HRSA 2024 Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+) FHIR IG
2.0.0 - STU2 Release 1 - Standard for Trial-Use
HRSA 2024 Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+) FHIR IG
2.0.0 - STU2 Release 1 - Standard for Trial-Use
This page is part of the HRSA Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+ or uds-plus) FHIR IG (v2.0.0: STU2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions
| Official URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-servicerequest | Version: 2.0.0 | |||
| Standards status: Trial-use | Maturity Level: 2 | Computable Name: UDSPlusServiceRequest | ||
The UDS+ profile is based on the ServiceRequest resource and establishes the core elements, extensions, vocabularies and value sets for representing ServiceRequest for UDS+ program.
This profile is used to represent de-identified ServiceRequest information. The de-identification process has to remove all data elements not explicitly identified as "SUPPORTED" in the profile.
The HHS De-identification Guidance is to be followed to ensure appropriate level of de-identification is performed.
According to the HHS guidance, dates should not have a precision of more than the year. This means month and day cannot be included. This includes ServiceRequest.occurenceDateTime.
In FHIR Resources, text elements and reference.display elements which provide human readable information to the providers may be generated using programs and tools from the data present within the resource. For e.g a ServiceRequest resource text element may contain information such as the ServiceRequest date, patient information. This type of information will enable identification of the individuals. In order to avoid inadvertent revealing of PII/PHI, text elements cannot be included in the De-identified FHIR resource and the submission will be rejected when text elements are present by the validation process.
Ids and References
The original ServiceRequest resource id should not be included in the De-identified ServiceRequest instance. Instead a new id should be created and provided as part of the FHIR resource. The Data Submitter should be capable of using the generated id to relink the data to the original ServiceRequest. All resource references to the ServiceRequest submitted as part of the UDS+ report should refer to newly generated id.
Resource references cannot contain text element as it may contain PHI/PII. The text element for following references are not allowed
Date Truncation
The Data Submitter has to truncate the following dates to only have a precision of year
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  ServiceRequest |
C | 0..* | ServiceRequest | De-Identified UDS Plus ServiceRequest dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management prr-1: orderDetail SHALL only be present if code is present |
  id |
SΣ | 0..1 | id | The de-identified ServiceRequest identifier created by the health center to send data to UDS+ Data Receiver |
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children |
 modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
| status |
?!SΣ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order. ele-1: All FHIR elements must have a @value or children |
| intent |
?!SΣ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. ele-1: All FHIR elements must have a @value or children |
| doNotPerform |
?!SΣ | 1..1 | boolean | True if service/procedure should not be performed ele-1: All FHIR elements must have a @value or children |
 code |
SΣ | 1..1 | CodeableConcept | What is being requested/ordered Binding: US Core Procedure Codes (extensible): The set of codes indicating the ServiceRequests ele-1: All FHIR elements must have a @value or children |
 subject |
SΣ | 1..1 | Reference(De-Identified UDS Plus Patient) | Individual or Entity the service is ordered for ele-1: All FHIR elements must have a @value or children |
| encounter |
SΣ | 0..1 | Reference(De-Identified UDS Plus Encounter) | Encounter in which the request was created ele-1: All FHIR elements must have a @value or children |
  occurrence[x] |
SΣC | 0..1 | When service should occur ele-1: All FHIR elements must have a @value or children uds-plus-svr-1: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-svr-1a: All dateTime data elements should have valid year > 1900 uds-plus-svr-1b: All dateTime data elements should have valid year < 2030 uds-plus-svr-2: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-svr-2a: All Period.start data elements should have valid year > 1900 uds-plus-svr-2b: All Period.start data elements should have valid year < 2030 uds-plus-svr-3: All Period.emd data elements should be truncated to a year only for de-identified resources. uds-plus-svr-3a: All Period.end data elements should have valid year > 1900 uds-plus-svr-3b: All Period.end data elements should have valid year < 2030 uds-plus-svr-4: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-svr-5: All Timing.event data elements should be truncated to a year only for de-identified resources. uds-plus-svr-5a: All Timing data elements should have valid year > 1900 uds-plus-svr-5b: All Timing data elements should have valid year < 2030 | |
  occurrenceDateTime |
dateTime | |||
| authoredOn |
SΣC | 0..1 | dateTime | Date request signed ele-1: All FHIR elements must have a @value or children uds-plus-svr-6: All dateTime data elements should be truncated to a year only for de-identified resources. uds-plus-svr-6a: All dateTime data elements should have valid year > 1900 uds-plus-svr-6b: All dateTime data elements should have valid year < 2030 |
| requester |
SΣ | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | Who/what is requesting service ele-1: All FHIR elements must have a @value or children |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| ServiceRequest.status | required | RequestStatushttp://hl7.org/fhir/ValueSet/request-status|4.0.1from the FHIR Standard | |
| ServiceRequest.intent | required | RequestIntenthttp://hl7.org/fhir/ValueSet/request-intent|4.0.1from the FHIR Standard | |
| ServiceRequest.code | extensible | USCoreProcedureCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | ServiceRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | ServiceRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | ServiceRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | ServiceRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | ServiceRequest | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| prr-1 | error | ServiceRequest | orderDetail SHALL only be present if code is present : orderDetail.empty() or code.exists() | |
| uds-plus-svr-1 | error | ServiceRequest.occurrence[x] | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is DateTime implies $this.toString().length() = 4 | |
| uds-plus-svr-1a | error | ServiceRequest.occurrence[x] | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' | |
| uds-plus-svr-1b | error | ServiceRequest.occurrence[x] | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' | |
| uds-plus-svr-2 | error | ServiceRequest.occurrence[x] | All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.start.exists() implies $this.start.toString().length() = 4 | |
| uds-plus-svr-2a | error | ServiceRequest.occurrence[x] | All Period.start data elements should have valid year > 1900 : $this is Period and Period.start.exists() implies $this.start.toString() >= '1900' | |
| uds-plus-svr-2b | error | ServiceRequest.occurrence[x] | All Period.start data elements should have valid year < 2030 : $this is Period and Period.start.exists() implies $this.start.toString() <= '2030' | |
| uds-plus-svr-3 | error | ServiceRequest.occurrence[x] | All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and Period.end.exists() implies $this.end.toString().length() = 4 | |
| uds-plus-svr-3a | error | ServiceRequest.occurrence[x] | All Period.end data elements should have valid year > 1900 : $this is Period and Period.end.exists() implies $this.end.toString() >= '1900' | |
| uds-plus-svr-3b | error | ServiceRequest.occurrence[x] | All Period.end data elements should have valid year < 2030 : $this is Period and Period.end.exists() implies $this.end.toString() <= '2030' | |
| uds-plus-svr-4 | error | ServiceRequest.occurrence[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.count() = 1 | |
| uds-plus-svr-5 | error | ServiceRequest.occurrence[x] | All Timing.event data elements should be truncated to a year only for de-identified resources. : $this is Timing and Timing.event.exists() implies $this.event.first().toString().length() = 4 | |
| uds-plus-svr-5a | error | ServiceRequest.occurrence[x] | All Timing data elements should have valid year > 1900 : $this is Timing and Timing.event.exists() implies $this.event.first().toString() >= '1900' | |
| uds-plus-svr-5b | error | ServiceRequest.occurrence[x] | All Timing data elements should have valid year < 2030 : $this is Timing and Timing.event.exists() implies $this.event.first().toString() <= '2030' | |
| uds-plus-svr-6 | error | ServiceRequest.authoredOn | All dateTime data elements should be truncated to a year only for de-identified resources. : $this is DateTime implies $this.toString().length() = 4 | |
| uds-plus-svr-6a | error | ServiceRequest.authoredOn | All dateTime data elements should have valid year > 1900 : $this is DateTime implies $this.toString() >= '1900' | |
| uds-plus-svr-6b | error | ServiceRequest.authoredOn | All dateTime data elements should have valid year < 2030 : $this is DateTime implies $this.toString() <= '2030' |
Other representations of profile: CSV, Excel, Schematron
