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Resource Profile: Procedure

Procedure as used within PLUGIN. Inherits from nl-core-Procedure-event.

Usage:

• This Resource Profile is not used by any profiles in this Implementation Guide

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from NlcoreProcedureevent

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	NlcoreProcedureevent	Procedure
extension		1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
episodeOfCare		1..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
code		1..1	CodeableConcept	ProcedureType
subject		1..1	Reference(Patient | nl core Patient | Patient)	Who the procedure was performed on
reasonReference		1..*	Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference | nl core Problem)	Indication
bodySite
Slices for extension				Content/Rules for all slices
extension:laterality	S	0..1	ExtAnatomicalLocationLaterality	Optional Extensions Element
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	NlcoreProcedureevent	Procedure
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
procedureMethod	N	0..*	CodeableConcept	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-Procedure.ProcedureMethod Binding: VerrichtingMethodeCodelijst (required)
episodeOfCare		1..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
modifierExtension	?!N	0..*	Extension	Extensions that cannot be ignored Slice: Unordered, Open by value:url
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
code	Σ	1..1	CodeableConcept	ProcedureType Binding: VerrichtingTypeCodelijsten (required): A code to identify a specific procedure .
subject	ΣC	1..1	Reference(Patient | nl core Patient | Patient)	Who the procedure was performed on ref-1: SHALL have a contained resource if a local reference is provided
Slices for performed[x]	ΣN	0..1		When the procedure was performed Slice: Unordered, Open by type:$this
performedDateTime			dateTime
performedPeriod			Period
performedString			string
performedAge			Age
performedRange			Range
performed[x]:performedPeriod	ΣN	0..1	Period	When the procedure was performed
start	ΣC	0..1	dateTime	ProcedureStartDate
end	ΣC	0..1	dateTime	ProcedureEndDate
performed[x]:performedDateTime	ΣN	0..1	dateTime	ProcedureStartDate
reasonReference	ΣC	1..*	Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference | nl core Problem)	Indication ref-1: SHALL have a contained resource if a local reference is provided
bodySite	Σ	0..1	NlcoreAnatomicalLocation	Location Binding: LocatieCodelijsten (required): Codes describing anatomical locations. May include laterality.
Slices for extension				Content/Rules for all slices
laterality	S	0..1	CodeableConcept	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-AnatomicalLocation.Laterality Binding: LateraliteitCodelijst (required)
Slices for report	CN	0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Any report resulting from the procedure Slice: Unordered, Open by profile:resolve() ref-1: SHALL have a contained resource if a local reference is provided
report:textResult	CN	0..*	Reference(nl core TextResult)	TextResult ref-1: SHALL have a contained resource if a local reference is provided
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 from the FHIR Standard
Procedure.code	required	VerrichtingTypeCodelijsten http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.19--20200901000000
Procedure.bodySite	required	LocatieCodelijsten http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.11--20200901000000

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Procedure	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Procedure	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ref-1	error	Procedure.subject, Procedure.reasonReference, Procedure.report, Procedure.report:textResult	SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	NlcoreProcedureevent	Procedure
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
procedureMethod	N	0..*	CodeableConcept	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-Procedure.ProcedureMethod Binding: VerrichtingMethodeCodelijst (required)
episodeOfCare		1..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
modifierExtension	?!N	0..*	Extension	Extensions that cannot be ignored Slice: Unordered, Open by value:url
identifier	Σ	0..*	Identifier	External Identifiers for this procedure
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	ΣC	0..*	Reference(CarePlan | ServiceRequest | nl core Procedure request)	A request for this procedure ref-1: SHALL have a contained resource if a local reference is provided
partOf	ΣC	0..*	Reference(Procedure | Observation | MedicationAdministration)	Part of referenced event ref-1: SHALL have a contained resource if a local reference is provided
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
statusReason	Σ	0..1	CodeableConcept	Reason for current status Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.
category	Σ	0..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes.
code	Σ	1..1	CodeableConcept	ProcedureType Binding: VerrichtingTypeCodelijsten (required): A code to identify a specific procedure .
subject	ΣC	1..1	Reference(Patient | nl core Patient | Patient)	Who the procedure was performed on ref-1: SHALL have a contained resource if a local reference is provided
encounter	ΣC	0..1	Reference(Encounter)	Encounter created as part of ref-1: SHALL have a contained resource if a local reference is provided
Slices for performed[x]	ΣN	0..1		When the procedure was performed Slice: Unordered, Open by type:$this
performedDateTime			dateTime
performedPeriod			Period
performedString			string
performedAge			Age
performedRange			Range
performed[x]:performedPeriod	ΣN	0..1	Period	When the procedure was performed
id		0..1	string	Unique id for inter-element referencing
extension	N	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	ΣC	0..1	dateTime	ProcedureStartDate
end	ΣC	0..1	dateTime	ProcedureEndDate
performed[x]:performedDateTime	ΣN	0..1	dateTime	ProcedureStartDate
recorder	ΣC	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Who recorded the procedure ref-1: SHALL have a contained resource if a local reference is provided
asserter	ΣC	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Person who asserts this procedure ref-1: SHALL have a contained resource if a local reference is provided
performer	Σ	0..*	BackboneElement	The people who performed the procedure
id		0..1	string	Unique id for inter-element referencing
extension	N	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
actor	ΣC	1..1	PatternNlCoreHealthProfessionalReference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device | nl core HealthProfessional PractitionerRole)	A reference from one resource to another ref-1: SHALL have a contained resource if a local reference is provided
onBehalfOf	C	0..1	Reference(Organization)	Organization the device or practitioner was acting for ref-1: SHALL have a contained resource if a local reference is provided
location	ΣC	0..1	Reference(Location | nl core HealthcareProvider)	Location ref-1: SHALL have a contained resource if a local reference is provided
reasonCode	Σ	0..*	CodeableConcept	Coded reason procedure performed Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required.
reasonReference	ΣC	1..*	Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference | nl core Problem)	Indication ref-1: SHALL have a contained resource if a local reference is provided
bodySite	Σ	0..1	NlcoreAnatomicalLocation	Location Binding: LocatieCodelijsten (required): Codes describing anatomical locations. May include laterality.
id		0..1	string	Unique id for inter-element referencing
Slices for extension	N	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
laterality	S	0..1	CodeableConcept	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-AnatomicalLocation.Laterality Binding: LateraliteitCodelijst (required)
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
outcome	Σ	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
Slices for report	CN	0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Any report resulting from the procedure Slice: Unordered, Open by profile:resolve() ref-1: SHALL have a contained resource if a local reference is provided
report:textResult	CN	0..*	Reference(nl core TextResult)	TextResult ref-1: SHALL have a contained resource if a local reference is provided
complication		0..*	CodeableConcept	Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
complicationDetail	C	0..*	Reference(Condition)	A condition that is a result of the procedure ref-1: SHALL have a contained resource if a local reference is provided
followUp		0..*	CodeableConcept	Instructions for follow up Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.
note		0..*	Annotation	Additional information about the procedure
focalDevice		0..*	BackboneElement	Manipulated, implanted, or removed device
id		0..1	string	Unique id for inter-element referencing
extension	N	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
action		0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.
manipulated	C	1..1	Reference(Device)	Device that was changed ref-1: SHALL have a contained resource if a local reference is provided
usedReference	C	0..*	Reference(Device | Medication | Substance)	Items used during procedure ref-1: SHALL have a contained resource if a local reference is provided
usedCode		0..*	CodeableConcept	Coded items used during the procedure Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Procedure.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 from the FHIR Standard
Procedure.statusReason	example	ProcedureNotPerformedReason(SNOMED-CT) http://hl7.org/fhir/ValueSet/procedure-not-performed-reason from the FHIR Standard
Procedure.category	example	ProcedureCategoryCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-category from the FHIR Standard
Procedure.code	required	VerrichtingTypeCodelijsten http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.19--20200901000000
Procedure.performer.function	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
Procedure.reasonCode	example	ProcedureReasonCodes http://hl7.org/fhir/ValueSet/procedure-reason from the FHIR Standard
Procedure.bodySite	required	LocatieCodelijsten http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.11--20200901000000
Procedure.outcome	example	ProcedureOutcomeCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-outcome from the FHIR Standard
Procedure.complication	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
Procedure.followUp	example	ProcedureFollowUpCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-followup from the FHIR Standard
Procedure.focalDevice.action	preferred	ProcedureDeviceActionCodes http://hl7.org/fhir/ValueSet/device-action from the FHIR Standard
Procedure.usedCode	example	FHIRDeviceTypes http://hl7.org/fhir/ValueSet/device-kind from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Procedure	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Procedure	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ref-1	error	Procedure.basedOn, Procedure.partOf, Procedure.subject, Procedure.encounter, Procedure.recorder, Procedure.asserter, Procedure.performer.actor, Procedure.performer.onBehalfOf, Procedure.location, Procedure.reasonReference, Procedure.report, Procedure.report:textResult, Procedure.complicationDetail, Procedure.focalDevice.manipulated, Procedure.usedReference	SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

This structure is derived from NlcoreProcedureevent

Summary

Mandatory: 4 elements
Must-Support: 1 element

Structures

This structure refers to these other structures:

• nl core Patient (http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient)
• Patient (https://plugin.healthcare/fhir/StructureDefinition/plugin-patient)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare

Differential View

This structure is derived from NlcoreProcedureevent

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	NlcoreProcedureevent	Procedure
extension		1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
episodeOfCare		1..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
code		1..1	CodeableConcept	ProcedureType
subject		1..1	Reference(Patient | nl core Patient | Patient)	Who the procedure was performed on
reasonReference		1..*	Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference | nl core Problem)	Indication
bodySite
Slices for extension				Content/Rules for all slices
extension:laterality	S	0..1	ExtAnatomicalLocationLaterality	Optional Extensions Element
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	NlcoreProcedureevent	Procedure
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
procedureMethod	N	0..*	CodeableConcept	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-Procedure.ProcedureMethod Binding: VerrichtingMethodeCodelijst (required)
episodeOfCare		1..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
modifierExtension	?!N	0..*	Extension	Extensions that cannot be ignored Slice: Unordered, Open by value:url
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
code	Σ	1..1	CodeableConcept	ProcedureType Binding: VerrichtingTypeCodelijsten (required): A code to identify a specific procedure .
subject	ΣC	1..1	Reference(Patient | nl core Patient | Patient)	Who the procedure was performed on ref-1: SHALL have a contained resource if a local reference is provided
Slices for performed[x]	ΣN	0..1		When the procedure was performed Slice: Unordered, Open by type:$this
performedDateTime			dateTime
performedPeriod			Period
performedString			string
performedAge			Age
performedRange			Range
performed[x]:performedPeriod	ΣN	0..1	Period	When the procedure was performed
start	ΣC	0..1	dateTime	ProcedureStartDate
end	ΣC	0..1	dateTime	ProcedureEndDate
performed[x]:performedDateTime	ΣN	0..1	dateTime	ProcedureStartDate
reasonReference	ΣC	1..*	Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference | nl core Problem)	Indication ref-1: SHALL have a contained resource if a local reference is provided
bodySite	Σ	0..1	NlcoreAnatomicalLocation	Location Binding: LocatieCodelijsten (required): Codes describing anatomical locations. May include laterality.
Slices for extension				Content/Rules for all slices
laterality	S	0..1	CodeableConcept	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-AnatomicalLocation.Laterality Binding: LateraliteitCodelijst (required)
Slices for report	CN	0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Any report resulting from the procedure Slice: Unordered, Open by profile:resolve() ref-1: SHALL have a contained resource if a local reference is provided
report:textResult	CN	0..*	Reference(nl core TextResult)	TextResult ref-1: SHALL have a contained resource if a local reference is provided
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 from the FHIR Standard
Procedure.code	required	VerrichtingTypeCodelijsten http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.19--20200901000000
Procedure.bodySite	required	LocatieCodelijsten http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.11--20200901000000

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Procedure	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Procedure	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ref-1	error	Procedure.subject, Procedure.reasonReference, Procedure.report, Procedure.report:textResult	SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	NlcoreProcedureevent	Procedure
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
procedureMethod	N	0..*	CodeableConcept	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-Procedure.ProcedureMethod Binding: VerrichtingMethodeCodelijst (required)
episodeOfCare		1..1	Reference(EpisodeOfCare)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
modifierExtension	?!N	0..*	Extension	Extensions that cannot be ignored Slice: Unordered, Open by value:url
identifier	Σ	0..*	Identifier	External Identifiers for this procedure
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	ΣC	0..*	Reference(CarePlan | ServiceRequest | nl core Procedure request)	A request for this procedure ref-1: SHALL have a contained resource if a local reference is provided
partOf	ΣC	0..*	Reference(Procedure | Observation | MedicationAdministration)	Part of referenced event ref-1: SHALL have a contained resource if a local reference is provided
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
statusReason	Σ	0..1	CodeableConcept	Reason for current status Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.
category	Σ	0..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes.
code	Σ	1..1	CodeableConcept	ProcedureType Binding: VerrichtingTypeCodelijsten (required): A code to identify a specific procedure .
subject	ΣC	1..1	Reference(Patient | nl core Patient | Patient)	Who the procedure was performed on ref-1: SHALL have a contained resource if a local reference is provided
encounter	ΣC	0..1	Reference(Encounter)	Encounter created as part of ref-1: SHALL have a contained resource if a local reference is provided
Slices for performed[x]	ΣN	0..1		When the procedure was performed Slice: Unordered, Open by type:$this
performedDateTime			dateTime
performedPeriod			Period
performedString			string
performedAge			Age
performedRange			Range
performed[x]:performedPeriod	ΣN	0..1	Period	When the procedure was performed
id		0..1	string	Unique id for inter-element referencing
extension	N	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	ΣC	0..1	dateTime	ProcedureStartDate
end	ΣC	0..1	dateTime	ProcedureEndDate
performed[x]:performedDateTime	ΣN	0..1	dateTime	ProcedureStartDate
recorder	ΣC	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Who recorded the procedure ref-1: SHALL have a contained resource if a local reference is provided
asserter	ΣC	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Person who asserts this procedure ref-1: SHALL have a contained resource if a local reference is provided
performer	Σ	0..*	BackboneElement	The people who performed the procedure
id		0..1	string	Unique id for inter-element referencing
extension	N	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
actor	ΣC	1..1	PatternNlCoreHealthProfessionalReference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device | nl core HealthProfessional PractitionerRole)	A reference from one resource to another ref-1: SHALL have a contained resource if a local reference is provided
onBehalfOf	C	0..1	Reference(Organization)	Organization the device or practitioner was acting for ref-1: SHALL have a contained resource if a local reference is provided
location	ΣC	0..1	Reference(Location | nl core HealthcareProvider)	Location ref-1: SHALL have a contained resource if a local reference is provided
reasonCode	Σ	0..*	CodeableConcept	Coded reason procedure performed Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required.
reasonReference	ΣC	1..*	Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference | nl core Problem)	Indication ref-1: SHALL have a contained resource if a local reference is provided
bodySite	Σ	0..1	NlcoreAnatomicalLocation	Location Binding: LocatieCodelijsten (required): Codes describing anatomical locations. May include laterality.
id		0..1	string	Unique id for inter-element referencing
Slices for extension	N	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
laterality	S	0..1	CodeableConcept	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-AnatomicalLocation.Laterality Binding: LateraliteitCodelijst (required)
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
outcome	Σ	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
Slices for report	CN	0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Any report resulting from the procedure Slice: Unordered, Open by profile:resolve() ref-1: SHALL have a contained resource if a local reference is provided
report:textResult	CN	0..*	Reference(nl core TextResult)	TextResult ref-1: SHALL have a contained resource if a local reference is provided
complication		0..*	CodeableConcept	Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
complicationDetail	C	0..*	Reference(Condition)	A condition that is a result of the procedure ref-1: SHALL have a contained resource if a local reference is provided
followUp		0..*	CodeableConcept	Instructions for follow up Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.
note		0..*	Annotation	Additional information about the procedure
focalDevice		0..*	BackboneElement	Manipulated, implanted, or removed device
id		0..1	string	Unique id for inter-element referencing
extension	N	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
action		0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.
manipulated	C	1..1	Reference(Device)	Device that was changed ref-1: SHALL have a contained resource if a local reference is provided
usedReference	C	0..*	Reference(Device | Medication | Substance)	Items used during procedure ref-1: SHALL have a contained resource if a local reference is provided
usedCode		0..*	CodeableConcept	Coded items used during the procedure Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Procedure.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 from the FHIR Standard
Procedure.statusReason	example	ProcedureNotPerformedReason(SNOMED-CT) http://hl7.org/fhir/ValueSet/procedure-not-performed-reason from the FHIR Standard
Procedure.category	example	ProcedureCategoryCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-category from the FHIR Standard
Procedure.code	required	VerrichtingTypeCodelijsten http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.19--20200901000000
Procedure.performer.function	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
Procedure.reasonCode	example	ProcedureReasonCodes http://hl7.org/fhir/ValueSet/procedure-reason from the FHIR Standard
Procedure.bodySite	required	LocatieCodelijsten http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.11--20200901000000
Procedure.outcome	example	ProcedureOutcomeCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-outcome from the FHIR Standard
Procedure.complication	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
Procedure.followUp	example	ProcedureFollowUpCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-followup from the FHIR Standard
Procedure.focalDevice.action	preferred	ProcedureDeviceActionCodes http://hl7.org/fhir/ValueSet/device-action from the FHIR Standard
Procedure.usedCode	example	FHIRDeviceTypes http://hl7.org/fhir/ValueSet/device-kind from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Procedure	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Procedure	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ref-1	error	Procedure.basedOn, Procedure.partOf, Procedure.subject, Procedure.encounter, Procedure.recorder, Procedure.asserter, Procedure.performer.actor, Procedure.performer.onBehalfOf, Procedure.location, Procedure.reasonReference, Procedure.report, Procedure.report:textResult, Procedure.complicationDetail, Procedure.focalDevice.manipulated, Procedure.usedReference	SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

This structure is derived from NlcoreProcedureevent

Summary

Mandatory: 4 elements
Must-Support: 1 element

Structures

This structure refers to these other structures:

• nl core Patient (http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient)
• Patient (https://plugin.healthcare/fhir/StructureDefinition/plugin-patient)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare

Other representations of profile: CSV, Excel, Schematron