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CA Core+

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    1. Index
    2. FHIR Artifacts
    3. Profiles
    4. Procedure (CA-Core)

DFT-Ballot - The specification is a DFT-Ballot version of CA Core+ for collecting ballot feedback. For a full list of available versions, see the Directory of published versions

Procedure (CA-Core)

Links

Profile

procedure-ca-core

Derived from

http://hl7.org/fhir/StructureDefinition/Procedure

Examples

example-procedure-ca-core

Description

This profile applies constraints to the Procedure resource for CA Core+ to support clinical and diagnostic procedure documentation in the pan-Canadian context.

References to this resource

AppointmentCACore

CFMM: 2

Resource Content

  • Tree view
  • Overview
  • XML
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ProcedureCACore (Procedure)CProcedure
There are no (further) constraints on this element
Element id
Procedure
Short description

An action that is being or was performed on a patient

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.

Data type

Procedure

Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.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-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-6: A resource should have narrative for robust management
    text.`div`.exists()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Event
  • rim: Procedure[moodCode=EVN]
idΣ0..1string
There are no (further) constraints on this element
Element id
Procedure.id
Short description

Logical id of this artifact

Definition

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

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.

Data type

string

metaΣ0..1Meta
There are no (further) constraints on this element
Element id
Procedure.meta
Short description

Metadata about the resource

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.

Data type

Meta

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
implicitRulesΣ ?!0..1uri
There are no (further) constraints on this element
Element id
Procedure.implicitRules
Short description

A set of rules under which this content was created

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.

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.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
language0..1codeBinding
There are no (further) constraints on this element
Element id
Procedure.language
Short description

Language of the resource content

Definition

The base language in which the resource is written.

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).

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions
maxValueSetAllLanguages
Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
text0..1Narrative
There are no (further) constraints on this element
Element id
Procedure.text
Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

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.

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.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
contained0..*Resource
There are no (further) constraints on this element
Element id
Procedure.contained
Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

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.

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.

Data type

Resource

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
extensionC0..*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 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.

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
modifierExtension?! C0..*Extension
There are no (further) constraints on this element
Element id
Procedure.modifierExtension
Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

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).

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.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
identifierΣ0..*Identifier
There are no (further) constraints on this element
Element id
Procedure.identifier
Short description

External Identifiers for this procedure

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.

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.

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • workflow: Event.identifier
  • w5: FiveWs.identifier
  • v2: Some combination of ORC-2 / ORC-3 / OBR-2 / OBR-3 / IPC-1 / IPC-2 / IPC-3 / IPC-4
  • rim: .id
instantiatesCanonicalΣ0..*canonical(ActivityDefinition | Measure | OperationDefinition | PlanDefinition | Questionnaire)
There are no (further) constraints on this element
Element id
Procedure.instantiatesCanonical
Short description

Instantiates FHIR protocol or definition

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.

Comments

see Canonical References

Data type

canonical(ActivityDefinition | Measure | OperationDefinition | PlanDefinition | Questionnaire)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.instantiatesCanonical
  • rim: .outboundRelationship[typeCode=DEFN].target
instantiatesUriΣ0..*uri
There are no (further) constraints on this element
Element id
Procedure.instantiatesUri
Short description

Instantiates external protocol or definition

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.

Comments

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

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.instantiatesUri
  • rim: .outboundRelationship[typeCode=DEFN].target
basedOnΣ C0..*Reference(CarePlan | ServiceRequest)
There are no (further) constraints on this element
Element id
Procedure.basedOn
Short description

A request for this procedure

Alternate names

fulfills

Definition

A reference to a resource that contains details of the request for this 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(CarePlan | ServiceRequest)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • workflow: Event.basedOn
  • rim: .outboundRelationship[typeCode=FLFS].target[classCode=(various e.g. PROC, OBS, PCPR, ACT, moodCode=RQO].code
partOfΣ C0..*Reference(MedicationAdministration | Observation | Procedure)
There are no (further) constraints on this element
Element id
Procedure.partOf
Short description

Part of referenced event

Alternate names

container

Definition

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

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).

Data type

Reference(MedicationAdministration | Observation | Procedure)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • workflow: Event.partOf
  • rim: .inboundRelationship[typeCode=COMP].source[classCode=SBADM or PROC or OBS, moodCode=EVN]
statusΣ ?!1..1codeBinding
There are no (further) constraints on this element
Element id
Procedure.status
Short description

preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown

Definition

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

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.

Data type

code

Binding

A code specifying the state of the procedure.

EventStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.status
  • w5: FiveWs.status
  • rim: statusCode
statusReasonΣ0..1CodeableConcept
There are no (further) constraints on this element
Element id
Procedure.statusReason
Short description

Reason for current status

Alternate names

Suspended Reason, Cancelled Reason

Definition

Captures the reason for the current state of the procedure.

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.

Data type

CodeableConcept

Binding

A code that identifies the reason a procedure was not performed.

ProcedureNotPerformedReason(SNOMED-CT) (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • workflow: Event.statusReason
  • rim: .reason.Observation.value
categoryΣ0..1CodeableConcept
There are no (further) constraints on this element
Element id
Procedure.category
Short description

Classification of the procedure

Definition

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

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

ProcedureCategoryCodes(SNOMEDCT) (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • w5: FiveWs.class
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
codeO Σ0..1CodeableConceptCACoreBindingElement id
Procedure.code
Short description

Concept - reference to a terminology or just text

Alternate names

type

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

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.

Data type

CodeableConceptCACore

Binding

A code to identify a specific procedure .

ProcedureCode (preferred)

Additional bindings
  • CodeCCI (candidate)

    CCI Codes

  • CodeICD10CA (candidate)

    International Classifications of Disease 10 CA Codes

  • CodeICD9CM (candidate)

    International Classifications of Disease 9 CM Codes

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • workflow: Event.code
  • w5: FiveWs.what[x]
  • v2: OBR-44/OBR-45
  • rim: .code
  • CACDI: Procedure Performed
  • CACDI: Procedure Code
Obligations
CodeActor
MAY:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
subjectΣ C1..1Reference(Group | Patient)
There are no (further) constraints on this element
Element id
Procedure.subject
Short description

Who the procedure was performed on

Alternate names

patient

Definition

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

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(Group | Patient)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • workflow: Event.subject
  • w5: FiveWs.subject[x]
  • v2: PID-3
  • rim: .participation[typeCode=SBJ].role
  • w5: FiveWs.subject
encounterΣ C0..1Reference(Encounter)
There are no (further) constraints on this element
Element id
Procedure.encounter
Short description

Encounter created as part of

Definition

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

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.

Data type

Reference(Encounter)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • workflow: Event.context
  • w5: FiveWs.context
  • v2: PV1-19
  • rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
performed[x]Σ0..1Element id
Procedure.performed[x]
Short description

When the procedure was performed

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.

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.

Slicing

Unordered, Open, by $this(Type)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.occurrence[x]
  • w5: FiveWs.done[x]
  • v2: OBR-7
  • rim: .effectiveTime
  • CACDI: Reported Clinical Information Date Time
performedAgeAge
There are no (further) constraints on this element
Data type

Age

performedRangeRange
There are no (further) constraints on this element
Data type

Range

performedStringstring
There are no (further) constraints on this element
Data type

string

performedDateTimeΣ0..1dateTimeElement id
Procedure.performed[x]:performedDateTime
Short description

When the procedure was performed

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.

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.

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.occurrence[x]
  • w5: FiveWs.done[x]
  • v2: OBR-7
  • rim: .effectiveTime
  • CACDI: Procedure Date and Time
performedPeriodΣ0..1PeriodElement id
Procedure.performed[x]:performedPeriod
Short description

When the procedure was performed

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.

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.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.occurrence[x]
  • w5: FiveWs.done[x]
  • v2: OBR-7
  • rim: .effectiveTime
id0..1string
There are no (further) constraints on this element
Element id
Procedure.performed[x]:performedPeriod.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
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Procedure.performed[x]:performedPeriod.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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
startΣ C0..1dateTimeElement id
Procedure.performed[x]:performedPeriod.start
Short description

Starting time with inclusive boundary

Definition

The start of the period. The boundary is inclusive.

Comments

If the low element is missing, the meaning is that the low boundary is not known.

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, per-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: DR.1
  • rim: ./low
  • CACDI: Event Start Date and Time
endΣ C0..1dateTimeElement id
Procedure.performed[x]:performedPeriod.end
Short description

End time with inclusive boundary, if not ongoing

Definition

The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

Meaning when missing

If the end of the period is missing, it means that the period is ongoing

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, per-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: DR.2
  • rim: ./high
  • CACDI: Event End Date and Time
recorderΣ C0..1Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)
There are no (further) constraints on this element
Element id
Procedure.recorder
Short description

Who recorded the procedure

Definition

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

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(Patient | Practitioner | PractitionerRole | RelatedPerson)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • w5: FiveWs.author
  • rim: .participation[typeCode=AUT].role
asserterΣ C0..1Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)Element id
Procedure.asserter
Short description

Person who asserts this procedure

Definition

Individual who is making the procedure statement.

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(Patient | Practitioner | PractitionerRole | RelatedPerson)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • w5: FiveWs.source
  • rim: .participation[typeCode=INF].role
  • CACDI: Reported Clinical Information Source (Recommended)
performerΣ0..*BackboneElement
There are no (further) constraints on this element
Element id
Procedure.performer
Short description

The people who performed the procedure

Definition

Limited to "real" people rather than equipment.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.performer
  • rim: .participation[typeCode=PRF]
id0..1string
There are no (further) constraints on this element
Element id
Procedure.performer.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
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Procedure.performer.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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Procedure.performer.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

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).

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.

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
functionΣ0..1CodeableConcept
There are no (further) constraints on this element
Element id
Procedure.performer.function
Short description

Type of performance

Definition

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

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.

Data type

CodeableConcept

Binding

A code that identifies the role of a performer of the procedure.

ProcedurePerformerRoleCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • workflow: Event.performer.function
  • v2: Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25
  • rim: .functionCode
actorΣ C1..1Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
There are no (further) constraints on this element
Element id
Procedure.performer.actor
Short description

The reference to the practitioner

Definition

The practitioner who was involved in the procedure.

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.

Data type

Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • workflow: Event.performer.actor
  • w5: FiveWs.actor
  • v2: ORC-19/PRT-5
  • rim: .role
onBehalfOfC0..1Reference(Organization)
There are no (further) constraints on this element
Element id
Procedure.performer.onBehalfOf
Short description

Organization the device or practitioner was acting for

Definition

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

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.

Data type

Reference(Organization)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • rim: .scoper
locationΣ C0..1Reference(Location)
There are no (further) constraints on this element
Element id
Procedure.location
Short description

Where the procedure happened

Definition

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

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.

Data type

Reference(Location)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • w5: FiveWs.where[x]
  • rim: .participation[typeCode=LOC].role[classCode=SDLOC]
reasonCodeΣ0..*CodeableConceptElement id
Procedure.reasonCode
Short description

Coded reason procedure performed

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.

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.

Data type

CodeableConcept

Binding

A code that identifies the reason a procedure is required.

ProcedureReasonCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • workflow: Event.reasonCode
  • w5: FiveWs.why[x]
  • rim: .reasonCode
  • CACDI: Procedure Reason
reasonReferenceΣ C0..*Reference(Condition | DiagnosticReport | DocumentReference | Observation | Procedure)Element id
Procedure.reasonReference
Short description

The justification that the procedure was performed

Definition

The justification of why the procedure was performed.

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.

Data type

Reference(Condition | DiagnosticReport | DocumentReference | Observation | Procedure)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • workflow: Event.reasonReference
  • w5: FiveWs.why[x]
  • rim: .reasonCode
  • CACDI: Procedure Reason
bodySiteΣ0..*CodeableConceptElement id
Procedure.bodySite
Short description

Target body sites

Definition

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

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.

Data type

CodeableConcept

Binding

Codes describing anatomical locations. May include laterality.

SNOMEDCTBodyStructures (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • v2: OBX-20
  • rim: .targetSiteCode
  • CACDI: Procedure Body Site
outcomeΣ0..1CodeableConcept
There are no (further) constraints on this element
Element id
Procedure.outcome
Short description

The result of procedure

Definition

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

Comments

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

Data type

CodeableConcept

Binding

An outcome of a procedure - whether it was resolved or otherwise.

ProcedureOutcomeCodes(SNOMEDCT) (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • rim: .outboundRelationship[typeCode=OUT].target.text
reportC0..*Reference(Composition | DiagnosticReport | DocumentReference)
There are no (further) constraints on this element
Element id
Procedure.report
Short description

Any report resulting from the procedure

Definition

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

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.

Data type

Reference(Composition | DiagnosticReport | DocumentReference)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN]
complication0..*CodeableConcept
There are no (further) constraints on this element
Element id
Procedure.complication
Short description

Complication following the procedure

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.

Comments

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

Data type

CodeableConcept

Binding

Codes describing complications that resulted from a procedure.

Condition/Problem/DiagnosisCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • rim: .outboundRelationship[typeCode=OUTC].target[classCode=OBS, code="complication", moodCode=EVN].value
complicationDetailC0..*Reference(Condition)
There are no (further) constraints on this element
Element id
Procedure.complicationDetail
Short description

A condition that is a result of the procedure

Definition

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

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.

Data type

Reference(Condition)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • rim: .outboundRelationship[typeCode=OUTC].target[classCode=OBS, code="complication", moodCode=EVN].value
followUp0..*CodeableConcept
There are no (further) constraints on this element
Element id
Procedure.followUp
Short description

Instructions for follow up

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.

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

Specific follow up required for a procedure e.g. removal of sutures.

ProcedureFollowUpCodes(SNOMEDCT) (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=ACT, moodCode=INT].code
note0..*Annotation
There are no (further) constraints on this element
Element id
Procedure.note
Short description

Additional information about the procedure

Definition

Any other notes and comments about the procedure.

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).

Data type

Annotation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act
  • workflow: Event.note
  • v2: NTE
  • rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value
focalDevice0..*BackboneElement
There are no (further) constraints on this element
Element id
Procedure.focalDevice
Short description

Manipulated, implanted, or removed device

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.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .participation[typeCode=DEV].role[classCode=MANU]
id0..1string
There are no (further) constraints on this element
Element id
Procedure.focalDevice.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
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Procedure.focalDevice.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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Procedure.focalDevice.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

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).

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.

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
action0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Procedure.focalDevice.action
Short description

Kind of change to device

Definition

The 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.

Data type

CodeableConcept

Binding

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

ProcedureDeviceActionCodes (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="procedure device action"].value=:procedure device action codes
manipulatedC1..1Reference(Device)
There are no (further) constraints on this element
Element id
Procedure.focalDevice.manipulated
Short description

Device that was changed

Definition

The device that was manipulated (changed) during 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(Device)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • rim: .participation[typeCode=DEV].role[classCode=SDLOC]
usedReferenceC0..*Reference(Device | Medication | Substance)
There are no (further) constraints on this element
Element id
Procedure.usedReference
Short description

Items used during procedure

Definition

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

Requirements

Used for tracking contamination, etc.

Comments

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

Data type

Reference(Device | Medication | Substance)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • rim: .participation[typeCode=DEV].role[classCode=MANU] or .participation[typeCode=CSM].role[classCode=ADMM] (for Medication or Substance)
usedCode0..*CodeableConcept
There are no (further) constraints on this element
Element id
Procedure.usedCode
Short description

Coded items used during the procedure

Definition

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

Comments

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

Data type

CodeableConcept

Binding

Codes describing items used during a procedure.

FHIRDeviceTypes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • rim: participation[typeCode=Dev].role[classCode=MANU]
ProcedureCACore (Procedure)CProcedure
There are no (further) constraints on this element
Element id
Procedure
Short description

An action that is being or was performed on a patient

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.

Data type

Procedure

Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.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-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-6: A resource should have narrative for robust management
    text.`div`.exists()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Event
  • rim: Procedure[moodCode=EVN]
idΣ0..1string
There are no (further) constraints on this element
Element id
Procedure.id
Short description

Logical id of this artifact

Definition

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

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.

Data type

string

metaΣ0..1Meta
There are no (further) constraints on this element
Element id
Procedure.meta
Short description

Metadata about the resource

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.

Data type

Meta

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
implicitRulesΣ ?!0..1uri
There are no (further) constraints on this element
Element id
Procedure.implicitRules
Short description

A set of rules under which this content was created

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.

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.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
language0..1codeBinding
There are no (further) constraints on this element
Element id
Procedure.language
Short description

Language of the resource content

Definition

The base language in which the resource is written.

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).

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions
maxValueSetAllLanguages
Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
text0..1Narrative
There are no (further) constraints on this element
Element id
Procedure.text
Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

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.

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.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
contained0..*Resource
There are no (further) constraints on this element
Element id
Procedure.contained
Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

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.

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.

Data type

Resource

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
extensionC0..*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 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.

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
modifierExtension?! C0..*Extension
There are no (further) constraints on this element
Element id
Procedure.modifierExtension
Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

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).

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.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
identifierΣ0..*Identifier
There are no (further) constraints on this element
Element id
Procedure.identifier
Short description

External Identifiers for this procedure

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.

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.

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • workflow: Event.identifier
  • w5: FiveWs.identifier
  • v2: Some combination of ORC-2 / ORC-3 / OBR-2 / OBR-3 / IPC-1 / IPC-2 / IPC-3 / IPC-4
  • rim: .id
instantiatesCanonicalΣ0..*canonical(ActivityDefinition | Measure | OperationDefinition | PlanDefinition | Questionnaire)
There are no (further) constraints on this element
Element id
Procedure.instantiatesCanonical
Short description

Instantiates FHIR protocol or definition

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.

Comments

see Canonical References

Data type

canonical(ActivityDefinition | Measure | OperationDefinition | PlanDefinition | Questionnaire)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.instantiatesCanonical
  • rim: .outboundRelationship[typeCode=DEFN].target
instantiatesUriΣ0..*uri
There are no (further) constraints on this element
Element id
Procedure.instantiatesUri
Short description

Instantiates external protocol or definition

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.

Comments

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

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.instantiatesUri
  • rim: .outboundRelationship[typeCode=DEFN].target
basedOnΣ C0..*Reference(CarePlan | ServiceRequest)
There are no (further) constraints on this element
Element id
Procedure.basedOn
Short description

A request for this procedure

Alternate names

fulfills

Definition

A reference to a resource that contains details of the request for this 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(CarePlan | ServiceRequest)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • workflow: Event.basedOn
  • rim: .outboundRelationship[typeCode=FLFS].target[classCode=(various e.g. PROC, OBS, PCPR, ACT, moodCode=RQO].code
partOfΣ C0..*Reference(MedicationAdministration | Observation | Procedure)
There are no (further) constraints on this element
Element id
Procedure.partOf
Short description

Part of referenced event

Alternate names

container

Definition

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

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).

Data type

Reference(MedicationAdministration | Observation | Procedure)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • workflow: Event.partOf
  • rim: .inboundRelationship[typeCode=COMP].source[classCode=SBADM or PROC or OBS, moodCode=EVN]
statusΣ ?!1..1codeBinding
There are no (further) constraints on this element
Element id
Procedure.status
Short description

preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown

Definition

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

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.

Data type

code

Binding

A code specifying the state of the procedure.

EventStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.status
  • w5: FiveWs.status
  • rim: statusCode
statusReasonΣ0..1CodeableConcept
There are no (further) constraints on this element
Element id
Procedure.statusReason
Short description

Reason for current status

Alternate names

Suspended Reason, Cancelled Reason

Definition

Captures the reason for the current state of the procedure.

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.

Data type

CodeableConcept

Binding

A code that identifies the reason a procedure was not performed.

ProcedureNotPerformedReason(SNOMED-CT) (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • workflow: Event.statusReason
  • rim: .reason.Observation.value
categoryΣ0..1CodeableConcept
There are no (further) constraints on this element
Element id
Procedure.category
Short description

Classification of the procedure

Definition

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

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

ProcedureCategoryCodes(SNOMEDCT) (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • w5: FiveWs.class
  • rim: .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
codeO Σ0..1CodeableConceptCACoreBinding
There are no (further) constraints on this element
Element id
Procedure.code
Short description

Concept - reference to a terminology or just text

Alternate names

type

Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

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.

Data type

CodeableConceptCACore

Binding

A code to identify a specific procedure .

ProcedureCode (preferred)

Additional bindings
  • CodeCCI (candidate)

    CCI Codes

  • CodeICD10CA (candidate)

    International Classifications of Disease 10 CA Codes

  • CodeICD9CM (candidate)

    International Classifications of Disease 9 CM Codes

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • workflow: Event.code
  • w5: FiveWs.what[x]
  • v2: OBR-44/OBR-45
  • rim: .code
  • CACDI: Procedure Performed
  • CACDI: Procedure Code
Obligations
CodeActor
MAY:populate-if-knownhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer
SHALL:no-errorhttp://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer
subjectΣ C1..1Reference(Group | Patient)
There are no (further) constraints on this element
Element id
Procedure.subject
Short description

Who the procedure was performed on

Alternate names

patient

Definition

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

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(Group | Patient)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • workflow: Event.subject
  • w5: FiveWs.subject[x]
  • v2: PID-3
  • rim: .participation[typeCode=SBJ].role
  • w5: FiveWs.subject
encounterΣ C0..1Reference(Encounter)
There are no (further) constraints on this element
Element id
Procedure.encounter
Short description

Encounter created as part of

Definition

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

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.

Data type

Reference(Encounter)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • workflow: Event.context
  • w5: FiveWs.context
  • v2: PV1-19
  • rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
performed[x]Σ0..1
There are no (further) constraints on this element
Element id
Procedure.performed[x]
Short description

When the procedure was performed

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.

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.

Slicing

Unordered, Open, by $this(Type)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.occurrence[x]
  • w5: FiveWs.done[x]
  • v2: OBR-7
  • rim: .effectiveTime
  • CACDI: Reported Clinical Information Date Time
performedAgeAge
There are no (further) constraints on this element
Data type

Age

performedRangeRange
There are no (further) constraints on this element
Data type

Range

performedStringstring
There are no (further) constraints on this element
Data type

string

performedDateTimeΣ0..1dateTime
There are no (further) constraints on this element
Element id
Procedure.performed[x]:performedDateTime
Short description

When the procedure was performed

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.

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.

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.occurrence[x]
  • w5: FiveWs.done[x]
  • v2: OBR-7
  • rim: .effectiveTime
  • CACDI: Procedure Date and Time
performedPeriodΣ0..1Period
There are no (further) constraints on this element
Element id
Procedure.performed[x]:performedPeriod
Short description

When the procedure was performed

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.

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.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.occurrence[x]
  • w5: FiveWs.done[x]
  • v2: OBR-7
  • rim: .effectiveTime
id0..1string
There are no (further) constraints on this element
Element id
Procedure.performed[x]:performedPeriod.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
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Procedure.performed[x]:performedPeriod.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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
startΣ C0..1dateTime
There are no (further) constraints on this element
Element id
Procedure.performed[x]:performedPeriod.start
Short description

Starting time with inclusive boundary

Definition

The start of the period. The boundary is inclusive.

Comments

If the low element is missing, the meaning is that the low boundary is not known.

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, per-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: DR.1
  • rim: ./low
  • CACDI: Event Start Date and Time
endΣ C0..1dateTime
There are no (further) constraints on this element
Element id
Procedure.performed[x]:performedPeriod.end
Short description

End time with inclusive boundary, if not ongoing

Definition

The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

Meaning when missing

If the end of the period is missing, it means that the period is ongoing

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1, per-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: DR.2
  • rim: ./high
  • CACDI: Event End Date and Time
recorderΣ C0..1Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)
There are no (further) constraints on this element
Element id
Procedure.recorder
Short description

Who recorded the procedure

Definition

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

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(Patient | Practitioner | PractitionerRole | RelatedPerson)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • w5: FiveWs.author
  • rim: .participation[typeCode=AUT].role
asserterΣ C0..1Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)
There are no (further) constraints on this element
Element id
Procedure.asserter
Short description

Person who asserts this procedure

Definition

Individual who is making the procedure statement.

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(Patient | Practitioner | PractitionerRole | RelatedPerson)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • w5: FiveWs.source
  • rim: .participation[typeCode=INF].role
  • CACDI: Reported Clinical Information Source (Recommended)
performerΣ0..*BackboneElement
There are no (further) constraints on this element
Element id
Procedure.performer
Short description

The people who performed the procedure

Definition

Limited to "real" people rather than equipment.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Event.performer
  • rim: .participation[typeCode=PRF]
id0..1string
There are no (further) constraints on this element
Element id
Procedure.performer.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
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Procedure.performer.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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Procedure.performer.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

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).

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.

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
functionΣ0..1CodeableConcept
There are no (further) constraints on this element
Element id
Procedure.performer.function
Short description

Type of performance

Definition

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

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.

Data type

CodeableConcept

Binding

A code that identifies the role of a performer of the procedure.

ProcedurePerformerRoleCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • workflow: Event.performer.function
  • v2: Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25
  • rim: .functionCode
actorΣ C1..1Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
There are no (further) constraints on this element
Element id
Procedure.performer.actor
Short description

The reference to the practitioner

Definition

The practitioner who was involved in the procedure.

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.

Data type

Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • workflow: Event.performer.actor
  • w5: FiveWs.actor
  • v2: ORC-19/PRT-5
  • rim: .role
onBehalfOfC0..1Reference(Organization)
There are no (further) constraints on this element
Element id
Procedure.performer.onBehalfOf
Short description

Organization the device or practitioner was acting for

Definition

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

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.

Data type

Reference(Organization)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • rim: .scoper
locationΣ C0..1Reference(Location)
There are no (further) constraints on this element
Element id
Procedure.location
Short description

Where the procedure happened

Definition

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

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.

Data type

Reference(Location)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • w5: FiveWs.where[x]
  • rim: .participation[typeCode=LOC].role[classCode=SDLOC]
reasonCodeΣ0..*CodeableConcept
There are no (further) constraints on this element
Element id
Procedure.reasonCode
Short description

Coded reason procedure performed

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.

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.

Data type

CodeableConcept

Binding

A code that identifies the reason a procedure is required.

ProcedureReasonCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • workflow: Event.reasonCode
  • w5: FiveWs.why[x]
  • rim: .reasonCode
  • CACDI: Procedure Reason
reasonReferenceΣ C0..*Reference(Condition | DiagnosticReport | DocumentReference | Observation | Procedure)
There are no (further) constraints on this element
Element id
Procedure.reasonReference
Short description

The justification that the procedure was performed

Definition

The justification of why the procedure was performed.

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.

Data type

Reference(Condition | DiagnosticReport | DocumentReference | Observation | Procedure)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • workflow: Event.reasonReference
  • w5: FiveWs.why[x]
  • rim: .reasonCode
  • CACDI: Procedure Reason
bodySiteΣ0..*CodeableConcept
There are no (further) constraints on this element
Element id
Procedure.bodySite
Short description

Target body sites

Definition

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

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.

Data type

CodeableConcept

Binding

Codes describing anatomical locations. May include laterality.

SNOMEDCTBodyStructures (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • v2: OBX-20
  • rim: .targetSiteCode
  • CACDI: Procedure Body Site
outcomeΣ0..1CodeableConcept
There are no (further) constraints on this element
Element id
Procedure.outcome
Short description

The result of procedure

Definition

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

Comments

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

Data type

CodeableConcept

Binding

An outcome of a procedure - whether it was resolved or otherwise.

ProcedureOutcomeCodes(SNOMEDCT) (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • rim: .outboundRelationship[typeCode=OUT].target.text
reportC0..*Reference(Composition | DiagnosticReport | DocumentReference)
There are no (further) constraints on this element
Element id
Procedure.report
Short description

Any report resulting from the procedure

Definition

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

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.

Data type

Reference(Composition | DiagnosticReport | DocumentReference)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN]
complication0..*CodeableConcept
There are no (further) constraints on this element
Element id
Procedure.complication
Short description

Complication following the procedure

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.

Comments

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

Data type

CodeableConcept

Binding

Codes describing complications that resulted from a procedure.

Condition/Problem/DiagnosisCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • rim: .outboundRelationship[typeCode=OUTC].target[classCode=OBS, code="complication", moodCode=EVN].value
complicationDetailC0..*Reference(Condition)
There are no (further) constraints on this element
Element id
Procedure.complicationDetail
Short description

A condition that is a result of the procedure

Definition

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

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.

Data type

Reference(Condition)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • rim: .outboundRelationship[typeCode=OUTC].target[classCode=OBS, code="complication", moodCode=EVN].value
followUp0..*CodeableConcept
There are no (further) constraints on this element
Element id
Procedure.followUp
Short description

Instructions for follow up

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.

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

Specific follow up required for a procedure e.g. removal of sutures.

ProcedureFollowUpCodes(SNOMEDCT) (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=ACT, moodCode=INT].code
note0..*Annotation
There are no (further) constraints on this element
Element id
Procedure.note
Short description

Additional information about the procedure

Definition

Any other notes and comments about the procedure.

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).

Data type

Annotation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act
  • workflow: Event.note
  • v2: NTE
  • rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value
focalDevice0..*BackboneElement
There are no (further) constraints on this element
Element id
Procedure.focalDevice
Short description

Manipulated, implanted, or removed device

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.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .participation[typeCode=DEV].role[classCode=MANU]
id0..1string
There are no (further) constraints on this element
Element id
Procedure.focalDevice.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
extensionC0..*Extension
There are no (further) constraints on this element
Element id
Procedure.focalDevice.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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
modifierExtensionΣ ?! C0..*Extension
There are no (further) constraints on this element
Element id
Procedure.focalDevice.modifierExtension
Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

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).

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.

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
action0..1CodeableConceptBinding
There are no (further) constraints on this element
Element id
Procedure.focalDevice.action
Short description

Kind of change to device

Definition

The 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.

Data type

CodeableConcept

Binding

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

ProcedureDeviceActionCodes (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="procedure device action"].value=:procedure device action codes
manipulatedC1..1Reference(Device)
There are no (further) constraints on this element
Element id
Procedure.focalDevice.manipulated
Short description

Device that was changed

Definition

The device that was manipulated (changed) during 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(Device)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • rim: .participation[typeCode=DEV].role[classCode=SDLOC]
usedReferenceC0..*Reference(Device | Medication | Substance)
There are no (further) constraints on this element
Element id
Procedure.usedReference
Short description

Items used during procedure

Definition

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

Requirements

Used for tracking contamination, etc.

Comments

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

Data type

Reference(Device | Medication | Substance)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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)
  • rim: .participation[typeCode=DEV].role[classCode=MANU] or .participation[typeCode=CSM].role[classCode=ADMM] (for Medication or Substance)
usedCode0..*CodeableConcept
There are no (further) constraints on this element
Element id
Procedure.usedCode
Short description

Coded items used during the procedure

Definition

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

Comments

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

Data type

CodeableConcept

Binding

Codes describing items used during a procedure.

FHIRDeviceTypes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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
  • rim: participation[typeCode=Dev].role[classCode=MANU]
{{ren
<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="procedure-ca-core" />
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
<valueInteger value="2" />
</extension>
<url value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/procedure-ca-core" />
<version value="1.1.0" />
<name value="ProcedureCACore" />
<title value="Procedure (CA-Core)" />
<status value="active" />
<experimental value="false" />
<date value="2025-03-06" />
<publisher value="Canada Health Infoway" />
<contact>
<name value="National Standards Release Centre" />
<telecom>
<system value="url" />
<value value="http://www.infoway-inforoute.ca" />
</telecom>
<telecom>
<system value="email" />
<value value="standards@infoway-inforoute.ca" />
</telecom>
</contact>
<description value="This profile applies constraints to the Procedure resource for CA Core+ to support clinical and diagnostic procedure documentation in the pan-Canadian context." />
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166" />
<code value="CA" />
</coding>
</jurisdiction>
<copyright value="Copyright © 2025+ 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)." />
<fhirVersion value="4.0.1" />
<mapping>
<identity value="CACDI" />
<name value="Canadian Core Data for Interoperability (CACDI)" />
</mapping>
<kind value="resource" />
<abstract value="false" />
<type value="Procedure" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Procedure" />
<derivation value="constraint" />
<snapshot>
<element id="Procedure">
<path value="Procedure" />
<short value="An action that is being or was performed on a patient" />
<definition value="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." />
<min value="0" />
<max value="*" />
<base>
<path value="Procedure" />
<min value="0" />
<max value="*" />
</base>
<constraint>
<key value="dom-2" />
<severity value="error" />
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
<expression value="contained.contained.empty()" />
<xpath value="not(parent::f:contained and f:contained)" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="dom-4" />
<severity value="error" />
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="dom-3" />
<severity value="error" />
<human value="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" />
<expression value="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()" />
<xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
<valueBoolean value="true" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
</extension>
<key value="dom-6" />
<severity value="warning" />
<human value="A resource should have narrative for robust management" />
<expression value="text.`div`.exists()" />
<xpath value="exists(f:text/h:div)" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<constraint>
<key value="dom-5" />
<severity value="error" />
<human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
<expression value="contained.meta.security.empty()" />
<xpath value="not(exists(f:contained/*/f:meta/f:security))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<mapping>
<identity value="rim" />
<map value="Entity. Role, or Act" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Procedure[moodCode=EVN]" />
</mapping>
</element>
<element id="Procedure.id">
<path value="Procedure.id" />
<short value="Logical id of this artifact" />
<definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
<comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<isSummary value="true" />
</element>
<element id="Procedure.meta">
<path value="Procedure.meta" />
<short value="Metadata about the resource" />
<definition value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.meta" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Meta" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Procedure.implicitRules">
<path value="Procedure.implicitRules" />
<short value="A set of rules under which this content was created" />
<definition value="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." />
<comment value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.implicitRules" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="uri" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Procedure.language">
<path value="Procedure.language" />
<short value="Language of the resource content" />
<definition value="The base language in which the resource is written." />
<comment value="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)." />
<min value="0" />
<max value="1" />
<base>
<path value="Resource.language" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
<valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="Language" />
</extension>
<strength value="preferred" />
<description value="A human language." />
<valueSet value="http://hl7.org/fhir/ValueSet/languages" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Procedure.text">
<path value="Procedure.text" />
<short value="Text summary of the resource, for human interpretation" />
<definition value="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." />
<comment value="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." />
<alias value="narrative" />
<alias value="html" />
<alias value="xhtml" />
<alias value="display" />
<min value="0" />
<max value="1" />
<base>
<path value="DomainResource.text" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Narrative" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Act.text?" />
</mapping>
</element>
<element id="Procedure.contained">
<path value="Procedure.contained" />
<short value="Contained, inline Resources" />
<definition value="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." />
<comment value="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." />
<alias value="inline resources" />
<alias value="anonymous resources" />
<alias value="contained resources" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.contained" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Resource" />
</type>
<mapping>
<identity value="rim" />
<map value="Entity. Role, or Act" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Procedure.extension">
<path value="Procedure.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Procedure.modifierExtension">
<path value="Procedure.modifierExtension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Extensions that cannot be ignored" />
<definition value="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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="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](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="DomainResource.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Procedure.identifier">
<path value="Procedure.identifier" />
<short value="External Identifiers for this procedure" />
<definition value="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." />
<comment value="This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)). 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." />
<requirements value="Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers." />
<min value="0" />
<max value="*" />
<base>
<path value="Procedure.identifier" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Identifier" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" />
</mapping>
<mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.identifier" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<mapping>
<identity value="v2" />
<map value="Some combination of ORC-2 / ORC-3 / OBR-2 / OBR-3 / IPC-1 / IPC-2 / IPC-3 / IPC-4" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".id" />
</mapping>
</element>
<element id="Procedure.instantiatesCanonical">
<path value="Procedure.instantiatesCanonical" />
<short value="Instantiates FHIR protocol or definition" />
<definition value="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." />
<comment value="see [Canonical References](references.html#canonical)" />
<min value="0" />
<max value="*" />
<base>
<path value="Procedure.instantiatesCanonical" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="canonical" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PlanDefinition" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ActivityDefinition" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Measure" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/OperationDefinition" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Questionnaire" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.instantiatesCanonical" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=DEFN].target" />
</mapping>
</element>
<element id="Procedure.instantiatesUri">
<path value="Procedure.instantiatesUri" />
<short value="Instantiates external protocol or definition" />
<definition value="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." />
<comment value="This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier." />
<min value="0" />
<max value="*" />
<base>
<path value="Procedure.instantiatesUri" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="uri" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.instantiatesUri" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=DEFN].target" />
</mapping>
</element>
<element id="Procedure.basedOn">
<path value="Procedure.basedOn" />
<short value="A request for this procedure" />
<definition value="A reference to a resource that contains details of the request for this procedure." />
<comment value="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." />
<alias value="fulfills" />
<min value="0" />
<max value="*" />
<base>
<path value="Procedure.basedOn" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.basedOn" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=FLFS].target[classCode=(various e.g. PROC, OBS, PCPR, ACT, moodCode=RQO].code" />
</mapping>
</element>
<element id="Procedure.partOf">
<path value="Procedure.partOf" />
<short value="Part of referenced event" />
<definition value="A larger event of which this particular procedure is a component or step." />
<comment value="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)." />
<alias value="container" />
<min value="0" />
<max value="*" />
<base>
<path value="Procedure.partOf" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.partOf" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=COMP].source[classCode=SBADM or PROC or OBS, moodCode=EVN]" />
</mapping>
</element>
<element id="Procedure.status">
<path value="Procedure.status" />
<short value="preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown" />
<definition value="A code specifying the state of the procedure. Generally, this will be the in-progress or completed state." />
<comment value="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.\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid." />
<min value="1" />
<max value="1" />
<base>
<path value="Procedure.status" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="code" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid" />
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ProcedureStatus" />
</extension>
<strength value="required" />
<description value="A code specifying the state of the procedure." />
<valueSet value="http://hl7.org/fhir/ValueSet/event-status|4.0.1" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.status" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.status" />
</mapping>
<mapping>
<identity value="rim" />
<map value="statusCode" />
</mapping>
</element>
<element id="Procedure.statusReason">
<path value="Procedure.statusReason" />
<short value="Reason for current status" />
<definition value="Captures the reason for the current state of the procedure." />
<comment value="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." />
<alias value="Suspended Reason" />
<alias value="Cancelled Reason" />
<min value="0" />
<max value="1" />
<base>
<path value="Procedure.statusReason" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ProcedureNegationReason" />
</extension>
<strength value="example" />
<description value="A code that identifies the reason a procedure was not performed." />
<valueSet value="http://hl7.org/fhir/ValueSet/procedure-not-performed-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.statusReason" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".reason.Observation.value" />
</mapping>
</element>
<element id="Procedure.category">
<path value="Procedure.category" />
<short value="Classification of the procedure" />
<definition value="A code that classifies the procedure for searching, sorting and display purposes (e.g. "Surgical Procedure")." />
<comment value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Procedure.category" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ProcedureCategory" />
</extension>
<strength value="example" />
<description value="A code that classifies a procedure for searching, sorting and display purposes." />
<valueSet value="http://hl7.org/fhir/ValueSet/procedure-category" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.class" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code" />
</mapping>
</element>
<element id="Procedure.code">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="MAY:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="Procedure.code" />
<short value="Concept - reference to a terminology or just text" />
<definition value="A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text." />
<comment value="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." />
<requirements value="0..1 to account for primarily narrative only resources." />
<alias value="type" />
<min value="0" />
<max value="1" />
<base>
<path value="Procedure.code" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ProcedureCode" />
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/CCI" />
</extension>
<extension url="documentation">
<valueMarkdown value="CCI Codes" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/ICD10CA" />
</extension>
<extension url="documentation">
<valueMarkdown value="International Classifications of Disease 10 CA Codes" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/ICD9CM" />
</extension>
<extension url="documentation">
<valueMarkdown value="International Classifications of Disease 9 CM Codes" />
</extension>
</extension>
<strength value="preferred" />
<description value="A code to identify a specific procedure ." />
<valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/procedurecode" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.code" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.what[x]" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBR-44/OBR-45" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".code" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Procedure Performed" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Procedure Code" />
</mapping>
</element>
<element id="Procedure.subject">
<path value="Procedure.subject" />
<short value="Who the procedure was performed on" />
<definition value="The person, animal or group on which the procedure was performed." />
<comment value="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." />
<alias value="patient" />
<min value="1" />
<max value="1" />
<base>
<path value="Procedure.subject" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.subject" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.subject[x]" />
</mapping>
<mapping>
<identity value="v2" />
<map value="PID-3" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode=SBJ].role" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.subject" />
</mapping>
</element>
<element id="Procedure.encounter">
<path value="Procedure.encounter" />
<short value="Encounter created as part of" />
<definition value="The Encounter during which this Procedure was created or performed or to which the creation of this record is tightly associated." />
<comment value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Procedure.encounter" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.context" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.context" />
</mapping>
<mapping>
<identity value="v2" />
<map value="PV1-19" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]" />
</mapping>
</element>
<element id="Procedure.performed[x]">
<path value="Procedure.performed[x]" />
<slicing>
<discriminator>
<type value="type" />
<path value="$this" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="When the procedure was performed" />
<definition value="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." />
<comment value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Procedure.performed[x]" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="dateTime" />
</type>
<type>
<code value="Period" />
</type>
<type>
<code value="string" />
</type>
<type>
<code value="Age" />
</type>
<type>
<code value="Range" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.occurrence[x]" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.done[x]" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBR-7" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".effectiveTime" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Reported Clinical Information Date Time" />
</mapping>
</element>
<element id="Procedure.performed[x]:performedDateTime">
<path value="Procedure.performed[x]" />
<sliceName value="performedDateTime" />
<short value="When the procedure was performed" />
<definition value="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." />
<comment value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Procedure.performed[x]" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="dateTime" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.occurrence[x]" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.done[x]" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBR-7" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".effectiveTime" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Procedure Date and Time" />
</mapping>
</element>
<element id="Procedure.performed[x]:performedPeriod">
<path value="Procedure.performed[x]" />
<sliceName value="performedPeriod" />
<short value="When the procedure was performed" />
<definition value="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." />
<comment value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Procedure.performed[x]" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Period" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.occurrence[x]" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.done[x]" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBR-7" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".effectiveTime" />
</mapping>
</element>
<element id="Procedure.performed[x]:performedPeriod.id">
<path value="Procedure.performed[x].id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Procedure.performed[x]:performedPeriod.extension">
<path value="Procedure.performed[x].extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Procedure.performed[x]:performedPeriod.start">
<path value="Procedure.performed[x].start" />
<short value="Starting time with inclusive boundary" />
<definition value="The start of the period. The boundary is inclusive." />
<comment value="If the low element is missing, the meaning is that the low boundary is not known." />
<min value="0" />
<max value="1" />
<base>
<path value="Period.start" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="dateTime" />
</type>
<condition value="ele-1" />
<condition value="per-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="DR.1" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./low" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Event Start Date and Time" />
</mapping>
</element>
<element id="Procedure.performed[x]:performedPeriod.end">
<path value="Procedure.performed[x].end" />
<short value="End time with inclusive boundary, if not ongoing" />
<definition value="The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time." />
<comment value="The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03." />
<min value="0" />
<max value="1" />
<base>
<path value="Period.end" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="dateTime" />
</type>
<meaningWhenMissing value="If the end of the period is missing, it means that the period is ongoing" />
<condition value="ele-1" />
<condition value="per-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="DR.2" />
</mapping>
<mapping>
<identity value="rim" />
<map value="./high" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Event End Date and Time" />
</mapping>
</element>
<element id="Procedure.recorder">
<path value="Procedure.recorder" />
<short value="Who recorded the procedure" />
<definition value="Individual who recorded the record and takes responsibility for its content." />
<comment value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Procedure.recorder" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.author" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode=AUT].role" />
</mapping>
</element>
<element id="Procedure.asserter">
<path value="Procedure.asserter" />
<short value="Person who asserts this procedure" />
<definition value="Individual who is making the procedure statement." />
<comment value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Procedure.asserter" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.source" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode=INF].role" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Reported Clinical Information Source (Recommended)" />
</mapping>
</element>
<element id="Procedure.performer">
<path value="Procedure.performer" />
<short value="The people who performed the procedure" />
<definition value="Limited to "real" people rather than equipment." />
<min value="0" />
<max value="*" />
<base>
<path value="Procedure.performer" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.performer" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode=PRF]" />
</mapping>
</element>
<element id="Procedure.performer.id">
<path value="Procedure.performer.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Procedure.performer.extension">
<path value="Procedure.performer.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Procedure.performer.modifierExtension">
<path value="Procedure.performer.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="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](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Procedure.performer.function">
<path value="Procedure.performer.function" />
<short value="Type of performance" />
<definition value="Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist." />
<comment value="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." />
<requirements value="Allows disambiguation of the types of involvement of different performers." />
<min value="0" />
<max value="1" />
<base>
<path value="Procedure.performer.function" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ProcedurePerformerRole" />
</extension>
<strength value="example" />
<description value="A code that identifies the role of a performer of the procedure." />
<valueSet value="http://hl7.org/fhir/ValueSet/performer-role" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.performer.function" />
</mapping>
<mapping>
<identity value="v2" />
<map value="Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".functionCode" />
</mapping>
</element>
<element id="Procedure.performer.actor">
<path value="Procedure.performer.actor" />
<short value="The reference to the practitioner" />
<definition value="The practitioner who was involved in the procedure." />
<comment value="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." />
<requirements value="A reference to Device supports use cases, such as pacemakers." />
<min value="1" />
<max value="1" />
<base>
<path value="Procedure.performer.actor" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.performer.actor" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.actor" />
</mapping>
<mapping>
<identity value="v2" />
<map value="ORC-19/PRT-5" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".role" />
</mapping>
</element>
<element id="Procedure.performer.onBehalfOf">
<path value="Procedure.performer.onBehalfOf" />
<short value="Organization the device or practitioner was acting for" />
<definition value="The organization the device or practitioner was acting on behalf of." />
<comment value="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." />
<requirements value="Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action." />
<min value="0" />
<max value="1" />
<base>
<path value="Procedure.performer.onBehalfOf" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".scoper" />
</mapping>
</element>
<element id="Procedure.location">
<path value="Procedure.location" />
<short value="Where the procedure happened" />
<definition value="The location where the procedure actually happened. E.g. a newborn at home, a tracheostomy at a restaurant." />
<comment value="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." />
<requirements value="Ties a procedure to where the records are likely kept." />
<min value="0" />
<max value="1" />
<base>
<path value="Procedure.location" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Location" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.where[x]" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode=LOC].role[classCode=SDLOC]" />
</mapping>
</element>
<element id="Procedure.reasonCode">
<path value="Procedure.reasonCode" />
<short value="Coded reason procedure performed" />
<definition value="The coded reason why the procedure was performed. This may be a coded entity of some type, or may simply be present as text." />
<comment value="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." />
<min value="0" />
<max value="*" />
<base>
<path value="Procedure.reasonCode" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ProcedureReason" />
</extension>
<strength value="example" />
<description value="A code that identifies the reason a procedure is required." />
<valueSet value="http://hl7.org/fhir/ValueSet/procedure-reason" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.reasonCode" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.why[x]" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".reasonCode" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Procedure Reason" />
</mapping>
</element>
<element id="Procedure.reasonReference">
<path value="Procedure.reasonReference" />
<short value="The justification that the procedure was performed" />
<definition value="The justification of why the procedure was performed." />
<comment value="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). \nUse 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." />
<min value="0" />
<max value="*" />
<base>
<path value="Procedure.reasonReference" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.reasonReference" />
</mapping>
<mapping>
<identity value="w5" />
<map value="FiveWs.why[x]" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".reasonCode" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Procedure Reason" />
</mapping>
</element>
<element id="Procedure.bodySite">
<path value="Procedure.bodySite" />
<short value="Target body sites" />
<definition value="Detailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion." />
<comment value="If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [procedure-targetbodystructure](extension-procedure-targetbodystructure.html)." />
<min value="0" />
<max value="*" />
<base>
<path value="Procedure.bodySite" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="BodySite" />
</extension>
<strength value="example" />
<description value="Codes describing anatomical locations. May include laterality." />
<valueSet value="http://hl7.org/fhir/ValueSet/body-site" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="v2" />
<map value="OBX-20" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".targetSiteCode" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Procedure Body Site" />
</mapping>
</element>
<element id="Procedure.outcome">
<path value="Procedure.outcome" />
<short value="The result of procedure" />
<definition value="The outcome of the procedure - did it resolve the reasons for the procedure being performed?" />
<comment value="If outcome contains narrative text only, it can be captured using the CodeableConcept.text." />
<min value="0" />
<max value="1" />
<base>
<path value="Procedure.outcome" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ProcedureOutcome" />
</extension>
<strength value="example" />
<description value="An outcome of a procedure - whether it was resolved or otherwise." />
<valueSet value="http://hl7.org/fhir/ValueSet/procedure-outcome" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=OUT].target.text" />
</mapping>
</element>
<element id="Procedure.report">
<path value="Procedure.report" />
<short value="Any report resulting from the procedure" />
<definition value="This could be a histology result, pathology report, surgical report, etc." />
<comment value="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." />
<min value="0" />
<max value="*" />
<base>
<path value="Procedure.report" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Composition" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN]" />
</mapping>
</element>
<element id="Procedure.complication">
<path value="Procedure.complication" />
<short value="Complication following the procedure" />
<definition value="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." />
<comment value="If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text." />
<min value="0" />
<max value="*" />
<base>
<path value="Procedure.complication" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ProcedureComplication" />
</extension>
<strength value="example" />
<description value="Codes describing complications that resulted from a procedure." />
<valueSet value="http://hl7.org/fhir/ValueSet/condition-code" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code="complication", moodCode=EVN].value" />
</mapping>
</element>
<element id="Procedure.complicationDetail">
<path value="Procedure.complicationDetail" />
<short value="A condition that is a result of the procedure" />
<definition value="Any complications that occurred during the procedure, or in the immediate post-performance period." />
<comment value="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." />
<requirements value="This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure." />
<min value="0" />
<max value="*" />
<base>
<path value="Procedure.complicationDetail" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code="complication", moodCode=EVN].value" />
</mapping>
</element>
<element id="Procedure.followUp">
<path value="Procedure.followUp" />
<short value="Instructions for follow up" />
<definition value="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." />
<comment value="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." />
<min value="0" />
<max value="*" />
<base>
<path value="Procedure.followUp" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ProcedureFollowUp" />
</extension>
<strength value="example" />
<description value="Specific follow up required for a procedure e.g. removal of sutures." />
<valueSet value="http://hl7.org/fhir/ValueSet/procedure-followup" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".outboundRelationship[typeCode=COMP].target[classCode=ACT, moodCode=INT].code" />
</mapping>
</element>
<element id="Procedure.note">
<path value="Procedure.note" />
<short value="Additional information about the procedure" />
<definition value="Any other notes and comments about the procedure." />
<comment value="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)." />
<min value="0" />
<max value="*" />
<base>
<path value="Procedure.note" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Annotation" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="N/A" />
</mapping>
<mapping>
<identity value="rim" />
<map value="Act" />
</mapping>
<mapping>
<identity value="workflow" />
<map value="Event.note" />
</mapping>
<mapping>
<identity value="v2" />
<map value="NTE" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value" />
</mapping>
</element>
<element id="Procedure.focalDevice">
<path value="Procedure.focalDevice" />
<short value="Manipulated, implanted, or removed device" />
<definition value="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." />
<min value="0" />
<max value="*" />
<base>
<path value="Procedure.focalDevice" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="BackboneElement" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode=DEV].role[classCode=MANU]" />
</mapping>
</element>
<element id="Procedure.focalDevice.id">
<path value="Procedure.focalDevice.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<base>
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<type>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="Procedure.focalDevice.extension">
<path value="Procedure.focalDevice.extension" />
<slicing>
<discriminator>
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="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." />
<comment value="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." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<base>
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Procedure.focalDevice.modifierExtension">
<path value="Procedure.focalDevice.modifierExtension" />
<short value="Extensions that cannot be ignored even if unrecognized" />
<definition value="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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="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](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<alias value="modifiers" />
<min value="0" />
<max value="*" />
<base>
<path value="BackboneElement.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Extension" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
<isSummary value="true" />
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="Procedure.focalDevice.action">
<path value="Procedure.focalDevice.action" />
<short value="Kind of change to device" />
<definition value="The kind of change that happened to the device during the procedure." />
<comment value="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." />
<min value="0" />
<max value="1" />
<base>
<path value="Procedure.focalDevice.action" />
<min value="0" />
<max value="1" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="DeviceActionKind" />
</extension>
<strength value="preferred" />
<description value="A kind of change that happened to the device during the procedure." />
<valueSet value="http://hl7.org/fhir/ValueSet/device-action" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="procedure device action"].value=:procedure device action codes" />
</mapping>
</element>
<element id="Procedure.focalDevice.manipulated">
<path value="Procedure.focalDevice.manipulated" />
<short value="Device that was changed" />
<definition value="The device that was manipulated (changed) during the procedure." />
<comment value="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." />
<min value="1" />
<max value="1" />
<base>
<path value="Procedure.focalDevice.manipulated" />
<min value="1" />
<max value="1" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode=DEV].role[classCode=SDLOC]" />
</mapping>
</element>
<element id="Procedure.usedReference">
<path value="Procedure.usedReference" />
<short value="Items used during procedure" />
<definition value="Identifies medications, devices and any other substance used as part of the procedure." />
<comment value="For devices actually implanted or removed, use Procedure.device." />
<requirements value="Used for tracking contamination, etc." />
<min value="0" />
<max value="*" />
<base>
<path value="Procedure.usedReference" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Medication" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Substance" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<mapping>
<identity value="rim" />
<map value=".participation[typeCode=DEV].role[classCode=MANU] or\n.participation[typeCode=CSM].role[classCode=ADMM] (for Medication or Substance)" />
</mapping>
</element>
<element id="Procedure.usedCode">
<path value="Procedure.usedCode" />
<short value="Coded items used during the procedure" />
<definition value="Identifies coded items that were used as part of the procedure." />
<comment value="For devices actually implanted or removed, use Procedure.device." />
<min value="0" />
<max value="*" />
<base>
<path value="Procedure.usedCode" />
<min value="0" />
<max value="*" />
</base>
<type>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<constraint>
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<binding>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="ProcedureUsed" />
</extension>
<strength value="example" />
<description value="Codes describing items used during a procedure." />
<valueSet value="http://hl7.org/fhir/ValueSet/device-kind" />
</binding>
<mapping>
<identity value="rim" />
<map value="n/a" />
</mapping>
<mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<mapping>
<identity value="rim" />
<map value="participation[typeCode=Dev].role[classCode=MANU]" />
</mapping>
</element>
</snapshot>
<differential>
<element id="Procedure.code">
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="MAY:populate-if-known" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/obligation">
<extension url="code">
<valueCode value="SHALL:no-error" />
</extension>
<extension url="actor">
<valueCanonical value="http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer" />
</extension>
</extension>
<path value="Procedure.code" />
<type>
<code value="CodeableConcept" />
<profile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core" />
</type>
<binding>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/CCI" />
</extension>
<extension url="documentation">
<valueMarkdown value="CCI Codes" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/ICD10CA" />
</extension>
<extension url="documentation">
<valueMarkdown value="International Classifications of Disease 10 CA Codes" />
</extension>
</extension>
<extension url="http://hl7.org/fhir/tools/StructureDefinition/additional-binding">
<extension url="purpose">
<valueCode value="candidate" />
</extension>
<extension url="valueSet">
<valueCanonical value="https://fhir.infoway-inforoute.ca/ValueSet/ICD9CM" />
</extension>
<extension url="documentation">
<valueMarkdown value="International Classifications of Disease 9 CM Codes" />
</extension>
</extension>
<strength value="preferred" />
<valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/procedurecode" />
</binding>
<mapping>
<identity value="CACDI" />
<map value="Procedure Performed" />
</mapping>
<mapping>
<identity value="CACDI" />
<map value="Procedure Code" />
</mapping>
</element>
<element id="Procedure.performed[x]">
<path value="Procedure.performed[x]" />
<slicing>
<discriminator>
<type value="type" />
<path value="$this" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
<mapping>
<identity value="CACDI" />
<map value="Reported Clinical Information Date Time" />
</mapping>
</element>
<element id="Procedure.performed[x]:performedDateTime">
<path value="Procedure.performed[x]" />
<sliceName value="performedDateTime" />
<min value="0" />
<max value="1" />
<type>
<code value="dateTime" />
</type>
<mapping>
<identity value="CACDI" />
<map value="Procedure Date and Time" />
</mapping>
</element>
<element id="Procedure.performed[x]:performedPeriod">
<path value="Procedure.performed[x]" />
<sliceName value="performedPeriod" />
<min value="0" />
<max value="1" />
<type>
<code value="Period" />
</type>
</element>
<element id="Procedure.performed[x]:performedPeriod.start">
<path value="Procedure.performed[x].start" />
<mapping>
<identity value="CACDI" />
<map value="Event Start Date and Time" />
</mapping>
</element>
<element id="Procedure.performed[x]:performedPeriod.end">
<path value="Procedure.performed[x].end" />
<mapping>
<identity value="CACDI" />
<map value="Event End Date and Time" />
</mapping>
</element>
<element id="Procedure.asserter">
<path value="Procedure.asserter" />
<mapping>
<identity value="CACDI" />
<map value="Reported Clinical Information Source (Recommended)" />
</mapping>
</element>
<element id="Procedure.reasonCode">
<path value="Procedure.reasonCode" />
<mapping>
<identity value="CACDI" />
<map value="Procedure Reason" />
</mapping>
</element>
<element id="Procedure.reasonReference">
<path value="Procedure.reasonReference" />
<mapping>
<identity value="CACDI" />
<map value="Procedure Reason" />
</mapping>
</element>
<element id="Procedure.bodySite">
<path value="Procedure.bodySite" />
<mapping>
<identity value="CACDI" />
<map value="Procedure Body Site" />
</mapping>
</element>
</differential>
</StructureDefinition>
{
"resourceType": "StructureDefinition",
"id": "procedure-ca-core",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger": 2
}
],
"url": "http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/procedure-ca-core",
"version": "1.1.0",
"name": "ProcedureCACore",
"title": "Procedure (CA-Core)",
"status": "active",
"experimental": false,
"date": "2025-03-06",
"publisher": "Canada Health Infoway",
"contact": [
{
"name": "National Standards Release Centre",
"telecom": [
{
"system": "url",
"value": "http://www.infoway-inforoute.ca"
},
{
"system": "email",
"value": "standards@infoway-inforoute.ca"
}
]
}
],
"description": "This profile applies constraints to the Procedure resource for CA Core+ to support clinical and diagnostic procedure documentation in the pan-Canadian context.",
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "CA"
}
]
}
],
"copyright": "Copyright © 2025+ 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).",
"fhirVersion": "4.0.1",
"mapping": [
{
"identity": "CACDI",
"name": "Canadian Core Data for Interoperability (CACDI)"
}
],
"kind": "resource",
"abstract": false,
"type": "Procedure",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Procedure",
"derivation": "constraint",
"snapshot": {
"element": [
{
"id": "Procedure",
"path": "Procedure",
"short": "An action that is being or was performed on a patient",
"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.",
"min": 0,
"max": "*",
"base": {
"path": "Procedure",
"min": 0,
"max": "*"
},
"constraint": [
{
"key": "dom-2",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"expression": "contained.contained.empty()",
"xpath": "not(parent::f:contained and f:contained)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-4",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-3",
"severity": "error",
"human": "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",
"expression": "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()",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean": true
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
}
],
"key": "dom-6",
"severity": "warning",
"human": "A resource should have narrative for robust management",
"expression": "text.`div`.exists()",
"xpath": "exists(f:text/h:div)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-5",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a security label",
"expression": "contained.meta.security.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:security))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
}
],
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "workflow",
"map": "Event"
},
{
"identity": "rim",
"map": "Procedure[moodCode=EVN]"
}
]
},
{
"id": "Procedure.id",
"path": "Procedure.id",
"short": "Logical id of this artifact",
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"isSummary": true
},
{
"id": "Procedure.meta",
"path": "Procedure.meta",
"short": "Metadata about the resource",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.meta",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Meta"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Procedure.implicitRules",
"path": "Procedure.implicitRules",
"short": "A set of rules under which this content was created",
"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.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.implicitRules",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Procedure.language",
"path": "Procedure.language",
"short": "Language of the resource content",
"definition": "The base language in which the resource is written.",
"comment": "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).",
"min": 0,
"max": "1",
"base": {
"path": "Resource.language",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
}
],
"strength": "preferred",
"description": "A human language.",
"valueSet": "http://hl7.org/fhir/ValueSet/languages"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Procedure.text",
"path": "Procedure.text",
"short": "Text summary of the resource, for human interpretation",
"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.",
"comment": "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.",
"alias": [
"narrative",
"html",
"xhtml",
"display"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
},
{
"identity": "rim",
"map": "Act.text?"
}
]
},
{
"id": "Procedure.contained",
"path": "Procedure.contained",
"short": "Contained, inline Resources",
"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.",
"comment": "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.",
"alias": [
"inline resources",
"anonymous resources",
"contained resources"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.contained",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Resource"
}
],
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Procedure.extension",
"path": "Procedure.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Procedure.modifierExtension",
"path": "Procedure.modifierExtension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Extensions that cannot be ignored",
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"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](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Procedure.identifier",
"path": "Procedure.identifier",
"short": "External Identifiers for this procedure",
"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.",
"comment": "This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)). 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.",
"requirements": "Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers.",
"min": 0,
"max": "*",
"base": {
"path": "Procedure.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "workflow",
"map": "Event.identifier"
},
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "v2",
"map": "Some combination of ORC-2 / ORC-3 / OBR-2 / OBR-3 / IPC-1 / IPC-2 / IPC-3 / IPC-4"
},
{
"identity": "rim",
"map": ".id"
}
]
},
{
"id": "Procedure.instantiatesCanonical",
"path": "Procedure.instantiatesCanonical",
"short": "Instantiates FHIR protocol or definition",
"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.",
"comment": "see [Canonical References](references.html#canonical)",
"min": 0,
"max": "*",
"base": {
"path": "Procedure.instantiatesCanonical",
"min": 0,
"max": "*"
},
"type": [
{
"code": "canonical",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/PlanDefinition",
"http://hl7.org/fhir/StructureDefinition/ActivityDefinition",
"http://hl7.org/fhir/StructureDefinition/Measure",
"http://hl7.org/fhir/StructureDefinition/OperationDefinition",
"http://hl7.org/fhir/StructureDefinition/Questionnaire"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Event.instantiatesCanonical"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=DEFN].target"
}
]
},
{
"id": "Procedure.instantiatesUri",
"path": "Procedure.instantiatesUri",
"short": "Instantiates external protocol or definition",
"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.",
"comment": "This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.",
"min": 0,
"max": "*",
"base": {
"path": "Procedure.instantiatesUri",
"min": 0,
"max": "*"
},
"type": [
{
"code": "uri"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Event.instantiatesUri"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=DEFN].target"
}
]
},
{
"id": "Procedure.basedOn",
"path": "Procedure.basedOn",
"short": "A request for this procedure",
"definition": "A reference to a resource that contains details of the request for this procedure.",
"comment": "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.",
"alias": [
"fulfills"
],
"min": 0,
"max": "*",
"base": {
"path": "Procedure.basedOn",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/CarePlan",
"http://hl7.org/fhir/StructureDefinition/ServiceRequest"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Event.basedOn"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=FLFS].target[classCode=(various e.g. PROC, OBS, PCPR, ACT, moodCode=RQO].code"
}
]
},
{
"id": "Procedure.partOf",
"path": "Procedure.partOf",
"short": "Part of referenced event",
"definition": "A larger event of which this particular procedure is a component or step.",
"comment": "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).",
"alias": [
"container"
],
"min": 0,
"max": "*",
"base": {
"path": "Procedure.partOf",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Procedure",
"http://hl7.org/fhir/StructureDefinition/Observation",
"http://hl7.org/fhir/StructureDefinition/MedicationAdministration"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Event.partOf"
},
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=COMP].source[classCode=SBADM or PROC or OBS, moodCode=EVN]"
}
]
},
{
"id": "Procedure.status",
"path": "Procedure.status",
"short": "preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown",
"definition": "A code specifying the state of the procedure. Generally, this will be the in-progress or completed state.",
"comment": "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.\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
"min": 1,
"max": "1",
"base": {
"path": "Procedure.status",
"min": 1,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureStatus"
}
],
"strength": "required",
"description": "A code specifying the state of the procedure.",
"valueSet": "http://hl7.org/fhir/ValueSet/event-status|4.0.1"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Event.status"
},
{
"identity": "w5",
"map": "FiveWs.status"
},
{
"identity": "rim",
"map": "statusCode"
}
]
},
{
"id": "Procedure.statusReason",
"path": "Procedure.statusReason",
"short": "Reason for current status",
"definition": "Captures the reason for the current state of the procedure.",
"comment": "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.",
"alias": [
"Suspended Reason",
"Cancelled Reason"
],
"min": 0,
"max": "1",
"base": {
"path": "Procedure.statusReason",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureNegationReason"
}
],
"strength": "example",
"description": "A code that identifies the reason a procedure was not performed.",
"valueSet": "http://hl7.org/fhir/ValueSet/procedure-not-performed-reason"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "workflow",
"map": "Event.statusReason"
},
{
"identity": "rim",
"map": ".reason.Observation.value"
}
]
},
{
"id": "Procedure.category",
"path": "Procedure.category",
"short": "Classification of the procedure",
"definition": "A code that classifies the procedure for searching, sorting and display purposes (e.g. \"Surgical Procedure\").",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Procedure.category",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureCategory"
}
],
"strength": "example",
"description": "A code that classifies a procedure for searching, sorting and display purposes.",
"valueSet": "http://hl7.org/fhir/ValueSet/procedure-category"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"EVN\"].code"
}
]
},
{
"id": "Procedure.code",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "MAY:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Procedure.code",
"short": "Concept - reference to a terminology or just text",
"definition": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"comment": "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.",
"requirements": "0..1 to account for primarily narrative only resources.",
"alias": [
"type"
],
"min": 0,
"max": "1",
"base": {
"path": "Procedure.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept",
"profile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureCode"
},
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/CCI"
},
{
"url": "documentation",
"valueMarkdown": "CCI Codes"
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
},
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/ICD10CA"
},
{
"url": "documentation",
"valueMarkdown": "International Classifications of Disease 10 CA Codes"
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
},
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/ICD9CM"
},
{
"url": "documentation",
"valueMarkdown": "International Classifications of Disease 9 CM Codes"
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
}
],
"strength": "preferred",
"description": "A code to identify a specific procedure .",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/procedurecode"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "workflow",
"map": "Event.code"
},
{
"identity": "w5",
"map": "FiveWs.what[x]"
},
{
"identity": "v2",
"map": "OBR-44/OBR-45"
},
{
"identity": "rim",
"map": ".code"
},
{
"identity": "CACDI",
"map": "Procedure Performed"
},
{
"identity": "CACDI",
"map": "Procedure Code"
}
]
},
{
"id": "Procedure.subject",
"path": "Procedure.subject",
"short": "Who the procedure was performed on",
"definition": "The person, animal or group on which the procedure was performed.",
"comment": "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.",
"alias": [
"patient"
],
"min": 1,
"max": "1",
"base": {
"path": "Procedure.subject",
"min": 1,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/Group"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Event.subject"
},
{
"identity": "w5",
"map": "FiveWs.subject[x]"
},
{
"identity": "v2",
"map": "PID-3"
},
{
"identity": "rim",
"map": ".participation[typeCode=SBJ].role"
},
{
"identity": "w5",
"map": "FiveWs.subject"
}
]
},
{
"id": "Procedure.encounter",
"path": "Procedure.encounter",
"short": "Encounter created as part of",
"definition": "The Encounter during which this Procedure was created or performed or to which the creation of this record is tightly associated.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Procedure.encounter",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Encounter"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Event.context"
},
{
"identity": "w5",
"map": "FiveWs.context"
},
{
"identity": "v2",
"map": "PV1-19"
},
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"
}
]
},
{
"id": "Procedure.performed[x]",
"path": "Procedure.performed[x]",
"slicing": {
"discriminator": [
{
"type": "type",
"path": "$this"
}
],
"ordered": false,
"rules": "open"
},
"short": "When the procedure was performed",
"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.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Procedure.performed[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
},
{
"code": "Period"
},
{
"code": "string"
},
{
"code": "Age"
},
{
"code": "Range"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Event.occurrence[x]"
},
{
"identity": "w5",
"map": "FiveWs.done[x]"
},
{
"identity": "v2",
"map": "OBR-7"
},
{
"identity": "rim",
"map": ".effectiveTime"
},
{
"identity": "CACDI",
"map": "Reported Clinical Information Date Time"
}
]
},
{
"id": "Procedure.performed[x]:performedDateTime",
"path": "Procedure.performed[x]",
"sliceName": "performedDateTime",
"short": "When the procedure was performed",
"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.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Procedure.performed[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Event.occurrence[x]"
},
{
"identity": "w5",
"map": "FiveWs.done[x]"
},
{
"identity": "v2",
"map": "OBR-7"
},
{
"identity": "rim",
"map": ".effectiveTime"
},
{
"identity": "CACDI",
"map": "Procedure Date and Time"
}
]
},
{
"id": "Procedure.performed[x]:performedPeriod",
"path": "Procedure.performed[x]",
"sliceName": "performedPeriod",
"short": "When the procedure was performed",
"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.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Procedure.performed[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Event.occurrence[x]"
},
{
"identity": "w5",
"map": "FiveWs.done[x]"
},
{
"identity": "v2",
"map": "OBR-7"
},
{
"identity": "rim",
"map": ".effectiveTime"
}
]
},
{
"id": "Procedure.performed[x]:performedPeriod.id",
"path": "Procedure.performed[x].id",
"representation": [
"xmlAttr"
],
"short": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Procedure.performed[x]:performedPeriod.extension",
"path": "Procedure.performed[x].extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Procedure.performed[x]:performedPeriod.start",
"path": "Procedure.performed[x].start",
"short": "Starting time with inclusive boundary",
"definition": "The start of the period. The boundary is inclusive.",
"comment": "If the low element is missing, the meaning is that the low boundary is not known.",
"min": 0,
"max": "1",
"base": {
"path": "Period.start",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
}
],
"condition": [
"ele-1",
"per-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "DR.1"
},
{
"identity": "rim",
"map": "./low"
},
{
"identity": "CACDI",
"map": "Event Start Date and Time"
}
]
},
{
"id": "Procedure.performed[x]:performedPeriod.end",
"path": "Procedure.performed[x].end",
"short": "End time with inclusive boundary, if not ongoing",
"definition": "The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.",
"comment": "The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.",
"min": 0,
"max": "1",
"base": {
"path": "Period.end",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
}
],
"meaningWhenMissing": "If the end of the period is missing, it means that the period is ongoing",
"condition": [
"ele-1",
"per-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "DR.2"
},
{
"identity": "rim",
"map": "./high"
},
{
"identity": "CACDI",
"map": "Event End Date and Time"
}
]
},
{
"id": "Procedure.recorder",
"path": "Procedure.recorder",
"short": "Who recorded the procedure",
"definition": "Individual who recorded the record and takes responsibility for its content.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Procedure.recorder",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "w5",
"map": "FiveWs.author"
},
{
"identity": "rim",
"map": ".participation[typeCode=AUT].role"
}
]
},
{
"id": "Procedure.asserter",
"path": "Procedure.asserter",
"short": "Person who asserts this procedure",
"definition": "Individual who is making the procedure statement.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Procedure.asserter",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "w5",
"map": "FiveWs.source"
},
{
"identity": "rim",
"map": ".participation[typeCode=INF].role"
},
{
"identity": "CACDI",
"map": "Reported Clinical Information Source (Recommended)"
}
]
},
{
"id": "Procedure.performer",
"path": "Procedure.performer",
"short": "The people who performed the procedure",
"definition": "Limited to \"real\" people rather than equipment.",
"min": 0,
"max": "*",
"base": {
"path": "Procedure.performer",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "workflow",
"map": "Event.performer"
},
{
"identity": "rim",
"map": ".participation[typeCode=PRF]"
}
]
},
{
"id": "Procedure.performer.id",
"path": "Procedure.performer.id",
"representation": [
"xmlAttr"
],
"short": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Procedure.performer.extension",
"path": "Procedure.performer.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Procedure.performer.modifierExtension",
"path": "Procedure.performer.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"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](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Procedure.performer.function",
"path": "Procedure.performer.function",
"short": "Type of performance",
"definition": "Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist.",
"comment": "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.",
"requirements": "Allows disambiguation of the types of involvement of different performers.",
"min": 0,
"max": "1",
"base": {
"path": "Procedure.performer.function",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedurePerformerRole"
}
],
"strength": "example",
"description": "A code that identifies the role of a performer of the procedure.",
"valueSet": "http://hl7.org/fhir/ValueSet/performer-role"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "workflow",
"map": "Event.performer.function"
},
{
"identity": "v2",
"map": "Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25"
},
{
"identity": "rim",
"map": ".functionCode"
}
]
},
{
"id": "Procedure.performer.actor",
"path": "Procedure.performer.actor",
"short": "The reference to the practitioner",
"definition": "The practitioner who was involved in the procedure.",
"comment": "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.",
"requirements": "A reference to Device supports use cases, such as pacemakers.",
"min": 1,
"max": "1",
"base": {
"path": "Procedure.performer.actor",
"min": 1,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Practitioner",
"http://hl7.org/fhir/StructureDefinition/PractitionerRole",
"http://hl7.org/fhir/StructureDefinition/Organization",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Device"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Event.performer.actor"
},
{
"identity": "w5",
"map": "FiveWs.actor"
},
{
"identity": "v2",
"map": "ORC-19/PRT-5"
},
{
"identity": "rim",
"map": ".role"
}
]
},
{
"id": "Procedure.performer.onBehalfOf",
"path": "Procedure.performer.onBehalfOf",
"short": "Organization the device or practitioner was acting for",
"definition": "The organization the device or practitioner was acting on behalf of.",
"comment": "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.",
"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.",
"min": 0,
"max": "1",
"base": {
"path": "Procedure.performer.onBehalfOf",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "rim",
"map": ".scoper"
}
]
},
{
"id": "Procedure.location",
"path": "Procedure.location",
"short": "Where the procedure happened",
"definition": "The location where the procedure actually happened. E.g. a newborn at home, a tracheostomy at a restaurant.",
"comment": "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.",
"requirements": "Ties a procedure to where the records are likely kept.",
"min": 0,
"max": "1",
"base": {
"path": "Procedure.location",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Location"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "w5",
"map": "FiveWs.where[x]"
},
{
"identity": "rim",
"map": ".participation[typeCode=LOC].role[classCode=SDLOC]"
}
]
},
{
"id": "Procedure.reasonCode",
"path": "Procedure.reasonCode",
"short": "Coded reason procedure performed",
"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.",
"comment": "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.",
"min": 0,
"max": "*",
"base": {
"path": "Procedure.reasonCode",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureReason"
}
],
"strength": "example",
"description": "A code that identifies the reason a procedure is required.",
"valueSet": "http://hl7.org/fhir/ValueSet/procedure-reason"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "workflow",
"map": "Event.reasonCode"
},
{
"identity": "w5",
"map": "FiveWs.why[x]"
},
{
"identity": "rim",
"map": ".reasonCode"
},
{
"identity": "CACDI",
"map": "Procedure Reason"
}
]
},
{
"id": "Procedure.reasonReference",
"path": "Procedure.reasonReference",
"short": "The justification that the procedure was performed",
"definition": "The justification of why the procedure was performed.",
"comment": "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). \nUse 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.",
"min": 0,
"max": "*",
"base": {
"path": "Procedure.reasonReference",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Condition",
"http://hl7.org/fhir/StructureDefinition/Observation",
"http://hl7.org/fhir/StructureDefinition/Procedure",
"http://hl7.org/fhir/StructureDefinition/DiagnosticReport",
"http://hl7.org/fhir/StructureDefinition/DocumentReference"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "workflow",
"map": "Event.reasonReference"
},
{
"identity": "w5",
"map": "FiveWs.why[x]"
},
{
"identity": "rim",
"map": ".reasonCode"
},
{
"identity": "CACDI",
"map": "Procedure Reason"
}
]
},
{
"id": "Procedure.bodySite",
"path": "Procedure.bodySite",
"short": "Target body sites",
"definition": "Detailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion.",
"comment": "If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [procedure-targetbodystructure](extension-procedure-targetbodystructure.html).",
"min": 0,
"max": "*",
"base": {
"path": "Procedure.bodySite",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "BodySite"
}
],
"strength": "example",
"description": "Codes describing anatomical locations. May include laterality.",
"valueSet": "http://hl7.org/fhir/ValueSet/body-site"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "v2",
"map": "OBX-20"
},
{
"identity": "rim",
"map": ".targetSiteCode"
},
{
"identity": "CACDI",
"map": "Procedure Body Site"
}
]
},
{
"id": "Procedure.outcome",
"path": "Procedure.outcome",
"short": "The result of procedure",
"definition": "The outcome of the procedure - did it resolve the reasons for the procedure being performed?",
"comment": "If outcome contains narrative text only, it can be captured using the CodeableConcept.text.",
"min": 0,
"max": "1",
"base": {
"path": "Procedure.outcome",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureOutcome"
}
],
"strength": "example",
"description": "An outcome of a procedure - whether it was resolved or otherwise.",
"valueSet": "http://hl7.org/fhir/ValueSet/procedure-outcome"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=OUT].target.text"
}
]
},
{
"id": "Procedure.report",
"path": "Procedure.report",
"short": "Any report resulting from the procedure",
"definition": "This could be a histology result, pathology report, surgical report, etc.",
"comment": "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.",
"min": 0,
"max": "*",
"base": {
"path": "Procedure.report",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/DiagnosticReport",
"http://hl7.org/fhir/StructureDefinition/DocumentReference",
"http://hl7.org/fhir/StructureDefinition/Composition"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN]"
}
]
},
{
"id": "Procedure.complication",
"path": "Procedure.complication",
"short": "Complication following the procedure",
"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.",
"comment": "If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.",
"min": 0,
"max": "*",
"base": {
"path": "Procedure.complication",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureComplication"
}
],
"strength": "example",
"description": "Codes describing complications that resulted from a procedure.",
"valueSet": "http://hl7.org/fhir/ValueSet/condition-code"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code=\"complication\", moodCode=EVN].value"
}
]
},
{
"id": "Procedure.complicationDetail",
"path": "Procedure.complicationDetail",
"short": "A condition that is a result of the procedure",
"definition": "Any complications that occurred during the procedure, or in the immediate post-performance period.",
"comment": "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.",
"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.",
"min": 0,
"max": "*",
"base": {
"path": "Procedure.complicationDetail",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Condition"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code=\"complication\", moodCode=EVN].value"
}
]
},
{
"id": "Procedure.followUp",
"path": "Procedure.followUp",
"short": "Instructions for follow up",
"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.",
"comment": "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.",
"min": 0,
"max": "*",
"base": {
"path": "Procedure.followUp",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureFollowUp"
}
],
"strength": "example",
"description": "Specific follow up required for a procedure e.g. removal of sutures.",
"valueSet": "http://hl7.org/fhir/ValueSet/procedure-followup"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=COMP].target[classCode=ACT, moodCode=INT].code"
}
]
},
{
"id": "Procedure.note",
"path": "Procedure.note",
"short": "Additional information about the procedure",
"definition": "Any other notes and comments about the procedure.",
"comment": "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).",
"min": 0,
"max": "*",
"base": {
"path": "Procedure.note",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Annotation"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "N/A"
},
{
"identity": "rim",
"map": "Act"
},
{
"identity": "workflow",
"map": "Event.note"
},
{
"identity": "v2",
"map": "NTE"
},
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"annotation\"].value"
}
]
},
{
"id": "Procedure.focalDevice",
"path": "Procedure.focalDevice",
"short": "Manipulated, implanted, or removed device",
"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.",
"min": 0,
"max": "*",
"base": {
"path": "Procedure.focalDevice",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": ".participation[typeCode=DEV].role[classCode=MANU]"
}
]
},
{
"id": "Procedure.focalDevice.id",
"path": "Procedure.focalDevice.id",
"representation": [
"xmlAttr"
],
"short": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Procedure.focalDevice.extension",
"path": "Procedure.focalDevice.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"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.",
"comment": "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.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Procedure.focalDevice.modifierExtension",
"path": "Procedure.focalDevice.modifierExtension",
"short": "Extensions that cannot be ignored even if unrecognized",
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"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](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Procedure.focalDevice.action",
"path": "Procedure.focalDevice.action",
"short": "Kind of change to device",
"definition": "The kind of change that happened to the device during the procedure.",
"comment": "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.",
"min": 0,
"max": "1",
"base": {
"path": "Procedure.focalDevice.action",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DeviceActionKind"
}
],
"strength": "preferred",
"description": "A kind of change that happened to the device during the procedure.",
"valueSet": "http://hl7.org/fhir/ValueSet/device-action"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"procedure device action\"].value=:procedure device action codes"
}
]
},
{
"id": "Procedure.focalDevice.manipulated",
"path": "Procedure.focalDevice.manipulated",
"short": "Device that was changed",
"definition": "The device that was manipulated (changed) during the procedure.",
"comment": "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.",
"min": 1,
"max": "1",
"base": {
"path": "Procedure.focalDevice.manipulated",
"min": 1,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Device"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "rim",
"map": ".participation[typeCode=DEV].role[classCode=SDLOC]"
}
]
},
{
"id": "Procedure.usedReference",
"path": "Procedure.usedReference",
"short": "Items used during procedure",
"definition": "Identifies medications, devices and any other substance used as part of the procedure.",
"comment": "For devices actually implanted or removed, use Procedure.device.",
"requirements": "Used for tracking contamination, etc.",
"min": 0,
"max": "*",
"base": {
"path": "Procedure.usedReference",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Device",
"http://hl7.org/fhir/StructureDefinition/Medication",
"http://hl7.org/fhir/StructureDefinition/Substance"
]
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "rim",
"map": ".participation[typeCode=DEV].role[classCode=MANU] or\n.participation[typeCode=CSM].role[classCode=ADMM] (for Medication or Substance)"
}
]
},
{
"id": "Procedure.usedCode",
"path": "Procedure.usedCode",
"short": "Coded items used during the procedure",
"definition": "Identifies coded items that were used as part of the procedure.",
"comment": "For devices actually implanted or removed, use Procedure.device.",
"min": 0,
"max": "*",
"base": {
"path": "Procedure.usedCode",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureUsed"
}
],
"strength": "example",
"description": "Codes describing items used during a procedure.",
"valueSet": "http://hl7.org/fhir/ValueSet/device-kind"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "rim",
"map": "participation[typeCode=Dev].role[classCode=MANU]"
}
]
}
]
},
"differential": {
"element": [
{
"id": "Procedure.code",
"extension": [
{
"extension": [
{
"url": "code",
"valueCode": "MAY:populate-if-known"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/producer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
},
{
"extension": [
{
"url": "code",
"valueCode": "SHALL:no-error"
},
{
"url": "actor",
"valueCanonical": "http://fhir.infoway-inforoute.ca/ca-core/ActorDefinition/consumer"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/obligation"
}
],
"path": "Procedure.code",
"type": [
{
"code": "CodeableConcept",
"profile": [
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/codeableconcept-ca-core"
]
}
],
"binding": {
"extension": [
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/CCI"
},
{
"url": "documentation",
"valueMarkdown": "CCI Codes"
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
},
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/ICD10CA"
},
{
"url": "documentation",
"valueMarkdown": "International Classifications of Disease 10 CA Codes"
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
},
{
"extension": [
{
"url": "purpose",
"valueCode": "candidate"
},
{
"url": "valueSet",
"valueCanonical": "https://fhir.infoway-inforoute.ca/ValueSet/ICD9CM"
},
{
"url": "documentation",
"valueMarkdown": "International Classifications of Disease 9 CM Codes"
}
],
"url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding"
}
],
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/procedurecode"
},
"mapping": [
{
"identity": "CACDI",
"map": "Procedure Performed"
},
{
"identity": "CACDI",
"map": "Procedure Code"
}
]
},
{
"id": "Procedure.performed[x]",
"path": "Procedure.performed[x]",
"slicing": {
"discriminator": [
{
"type": "type",
"path": "$this"
}
],
"ordered": false,
"rules": "open"
},
"mapping": [
{
"identity": "CACDI",
"map": "Reported Clinical Information Date Time"
}
]
},
{
"id": "Procedure.performed[x]:performedDateTime",
"path": "Procedure.performed[x]",
"sliceName": "performedDateTime",
"min": 0,
"max": "1",
"type": [
{
"code": "dateTime"
}
],
"mapping": [
{
"identity": "CACDI",
"map": "Procedure Date and Time"
}
]
},
{
"id": "Procedure.performed[x]:performedPeriod",
"path": "Procedure.performed[x]",
"sliceName": "performedPeriod",
"min": 0,
"max": "1",
"type": [
{
"code": "Period"
}
]
},
{
"id": "Procedure.performed[x]:performedPeriod.start",
"path": "Procedure.performed[x].start",
"mapping": [
{
"identity": "CACDI",
"map": "Event Start Date and Time"
}
]
},
{
"id": "Procedure.performed[x]:performedPeriod.end",
"path": "Procedure.performed[x].end",
"mapping": [
{
"identity": "CACDI",
"map": "Event End Date and Time"
}
]
},
{
"id": "Procedure.asserter",
"path": "Procedure.asserter",
"mapping": [
{
"identity": "CACDI",
"map": "Reported Clinical Information Source (Recommended)"
}
]
},
{
"id": "Procedure.reasonCode",
"path": "Procedure.reasonCode",
"mapping": [
{
"identity": "CACDI",
"map": "Procedure Reason"
}
]
},
{
"id": "Procedure.reasonReference",
"path": "Procedure.reasonReference",
"mapping": [
{
"identity": "CACDI",
"map": "Procedure Reason"
}
]
},
{
"id": "Procedure.bodySite",
"path": "Procedure.bodySite",
"mapping": [
{
"identity": "CACDI",
"map": "Procedure Body Site"
}
]
}
]
}
}

Terminology bindings

PathConformanceValueSet
Procedure.codepreferredhttps://fhir.infoway-inforoute.ca/ValueSet/procedurecode

Additional Terminology Bindings

These bindings may be used in lieu of the primary bindings in the table above.

PathConformanceAdditionalValueSet
Procedure.codecandidatehttps://fhir.infoway-inforoute.ca/ValueSet/CCI

Mappings to CACDI

The following tables list how the data elements from CA Core+ map to CACDI. For more information visit Mapping Logic.

FHIR Profile ElementCACDI Element(s)
Procedure.codeProcedure Performed, Procedure Code
Procedure.performed[x]Reported Clinical Information Date Time
Procedure.performed[x]:performedDateTimeProcedure Date and Time
Procedure.performed[x]:performedPeriod.startEvent Start Date and Time
Procedure.performed[x]:performedPeriod.endEvent End Date and Time
Procedure.asserterReported Clinical Information Source (Recommended)
Procedure.reasonCodeProcedure Reason
Procedure.reasonReferenceProcedure Reason
Procedure.bodySiteProcedure Body Site

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