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

                       UsageNotes: Commitments may be retracted or cancelled.

                       >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.

Source1

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  "version": "0.0.1-snapshot-2",
  "name": "R3_v3_ActMoodIntent_for_R5",
  "title": "Cross-version VS for R3.ActMoodIntent for use in FHIR R5",
  "status": "active",
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  "date": "2025-09-01T22:36:00.291172+10:00",
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        "display": "permission request"
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        "code": "RQO",
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        "code": "RMD",
        "display": "recommendation"
      },
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        "code": "PRP",
        "display": "proposal"
      },
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        "version": "2016-11-11",
        "code": "APT",
        "display": "appointment"
      },
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        "version": "2016-11-11",
        "code": "PRMS",
        "display": "promise"
      },
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