HdBe-Procedure

ProfileStatusURL
HdBe-Proceduredrafthttps://fhir.healthdata.be/StructureDefinition/LogicalModel/HdBe-Procedure

ProcedureStartDate0..1dateTime
ProcedureEndDate0..1dateTime
ProcedureType1..1CodeableConcept
ProcedureMethod0..*CodeableConceptBinding
ProcedureAnatomicalLocation0..1Reference(HdBe AnatomicalLocation)
Indication0..*Reference(HdBe Problem)
MedicalDevice0..*Reference(HdBe MedicalDevice)
Location0..1Reference(HdBe HealthcareOrganization)
Performer0..*Reference(HdBe HealthProfessional)
Requester0..*Reference(HdBe HealthProfessional)

Procedure0..*
Procedure.ProcedureStartDatedateTime0..1
Procedure.ProcedureEndDatedateTime0..1
Procedure.ProcedureTypeCodeableConcept1..1
Procedure.ProcedureMethodCodeableConcept0..*
Procedure.ProcedureAnatomicalLocationReference(HdBe AnatomicalLocation)0..1
Procedure.IndicationReference(HdBe Problem)0..*
Procedure.MedicalDeviceReference(HdBe MedicalDevice)0..*
Procedure.LocationReference(HdBe HealthcareOrganization)0..1
Procedure.PerformerReference(HdBe HealthProfessional)0..*
Procedure.RequesterReference(HdBe HealthProfessional)0..*



Procedure
DefinitionRoot concept of the Procedure information model. This root concept contains all data elements of the Procedure information model.
Cardinality0...*
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim:n/a
Procedure.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
TypeSystem.String
Mappings
  • rim:n/a
Procedure.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
Procedure.ProcedureStartDate
DefinitionThe (desired) start date (and if possible start time) of the procedure. A ‘vague’ date, such as only the year, is permitted. The element offers the option to indicate the start of the period of a series of related procedures.
Cardinality0...1
TypedateTime
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim:n/a
Procedure.ProcedureEndDate
DefinitionThe end date (and if possible end time) of the procedure. A ‘vague’ date, such as only the year, is permitted. The element offers the option to indicate the end of the period of a series of related procedures. The end date element is only used for a procedures that takes some time and is then always applied. If the procedure still continues, the value is left empty. For instantaneous or very short lasting procedures the element is omitted.
Cardinality0...1
TypedateTime
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim:n/a
Procedure.ProcedureType
DefinitionThe name of the procedure. Choices are the DHD procedure thesaurus,  the procedures file (CBV), the Care activities file (NZa), the Dutch Mental Health and Addiction Care procedures list (GGZ) and the procedures list of the Dutch College of General Practitioners (NHG).
Cardinality1...1
TypeCodeableConcept
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
Procedure.ProcedureMethod
Definitionthe method or technique that was used to perform the procedure, *e.g. *approach, lavage, pressuring, ets
Cardinality0...*
TypeCodeableConcept
Binding

ProcedureMethod codes

https://fhir.healthdata.be/ValueSet/VerrichtingMethode (required)
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
Procedure.ProcedureAnatomicalLocation
DefinitionAnatomical location which is the focus of the procedure.
Cardinality0...1
TypeReference(HdBe AnatomicalLocation)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Procedure.Indication
DefinitionThe indication is the reason for the procedure.
Cardinality0...*
TypeReference(HdBe Problem)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Procedure.MedicalDevice
DefinitionThe product, the placing of which in or on the body is the purpose of the procedure, for example placing an implant.
Cardinality0...*
TypeReference(HdBe MedicalDevice)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Procedure.Location
DefinitionThe healthcare center where the procedure was, is or or will be carried out.
Cardinality0...1
TypeReference(HdBe HealthcareOrganization)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Procedure.Performer
DefinitionThe healthcare provider who carried out or will carry out the procedure. In most cases, only the medical specialty is entered, and not the name of the healthcare provider.
Cardinality0...*
TypeReference(HdBe HealthProfessional)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Procedure.Requester
DefinitionThe healthcare provider who requested the procedure.
Cardinality0...*
TypeReference(HdBe HealthProfessional)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1:SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)

Example instances

procedure (event)
ProcedureStartDate 2020-06-05T12:00:00
ProcedureEndDate 2020-06-05T14:25:00
ProcedureType 609588000 - Total knee replacement (code by SNOMED CT)
ProcedureMethod 129284003 - Surgical action (code by SNOMED CT)
ProcedureAnatomicalLocation.Location 72696002 - Knee region structure (code by SNOMED CT)
ProcedureAnatomicalLocation.Laterality 7771000 - Left (code by SNOMED CT)
indication Reference to Problem (Arthropathy of knee joint)
MedicalDevice
location Reference to HealthcareOrganization (UMCG)
performer Reference to HealthProfessional (Orthopodist)
requester
procedure (request)
ProcedureStartDate 2020-06-05
ProcedureEndDate
ProcedureType 609588000 - Total knee replacement (code by SNOMED CT)
ProcedureMethod 129284003 - Surgical action (code by SNOMED CT)
ProcedureAnatomicalLocation.Location 72696002 - Knee region structure (code by SNOMED CT)
ProcedureAnatomicalLocation.Laterality 7771000 - Left (code by SNOMED CT)
indication Reference to Problem (Arthropathy of knee joint)
MedicalDevice
location Reference to HealthcareOrganization (UMCG)
performer
requester Reference to HealthProfessional (Orthopodist)
procedure (event)
ProcedureStartDate 2022-05-12
ProcedureEndDate 2022-05-12
ProcedureType 80146002 - Excision of appendix (code by SNOMED CT)
ProcedureMethod 73632009 - Laparoscopy (code by SNOMED CT)
ProcedureAnatomicalLocation.Location 66754008 - Appendix structure (code by SNOMED CT)
ProcedureAnatomicalLocation.Laterality 24028007 - Right (code by SNOMED CT)
indication Reference to Problem (Appendicitis)
MedicalDevice
location
performer
requester

zib Procedure-v5.2 difference

Concept Category Description
ProcedureType textual Removed (Dutch) CodeSystem names in the definition.
ProcedureType terminology Replaced (Dutch) ValueSets with one ValueSet that includes all SNOMED child concepts of 71388002 Procedure.
ProcedureMethod terminology Widened terminology from descendent of 129264002(Action) to all of SNOMED. Changed the binding strenght from required to extensible.
Location textual Replaced 'healthcare center' with 'healthcare provider' in the definition.
Performer textual Replaced 'healthcare provider' with 'healthcare professional' in the definition.
Requester textual Replaced 'healthcare provider' with 'healthcare professional' in the definition.
Requester cardinality Restricted requester from 0..* to 0..1. This aligns with FHIR and a future version of the zib. ZIB-1488 and Nictiz-ticket #69.



Terminology Bindings

PathNameStrengthURL
ProcedureMethodVerrichtingMethoderequiredhttps://fhir.healthdata.be/ValueSet/VerrichtingMethode