Procedure
An action that is or was performed on or for a patient, practitioner, device, organization, or location. For example, this can be a physical intervention on a patient like an operation, or less invasive like long term services, counseling, or hypnotherapy. This can be a quality or safety inspection for a location, organization, or device. This can be an accreditation procedure on a practitioner for licensing.
Scope and Usage
Procedure is one of the event resources in the FHIR workflow specification.
This resource is used to record the details of current and historical procedures performed on, with, or for a patient, practitioner, device, organization, or location. Examples include surgical procedures, diagnostic procedures, endoscopic procedures, biopsies, counseling, physiotherapy, personal support services, adult day care services, non-emergency transportation, home modification, exercise, verification of enrollment qualifications for a social program etc. Procedures may be performed by a healthcare professional, a service provider, a friend or relative or in some cases by the patient themselves.
Procedures can be performed on other non-patient subjects. For example, a procedure can represent an inspection to verify temperature or humidity for storage at a given location. Additionally, a procedure can represent the verification of the practitioner's qualifications for accreditation.
This resource provides summary information about the occurrence of the procedure and is not intended to provide real-time snapshots of a procedure as it unfolds, though for long-running procedures such as psychotherapy, it could represent summary level information about overall progress. The creation of a resource to support detailed real-time procedure information awaits the identification of a specific implementation use-case to share such information.
Resource content
These are different views on this resource:
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. |
Cardinality | 0...* |
Invariants |
|
Mappings |
|
Procedure.id | |
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Cardinality | 0...1 |
Type | string |
Summary | True |
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. |
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. |
Cardinality | 0...1 |
Type | Meta |
Summary | True |
Invariants |
|
Mappings |
|
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. |
Cardinality | 0...1 |
Type | uri |
Modifier | True |
Summary | True |
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. |
Invariants |
|
Mappings |
|
Procedure.language | |
Definition | The base language in which the resource is written. |
Cardinality | 0...1 |
Type | code |
Binding | A human language. |
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). |
Invariants |
|
Mappings |
|
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. |
Cardinality | 0...1 |
Type | Narrative |
Alias | narrative, 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. |
Invariants |
|
Mappings |
|
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. |
Cardinality | 0...* |
Type | Resource |
Alias | inline 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. |
Mappings |
|
Procedure.extension | |
Definition | 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. |
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 |
|
Mappings |
|
Procedure.extension:organization | |
Definition | The facility where the procedure was done |
Cardinality | 0...* |
Type | Extension(string) |
Alias | extensions, user content |
Comments | This is an entension |
Invariants |
|
Mappings |
|
Procedure.extension:recordedDate | |
Definition | This is the date the procedure was recorded in NHDR |
Cardinality | 0...* |
Type | Extension(dateTime) |
Alias | extensions, user content |
Comments | This is an extension |
Invariants |
|
Mappings |
|
Procedure.extension:illnessClass | |
Definition | Illness code of the disease as listed in Philhealth |
Cardinality | 0...* |
Type | Extension(CodeableConcept) |
Alias | extensions, user content |
Comments | This is an extension |
Invariants |
|
Mappings |
|
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). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Alias | extensions, user content |
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. |
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 |
|
Mappings |
|
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. |
Cardinality | 0...* |
Type | Identifier |
Summary | True |
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. |
Invariants |
|
Mappings |
|
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. |
Cardinality | 0...0 |
Type | canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire) |
Summary | True |
Comments | |
Invariants |
|
Mappings |
|
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. |
Cardinality | 0...0 |
Type | uri |
Summary | True |
Comments | This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier. |
Invariants |
|
Mappings |
|
Procedure.basedOn | |
Definition | A reference to a resource that contains details of the request for this procedure. |
Cardinality | 0...0 |
Type | Reference(CarePlan | ServiceRequest) |
Summary | True |
Alias | fulfills |
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 |
|
Mappings |
|
Procedure.partOf | |
Definition | A larger event of which this particular procedure is a component or step. |
Cardinality | 0...0 |
Type | Reference(Procedure | Observation | MedicationAdministration) |
Summary | True |
Alias | container |
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). |
Invariants |
|
Mappings |
|
Procedure.status | |
Definition | A code specifying the state of the procedure. Generally, this will be the in-progress or completed state. |
Cardinality | 1...1 |
Type | code |
Binding | A code specifying the state of the procedure. |
Modifier | True |
Summary | True |
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. |
Invariants |
|
Mappings |
|
Procedure.statusReason | |
Definition | Captures the reason for the current state of the procedure. |
Cardinality | 0...0 |
Type | CodeableConcept |
Binding | A code that identifies the reason a procedure was not performed. |
Summary | True |
Alias | Suspended 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. |
Invariants |
|
Mappings |
|
Procedure.category | |
Definition | A code that classifies the procedure for searching, sorting and display purposes (e.g. "Surgical Procedure"). |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A code that classifies a procedure for searching, sorting and display purposes. |
Summary | True |
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 |
|
Mappings |
|
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"). |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A code to identify a specific procedure . |
Summary | True |
Alias | type |
Requirements | 0..1 to account for primarily narrative only resources. |
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 |
|
Mappings |
|
Procedure.subject | |
Definition | The person, animal or group on which the procedure was performed. |
Cardinality | 1...1 |
Type | Reference(Patient | Group) |
Summary | True |
Alias | patient |
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 |
|
Mappings |
|
Procedure.encounter | |
Definition | The Encounter during which this Procedure was created or performed or to which the creation of this record is tightly associated. |
Cardinality | 0...1 |
Type | Reference(Encounter) |
Summary | True |
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. |
Invariants |
|
Mappings |
|
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. |
Cardinality | 0...1 |
Type | dateTime |
Summary | True |
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. |
Invariants |
|
Mappings |
|
Procedure.recorder | |
Definition | Individual who recorded the record and takes responsibility for its content. |
Cardinality | 0...0 |
Type | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) |
Summary | True |
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 |
|
Mappings |
|
Procedure.asserter | |
Definition | Individual who is making the procedure statement. |
Cardinality | 0...0 |
Type | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) |
Summary | True |
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 |
|
Mappings |
|
Procedure.performer | |
Definition | Limited to "real" people rather than equipment. |
Cardinality | 0...0 |
Type | BackboneElement |
Summary | True |
Invariants |
|
Mappings |
|
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. |
Cardinality | 0...1 |
Type | string |
Mappings |
|
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. |
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 |
|
Mappings |
|
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). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
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. |
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. |
Invariants |
|
Mappings |
|
Procedure.performer.function | |
Definition | Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A code that identifies the role of a performer of the procedure. |
Summary | True |
Requirements | Allows disambiguation of the types of involvement of different performers. |
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 |
|
Mappings |
|
Procedure.performer.actor | |
Definition | The practitioner who was involved in the procedure. |
Cardinality | 1...1 |
Type | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) |
Summary | True |
Requirements | A reference to Device supports use cases, such as pacemakers. |
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 |
|
Mappings |
|
Procedure.performer.onBehalfOf | |
Definition | The organization the device or practitioner was acting on behalf of. |
Cardinality | 0...1 |
Type | Reference(Organization) |
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. |
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 |
|
Mappings |
|
Procedure.location | |
Definition | The location where the procedure actually happened. E.g. a newborn at home, a tracheostomy at a restaurant. |
Cardinality | 0...0 |
Type | Reference(Location) |
Summary | True |
Requirements | Ties a procedure to where the records are likely kept. |
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 |
|
Mappings |
|
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. |
Cardinality | 0...0 |
Type | CodeableConcept |
Binding | A code that identifies the reason a procedure is required. |
Summary | True |
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. |
Invariants |
|
Mappings |
|
Procedure.reasonReference | |
Definition | The justification of why the procedure was performed. |
Cardinality | 0...0 |
Type | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) |
Summary | True |
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. |
Invariants |
|
Mappings |
|
Procedure.bodySite | |
Definition | Detailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion. |
Cardinality | 0...* |
Type | CodeableConcept |
Binding | Codes describing anatomical locations. May include laterality. |
Summary | True |
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. |
Invariants |
|
Mappings |
|
Procedure.outcome | |
Definition | The outcome of the procedure - did it resolve the reasons for the procedure being performed? |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | An outcome of a procedure - whether it was resolved or otherwise. |
Summary | True |
Comments | If outcome contains narrative text only, it can be captured using the CodeableConcept.text. |
Invariants |
|
Mappings |
|
Procedure.report | |
Definition | This could be a histology result, pathology report, surgical report, etc. |
Cardinality | 0...0 |
Type | Reference(DiagnosticReport | DocumentReference | Composition) |
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. |
Invariants |
|
Mappings |
|
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. |
Cardinality | 0...0 |
Type | CodeableConcept |
Binding | Codes describing complications that resulted from a procedure. |
Comments | If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text. |
Invariants |
|
Mappings |
|
Procedure.complicationDetail | |
Definition | Any complications that occurred during the procedure, or in the immediate post-performance period. |
Cardinality | 0...0 |
Type | Reference(Condition) |
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. |
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 |
|
Mappings |
|
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. |
Cardinality | 0...0 |
Type | CodeableConcept |
Binding | Specific follow up required for a procedure e.g. removal of sutures. |
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 |
|
Mappings |
|
Procedure.note | |
Definition | Any other notes and comments about the procedure. |
Cardinality | 0...* |
Type | Annotation |
Comments | For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible). |
Invariants |
|
Mappings |
|
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. |
Cardinality | 0...0 |
Type | BackboneElement |
Invariants |
|
Mappings |
|
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. |
Cardinality | 0...1 |
Type | string |
Mappings |
|
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. |
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 |
|
Mappings |
|
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). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
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. |
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. |
Invariants |
|
Mappings |
|
Procedure.focalDevice.action | |
Definition | The kind of change that happened to the device during the procedure. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A kind of change that happened to the device during 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. |
Invariants |
|
Mappings |
|
Procedure.focalDevice.manipulated | |
Definition | The device that was manipulated (changed) during the procedure. |
Cardinality | 1...1 |
Type | Reference(Device) |
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 |
|
Mappings |
|
Procedure.usedReference | |
Definition | Identifies medications, devices and any other substance used as part of the procedure. |
Cardinality | 0...0 |
Type | Reference(Device | Medication | Substance) |
Requirements | Used for tracking contamination, etc. |
Comments | For devices actually implanted or removed, use Procedure.device. |
Invariants |
|
Mappings |
|
Procedure.usedCode | |
Definition | Identifies coded items that were used as part of the procedure. |
Cardinality | 0...0 |
Type | CodeableConcept |
Binding | Codes describing items used during a procedure. |
Comments | For devices actually implanted or removed, use Procedure.device. |
Invariants |
|
Mappings |
|
<StructureDefinition xmlns="http://hl7.org/fhir"> <url value="https://example.org/fhir/StructureDefinition/PH_Procedure" /> <name value="PH_Procedure" /> <status value="draft" /> <fhirVersion value="4.0.1" /> <kind value="resource" /> <abstract value="false" /> <type value="Procedure" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Procedure" /> <derivation value="constraint" /> <differential> <element id="Procedure.extension:organization"> <path value="Procedure.extension" /> <sliceName value="organization" /> <short value="The facility where the procedure was done" /> <definition value="The facility where the procedure was done" /> <comment value="This is an entension" /> <type> <code value="Extension" /> <profile value="https://example.org/fhir/StructureDefinition/Organization" /> </type> <isModifier value="false" /> </element> <element id="Procedure.extension:recordedDate"> <path value="Procedure.extension" /> <sliceName value="recordedDate" /> <short value="This is the date the procedure was recorded in NHDR" /> <definition value="This is the date the procedure was recorded in NHDR" /> <comment value="This is an extension" /> <type> <code value="Extension" /> <profile value="https://example.org/fhir/StructureDefinition/RecordedDate" /> </type> <isModifier value="false" /> </element> <element id="Procedure.extension:illnessClass"> <path value="Procedure.extension" /> <sliceName value="illnessClass" /> <short value="Illness code of the disease as listed in Philhealth" /> <definition value="Illness code of the disease as listed in Philhealth" /> <comment value="This is an extension" /> <type> <code value="Extension" /> <profile value="https://example.org/fhir/StructureDefinition/IllnessClass" /> </type> <isModifier value="false" /> </element> <element id="Procedure.instantiatesCanonical"> <path value="Procedure.instantiatesCanonical" /> <max value="0" /> </element> <element id="Procedure.instantiatesUri"> <path value="Procedure.instantiatesUri" /> <max value="0" /> </element> <element id="Procedure.basedOn"> <path value="Procedure.basedOn" /> <max value="0" /> </element> <element id="Procedure.partOf"> <path value="Procedure.partOf" /> <max value="0" /> </element> <element id="Procedure.statusReason"> <path value="Procedure.statusReason" /> <max value="0" /> </element> <element id="Procedure.recorder"> <path value="Procedure.recorder" /> <max value="0" /> </element> <element id="Procedure.asserter"> <path value="Procedure.asserter" /> <max value="0" /> </element> <element id="Procedure.performer"> <path value="Procedure.performer" /> <max value="0" /> </element> <element id="Procedure.location"> <path value="Procedure.location" /> <max value="0" /> </element> <element id="Procedure.reasonCode"> <path value="Procedure.reasonCode" /> <max value="0" /> </element> <element id="Procedure.reasonReference"> <path value="Procedure.reasonReference" /> <max value="0" /> </element> <element id="Procedure.report"> <path value="Procedure.report" /> <max value="0" /> </element> <element id="Procedure.complication"> <path value="Procedure.complication" /> <max value="0" /> </element> <element id="Procedure.complicationDetail"> <path value="Procedure.complicationDetail" /> <max value="0" /> </element> <element id="Procedure.followUp"> <path value="Procedure.followUp" /> <max value="0" /> </element> <element id="Procedure.focalDevice"> <path value="Procedure.focalDevice" /> <max value="0" /> </element> <element id="Procedure.usedReference"> <path value="Procedure.usedReference" /> <max value="0" /> </element> <element id="Procedure.usedCode"> <path value="Procedure.usedCode" /> <max value="0" /> </element> </differential> </StructureDefinition>
{ "resourceType": "StructureDefinition", "url": "https://example.org/fhir/StructureDefinition/PH_Procedure", "name": "PH_Procedure", "status": "draft", "fhirVersion": "4.0.1", "kind": "resource", "abstract": false, "type": "Procedure", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Procedure", "derivation": "constraint", "differential": { "element": [ { "id": "Procedure.extension:organization", "path": "Procedure.extension", "sliceName": "organization", "short": "The facility where the procedure was done", "definition": "The facility where the procedure was done", "comment": "This is an entension", "type": [ { "code": "Extension", "profile": [ "https://example.org/fhir/StructureDefinition/Organization" ] } ], "isModifier": false }, { "id": "Procedure.extension:recordedDate", "path": "Procedure.extension", "sliceName": "recordedDate", "short": "This is the date the procedure was recorded in NHDR", "definition": "This is the date the procedure was recorded in NHDR", "comment": "This is an extension", "type": [ { "code": "Extension", "profile": [ "https://example.org/fhir/StructureDefinition/RecordedDate" ] } ], "isModifier": false }, { "id": "Procedure.extension:illnessClass", "path": "Procedure.extension", "sliceName": "illnessClass", "short": "Illness code of the disease as listed in Philhealth", "definition": "Illness code of the disease as listed in Philhealth", "comment": "This is an extension", "type": [ { "code": "Extension", "profile": [ "https://example.org/fhir/StructureDefinition/IllnessClass" ] } ], "isModifier": false }, { "id": "Procedure.instantiatesCanonical", "path": "Procedure.instantiatesCanonical", "max": "0" }, { "id": "Procedure.instantiatesUri", "path": "Procedure.instantiatesUri", "max": "0" }, { "id": "Procedure.basedOn", "path": "Procedure.basedOn", "max": "0" }, { "id": "Procedure.partOf", "path": "Procedure.partOf", "max": "0" }, { "id": "Procedure.statusReason", "path": "Procedure.statusReason", "max": "0" }, { "id": "Procedure.recorder", "path": "Procedure.recorder", "max": "0" }, { "id": "Procedure.asserter", "path": "Procedure.asserter", "max": "0" }, { "id": "Procedure.performer", "path": "Procedure.performer", "max": "0" }, { "id": "Procedure.location", "path": "Procedure.location", "max": "0" }, { "id": "Procedure.reasonCode", "path": "Procedure.reasonCode", "max": "0" }, { "id": "Procedure.reasonReference", "path": "Procedure.reasonReference", "max": "0" }, { "id": "Procedure.report", "path": "Procedure.report", "max": "0" }, { "id": "Procedure.complication", "path": "Procedure.complication", "max": "0" }, { "id": "Procedure.complicationDetail", "path": "Procedure.complicationDetail", "max": "0" }, { "id": "Procedure.followUp", "path": "Procedure.followUp", "max": "0" }, { "id": "Procedure.focalDevice", "path": "Procedure.focalDevice", "max": "0" }, { "id": "Procedure.usedReference", "path": "Procedure.usedReference", "max": "0" }, { "id": "Procedure.usedCode", "path": "Procedure.usedCode", "max": "0" } ] } }