Pan-Canadian Patient Summary (PS-CA) CI Build
current 
CI Build - For a full list of available versions, see the Directory of published versions
Procedure (PS-CA)
Links
Profile
Derived from
http://hl7.org/fhir/StructureDefinition/Procedure
Examples
Description
This profile represents the constraints applied to the Procedure resource by the PS-CA project, which is informed by the constraints of the Procedure IPS-UV profile and the Canadian Baseline Profile to allow for cross-border and cross-jurisdiction sharing of History of Procedure information.
References to this resource
Resource Content
| ProcedurePSCA (Procedure) | Procedure | ||
| status | S | ||
| code | S | 1..1 | CodeableConceptPSCABinding |
| subject | S | Reference(PatientPSCA) | |
| reference | S | 1.. | |
| performed[x] | S | 1..1 | |
| extension | |||
| data-absent-reason | ..1 | Extension(code) | |
| bodySite | CodeableConceptPSCABinding |
<description value="This profile represents the constraints applied to the Procedure resource by the PS-CA project, which is informed by the constraints of the [Procedure IPS-UV profile](http://hl7.org/fhir/uv/ips/StructureDefinition-Procedure-uv-ips.html) and the [Canadian Baseline Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-procedure.html) to allow for cross-border and cross-jurisdiction sharing of History of Procedure information." />
<copyright value="Copyright © 2024+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy)." />
</element>
<definition value="Identification of the procedure or recording of "absence of relevant procedures" or of "procedures unknown"." />
<comment value="Many Canadian implementations use codes from either SNOMED CT and the SNOMED CT Canada Extension to describe this concept, while others may still be using localized code systems or text descriptions. The Procedures - IPS ValueSet contains codes that are subsumed within the SNOMED CT CA ProcedureCode ValueSet that is preferred for this element.\n\nFuture releases of PS-CA may require use of coded entries. In this release, however, implementations that support codings are encouraged to send the codings for codeable concepts if they are available. Consistent with FHIR best practice, receivers should not produce failures or rejections if codings are received. Vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content.\n\nCIHI has been working on Procedure as part of our publication for Sept 2025. CIHI has recommended the Canadian Classification of Health Interventions (CCI) as an alternate Pan-Canadian value set, but additional consultation work is needed to validate this recommendation." />
<profile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" />
</type>
</extension>
</extension>
<valueMarkdown value="Any code from CCI. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology." />
</extension>
</extension>
</extension>
</extension>
<valueMarkdown value="Any code from ICD-9 CM. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology." />
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</binding>
</element>
<targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps" />
</type>
</element>
</element>
</element>
</slicing>
</element>
<comment value="Some Canadian implementations cannot guarantee that a procedure performed date will always be available in every instance of legacy data. Any implementers who do not require a performed date be available on every procedure need to be able to produce a dataAbsentReason extension in order to be conformant" />
</type>
</element>
<comment value="IPS-UV no longer flags this as a Must Support Element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received." />
<profile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" />
</type>
<valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/anatomicaloracquiredbodystructurecode" />
</binding>
</element>
</differential>
</StructureDefinition>
{
"description": "This profile represents the constraints applied to the Procedure resource by the PS-CA project, which is informed by the constraints of the [Procedure IPS-UV profile](http://hl7.org/fhir/uv/ips/StructureDefinition-Procedure-uv-ips.html) and the [Canadian Baseline Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-procedure.html) to allow for cross-border and cross-jurisdiction sharing of History of Procedure information.",
"copyright": "Copyright © 2024+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
{
},
{
"definition": "Identification of the procedure or recording of \"absence of relevant procedures\" or of \"procedures unknown\".",
"comment": "Many Canadian implementations use codes from either SNOMED CT and the SNOMED CT Canada Extension to describe this concept, while others may still be using localized code systems or text descriptions. The Procedures - IPS ValueSet contains codes that are subsumed within the SNOMED CT CA ProcedureCode ValueSet that is preferred for this element.\n\nFuture releases of PS-CA may require use of coded entries. In this release, however, implementations that support codings are encouraged to send the codings for codeable concepts if they are available. Consistent with FHIR best practice, receivers should not produce failures or rejections if codings are received. Vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content.\n\nCIHI has been working on Procedure as part of our publication for Sept 2025. CIHI has recommended the Canadian Classification of Health Interventions (CCI) as an alternate Pan-Canadian value set, but additional consultation work is needed to validate this recommendation.",
{
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps"
]
}
],
{
{
},
{
},
{
"valueMarkdown": "Any code from CCI. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology."
}
],
},
{
{
},
{
},
{
"valueMarkdown": "Any code from ICD-9 CM. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology."
}
],
},
{
{
},
{
},
{
}
],
}
],
}
},
{
{
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps"
]
}
],
},
{
},
{
},
{
}
},
{
"comment": "Some Canadian implementations cannot guarantee that a procedure performed date will always be available in every instance of legacy data. Any implementers who do not require a performed date be available on every procedure need to be able to produce a dataAbsentReason extension in order to be conformant",
{
}
]
},
{
"comment": "IPS-UV no longer flags this as a Must Support Element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received.",
{
"http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps"
]
}
],
}
}
]
}
}
Terminology bindings (Differential)
| Path | Conformance | ValueSet |
|---|---|---|
| Procedure.code | preferred | https://fhir.infoway-inforoute.ca/ValueSet/procedurecode |
| Procedure.bodySite | preferred | https://fhir.infoway-inforoute.ca/ValueSet/anatomicaloracquiredbodystructurecode |
Terminology bindings (Snapshot)
Constraints
Key Differences between the IPS-UV and PS-CA
Must Support Differences:
Procedure.performed[x]: data-absent-reason is considered Must Support in the Procedure (IPS) profile that is relaxed in this version of the PS-CA profile.Procedure.statusis not Must Support in IPS-UV and is Must Support in PS-CA.Note: Systems that support these elements are encouraged to send them in patient summaries
Cardinality Differences:
There are no cardinality differences between this profile and IPS-UV
Vocabulary Differences:
Procedure.code- added preferred binding of: SNOMED CT Canadian Edition https://fhir.infoway-inforoute.ca/ValueSet/procedurecode
- additionalBindings added for:
- Canadian Classification of Health Interventions CCIAllCode,
- ICD-9 CM ICD9CMAllCode,
- absent or unknown procedures AbsentOrUnknownProceduresUvIps IPS absent/unknown ValueSets have been deprecated as of IPS 2.0.0-ballot and subsumed into their ProceduresUvIps. This change is pending analysis & alignment in a future update.
Procedure.bodySite- added preferred binding of SNOMED CT Canadian Edition AnatomicalOrAcquiredBodyStructureCode
Other differences between the IPS and PS-CA Include:
- Data type profiles (e.g., CodeableConcept) and reference targets (e.g., Patient) replaced with PS-CA equivalents when appropriate