Could not find a clinic state related to ServiceRequest for a laboratory order

[mduna]

Is it possible to create a ServiceRequest resource for a non-medication order, such as a laboratory order? Thanks.

[jawalonoski]

Today, out of the box, it is not possible because Synthea does not currently support the ServiceRequest resource.

You have two options: post-process or modify code.

Post Process

Write a script that processes every patient file, and creates a ServiceRequest every time you see a DiagnosticReport with the category LAB.

Modify Code

If you are willing and able to modify Java code, you could edit the one of the FHIR exporter classes to produce a ServiceRequest prior to every occassion a DiagnosticReport is created.

For example, in FHIR R4, here are the two spots of interest where the DiagnosticReports are created:

synthea/src/main/java/org/mitre/synthea/export/FhirR4.java

Lines 308 to 310 in d90b4e3

	for (Report report : encounter.reports) {
	report(person, personEntry, bundle, encounterEntry, report);
	}

synthea/src/main/java/org/mitre/synthea/export/FhirR4.java

Lines 2229 to 2267 in d90b4e3

	/**
	* Map the given Report to a FHIR DiagnosticReport resource, and add it to the given Bundle.
	*
	* @param rand Source of randomness to use when generating ids etc
	* @param personEntry The Entry for the Person
	* @param bundle Bundle to add the Report to
	* @param encounterEntry Current Encounter entry
	* @param report The Report
	* @return The added Entry
	*/
	private static BundleEntryComponent report(RandomNumberGenerator rand,
	BundleEntryComponent personEntry, Bundle bundle, BundleEntryComponent encounterEntry,
	Report report) {
	DiagnosticReport reportResource = new DiagnosticReport();
	if (USE_US_CORE_IG) {
	Meta meta = new Meta();
	meta.addProfile(
	"http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-lab");
	reportResource.setMeta(meta);
	org.hl7.fhir.r4.model.Encounter encounterResource =
	(org.hl7.fhir.r4.model.Encounter) encounterEntry.getResource();
	reportResource.addPerformer(encounterResource.getServiceProvider());
	}
	reportResource.setStatus(DiagnosticReportStatus.FINAL);
	reportResource.addCategory(new CodeableConcept(
	new Coding("http://terminology.hl7.org/CodeSystem/v2-0074", "LAB", "Laboratory")));
	reportResource.setCode(mapCodeToCodeableConcept(report.codes.get(0), LOINC_URI));
	reportResource.setSubject(new Reference(personEntry.getFullUrl()));
	reportResource.setEncounter(new Reference(encounterEntry.getFullUrl()));
	reportResource.setEffective(convertFhirDateTime(report.start, true));
	reportResource.setIssued(new Date(report.start));
	for (Observation observation : report.observations) {
	Reference reference = new Reference(observation.fullUrl);
	reference.setDisplay(observation.codes.get(0).display);
	reportResource.addResult(reference);
	}
	return newEntry(rand, bundle, reportResource);
	}

[mduna]

Thank you for the suggestions, will give a try.