http://hl7.org/fhir/us/core/StructureDefinition/us-core-pmo-servicerequest | Values Differ
version | 8.0.0 | 0.1.0 | Values Differ

### Structure

Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments
--- | --- | --- | --- | --- | --- | --- | --- | --- | ---
ServiceRequest | C | 0..* | ServiceRequest | A request for a service to be performed | C | 0..* | ServiceRequest | A request for a service to be performed |
id | Σ | 0..1 | id | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact |
meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
language |  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
|  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
| Example/preferred bindings differ at ServiceRequest.language using binding from USCoreServiceRequestProfile
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements |
contained |  | 0..* | Resource | Contained, inline Resources |  | 0..* | Resource | Contained, inline Resources |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored |
identifier | Σ | 0..* | Identifier | Identifiers assigned to this order | Σ | 0..* | Identifier | Identifiers assigned to this order |
instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition |
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition | Σ | 0..* | uri | Instantiates external protocol or definition |
basedOn | Σ | 0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | What request fulfills | Σ | 0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | What request fulfills |
replaces | Σ | 0..* | Reference(ServiceRequest) | What request replaces | Σ | 0..* | Reference(ServiceRequest) | What request replaces |
requisition | Σ | 0..1 | Identifier | Composite Request ID | Σ | 0..1 | Identifier | Composite Request ID |
status | ?!S Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: ?? (required): The status of a service order. | ?!S Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: ?? (required): The status of a service order. |
intent | ?!S Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: ?? (required): The kind of service request. | ?!S Σ | 1..1 | code | Note: To allow for the resource life cycle, no constraint on intent, use "directive" in PMO document Binding: ?? (required): The kind of service request. |
Slices for category | S Σ | 0..* | CodeableConcept | Classification of service Slice: Unordered, Open by value:$this Binding: ?? (example): Classification of the requested service. | S Σ | 0..* | CodeableConcept | Classification of service Slice: Unordered, Open by value:$this Binding: ?? (example): Classification of the requested service. |
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: ?? (required): Identifies the level of importance to be assigned to actioning the request. | Σ | 0..1 | code | routine | urgent | asap | stat Binding: ?? (required): Identifies the level of importance to be assigned to actioning the request. |
doNotPerform | ?!Σ | 0..1 | boolean | True if service/procedure should not be performed | ?!Σ | 0..1 | boolean | True if service/procedure should not be performed |
code | S Σ | 1..1 | CodeableConcept | What is being requested/ordered Binding: ?? (extensible) | S Σ | 1..1 | CodeableConcept | What is being requested/ordered Binding: ?? (extensible): Portable Medical Order panel answers - mostly free-text
Additional Bindings | Purpose | Documentation
?? | Extensible | SeviceRequest.category = Cardiopulmonary resuscitation orders
?? | Extensible | SeviceRequest.category = Initial portable medical treatment orders
?? | Extensible | SeviceRequest.category = Additional portable medical orders or instructions
| Unable to resolve right value set http://hl7.org/fhir/us/core/ValueSet/us-core-pmo-procedure-code at ServiceRequest.code
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
coding | Σ | 0..* | Coding | Code defined by a terminology system | Σ | 0..* | Coding | Code defined by a terminology system |
text | Σ | 0..1 | string | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: The name of the test, procedure, or service to be performed. | S Σ | 0..1 | string | Plain text representation of the PMO procedure or service. | Elements differ in definition for mustSupport: 'false' vs 'true'
orderDetail | Σ C | 0..* | CodeableConcept | Additional order information Binding: ?? (example): Codified order entry details which are based on order context. | S Σ C | 0..* | CodeableConcept | Additional order information Binding: ?? (example): Codified order entry details which are based on order context. | Elements differ in definition for mustSupport: 'false' vs 'true'
id |  |  |  |  |  | 0..1 | string | Unique id for inter-element referencing | Added this element
Slices for extension |  |  |  |  |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | Added this element
coding |  |  |  |  | Σ | 0..* | Coding | Code defined by a terminology system | Added this element
text |  |  |  |  | S Σ | 0..1 | string | Plain text representation to capture additional PMO order details. | Added this element
quantity[x] | Σ | 0..1 | Quantity, Ratio, Range | Service amount | Σ | 0..1 | Quantity, Ratio, Range | Service amount |
subject | S Σ | 1..1 | Reference(US Core Patient Profile S | Group | US Core Location Profile | Device) | Individual or Entity the service is ordered for | S Σ | 1..1 | Reference(US Core Patient Profile) | limited to Patient |
encounter | S Σ | 0..1 | Reference(US Core Encounter Profile) | Encounter in which the request was created | S Σ | 0..1 | Reference(US Core Encounter Profile) | **NOT USED WHEN PART OF A PMO DOCUMENT** |
occurrence[x] | S Σ | 0..1 | Period S, dateTime, Timing | When service should occur | S Σ | 0..1 | Period S, dateTime, Timing | Often just a start date |
asNeeded[x] | Σ | 0..1 | boolean, CodeableConcept | Preconditions for service Binding: ?? (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. | Σ | 0..1 | boolean, CodeableConcept | Preconditions for service Binding: ?? (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. |
authoredOn | S Σ | 0..1 | dateTime | Date request signed | S Σ | 0..1 | dateTime | Date Order signed vs date of PMO document - same if part of PMO document |
requester | S Σ | 0..1 | Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile | Device) | Who/what is requesting service | S Σ | 0..1 | Reference(US Core Practitioner Profile S | US Core Organization Profile | PractitionerRole) | Authored only by Practitioner |
performerType | Σ | 0..1 | CodeableConcept | Performer role Binding: ?? (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. | Σ | 0..1 | CodeableConcept | Performer role Binding: ?? (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. |
performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) | Requested performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) | Requested performer |
locationCode | Σ | 0..* | CodeableConcept | Requested location Binding: ?? (example): A location type where services are delivered. | Σ | 0..* | CodeableConcept | Requested location Binding: ?? (example): A location type where services are delivered. |
locationReference | Σ | 0..* | Reference(Location) | Requested location | Σ | 0..* | Reference(Location) | Requested location |
reasonCode | Σ | 0..* | CodeableConcept | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Explanation/Justification for procedure or service Binding: ?? (extensible) | S Σ | 0..* | CodeableConcept | Explanation/Justification for procedure or service Binding: ?? (extensible) | Elements differ in definition for mustSupport: 'false' vs 'true'
reasonReference | Σ | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profile that supports the requested service | S Σ | 0..* | Reference(US Core ADI DocumentReference Profile S | us-core-condition | us-core-observation | us-core-diagnosticreport) | US Core ADI DocumentReference Profile or other US Core profiles that support the requested PMO service. | Elements differ in definition for mustSupport: 'false' vs 'true' Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/Condition], CanonicalType[http://hl7.org/fhir/StructureDefinition/Observation], CanonicalType[http://hl7.org/fhir/StructureDefinition/DiagnosticReport], CanonicalType[http://hl7.org/fhir/StructureDefinition/DocumentReference]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-adi-documentreference], CanonicalType[http://hl7.org/fhir/StructureDefinition/us-core-condition], CanonicalType[http://hl7.org/fhir/StructureDefinition/us-core-observation], CanonicalType[http://hl7.org/fhir/StructureDefinition/us-core-diagnosticreport]])
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage |
supportingInfo |  | 0..* | Reference(Resource) | Additional clinical information |  | 0..* | Reference(Resource) | Additional clinical information |
specimen | Σ | 0..* | Reference(Specimen) | Procedure Samples | Σ | 0..* | Reference(Specimen) | Procedure Samples |
bodySite | Σ | 0..* | CodeableConcept | Location on Body Binding: ?? (example): Codes describing anatomical locations. May include laterality. | Σ | 0..* | CodeableConcept | Location on Body Binding: ?? (example): Codes describing anatomical locations. May include laterality. |
note |  | 0..* | Annotation | Comments |  | 0..* | Annotation | Comments |
patientInstruction | Σ | 0..1 | string | Patient or consumer-oriented instructions | Σ | 0..1 | string | Patient or consumer-oriented instructions |
relevantHistory |  | 0..* | Reference(Provenance) | Request provenance |  | 0..* | Reference(Provenance) | Request provenance |
Documentation for this format