HL7 Czech EMS Implementation Guide
0.0.2 - ci-build

HL7 Czech EMS Implementation Guide, published by HL7 Czech Republic. This guide is not an authorized publication; it is the continuous build for version 0.0.2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-cz/cz-ems/ and changes regularly. See the Directory of published versions

## Resource Profile: Procedure: EMS Report (CZ)

Official URL: https://hl7.cz/fhir/cz-ems/StructureDefinition/cz-procedure-ems | Version: 0.0.2
Standards status: Draft | Maturity Level: 1 | Computable Name: CZ_ProcedureEms

This profile on Procedure represents the ems procedure for the scope of the Czech national interoperability project.

Usages:

- Use this Profile: Bundle: EMS Report (CZ)
- Refer to this Profile: Medication Administration: EMS Report (CZ) and Composition (EMS CZ)
- Examples for this Profile: Procedure/3af2e7a6-c16e-4b80-a173-ca2c8aa081b6

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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
status | ?!Σ | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
code | Σ | 1..1 | CodeableConcept | Identification of the procedure Binding: ProcedureCodes(SNOMEDCT) (example): A code to identify a specific procedure .
subject | Σ | 1..1 | Reference(Patient (CZ core) | Patient: Animal (CZ) | Group) | Who the procedure was performed on
recorder | Σ | 0..1 | Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Patient (CZ core) | Related Person (CZ core)) | Who recorded the procedure
asserter | Σ | 0..1 | Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Patient (CZ core) | Related Person (CZ core)) | Person who asserts this procedure
Slices for performer | Σ | 0..* | BackboneElement | The people who performed the procedure Slice: Unordered, Open by value:function
performer:All Slices |  |  |  | Content/Rules for all slices
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function | Σ | 1..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 (CZ core) | Practitioner Role (CZ core) | Organization (CZ core) | Patient (CZ core) | Related Person (CZ core) | Device: Performer/Observer (CZ) | Medical Device (CZ)) | The reference to the practitioner
onBehalfOf |  | 0..1 | Reference(Organization (CZ core)) | Organization the device or practitioner was acting for
performer:performer | Σ | 0..* | BackboneElement | The people who performed the procedure
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function | Σ | 1..1 | CodeableConcept | Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:""$this""
coding:healthcare-professional | Σ | 0..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
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: 223366009
display |  | 1..1 | string | Representation defined by the system Fixed Value: Healthcare professional
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
actor | Σ | 1..1 | Reference(Practitioner Role (CZ core)) | The reference to the practitioner
performer:imaging-device | Σ | 0..* | BackboneElement | The people who performed the procedure
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function | Σ | 1..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 (CZ core) | Practitioner Role (CZ core) | Organization (CZ core) | Patient (CZ core) | Related Person (CZ core) | Device: Performer/Observer (CZ) | Medical Device (CZ)) | The reference to the practitioner
usedReference |  | 0..* | Reference(Device: Performer/Observer (CZ) | Medical Device (CZ) | Medication (CZ) | Substance) | Items used during procedure
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Procedure.status | Base | required | EventStatus | 📍4.0.1 | FHIR Std.
Procedure.code | Base | example | Procedure Codes (SNOMED CT) | 📍4.0.1 | FHIR Std.
Procedure.performer.​function | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.
Procedure.performer:performer.​function | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.
Procedure.performer:imaging-device.​function | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.

#### Constraints

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

This structure is derived from Procedure

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Procedure |  |  | Procedure |
code |  | 1..1 | CodeableConcept | Identification of the procedure
subject |  | 1..1 | Reference(Patient (CZ core) | Patient: Animal (CZ) | Group) | Who the procedure was performed on
recorder |  | 0..1 | Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Patient (CZ core) | Related Person (CZ core)) | Who recorded the procedure
asserter |  | 0..1 | Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Patient (CZ core) | Related Person (CZ core)) | Person who asserts this procedure
Slices for performer |  | 0..* | BackboneElement | The people who performed the procedure Slice: Unordered, Open by value:function
performer:All Slices |  |  |  | Content/Rules for all slices
function |  | 1..1 | CodeableConcept | Type of performance
actor |  | 1..1 | Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Organization (CZ core) | Patient (CZ core) | Related Person (CZ core) | Device: Performer/Observer (CZ) | Medical Device (CZ)) | The reference to the practitioner
onBehalfOf |  | 0..1 | Reference(Organization (CZ core)) | Organization the device or practitioner was acting for
performer:performer |  | 0..* | BackboneElement | The people who performed the procedure
function |  |  |  |
Slices for coding |  | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:""$this""
coding:healthcare-professional |  | 0..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
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: 223366009
display |  | 1..1 | string | Representation defined by the system Fixed Value: Healthcare professional
actor |  | 1..1 | Reference(Practitioner Role (CZ core)) | The reference to the practitioner
performer:imaging-device |  | 0..* | BackboneElement | The people who performed the procedure
usedReference |  | 0..* | Reference(Device: Performer/Observer (CZ) | Medical Device (CZ) | Medication (CZ) | Substance) | Items used during procedure
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
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 | Σ | 0..* | Reference(Procedure | Observation | MedicationAdministration) | Part of referenced event
status | ?!Σ | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
statusReason | Σ | 0..1 | CodeableConcept | Reason for current status Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.
category | Σ | 0..1 | CodeableConcept | Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes.
code | Σ | 1..1 | CodeableConcept | Identification of the procedure Binding: ProcedureCodes(SNOMEDCT) (example): A code to identify a specific procedure .
subject | Σ | 1..1 | Reference(Patient (CZ core) | Patient: Animal (CZ) | Group) | Who the procedure was performed on
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
performed[x] | Σ | 0..1 |  | When the procedure was performed
performedDateTime |  |  | dateTime |
performedPeriod |  |  | Period |
performedString |  |  | string |
performedAge |  |  | Age |
performedRange |  |  | Range |
recorder | Σ | 0..1 | Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Patient (CZ core) | Related Person (CZ core)) | Who recorded the procedure
asserter | Σ | 0..1 | Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Patient (CZ core) | Related Person (CZ core)) | Person who asserts this procedure
Slices for performer | Σ | 0..* | BackboneElement | The people who performed the procedure Slice: Unordered, Open by value:function
performer:All Slices |  |  |  | Content/Rules for all slices
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 | 1..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 (CZ core) | Practitioner Role (CZ core) | Organization (CZ core) | Patient (CZ core) | Related Person (CZ core) | Device: Performer/Observer (CZ) | Medical Device (CZ)) | The reference to the practitioner
onBehalfOf |  | 0..1 | Reference(Organization (CZ core)) | Organization the device or practitioner was acting for
performer: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 | 1..1 | CodeableConcept | Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:""$this""
coding:healthcare-professional | Σ | 0..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
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: 223366009
display |  | 1..1 | string | Representation defined by the system Fixed Value: Healthcare professional
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
actor | Σ | 1..1 | Reference(Practitioner Role (CZ core)) | The reference to the practitioner
onBehalfOf |  | 0..1 | Reference(Organization (CZ core)) | Organization the device or practitioner was acting for
performer:imaging-device | 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 | 1..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 (CZ core) | Practitioner Role (CZ core) | Organization (CZ core) | Patient (CZ core) | Related Person (CZ core) | Device: Performer/Observer (CZ) | Medical Device (CZ)) | The reference to the practitioner
onBehalfOf |  | 0..1 | Reference(Organization (CZ core)) | Organization the device or practitioner was acting for
location | Σ | 0..1 | Reference(Location) | Where the procedure happened
reasonCode | Σ | 0..* | CodeableConcept | Coded reason procedure performed Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required.
reasonReference | Σ | 0..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) | 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: Performer/Observer (CZ) | Medical Device (CZ) | Medication (CZ) | 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 | Status | Usage | ValueSet | Version | Source
Procedure.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Procedure.status | Base | required | EventStatus | 📍4.0.1 | FHIR Std.
Procedure.statusReason | Base | example | Procedure Not Performed Reason (SNOMED-CT) | 📍4.0.1 | FHIR Std.
Procedure.category | Base | example | Procedure Category Codes (SNOMED CT) | 📍4.0.1 | FHIR Std.
Procedure.code | Base | example | Procedure Codes (SNOMED CT) | 📍4.0.1 | FHIR Std.
Procedure.performer.​function | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.
Procedure.performer:performer.​function | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.
Procedure.performer:imaging-device.​function | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.
Procedure.reasonCode | Base | example | Procedure Reason Codes | 📍4.0.1 | FHIR Std.
Procedure.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.
Procedure.outcome | Base | example | Procedure Outcome Codes (SNOMED CT) | 📍4.0.1 | FHIR Std.
Procedure.complication | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.
Procedure.followUp | Base | example | Procedure Follow up Codes (SNOMED CT) | 📍4.0.1 | FHIR Std.
Procedure.focalDevice.​action | Base | preferred | Procedure Device Action Codes | 📍4.0.1 | FHIR Std.
Procedure.usedCode | Base | example | FHIR Device Types | 📍4.0.1 | FHIR Std.

#### Constraints

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

This structure is derived from Procedure

Summary

Mandatory: 1 element(1 nested mandatory element)

Structures

This structure refers to these other structures:

- Patient (CZ core) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-patient-core)
- Patient: Animal (CZ) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-patient-animal)
- Practitioner (CZ core) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-practitioner-core)
- Practitioner Role (CZ core) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-practitionerrole-core)
- Related Person (CZ core) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-relatedPerson-core)
- Organization (CZ core) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-organization-core)
- Device: Performer/Observer (CZ) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-device-observer)
- Medical Device (CZ) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-medical-device)
- Medication (CZ) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-Medication)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Procedure.performer
- The element 1 is sliced based on the value of Procedure.performer.function.coding

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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
status | ?!Σ | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
code | Σ | 1..1 | CodeableConcept | Identification of the procedure Binding: ProcedureCodes(SNOMEDCT) (example): A code to identify a specific procedure .
subject | Σ | 1..1 | Reference(Patient (CZ core) | Patient: Animal (CZ) | Group) | Who the procedure was performed on
recorder | Σ | 0..1 | Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Patient (CZ core) | Related Person (CZ core)) | Who recorded the procedure
asserter | Σ | 0..1 | Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Patient (CZ core) | Related Person (CZ core)) | Person who asserts this procedure
Slices for performer | Σ | 0..* | BackboneElement | The people who performed the procedure Slice: Unordered, Open by value:function
performer:All Slices |  |  |  | Content/Rules for all slices
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function | Σ | 1..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 (CZ core) | Practitioner Role (CZ core) | Organization (CZ core) | Patient (CZ core) | Related Person (CZ core) | Device: Performer/Observer (CZ) | Medical Device (CZ)) | The reference to the practitioner
onBehalfOf |  | 0..1 | Reference(Organization (CZ core)) | Organization the device or practitioner was acting for
performer:performer | Σ | 0..* | BackboneElement | The people who performed the procedure
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function | Σ | 1..1 | CodeableConcept | Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:""$this""
coding:healthcare-professional | Σ | 0..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
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: 223366009
display |  | 1..1 | string | Representation defined by the system Fixed Value: Healthcare professional
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
actor | Σ | 1..1 | Reference(Practitioner Role (CZ core)) | The reference to the practitioner
performer:imaging-device | Σ | 0..* | BackboneElement | The people who performed the procedure
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function | Σ | 1..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 (CZ core) | Practitioner Role (CZ core) | Organization (CZ core) | Patient (CZ core) | Related Person (CZ core) | Device: Performer/Observer (CZ) | Medical Device (CZ)) | The reference to the practitioner
usedReference |  | 0..* | Reference(Device: Performer/Observer (CZ) | Medical Device (CZ) | Medication (CZ) | Substance) | Items used during procedure
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Procedure.status | Base | required | EventStatus | 📍4.0.1 | FHIR Std.
Procedure.code | Base | example | Procedure Codes (SNOMED CT) | 📍4.0.1 | FHIR Std.
Procedure.performer.​function | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.
Procedure.performer:performer.​function | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.
Procedure.performer:imaging-device.​function | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.

#### Constraints

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

Differential View

This structure is derived from Procedure

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Procedure |  |  | Procedure |
code |  | 1..1 | CodeableConcept | Identification of the procedure
subject |  | 1..1 | Reference(Patient (CZ core) | Patient: Animal (CZ) | Group) | Who the procedure was performed on
recorder |  | 0..1 | Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Patient (CZ core) | Related Person (CZ core)) | Who recorded the procedure
asserter |  | 0..1 | Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Patient (CZ core) | Related Person (CZ core)) | Person who asserts this procedure
Slices for performer |  | 0..* | BackboneElement | The people who performed the procedure Slice: Unordered, Open by value:function
performer:All Slices |  |  |  | Content/Rules for all slices
function |  | 1..1 | CodeableConcept | Type of performance
actor |  | 1..1 | Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Organization (CZ core) | Patient (CZ core) | Related Person (CZ core) | Device: Performer/Observer (CZ) | Medical Device (CZ)) | The reference to the practitioner
onBehalfOf |  | 0..1 | Reference(Organization (CZ core)) | Organization the device or practitioner was acting for
performer:performer |  | 0..* | BackboneElement | The people who performed the procedure
function |  |  |  |
Slices for coding |  | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:""$this""
coding:healthcare-professional |  | 0..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
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: 223366009
display |  | 1..1 | string | Representation defined by the system Fixed Value: Healthcare professional
actor |  | 1..1 | Reference(Practitioner Role (CZ core)) | The reference to the practitioner
performer:imaging-device |  | 0..* | BackboneElement | The people who performed the procedure
usedReference |  | 0..* | Reference(Device: Performer/Observer (CZ) | Medical Device (CZ) | Medication (CZ) | Substance) | Items used during procedure
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
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 | Σ | 0..* | Reference(Procedure | Observation | MedicationAdministration) | Part of referenced event
status | ?!Σ | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
statusReason | Σ | 0..1 | CodeableConcept | Reason for current status Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.
category | Σ | 0..1 | CodeableConcept | Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes.
code | Σ | 1..1 | CodeableConcept | Identification of the procedure Binding: ProcedureCodes(SNOMEDCT) (example): A code to identify a specific procedure .
subject | Σ | 1..1 | Reference(Patient (CZ core) | Patient: Animal (CZ) | Group) | Who the procedure was performed on
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
performed[x] | Σ | 0..1 |  | When the procedure was performed
performedDateTime |  |  | dateTime |
performedPeriod |  |  | Period |
performedString |  |  | string |
performedAge |  |  | Age |
performedRange |  |  | Range |
recorder | Σ | 0..1 | Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Patient (CZ core) | Related Person (CZ core)) | Who recorded the procedure
asserter | Σ | 0..1 | Reference(Practitioner (CZ core) | Practitioner Role (CZ core) | Patient (CZ core) | Related Person (CZ core)) | Person who asserts this procedure
Slices for performer | Σ | 0..* | BackboneElement | The people who performed the procedure Slice: Unordered, Open by value:function
performer:All Slices |  |  |  | Content/Rules for all slices
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 | 1..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 (CZ core) | Practitioner Role (CZ core) | Organization (CZ core) | Patient (CZ core) | Related Person (CZ core) | Device: Performer/Observer (CZ) | Medical Device (CZ)) | The reference to the practitioner
onBehalfOf |  | 0..1 | Reference(Organization (CZ core)) | Organization the device or practitioner was acting for
performer: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 | 1..1 | CodeableConcept | Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:""$this""
coding:healthcare-professional | Σ | 0..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
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: 223366009
display |  | 1..1 | string | Representation defined by the system Fixed Value: Healthcare professional
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
actor | Σ | 1..1 | Reference(Practitioner Role (CZ core)) | The reference to the practitioner
onBehalfOf |  | 0..1 | Reference(Organization (CZ core)) | Organization the device or practitioner was acting for
performer:imaging-device | 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 | 1..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 (CZ core) | Practitioner Role (CZ core) | Organization (CZ core) | Patient (CZ core) | Related Person (CZ core) | Device: Performer/Observer (CZ) | Medical Device (CZ)) | The reference to the practitioner
onBehalfOf |  | 0..1 | Reference(Organization (CZ core)) | Organization the device or practitioner was acting for
location | Σ | 0..1 | Reference(Location) | Where the procedure happened
reasonCode | Σ | 0..* | CodeableConcept | Coded reason procedure performed Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required.
reasonReference | Σ | 0..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) | 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: Performer/Observer (CZ) | Medical Device (CZ) | Medication (CZ) | 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 | Status | Usage | ValueSet | Version | Source
Procedure.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Procedure.status | Base | required | EventStatus | 📍4.0.1 | FHIR Std.
Procedure.statusReason | Base | example | Procedure Not Performed Reason (SNOMED-CT) | 📍4.0.1 | FHIR Std.
Procedure.category | Base | example | Procedure Category Codes (SNOMED CT) | 📍4.0.1 | FHIR Std.
Procedure.code | Base | example | Procedure Codes (SNOMED CT) | 📍4.0.1 | FHIR Std.
Procedure.performer.​function | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.
Procedure.performer:performer.​function | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.
Procedure.performer:imaging-device.​function | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.
Procedure.reasonCode | Base | example | Procedure Reason Codes | 📍4.0.1 | FHIR Std.
Procedure.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.
Procedure.outcome | Base | example | Procedure Outcome Codes (SNOMED CT) | 📍4.0.1 | FHIR Std.
Procedure.complication | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.
Procedure.followUp | Base | example | Procedure Follow up Codes (SNOMED CT) | 📍4.0.1 | FHIR Std.
Procedure.focalDevice.​action | Base | preferred | Procedure Device Action Codes | 📍4.0.1 | FHIR Std.
Procedure.usedCode | Base | example | FHIR Device Types | 📍4.0.1 | FHIR Std.

#### Constraints

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

This structure is derived from Procedure

Summary

Mandatory: 1 element(1 nested mandatory element)

Structures

This structure refers to these other structures:

- Patient (CZ core) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-patient-core)
- Patient: Animal (CZ) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-patient-animal)
- Practitioner (CZ core) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-practitioner-core)
- Practitioner Role (CZ core) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-practitionerrole-core)
- Related Person (CZ core) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-relatedPerson-core)
- Organization (CZ core) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-organization-core)
- Device: Performer/Observer (CZ) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-device-observer)
- Medical Device (CZ) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-medical-device)
- Medication (CZ) (https://fhir.hl7cr.eu/core/StructureDefinition/cz-Medication)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Procedure.performer
- The element 1 is sliced based on the value of Procedure.performer.function.coding

Maturity: 1

Other representations of profile: CSV, Excel, Schematron