PLUGIN
0.1.0-ci - ci-build NL

PLUGIN - Local Development build (v0.1.0-ci) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: PluginProcedure - XML Profile

Draft as of 2024-11-05

XML representation of the plugin-Procedure resource profile.

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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="plugin-Procedure"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: StructureDefinition plugin-Procedure</b></p><a name="plugin-Procedure"> </a><a name="hcplugin-Procedure"> </a><a name="plugin-Procedure-en-US"> </a><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3goXBCwdPqAP0wAAAldJREFUOMuNk0tIlFEYhp9z/vE2jHkhxXA0zJCMitrUQlq4lnSltEqCFhFG2MJFhIvIFpkEWaTQqjaWZRkp0g26URZkTpbaaOJkDqk10szoODP//7XIMUe0elcfnPd9zsfLOYplGrpRwZaqTtw3K7PtGem7Q6FoidbGgqHVy/HRb669R+56zx7eRV1L31JGxYbBtjKK93cxeqfyQHbehkZbUkK20goELEuIzEd+dHS+qz/Y8PTSif0FnGkbiwcAjHaU1+QWOptFiyCLp/LnKptpqIuXHx6rbR26kJcBX3yLgBfnd7CxwJmflpP2wUg0HIAoUUpZBmKzELGWcN8nAr6Gpu7tLU/CkwAaoKTWRSQyt89Q8w6J+oVQkKnBoblH7V0PPvUOvDYXfopE/SJmALsxnVm6LbkotrUtNowMeIrVrBcBpaMmdS0j9df7abpSuy7HWehwJdt1lhVwi/J58U5beXGAF6c3UXLycw1wdFklArBn87xdh0ZsZtArghBdAA3+OEDVubG4UEzP6x1FOWneHh2VDAHBAt80IbdXDcesNoCvs3E5AFyNSU5nbrDPZpcUEQQTFZiEVx+51fxMhhyJEAgvlriadIJZZksRuwBYMOPBbO3hePVVqgEJhFeUuFLhIPkRP6BQLIBrmMenujm/3g4zc398awIe90Zb5A1vREALqneMcYgP/xVQWlG+Ncu5vgwwlaUNx+3799rfe96u9K0JSDXcOzOTJg4B6IgmXfsygc7/Bvg9g9E58/cDVmGIBOP/zT8Bz1zqWqpbXIsd0O9hajXfL6u4BaOS6SeWAAAAAElFTkSuQmCC" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-plugin-Procedure-definitions.html#Procedure">Procedure</a><a name="Procedure"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://simplifier.net/resolve?scope=nictiz.fhir.nl.r4.nl-core@0.11.0-beta.1&amp;canonical=http://nictiz.nl/fhir/StructureDefinition/nl-core-Procedure-event">NlcoreProcedureevent</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Procedure</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_extension_simple.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Simple Extension" class="hierarchy"/> <a href="StructureDefinition-plugin-Procedure-definitions.html#Procedure.extension">extension</a><a name="Procedure.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/extensibility.html#Extension">Extension</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Extension</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice.png" alt="." style="background-color: white; background-color: inherit" title="Slice Definition" class="hierarchy"/> Slices for extension<a name="Procedure.extension.2"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Content/Rules for all slices</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck124.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-plugin-Procedure-definitions.html#Procedure.extension:episodeOfCare" title="Extension URL = http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare">episodeOfCare</a><a name="Procedure.extension.3"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="http://hl7.org/fhir/R4/episodeofcare.html">EpisodeOfCare</a>)</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Associated Encounter episode of care</span><br/><span style="font-weight:bold">URL: </span><a href="http://hl7.org/fhir/extensions/5.1.0/StructureDefinition-workflow-episodeOfCare.html">http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare</a></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-plugin-Procedure-definitions.html#Procedure.code">code</a><a name="Procedure.code"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">ProcedureType</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="StructureDefinition-plugin-Procedure-definitions.html#Procedure.subject">subject</a><a name="Procedure.subject"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a href="http://hl7.org/fhir/R4/patient.html">Patient</a> | <a href="https://simplifier.net/resolve?scope=nictiz.fhir.nl.r4.nl-core@0.11.0-beta.1&amp;canonical=http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient">nl core Patient</a> | <a href="StructureDefinition-plugin-patient.html">Patient</a>)</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Who the procedure was performed on</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-plugin-Procedure-definitions.html#Procedure.reasonReference">reasonReference</a><a name="Procedure.reasonReference"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/references.html">Reference</a>(<a style="opacity: 0.5" href="http://hl7.org/fhir/R4/condition.html">Condition</a> | <a style="opacity: 0.5" href="http://hl7.org/fhir/R4/observation.html">Observation</a> | <a style="opacity: 0.5" href="http://hl7.org/fhir/R4/procedure.html">Procedure</a> | <a style="opacity: 0.5" href="http://hl7.org/fhir/R4/diagnosticreport.html">DiagnosticReport</a> | <a style="opacity: 0.5" href="http://hl7.org/fhir/R4/documentreference.html">DocumentReference</a> | <a style="opacity: 0.5" href="https://simplifier.net/resolve?scope=nictiz.fhir.nl.r4.nl-core@0.11.0-beta.1&amp;canonical=http://nictiz.nl/fhir/StructureDefinition/nl-core-Problem">nl core Problem</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Indication</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-plugin-Procedure-definitions.html#Procedure.bodySite">bodySite</a><a name="Procedure.bodySite"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck003.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice.png" alt="." style="background-color: white; background-color: inherit" title="Slice Definition" class="hierarchy"/> Slices for extension<a name="Procedure.bodySite.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Content/Rules for all slices</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0024.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-plugin-Procedure-definitions.html#Procedure.bodySite.extension:laterality" title="Slice laterality">extension:laterality</a><a name="Procedure.bodySite.extension.2"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="https://simplifier.net/resolve?scope=nictiz.fhir.nl.r4.zib2020@0.10.0-beta.1&amp;canonical=http://nictiz.nl/fhir/StructureDefinition/ext-AnatomicalLocation.Laterality" title="Extension">ExtAnatomicalLocationLaterality</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">Optional Extensions Element</span></td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
  </text>
  <url
       value="https://plugin.healthcare/fhir/StructureDefinition/plugin-Procedure"/>
  <version value="0.1.0-ci"/>
  <name value="PluginProcedure"/>
  <title value="Procedure"/>
  <status value="draft"/>
  <date value="2024-11-05T09:53:52+00:00"/>
  <publisher value="PLUGIN"/>
  <contact>
    <name value="PLUGIN"/>
    <telecom>
      <system value="url"/>
      <value value="https://plugin.healthcare"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="m.sieswerda@iknl.nl"/>
    </telecom>
  </contact>
  <description
               value="Procedure as used within PLUGIN. Inherits from
[nl-core-Procedure-event](https://simplifier.net/nictiz-r4-zib2020/nlcoreprocedureevent).
"/>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="528"/>
      <display value="NL"/>
    </coding>
  </jurisdiction>
  <copyright
             value="Used by permission of the PLUGIN team, all rights reserved Creative Commons License"/>
  <fhirVersion value="4.0.1"/>
  <mapping>
    <identity value="zib-procedure-v5.2-2020EN"/>
    <uri value="https://zibs.nl/wiki/Procedure-v5.2(2020EN)"/>
    <name value="zib Procedure-v5.2(2020EN)"/>
  </mapping>
  <mapping>
    <identity value="zib-textresult-v4.4-2020EN"/>
    <uri value="https://zibs.nl/wiki/TextResult-v4.4(2020EN)"/>
    <name value="zib TextResult-v4.4(2020EN)"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="Procedure"/>
  <baseDefinition
                  value="http://nictiz.nl/fhir/StructureDefinition/nl-core-Procedure-event"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="Procedure">
      <path value="Procedure"/>
      <short value="Procedure"/>
      <definition
                  value="An action that is or was performed on or for a patient. This can be a physical intervention like an operation, or less invasive like long term services, counseling, or hypnotherapy."/>
      <comment
               value="The zib Procedure is mapped both to this Procedure profile and a profile on ServiceRequest (&lt;http://nictiz.nl/fhir/StructureDefinition/nl-core-Procedure-request&gt;) to align with the intention of FHIR. All past procedures are covered using this Procedure resource, while all future procedures, including the advised procedures, are covered in the ServiceRequest resource. Both resources contain the zib mappings, with the exception of the Requester concept; this is not relevant for past procedures and has only been mapped to the ServiceRequest profile.

The planned and performed procedures can be linked using `Procedure.basedOn`."/>
      <alias value="Verrichting"/>
      <alias value="nl-core-Procedure-event"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource"/>
        <expression
                    value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown
                         value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/>
        </extension>
        <key value="dom-6"/>
        <severity value="warning"/>
        <human
               value="A resource should have narrative for robust management"/>
        <expression value="text.`div`.exists()"/>
        <xpath value="exists(f:text/h:div)"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-5"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a security label"/>
        <expression value="contained.meta.security.empty()"/>
        <xpath value="not(exists(f:contained/*/f:meta/f:security))"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Procedure[moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="zib-procedure-v5.2-2020EN"/>
        <map value="NL-CM:14.1.1"/>
        <comment value="Procedure"/>
      </mapping>
    </element>
    <element id="Procedure.id">
      <path value="Procedure.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comment
               value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="Procedure.meta">
      <path value="Procedure.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Procedure.implicitRules">
      <path value="Procedure.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc."/>
      <comment
               value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Procedure.language">
      <path value="Procedure.language"/>
      <short value="Language of the resource content"/>
      <definition
                  value="The base language in which the resource is written."/>
      <comment
               value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/>
        </extension>
        <strength value="preferred"/>
        <description value="A human language."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Procedure.text">
      <path value="Procedure.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
      <comment
               value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="Procedure.contained">
      <path value="Procedure.contained"/>
      <short value="Contained, inline Resources"/>
      <definition
                  value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/>
      <comment
               value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Procedure.extension">
      <path value="Procedure.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
    </element>
    <element id="Procedure.extension:procedureMethod">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="normative"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
        <valueCode value="4.0.0"/>
      </extension>
      <path value="Procedure.extension"/>
      <sliceName value="procedureMethod"/>
      <short value="Optional Extensions Element"/>
      <definition
                  value="Optional Extension Element - found in all resources."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://nictiz.nl/fhir/StructureDefinition/ext-Procedure.ProcedureMethod"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Procedure.extension:episodeOfCare">
      <path value="Procedure.extension"/>
      <sliceName value="episodeOfCare"/>
      <short value="Associated Encounter episode of care"/>
      <definition
                  value="Identifies the episode(s) of care that this resource is relevant to.  Establishes the EpisodeOfCare as a 'grouper' of resources that are relevant to that episode."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship(typeCode=COMP].source[classCode&lt;=PCPR, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="Procedure.modifierExtension">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="normative"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
        <valueCode value="4.0.0"/>
      </extension>
      <path value="Procedure.modifierExtension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Procedure.identifier">
      <path value="Procedure.identifier"/>
      <short value="External Identifiers for this procedure"/>
      <definition
                  value="Business identifiers assigned to this procedure by the performer or other systems which remain constant as the resource is updated and is propagated from server to server."/>
      <comment
               value="This is a business identifier, not a resource identifier (see [discussion](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."/>
      <requirements
                    value="Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map
             value="CX / EI (occasionally, more often EI maps to a resource id or a URL)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="Identifier"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.identifier"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.identifier"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map
             value="Some combination of ORC-2 / ORC-3 / OBR-2 / OBR-3 / IPC-1 / IPC-2 / IPC-3 / IPC-4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
    </element>
    <element id="Procedure.instantiatesCanonical">
      <path value="Procedure.instantiatesCanonical"/>
      <short value="Instantiates FHIR protocol or definition"/>
      <definition
                  value="The URL pointing to a FHIR-defined protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure."/>
      <comment
               value="see [Canonical References](http://hl7.org/fhir/R4/references.html#canonical)"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.instantiatesCanonical"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="canonical"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/PlanDefinition"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/ActivityDefinition"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Measure"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/OperationDefinition"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Questionnaire"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.instantiatesCanonical"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=DEFN].target"/>
      </mapping>
    </element>
    <element id="Procedure.instantiatesUri">
      <path value="Procedure.instantiatesUri"/>
      <short value="Instantiates external protocol or definition"/>
      <definition
                  value="The URL pointing to an externally maintained protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure."/>
      <comment
               value="This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.instantiatesUri"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.instantiatesUri"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=DEFN].target"/>
      </mapping>
    </element>
    <element id="Procedure.basedOn">
      <path value="Procedure.basedOn"/>
      <short value="A request for this procedure"/>
      <definition
                  value="A reference to a resource that contains details of the request for this procedure."/>
      <comment
               value="The root element provides more information on the usage of `Procedure.basedOn` for the zib Procedure."/>
      <alias value="fulfills"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.basedOn"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/CarePlan"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/ServiceRequest"/>
        <targetProfile
                       value="http://nictiz.nl/fhir/StructureDefinition/nl-core-Procedure-request"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ref-1"/>
        <severity value="error"/>
        <human
               value="SHALL have a contained resource if a local reference is provided"/>
        <expression
                    value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"/>
        <xpath
               value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Reference"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.basedOn"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=FLFS].target[classCode=(various e.g. PROC, OBS, PCPR, ACT,  moodCode=RQO].code"/>
      </mapping>
    </element>
    <element id="Procedure.partOf">
      <path value="Procedure.partOf"/>
      <short value="Part of referenced event"/>
      <definition
                  value="A larger event of which this particular procedure is a component or step."/>
      <comment
               value="The MedicationAdministration resource has a partOf reference to Procedure, but this is not a circular reference.   For example, the anesthesia MedicationAdministration is part of the surgical Procedure (MedicationAdministration.partOf = Procedure).  For example, the procedure to insert the IV port for an IV medication administration is part of the medication administration (Procedure.partOf = MedicationAdministration)."/>
      <alias value="container"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.partOf"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Observation"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ref-1"/>
        <severity value="error"/>
        <human
               value="SHALL have a contained resource if a local reference is provided"/>
        <expression
                    value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"/>
        <xpath
               value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Reference"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.partOf"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=COMP].source[classCode=SBADM or PROC or OBS, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="Procedure.status">
      <path value="Procedure.status"/>
      <short
             value="preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown"/>
      <definition
                  value="This element is implictly mapped to the zib concepts ProcedureStartDate (NL-CM:14.1.2) and ProcedureEndDate (NL-CM:14.1.3). Unless the status is explicitly recorded, the following guidance applies:

* When the ProcedureStartDate is in the future, `.status` will usually be set to _preparation_.
* When ProcedureStartDate is in the past and ProcedureEndDate is in the future, `.status` will usually be set to _in-progress_.
* When ProcedureEndDate is in the past, `.status` will usually be set to _completed_.
* When ProcedureStartDate is in the past and ProcedureEndDate is missing, it may be assumed that the Procedure was recorded as a point in time and `.status` will usually be set to _completed_.
* When a system is unable to infer the status from the ProcedureStartDate and ProcedureEndDate , `.status` will be set to _unknown_. 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."/>
      <comment
               value="The &quot;unknown&quot; code is not to be used to convey other statuses.  The &quot;unknown&quot; code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Procedure.status"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ProcedureStatus"/>
        </extension>
        <strength value="required"/>
        <description value="A code specifying the state of the procedure."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/event-status|4.0.1"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.status"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.status"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="statusCode"/>
      </mapping>
      <mapping>
        <identity value="zib-procedure-v5.2-2020EN"/>
        <map value="NL-CM:14.1.2"/>
        <comment
                 value="ProcedureStartDate (implicit, main mapping is on Procedure.performedPeriod.start and Procedure.performedDateTime)"/>
      </mapping>
      <mapping>
        <identity value="zib-procedure-v5.2-2020EN"/>
        <map value="NL-CM:14.1.3"/>
        <comment
                 value="ProcedureEndDate (implicit, main mapping is on Procedure.performedPeriod.end)"/>
      </mapping>
    </element>
    <element id="Procedure.statusReason">
      <path value="Procedure.statusReason"/>
      <short value="Reason for current status"/>
      <definition
                  value="Captures the reason for the current state of the procedure."/>
      <comment
               value="This is generally only used for &quot;exception&quot; statuses such as &quot;not-done&quot;, &quot;suspended&quot; or &quot;aborted&quot;. The reason for performing the event at all is captured in reasonCode, not here."/>
      <alias value="Suspended Reason"/>
      <alias value="Cancelled Reason"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.statusReason"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ProcedureNegationReason"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A code that identifies the reason a procedure was not performed."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/procedure-not-performed-reason"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="CE/CNE/CWE"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.statusReason"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".reason.Observation.value"/>
      </mapping>
    </element>
    <element id="Procedure.category">
      <path value="Procedure.category"/>
      <short value="Classification of the procedure"/>
      <definition
                  value="A code that classifies the procedure for searching, sorting and display purposes (e.g. &quot;Surgical Procedure&quot;)."/>
      <comment
               value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.category"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ProcedureCategory"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A code that classifies a procedure for searching, sorting and display purposes."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/procedure-category"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="CE/CNE/CWE"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.class"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=&quot;COMP].target[classCode=&quot;LIST&quot;, moodCode=&quot;EVN&quot;].code"/>
      </mapping>
    </element>
    <element id="Procedure.code">
      <path value="Procedure.code"/>
      <short value="ProcedureType"/>
      <definition
                  value="The name of the procedure. Choices are the DHD procedure thesaurus, the procedures file (CBV), the Care activities file (NZa), the Dutch Mental Health and Addiction Care procedures list (GGZ) and the procedures list of the Dutch College of General Practitioners (NHG)."/>
      <comment
               value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination."/>
      <requirements
                    value="0..1 to account for primarily narrative only resources."/>
      <alias value="type"/>
      <alias value="VerrichtingType"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Procedure.code"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ProcedureCode"/>
        </extension>
        <strength value="required"/>
        <description value="A code to identify a specific procedure ."/>
        <valueSet
                  value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.19--20200901000000"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="CE/CNE/CWE"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.what[x]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-44/OBR-45"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
      <mapping>
        <identity value="zib-procedure-v5.2-2020EN"/>
        <map value="NL-CM:14.1.4"/>
        <comment value="ProcedureType"/>
      </mapping>
    </element>
    <element id="Procedure.subject">
      <path value="Procedure.subject"/>
      <short value="Who the procedure was performed on"/>
      <definition
                  value="The person, animal or group on which the procedure was performed."/>
      <comment
               value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository."/>
      <alias value="patient"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Procedure.subject"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        <targetProfile
                       value="http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient"/>
        <targetProfile
                       value="https://plugin.healthcare/fhir/StructureDefinition/plugin-patient"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ref-1"/>
        <severity value="error"/>
        <human
               value="SHALL have a contained resource if a local reference is provided"/>
        <expression
                    value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"/>
        <xpath
               value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Reference"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.subject"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.subject[x]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.subject"/>
      </mapping>
    </element>
    <element id="Procedure.encounter">
      <path value="Procedure.encounter"/>
      <short value="Encounter created as part of"/>
      <definition
                  value="The Encounter during which this Procedure was created or performed or to which the creation of this record is tightly associated."/>
      <comment
               value="This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.encounter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ref-1"/>
        <severity value="error"/>
        <human
               value="SHALL have a contained resource if a local reference is provided"/>
        <expression
                    value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"/>
        <xpath
               value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Reference"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.context"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.context"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PV1-19"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="Procedure.performed[x]">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="normative"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
        <valueCode value="4.0.0"/>
      </extension>
      <path value="Procedure.performed[x]"/>
      <slicing>
        <discriminator>
          <type value="type"/>
          <path value="$this"/>
        </discriminator>
        <rules value="open"/>
      </slicing>
      <short value="When the procedure was performed"/>
      <definition
                  value="Estimated or actual date, date-time, period, or age when the procedure was performed.  Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured."/>
      <comment
               value="Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old.  dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.performed[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <type>
        <code value="Age"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.occurrence[x]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.done[x]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
    </element>
    <element id="Procedure.performed[x]:performedPeriod">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="normative"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
        <valueCode value="4.0.0"/>
      </extension>
      <path value="Procedure.performed[x]"/>
      <sliceName value="performedPeriod"/>
      <short value="When the procedure was performed"/>
      <definition
                  value="Estimated or actual date, date-time, period, or age when the procedure was performed.  Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured."/>
      <comment
               value="Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old.  dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.performed[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Period"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.occurrence[x]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.done[x]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
    </element>
    <element id="Procedure.performed[x]:performedPeriod.id">
      <path value="Procedure.performed[x].id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Procedure.performed[x]:performedPeriod.extension">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="normative"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
        <valueCode value="4.0.0"/>
      </extension>
      <path value="Procedure.performed[x].extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Procedure.performed[x]:performedPeriod.start">
      <path value="Procedure.performed[x].start"/>
      <short value="ProcedureStartDate"/>
      <definition
                  value="The start date (and if possible start time) of the procedure. A ‘vague’ date, such as only the year, is permitted. The element offers the option to indicate the start of the period of a series of related procedures."/>
      <comment
               value="If the zib Procedure concerns a procedure performed over a period, `Procedure.performedPeriod.start` and `Procedure.performedPeriod.end` are used to represent zib concepts ProcedureStartDate and ProcedureEndDate. For instantaneous or very short lasting procedures, `Procedure.performedDateTime` is used for ProcedureStartDate (ProcedureEndDate doesn't have a meaning in this case; ProcedureStartDate is the moment the procedure is performed)."/>
      <alias value="VerrichtingStartDatum"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Period.start"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <condition value="ele-1"/>
      <condition value="per-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="DR.1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./low"/>
      </mapping>
      <mapping>
        <identity value="zib-procedure-v5.2-2020EN"/>
        <map value="NL-CM:14.1.2"/>
        <comment value="ProcedureStartDate"/>
      </mapping>
    </element>
    <element id="Procedure.performed[x]:performedPeriod.end">
      <path value="Procedure.performed[x].end"/>
      <short value="ProcedureEndDate"/>
      <definition
                  value="The end date (and if possible end time) of the procedure. A ‘vague’ date, such as only the year, is permitted. The element offers the option to indicate the end of the period of a series of related procedures. The end date element is only used for a procedures that takes some time and is then always applied. If the procedure still continues, the value is left empty."/>
      <comment
               value="If the zib Procedure concerns a procedure performed over a period, `Procedure.performedPeriod.start` and `Procedure.performedPeriod.end` are used to represent zib concepts ProcedureStartDate and ProcedureEndDate. For instantaneous or very short lasting procedures, `Procedure.performedDateTime` is used for ProcedureStartDate (ProcedureEndDate doesn't have a meaning in this case; ProcedureStartDate is the moment the procedure is performed)."/>
      <alias value="VerrichtingEindDatum"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Period.end"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <meaningWhenMissing
                          value="If the end of the period is missing, it means that the period is ongoing"/>
      <condition value="ele-1"/>
      <condition value="per-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="DR.2"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./high"/>
      </mapping>
      <mapping>
        <identity value="zib-procedure-v5.2-2020EN"/>
        <map value="NL-CM:14.1.3"/>
        <comment value="ProcedureEndDate"/>
      </mapping>
    </element>
    <element id="Procedure.performed[x]:performedDateTime">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="normative"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
        <valueCode value="4.0.0"/>
      </extension>
      <path value="Procedure.performed[x]"/>
      <sliceName value="performedDateTime"/>
      <short value="ProcedureStartDate"/>
      <definition
                  value="The (desired) start date (and if possible start time) of the procedure. A ‘vague’ date, such as only the year, is permitted. `performedDateTime` is used for instantaneous or very short lasting procedures."/>
      <comment
               value="If the zib Procedure concerns a procedure performed over a period, `Procedure.performedPeriod.start` and `Procedure.performedPeriod.end` are used to represent zib concepts ProcedureStartDate and ProcedureEndDate. For instantaneous or very short lasting procedures, `Procedure.performedDateTime` is used for ProcedureStartDate (ProcedureEndDate doesn't have a meaning in this case; ProcedureStartDate is the moment the procedure is performed)."/>
      <alias value="VerrichtingStartDatum"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.performed[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.occurrence[x]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.done[x]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
      <mapping>
        <identity value="zib-procedure-v5.2-2020EN"/>
        <map value="NL-CM:14.1.2"/>
        <comment value="ProcedureStartDate"/>
      </mapping>
    </element>
    <element id="Procedure.recorder">
      <path value="Procedure.recorder"/>
      <short value="Who recorded the procedure"/>
      <definition
                  value="Individual who recorded the record and takes responsibility for its content."/>
      <comment
               value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.recorder"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ref-1"/>
        <severity value="error"/>
        <human
               value="SHALL have a contained resource if a local reference is provided"/>
        <expression
                    value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"/>
        <xpath
               value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Reference"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.author"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].role"/>
      </mapping>
    </element>
    <element id="Procedure.asserter">
      <path value="Procedure.asserter"/>
      <short value="Person who asserts this procedure"/>
      <definition value="Individual who is making the procedure statement."/>
      <comment
               value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.asserter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ref-1"/>
        <severity value="error"/>
        <human
               value="SHALL have a contained resource if a local reference is provided"/>
        <expression
                    value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"/>
        <xpath
               value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Reference"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.source"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=INF].role"/>
      </mapping>
    </element>
    <element id="Procedure.performer">
      <path value="Procedure.performer"/>
      <short value="The people who performed the procedure"/>
      <definition
                  value="Limited to &quot;real&quot; people rather than equipment."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.performer"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.performer"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRF]"/>
      </mapping>
    </element>
    <element id="Procedure.performer.id">
      <path value="Procedure.performer.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Procedure.performer.extension">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="normative"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
        <valueCode value="4.0.0"/>
      </extension>
      <path value="Procedure.performer.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Procedure.performer.modifierExtension">
      <path value="Procedure.performer.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Procedure.performer.function">
      <path value="Procedure.performer.function"/>
      <short value="Type of performance"/>
      <definition
                  value="Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist."/>
      <comment
               value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination."/>
      <requirements
                    value="Allows disambiguation of the types of involvement of different performers."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.performer.function"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ProcedurePerformerRole"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A code that identifies the role of a performer of the procedure."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/performer-role"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="CE/CNE/CWE"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.performer.function"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map
             value="Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".functionCode"/>
      </mapping>
    </element>
    <element id="Procedure.performer.actor">
      <path value="Procedure.performer.actor"/>
      <short value="A reference from one resource to another"/>
      <definition value="A reference from one resource to another."/>
      <comment
               value="Each occurrence of the zib HealthProfessional is normally represented by _two_ FHIR resources: a PractitionerRole resource (instance of [nl-core-HealthProfessional-PractitionerRole](http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole)) and a Practitioner resource (instance of [nl-core-HealthProfessional-Practitioner](http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner)). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance.

In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the nl-core-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile."/>
      <requirements
                    value="A reference to Device supports use cases, such as pacemakers."/>
      <alias value="Uitvoerder"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Procedure.performer.actor"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://nictiz.nl/fhir/StructureDefinition/pattern-NlCoreHealthProfessionalReference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Device"/>
        <targetProfile
                       value="http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ref-1"/>
        <severity value="error"/>
        <human
               value="SHALL have a contained resource if a local reference is provided"/>
        <expression
                    value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"/>
        <xpath
               value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Reference"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.performer.actor"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.actor"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="ORC-19/PRT-5"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".role"/>
      </mapping>
      <mapping>
        <identity value="zib-procedure-v5.2-2020EN"/>
        <map value="NL-CM:14.1.6"/>
        <comment value="Performer"/>
      </mapping>
    </element>
    <element id="Procedure.performer.onBehalfOf">
      <path value="Procedure.performer.onBehalfOf"/>
      <short value="Organization the device or practitioner was acting for"/>
      <definition
                  value="The organization the device or practitioner was acting on behalf of."/>
      <comment
               value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository."/>
      <requirements
                    value="Practitioners and Devices can be associated with multiple organizations.  This element indicates which organization they were acting on behalf of when performing the action."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.performer.onBehalfOf"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ref-1"/>
        <severity value="error"/>
        <human
               value="SHALL have a contained resource if a local reference is provided"/>
        <expression
                    value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"/>
        <xpath
               value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Reference"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".scoper"/>
      </mapping>
    </element>
    <element id="Procedure.location">
      <path value="Procedure.location"/>
      <short value="Location"/>
      <definition
                  value="The healthcare center where the procedure was, is or or will be carried out."/>
      <comment
               value="Please note that the zib concept Location::HealthcareProvider of zib MedicalDevice (NL-CM:10.1.8) is mapped onto this element, but it is also directly represented using a custom extension in the focal profile for that zib ([nl-core-MedicalDevice](http://nictiz.nl/fhir/StructureDefinition/nl-core-MedicalDevice)). The reason for this is that the Location concept from zib MedicalDevice aligns with the Location concept from zib Procedure, but only for the situation that the Procedure is about placing an implant which is described using the instance of zib MedicalDevice. In this situation, the extension in the nl-core-MedicalDevice profile is redundant and it is advised to only use the current element to represent the Location concept."/>
      <requirements
                    value="Ties a procedure to where the records are likely kept."/>
      <alias value="Locatie"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.location"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Location"/>
        <targetProfile
                       value="http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ref-1"/>
        <severity value="error"/>
        <human
               value="SHALL have a contained resource if a local reference is provided"/>
        <expression
                    value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"/>
        <xpath
               value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Reference"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.where[x]"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=LOC].role[classCode=SDLOC]"/>
      </mapping>
      <mapping>
        <identity value="zib-procedure-v5.2-2020EN"/>
        <map value="NL-CM:14.1.5"/>
        <comment value="Location"/>
      </mapping>
      <mapping>
        <identity value="zib-medicaldevice-v3.3.1-2020EN"/>
        <map value="NL-CM:10.1.8"/>
        <comment
                 value="Location (For specific situations only. See the comment on this element for more information.)"/>
      </mapping>
    </element>
    <element id="Procedure.reasonCode">
      <path value="Procedure.reasonCode"/>
      <short value="Coded reason procedure performed"/>
      <definition
                  value="The coded reason why the procedure was performed. This may be a coded entity of some type, or may simply be present as text."/>
      <comment
               value="Use Procedure.reasonCode when a code sufficiently describes the reason.  Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative.  For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used.  Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference.  Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.reasonCode"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ProcedureReason"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A code that identifies the reason a procedure is  required."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/procedure-reason"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="CE/CNE/CWE"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.reasonCode"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.why[x]"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".reasonCode"/>
      </mapping>
    </element>
    <element id="Procedure.reasonReference">
      <path value="Procedure.reasonReference"/>
      <short value="Indication"/>
      <definition value="The indication is the reason for the procedure."/>
      <comment
               value="It is possible for a procedure to be a reason (such as C-Section) for another procedure (such as an epidural). Other examples include endoscopy for dilatation and biopsy (a combination of diagnostic and therapeutic use). 
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."/>
      <alias value="Indicatie"/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="Procedure.reasonReference"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Condition"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Observation"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/>
        <targetProfile
                       value="http://nictiz.nl/fhir/StructureDefinition/nl-core-Problem"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ref-1"/>
        <severity value="error"/>
        <human
               value="SHALL have a contained resource if a local reference is provided"/>
        <expression
                    value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"/>
        <xpath
               value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Reference"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.reasonReference"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.why[x]"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".reasonCode"/>
      </mapping>
      <mapping>
        <identity value="zib-procedure-v5.2-2020EN"/>
        <map value="NL-CM:14.1.9"/>
        <comment value="Indication"/>
      </mapping>
    </element>
    <element id="Procedure.bodySite">
      <path value="Procedure.bodySite"/>
      <short value="Location"/>
      <definition value="Localisation on/in the body."/>
      <comment
               value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination."/>
      <alias value="Locatie"/>
      <alias value="VerrichtingAnatomischeLocatie"/>
      <alias value="nl-core-AnatomicalLocation"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.bodySite"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
        <profile
                 value="http://nictiz.nl/fhir/StructureDefinition/nl-core-AnatomicalLocation"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="BodySite"/>
        </extension>
        <strength value="required"/>
        <description
                     value="Codes describing anatomical locations. May include laterality."/>
        <valueSet
                  value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.11--20200901000000"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="CE/CNE/CWE"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-20"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".targetSiteCode"/>
      </mapping>
      <mapping>
        <identity value="zib-anatomicallocation-v1.0-2020EN"/>
        <map value="NL-CM:20.7.4"/>
        <comment value="Location"/>
      </mapping>
      <mapping>
        <identity value="zib-procedure-v5.2-2020EN"/>
        <map value="NL-CM:14.1.13"/>
        <comment value="ProcedureAnatomicalLocation"/>
      </mapping>
    </element>
    <element id="Procedure.bodySite.id">
      <path value="Procedure.bodySite.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Procedure.bodySite.extension">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="normative"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
        <valueCode value="4.0.0"/>
      </extension>
      <path value="Procedure.bodySite.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Procedure.bodySite.extension:laterality">
      <path value="Procedure.bodySite.extension"/>
      <sliceName value="laterality"/>
      <short value="Optional Extensions Element"/>
      <definition
                  value="Optional Extension Element - found in all resources."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://nictiz.nl/fhir/StructureDefinition/ext-AnatomicalLocation.Laterality"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Procedure.bodySite.coding">
      <path value="Procedure.bodySite.coding"/>
      <short value="Code defined by a terminology system"/>
      <definition
                  value="A reference to a code defined by a terminology system."/>
      <comment
               value="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.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true."/>
      <requirements
                    value="Allows for alternative encodings within a code system, and translations to other code systems."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="CodeableConcept.coding"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map
             value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CV"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:Coding rdfs:subClassOf dt:CDCoding"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1-8, C*E.10-22"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="union(., ./translation)"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
      </mapping>
    </element>
    <element id="Procedure.bodySite.text">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="Procedure.bodySite.text"/>
      <short value="Plain text representation of the concept"/>
      <definition
                  value="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."/>
      <comment
               value="Very often the text is the same as a displayName of one of the codings."/>
      <requirements
                    value="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 value="0"/>
      <max value="1"/>
      <base>
        <path value="CodeableConcept.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.9. But note many systems use C*E.2 for this"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="./originalText[mediaType/code=&quot;text/plain&quot;]/data"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
      </mapping>
    </element>
    <element id="Procedure.outcome">
      <path value="Procedure.outcome"/>
      <short value="The result of procedure"/>
      <definition
                  value="The outcome of the procedure - did it resolve the reasons for the procedure being performed?"/>
      <comment
               value="If outcome contains narrative text only, it can be captured using the CodeableConcept.text."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.outcome"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ProcedureOutcome"/>
        </extension>
        <strength value="example"/>
        <description
                     value="An outcome of a procedure - whether it was resolved or otherwise."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/procedure-outcome"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="CE/CNE/CWE"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=OUT].target.text"/>
      </mapping>
    </element>
    <element id="Procedure.report">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="normative"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
        <valueCode value="4.0.0"/>
      </extension>
      <path value="Procedure.report"/>
      <slicing>
        <discriminator>
          <type value="profile"/>
          <path value="resolve()"/>
        </discriminator>
        <rules value="open"/>
      </slicing>
      <short value="Any report resulting from the procedure"/>
      <definition
                  value="This could be a histology result, pathology report, surgical report, etc."/>
      <comment
               value="There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.report"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/DocumentReference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Composition"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ref-1"/>
        <severity value="error"/>
        <human
               value="SHALL have a contained resource if a local reference is provided"/>
        <expression
                    value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"/>
        <xpath
               value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Reference"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="Procedure.report:textResult">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="normative"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
        <valueCode value="4.0.0"/>
      </extension>
      <path value="Procedure.report"/>
      <sliceName value="textResult"/>
      <short value="TextResult"/>
      <definition
                  value="This could be a histology result, pathology report, surgical report, etc."/>
      <comment
               value="The direction of the reference between zibs TextResult and Procedure is reversed in FHIR. Therefore the concept Procedure (NL-CM:13.2.5) of zib TextResult is mapped to this element.

Please note that on a functional level, zib TextResult references zib Procedure, but in FHIR this direction is reversed."/>
      <alias value="TekstUitslag"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.report"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://nictiz.nl/fhir/StructureDefinition/nl-core-TextResult"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ref-1"/>
        <severity value="error"/>
        <human
               value="SHALL have a contained resource if a local reference is provided"/>
        <expression
                    value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"/>
        <xpath
               value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Reference"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="zib-textresult-v4.4-2020EN"/>
        <map value="NL-CM:13.2.5"/>
        <comment value="Reversed reference for zib TextResult.Procedure"/>
      </mapping>
    </element>
    <element id="Procedure.complication">
      <path value="Procedure.complication"/>
      <short value="Complication following the procedure"/>
      <definition
                  value="Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues."/>
      <comment
               value="If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.complication"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ProcedureComplication"/>
        </extension>
        <strength value="example"/>
        <description
                     value="Codes describing complications that resulted from a procedure."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/condition-code"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="CE/CNE/CWE"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code=&quot;complication&quot;, moodCode=EVN].value"/>
      </mapping>
    </element>
    <element id="Procedure.complicationDetail">
      <path value="Procedure.complicationDetail"/>
      <short value="A condition that is a result of the procedure"/>
      <definition
                  value="Any complications that occurred during the procedure, or in the immediate post-performance period."/>
      <comment
               value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository."/>
      <requirements
                    value="This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.complicationDetail"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Condition"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ref-1"/>
        <severity value="error"/>
        <human
               value="SHALL have a contained resource if a local reference is provided"/>
        <expression
                    value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"/>
        <xpath
               value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Reference"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code=&quot;complication&quot;, moodCode=EVN].value"/>
      </mapping>
    </element>
    <element id="Procedure.followUp">
      <path value="Procedure.followUp"/>
      <short value="Instructions for follow up"/>
      <definition
                  value="If the procedure required specific follow up - e.g. removal of sutures. The follow up may be represented as a simple note or could potentially be more complex, in which case the CarePlan resource can be used."/>
      <comment
               value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.followUp"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ProcedureFollowUp"/>
        </extension>
        <strength value="example"/>
        <description
                     value="Specific follow up required for a procedure e.g. removal of sutures."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/procedure-followup"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="CE/CNE/CWE"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=COMP].target[classCode=ACT, moodCode=INT].code"/>
      </mapping>
    </element>
    <element id="Procedure.note">
      <path value="Procedure.note"/>
      <short value="Additional information about the procedure"/>
      <definition value="Any other notes and comments about the procedure."/>
      <comment
               value="For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time.  This element may need to be included in narrative because of the potential for modifying information.  *Annotations SHOULD NOT* be used to communicate &quot;modifying&quot; information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible)."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.note"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Annotation"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Act"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.note"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="NTE"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;annotation&quot;].value"/>
      </mapping>
    </element>
    <element id="Procedure.focalDevice">
      <path value="Procedure.focalDevice"/>
      <short value="Manipulated, implanted, or removed device"/>
      <definition
                  value="A device that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.focalDevice"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=DEV].role[classCode=MANU]"/>
      </mapping>
    </element>
    <element id="Procedure.focalDevice.id">
      <path value="Procedure.focalDevice.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Procedure.focalDevice.extension">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="normative"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version">
        <valueCode value="4.0.0"/>
      </extension>
      <path value="Procedure.focalDevice.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Procedure.focalDevice.modifierExtension">
      <path value="Procedure.focalDevice.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Procedure.focalDevice.action">
      <path value="Procedure.focalDevice.action"/>
      <short value="Kind of change to device"/>
      <definition
                  value="The kind of change that happened to the device during the procedure."/>
      <comment
               value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.focalDevice.action"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DeviceActionKind"/>
        </extension>
        <strength value="preferred"/>
        <description
                     value="A kind of change that happened to the device during the procedure."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/device-action"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="CE/CNE/CWE"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;procedure device action&quot;].value=:procedure device action codes"/>
      </mapping>
    </element>
    <element id="Procedure.focalDevice.manipulated">
      <path value="Procedure.focalDevice.manipulated"/>
      <short value="Device that was changed"/>
      <definition
                  value="The device that was manipulated (changed) during the procedure."/>
      <comment
               value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Procedure.focalDevice.manipulated"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Device"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ref-1"/>
        <severity value="error"/>
        <human
               value="SHALL have a contained resource if a local reference is provided"/>
        <expression
                    value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"/>
        <xpath
               value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Reference"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=DEV].role[classCode=SDLOC]"/>
      </mapping>
    </element>
    <element id="Procedure.usedReference">
      <path value="Procedure.usedReference"/>
      <short value="Items used during procedure"/>
      <definition
                  value="Identifies medications, devices and any other substance used as part of the procedure."/>
      <comment
               value="For devices actually implanted or removed, use Procedure.device."/>
      <requirements value="Used for tracking contamination, etc."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.usedReference"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Device"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Medication"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Substance"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ref-1"/>
        <severity value="error"/>
        <human
               value="SHALL have a contained resource if a local reference is provided"/>
        <expression
                    value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"/>
        <xpath
               value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Reference"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".participation[typeCode=DEV].role[classCode=MANU] or
.participation[typeCode=CSM].role[classCode=ADMM] (for Medication or Substance)"/>
      </mapping>
    </element>
    <element id="Procedure.usedCode">
      <path value="Procedure.usedCode"/>
      <short value="Coded items used during the procedure"/>
      <definition
                  value="Identifies coded items that were used as part of the procedure."/>
      <comment
               value="For devices actually implanted or removed, use Procedure.device."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.usedCode"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ProcedureUsed"/>
        </extension>
        <strength value="example"/>
        <description value="Codes describing items used during a procedure."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/device-kind"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="CE/CNE/CWE"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=Dev].role[classCode=MANU]"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="Procedure">
      <path value="Procedure"/>
    </element>
    <element id="Procedure.extension">
      <path value="Procedure.extension"/>
      <min value="1"/>
    </element>
    <element id="Procedure.extension:episodeOfCare">
      <path value="Procedure.extension"/>
      <sliceName value="episodeOfCare"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare"/>
      </type>
      <isModifier value="false"/>
    </element>
    <element id="Procedure.code">
      <path value="Procedure.code"/>
      <min value="1"/>
    </element>
    <element id="Procedure.subject">
      <path value="Procedure.subject"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        <targetProfile
                       value="http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient"/>
        <targetProfile
                       value="https://plugin.healthcare/fhir/StructureDefinition/plugin-patient"/>
      </type>
    </element>
    <element id="Procedure.reasonReference">
      <path value="Procedure.reasonReference"/>
      <min value="1"/>
    </element>
    <element id="Procedure.bodySite.extension:laterality">
      <path value="Procedure.bodySite.extension"/>
      <sliceName value="laterality"/>
      <mustSupport value="true"/>
    </element>
  </differential>
</StructureDefinition>