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                       >UsageNotes: The final outcome of the intent, the act that is intended to occur, is always an event. However the final outcome may be reached indirectly via steps through other intents, such as promise, permission request, or an appointment that may lead to an actual event to occur. Alternatively, the intended act may never occur.

                       UsageNotes: Commitments may be retracted or cancelled.

                       UsageNotes: Where there is no clear definition or applicable concept of "professional responsibility�, RMD becomes indistinguishable from PRP. .

                       UsageNotes: The fulfillment cycle may involve intermediary fulfilling acts in moods such as PRMS, APT, or even another RQO before being fulfilled by the final event. 

                    
                       UsageNotes: The concepts of a "request" and an "order" are viewed as different, because there is an implication of a mandate associated with order.  In practice, however, this distinction has no general functional value in the inter-operation of health care computing.  "Orders" are commonly refused for a variety of clinical and business reasons, and the notion of a "request" obligates the recipient (the fulfiller) to respond to the sender (the author).  Indeed, in many regions, including Australia and Europe, the common term used is "request."

                    Thus, the concept embodies both notions, as there is no useful distinction to be made.  If a mandate is to be associated with a request, this will be embodied in the "local" business rules applied to the transactions.  Should HL7 desire to provide a distinction between these in the future, the individual concepts could be added as specializations of this concept.

                    The critical distinction here, is the difference between this concept and an "intent", of which it is a specialization.  An intent involves decisions by a single party, the author.  A request, however, involves decisions by two parties, the author and the fulfiller, with an obligation on the part of the fulfiller to respond to the request indicating that the fulfiller will indeed fulfill the request.

                       UsageNotes: Use of an HL7 defined request/fulfillment framework is not required to use this mood code.

Source1

{
  "resourceType": "ValueSet",
  "id": "R3-v3-ActMoodIntent-for-R4B",
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 0
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fhir"
    },
    {
      "extension": [
        {
          "url": "packageId",
          "valueId": "hl7.fhir.uv.xver-r3.r4b"
        },
        {
          "url": "version",
          "valueString": "0.1.0"
        },
        {
          "url": "uri",
          "valueUri": "http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r3.r4b"
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/package-source"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode": "trial-use",
      "_valueCode": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical": "http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r3.r4b"
          }
        ]
      }
    }
  ],
  "url": "http://hl7.org/fhir/uv/xver/ValueSet/R3-v3-ActMoodIntent-for-R4B",
  "version": "0.1.0",
  "name": "R3V3ActMoodIntentForR4B",
  "title": "Cross-version ValueSet STU3.ActMoodIntent for use in FHIR R4B",
  "status": "active",
  "experimental": false,
  "date": "2026-03-17T21:02:03.8104715+00:00",
  "publisher": "FHIR Infrastructure",
  "contact": [
    {
      "name": "FHIR Infrastructure",
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/fiwg"
        }
      ]
    }
  ],
  "description": "This cross-version ValueSet represents content from `http://hl7.org/fhir/ValueSet/v3-ActMoodIntent|2014-03-26` for use in FHIR R4B.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001",
          "display": "World"
        }
      ]
    }
  ],
  "purpose": "This value set is part of the cross-version definitions generated to enable use of the\r\nvalue set `http://hl7.org/fhir/ValueSet/v3-ActMoodIntent|2014-03-26` as defined in FHIR STU3\r\nin FHIR R4B.\r\n\r\nThe source value set is bound to the following FHIR STU3 elements:\r\n* \r\n\r\nAcross FHIR versions, the value set has been mapped as:\r\n* `http://hl7.org/fhir/ValueSet/v3-ActMoodIntent|2014-03-26`\n* `http://terminology.hl7.org/ValueSet/v3-ActMoodIntent|2014-03-26`\r\n\r\nNote that all concepts are included in this cross-version definition because no concepts have compatible representations\r\n\r\nFollowing are the generation technical comments:\r\nAll concepts in the comparison are listed as identical.\nThe source and target value sets have the same number of active concepts (8).\nFHIR ValueSet `http://hl7.org/fhir/ValueSet/v3-ActMoodIntent|2014-03-26`, defined in FHIR STU3 does not have any mapping to FHIR R4B",
  "compose": {
    "include": [
      {
        "system": "http://hl7.org/fhir/v3/ActMood",
        "version": "2016-11-11",
        "concept": [
          {
            "code": "APT",
            "display": "appointment"
          },
          {
            "code": "ARQ",
            "display": "appointment request"
          },
          {
            "code": "INT",
            "display": "intent"
          },
          {
            "code": "PERMRQ",
            "display": "permission request"
          },
          {
            "code": "PRMS",
            "display": "promise"
          },
          {
            "code": "PRP",
            "display": "proposal"
          },
          {
            "code": "RMD",
            "display": "recommendation"
          },
          {
            "code": "RQO",
            "display": "request"
          },
          {
            "code": "_ActMoodActRequest",
            "display": "act request"
          },
          {
            "code": "_ActMoodDesire",
            "display": "desire"
          }
        ]
      }
    ]
  },
  "expansion": {
    "timestamp": "2026-03-17T21:02:03.8104715+00:00",
    "contains": [
      {
        "system": "http://hl7.org/fhir/v3/ActMood",
        "version": "2016-11-11",
        "code": "APT",
        "display": "appointment"
      },
      {
        "system": "http://hl7.org/fhir/v3/ActMood",
        "version": "2016-11-11",
        "code": "ARQ",
        "display": "appointment request"
      },
      {
        "system": "http://hl7.org/fhir/v3/ActMood",
        "version": "2016-11-11",
        "code": "INT",
        "display": "intent"
      },
      {
        "system": "http://hl7.org/fhir/v3/ActMood",
        "version": "2016-11-11",
        "code": "PERMRQ",
        "display": "permission request"
      },
      {
        "system": "http://hl7.org/fhir/v3/ActMood",
        "version": "2016-11-11",
        "code": "PRMS",
        "display": "promise"
      },
      {
        "system": "http://hl7.org/fhir/v3/ActMood",
        "version": "2016-11-11",
        "code": "PRP",
        "display": "proposal"
      },
      {
        "system": "http://hl7.org/fhir/v3/ActMood",
        "version": "2016-11-11",
        "code": "RMD",
        "display": "recommendation"
      },
      {
        "system": "http://hl7.org/fhir/v3/ActMood",
        "version": "2016-11-11",
        "code": "RQO",
        "display": "request"
      },
      {
        "system": "http://hl7.org/fhir/v3/ActMood",
        "version": "2016-11-11",
        "code": "_ActMoodActRequest",
        "display": "act request"
      },
      {
        "system": "http://hl7.org/fhir/v3/ActMood",
        "version": "2016-11-11",
        "code": "_ActMoodDesire",
        "display": "desire"
      }
    ]
  }
}