To enable follow-up steps on a ServiceRequest with a status of complete (e.g., the results were communicated as final but the ordering provider wishes the observation to be re-interpreted in light of, e.g., the patient's clinical profile and/or demographic data updates) additional status codes are needed that can be valued after a SeviceRequest.status was set to "complete".

Additionally it is then necessary to indicate the reason why the related observation(s) need to be re-interpreted.

Once the re-interpretation is completed, the ServiceRequest.status is set back to "complete".

Proposal is to add:

• ServiceRequest.status codes for:
  • under-revision - a change to AOEs or demographics yielded the re-interpretation
  • under-review - the results do not appear to fit the patient's clinical profile
• ServiceRequest.reason.concept codes for:
  • clinical-reinterpretation - Re-interpretation (clinically questioned) + text  ( valid only with under-review)
  • demographic-reinterpretation - Re-Interpretation (demographic change) (valid only with under-revision)
  • ask-at-order-entry-response-reinterpretation - Re-interpretation (AOE change)  (valid only with under-revision)
    • Note for AOEs the Observation.status would have changed to corrected/amended.
• ServiceRequest.reason comments addition:
  • When a re-interpretation is requested, the observation(s) that are to be re-interpreted should be included as a reference in SeviceRequest.reason.reference.