{
"description": "This profile represents the constraints applied to the Procedure resource by the PS-CA project, which is informed by the constraints of the [Procedure IPS-UV profile](http://hl7.org/fhir/uv/ips/StructureDefinition-Procedure-uv-ips.html) and the [Canadian Baseline Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-procedure.html) to allow for cross-border and cross-jurisdiction sharing of History of Procedure information.",
"_filename": "StructureDefinition-procedure-ca-ps.json",
"package_name": "ca.infoway.io.psca",
"date": "2022-07-28T01:23:00-08:00",
"derivation": "constraint",
"publisher": "Canada Health Infoway",
"fhirVersion": "4.0.1",
"jurisdiction": [ {
"coding": [ {
"code": "CA",
"system": "urn:iso:std:iso:3166"
} ]
} ],
"name": "ProcedurePSCA",
"mapping": [ {
"uri": "http://hl7.org/fhir/workflow",
"name": "Workflow Pattern",
"identity": "workflow"
}, {
"uri": "http://hl7.org/v3",
"name": "RIM Mapping",
"identity": "rim"
}, {
"uri": "http://hl7.org/fhir/fivews",
"name": "FiveWs Pattern Mapping",
"identity": "w5"
}, {
"uri": "http://hl7.org/v2",
"name": "HL7 v2 Mapping",
"identity": "v2"
} ],
"abstract": false,
"copyright": "Copyright © 2021,2022 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).",
"type": "Procedure",
"experimental": "false",
"resourceType": "StructureDefinition",
"title": "Procedure (PS-CA)",
"package_version": "1.0.0",
"snapshot": {
"element": [ {
"constraint": [ {
"key": "dom-2",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"xpath": "not(parent::f:contained and f:contained)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.contained.empty()"
}, {
"key": "dom-3",
"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",
"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",
"severity": "error",
"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()"
}, {
"key": "dom-4",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"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",
"severity": "error",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
}, {
"key": "dom-5",
"human": "If a resource is contained in another resource, it SHALL NOT have a security label",
"xpath": "not(exists(f:contained/*/f:meta/f:security))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.meta.security.empty()"
}, {
"key": "dom-6",
"human": "A resource should have narrative for robust management",
"xpath": "exists(f:text/h:div)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "warning",
"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."
} ],
"expression": "text.`div`.exists()"
} ],
"path": "Procedure",
"min": 0,
"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.",
"isModifier": false,
"short": "An action that is being or was performed on a patient",
"mapping": [ {
"map": "Entity. Role, or Act",
"identity": "rim"
}, {
"map": "Event",
"identity": "workflow"
}, {
"map": "Procedure[moodCode=EVN]",
"identity": "rim"
} ],
"max": "*",
"id": "Procedure",
"base": {
"max": "*",
"min": 0,
"path": "Procedure"
},
"isSummary": false
}, {
"path": "Procedure.id",
"min": 0,
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"isModifier": false,
"short": "Logical id of this artifact",
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"max": "1",
"id": "Procedure.id",
"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.",
"base": {
"max": "1",
"min": 0,
"path": "Resource.id"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.meta",
"min": 0,
"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.",
"isModifier": false,
"short": "Metadata about the resource",
"type": [ {
"code": "Meta"
} ],
"max": "1",
"id": "Procedure.meta",
"base": {
"max": "1",
"min": 0,
"path": "Resource.meta"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.implicitRules",
"min": 0,
"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.",
"isModifier": true,
"short": "A set of rules under which this content was created",
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "Procedure.implicitRules",
"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.",
"base": {
"max": "1",
"min": 0,
"path": "Resource.implicitRules"
},
"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
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.language",
"min": 0,
"definition": "The base language in which the resource is written.",
"isModifier": false,
"short": "Language of the resource content",
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/ValueSet/languages",
"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"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
} ],
"description": "A human language."
},
"max": "1",
"id": "Procedure.language",
"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).",
"base": {
"max": "1",
"min": 0,
"path": "Resource.language"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.text",
"min": 0,
"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.",
"isModifier": false,
"short": "Text summary of the resource, for human interpretation",
"mapping": [ {
"map": "Act.text?",
"identity": "rim"
} ],
"type": [ {
"code": "Narrative"
} ],
"alias": [ "narrative", "html", "xhtml", "display" ],
"max": "1",
"id": "Procedure.text",
"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.",
"base": {
"max": "1",
"min": 0,
"path": "DomainResource.text"
},
"isSummary": false
}, {
"path": "Procedure.contained",
"min": 0,
"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.",
"isModifier": false,
"short": "Contained, inline Resources",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Resource"
} ],
"alias": [ "inline resources", "anonymous resources", "contained resources" ],
"max": "*",
"id": "Procedure.contained",
"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.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.contained"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Procedure.extension",
"min": 0,
"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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Procedure.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.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Procedure.modifierExtension",
"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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"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).",
"isModifier": true,
"short": "Extensions that cannot be ignored",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Procedure.modifierExtension",
"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.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.identifier",
"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,
"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.",
"isModifier": false,
"short": "External Identifiers for this procedure",
"mapping": [ {
"map": "Event.identifier",
"identity": "workflow"
}, {
"map": "FiveWs.identifier",
"identity": "w5"
}, {
"map": "Some combination of ORC-2 / ORC-3 / OBR-2 / OBR-3 / IPC-1 / IPC-2 / IPC-3 / IPC-4",
"identity": "v2"
}, {
"map": ".id",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"max": "*",
"id": "Procedure.identifier",
"comment": "This is a business identifier, not a resource identifier (see [discussion](http://hl7.org/fhir/R4/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.",
"base": {
"max": "*",
"min": 0,
"path": "Procedure.identifier"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.instantiatesCanonical",
"min": 0,
"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.",
"isModifier": false,
"short": "Instantiates FHIR protocol or definition",
"mapping": [ {
"map": "Event.instantiatesCanonical",
"identity": "workflow"
}, {
"map": ".outboundRelationship[typeCode=DEFN].target",
"identity": "rim"
} ],
"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" ]
} ],
"max": "*",
"id": "Procedure.instantiatesCanonical",
"base": {
"max": "*",
"min": 0,
"path": "Procedure.instantiatesCanonical"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.instantiatesUri",
"min": 0,
"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.",
"isModifier": false,
"short": "Instantiates external protocol or definition",
"mapping": [ {
"map": "Event.instantiatesUri",
"identity": "workflow"
}, {
"map": ".outboundRelationship[typeCode=DEFN].target",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"max": "*",
"id": "Procedure.instantiatesUri",
"comment": "This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.",
"base": {
"max": "*",
"min": 0,
"path": "Procedure.instantiatesUri"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.basedOn",
"min": 0,
"definition": "A reference to a resource that contains details of the request for this procedure.",
"isModifier": false,
"short": "A request for this procedure",
"mapping": [ {
"map": "Event.basedOn",
"identity": "workflow"
}, {
"map": ".outboundRelationship[typeCode=FLFS].target[classCode=(various e.g. PROC, OBS, PCPR, ACT, moodCode=RQO].code",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/CarePlan", "http://hl7.org/fhir/StructureDefinition/ServiceRequest" ]
} ],
"alias": [ "fulfills" ],
"max": "*",
"id": "Procedure.basedOn",
"base": {
"max": "*",
"min": 0,
"path": "Procedure.basedOn"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.partOf",
"min": 0,
"definition": "A larger event of which this particular procedure is a component or step.",
"isModifier": false,
"short": "Part of referenced event",
"mapping": [ {
"map": "Event.partOf",
"identity": "workflow"
}, {
"map": ".inboundRelationship[typeCode=COMP].source[classCode=SBADM or PROC or OBS, moodCode=EVN]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Procedure", "http://hl7.org/fhir/StructureDefinition/Observation", "http://hl7.org/fhir/StructureDefinition/MedicationAdministration" ]
} ],
"alias": [ "container" ],
"max": "*",
"id": "Procedure.partOf",
"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).",
"base": {
"max": "*",
"min": 0,
"path": "Procedure.partOf"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.status",
"min": 1,
"definition": "A code specifying the state of the procedure. Generally, this will be the in-progress or completed state.",
"isModifier": true,
"short": "preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown",
"mapping": [ {
"map": "Event.status",
"identity": "workflow"
}, {
"map": "FiveWs.status",
"identity": "w5"
}, {
"map": "statusCode",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/event-status|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureStatus"
} ],
"description": "A code specifying the state of the procedure."
},
"max": "1",
"id": "Procedure.status",
"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.",
"base": {
"max": "1",
"min": 1,
"path": "Procedure.status"
},
"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
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.statusReason",
"min": 0,
"definition": "Captures the reason for the current state of the procedure.",
"isModifier": false,
"short": "Reason for current status",
"mapping": [ {
"map": "Event.statusReason",
"identity": "workflow"
}, {
"map": ".reason.Observation.value",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/procedure-not-performed-reason",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureNegationReason"
} ],
"description": "A code that identifies the reason a procedure was not performed."
},
"alias": [ "Suspended Reason", "Cancelled Reason" ],
"max": "1",
"id": "Procedure.statusReason",
"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.",
"base": {
"max": "1",
"min": 0,
"path": "Procedure.statusReason"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.category",
"min": 0,
"definition": "A code that classifies the procedure for searching, sorting and display purposes (e.g. \"Surgical Procedure\").",
"isModifier": false,
"short": "Classification of the procedure",
"mapping": [ {
"map": "FiveWs.class",
"identity": "w5"
}, {
"map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"EVN\"].code",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/procedure-category",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureCategory"
} ],
"description": "A code that classifies a procedure for searching, sorting and display purposes."
},
"max": "1",
"id": "Procedure.category",
"base": {
"max": "1",
"min": 0,
"path": "Procedure.category"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.code",
"requirements": "0..1 to account for primarily narrative only resources.",
"min": 1,
"definition": "Identification of the procedure or recording of \"absence of relevant procedures\" or of \"procedures unknown\".",
"isModifier": false,
"short": "Concept - reference to a terminology or just text",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
} ],
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" ]
} ],
"mustSupport": true,
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/procedurecode",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureCode"
} ]
},
"max": "1",
"id": "Procedure.code",
"condition": [ "ele-1" ],
"comment": "Many Canadian implementations use codes from either SNOMED CT and the SNOMED CT Canada Extension to describe this concept, while others may still be using localized code systems or text descriptions. The Procedures - IPS ValueSet contains codes that are subsumed within the SNOMED CT CA ProcedureCode ValueSet that is preferred for this element.\n\nFuture releases of PS-CA may require use of coded entries. In this release, however, implementations that support codings are encouraged to send the codings for codeable concepts if they are available. Consistent with FHIR best practice, receivers should not produce failures or rejections if codings are received. Vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content.",
"base": {
"max": "1",
"min": 0,
"path": "Procedure.code"
}
}, {
"path": "Procedure.code.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "Procedure.code.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Procedure.code.extension",
"min": 0,
"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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Procedure.code.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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.code.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"isModifier": false,
"short": "A reference to a code defined by a terminology system",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
"identity": "v2"
}, {
"map": "CV",
"identity": "rim"
}, {
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
"identity": "orim"
} ],
"slicing": {
"rules": "open",
"description": "Discriminated by the bound value set",
"discriminator": [ {
"path": "$this",
"type": "pattern"
} ]
},
"type": [ {
"code": "Coding",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/Coding-ca-ps" ]
} ],
"max": "*",
"id": "Procedure.code.coding",
"condition": [ "ele-1" ],
"comment": "While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance.\r\n\r\nImplementors that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR).\r\n\r\nAdditionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.code.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "A reference to a code defined by a terminology system.",
"isModifier": false,
"short": "Optional slice for representing SNOMED CT CA codes for primary health care procedures",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
"identity": "v2"
}, {
"map": "CV",
"identity": "rim"
}, {
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
"identity": "orim"
} ],
"type": [ {
"code": "Coding",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/Coding-ca-ps" ]
} ],
"sliceName": "codeSCTCA",
"binding": {
"strength": "required",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/procedurecode",
"description": "SNOMED CT Canadian codes to describe Services/Activities represent activities performed in the provision of health care including invasive procedures, laboratory procedures, administration of medicines, imaging, education, therapies, and administrative procedures. This is the preferred code system for pan-Canadian use and should be provided, or used, if available."
},
"max": "*",
"id": "Procedure.code.coding:codeSCTCA",
"condition": [ "ele-1" ],
"comment": "Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.code.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "This slice reflects that the Canadian Classification of Health Interventions (CCI) is used in some Canadian jurisdictions for procedures. While SNOMED-CT CA is the preferred code system for this element, implementers may encounter CCI codes in some circumstances or jurisdictions.",
"isModifier": false,
"short": "Optional slice to reflect that CCI is used in some Canadian jurisdictions for procedures",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
"identity": "v2"
}, {
"map": "CV",
"identity": "rim"
}, {
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
"identity": "orim"
} ],
"type": [ {
"code": "Coding",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/Coding-ca-ps" ]
} ],
"sliceName": "codeCCI",
"binding": {
"strength": "required",
"valueSet": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CCI",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "codeCCI"
} ],
"description": "Any code from CCI."
},
"max": "*",
"id": "Procedure.code.coding:codeCCI",
"condition": [ "ele-1" ],
"comment": "Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.code.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "This slice reflects that ICD-9 CM is used in some Canadian jurisdictions for procedures. While SNOMED-CT CA is the preferred code system for this element, implementers may encounter ICD-9 CM codes in some circumstances or jurisdictions. Note: Implementers should be cautioned that ICD-9 CM is considered a legacy terminology that is no longer maintained by the organization that developed it.",
"isModifier": false,
"short": "Optional slice to reflect that ICD-9 CM is used in some Canadian jurisdictions for procedures",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
"identity": "v2"
}, {
"map": "CV",
"identity": "rim"
}, {
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
"identity": "orim"
} ],
"type": [ {
"code": "Coding",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/Coding-ca-ps" ]
} ],
"sliceName": "codeICD9CM",
"binding": {
"strength": "required",
"valueSet": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/ICD9CM",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "codeICD9CM"
} ],
"description": "Any code from ICD-9 CM."
},
"max": "*",
"id": "Procedure.code.coding:codeICD9CM",
"condition": [ "ele-1" ],
"comment": "Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.code.coding",
"requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
"min": 0,
"definition": "Code representing the statement \"absent problem\" or the statement \"procedures unknown\"",
"isModifier": false,
"short": "Optional slice for representing a code for absent problem or for unknown procedure",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
"identity": "v2"
}, {
"map": "CV",
"identity": "rim"
}, {
"map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
"identity": "orim"
} ],
"type": [ {
"code": "Coding",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/Coding-ca-ps" ]
} ],
"sliceName": "absentOrUnknownProcedure",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-procedures-uv-ips",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "absentOrUnknownProcedure"
} ],
"description": "A code to identify absent or unknown procedures"
},
"max": "*",
"id": "Procedure.code.coding:absentOrUnknownProcedure",
"condition": [ "ele-1" ],
"comment": "IPS-UV no longer flags this as a Must Support Element. Many systems will not have a field within their data dictionaries that directly corresponds to absentOrUnknownProblem and so the MS flag has been removed. However, it is recommended that systems be able to support the communication of this concept across a number of clinical profiles where population of the clinical element is crucial to clinical interpretation and use.",
"base": {
"max": "*",
"min": 0,
"path": "CodeableConcept.coding"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.code.text",
"requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
"min": 0,
"definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
"isModifier": false,
"short": "Plain text representation of the concept",
"mapping": [ {
"map": "C*E.9. But note many systems use C*E.2 for this",
"identity": "v2"
}, {
"map": "./originalText[mediaType/code=\"text/plain\"]/data",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
"identity": "orim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "Procedure.code.text",
"comment": "Very often the text is the same as a displayName of one of the codings.",
"base": {
"max": "1",
"min": 0,
"path": "CodeableConcept.text"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.subject",
"min": 1,
"definition": "The person on which the procedure was performed.",
"isModifier": false,
"short": "Who the procedure was performed on",
"mapping": [ {
"map": "Event.subject",
"identity": "workflow"
}, {
"map": "FiveWs.subject[x]",
"identity": "w5"
}, {
"map": "PID-3",
"identity": "v2"
}, {
"map": ".participation[typeCode=SBJ].role",
"identity": "rim"
}, {
"map": "FiveWs.subject",
"identity": "w5"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps" ]
} ],
"mustSupport": true,
"alias": [ "patient" ],
"max": "1",
"id": "Procedure.subject",
"base": {
"max": "1",
"min": 1,
"path": "Procedure.subject"
},
"isSummary": true
}, {
"path": "Procedure.subject.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "Procedure.subject.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Procedure.subject.extension",
"min": 0,
"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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Procedure.subject.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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.subject.reference",
"min": 1,
"definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
"isModifier": false,
"short": "Literal reference, Relative, internal or absolute URL",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"max": "1",
"id": "Procedure.subject.reference",
"condition": [ "ref-1" ],
"comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.reference"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.subject.type",
"min": 0,
"definition": "The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.\n\nThe type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. \"Patient\" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).",
"isModifier": false,
"short": "Type the reference refers to (e.g. \"Patient\")",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/resource-types",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "FHIRResourceTypeExt"
} ],
"description": "Aa resource (or, for logical models, the URI of the logical model)."
},
"max": "1",
"id": "Procedure.subject.type",
"comment": "This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.type"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.subject.identifier",
"min": 0,
"definition": "An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
"isModifier": false,
"short": "Logical reference, when literal reference is not known",
"mapping": [ {
"map": ".identifier",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"max": "1",
"id": "Procedure.subject.identifier",
"comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).",
"base": {
"max": "1",
"min": 0,
"path": "Reference.identifier"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.subject.display",
"min": 0,
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"isModifier": false,
"short": "Text alternative for the resource",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "Procedure.subject.display",
"comment": "This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.display"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.encounter",
"min": 0,
"definition": "The Encounter during which this Procedure was created or performed or to which the creation of this record is tightly associated.",
"isModifier": false,
"short": "Encounter created as part of",
"mapping": [ {
"map": "Event.context",
"identity": "workflow"
}, {
"map": "FiveWs.context",
"identity": "w5"
}, {
"map": "PV1-19",
"identity": "v2"
}, {
"map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Encounter" ]
} ],
"max": "1",
"id": "Procedure.encounter",
"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.",
"base": {
"max": "1",
"min": 0,
"path": "Procedure.encounter"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.performed[x]",
"min": 1,
"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.",
"isModifier": false,
"short": "When the procedure was performed",
"mapping": [ {
"map": "Event.occurrence[x]",
"identity": "workflow"
}, {
"map": "FiveWs.done[x]",
"identity": "w5"
}, {
"map": "OBR-7",
"identity": "v2"
}, {
"map": ".effectiveTime",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
}, {
"code": "Period"
}, {
"code": "string"
}, {
"code": "Age"
}, {
"code": "Range"
} ],
"mustSupport": true,
"max": "1",
"id": "Procedure.performed[x]",
"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.",
"base": {
"max": "1",
"min": 0,
"path": "Procedure.performed[x]"
},
"isSummary": true
}, {
"path": "Procedure.performed[x].id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "Procedure.performed[x].id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Procedure.performed[x].extension",
"min": 0,
"definition": "An Extension",
"isModifier": false,
"short": "Extension",
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"max": "*",
"id": "Procedure.performed[x].extension",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Procedure.performed[x].extension",
"min": 0,
"definition": "Provides a reason why the performed is missing.",
"isModifier": false,
"short": "performed[x] absence reason",
"mapping": [ {
"map": "ANY.nullFlavor",
"identity": "rim"
} ],
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/data-absent-reason" ]
} ],
"sliceName": "data-absent-reason",
"max": "1",
"id": "Procedure.performed[x].extension:data-absent-reason",
"comment": "Some Canadian implementations cannot guarantee that a procedure performed date will always be available in every instance of legacy data. Any implementers who do not require a performed date be available on every procedure need to be able to produce a dataAbsentReason extension in order to be conformant",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.recorder",
"min": 0,
"definition": "Individual who recorded the record and takes responsibility for its content.",
"isModifier": false,
"short": "Who recorded the procedure",
"mapping": [ {
"map": "FiveWs.author",
"identity": "w5"
}, {
"map": ".participation[typeCode=AUT].role",
"identity": "rim"
} ],
"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" ]
} ],
"max": "1",
"id": "Procedure.recorder",
"base": {
"max": "1",
"min": 0,
"path": "Procedure.recorder"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.asserter",
"min": 0,
"definition": "Individual who is making the procedure statement.",
"isModifier": false,
"short": "Person who asserts this procedure",
"mapping": [ {
"map": "FiveWs.source",
"identity": "w5"
}, {
"map": ".participation[typeCode=INF].role",
"identity": "rim"
} ],
"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" ]
} ],
"max": "1",
"id": "Procedure.asserter",
"base": {
"max": "1",
"min": 0,
"path": "Procedure.asserter"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.performer",
"min": 0,
"definition": "Limited to \"real\" people rather than equipment.",
"isModifier": false,
"short": "The people who performed the procedure",
"mapping": [ {
"map": "Event.performer",
"identity": "workflow"
}, {
"map": ".participation[typeCode=PRF]",
"identity": "rim"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"max": "*",
"id": "Procedure.performer",
"base": {
"max": "*",
"min": 0,
"path": "Procedure.performer"
},
"isSummary": true
}, {
"path": "Procedure.performer.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "Procedure.performer.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Procedure.performer.extension",
"min": 0,
"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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Procedure.performer.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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Procedure.performer.modifierExtension",
"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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"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).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "Procedure.performer.modifierExtension",
"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.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.performer.function",
"requirements": "Allows disambiguation of the types of involvement of different performers.",
"min": 0,
"definition": "Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist.",
"isModifier": false,
"short": "Type of performance",
"mapping": [ {
"map": "Event.performer.function",
"identity": "workflow"
}, {
"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": "v2"
}, {
"map": ".functionCode",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/performer-role",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedurePerformerRole"
} ],
"description": "A code that identifies the role of a performer of the procedure."
},
"max": "1",
"id": "Procedure.performer.function",
"base": {
"max": "1",
"min": 0,
"path": "Procedure.performer.function"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.performer.actor",
"requirements": "A reference to Device supports use cases, such as pacemakers.",
"min": 1,
"definition": "The practitioner who was involved in the procedure.",
"isModifier": false,
"short": "The reference to the practitioner",
"mapping": [ {
"map": "Event.performer.actor",
"identity": "workflow"
}, {
"map": "FiveWs.actor",
"identity": "w5"
}, {
"map": "ORC-19/PRT-5",
"identity": "v2"
}, {
"map": ".role",
"identity": "rim"
} ],
"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" ]
} ],
"max": "1",
"id": "Procedure.performer.actor",
"base": {
"max": "1",
"min": 1,
"path": "Procedure.performer.actor"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.performer.onBehalfOf",
"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,
"definition": "The organization the device or practitioner was acting on behalf of.",
"isModifier": false,
"short": "Organization the device or practitioner was acting for",
"mapping": [ {
"map": ".scoper",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ],
"max": "1",
"id": "Procedure.performer.onBehalfOf",
"base": {
"max": "1",
"min": 0,
"path": "Procedure.performer.onBehalfOf"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.location",
"requirements": "Ties a procedure to where the records are likely kept.",
"min": 0,
"definition": "The location where the procedure actually happened. E.g. a newborn at home, a tracheostomy at a restaurant.",
"isModifier": false,
"short": "Where the procedure happened",
"mapping": [ {
"map": "FiveWs.where[x]",
"identity": "w5"
}, {
"map": ".participation[typeCode=LOC].role[classCode=SDLOC]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Location" ]
} ],
"max": "1",
"id": "Procedure.location",
"base": {
"max": "1",
"min": 0,
"path": "Procedure.location"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.reasonCode",
"min": 0,
"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.",
"isModifier": false,
"short": "Coded reason procedure performed",
"mapping": [ {
"map": "Event.reasonCode",
"identity": "workflow"
}, {
"map": "FiveWs.why[x]",
"identity": "w5"
}, {
"map": ".reasonCode",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/procedure-reason",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureReason"
} ],
"description": "A code that identifies the reason a procedure is required."
},
"max": "*",
"id": "Procedure.reasonCode",
"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.",
"base": {
"max": "*",
"min": 0,
"path": "Procedure.reasonCode"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.reasonReference",
"min": 0,
"definition": "The justification of why the procedure was performed.",
"isModifier": false,
"short": "The justification that the procedure was performed",
"mapping": [ {
"map": "Event.reasonReference",
"identity": "workflow"
}, {
"map": "FiveWs.why[x]",
"identity": "w5"
}, {
"map": ".reasonCode",
"identity": "rim"
} ],
"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" ]
} ],
"max": "*",
"id": "Procedure.reasonReference",
"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.",
"base": {
"max": "*",
"min": 0,
"path": "Procedure.reasonReference"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.bodySite",
"min": 0,
"definition": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"isModifier": false,
"short": "Concept - reference to a terminology or just text",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
} ],
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" ]
} ],
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/anatomicaloracquiredbodystructurecode",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "BodySite"
} ]
},
"max": "*",
"id": "Procedure.bodySite",
"condition": [ "ele-1" ],
"comment": "IPS-UV no longer flags this as a Must Support Element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received.",
"base": {
"max": "*",
"min": 0,
"path": "Procedure.bodySite"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.outcome",
"min": 0,
"definition": "The outcome of the procedure - did it resolve the reasons for the procedure being performed?",
"isModifier": false,
"short": "The result of procedure",
"mapping": [ {
"map": ".outboundRelationship[typeCode=OUT].target.text",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/procedure-outcome",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureOutcome"
} ],
"description": "An outcome of a procedure - whether it was resolved or otherwise."
},
"max": "1",
"id": "Procedure.outcome",
"comment": "If outcome contains narrative text only, it can be captured using the CodeableConcept.text.",
"base": {
"max": "1",
"min": 0,
"path": "Procedure.outcome"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.report",
"min": 0,
"definition": "This could be a histology result, pathology report, surgical report, etc.",
"isModifier": false,
"short": "Any report resulting from the procedure",
"mapping": [ {
"map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/DiagnosticReport", "http://hl7.org/fhir/StructureDefinition/DocumentReference", "http://hl7.org/fhir/StructureDefinition/Composition" ]
} ],
"max": "*",
"id": "Procedure.report",
"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.",
"base": {
"max": "*",
"min": 0,
"path": "Procedure.report"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.complication",
"min": 0,
"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.",
"isModifier": false,
"short": "Complication following the procedure",
"mapping": [ {
"map": ".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code=\"complication\", moodCode=EVN].value",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/condition-code",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureComplication"
} ],
"description": "Codes describing complications that resulted from a procedure."
},
"max": "*",
"id": "Procedure.complication",
"comment": "If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.",
"base": {
"max": "*",
"min": 0,
"path": "Procedure.complication"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.complicationDetail",
"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,
"definition": "Any complications that occurred during the procedure, or in the immediate post-performance period.",
"isModifier": false,
"short": "A condition that is a result of the procedure",
"mapping": [ {
"map": ".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code=\"complication\", moodCode=EVN].value",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Condition" ]
} ],
"max": "*",
"id": "Procedure.complicationDetail",
"base": {
"max": "*",
"min": 0,
"path": "Procedure.complicationDetail"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.followUp",
"min": 0,
"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.",
"isModifier": false,
"short": "Instructions for follow up",
"mapping": [ {
"map": ".outboundRelationship[typeCode=COMP].target[classCode=ACT, moodCode=INT].code",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/procedure-followup",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureFollowUp"
} ],
"description": "Specific follow up required for a procedure e.g. removal of sutures."
},
"max": "*",
"id": "Procedure.followUp",
"base": {
"max": "*",
"min": 0,
"path": "Procedure.followUp"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.note",
"min": 0,
"definition": "Any other notes and comments about the procedure.",
"isModifier": false,
"short": "Additional information about the procedure",
"mapping": [ {
"map": "Event.note",
"identity": "workflow"
}, {
"map": "NTE",
"identity": "v2"
}, {
"map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"annotation\"].value",
"identity": "rim"
} ],
"type": [ {
"code": "Annotation"
} ],
"max": "*",
"id": "Procedure.note",
"base": {
"max": "*",
"min": 0,
"path": "Procedure.note"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.focalDevice",
"min": 0,
"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.",
"isModifier": false,
"short": "Manipulated, implanted, or removed device",
"mapping": [ {
"map": ".participation[typeCode=DEV].role[classCode=MANU]",
"identity": "rim"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"max": "*",
"id": "Procedure.focalDevice",
"base": {
"max": "*",
"min": 0,
"path": "Procedure.focalDevice"
},
"isSummary": false
}, {
"path": "Procedure.focalDevice.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "Procedure.focalDevice.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Procedure.focalDevice.extension",
"min": 0,
"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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Procedure.focalDevice.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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Procedure.focalDevice.modifierExtension",
"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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"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).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "Procedure.focalDevice.modifierExtension",
"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.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.focalDevice.action",
"min": 0,
"definition": "The kind of change that happened to the device during the procedure.",
"isModifier": false,
"short": "Kind of change to device",
"mapping": [ {
"map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"procedure device action\"].value=:procedure device action codes",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/ValueSet/device-action",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DeviceActionKind"
} ],
"description": "A kind of change that happened to the device during the procedure."
},
"max": "1",
"id": "Procedure.focalDevice.action",
"base": {
"max": "1",
"min": 0,
"path": "Procedure.focalDevice.action"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.focalDevice.manipulated",
"min": 1,
"definition": "The device that was manipulated (changed) during the procedure.",
"isModifier": false,
"short": "Device that was changed",
"mapping": [ {
"map": ".participation[typeCode=DEV].role[classCode=SDLOC]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Device" ]
} ],
"max": "1",
"id": "Procedure.focalDevice.manipulated",
"base": {
"max": "1",
"min": 1,
"path": "Procedure.focalDevice.manipulated"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.usedReference",
"requirements": "Used for tracking contamination, etc.",
"min": 0,
"definition": "Identifies medications, devices and any other substance used as part of the procedure.",
"isModifier": false,
"short": "Items used during procedure",
"mapping": [ {
"map": ".participation[typeCode=DEV].role[classCode=MANU] or\n.participation[typeCode=CSM].role[classCode=ADMM] (for Medication or Substance)",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Device", "http://hl7.org/fhir/StructureDefinition/Medication", "http://hl7.org/fhir/StructureDefinition/Substance" ]
} ],
"max": "*",
"id": "Procedure.usedReference",
"comment": "For devices actually implanted or removed, use Procedure.device.",
"base": {
"max": "*",
"min": 0,
"path": "Procedure.usedReference"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Procedure.usedCode",
"min": 0,
"definition": "Identifies coded items that were used as part of the procedure.",
"isModifier": false,
"short": "Coded items used during the procedure",
"mapping": [ {
"map": "participation[typeCode=Dev].role[classCode=MANU]",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/device-kind",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureUsed"
} ],
"description": "Codes describing items used during a procedure."
},
"max": "*",
"id": "Procedure.usedCode",
"comment": "For devices actually implanted or removed, use Procedure.device.",
"base": {
"max": "*",
"min": 0,
"path": "Procedure.usedCode"
},
"isSummary": false
} ]
},
"status": "active",
"id": "348919ef-fe33-41f6-b92c-f76ea108fc63",
"kind": "resource",
"url": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/procedure-ca-ps",
"version": "1.0.0",
"differential": {
"element": [ {
"id": "Procedure",
"path": "Procedure"
}, {
"id": "Procedure.status",
"path": "Procedure.status",
"mustSupport": true
}, {
"path": "Procedure.code",
"min": 1,
"definition": "Identification of the procedure or recording of \"absence of relevant procedures\" or of \"procedures unknown\".",
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" ]
} ],
"mustSupport": true,
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/procedurecode",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcedureCode"
} ]
},
"max": "1",
"id": "Procedure.code",
"comment": "Many Canadian implementations use codes from either SNOMED CT and the SNOMED CT Canada Extension to describe this concept, while others may still be using localized code systems or text descriptions. The Procedures - IPS ValueSet contains codes that are subsumed within the SNOMED CT CA ProcedureCode ValueSet that is preferred for this element.\n\nFuture releases of PS-CA may require use of coded entries. In this release, however, implementations that support codings are encouraged to send the codings for codeable concepts if they are available. Consistent with FHIR best practice, receivers should not produce failures or rejections if codings are received. Vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content."
}, {
"id": "Procedure.code.coding",
"path": "Procedure.code.coding",
"slicing": {
"rules": "open",
"description": "Discriminated by the bound value set",
"discriminator": [ {
"path": "$this",
"type": "pattern"
} ]
}
}, {
"id": "Procedure.code.coding:codeSCTCA",
"path": "Procedure.code.coding",
"short": "Optional slice for representing SNOMED CT CA codes for primary health care procedures",
"binding": {
"strength": "required",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/procedurecode",
"description": "SNOMED CT Canadian codes to describe Services/Activities represent activities performed in the provision of health care including invasive procedures, laboratory procedures, administration of medicines, imaging, education, therapies, and administrative procedures. This is the preferred code system for pan-Canadian use and should be provided, or used, if available."
},
"sliceName": "codeSCTCA"
}, {
"id": "Procedure.code.coding:codeCCI",
"path": "Procedure.code.coding",
"short": "Optional slice to reflect that CCI is used in some Canadian jurisdictions for procedures",
"binding": {
"strength": "required",
"valueSet": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CCI",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "codeCCI"
} ],
"description": "Any code from CCI."
},
"sliceName": "codeCCI",
"definition": "This slice reflects that the Canadian Classification of Health Interventions (CCI) is used in some Canadian jurisdictions for procedures. While SNOMED-CT CA is the preferred code system for this element, implementers may encounter CCI codes in some circumstances or jurisdictions."
}, {
"id": "Procedure.code.coding:codeICD9CM",
"path": "Procedure.code.coding",
"short": "Optional slice to reflect that ICD-9 CM is used in some Canadian jurisdictions for procedures",
"binding": {
"strength": "required",
"valueSet": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/ICD9CM",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "codeICD9CM"
} ],
"description": "Any code from ICD-9 CM."
},
"sliceName": "codeICD9CM",
"definition": "This slice reflects that ICD-9 CM is used in some Canadian jurisdictions for procedures. While SNOMED-CT CA is the preferred code system for this element, implementers may encounter ICD-9 CM codes in some circumstances or jurisdictions. Note: Implementers should be cautioned that ICD-9 CM is considered a legacy terminology that is no longer maintained by the organization that developed it."
}, {
"id": "Procedure.code.coding:absentOrUnknownProcedure",
"path": "Procedure.code.coding",
"short": "Optional slice for representing a code for absent problem or for unknown procedure",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-procedures-uv-ips",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "absentOrUnknownProcedure"
} ],
"description": "A code to identify absent or unknown procedures"
},
"comment": "IPS-UV no longer flags this as a Must Support Element. Many systems will not have a field within their data dictionaries that directly corresponds to absentOrUnknownProblem and so the MS flag has been removed. However, it is recommended that systems be able to support the communication of this concept across a number of clinical profiles where population of the clinical element is crucial to clinical interpretation and use.",
"sliceName": "absentOrUnknownProcedure",
"definition": "Code representing the statement \"absent problem\" or the statement \"procedures unknown\""
}, {
"id": "Procedure.subject",
"path": "Procedure.subject",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps" ]
} ],
"definition": "The person on which the procedure was performed.",
"mustSupport": true
}, {
"id": "Procedure.subject.reference",
"min": 1,
"path": "Procedure.subject.reference",
"mustSupport": true
}, {
"id": "Procedure.performed[x]",
"max": "1",
"min": 1,
"path": "Procedure.performed[x]",
"mustSupport": true
}, {
"id": "Procedure.performed[x].extension",
"path": "Procedure.performed[x].extension",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
}
}, {
"id": "Procedure.performed[x].extension:data-absent-reason",
"max": "1",
"path": "Procedure.performed[x].extension",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/data-absent-reason" ]
} ],
"short": "performed[x] absence reason",
"comment": "Some Canadian implementations cannot guarantee that a procedure performed date will always be available in every instance of legacy data. Any implementers who do not require a performed date be available on every procedure need to be able to produce a dataAbsentReason extension in order to be conformant",
"sliceName": "data-absent-reason",
"definition": "Provides a reason why the performed is missing."
}, {
"id": "Procedure.bodySite",
"path": "Procedure.bodySite",
"type": [ {
"code": "CodeableConcept",
"profile": [ "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" ]
} ],
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/anatomicaloracquiredbodystructurecode",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "BodySite"
} ]
},
"comment": "IPS-UV no longer flags this as a Must Support Element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received."
} ]
},
"contact": [ {
"name": "National Standards Release Centre",
"telecom": [ {
"value": "http://www.infoway-inforoute.ca",
"system": "url"
}, {
"value": "standards@infoway-inforoute.ca",
"system": "email"
} ]
} ],
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Procedure"
}