Eswatini HL7 FHIR Implementation Guide
1.0.0 - draft Eswatini

Eswatini HL7 FHIR Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Eswatini Referral Profile

Official URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferral Version: 1.0.0
Active as of 2026-08-21 Computable Name: SzReferral

The Eswatini Referral Profile defines the constraints and usage of the HL7 FHIR ServiceRequest resource for representing referrals for healthcare services within the Eswatini National Digital Health Ecosystem. It provides a standardized and interoperable way to document requests to transfer a patient’s care, or part of their care, from one provider, facility, or service point to another. This profile ensures that referral information is captured and exchanged in a consistent, structured, and nationally aligned manner, supporting continuity of care, coordination across levels of service, and referral tracking.

Scope and Usage

This profile SHALL be used by systems that create, manage, or exchange referral information, including:

Electronic Medical Record (EMR) systems Referral and care coordination platforms Facility management and clinical systems Programme‑specific care and reporting systems National health information exchange (HIE) services

The profile applies to referrals such as:

Referrals between healthcare facilities Referrals from primary to secondary or tertiary care Internal referrals between departments or services Programme‑specific or specialist referrals Referrals for diagnostic, therapeutic, or consultative services

Each Referral represents a formal request for another provider or service to take responsibility for part or all of a patient’s care.

Conceptual Overview

The Eswatini Referral Profile represents a clinical and administrative request for healthcare services to be provided by another provider or organization. It captures the intent and details of the referral, distinct from the actual delivery of care that may follow. A Referral:

Is associated with a Patient Is typically initiated by a Practitioner or organization Specifies the service or care requested May be linked to an Encounter Has a lifecycle, from creation through acceptance, completion, or cancellation

This separation allows systems to clearly distinguish between referral intent and subsequent care delivery.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* ServiceRequest A request for a service to be performed
Constraints: prr-1
... id Σ 1..1 id Logical id of this artifact
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:recipient 1..1 Reference(Eswatini Organization Profile) Health facility where the patient is being referred to.
URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferralRecipientExtension
.... extension:servicepoint 0..1 CodeableConcept Service point where the client is being sent.
URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferralServicePointExtension
Binding: Value set: Eswatini Facility Service Points (required)
.... extension:servicelocation 0..1 Reference(Eswatini Organization Profile) Health facility where the patient received the service requested in the referral.
URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferralServiceLocation
... identifier Σ 1..1 Identifier Identifiers assigned to this order
... status ?!Σ 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.
... intent ?!Σ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.
... category Σ 1..1 CodeableConcept Classification of service
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
... doNotPerform ?!Σ 0..1 boolean True if service/procedure should not be performed
... code Σ 1..1 CodeableConcept What is being requested/ordered
Binding: ProcedureCodes(SNOMEDCT) (example): Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred.
... subject Σ 1..1 Reference(Eswatini Patient Profile) Patient associated with the referral
... encounter Σ 1..1 Reference(Eswatini Encounter Profile) Visit or Encounter associated with the referral
... occurrence[x] Σ 1..1 Date the patient is expected to arrive at the reciving facility
.... occurrenceDateTime dateTime
.... occurrencePeriod Period
.... occurrenceTiming Timing
... authoredOn Σ 1..1 dateTime Date the referral was created
... requester Σ 1..1 Reference(Eswatini Organization Profile) Health facility making the referral
... reasonCode Σ 1..1 CodeableConcept Reason the patient is being referred
Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation.

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ServiceRequest.status Base required RequestStatus 📍4.0.1 FHIR Std.
ServiceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
ServiceRequest.category Base example Service Request Category Codes 📍4.0.1 FHIR Std.
ServiceRequest.code Base example Procedure Codes (SNOMED CT) 📍4.0.1 FHIR Std.
ServiceRequest.reasonCode Base example Procedure Reason Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()

This structure is derived from ServiceRequest

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest 0..* ServiceRequest A request for a service to be performed
... id 1..1 id Logical id of this artifact
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:recipient 1..1 Reference(Eswatini Organization Profile) Health facility where the patient is being referred to.
URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferralRecipientExtension
.... extension:servicepoint 0..1 CodeableConcept Service point where the client is being sent.
URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferralServicePointExtension
Binding: Value set: Eswatini Facility Service Points (required)
.... extension:servicelocation 0..1 Reference(Eswatini Organization Profile) Health facility where the patient received the service requested in the referral.
URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferralServiceLocation
... identifier 1..1 Identifier Identifiers assigned to this order
... code 1..1 CodeableConcept What is being requested/ordered
... subject 1..1 Reference(Eswatini Patient Profile) Patient associated with the referral
... encounter 1..1 Reference(Eswatini Encounter Profile) Visit or Encounter associated with the referral
... occurrence[x] 1..1 dateTime, Period, Timing Date the patient is expected to arrive at the reciving facility
... authoredOn 1..1 dateTime Date the referral was created
... requester 1..1 Reference(Eswatini Organization Profile) Health facility making the referral
... reasonCode 1..1 CodeableConcept Reason the patient is being referred

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* ServiceRequest A request for a service to be performed
Constraints: prr-1
... id Σ 1..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... 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
... contained 0..* Resource Contained, inline Resources
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:recipient 1..1 Reference(Eswatini Organization Profile) Health facility where the patient is being referred to.
URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferralRecipientExtension
.... extension:servicepoint 0..1 CodeableConcept Service point where the client is being sent.
URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferralServicePointExtension
Binding: Value set: Eswatini Facility Service Points (required)
.... extension:servicelocation 0..1 Reference(Eswatini Organization Profile) Health facility where the patient received the service requested in the referral.
URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferralServiceLocation
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 1..1 Identifier Identifiers assigned to this order
... instantiatesCanonical Σ 0..* canonical(ActivityDefinition | PlanDefinition) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan | ServiceRequest | MedicationRequest) What request fulfills
... replaces Σ 0..* Reference(ServiceRequest) What request replaces
... requisition Σ 0..1 Identifier Composite Request ID
... status ?!Σ 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.
... intent ?!Σ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.
... category Σ 1..1 CodeableConcept Classification of service
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (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
... code Σ 1..1 CodeableConcept What is being requested/ordered
Binding: ProcedureCodes(SNOMEDCT) (example): Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred.
... orderDetail ΣC 0..* CodeableConcept Additional order information
Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
... quantity[x] Σ 0..1 Service amount
.... quantityQuantity Quantity
.... quantityRatio Ratio
.... quantityRange Range
... subject Σ 1..1 Reference(Eswatini Patient Profile) Patient associated with the referral
... encounter Σ 1..1 Reference(Eswatini Encounter Profile) Visit or Encounter associated with the referral
... occurrence[x] Σ 1..1 Date the patient is expected to arrive at the reciving facility
.... occurrenceDateTime dateTime
.... occurrencePeriod Period
.... occurrenceTiming Timing
... asNeeded[x] Σ 0..1 Preconditions for service
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
.... asNeededBoolean boolean
.... asNeededCodeableConcept CodeableConcept
... authoredOn Σ 1..1 dateTime Date the referral was created
... requester Σ 1..1 Reference(Eswatini Organization Profile) Health facility making the referral
... performerType Σ 0..1 CodeableConcept Performer role
Binding: ParticipantRoles (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
... locationCode Σ 0..* CodeableConcept Requested location
Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
... locationReference Σ 0..* Reference(Location) Requested location
... reasonCode Σ 1..1 CodeableConcept Reason the patient is being referred
Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation.
... reasonReference Σ 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Explanation/Justification for service or service
... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... supportingInfo 0..* Reference(Resource) Additional clinical information
... specimen Σ 0..* Reference(Specimen) Procedure Samples
... bodySite Σ 0..* CodeableConcept Location on Body
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... note 0..* Annotation Comments
... patientInstruction Σ 0..1 string Patient or consumer-oriented instructions
... relevantHistory 0..* Reference(Provenance) Request provenance

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ServiceRequest.language Base preferred Common Languages 📍4.0.1 FHIR Std.
ServiceRequest.status Base required RequestStatus 📍4.0.1 FHIR Std.
ServiceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
ServiceRequest.category Base example Service Request Category Codes 📍4.0.1 FHIR Std.
ServiceRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
ServiceRequest.code Base example Procedure Codes (SNOMED CT) 📍4.0.1 FHIR Std.
ServiceRequest.orderDetail Base example Service Request Order Details Codes 📍4.0.1 FHIR Std.
ServiceRequest.asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📍4.0.1 FHIR Std.
ServiceRequest.performerType Base example Participant Roles 📍4.0.1 FHIR Std.
ServiceRequest.locationCode Base example ServiceDeliveryLocationRoleType 📦3.0.0 THO v7.3
ServiceRequest.reasonCode Base example Procedure Reason Codes 📍4.0.1 FHIR Std.
ServiceRequest.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* ServiceRequest A request for a service to be performed
Constraints: prr-1
... id Σ 1..1 id Logical id of this artifact
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:recipient 1..1 Reference(Eswatini Organization Profile) Health facility where the patient is being referred to.
URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferralRecipientExtension
.... extension:servicepoint 0..1 CodeableConcept Service point where the client is being sent.
URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferralServicePointExtension
Binding: Value set: Eswatini Facility Service Points (required)
.... extension:servicelocation 0..1 Reference(Eswatini Organization Profile) Health facility where the patient received the service requested in the referral.
URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferralServiceLocation
... identifier Σ 1..1 Identifier Identifiers assigned to this order
... status ?!Σ 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.
... intent ?!Σ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.
... category Σ 1..1 CodeableConcept Classification of service
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
... doNotPerform ?!Σ 0..1 boolean True if service/procedure should not be performed
... code Σ 1..1 CodeableConcept What is being requested/ordered
Binding: ProcedureCodes(SNOMEDCT) (example): Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred.
... subject Σ 1..1 Reference(Eswatini Patient Profile) Patient associated with the referral
... encounter Σ 1..1 Reference(Eswatini Encounter Profile) Visit or Encounter associated with the referral
... occurrence[x] Σ 1..1 Date the patient is expected to arrive at the reciving facility
.... occurrenceDateTime dateTime
.... occurrencePeriod Period
.... occurrenceTiming Timing
... authoredOn Σ 1..1 dateTime Date the referral was created
... requester Σ 1..1 Reference(Eswatini Organization Profile) Health facility making the referral
... reasonCode Σ 1..1 CodeableConcept Reason the patient is being referred
Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation.

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ServiceRequest.status Base required RequestStatus 📍4.0.1 FHIR Std.
ServiceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
ServiceRequest.category Base example Service Request Category Codes 📍4.0.1 FHIR Std.
ServiceRequest.code Base example Procedure Codes (SNOMED CT) 📍4.0.1 FHIR Std.
ServiceRequest.reasonCode Base example Procedure Reason Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()

Differential View

This structure is derived from ServiceRequest

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest 0..* ServiceRequest A request for a service to be performed
... id 1..1 id Logical id of this artifact
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:recipient 1..1 Reference(Eswatini Organization Profile) Health facility where the patient is being referred to.
URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferralRecipientExtension
.... extension:servicepoint 0..1 CodeableConcept Service point where the client is being sent.
URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferralServicePointExtension
Binding: Value set: Eswatini Facility Service Points (required)
.... extension:servicelocation 0..1 Reference(Eswatini Organization Profile) Health facility where the patient received the service requested in the referral.
URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferralServiceLocation
... identifier 1..1 Identifier Identifiers assigned to this order
... code 1..1 CodeableConcept What is being requested/ordered
... subject 1..1 Reference(Eswatini Patient Profile) Patient associated with the referral
... encounter 1..1 Reference(Eswatini Encounter Profile) Visit or Encounter associated with the referral
... occurrence[x] 1..1 dateTime, Period, Timing Date the patient is expected to arrive at the reciving facility
... authoredOn 1..1 dateTime Date the referral was created
... requester 1..1 Reference(Eswatini Organization Profile) Health facility making the referral
... reasonCode 1..1 CodeableConcept Reason the patient is being referred

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* ServiceRequest A request for a service to be performed
Constraints: prr-1
... id Σ 1..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... 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
... contained 0..* Resource Contained, inline Resources
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:recipient 1..1 Reference(Eswatini Organization Profile) Health facility where the patient is being referred to.
URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferralRecipientExtension
.... extension:servicepoint 0..1 CodeableConcept Service point where the client is being sent.
URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferralServicePointExtension
Binding: Value set: Eswatini Facility Service Points (required)
.... extension:servicelocation 0..1 Reference(Eswatini Organization Profile) Health facility where the patient received the service requested in the referral.
URL: https://eswatinihie.com/fhir/StructureDefinition/SzReferralServiceLocation
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 1..1 Identifier Identifiers assigned to this order
... instantiatesCanonical Σ 0..* canonical(ActivityDefinition | PlanDefinition) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan | ServiceRequest | MedicationRequest) What request fulfills
... replaces Σ 0..* Reference(ServiceRequest) What request replaces
... requisition Σ 0..1 Identifier Composite Request ID
... status ?!Σ 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.
... intent ?!Σ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.
... category Σ 1..1 CodeableConcept Classification of service
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (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
... code Σ 1..1 CodeableConcept What is being requested/ordered
Binding: ProcedureCodes(SNOMEDCT) (example): Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred.
... orderDetail ΣC 0..* CodeableConcept Additional order information
Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
... quantity[x] Σ 0..1 Service amount
.... quantityQuantity Quantity
.... quantityRatio Ratio
.... quantityRange Range
... subject Σ 1..1 Reference(Eswatini Patient Profile) Patient associated with the referral
... encounter Σ 1..1 Reference(Eswatini Encounter Profile) Visit or Encounter associated with the referral
... occurrence[x] Σ 1..1 Date the patient is expected to arrive at the reciving facility
.... occurrenceDateTime dateTime
.... occurrencePeriod Period
.... occurrenceTiming Timing
... asNeeded[x] Σ 0..1 Preconditions for service
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
.... asNeededBoolean boolean
.... asNeededCodeableConcept CodeableConcept
... authoredOn Σ 1..1 dateTime Date the referral was created
... requester Σ 1..1 Reference(Eswatini Organization Profile) Health facility making the referral
... performerType Σ 0..1 CodeableConcept Performer role
Binding: ParticipantRoles (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
... locationCode Σ 0..* CodeableConcept Requested location
Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
... locationReference Σ 0..* Reference(Location) Requested location
... reasonCode Σ 1..1 CodeableConcept Reason the patient is being referred
Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation.
... reasonReference Σ 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Explanation/Justification for service or service
... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... supportingInfo 0..* Reference(Resource) Additional clinical information
... specimen Σ 0..* Reference(Specimen) Procedure Samples
... bodySite Σ 0..* CodeableConcept Location on Body
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... note 0..* Annotation Comments
... patientInstruction Σ 0..1 string Patient or consumer-oriented instructions
... relevantHistory 0..* Reference(Provenance) Request provenance

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ServiceRequest.language Base preferred Common Languages 📍4.0.1 FHIR Std.
ServiceRequest.status Base required RequestStatus 📍4.0.1 FHIR Std.
ServiceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
ServiceRequest.category Base example Service Request Category Codes 📍4.0.1 FHIR Std.
ServiceRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
ServiceRequest.code Base example Procedure Codes (SNOMED CT) 📍4.0.1 FHIR Std.
ServiceRequest.orderDetail Base example Service Request Order Details Codes 📍4.0.1 FHIR Std.
ServiceRequest.asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📍4.0.1 FHIR Std.
ServiceRequest.performerType Base example Participant Roles 📍4.0.1 FHIR Std.
ServiceRequest.locationCode Base example ServiceDeliveryLocationRoleType 📦3.0.0 THO v7.3
ServiceRequest.reasonCode Base example Procedure Reason Codes 📍4.0.1 FHIR Std.
ServiceRequest.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Core Data Requirements

The profile constrains the base ServiceRequest resource to ensure capture of essential referral information, including:

Referral status, reflecting the state of the referral request Intent, indicating that the request represents a referral Requested service or reason for referral Subject (Patient) for whom the referral is made Requester, identifying the referring practitioner or organization Authored date, indicating when the referral was initiated

These elements support accurate referral management, follow‑up, and reporting.

Interoperability and National Alignment

This profile is designed to:

Conform to HL7 FHIR R4 ServiceRequest semantics Support interoperability within the Eswatini National HIE Enable consistent exchange of referral data across systems and levels of care Support national referral management, monitoring, and evaluation

Standardized referral data improves continuity of care and reduces fragmentation across the health system.

Data Quality and Conformance

Systems claiming conformance to this profile SHALL:

Populate all required and Must Support elements defined by the profile Maintain accurate referral status throughout the referral lifecycle Ensure referral data reflects real clinical and administrative workflows

Optional elements from the base ServiceRequest resource may be used where relevant, provided they do not conflict with the constraints defined in this profile.

Extensibility

The Eswatini Referral Profile supports extensibility through standard FHIR mechanisms. Additional referral‑related details—such as programme indicators, referral outcomes, or prioritization information—may be introduced using FHIR extensions, subject to national governance and approval.

Summary

The Eswatini Referral Profile provides a standardized and interoperable representation of healthcare referrals, supporting coordinated care, effective use of services, and reliable information exchange across the national health system. Adoption of this profile improves referral tracking, strengthens continuity of care, and enhances interoperability throughout the Kingdom of Eswatini.