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  1. FHIR Specification Feedback
  2. FHIR-26674

clarify description of asNeeded element to help differentiate from reason element

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • FHIR Core (FHIR)
    • R4
    • Orders & Observations
    • ServiceRequest (Diagnostic/Procedure/ReferralRequest)
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       1. Make asNeededBoolean and asNeededCodeableConcept separate elements, and change the names and cardinalities to be asNeeded (0..1) and asNeededFor (0..*), respectively, to follow the pattern in MedicationRequest.dosageInstruction.Dosage and DeviceRequest
       2. Add this invariant:  "AsNeededFor can only be set if AsNeeded is empty or true"    

       3. Update definitions to reflect the changes in the elements

      a. Reason: 

      Short: Reason or indication for requesting the service

      Description: The reason or the indication for requesting the service (e.g., procedure, lab test)

      b. asNeeded

            Short: Perform the service "as needed"

            Long: Indicates that the service (e.g., procedure, lab test) should be performed when needed (Boolean option).

       c. asNeededFor 

             Short: Specified criteria for the service

             Long: Indicates specific criteria that need to be met to perform the service (e.g., lab results or symptoms)

                      
       4. Provide example showing how to use asNeeded/AsNeededFor and Reason
           1. An example showing asNeeded and asNeededFor being used with Reason

                  Reason: glucose monitoring 

                   AsNeeded: true

                   AsNeededFor: series of elevated glucose levels

        2. An example showing asNeeded with Reason without AsNeededFor

                 Reason: continuous glucose monitoring 

                  AsNeeded: true

                  AsNeededFor: empty

              

           

       

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       1. Make asNeededBoolean and asNeededCodeableConcept separate elements, and change the names and cardinalities to be asNeeded (0..1) and asNeededFor (0..*), respectively, to follow the pattern in MedicationRequest.dosageInstruction.Dosage and DeviceRequest  2. Add this invariant:  "AsNeededFor can only be set if AsNeeded is empty or true"      3. Update definitions to reflect the changes in the elements a. Reason:  Short: Reason or indication for requesting the service Description: The reason or the indication for requesting the service (e.g., procedure, lab test) b. asNeeded       Short: Perform the service "as needed"       Long: Indicates that the service (e.g., procedure, lab test) should be performed when needed (Boolean option).  c. asNeededFor         Short: Specified criteria for the service        Long: Indicates specific criteria that need to be met to perform the service (e.g., lab results or symptoms)                   4. Provide example showing how to use asNeeded/AsNeededFor and Reason      1. An example showing asNeeded and asNeededFor being used with Reason             Reason: glucose monitoring               AsNeeded: true              AsNeededFor: series of elevated glucose levels   2. An example showing asNeeded with Reason without AsNeededFor            Reason: continuous glucose monitoring              AsNeeded: true             AsNeededFor: empty                 
    • Marti Velezis / Dan Rutz : 6 - 0 - 1
    • Enhancement
    • Non-compatible

    Description

      asNeeded is timing "modifier" - clarify definition and provide an example (bandage change q1 hr as needed)

      to do - Get history of were it came from

      consider if should be an extension instead -  in 80%? used  mostly in meds..

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            jdlnolen John D.L. Nolen
            ehaas Eric Haas
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              Updated:
              Resolved: