PanCareSurPass Project HL7 FHIR Implementation Guide
0.1.0 - trial-use 150

This page is part of the PanCareSurPass Project HL7 FHIR Implementation Guide (v0.1.0: QA Preview) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: ProcedureRadiotherapyBoostPcsp - Detailed Descriptions

Active as of 2023-01-26

Definitions for the Procedure-radiotheraphyBoost-eu-pcsp resource profile.

Guidance on how to interpret the contents of this table can be found here.

1. Procedure
2. Procedure.extension
SlicingThis element introduces a set of slices on Procedure.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
3. Procedure.extension:relatedDose
SliceNamerelatedDose
Control0..*
TypeExtension(ResourceRelatedInfo) (Extension Type: Reference(Resource))
4. Procedure.extension:relatedDose.valueReference
Control0..1
TypeReference(TotalDoseRadObsPcsp)
5. Procedure.extension:procedureMethod
SliceNameprocedureMethod
Control0..1
TypeExtension(method) (Extension Type: CodeableConcept)
6. Procedure.extension:procedureMethod.valueCodeableConcept
Control1..1
BindingThe codes SHALL be taken from Brachytherapy Type
7. Procedure.extension:energyOrIsotope
SliceNameenergyOrIsotope
Control0..*
TypeExtension(RadiotherapyEnergyOrIsotope) (Extension Type: Choice of: CodeableConcept, Quantity(SimpleQuantity))
8. Procedure.extension:performedTiming
SliceNameperformedTiming
Control0..1
TypeExtension(PerformedTiming) (Extension Type: Timing)
9. Procedure.extension:performedTiming.valueTiming
Control0..1
10. Procedure.extension:performedTiming.valueTiming.repeat
Control0..?
11. Procedure.extension:performedTiming.valueTiming.repeat.count
Control0..?
12. Procedure.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
13. Procedure.partOf
Control10..1*
TypeReference(ProcedureRadiotherapyPcsp|Procedure|Observation|MedicationAdministration)
14. Procedure.status
15. Procedure.category
Control10..1
16. Procedure.category.coding
Control2..?
SlicingThis element introduces a set of slices on Procedure.category.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
17. Procedure.category.coding:radiotheraphy
SliceNameradiotheraphy
Control1..1
Pattern Value<valueCoding xmlns="http://hl7.org/fhir">
  <system value="http://snomed.info/sct"/>
  <code value="108290001"/>
  <display value="Radiotherapy"/>
</valueCoding>
18. Procedure.category.coding:boost
SliceNameboost
Control1..1
Pattern Value<valueCoding xmlns="http://hl7.org/fhir">
  <system value="http://snomed.info/sct"/>
  <code value="445232009"/>
  <display value="Boost radiation therapy"/>
</valueCoding>
19. Procedure.code
Control10..1
BindingThe codes SHALL be taken from Radiotherapy Type; other codes may be used where these codes are not suitableFor example codes, see ProcedureCodes(SNOMEDCT)
20. Procedure.subject
TypeReference(PatientPcsp|Patient|Group)
21. Procedure.performed[x]
Control10..1
[x] NoteSee Choice of Data Types for further information about how to use [x]
SlicingThis element introduces a set of slices on Procedure.performed[x]. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
22. Procedure.performedPeriod
Control1..1
TypePeriod
23. Procedure.reasonReference
Control10..*
TypeReference(ConditionPrimaryCancerPcsp|Condition|Observation|Procedure|DiagnosticReport|DocumentReference)
24. Procedure.bodySite
BindingThe codes SHALL be taken from Radiotherapy sitesFor example codes, see SNOMEDCTBodyStructures
25. Procedure.bodySite.extension:locationQualifier
SliceNamelocationQualifier
Control0..*
TypeExtension(BodyLocationQualifier) (Extension Type: CodeableConcept)
26. Procedure.bodySite.extension:locationQualifier.valueCodeableConcept
Control1..1
BindingThe codes SHALL be taken from Body Location Qualifier Value Set
27. Procedure.bodySite.extension:lateralityQualifier
SliceNamelateralityQualifier
Control0..1
TypeExtension(LateralityQualifier) (Extension Type: CodeableConcept)
28. Procedure.note

Guidance on how to interpret the contents of this table can be found here.

1. Procedure
Definition

An action that is or was performed on or for a patient. This can be a physical intervention like an operation, or less invasive like long term services, counseling, or hypnotherapy.

Control0..*
Summaryfalse
InvariantsDefined on this element
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (: text.`div`.exists())
2. Procedure.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Control0..1
Typeuri
Is Modifiertrue
Summarytrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
3. Procedure.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Procedure.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
4. Procedure.extension:relatedDose
SliceNamerelatedDose
Definition

This extension provides a means to link the source resource to any target related information. This extension shall not be used when other more specific elements or standard extensions apply. E.g. Observation.hasMember.

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ResourceRelatedInfo) (Extension Type: Reference(Resource))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
5. Procedure.extension:relatedDose.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Procedure.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
6. Procedure.extension:relatedDose.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.eu/fhir/ig/pcsp/StructureDefinition/resource-relatedInfo
7. Procedure.extension:relatedDose.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control0..1
TypeChoice of: Reference(Resource), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Procedure.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
8. Procedure.extension:relatedDose.value[x]:valueReference
SliceNamevalueReference
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control0..1
TypeChoice of: Reference(TotalDoseRadObsPcsp), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
9. Procedure.extension:procedureMethod
SliceNameprocedureMethod
Definition

The method used to perform this procedure.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(method) (Extension Type: CodeableConcept)
Comments

Improve definition. Add mappings.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. Procedure.extension:procedureMethod.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Procedure.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
11. Procedure.extension:procedureMethod.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/procedure-method
12. Procedure.extension:procedureMethod.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
TypeChoice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Procedure.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
13. Procedure.extension:procedureMethod.value[x]:valueCodeableConcept
SliceNamevalueCodeableConcept
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from Brachytherapy TypeFor codes, see (unbound)
TypeChoice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
14. Procedure.extension:energyOrIsotope
SliceNameenergyOrIsotope
Definition

The radiation energy used for radiotherapy. The energy spectrum is characterized by the maximum energy, the maximum accelaration voltage, or the used isotope.

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(RadiotherapyEnergyOrIsotope) (Extension Type: Choice of: CodeableConcept, Quantity(SimpleQuantity))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
15. Procedure.extension:performedTiming
SliceNameperformedTiming
Definition

This extension allows to indicate when the procedure was performed as Timing.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(PerformedTiming) (Extension Type: Timing)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
16. Procedure.extension:performedTiming.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Procedure.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
17. Procedure.extension:performedTiming.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.eu/fhir/ig/pcsp/StructureDefinition/procedure-performedTiming
18. Procedure.extension:performedTiming.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control0..1
TypeChoice of: Timing, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Procedure.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
19. Procedure.extension:performedTiming.value[x]:valueTiming
SliceNamevalueTiming
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control0..1
TypeChoice of: Timing, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
20. Procedure.extension:performedTiming.value[x]:valueTiming.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
21. Procedure.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
22. Procedure.identifier
Definition

Business identifiers assigned to this procedure by the performer or other systems which remain constant as the resource is updated and is propagated from server to server.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Summarytrue
Requirements

Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers.

Comments

This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and Person resource instances might share the same social insurance number.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
23. Procedure.partOf
Definition

A larger event of which this particular procedure is a component or step.

Control10..1*
TypeReference(ProcedureRadiotherapyPcsp|Procedure|Observation|MedicationAdministration)
Summarytrue
Alternate Namescontainer
Comments

The MedicationAdministration resource has a partOf reference to Procedure, but this is not a circular reference. For example, the anesthesia MedicationAdministration is part of the surgical Procedure (MedicationAdministration.partOf = Procedure). For example, the procedure to insert the IV port for an IV medication administration is part of the medication administration (Procedure.partOf = MedicationAdministration).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
24. Procedure.status
Definition

A code specifying the state of the procedure. Generally, this will be the in-progress or completed state.

Control1..1
BindingThe codes SHALL be taken from EventStatus

A code specifying the state of the procedure.

Typecode
Is Modifiertrue
Summarytrue
Comments

The "unknown" code is not to be used to convey other statuses. The "unknown" code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
25. Procedure.category
Definition

A code that classifies the procedure for searching, sorting and display purposes (e.g. "Surgical Procedure").

Control10..1
BindingFor example codes, see ProcedureCategoryCodes(SNOMEDCT)

A code that classifies a procedure for searching, sorting and display purposes.

TypeCodeableConcept
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
26. Procedure.category.coding
Definition

A reference to a code defined by a terminology system.

Control20..*
TypeCoding
Summarytrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Procedure.category.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
27. Procedure.category.coding:radiotheraphy
SliceNameradiotheraphy
Definition

A reference to a code defined by a terminology system.

Control10..1*
TypeCoding
Summarytrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Pattern Value<valueCoding xmlns="http://hl7.org/fhir">
  <system value="http://snomed.info/sct"/>
  <code value="108290001"/>
  <display value="Radiotherapy"/>
</valueCoding>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
28. Procedure.category.coding:boost
SliceNameboost
Definition

A reference to a code defined by a terminology system.

Control10..1*
TypeCoding
Summarytrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Pattern Value<valueCoding xmlns="http://hl7.org/fhir">
  <system value="http://snomed.info/sct"/>
  <code value="445232009"/>
  <display value="Boost radiation therapy"/>
</valueCoding>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. Procedure.code
Definition

The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. "Laparoscopic Appendectomy").

Control10..1
BindingThe codes SHALL be taken from Radiotherapy Type; other codes may be used where these codes are not suitableFor example codes, see ProcedureCodes(SNOMEDCT)
TypeCodeableConcept
Summarytrue
Requirements

0..1 to account for primarily narrative only resources.

Alternate Namestype
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
30. Procedure.subject
Definition

The person, animal or group on which the procedure was performed.

Control1..1
TypeReference(PatientPcsp|Patient|Group)
Summarytrue
Alternate Namespatient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
31. Procedure.performed[x]
Definition

Estimated or actual date, date-time, period, or age when the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.

Control10..1
TypeChoice of: Period, dateTime, string, Range, Age
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summarytrue
Comments

Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old. dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Procedure.performed[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
32. Procedure.performed[x]:performedPeriod
SliceNameperformedPeriod
Definition

Estimated or actual date, date-time, period, or age when the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.

Control10..1
TypeChoice of: Period, dateTime, string, Range, Age
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summarytrue
Comments

Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old. dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
33. Procedure.reasonReference
Definition

The justification of why the procedure was performed.

Control10..*
TypeReference(ConditionPrimaryCancerPcsp|Condition|Observation|Procedure|DiagnosticReport|DocumentReference)
Summarytrue
Comments

It is possible for a procedure to be a reason (such as C-Section) for another procedure (such as an epidural). Other examples include endoscopy for dilatation and biopsy (a combination of diagnostic and therapeutic use). Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
34. Procedure.bodySite
Definition

Detailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion.

Control0..*
BindingThe codes SHALL be taken from Radiotherapy sitesFor example codes, see SNOMEDCTBodyStructures
TypeCodeableConcept
Summarytrue
Comments

If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension procedure-targetbodystructure.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
35. Procedure.bodySite.extension:locationQualifier
SliceNamelocationQualifier
Definition

Qualifier to refine an body location. These include qualifiers for relative location, directionality, number, and plane, and exclude qualifiers for laterality.

Control0..*
TypeExtension(BodyLocationQualifier) (Extension Type: CodeableConcept)
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
36. Procedure.bodySite.extension:locationQualifier.extension
Definition

An Extension

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Procedure.bodySite.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
37. Procedure.bodySite.extension:locationQualifier.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-body-location-qualifier
38. Procedure.bodySite.extension:locationQualifier.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHOULD be taken from Body Location Qualifier Value SetFor codes, see (unbound)
TypeChoice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Procedure.bodySite.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
39. Procedure.bodySite.extension:locationQualifier.value[x]:valueCodeableConcept
SliceNamevalueCodeableConcept
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from Body Location Qualifier Value SetFor codes, see (unbound)
TypeChoice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
40. Procedure.bodySite.extension:lateralityQualifier
SliceNamelateralityQualifier
Definition

Qualifier to specify laterality.

Control0..1
TypeExtension(LateralityQualifier) (Extension Type: CodeableConcept)
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
41. Procedure.note
Definition

Any other notes and comments about the procedure.

Control0..*
TypeAnnotation
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be found here.

1. Procedure
Definition

An action that is or was performed on or for a patient. This can be a physical intervention like an operation, or less invasive like long term services, counseling, or hypnotherapy.

Control0..*
Summaryfalse
2. Procedure.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Control0..1
Typeid
Summarytrue
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

3. Procedure.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Control0..1
TypeMeta
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. Procedure.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Control0..1
Typeuri
Is Modifiertrue
Summarytrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
5. Procedure.language
Definition

The base language in which the resource is written.

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages A human language
Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Summaryfalse
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. Procedure.text
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
TypeNarrative
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. Procedure.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Control0..*
TypeResource
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

8. Procedure.extension
Definition

An Extension

Control0..*
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Procedure.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
9. Procedure.extension:relatedDose
SliceNamerelatedDose
Definition

This extension provides a means to link the source resource to any target related information. This extension shall not be used when other more specific elements or standard extensions apply. E.g. Observation.hasMember.

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ResourceRelatedInfo) (Extension Type: Reference(Resource))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. Procedure.extension:relatedDose.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
11. Procedure.extension:relatedDose.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Procedure.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
12. Procedure.extension:relatedDose.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.eu/fhir/ig/pcsp/StructureDefinition/resource-relatedInfo
13. Procedure.extension:relatedDose.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control0..1
TypeReference(Resource)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Procedure.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
14. Procedure.extension:relatedDose.value[x]:valueReference
SliceNamevalueReference
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control0..1
TypeReference(TotalDoseRadObsPcsp)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
15. Procedure.extension:procedureMethod
SliceNameprocedureMethod
Definition

The method used to perform this procedure.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(method) (Extension Type: CodeableConcept)
Comments

Improve definition. Add mappings.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
16. Procedure.extension:procedureMethod.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
17. Procedure.extension:procedureMethod.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Procedure.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
18. Procedure.extension:procedureMethod.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/procedure-method
19. Procedure.extension:procedureMethod.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Procedure.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
20. Procedure.extension:procedureMethod.value[x]:valueCodeableConcept
SliceNamevalueCodeableConcept
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from Brachytherapy Type
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
21. Procedure.extension:energyOrIsotope
SliceNameenergyOrIsotope
Definition

The radiation energy used for radiotherapy. The energy spectrum is characterized by the maximum energy, the maximum accelaration voltage, or the used isotope.

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(RadiotherapyEnergyOrIsotope) (Extension Type: Choice of: CodeableConcept, Quantity(SimpleQuantity))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
22. Procedure.extension:performedTiming
SliceNameperformedTiming
Definition

This extension allows to indicate when the procedure was performed as Timing.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(PerformedTiming) (Extension Type: Timing)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
23. Procedure.extension:performedTiming.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
24. Procedure.extension:performedTiming.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Procedure.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
25. Procedure.extension:performedTiming.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.eu/fhir/ig/pcsp/StructureDefinition/procedure-performedTiming
26. Procedure.extension:performedTiming.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control0..1
TypeTiming
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Procedure.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
27. Procedure.extension:performedTiming.value[x]:valueTiming
SliceNamevalueTiming
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control0..1
TypeTiming
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
28. Procedure.extension:performedTiming.value[x]:valueTiming.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
29. Procedure.extension:performedTiming.value[x]:valueTiming.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Procedure.extension.value[x].extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
30. Procedure.extension:performedTiming.value[x]:valueTiming.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
31. Procedure.extension:performedTiming.value[x]:valueTiming.event
Definition

Identifies specific times when the event occurs.

Control0..*
TypedateTime
Summarytrue
Requirements

In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
32. Procedure.extension:performedTiming.value[x]:valueTiming.repeat
Definition

A set of rules that describe when the event is scheduled.

Control0..1
TypeElement
Summarytrue
Requirements

Many timing schedules are determined by regular repetitions.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
tim-1: if there's a duration, there needs to be duration units (: duration.empty() or durationUnit.exists())
tim-2: if there's a period, there needs to be period units (: period.empty() or periodUnit.exists())
tim-4: duration SHALL be a non-negative value (: duration.exists() implies duration >= 0)
tim-5: period SHALL be a non-negative value (: period.exists() implies period >= 0)
tim-6: If there's a periodMax, there must be a period (: periodMax.empty() or period.exists())
tim-7: If there's a durationMax, there must be a duration (: durationMax.empty() or duration.exists())
tim-8: If there's a countMax, there must be a count (: countMax.empty() or count.exists())
tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV) (: offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not())))
tim-10: If there's a timeOfDay, there cannot be a when, or vice versa (: timeOfDay.empty() or when.empty())
33. Procedure.extension:performedTiming.value[x]:valueTiming.repeat.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
34. Procedure.extension:performedTiming.value[x]:valueTiming.repeat.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Procedure.extension.value[x].repeat.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
35. Procedure.extension:performedTiming.value[x]:valueTiming.repeat.bounds[x]
Definition

Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.

Control0..1
TypeChoice of: Duration, Range, Period
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
36. Procedure.extension:performedTiming.value[x]:valueTiming.repeat.count
Definition

A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.

Control0..1
TypepositiveInt
Summarytrue
Requirements

Repetitions may be limited by end time or total occurrences.

Comments

If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
37. Procedure.extension:performedTiming.value[x]:valueTiming.repeat.countMax
Definition

If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.

Control0..1
TypepositiveInt
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
38. Procedure.extension:performedTiming.value[x]:valueTiming.repeat.duration
Definition

How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.

Control0..1
Typedecimal
Summarytrue
Requirements

Some activities are not instantaneous and need to be maintained for a period of time.

Comments

For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
39. Procedure.extension:performedTiming.value[x]:valueTiming.repeat.durationMax
Definition

If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.

Control0..1
Typedecimal
Summarytrue
Requirements

Some activities are not instantaneous and need to be maintained for a period of time.

Comments

For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
40. Procedure.extension:performedTiming.value[x]:valueTiming.repeat.durationUnit
Definition

The units of time for the duration, in UCUM units.

Control0..1
BindingThe codes SHALL be taken from UnitsOfTime A unit of time (units from UCUM)
Typecode
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
41. Procedure.extension:performedTiming.value[x]:valueTiming.repeat.frequency
Definition

The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.

Control0..1
TypepositiveInt
Summarytrue
Meaning if MissingIf no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
42. Procedure.extension:performedTiming.value[x]:valueTiming.repeat.frequencyMax
Definition

If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.

Control0..1
TypepositiveInt
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
43. Procedure.extension:performedTiming.value[x]:valueTiming.repeat.period
Definition

Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.

Control0..1
Typedecimal
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
44. Procedure.extension:performedTiming.value[x]:valueTiming.repeat.periodMax
Definition

If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.

Control0..1
Typedecimal
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
45. Procedure.extension:performedTiming.value[x]:valueTiming.repeat.periodUnit
Definition

The units of time for the period in UCUM units.

Control0..1
BindingThe codes SHALL be taken from UnitsOfTime A unit of time (units from UCUM)
Typecode
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
46. Procedure.extension:performedTiming.value[x]:valueTiming.repeat.dayOfWeek
Definition

If one or more days of week is provided, then the action happens only on the specified day(s).

Control0..*
BindingThe codes SHALL be taken from DaysOfWeek
Typecode
Summarytrue
Comments

If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
47. Procedure.extension:performedTiming.value[x]:valueTiming.repeat.timeOfDay
Definition

Specified time of day for action to take place.

Control0..*
Typetime
Summarytrue
Comments

When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
48. Procedure.extension:performedTiming.value[x]:valueTiming.repeat.when
Definition

An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.

Control0..*
BindingThe codes SHALL be taken from EventTiming Real world event relating to the schedule
Typecode
Summarytrue
Requirements

Timings are frequently determined by occurrences such as waking, eating and sleep.

Comments

When more than one event is listed, the event is tied to the union of the specified events.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
49. Procedure.extension:performedTiming.value[x]:valueTiming.repeat.offset
Definition

The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.

Control0..1
TypeunsignedInt
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
50. Procedure.extension:performedTiming.value[x]:valueTiming.code
Definition

A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).

Control0..1
BindingThe codes SHOULD be taken from TimingAbbreviation Code for a known / defined timing pattern
TypeCodeableConcept
Summarytrue
Comments

BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
51. Procedure.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
52. Procedure.identifier
Definition

Business identifiers assigned to this procedure by the performer or other systems which remain constant as the resource is updated and is propagated from server to server.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Summarytrue
Requirements

Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers.

Comments

This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and Person resource instances might share the same social insurance number.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
53. Procedure.instantiatesCanonical
Definition

The URL pointing to a FHIR-defined protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure.

Control0..*
Typecanonical(PlanDefinition|ActivityDefinition|Measure|OperationDefinition|Questionnaire)
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
54. Procedure.instantiatesUri
Definition

The URL pointing to an externally maintained protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure.

Control0..*
Typeuri
Summarytrue
Comments

This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
55. Procedure.basedOn
Definition

A reference to a resource that contains details of the request for this procedure.

Control0..*
TypeReference(CarePlan|ServiceRequest)
Summarytrue
Alternate Namesfulfills
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
56. Procedure.partOf
Definition

A larger event of which this particular procedure is a component or step.

Control1..1
TypeReference(ProcedureRadiotherapyPcsp)
Summarytrue
Alternate Namescontainer
Comments

The MedicationAdministration resource has a partOf reference to Procedure, but this is not a circular reference. For example, the anesthesia MedicationAdministration is part of the surgical Procedure (MedicationAdministration.partOf = Procedure). For example, the procedure to insert the IV port for an IV medication administration is part of the medication administration (Procedure.partOf = MedicationAdministration).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
57. Procedure.status
Definition

A code specifying the state of the procedure. Generally, this will be the in-progress or completed state.

Control1..1
BindingThe codes SHALL be taken from EventStatus A code specifying the state of the procedure
Typecode
Is Modifiertrue
Summarytrue
Comments

The "unknown" code is not to be used to convey other statuses. The "unknown" code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
58. Procedure.statusReason
Definition

Captures the reason for the current state of the procedure.

Control0..1
BindingFor example codes, see ProcedureNotPerformedReason(SNOMED-CT) A code that identifies the reason a procedure was not performed
TypeCodeableConcept
Summarytrue
Alternate NamesSuspended Reason, Cancelled Reason
Comments

This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
59. Procedure.category
Definition

A code that classifies the procedure for searching, sorting and display purposes (e.g. "Surgical Procedure").

Control1..1
BindingFor example codes, see ProcedureCategoryCodes(SNOMEDCT) A code that classifies a procedure for searching, sorting and display purposes
TypeCodeableConcept
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
60. Procedure.category.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
61. Procedure.category.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Procedure.category.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
62. Procedure.category.coding
Definition

A reference to a code defined by a terminology system.

Control2..*
TypeCoding
Summarytrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Procedure.category.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
63. Procedure.category.coding:radiotheraphy
SliceNameradiotheraphy
Definition

A reference to a code defined by a terminology system.

Control1..1
TypeCoding
Summarytrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Pattern Value<valueCoding xmlns="http://hl7.org/fhir">
  <system value="http://snomed.info/sct"/>
  <code value="108290001"/>
  <display value="Radiotherapy"/>
</valueCoding>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
64. Procedure.category.coding:boost
SliceNameboost
Definition

A reference to a code defined by a terminology system.

Control1..1
TypeCoding
Summarytrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Pattern Value<valueCoding xmlns="http://hl7.org/fhir">
  <system value="http://snomed.info/sct"/>
  <code value="445232009"/>
  <display value="Boost radiation therapy"/>
</valueCoding>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
65. Procedure.category.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control0..1
Typestring
Summarytrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
66. Procedure.code
Definition

The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. "Laparoscopic Appendectomy").

Control1..1
BindingThe codes SHALL be taken from Radiotherapy Type; other codes may be used where these codes are not suitable
TypeCodeableConcept
Summarytrue
Requirements

0..1 to account for primarily narrative only resources.

Alternate Namestype
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
67. Procedure.subject
Definition

The person, animal or group on which the procedure was performed.

Control1..1
TypeReference(PatientPcsp)
Summarytrue
Alternate Namespatient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
68. Procedure.encounter
Definition

The Encounter during which this Procedure was created or performed or to which the creation of this record is tightly associated.

Control0..1
TypeReference(Encounter)
Summarytrue
Comments

This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
69. Procedure.performed[x]
Definition

Estimated or actual date, date-time, period, or age when the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.

Control1..1
TypePeriod
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summarytrue
Comments

Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old. dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Procedure.performed[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
70. Procedure.performed[x]:performedPeriod
SliceNameperformedPeriod
Definition

Estimated or actual date, date-time, period, or age when the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.

Control1..1
TypePeriod
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summarytrue
Comments

Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old. dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
71. Procedure.recorder
Definition

Individual who recorded the record and takes responsibility for its content.

Control0..1
TypeReference(Patient|RelatedPerson|Practitioner|PractitionerRole)
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
72. Procedure.asserter
Definition

Individual who is making the procedure statement.

Control0..1
TypeReference(Patient|RelatedPerson|Practitioner|PractitionerRole)
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
73. Procedure.performer
Definition

Limited to "real" people rather than equipment.

Control0..*
TypeBackboneElement
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
74. Procedure.performer.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
75. Procedure.performer.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
76. Procedure.performer.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
77. Procedure.performer.function
Definition

Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist.

Control0..1
BindingFor example codes, see ProcedurePerformerRoleCodes A code that identifies the role of a performer of the procedure
TypeCodeableConcept
Summarytrue
Requirements

Allows disambiguation of the types of involvement of different performers.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
78. Procedure.performer.actor
Definition

The practitioner who was involved in the procedure.

Control1..1
TypeReference(Practitioner|PractitionerRole|Organization|Patient|RelatedPerson|Device)
Summarytrue
Requirements

A reference to Device supports use cases, such as pacemakers.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
79. Procedure.performer.onBehalfOf
Definition

The organization the device or practitioner was acting on behalf of.

Control0..1
TypeReference(Organization)
Summaryfalse
Requirements

Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
80. Procedure.location
Definition

The location where the procedure actually happened. E.g. a newborn at home, a tracheostomy at a restaurant.

Control0..1
TypeReference(Location)
Summarytrue
Requirements

Ties a procedure to where the records are likely kept.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
81. Procedure.reasonCode
Definition

The coded reason why the procedure was performed. This may be a coded entity of some type, or may simply be present as text.

Control0..*
BindingFor example codes, see ProcedureReasonCodes A code that identifies the reason a procedure is required
TypeCodeableConcept
Summarytrue
Comments

Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
82. Procedure.reasonReference
Definition

The justification of why the procedure was performed.

Control1..*
TypeReference(ConditionPrimaryCancerPcsp)
Summarytrue
Comments

It is possible for a procedure to be a reason (such as C-Section) for another procedure (such as an epidural). Other examples include endoscopy for dilatation and biopsy (a combination of diagnostic and therapeutic use). Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
83. Procedure.bodySite
Definition

Detailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion.

Control0..*
BindingThe codes SHALL be taken from Radiotherapy sites
TypeCodeableConcept
Summarytrue
Comments

If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension procedure-targetbodystructure.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
84. Procedure.bodySite.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
85. Procedure.bodySite.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Procedure.bodySite.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
86. Procedure.bodySite.extension:locationQualifier
SliceNamelocationQualifier
Definition

Qualifier to refine an body location. These include qualifiers for relative location, directionality, number, and plane, and exclude qualifiers for laterality.

Control0..*
TypeExtension(BodyLocationQualifier) (Extension Type: CodeableConcept)
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
87. Procedure.bodySite.extension:locationQualifier.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
88. Procedure.bodySite.extension:locationQualifier.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Procedure.bodySite.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
89. Procedure.bodySite.extension:locationQualifier.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-body-location-qualifier
90. Procedure.bodySite.extension:locationQualifier.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHOULD be taken from Body Location Qualifier Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Procedure.bodySite.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
91. Procedure.bodySite.extension:locationQualifier.value[x]:valueCodeableConcept
SliceNamevalueCodeableConcept
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from Body Location Qualifier Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
92. Procedure.bodySite.extension:lateralityQualifier
SliceNamelateralityQualifier
Definition

Qualifier to specify laterality.

Control0..1
TypeExtension(LateralityQualifier) (Extension Type: CodeableConcept)
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
93. Procedure.bodySite.coding
Definition

A reference to a code defined by a terminology system.

Control0..*
TypeCoding
Summarytrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
94. Procedure.bodySite.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control0..1
Typestring
Summarytrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
95. Procedure.outcome
Definition

The outcome of the procedure - did it resolve the reasons for the procedure being performed?

Control0..1
BindingFor example codes, see ProcedureOutcomeCodes(SNOMEDCT) An outcome of a procedure - whether it was resolved or otherwise
TypeCodeableConcept
Summarytrue
Comments

If outcome contains narrative text only, it can be captured using the CodeableConcept.text.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
96. Procedure.report
Definition

This could be a histology result, pathology report, surgical report, etc.

Control0..*
TypeReference(DiagnosticReport|DocumentReference|Composition)
Summaryfalse
Comments

There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
97. Procedure.complication
Definition

Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues.

Control0..*
BindingFor example codes, see Condition/Problem/DiagnosisCodes Codes describing complications that resulted from a procedure
TypeCodeableConcept
Summaryfalse
Comments

If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
98. Procedure.complicationDetail
Definition

Any complications that occurred during the procedure, or in the immediate post-performance period.

Control0..*
TypeReference(Condition)
Summaryfalse
Requirements

This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
99. Procedure.followUp
Definition

If the procedure required specific follow up - e.g. removal of sutures. The follow up may be represented as a simple note or could potentially be more complex, in which case the CarePlan resource can be used.

Control0..*
BindingFor example codes, see ProcedureFollowUpCodes(SNOMEDCT) Specific follow up required for a procedure e.g. removal of sutures
TypeCodeableConcept
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
100. Procedure.note
Definition

Any other notes and comments about the procedure.

Control0..*
TypeAnnotation
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
101. Procedure.focalDevice
Definition

A device that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure.

Control0..*
TypeBackboneElement
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
102. Procedure.focalDevice.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
103. Procedure.focalDevice.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
104. Procedure.focalDevice.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
105. Procedure.focalDevice.action
Definition

The kind of change that happened to the device during the procedure.

Control0..1
BindingThe codes SHOULD be taken from ProcedureDeviceActionCodes A kind of change that happened to the device during the procedure
TypeCodeableConcept
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
106. Procedure.focalDevice.manipulated
Definition

The device that was manipulated (changed) during the procedure.

Control1..1
TypeReference(Device)
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
107. Procedure.usedReference
Definition

Identifies medications, devices and any other substance used as part of the procedure.

Control0..*
TypeReference(Device|Medication|Substance)
Summaryfalse
Requirements

Used for tracking contamination, etc.

Comments

For devices actually implanted or removed, use Procedure.device.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
108. Procedure.usedCode
Definition

Identifies coded items that were used as part of the procedure.

Control0..*
BindingFor example codes, see FHIRDeviceTypes Codes describing items used during a procedure
TypeCodeableConcept
Summaryfalse
Comments

For devices actually implanted or removed, use Procedure.device.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))