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HdBe-Procedure

CBB	Description	Status
HdBe-Procedure	The concept Procedure describes therapeutic or diagnostic procedures undergone by the patient or which the patient will undergo. The concept can describe in the right context historical, future as well as advised procedures. A procedure can be a simple blood pressure measurement, but also a complex heart surgery. In some care settings, the term treatment is used instead of the term procedure. Purpose A procedure is carried out or planned as part of a planned policy or to obtain additional information in the diagnostic process. Procedures are documented to gain insight into the treatment of a patient. In addition, procedures are documented for administrative purposes such as invoicing and workload measurement, scientific research and/or education.	active

CBB

Description

Status

HdBe-Procedure

The concept Procedure describes therapeutic or diagnostic procedures undergone by the patient or which the patient will undergo. The concept can describe in the right context historical, future as well as advised procedures. A procedure can be a simple blood pressure measurement, but also a complex heart surgery. In some care settings, the term treatment is used instead of the term procedure.

Purpose

A procedure is carried out or planned as part of a planned policy or to obtain additional information in the diagnostic process. Procedures are documented to gain insight into the treatment of a patient. In addition, procedures are documented for administrative purposes such as invoicing and workload measurement, scientific research and/or education.

active

Procedure			Procedure	Element id Procedure Short description Procedure Definition Root concept of the Procedure information model. This root concept contains all data elements of the Procedure information model. Data type Procedure Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id Procedure.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Procedure.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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()` Mappings rim: n/a rim: N/A
ProcedureStartDate		0..1	dateTime	Element id Procedure.ProcedureStartDate Short description ProcedureStartDate Definition The (desired) start date (and if possible start time) of the procedure. A ‘vague’ date, such as only the year, is permitted. The element offers the option to indicate the start of the period of a series of related procedures. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
ProcedureEndDate		0..1	dateTime	Element id Procedure.ProcedureEndDate Short description ProcedureEndDate Definition The end date (and if possible end time) of the procedure. A ‘vague’ date, such as only the year, is permitted. The element offers the option to indicate the end of the period of a series of related procedures. The end date element is only used for a procedures that takes some time and is then always applied. If the procedure still continues, the value is left empty. For instantaneous or very short lasting procedures the element is omitted. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
ProcedureType		1..1	CodeableConceptBinding	Element id Procedure.ProcedureType Short description ProcedureType Definition The name of the procedure. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding ProcedureType codes ProcedureType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
ProcedureMethod		0..*	CodeableConceptBinding	Element id Procedure.ProcedureMethod Short description ProcedureMethod Definition The method or technique that was used to perform the procedure, e.g. approach, lavage, pressuring, etc. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding ProcedureMethod codes ProcedureMethod (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
ProcedureAnatomicalLocation	I	0..1	Reference(HdBe-AnatomicalLocation)	Element id Procedure.ProcedureAnatomicalLocation Short description ProcedureAnatomicalLocation Definition Anatomical location that is the focus of the procedure. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(HdBe-AnatomicalLocation) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Indication	I	0..*	Reference(HdBe-Problem)	Element id Procedure.Indication Short description Indication Definition The indication is the reason for the procedure. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(HdBe-Problem) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
MedicalDevice	I	0..*	Reference(HdBe-MedicalDevice)	Element id Procedure.MedicalDevice Short description MedicalDevice Definition The product, the placing of which in or on the body is the purpose of the procedure, for example placing an implant. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(HdBe-MedicalDevice) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Location	I	0..1	Reference(HdBe-HealthcareOrganization)	Element id Procedure.Location Short description Location Definition The healthcare center where the procedure was, is or will be carried out. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(HdBe-HealthcareOrganization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Performer	I	0..*	Reference(HdBe-HealthProfessional)	Element id Procedure.Performer Short description Performer Definition The healthcare professional who carried out or will carry out the procedure. In most cases, only the medical specialty is entered, and not the name of the healthcare professional. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(HdBe-HealthProfessional) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Requester	I	0..1	Reference(HdBe-HealthProfessional)	Element id Procedure.Requester Short description Requester Definition The healthcare professional who requested the procedure. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(HdBe-HealthProfessional) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

Procedure		0..*
Procedure.ProcedureStartDate	dateTime	0..1
Procedure.ProcedureEndDate	dateTime	0..1
Procedure.ProcedureType	CodeableConcept	1..1
Procedure.ProcedureMethod	CodeableConcept	0..*
Procedure.ProcedureAnatomicalLocation	Reference(HdBe-AnatomicalLocation)	0..1
Procedure.Indication	Reference(HdBe-Problem)	0..*
Procedure.MedicalDevice	Reference(HdBe-MedicalDevice)	0..*
Procedure.Location	Reference(HdBe-HealthcareOrganization)	0..1
Procedure.Performer	Reference(HdBe-HealthProfessional)	0..*
Procedure.Requester	Reference(HdBe-HealthProfessional)	0..1

Procedure
Definition	Root concept of the Procedure information model. This root concept contains all data elements of the Procedure information model.
Cardinality	0...*
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
Procedure.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
Procedure.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.
Cardinality	0...*
Type	Extension
Alias	extensions, 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.
Slicing	Unordered, Open, by url(Value)
Invariants	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()`
Mappings	rim: n/a rim: N/A
Procedure.ProcedureStartDate
Definition	The (desired) start date (and if possible start time) of the procedure. A ‘vague’ date, such as only the year, is permitted. The element offers the option to indicate the start of the period of a series of related procedures.
Cardinality	0...1
Type	dateTime
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
Procedure.ProcedureEndDate
Definition	The end date (and if possible end time) of the procedure. A ‘vague’ date, such as only the year, is permitted. The element offers the option to indicate the end of the period of a series of related procedures. The end date element is only used for a procedures that takes some time and is then always applied. If the procedure still continues, the value is left empty. For instantaneous or very short lasting procedures the element is omitted.
Cardinality	0...1
Type	dateTime
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
Procedure.ProcedureType
Definition	The name of the procedure.
Cardinality	1...1
Type	CodeableConcept
Binding	ProcedureType codes ProcedureType (extensible)
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
Procedure.ProcedureMethod
Definition	The method or technique that was used to perform the procedure, e.g. approach, lavage, pressuring, etc.
Cardinality	0...*
Type	CodeableConcept
Binding	ProcedureMethod codes ProcedureMethod (required)
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
Procedure.ProcedureAnatomicalLocation
Definition	Anatomical location that is the focus of the procedure.
Cardinality	0...1
Type	Reference(HdBe-AnatomicalLocation)
Comments	References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Procedure.Indication
Definition	The indication is the reason for the procedure.
Cardinality	0...*
Type	Reference(HdBe-Problem)
Comments	References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Procedure.MedicalDevice
Definition	The product, the placing of which in or on the body is the purpose of the procedure, for example placing an implant.
Cardinality	0...*
Type	Reference(HdBe-MedicalDevice)
Comments	References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Procedure.Location
Definition	The healthcare center where the procedure was, is or will be carried out.
Cardinality	0...1
Type	Reference(HdBe-HealthcareOrganization)
Comments	References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Procedure.Performer
Definition	The healthcare professional who carried out or will carry out the procedure. In most cases, only the medical specialty is entered, and not the name of the healthcare professional.
Cardinality	0...*
Type	Reference(HdBe-HealthProfessional)
Comments	References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Procedure.Requester
Definition	The healthcare professional who requested the procedure.
Cardinality	0...1
Type	Reference(HdBe-HealthProfessional)
Comments	References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`
Mappings	rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

Example instances

procedure (event)
ProcedureStartDate	2020-06-05T12:00:00
ProcedureEndDate	2020-06-05T14:25:00
ProcedureType	609588000 - Total knee replacement (code by SNOMED CT)
ProcedureMethod	129284003 - Surgical action (code by SNOMED CT)
ProcedureAnatomicalLocation.Location	72696002 - Knee region structure (code by SNOMED CT)
ProcedureAnatomicalLocation.Laterality	7771000 - Left (code by SNOMED CT)
indication	Reference to Problem (Arthropathy of knee joint)
MedicalDevice
location	Reference to HealthcareOrganization (UMCG)
performer	Reference to HealthProfessional (Orthopodist)
requester

procedure (request)
ProcedureStartDate	2020-06-05
ProcedureEndDate
ProcedureType	609588000 - Total knee replacement (code by SNOMED CT)
ProcedureMethod	129284003 - Surgical action (code by SNOMED CT)
ProcedureAnatomicalLocation.Location	72696002 - Knee region structure (code by SNOMED CT)
ProcedureAnatomicalLocation.Laterality	7771000 - Left (code by SNOMED CT)
indication	Reference to Problem (Arthropathy of knee joint)
MedicalDevice
location	Reference to HealthcareOrganization (UMCG)
performer
requester	Reference to HealthProfessional (Orthopodist)

procedure (event)
ProcedureStartDate	2022-05-12
ProcedureEndDate	2022-05-12
ProcedureType	80146002 - Excision of appendix (code by SNOMED CT)
ProcedureMethod	73632009 - Laparoscopy (code by SNOMED CT)
ProcedureAnatomicalLocation.Location	66754008 - Appendix structure (code by SNOMED CT)
ProcedureAnatomicalLocation.Laterality	24028007 - Right (code by SNOMED CT)
indication	Reference to Problem (Appendicitis)
MedicalDevice
location
performer
requester

zib Procedure-v5.2 difference

Concept	Category	Description
`ProcedureType`	textual	Removed (Dutch) CodeSystem names in the definition.
`ProcedureType`	terminology	Replaced (Dutch) ValueSets with one ValueSet that includes all SNOMED child concepts of 71388002 Procedure.
`ProcedureMethod`	terminology	Widened terminology from descendent of 129264002(Action) to all of SNOMED. Changed the binding strenght from required to extensible.
`Location`	textual	Replaced 'healthcare center' with 'healthcare provider' in the definition.
`Location`	textual	Removed a double 'or' in the definition.
`Performer`	textual	Replaced 'healthcare provider' with 'healthcare professional' in the definition.
`Requester`	textual	Replaced 'healthcare provider' with 'healthcare professional' in the definition.
`Requester`	cardinality	Restricted requester from 0..* to 0..1. This aligns with FHIR and a future version of the zib. ZIB-1488 and Nictiz-ticket #69.
`ProcedureMethod`	textual	Replaced 'e.g. ' with 'e.g. '.
`ProcedureMethod`	textual	Replaced 'ets' with 'etc.'.
`ProcedureAnatomicalLocation`	textual	Replaced 'Anatomical location which is' with 'Anatomical location that is'.
`Requester`	textual	Replaced 'healthcare provider who requested' with 'healthcare professional who requested'.
description.concept	textual	Replaced 'therapeutic or diagnostic procedure' with 'therapeutic or diagnostic procedures'.
description.concept	textual	Replaced 'the term treatment t is used' with 'the term treatment is used'.

Terminology Bindings

Path	Name	Strength	URL
ProcedureType	ProcedureType	extensible	https://fhir.healthdata.be/ValueSet/ProcedureType
ProcedureMethod	ProcedureMethod	required	https://fhir.healthdata.be/ValueSet/ProcedureMethod