SDOH Clinical Care
3.0.0 - STU 3

SDOH Clinical Care, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 3.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-sdoh-clinicalcare/ and changes regularly. See the Directory of published versions

## Resource Profile: SDOHCC Procedure

Official URL: http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-Procedure | Version: 3.0.0
Standards status: Trial-use | Maturity Level: 2 | Computable Name: SDOHCCProcedure

Profile for interventions that address Social Determinants of Health.

### Purpose

SDOHCC Procedure is generally intended to represent a procedure performed to address an identified social risk or need (e.g., SDOHCC Condition, SDOHCC Observation Screening Response, SDOHCC Observation Assessment). SDOHCC Procedure can be based on an SDOHCC ServiceRequest, pertain to an SDOHCC Goal, or be the output of an SDOHCC Task For Referral Management. See the Data Modeling Framework for more detail on the relationships between SDOHCC Procedure and the other profiles in this IG.

### Usage

`Procedure.code` has a binding to US Core Procedure Codes (required). `Procedure.code` also has additional bindings to SDOH domain-specific value sets (e.g., for Food Insecurity) which are determined by the value selected for `Procedure.category`. When `Procedure.category` is a value from SDOHCC ValueSet SDOH Category (e.g., food-insecurity), `Procedure.code` SHALL be selected from the corresponding domain-specific value set found in Additional Bindings (i.e. Food Insecurity Procedures). If more than one value is selected from SDOHCC ValueSet SDOH Category (e.g., food-insecurity and financial-insecurity) for `Procedure.category`, then `Procedure.code` SHALL be selected from at least one of the corresponding domain-specific value sets found in Additional Bindings (e.g. Food Insecurity Procedures).

Of note, Gravity Project is continuously developing terminology for new SDOH domains. For new SDOH domains where the Gravity terminology development cycle is in progress, domain-specific value sets may not yet be available in VSAC. If a domain-specific value set is not yet available in VSAC, the Additional Binding is the default binding for the profile element. Additionally, sometimes a domain-specific value set for a new domain is available in VSAC but does not yet include all standardized codes identified during the domain’s terminology development cycle. In this case, the value set’s “Description” tab in VSAC will state, “In progress”. If a domain-specific value set is available in VSAC but does not yet include all standardized codes identified during the domain’s terminology development cycle, the value set’s VSAC “Description” tab will state, “In progress”. Additional information related to Gravity value sets is provided on the Social Risk Terminology Value Sets page on the Gravity Project Confluence site.

Additionally, some SDOH domains may not yet be represented in SDOHCC ValueSet SDOH Category. In this case, `Procedure.category`: sdoh-category-unspecified can be used so that the Procedure instance can still be categorized as SDOH-related. If desired, category.text can also be used to further specify the domain. For example, at the time of publication of this IG, “disability-status” is not yet included in SDOHCC ValueSet SDOH Category. In this case, `Procedure.category`: sdoh-category-unspecified can be used along with category.text: Disability Status. For `Procedure.category`: sdoh-category-unspecified, there will not be domain-specific value sets and Additional Bindings for `Procedure.code` will designate the default binding to US Core Procedure Codes (required).

For more information on the correlation between `Procedure.category` and the domain-specific value sets in Additional Bindings for `Procedure.code`, see Gravity Project Value Sets.

Usages:

- Refer to this Profile: SDOHCC Task For Referral Management
- Examples for this Profile: Procedure/SDOHCC-ProcedureFoodPantryApplicationAssistanceExample, Procedure/SDOHCC-ProcedureProvisionOfFoodExample and Procedure/SDOHCC-ProcedureSummerFoodProgramApplicationAssistanceExample
- CapabilityStatements using this Profile: SDOHCC Coordination Platform, SDOHCC Referral Recipient, SDOHCC Referral Recipient - Light and SDOHCC Referral Source

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 | C | 0..* | Procedure | An action that is being or was performed on a patient Constraints: us-core-7
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:pertainsToGoal | S | 0..* | (Complex) | Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal"
value[x] | S | 1..1 | Reference(SDOHCC Goal) | Value of extension
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for basedOn | S Σ | 0..* | Reference(CarePlan | ServiceRequest) | A request for this procedure Slice: Unordered, Open by profile:resolve()
basedOn:SupportedBasedOn | S Σ | 0..* | Reference(SDOHCC ServiceRequest | US Core CarePlan Profile(7.0.0)) | An SDOH service request or US Core Care Plan for this procedure
status | ?!S Σ C | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required)
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.
Slices for coding | S Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:SDOHCC | S Σ | 0..1 | Coding | e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories.
code | S Σ | 1..1 | CodeableConcept | Identification of the procedure Binding: USCoreProcedureCodes (7.0.0) (required): Codes describing the type of Procedure
Additional Bindings | Purpose | Usage
USCoreProcedureCodes (7.0.0) | Current |
DigitalAccessProcedures (20240615) | Extensible | SDOHCCProcedure#`Procedure.category` = digital-access
DigitalLiteracyProcedures (20240628) | Extensible | SDOHCCProcedure#`Procedure.category` = digital-literacy
LessThanHighSchoolEducationProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = educational-attainment
ElderAbuseProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = elder-abuse
UnemploymentProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = employment-status
FinancialInsecurityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = financial-insecurity
FoodInsecurityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = food-insecurity
HealthInsuranceCoverageStatusProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = health-insurance-coverage-status
HomelessnessProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = homelessness
HousingInstabilityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = housing-instability
InadequateHousingProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = inadequate-housing
Incarceration Status Procedures | Extensible | SDOHCCProcedure#`Procedure.category` = incarceration-status
IntimatePartnerViolenceProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = intimate-partner-violence
Language Access Procedures | Extensible | SDOHCCProcedure#`Procedure.category` = language-access
MaterialHardshipProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = material-hardship
MedicalCostBurdenProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = medical-cost-burden
HealthLiteracyProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = personal-health-literacy
SocialConnectionProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = social-connection
StressProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = stress
TransportationInsecurityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = transportation-insecurity
UtilityInsecurityProcedures (20240524) | Extensible | SDOHCCProcedure#`Procedure.category` = utility-insecurity
VeteranStatusProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = veteran-status
USCoreProcedureCodes (7.0.0) | Required | SDOHCCProcedure#`Procedure.category` = sdoh-category-unspecified
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0)) | Who the procedure was performed on
encounter | S Σ | 0..1 | Reference(US Core Encounter Profile(7.0.0)) | Encounter associated with the procedure
performed[x] | S Σ C | 0..1 |  | When the procedure was performed
performedDateTime |  |  | dateTime S |
performedPeriod |  |  | Period |
performedString |  |  | string |
performedAge |  |  | Age |
performedRange |  |  | Range |
reasonCode | Σ | 0..* | CodeableConcept | Coded reason procedure performed Binding: USCoreConditionCodes (7.0.0) (extensible)
Slices for reasonReference | Σ | 0..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) | The justification that the procedure was performed Slice: Unordered, Open by profile:resolve()
reasonReference:SupportedReasonReference | S Σ | 0..* | Reference(SDOHCC Condition | SDOHCC Observation Screening Response | SDOHCC Observation Assessment) | The justification that the procedure was performed
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Procedure.status | required | EventStatus `http://hl7.org/fhir/ValueSet/event-status` From the FHIR Standard
Procedure.category | example | ProcedureCategoryCodes(SNOMEDCT) `http://hl7.org/fhir/ValueSet/procedure-category|4.0.1` From the FHIR Standard
Procedure.category.coding:SDOHCC | required | SDOHCCValueSetSDOHCategory `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory` From this IG
Procedure.code | required | USCoreProcedureCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code|7.0.0`
Procedure.reasonCode | extensible | USCoreConditionCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Procedure | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Procedure | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Procedure | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Procedure | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Procedure | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
us-core-7 | error | Procedure | Performed SHALL be present if the status is 'completed' or 'in-progress' : (status='completed' or status='in-progress') implies performed.exists() |

This structure is derived from Procedure

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Procedure | C | 0..* | Procedure | An action that is being or was performed on a patient Constraints: us-core-7
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:pertainsToGoal | S | 0..* | (Complex) | Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
value[x] | S | 1..1 | Reference(SDOHCC Goal) | Value of extension
Slices for basedOn | S | 0..* | Reference(CarePlan | ServiceRequest) | A request for this procedure Slice: Unordered, Open by profile:resolve()
basedOn:SupportedBasedOn | S | 0..* | Reference(SDOHCC ServiceRequest | US Core CarePlan Profile(7.0.0)) | An SDOH service request or US Core Care Plan for this procedure
status | S C | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required)
category |  | 0..1 | CodeableConcept | Classification of the procedure
Slices for coding | S | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:SDOHCC | S | 0..1 | Coding | e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories.
code | S | 1..1 | CodeableConcept | Identification of the procedure Binding: USCoreProcedureCodes (7.0.0) (required): Codes describing the type of Procedure
Additional Bindings | Purpose | Usage
USCoreProcedureCodes (7.0.0) | Current |
DigitalAccessProcedures (20240615) | Extensible | SDOHCCProcedure#`Procedure.category` = digital-access
DigitalLiteracyProcedures (20240628) | Extensible | SDOHCCProcedure#`Procedure.category` = digital-literacy
LessThanHighSchoolEducationProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = educational-attainment
ElderAbuseProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = elder-abuse
UnemploymentProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = employment-status
FinancialInsecurityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = financial-insecurity
FoodInsecurityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = food-insecurity
HealthInsuranceCoverageStatusProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = health-insurance-coverage-status
HomelessnessProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = homelessness
HousingInstabilityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = housing-instability
InadequateHousingProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = inadequate-housing
Incarceration Status Procedures | Extensible | SDOHCCProcedure#`Procedure.category` = incarceration-status
IntimatePartnerViolenceProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = intimate-partner-violence
Language Access Procedures | Extensible | SDOHCCProcedure#`Procedure.category` = language-access
MaterialHardshipProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = material-hardship
MedicalCostBurdenProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = medical-cost-burden
HealthLiteracyProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = personal-health-literacy
SocialConnectionProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = social-connection
StressProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = stress
TransportationInsecurityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = transportation-insecurity
UtilityInsecurityProcedures (20240524) | Extensible | SDOHCCProcedure#`Procedure.category` = utility-insecurity
VeteranStatusProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = veteran-status
USCoreProcedureCodes (7.0.0) | Required | SDOHCCProcedure#`Procedure.category` = sdoh-category-unspecified
subject | S | 1..1 | Reference(US Core Patient Profile(7.0.0)) | Who the procedure was performed on
encounter | S | 0..1 | Reference(US Core Encounter Profile(7.0.0)) | Encounter associated with the procedure
performed[x] | S C | 0..1 |  | When the procedure was performed
performedDateTime |  |  | dateTime S |
performedPeriod |  |  | Period |
performedString |  |  | string |
performedAge |  |  | Age |
performedRange |  |  | Range |
reasonCode |  | 0..* | CodeableConcept | Coded reason procedure performed Binding: USCoreConditionCodes (7.0.0) (extensible)
Slices for reasonReference |  | 0..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) | The justification that the procedure was performed Slice: Unordered, Open by profile:resolve()
reasonReference:SupportedReasonReference | S | 0..* | Reference(SDOHCC Condition | SDOHCC Observation Screening Response | SDOHCC Observation Assessment) | The justification that the procedure was performed
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Procedure.status | required | EventStatus `http://hl7.org/fhir/ValueSet/event-status` From the FHIR Standard
Procedure.category.coding:SDOHCC | required | SDOHCCValueSetSDOHCategory `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory` From this IG
Procedure.code | required | USCoreProcedureCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code|7.0.0`
Procedure.reasonCode | extensible | USCoreConditionCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
us-core-7 | error | Procedure | Performed SHALL be present if the status is 'completed' or 'in-progress' : (status='completed' or status='in-progress') implies performed.exists() |

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Procedure | C | 0..* | Procedure | An action that is being or was performed on a patient Constraints: us-core-7
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
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:pertainsToGoal | S | 0..* | (Complex) | Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
id |  | 0..1 | id | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal"
value[x] | S | 1..1 | Reference(SDOHCC Goal) | Value of extension
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
Slices for basedOn | S Σ | 0..* | Reference(CarePlan | ServiceRequest) | A request for this procedure Slice: Unordered, Open by profile:resolve()
basedOn:SupportedBasedOn | S Σ | 0..* | Reference(SDOHCC ServiceRequest | US Core CarePlan Profile(7.0.0)) | An SDOH service request or US Core Care Plan for this procedure
partOf | Σ | 0..* | Reference(Procedure | Observation | MedicationAdministration) | Part of referenced event
status | ?!S Σ C | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required)
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.
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 | S Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:SDOHCC | S Σ | 0..1 | Coding | e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories.
text | Σ | 0..1 | string | Plain text representation of the concept
code | S Σ | 1..1 | CodeableConcept | Identification of the procedure Binding: USCoreProcedureCodes (7.0.0) (required): Codes describing the type of Procedure
Additional Bindings | Purpose | Usage
USCoreProcedureCodes (7.0.0) | Current |
DigitalAccessProcedures (20240615) | Extensible | SDOHCCProcedure#`Procedure.category` = digital-access
DigitalLiteracyProcedures (20240628) | Extensible | SDOHCCProcedure#`Procedure.category` = digital-literacy
LessThanHighSchoolEducationProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = educational-attainment
ElderAbuseProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = elder-abuse
UnemploymentProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = employment-status
FinancialInsecurityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = financial-insecurity
FoodInsecurityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = food-insecurity
HealthInsuranceCoverageStatusProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = health-insurance-coverage-status
HomelessnessProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = homelessness
HousingInstabilityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = housing-instability
InadequateHousingProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = inadequate-housing
Incarceration Status Procedures | Extensible | SDOHCCProcedure#`Procedure.category` = incarceration-status
IntimatePartnerViolenceProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = intimate-partner-violence
Language Access Procedures | Extensible | SDOHCCProcedure#`Procedure.category` = language-access
MaterialHardshipProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = material-hardship
MedicalCostBurdenProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = medical-cost-burden
HealthLiteracyProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = personal-health-literacy
SocialConnectionProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = social-connection
StressProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = stress
TransportationInsecurityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = transportation-insecurity
UtilityInsecurityProcedures (20240524) | Extensible | SDOHCCProcedure#`Procedure.category` = utility-insecurity
VeteranStatusProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = veteran-status
USCoreProcedureCodes (7.0.0) | Required | SDOHCCProcedure#`Procedure.category` = sdoh-category-unspecified
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0)) | Who the procedure was performed on
encounter | S Σ | 0..1 | Reference(US Core Encounter Profile(7.0.0)) | Encounter associated with the procedure
performed[x] | S Σ C | 0..1 |  | When the procedure was performed
performedDateTime |  |  | dateTime S |
performedPeriod |  |  | Period |
performedString |  |  | string |
performedAge |  |  | Age |
performedRange |  |  | Range |
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 | Σ | 0..* | CodeableConcept | Coded reason procedure performed Binding: USCoreConditionCodes (7.0.0) (extensible)
Slices for reasonReference | Σ | 0..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) | The justification that the procedure was performed Slice: Unordered, Open by profile:resolve()
reasonReference:SupportedReasonReference | S Σ | 0..* | Reference(SDOHCC Condition | SDOHCC Observation Screening Response | SDOHCC Observation Assessment) | 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 | URI
Procedure.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages|4.0.1` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Procedure.status | required | EventStatus `http://hl7.org/fhir/ValueSet/event-status` From the FHIR Standard
Procedure.statusReason | example | ProcedureNotPerformedReason(SNOMED-CT) `http://hl7.org/fhir/ValueSet/procedure-not-performed-reason|4.0.1` From the FHIR Standard
Procedure.category | example | ProcedureCategoryCodes(SNOMEDCT) `http://hl7.org/fhir/ValueSet/procedure-category|4.0.1` From the FHIR Standard
Procedure.category.coding:SDOHCC | required | SDOHCCValueSetSDOHCategory `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory` From this IG
Procedure.code | required | USCoreProcedureCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code|7.0.0`
Procedure.performer.function | example | ProcedurePerformerRoleCodes `http://hl7.org/fhir/ValueSet/performer-role|4.0.1` From the FHIR Standard
Procedure.reasonCode | extensible | USCoreConditionCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0`
Procedure.bodySite | example | SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site|4.0.1` From the FHIR Standard
Procedure.outcome | example | ProcedureOutcomeCodes(SNOMEDCT) `http://hl7.org/fhir/ValueSet/procedure-outcome|4.0.1` From the FHIR Standard
Procedure.complication | example | Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code|4.0.1` From the FHIR Standard
Procedure.followUp | example | ProcedureFollowUpCodes(SNOMEDCT) `http://hl7.org/fhir/ValueSet/procedure-followup|4.0.1` From the FHIR Standard
Procedure.focalDevice.action | preferred | ProcedureDeviceActionCodes `http://hl7.org/fhir/ValueSet/device-action|4.0.1` From the FHIR Standard
Procedure.usedCode | example | FHIRDeviceTypes `http://hl7.org/fhir/ValueSet/device-kind|4.0.1` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Procedure | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Procedure | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Procedure | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Procedure | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Procedure | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
us-core-7 | error | Procedure | Performed SHALL be present if the status is 'completed' or 'in-progress' : (status='completed' or status='in-progress') implies performed.exists() |

This structure is derived from Procedure

Summary

Mandatory: 1 element
Must-Support: 12 elements

Structures

This structure refers to these other structures:

- SDOHCC Goal (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-Goal)
- SDOHCC ServiceRequest (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ServiceRequest)
- US Core CarePlan Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan|7.0.0)
- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|7.0.0)
- US Core Encounter Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter|7.0.0)
- SDOHCC Condition (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-Condition)
- SDOHCC Observation Screening Response (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationScreeningResponse)
- SDOHCC Observation Assessment (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationAssessment)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal|5.2.0

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Procedure.basedOn
- The element 1 is sliced based on the value of Procedure.category.coding
- The element 1 is sliced based on the value of Procedure.reasonReference

Maturity: 2

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Procedure | C | 0..* | Procedure | An action that is being or was performed on a patient Constraints: us-core-7
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:pertainsToGoal | S | 0..* | (Complex) | Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal"
value[x] | S | 1..1 | Reference(SDOHCC Goal) | Value of extension
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for basedOn | S Σ | 0..* | Reference(CarePlan | ServiceRequest) | A request for this procedure Slice: Unordered, Open by profile:resolve()
basedOn:SupportedBasedOn | S Σ | 0..* | Reference(SDOHCC ServiceRequest | US Core CarePlan Profile(7.0.0)) | An SDOH service request or US Core Care Plan for this procedure
status | ?!S Σ C | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required)
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.
Slices for coding | S Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:SDOHCC | S Σ | 0..1 | Coding | e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories.
code | S Σ | 1..1 | CodeableConcept | Identification of the procedure Binding: USCoreProcedureCodes (7.0.0) (required): Codes describing the type of Procedure
Additional Bindings | Purpose | Usage
USCoreProcedureCodes (7.0.0) | Current |
DigitalAccessProcedures (20240615) | Extensible | SDOHCCProcedure#`Procedure.category` = digital-access
DigitalLiteracyProcedures (20240628) | Extensible | SDOHCCProcedure#`Procedure.category` = digital-literacy
LessThanHighSchoolEducationProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = educational-attainment
ElderAbuseProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = elder-abuse
UnemploymentProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = employment-status
FinancialInsecurityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = financial-insecurity
FoodInsecurityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = food-insecurity
HealthInsuranceCoverageStatusProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = health-insurance-coverage-status
HomelessnessProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = homelessness
HousingInstabilityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = housing-instability
InadequateHousingProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = inadequate-housing
Incarceration Status Procedures | Extensible | SDOHCCProcedure#`Procedure.category` = incarceration-status
IntimatePartnerViolenceProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = intimate-partner-violence
Language Access Procedures | Extensible | SDOHCCProcedure#`Procedure.category` = language-access
MaterialHardshipProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = material-hardship
MedicalCostBurdenProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = medical-cost-burden
HealthLiteracyProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = personal-health-literacy
SocialConnectionProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = social-connection
StressProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = stress
TransportationInsecurityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = transportation-insecurity
UtilityInsecurityProcedures (20240524) | Extensible | SDOHCCProcedure#`Procedure.category` = utility-insecurity
VeteranStatusProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = veteran-status
USCoreProcedureCodes (7.0.0) | Required | SDOHCCProcedure#`Procedure.category` = sdoh-category-unspecified
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0)) | Who the procedure was performed on
encounter | S Σ | 0..1 | Reference(US Core Encounter Profile(7.0.0)) | Encounter associated with the procedure
performed[x] | S Σ C | 0..1 |  | When the procedure was performed
performedDateTime |  |  | dateTime S |
performedPeriod |  |  | Period |
performedString |  |  | string |
performedAge |  |  | Age |
performedRange |  |  | Range |
reasonCode | Σ | 0..* | CodeableConcept | Coded reason procedure performed Binding: USCoreConditionCodes (7.0.0) (extensible)
Slices for reasonReference | Σ | 0..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) | The justification that the procedure was performed Slice: Unordered, Open by profile:resolve()
reasonReference:SupportedReasonReference | S Σ | 0..* | Reference(SDOHCC Condition | SDOHCC Observation Screening Response | SDOHCC Observation Assessment) | The justification that the procedure was performed
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Procedure.status | required | EventStatus `http://hl7.org/fhir/ValueSet/event-status` From the FHIR Standard
Procedure.category | example | ProcedureCategoryCodes(SNOMEDCT) `http://hl7.org/fhir/ValueSet/procedure-category|4.0.1` From the FHIR Standard
Procedure.category.coding:SDOHCC | required | SDOHCCValueSetSDOHCategory `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory` From this IG
Procedure.code | required | USCoreProcedureCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code|7.0.0`
Procedure.reasonCode | extensible | USCoreConditionCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Procedure | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Procedure | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Procedure | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Procedure | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Procedure | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
us-core-7 | error | Procedure | Performed SHALL be present if the status is 'completed' or 'in-progress' : (status='completed' or status='in-progress') implies performed.exists() |

Differential View

This structure is derived from Procedure

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Procedure | C | 0..* | Procedure | An action that is being or was performed on a patient Constraints: us-core-7
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:pertainsToGoal | S | 0..* | (Complex) | Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
value[x] | S | 1..1 | Reference(SDOHCC Goal) | Value of extension
Slices for basedOn | S | 0..* | Reference(CarePlan | ServiceRequest) | A request for this procedure Slice: Unordered, Open by profile:resolve()
basedOn:SupportedBasedOn | S | 0..* | Reference(SDOHCC ServiceRequest | US Core CarePlan Profile(7.0.0)) | An SDOH service request or US Core Care Plan for this procedure
status | S C | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required)
category |  | 0..1 | CodeableConcept | Classification of the procedure
Slices for coding | S | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:SDOHCC | S | 0..1 | Coding | e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories.
code | S | 1..1 | CodeableConcept | Identification of the procedure Binding: USCoreProcedureCodes (7.0.0) (required): Codes describing the type of Procedure
Additional Bindings | Purpose | Usage
USCoreProcedureCodes (7.0.0) | Current |
DigitalAccessProcedures (20240615) | Extensible | SDOHCCProcedure#`Procedure.category` = digital-access
DigitalLiteracyProcedures (20240628) | Extensible | SDOHCCProcedure#`Procedure.category` = digital-literacy
LessThanHighSchoolEducationProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = educational-attainment
ElderAbuseProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = elder-abuse
UnemploymentProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = employment-status
FinancialInsecurityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = financial-insecurity
FoodInsecurityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = food-insecurity
HealthInsuranceCoverageStatusProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = health-insurance-coverage-status
HomelessnessProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = homelessness
HousingInstabilityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = housing-instability
InadequateHousingProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = inadequate-housing
Incarceration Status Procedures | Extensible | SDOHCCProcedure#`Procedure.category` = incarceration-status
IntimatePartnerViolenceProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = intimate-partner-violence
Language Access Procedures | Extensible | SDOHCCProcedure#`Procedure.category` = language-access
MaterialHardshipProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = material-hardship
MedicalCostBurdenProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = medical-cost-burden
HealthLiteracyProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = personal-health-literacy
SocialConnectionProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = social-connection
StressProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = stress
TransportationInsecurityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = transportation-insecurity
UtilityInsecurityProcedures (20240524) | Extensible | SDOHCCProcedure#`Procedure.category` = utility-insecurity
VeteranStatusProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = veteran-status
USCoreProcedureCodes (7.0.0) | Required | SDOHCCProcedure#`Procedure.category` = sdoh-category-unspecified
subject | S | 1..1 | Reference(US Core Patient Profile(7.0.0)) | Who the procedure was performed on
encounter | S | 0..1 | Reference(US Core Encounter Profile(7.0.0)) | Encounter associated with the procedure
performed[x] | S C | 0..1 |  | When the procedure was performed
performedDateTime |  |  | dateTime S |
performedPeriod |  |  | Period |
performedString |  |  | string |
performedAge |  |  | Age |
performedRange |  |  | Range |
reasonCode |  | 0..* | CodeableConcept | Coded reason procedure performed Binding: USCoreConditionCodes (7.0.0) (extensible)
Slices for reasonReference |  | 0..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) | The justification that the procedure was performed Slice: Unordered, Open by profile:resolve()
reasonReference:SupportedReasonReference | S | 0..* | Reference(SDOHCC Condition | SDOHCC Observation Screening Response | SDOHCC Observation Assessment) | The justification that the procedure was performed
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Procedure.status | required | EventStatus `http://hl7.org/fhir/ValueSet/event-status` From the FHIR Standard
Procedure.category.coding:SDOHCC | required | SDOHCCValueSetSDOHCategory `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory` From this IG
Procedure.code | required | USCoreProcedureCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code|7.0.0`
Procedure.reasonCode | extensible | USCoreConditionCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
us-core-7 | error | Procedure | Performed SHALL be present if the status is 'completed' or 'in-progress' : (status='completed' or status='in-progress') implies performed.exists() |

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Procedure | C | 0..* | Procedure | An action that is being or was performed on a patient Constraints: us-core-7
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
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:pertainsToGoal | S | 0..* | (Complex) | Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
id |  | 0..1 | id | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal"
value[x] | S | 1..1 | Reference(SDOHCC Goal) | Value of extension
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
Slices for basedOn | S Σ | 0..* | Reference(CarePlan | ServiceRequest) | A request for this procedure Slice: Unordered, Open by profile:resolve()
basedOn:SupportedBasedOn | S Σ | 0..* | Reference(SDOHCC ServiceRequest | US Core CarePlan Profile(7.0.0)) | An SDOH service request or US Core Care Plan for this procedure
partOf | Σ | 0..* | Reference(Procedure | Observation | MedicationAdministration) | Part of referenced event
status | ?!S Σ C | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required)
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.
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 | S Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:SDOHCC | S Σ | 0..1 | Coding | e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories.
text | Σ | 0..1 | string | Plain text representation of the concept
code | S Σ | 1..1 | CodeableConcept | Identification of the procedure Binding: USCoreProcedureCodes (7.0.0) (required): Codes describing the type of Procedure
Additional Bindings | Purpose | Usage
USCoreProcedureCodes (7.0.0) | Current |
DigitalAccessProcedures (20240615) | Extensible | SDOHCCProcedure#`Procedure.category` = digital-access
DigitalLiteracyProcedures (20240628) | Extensible | SDOHCCProcedure#`Procedure.category` = digital-literacy
LessThanHighSchoolEducationProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = educational-attainment
ElderAbuseProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = elder-abuse
UnemploymentProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = employment-status
FinancialInsecurityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = financial-insecurity
FoodInsecurityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = food-insecurity
HealthInsuranceCoverageStatusProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = health-insurance-coverage-status
HomelessnessProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = homelessness
HousingInstabilityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = housing-instability
InadequateHousingProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = inadequate-housing
Incarceration Status Procedures | Extensible | SDOHCCProcedure#`Procedure.category` = incarceration-status
IntimatePartnerViolenceProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = intimate-partner-violence
Language Access Procedures | Extensible | SDOHCCProcedure#`Procedure.category` = language-access
MaterialHardshipProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = material-hardship
MedicalCostBurdenProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = medical-cost-burden
HealthLiteracyProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = personal-health-literacy
SocialConnectionProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = social-connection
StressProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = stress
TransportationInsecurityProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = transportation-insecurity
UtilityInsecurityProcedures (20240524) | Extensible | SDOHCCProcedure#`Procedure.category` = utility-insecurity
VeteranStatusProcedures (20240604) | Extensible | SDOHCCProcedure#`Procedure.category` = veteran-status
USCoreProcedureCodes (7.0.0) | Required | SDOHCCProcedure#`Procedure.category` = sdoh-category-unspecified
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0)) | Who the procedure was performed on
encounter | S Σ | 0..1 | Reference(US Core Encounter Profile(7.0.0)) | Encounter associated with the procedure
performed[x] | S Σ C | 0..1 |  | When the procedure was performed
performedDateTime |  |  | dateTime S |
performedPeriod |  |  | Period |
performedString |  |  | string |
performedAge |  |  | Age |
performedRange |  |  | Range |
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 | Σ | 0..* | CodeableConcept | Coded reason procedure performed Binding: USCoreConditionCodes (7.0.0) (extensible)
Slices for reasonReference | Σ | 0..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) | The justification that the procedure was performed Slice: Unordered, Open by profile:resolve()
reasonReference:SupportedReasonReference | S Σ | 0..* | Reference(SDOHCC Condition | SDOHCC Observation Screening Response | SDOHCC Observation Assessment) | 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 | URI
Procedure.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages|4.0.1` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Procedure.status | required | EventStatus `http://hl7.org/fhir/ValueSet/event-status` From the FHIR Standard
Procedure.statusReason | example | ProcedureNotPerformedReason(SNOMED-CT) `http://hl7.org/fhir/ValueSet/procedure-not-performed-reason|4.0.1` From the FHIR Standard
Procedure.category | example | ProcedureCategoryCodes(SNOMEDCT) `http://hl7.org/fhir/ValueSet/procedure-category|4.0.1` From the FHIR Standard
Procedure.category.coding:SDOHCC | required | SDOHCCValueSetSDOHCategory `http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory` From this IG
Procedure.code | required | USCoreProcedureCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code|7.0.0`
Procedure.performer.function | example | ProcedurePerformerRoleCodes `http://hl7.org/fhir/ValueSet/performer-role|4.0.1` From the FHIR Standard
Procedure.reasonCode | extensible | USCoreConditionCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0`
Procedure.bodySite | example | SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site|4.0.1` From the FHIR Standard
Procedure.outcome | example | ProcedureOutcomeCodes(SNOMEDCT) `http://hl7.org/fhir/ValueSet/procedure-outcome|4.0.1` From the FHIR Standard
Procedure.complication | example | Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code|4.0.1` From the FHIR Standard
Procedure.followUp | example | ProcedureFollowUpCodes(SNOMEDCT) `http://hl7.org/fhir/ValueSet/procedure-followup|4.0.1` From the FHIR Standard
Procedure.focalDevice.action | preferred | ProcedureDeviceActionCodes `http://hl7.org/fhir/ValueSet/device-action|4.0.1` From the FHIR Standard
Procedure.usedCode | example | FHIRDeviceTypes `http://hl7.org/fhir/ValueSet/device-kind|4.0.1` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Procedure | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Procedure | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | Procedure | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | Procedure | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Procedure | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
us-core-7 | error | Procedure | Performed SHALL be present if the status is 'completed' or 'in-progress' : (status='completed' or status='in-progress') implies performed.exists() |

This structure is derived from Procedure

Summary

Mandatory: 1 element
Must-Support: 12 elements

Structures

This structure refers to these other structures:

- SDOHCC Goal (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-Goal)
- SDOHCC ServiceRequest (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ServiceRequest)
- US Core CarePlan Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan|7.0.0)
- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|7.0.0)
- US Core Encounter Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter|7.0.0)
- SDOHCC Condition (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-Condition)
- SDOHCC Observation Screening Response (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationScreeningResponse)
- SDOHCC Observation Assessment (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationAssessment)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal|5.2.0

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Procedure.basedOn
- The element 1 is sliced based on the value of Procedure.category.coding
- The element 1 is sliced based on the value of Procedure.reasonReference

Maturity: 2

Other representations of profile: CSV, Excel, Schematron