Existing Wording: Note that the Diagnostic Request itself is not a request to perform the investigation - but rather a record of the fact that a request was made. To actually initiate the workflow beyond simply the existence of a Diagnostic Request may be required.

Comment:

I think this remains confusing (I believe it was in earlier STUs as well). Of course, the diagnostic request resource is not the actual request (e.g., an order created in an EHR system), any more than the patient resource is the actual patient. Everything in an HIT system is a "record of the fact that" something exists or was done. For example, the Procedure resource says it is "an action that is or was performed on a patient." But it isn't really, it's actually a record that the procedure was performed. So I don't why it's important to make the point about the Diagnostic Request resource not actually being the request, but a record of the request. To be logically consistent, you'd have to make statements like that about almost all resources.

Back to the specifics of this resource: since the request "was made" (past tense), then that implies that the order was placed already. So it shouldn't be necessary to say "to actually initiate the workflow beyond simply the existence of a Diagnostic Request may be required."

Summary:

Confusion over meaning of DiagnosticRequest