ICHOM Patient Centered Outcomes Measure Set for Breast Cancer, published by HL7 International - Clinical Interoperability Council Group. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/HL7/fhir-ichom-breast-cancer-ig/ and changes regularly. See the Directory of published versions

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Resource Profile: Re-operation surgery ( Experimental )

Represents whether the patient has had a re-operation since their surgery for breast cancer and whether it was due to involved margins.

Usage:

• Examples for this Resource Profile: Procedure/ReoperationSurgeryPatient147

Formal Views of Profile Content

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

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

This structure is derived from Procedure

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	Procedure	An action that is being or was performed on a patient
partOf	S	0..*	Reference(Procedure | Observation | MedicationAdministration)	Original procedure that prompted the reoperation
status	S	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
category	S	0..1	CodeableConcept	Classification of the procedure Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 261554009
display		1..1	string	Representation defined by the system Fixed Value: Reoperation
code	S	0..1	CodeableConcept	Identification of the procedure Binding: Type of re-operation (required)
subject	S	1..1	Reference(Breast cancer patient)	Who the procedure was performed on
performed[x]	S	0..1	dateTime	When the procedure was performed
reasonCode	S	0..*	CodeableConcept	The reasonCode explains whether or not the reoperation was due to involved margins Binding: Reasoncode of the re-operation (preferred)
reasonReference	S	0..*	Reference(Primary Breast Cancer Condition)	The justification that the procedure was performed
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Procedure.code	required	ReoperationTypeVS
Procedure.reasonCode	preferred	ReoperationReasonVS

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	Procedure	An action that is being or was performed on a patient
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
partOf	SΣ	0..*	Reference(Procedure | Observation | MedicationAdministration)	Original procedure that prompted the reoperation
status	?!SΣ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
category	SΣ	0..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 261554009
display		1..1	string	Representation defined by the system Fixed Value: Reoperation
code	SΣ	0..1	CodeableConcept	Identification of the procedure Binding: Type of re-operation (required)
subject	SΣ	1..1	Reference(Breast cancer patient)	Who the procedure was performed on
performed[x]	SΣ	0..1	dateTime	When the procedure was performed
reasonCode	SΣ	0..*	CodeableConcept	The reasonCode explains whether or not the reoperation was due to involved margins Binding: Reasoncode of the re-operation (preferred)
reasonReference	SΣ	0..*	Reference(Primary Breast Cancer Condition)	The justification that the procedure was performed
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Procedure.status	required	EventStatus
Procedure.category	example	Pattern: SNOMED CT code 261554009("Reoperation")
Procedure.code	required	ReoperationTypeVS
Procedure.reasonCode	preferred	ReoperationReasonVS

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	Procedure	An action that is being or was performed on a patient
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Identifiers for this procedure
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | ServiceRequest)	A request for this procedure
partOf	SΣ	0..*	Reference(Procedure | Observation | MedicationAdministration)	Original procedure that prompted the reoperation
status	?!SΣ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
statusReason	Σ	0..1	CodeableConcept	Reason for current status Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.
category	SΣ	0..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 261554009
display		1..1	string	Representation defined by the system Fixed Value: Reoperation
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	SΣ	0..1	CodeableConcept	Identification of the procedure Binding: Type of re-operation (required)
subject	SΣ	1..1	Reference(Breast cancer patient)	Who the procedure was performed on
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
performed[x]	SΣ	0..1	dateTime	When the procedure was performed
recorder	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Who recorded the procedure
asserter	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Person who asserts this procedure
performer	Σ	0..*	BackboneElement	The people who performed the procedure
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
location	Σ	0..1	Reference(Location)	Where the procedure happened
reasonCode	SΣ	0..*	CodeableConcept	The reasonCode explains whether or not the reoperation was due to involved margins Binding: Reasoncode of the re-operation (preferred)
reasonReference	SΣ	0..*	Reference(Primary Breast Cancer Condition)	The justification that the procedure was performed
bodySite	Σ	0..*	CodeableConcept	Target body sites Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
outcome	Σ	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
report		0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Any report resulting from the procedure
complication		0..*	CodeableConcept	Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
complicationDetail		0..*	Reference(Condition)	A condition that is a result of the procedure
followUp		0..*	CodeableConcept	Instructions for follow up Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.
note		0..*	Annotation	Additional information about the procedure
focalDevice		0..*	BackboneElement	Manipulated, implanted, or removed device
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
action		0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.
manipulated		1..1	Reference(Device)	Device that was changed
usedReference		0..*	Reference(Device | Medication | Substance)	Items used during procedure
usedCode		0..*	CodeableConcept	Coded items used during the procedure Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Procedure.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Procedure.status	required	EventStatus
Procedure.statusReason	example	ProcedureNotPerformedReason(SNOMED-CT)
Procedure.category	example	Pattern: SNOMED CT code 261554009("Reoperation")
Procedure.code	required	ReoperationTypeVS
Procedure.performer.function	example	ProcedurePerformerRoleCodes
Procedure.reasonCode	preferred	ReoperationReasonVS
Procedure.bodySite	example	SNOMEDCTBodyStructures
Procedure.outcome	example	ProcedureOutcomeCodes(SNOMEDCT)
Procedure.complication	example	Condition/Problem/DiagnosisCodes
Procedure.followUp	example	ProcedureFollowUpCodes(SNOMEDCT)
Procedure.focalDevice.action	preferred	ProcedureDeviceActionCodes
Procedure.usedCode	example	FHIRDeviceTypes

This structure is derived from Procedure

Summary

Must-Support: 8 elements

Structures

This structure refers to these other structures:

• Breast cancer patient (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/patient)
• Primary Breast Cancer Condition (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/primary-breastcancer)

Differential View

This structure is derived from Procedure

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	Procedure	An action that is being or was performed on a patient
partOf	S	0..*	Reference(Procedure | Observation | MedicationAdministration)	Original procedure that prompted the reoperation
status	S	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
category	S	0..1	CodeableConcept	Classification of the procedure Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 261554009
display		1..1	string	Representation defined by the system Fixed Value: Reoperation
code	S	0..1	CodeableConcept	Identification of the procedure Binding: Type of re-operation (required)
subject	S	1..1	Reference(Breast cancer patient)	Who the procedure was performed on
performed[x]	S	0..1	dateTime	When the procedure was performed
reasonCode	S	0..*	CodeableConcept	The reasonCode explains whether or not the reoperation was due to involved margins Binding: Reasoncode of the re-operation (preferred)
reasonReference	S	0..*	Reference(Primary Breast Cancer Condition)	The justification that the procedure was performed
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Procedure.code	required	ReoperationTypeVS
Procedure.reasonCode	preferred	ReoperationReasonVS

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	Procedure	An action that is being or was performed on a patient
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
partOf	SΣ	0..*	Reference(Procedure | Observation | MedicationAdministration)	Original procedure that prompted the reoperation
status	?!SΣ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
category	SΣ	0..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 261554009
display		1..1	string	Representation defined by the system Fixed Value: Reoperation
code	SΣ	0..1	CodeableConcept	Identification of the procedure Binding: Type of re-operation (required)
subject	SΣ	1..1	Reference(Breast cancer patient)	Who the procedure was performed on
performed[x]	SΣ	0..1	dateTime	When the procedure was performed
reasonCode	SΣ	0..*	CodeableConcept	The reasonCode explains whether or not the reoperation was due to involved margins Binding: Reasoncode of the re-operation (preferred)
reasonReference	SΣ	0..*	Reference(Primary Breast Cancer Condition)	The justification that the procedure was performed
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Procedure.status	required	EventStatus
Procedure.category	example	Pattern: SNOMED CT code 261554009("Reoperation")
Procedure.code	required	ReoperationTypeVS
Procedure.reasonCode	preferred	ReoperationReasonVS

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	Procedure	An action that is being or was performed on a patient
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Identifiers for this procedure
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | ServiceRequest)	A request for this procedure
partOf	SΣ	0..*	Reference(Procedure | Observation | MedicationAdministration)	Original procedure that prompted the reoperation
status	?!SΣ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
statusReason	Σ	0..1	CodeableConcept	Reason for current status Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.
category	SΣ	0..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 261554009
display		1..1	string	Representation defined by the system Fixed Value: Reoperation
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	SΣ	0..1	CodeableConcept	Identification of the procedure Binding: Type of re-operation (required)
subject	SΣ	1..1	Reference(Breast cancer patient)	Who the procedure was performed on
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
performed[x]	SΣ	0..1	dateTime	When the procedure was performed
recorder	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Who recorded the procedure
asserter	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Person who asserts this procedure
performer	Σ	0..*	BackboneElement	The people who performed the procedure
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
location	Σ	0..1	Reference(Location)	Where the procedure happened
reasonCode	SΣ	0..*	CodeableConcept	The reasonCode explains whether or not the reoperation was due to involved margins Binding: Reasoncode of the re-operation (preferred)
reasonReference	SΣ	0..*	Reference(Primary Breast Cancer Condition)	The justification that the procedure was performed
bodySite	Σ	0..*	CodeableConcept	Target body sites Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
outcome	Σ	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
report		0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Any report resulting from the procedure
complication		0..*	CodeableConcept	Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
complicationDetail		0..*	Reference(Condition)	A condition that is a result of the procedure
followUp		0..*	CodeableConcept	Instructions for follow up Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.
note		0..*	Annotation	Additional information about the procedure
focalDevice		0..*	BackboneElement	Manipulated, implanted, or removed device
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
action		0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.
manipulated		1..1	Reference(Device)	Device that was changed
usedReference		0..*	Reference(Device | Medication | Substance)	Items used during procedure
usedCode		0..*	CodeableConcept	Coded items used during the procedure Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Procedure.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Procedure.status	required	EventStatus
Procedure.statusReason	example	ProcedureNotPerformedReason(SNOMED-CT)
Procedure.category	example	Pattern: SNOMED CT code 261554009("Reoperation")
Procedure.code	required	ReoperationTypeVS
Procedure.performer.function	example	ProcedurePerformerRoleCodes
Procedure.reasonCode	preferred	ReoperationReasonVS
Procedure.bodySite	example	SNOMEDCTBodyStructures
Procedure.outcome	example	ProcedureOutcomeCodes(SNOMEDCT)
Procedure.complication	example	Condition/Problem/DiagnosisCodes
Procedure.followUp	example	ProcedureFollowUpCodes(SNOMEDCT)
Procedure.focalDevice.action	preferred	ProcedureDeviceActionCodes
Procedure.usedCode	example	FHIRDeviceTypes

This structure is derived from Procedure

Summary

Must-Support: 8 elements

Structures

This structure refers to these other structures:

• Breast cancer patient (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/patient)
• Primary Breast Cancer Condition (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/primary-breastcancer)

Other representations of profile: CSV, Excel, Schematron