DeviceRequest — Prescription of a medical device

The request to supply a device to a patient: wheelchair, hearing aid, hospital bed, insulin pump. Cornerstone of the US DME (Durable Medical Equipment) workflow and of device prescribing in Europe.

Purpose of the resource

DeviceRequest represents a request for a patient to use a medical device. The canonical use case is DME prescription: wheelchair, hearing aid, brace, insulin pump, hospital bed. The resource also covers a request to implant a device and the prescription of a SaMD (Software as a Medical Device).

DeviceRequest aligns with the other FHIR request resources — ServiceRequest, MedicationRequest — via the status × intent combination that forms the unified "FHIR order" workflow pattern. The requested device can be referenced by type (generic SNOMED CT code) or by a precise instance (Reference(Device)) if it is already identified.

Key fields

Field	Type	Cardinality	Role
`identifier`	Identifier[]	0..*	External identifiers (prescription number, purchase order…).
`instantiatesCanonical`	canonical[]	0..*	Canonical reference to a PlanDefinition or ActivityDefinition.
`instantiatesUri`	uri[]	0..*	External URI of a protocol.
`basedOn`	Reference(any)[]	0..*	The DeviceRequest is created in execution of another Request (CarePlan, ServiceRequest…).
`replaces`	Reference(DeviceRequest)[]	0..*	The DeviceRequest replaces an earlier request.
`groupIdentifier`	Identifier	0..1	Group identifier linking multiple DeviceRequests issued together.
`status`	code	0..1	Request lifecycle state.
`intent`	code	1..1	Mandatory. Intent level. Modifier.
`priority`	code	0..1	`routine` / `urgent` / `asap` / `stat`.
`doNotPerform`	boolean	0..1	"Do not use" — semantic inversion. Modifier.
`code`	CodeableReference(Device \| DeviceDefinition)	1..1	Mandatory. Which device is requested: by SNOMED CT code or by reference to a precise instance.
`quantity`	integer	0..1	Requested quantity.
`parameter`	BackboneElement[]	0..*	Technical parameters (size, configuration, accessories…).
`subject`	Reference(Patient \| Group \| Location \| Device)	1..1	Mandatory. Beneficiary of the request, typically the patient.
`encounter`	Reference(Encounter)	0..1	Encounter in which the request was issued.
`occurrence[x]`	dateTime \| Period \| Timing	0..1	Planned date / period / schedule of use.
`authoredOn`	dateTime	0..1	Request authoring date.
`requester`	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device)	0..1	Request author.
`performer`	CodeableReference	0..1	Actor expected to fulfil the request (typically a DME supplier).
`reason`	CodeableReference[]	0..*	Clinical reason (linked Condition, SNOMED CT code…).
`asNeeded`	boolean	0..1	PRN ("as needed") request.
`asNeededFor`	CodeableConcept	0..1	Trigger condition for the PRN.
`insurance`	Reference(Coverage \| ClaimResponse)[]	0..*	Expected health coverage (CMS DME…).
`supportingInfo`	Reference(any)[]	0..*	Documents supporting the request (medical letter, imaging study…).
`note`	Annotation[]	0..*	Additional notes, instructions to the supplier.
`relevantHistory`	Reference(Provenance)[]	0..*	Change history of the request (audit trail).

status × intent

The status + intent pair is central to every FHIR Request. The Required bindings published in HL7 R5:

status	Meaning
`draft`	Draft — not transmitted to the performer.
`active`	Active request.
`on-hold`	Held (validation, coverage, suspension).
`revoked`	Revoked by the requester.
`completed`	Fulfilled (device delivered and accepted).
`entered-in-error`	Erroneous entry.
`unknown`	Indeterminate state.

intent	Meaning
`proposal`	Suggestion — not a commitment.
`plan`	Plan — intent to prescribe in the future.
`directive`	Patient or guardian directive.
`order`	Firm order — the most common value.
`original-order`	Original order, source of replications.
`reflex-order`	Automatic order triggered by another.
`filler-order`	Order relayed by the filler (supplier).
`instance-order`	Instance of a generic order.
`option`	Option chosen from a predefined menu.

JSON example

Prescription of a lightweight manual wheelchair for a diabetic patient by Dr Adam Careful, to be delivered by Acme DME Supplies on 25 May 2026.

json devicerequest-example.json

{
  "resourceType": "DeviceRequest",
  "id": "example",
  "identifier": [{
    "system": "http://example.org/identifiers/devicerequest",
    "value": "DR-2026-187"
  }],
  "status": "active",
  "intent": "order",
  "priority": "routine",
  "code": {
    "concept": {
      "coding": [{
        "system": "http://snomed.info/sct",
        "code": "58938008",
        "display": "Wheelchair"
      }]
    }
  },
  "quantity": 1,
  "parameter": [{
    "code": {
      "coding": [{
        "system": "http://snomed.info/sct",
        "code": "60668009",
        "display": "Length"
      }]
    },
    "valueQuantity": {
      "value": 220,
      "unit": "mm",
      "system": "http://unitsofmeasure.org",
      "code": "mm"
    }
  }],
  "subject": { "reference": "Patient/example" },
  "encounter": { "reference": "Encounter/example" },
  "occurrenceDateTime": "2026-05-25T09:00:00+02:00",
  "authoredOn": "2026-05-14T14:00:00+02:00",
  "requester": { "reference": "Practitioner/example", "display": "Dr Adam Careful" },
  "performer": {
    "reference": "Organization/dme-supplier-1",
    "display": "Acme DME Supplies"
  },
  "reason": [{
    "concept": {
      "coding": [{
        "system": "http://snomed.info/sct",
        "code": "44054006",
        "display": "Diabetes mellitus type 2"
      }]
    }
  }],
  "note": [{
    "text": "Lightweight manual wheelchair, reclining backrest. Home delivery."
  }]
}

Worth pointing out in this example:

intent=order + status=active = firm order transmitted to the performer.
code SNOMED CT 58938008 = wheelchair: device requested by type, not by instance.
parameter specifies the expected length (220 mm) — useful when the physical instance doesn't exist yet and the supplier must configure.
reason is mandatory for medical justification toward payers (CMS DMEPOS).
performer points to the DME supplier: automated Request → supplier communication goes through the Da Vinci PDex IG in the US.

Common pitfalls

Missing intent — 1..1 cardinality. Modifier — mandatory to give the resource meaning.
Empty code — 1..1 cardinality. The requested device must be specified (by concept or by reference). Without code, the resource is invalid.
Missing subject — 1..1 cardinality. A request without a beneficiary is uninterpretable.
Mixing Device instance / DeviceDefinition — code may point to a Reference(Device) (existing instance) or a Reference(DeviceDefinition) (product catalogue) or a concept. Pick one.
Confusion doNotPerform / status=revoked — doNotPerform=true = "order not to use this device" (rare but useful for advance directives). status=revoked = the order is cancelled.
Missing insurance for DMEPOS — in the US, a DeviceRequest without insurance is rejected by CMS Medicare. The Da Vinci PDex/Coverage profile requires the coverage link.
Past occurrence — typically a data-entry error. The device is requested for the future; a J-1 occurrence likely signals a retroactive workflow.

Device — the requested device, either generic concept or instance reference.
DeviceDispense — the dispense (delivery) of the device in response to the DeviceRequest.
DeviceUsage — the actual use of the device by the patient.
CarePlan — may contain activities based on a DeviceRequest.
ServiceRequest, MedicationRequest — other FHIR request resources with the same status × intent pattern.
Coverage — health coverage referenced by insurance.
Condition — pathology referenced by reason.

Foundations

Standards

Flagship messages

Tools

DeviceRequest — Prescription of a medical device

Purpose of the resource

Key fields

status × intent

JSON example

Common pitfalls

DeviceRequest — Prescription of a medical device

Purpose of the resource

Key fields

status × intent

JSON example

Common pitfalls

Related resources