{
  "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-profile-procedure-ca-ps.json",
  "package_name": "ca.infoway.io.psca",
  "date": "2023-11-06T00:00:00-08:00",
  "derivation": "constraint",
  "publisher": null,
  "fhirVersion": "4.0.1",
  "name": "ProcedurePSCA",
  "abstract": false,
  "copyright": "Copyright © 2024+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
  "type": "Procedure",
  "experimental": "false",
  "resourceType": "StructureDefinition",
  "title": "Procedure (PS-CA)",
  "package_version": "2.0.0-DFT-Ballot",
  "status": "draft",
  "id": "450232a8-4512-4629-84c5-d8f4d7ec8f97",
  "kind": "resource",
  "url": "http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/procedure-ca-ps",
  "version": null,
  "differential": {
    "element": [ {
      "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"
        }, {
          "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
          "extension": [ {
            "url": "purpose",
            "valueCode": "candidate"
          }, {
            "url": "valueSet",
            "valueCanonical": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CCI"
          }, {
            "url": "documentation",
            "valueMarkdown": "Any code from CCI. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology."
          } ]
        }, {
          "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
          "extension": [ {
            "url": "purpose",
            "valueCode": "candidate"
          }, {
            "url": "valueSet",
            "valueCanonical": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/ICD9CM"
          }, {
            "url": "documentation",
            "valueMarkdown": "Any code from ICD-9 CM. While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology."
          } ]
        }, {
          "url": "http://hl7.org/fhir/tools/StructureDefinition/additional-binding",
          "extension": [ {
            "url": "purpose",
            "valueCode": "candidate"
          }, {
            "url": "valueSet",
            "valueCanonical": "http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-procedures-uv-ips"
          }, {
            "url": "documentation",
            "valueMarkdown": "Code to identify absent or unknown procedures."
          } ]
        } ]
      },
      "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.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."
    } ]
  },
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Procedure"
}