Introduction

The CommunicationRequest resource allows for changes in the way the eHealth Infrastructure creates Communications (of profile ehealth-message).

Scope and Usage

The eHealth Infrastructure generates Communications (of profile ehealth-message) in the following cases:

• Automated processing has been performed on a submitted measurement - whether zero, one or more Communication are created depends on the automated processing rules involved.
• A measurement is missing, that is, expected measurement has not been submitted
• A measurement has been submitted at an unexpected time
• A reminder that a measurement is expected to be submitted
• A CarePlan or EpisodeOfCare has been created or updated
• A reminder that an order in the SSL domain is to be delivered (requires additional configuration in the SSL Contract)

The default behaviour and controllability for the different Communication scenarios differ. An overview of how to control the different Communication generation can be found here.

The CommunicationRequest is used to customize how and when Communications are created by the infrastructure:

• CommunicationRequest can in some scenarios specify suppression of a specific Communication for CareTeams and/or Patients
• CommunicationRequest can in some scenarios specify overriding of medium and/or payload for Patient Communications

If multiple CommunicationRequests for the same recipient are found the most recent (by occurrencePeriod.start) with status active takes precedence. If multiple CommunicationRequest resources are the most recent and active, any CommunicationRequest with doNotPerform = true takes precedence.

Suppression of Communications

When the infrastructure by default creates Communication for either a Patient or CareTeam, it may be possible to suppress creation for a specific recipient. An overview of when suppression is possible is given here. A CommunicationRequest states suppression when:

• doNotPerform is set to true

See the other requirements for a CommunicationRequest to take effect here.Updating doNotPerform to false or removing the attribute disables the specified suppression of the Communication. Alternatively, the CommunicationRequest lifecycle can be adjusted by setting a status value other than active.

Override medium and payload

In some scenarios it is possible to use CommunicationRequest to override some default values of the Communication:

• medium overrides the Communication medium.
• payload overrides the Communication payload.

Boundaries and Relationships

A CommunicationRequest is related to Communication (ehealth-message) and in some cases EpisodeOfCare (ehealth-episode-of-care) or ServiceRequest (ehealth-serviceRequest).

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
CommunicationRequest		0..*	CommunicationRequest	A request for information to be sent to a receiver
CommunicationRequest.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
CommunicationRequest.Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
CommunicationRequest.Slices for extension.extension:episodeOfCare		0..1	(Complex)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
CommunicationRequest.Slices for extension.extension:episodeOfCare.extension		0..0		Extension Slice: Unordered, Open by value:url
CommunicationRequest.Slices for extension.extension:episodeOfCare.url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare"
CommunicationRequest.Slices for extension.extension:episodeOfCare.value[x]		1..1	Reference(ehealth-episodeofcare) {r}	Value of extension
CommunicationRequest.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
CommunicationRequest.basedOn	Σ This element is included in summaries.	0..1	Reference(Resource)	Fulfills plan or proposal
CommunicationRequest.status	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request.
CommunicationRequest.category		0..*	CodeableConcept	Message category Binding: MessageCategory (required)
CommunicationRequest.priority	Σ This element is included in summaries.	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required)
CommunicationRequest.doNotPerform	?! This element is a modifier element. Σ This element is included in summaries.	0..1	boolean	True if request is prohibiting action
CommunicationRequest.medium		0..*	CodeableConcept	A channel of communication Binding: MessageMedium (required)
CommunicationRequest.subject		1..1	Reference(Patient)	Focus of message
CommunicationRequest.recipient		0..*	Reference(Patient | CareTeam) {r}	Message recipient
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
CommunicationRequest.​status	Base	required	RequestStatus	📍4.0.1	FHIR Std.
CommunicationRequest.​category	Base	required	MessageCategory	📦11.0.1	This IG
CommunicationRequest.​priority	Base	required	Request priority	📦4.0.1	FHIR Std.
CommunicationRequest.​medium	Base	required	MessageMedium	📦11.0.1	This IG

Constraints

Id

Grade

Path(s)

Description

Expression

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
CommunicationRequest		0..*	CommunicationRequest	A request for information to be sent to a receiver
CommunicationRequest.Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
CommunicationRequest.Slices for extension.extension:episodeOfCare		0..1	(Complex)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
CommunicationRequest.Slices for extension.extension:episodeOfCare.value[x]		1..1	Reference(ehealth-episodeofcare) {r}	Value of extension
CommunicationRequest.basedOn		0..1	Reference(Resource)	Fulfills plan or proposal
CommunicationRequest.category		0..*	CodeableConcept	Message category Binding: MessageCategory (required)
CommunicationRequest.priority		0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required)
CommunicationRequest.medium		0..*	CodeableConcept	A channel of communication Binding: MessageMedium (required)
CommunicationRequest.subject		1..1	Reference(Patient)	Focus of message
CommunicationRequest.recipient		0..*	Reference(Patient | CareTeam) {r}	Message recipient
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
CommunicationRequest.​category	Base	required	MessageCategory	📦11.0.1	This IG
CommunicationRequest.​priority	Base	required	Request priority	📦4.0.1	FHIR Std.
CommunicationRequest.​medium	Base	required	MessageMedium	📦11.0.1	This IG

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
CommunicationRequest		0..*	CommunicationRequest	A request for information to be sent to a receiver
CommunicationRequest.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
CommunicationRequest.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
CommunicationRequest.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
CommunicationRequest.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
CommunicationRequest.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
CommunicationRequest.contained		0..*	Resource	Contained, inline Resources
CommunicationRequest.Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
CommunicationRequest.Slices for extension.extension:episodeOfCare		0..1	(Complex)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
CommunicationRequest.Slices for extension.extension:episodeOfCare.id		0..1	string	Unique id for inter-element referencing
CommunicationRequest.Slices for extension.extension:episodeOfCare.extension		0..0		Extension Slice: Unordered, Open by value:url
CommunicationRequest.Slices for extension.extension:episodeOfCare.url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare"
CommunicationRequest.Slices for extension.extension:episodeOfCare.value[x]		1..1	Reference(ehealth-episodeofcare) {r}	Value of extension
CommunicationRequest.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
CommunicationRequest.identifier	Σ This element is included in summaries.	0..*	Identifier	Unique identifier
CommunicationRequest.basedOn	Σ This element is included in summaries.	0..1	Reference(Resource)	Fulfills plan or proposal
CommunicationRequest.replaces	Σ This element is included in summaries.	0..*	Reference(CommunicationRequest)	Request(s) replaced by this request
CommunicationRequest.groupIdentifier	Σ This element is included in summaries.	0..1	Identifier	Composite request this is part of
CommunicationRequest.status	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request.
CommunicationRequest.statusReason		0..1	CodeableConcept	Reason for current status Binding Description: (example): Codes identifying the reason for the current state of a request.
CommunicationRequest.category		0..*	CodeableConcept	Message category Binding: MessageCategory (required)
CommunicationRequest.priority	Σ This element is included in summaries.	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required)
CommunicationRequest.doNotPerform	?! This element is a modifier element. Σ This element is included in summaries.	0..1	boolean	True if request is prohibiting action
CommunicationRequest.medium		0..*	CodeableConcept	A channel of communication Binding: MessageMedium (required)
CommunicationRequest.subject		1..1	Reference(Patient)	Focus of message
CommunicationRequest.about		0..*	Reference(Resource)	Resources that pertain to this communication request
CommunicationRequest.encounter	Σ This element is included in summaries.	0..1	Reference(Encounter)	Encounter created as part of
CommunicationRequest.payload		0..*	BackboneElement	Message payload
CommunicationRequest.payload.id		0..1	string	Unique id for inter-element referencing
CommunicationRequest.payload.extension		0..*	Extension	Additional content defined by implementations
CommunicationRequest.payload.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
CommunicationRequest.payload.content[x]		1..1		Message part content
CommunicationRequest.payload.content[x].contentString			string
CommunicationRequest.payload.content[x].contentAttachment			Attachment
CommunicationRequest.payload.content[x].contentReference			Reference(Resource)
CommunicationRequest.occurrence[x]	Σ This element is included in summaries.	0..1		When scheduled
CommunicationRequest.occurrence[x].occurrenceDateTime			dateTime
CommunicationRequest.occurrence[x].occurrencePeriod			Period
CommunicationRequest.authoredOn	Σ This element is included in summaries.	0..1	dateTime	When request transitioned to being actionable
CommunicationRequest.requester	Σ This element is included in summaries.	0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Who/what is requesting service
CommunicationRequest.recipient		0..*	Reference(Patient | CareTeam) {r}	Message recipient
CommunicationRequest.sender	Σ This element is included in summaries.	0..1	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService)	Message sender
CommunicationRequest.reasonCode	Σ This element is included in summaries.	0..*	CodeableConcept	Why is communication needed? Binding: v3 Code System ActReason (example): Codes for describing reasons for the occurrence of a communication.
CommunicationRequest.reasonReference	Σ This element is included in summaries.	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Why is communication needed?
CommunicationRequest.note		0..*	Annotation	Comments made about communication request
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
CommunicationRequest.​language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
CommunicationRequest.​status	Base	required	RequestStatus	📍4.0.1	FHIR Std.
CommunicationRequest.​statusReason	Base	example		Not State	Unknown
CommunicationRequest.​category	Base	required	MessageCategory	📦11.0.1	This IG
CommunicationRequest.​priority	Base	required	Request priority	📦4.0.1	FHIR Std.
CommunicationRequest.​medium	Base	required	MessageMedium	📦11.0.1	This IG
CommunicationRequest.​reasonCode	Base	example	v3 Code System ActReason	📦3.0.0	THO v7.4

Constraints

Id

Grade

Path(s)

Description

Expression

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
CommunicationRequest		0..*	CommunicationRequest	A request for information to be sent to a receiver
CommunicationRequest.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
CommunicationRequest.Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
CommunicationRequest.Slices for extension.extension:episodeOfCare		0..1	(Complex)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
CommunicationRequest.Slices for extension.extension:episodeOfCare.extension		0..0		Extension Slice: Unordered, Open by value:url
CommunicationRequest.Slices for extension.extension:episodeOfCare.url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare"
CommunicationRequest.Slices for extension.extension:episodeOfCare.value[x]		1..1	Reference(ehealth-episodeofcare) {r}	Value of extension
CommunicationRequest.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
CommunicationRequest.basedOn	Σ This element is included in summaries.	0..1	Reference(Resource)	Fulfills plan or proposal
CommunicationRequest.status	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request.
CommunicationRequest.category		0..*	CodeableConcept	Message category Binding: MessageCategory (required)
CommunicationRequest.priority	Σ This element is included in summaries.	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required)
CommunicationRequest.doNotPerform	?! This element is a modifier element. Σ This element is included in summaries.	0..1	boolean	True if request is prohibiting action
CommunicationRequest.medium		0..*	CodeableConcept	A channel of communication Binding: MessageMedium (required)
CommunicationRequest.subject		1..1	Reference(Patient)	Focus of message
CommunicationRequest.recipient		0..*	Reference(Patient | CareTeam) {r}	Message recipient
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
CommunicationRequest.​status	Base	required	RequestStatus	📍4.0.1	FHIR Std.
CommunicationRequest.​category	Base	required	MessageCategory	📦11.0.1	This IG
CommunicationRequest.​priority	Base	required	Request priority	📦4.0.1	FHIR Std.
CommunicationRequest.​medium	Base	required	MessageMedium	📦11.0.1	This IG

Constraints

Id

Grade

Path(s)

Description

Expression

Differential View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
CommunicationRequest		0..*	CommunicationRequest	A request for information to be sent to a receiver
CommunicationRequest.Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
CommunicationRequest.Slices for extension.extension:episodeOfCare		0..1	(Complex)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
CommunicationRequest.Slices for extension.extension:episodeOfCare.value[x]		1..1	Reference(ehealth-episodeofcare) {r}	Value of extension
CommunicationRequest.basedOn		0..1	Reference(Resource)	Fulfills plan or proposal
CommunicationRequest.category		0..*	CodeableConcept	Message category Binding: MessageCategory (required)
CommunicationRequest.priority		0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required)
CommunicationRequest.medium		0..*	CodeableConcept	A channel of communication Binding: MessageMedium (required)
CommunicationRequest.subject		1..1	Reference(Patient)	Focus of message
CommunicationRequest.recipient		0..*	Reference(Patient | CareTeam) {r}	Message recipient
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
CommunicationRequest.​category	Base	required	MessageCategory	📦11.0.1	This IG
CommunicationRequest.​priority	Base	required	Request priority	📦4.0.1	FHIR Std.
CommunicationRequest.​medium	Base	required	MessageMedium	📦11.0.1	This IG

Snapshot ViewView

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
CommunicationRequest		0..*	CommunicationRequest	A request for information to be sent to a receiver
CommunicationRequest.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
CommunicationRequest.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
CommunicationRequest.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
CommunicationRequest.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
CommunicationRequest.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
CommunicationRequest.contained		0..*	Resource	Contained, inline Resources
CommunicationRequest.Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
CommunicationRequest.Slices for extension.extension:episodeOfCare		0..1	(Complex)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
CommunicationRequest.Slices for extension.extension:episodeOfCare.id		0..1	string	Unique id for inter-element referencing
CommunicationRequest.Slices for extension.extension:episodeOfCare.extension		0..0		Extension Slice: Unordered, Open by value:url
CommunicationRequest.Slices for extension.extension:episodeOfCare.url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare"
CommunicationRequest.Slices for extension.extension:episodeOfCare.value[x]		1..1	Reference(ehealth-episodeofcare) {r}	Value of extension
CommunicationRequest.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
CommunicationRequest.identifier	Σ This element is included in summaries.	0..*	Identifier	Unique identifier
CommunicationRequest.basedOn	Σ This element is included in summaries.	0..1	Reference(Resource)	Fulfills plan or proposal
CommunicationRequest.replaces	Σ This element is included in summaries.	0..*	Reference(CommunicationRequest)	Request(s) replaced by this request
CommunicationRequest.groupIdentifier	Σ This element is included in summaries.	0..1	Identifier	Composite request this is part of
CommunicationRequest.status	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request.
CommunicationRequest.statusReason		0..1	CodeableConcept	Reason for current status Binding Description: (example): Codes identifying the reason for the current state of a request.
CommunicationRequest.category		0..*	CodeableConcept	Message category Binding: MessageCategory (required)
CommunicationRequest.priority	Σ This element is included in summaries.	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required)
CommunicationRequest.doNotPerform	?! This element is a modifier element. Σ This element is included in summaries.	0..1	boolean	True if request is prohibiting action
CommunicationRequest.medium		0..*	CodeableConcept	A channel of communication Binding: MessageMedium (required)
CommunicationRequest.subject		1..1	Reference(Patient)	Focus of message
CommunicationRequest.about		0..*	Reference(Resource)	Resources that pertain to this communication request
CommunicationRequest.encounter	Σ This element is included in summaries.	0..1	Reference(Encounter)	Encounter created as part of
CommunicationRequest.payload		0..*	BackboneElement	Message payload
CommunicationRequest.payload.id		0..1	string	Unique id for inter-element referencing
CommunicationRequest.payload.extension		0..*	Extension	Additional content defined by implementations
CommunicationRequest.payload.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
CommunicationRequest.payload.content[x]		1..1		Message part content
CommunicationRequest.payload.content[x].contentString			string
CommunicationRequest.payload.content[x].contentAttachment			Attachment
CommunicationRequest.payload.content[x].contentReference			Reference(Resource)
CommunicationRequest.occurrence[x]	Σ This element is included in summaries.	0..1		When scheduled
CommunicationRequest.occurrence[x].occurrenceDateTime			dateTime
CommunicationRequest.occurrence[x].occurrencePeriod			Period
CommunicationRequest.authoredOn	Σ This element is included in summaries.	0..1	dateTime	When request transitioned to being actionable
CommunicationRequest.requester	Σ This element is included in summaries.	0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	Who/what is requesting service
CommunicationRequest.recipient		0..*	Reference(Patient | CareTeam) {r}	Message recipient
CommunicationRequest.sender	Σ This element is included in summaries.	0..1	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService)	Message sender
CommunicationRequest.reasonCode	Σ This element is included in summaries.	0..*	CodeableConcept	Why is communication needed? Binding: v3 Code System ActReason (example): Codes for describing reasons for the occurrence of a communication.
CommunicationRequest.reasonReference	Σ This element is included in summaries.	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Why is communication needed?
CommunicationRequest.note		0..*	Annotation	Comments made about communication request
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
CommunicationRequest.​language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
CommunicationRequest.​status	Base	required	RequestStatus	📍4.0.1	FHIR Std.
CommunicationRequest.​statusReason	Base	example		Not State	Unknown
CommunicationRequest.​category	Base	required	MessageCategory	📦11.0.1	This IG
CommunicationRequest.​priority	Base	required	Request priority	📦4.0.1	FHIR Std.
CommunicationRequest.​medium	Base	required	MessageMedium	📦11.0.1	This IG
CommunicationRequest.​reasonCode	Base	example	v3 Code System ActReason	📦3.0.0	THO v7.4

Constraints

Id

Grade

Path(s)

Description

Expression

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

• ehealth-episodeofcare (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-episodeofcare)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare