IDEA4RC FHIR Implementation Guide, published by IDEA4RC Project. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/idea4rc/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON
• TTL

Resource Profile: Procedure: Radiotherapy

This profile defines how to represent Procedures in FHIR for describing a set of Radiotherapy data required by the PanCareSurPass algorithm to generate the care plan.

Usages:

• Use this Profile: Bundle: IDEA4RC
• Refer to this Profile: Procedure: Other Treatment and AdverseEvent: IDEA4RC
• Examples for this Profile: Procedure/GOFSH-GENERATED-id-28

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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:adaptive		0..1	(Complex)	Adaptive URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/adaptive
extension:sameHospital		0..1	boolean	Same Hospital URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/same-hospital
extension:procedureCategoryR5		0..*	base64Binary, boolean, canonical(), code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference(), SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Procedure.category
extension:modalityAndTechnique		0..*	(Complex)	Radiotherapy Modality And Technique Extension URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality-and-technique
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:modality		1..1	(Complex)	Modality of external beam or brachytherapy radiation procedures URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Modality Value Set (preferred)
extension:technique		0..*	(Complex)	Technique of external beam or brachytherapy radiation procedures URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-technique
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-technique"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Technique Value Set (preferred)
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality-and-technique"
extension:doseToVolume		0..1	(Complex)	Radiotherapy Dose Delivered To Volume Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
extension:terminationReason		0..*	CodeableConcept	Treatment Termination Reason Extension (deprecated) URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason Binding: Treatment Termination Reason Value Set (extensible)
extension:procedureIntent		0..1	CodeableConcept	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible)
extension:settings		0..1	CodeableConcept	Radiotherapy Setting URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/radiotherapy-settings Binding: Setting Radiotherapy (preferred)
extension:totalHighDoseDelivered		0..1	(Complex)	Total High Dose Delivered URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/total-high-dose-delivered
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Identifiers for this radiotherapy / boost
status	?!Σ	1..1	code	Procedure status Binding: EventStatus (required): A code specifying the state of the procedure.
category	Σ	1..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 108290001
display		1..1	string	Representation defined by the system Fixed Value: Radiotherapy
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	Σ	1..1	CodeableConcept	ADD VOC BINDING Binding: ProcedureCodes(SNOMEDCT) (example): A code to identify a specific procedure .
subject	Σ	1..1	Reference(Patient: IDEA4RC)	Who the procedure was performed on
Slices for performed[x]	Σ	1..1	Period	When the procedure was performed Slice: Unordered, Closed by type:$this
performed[x]:performedPeriod	Σ	1..1	Period	When the procedure was performed
reasonCode	Σ	0..*	CodeableConcept	Coded reason procedure performed Binding: Re-irradiation reason (required)
reasonReference	Σ	1..*	Reference(Condition: Primary Cancer)	The justification that the procedure was performed
bodySite	Σ	0..*	CodeableConcept	required for Brachytherapy and External beam Binding: Radiotherapy Sites (required)
Slices for extension				Content/Rules for all slices
extension:locationQualifier		0..*	(Complex)	Body Location Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Surgery Location Qualifier (required)
extension:lateralityQualifier		0..1	(Complex)	Laterality Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Site Laterality Qualifier (required)
outcome	Σ	0..1	CodeableConcept	The result of procedure Binding: Treatment Response (required)
note		0..*	Annotation	Additional information about the Radiotherapy
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Procedure.extension:modalityAndTechnique.extension:modality.value[x]	preferred	RadiotherapyModalityVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs
Procedure.extension:modalityAndTechnique.extension:technique.value[x]	preferred	RadiotherapyTechniqueVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-technique-vs
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 From the FHIR Standard
Procedure.category	example	Pattern Value: SNOMED-CT Code 108290001("Radiotherapy") http://hl7.org/fhir/ValueSet/procedure-category|4.0.1 From the FHIR Standard
Procedure.code	example	ProcedureCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-code|4.0.1 From the FHIR Standard
Procedure.reasonCode	required	VsReIrradiationReasonI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/re-irradiation-reason-eu-i4rc From this IG
Procedure.bodySite	required	VsRadiotherapySiteI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/radiotherapy-site-eu-i4rc From this IG
Procedure.bodySite.extension:locationQualifier.value[x]	required	VsSurgeryLocationQualifierI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/surgery-location-qualifier-eu-i4rc From this IG
Procedure.bodySite.extension:lateralityQualifier.value[x]	required	VsRadioTherapySiteLateralityQualifierI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/radiotherapy-site-laterality-qualifier-eu-i4rc From this IG
Procedure.outcome	required	VsTreatmentResponseI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/treatment-response-eu-i4rc From this IG

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()

This structure is derived from Procedure

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure			Procedure
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:adaptive		0..1	(Complex)	Adaptive URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/adaptive
extension:sameHospital		0..1	boolean	Same Hospital URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/same-hospital
extension:procedureCategoryR5		0..*	base64Binary, boolean, canonical(), code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference(), SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Procedure.category
extension:modalityAndTechnique		0..*	(Complex)	Radiotherapy Modality And Technique Extension URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality-and-technique
Slices for extension				Content/Rules for all slices
extension:modality		1..1	RadiotherapyModality	Modality of external beam or brachytherapy radiation procedures
extension:technique		0..*	RadiotherapyTechnique	Technique of external beam or brachytherapy radiation procedures
extension:doseToVolume		0..1	(Complex)	Radiotherapy Dose Delivered To Volume Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
extension:terminationReason		0..*	CodeableConcept	Treatment Termination Reason Extension (deprecated) URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason Binding: Treatment Termination Reason Value Set (extensible)
extension:procedureIntent		0..1	CodeableConcept	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible)
extension:settings		0..1	CodeableConcept	Radiotherapy Setting URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/radiotherapy-settings Binding: Setting Radiotherapy (preferred)
extension:totalHighDoseDelivered		0..1	(Complex)	Total High Dose Delivered URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/total-high-dose-delivered
identifier		0..*	Identifier	External Identifiers for this radiotherapy / boost
status		1..1	code	Procedure status
category		1..1	CodeableConcept	Classification of the procedure Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 108290001
display		1..1	string	Representation defined by the system Fixed Value: Radiotherapy
code		1..1	CodeableConcept	ADD VOC BINDING
subject		1..1	Reference(Patient: IDEA4RC)	Who the procedure was performed on
Slices for performed[x]		1..1	Period	When the procedure was performed Slice: Unordered, Open by type:$this
performed[x]:performedPeriod		1..1	Period	When the procedure was performed
reasonCode		0..*	CodeableConcept	Coded reason procedure performed Binding: Re-irradiation reason (required)
reasonReference		1..*	Reference(Condition: Primary Cancer)	The justification that the procedure was performed
bodySite		0..*	CodeableConcept	required for Brachytherapy and External beam Binding: Radiotherapy Sites (required)
Slices for extension				Content/Rules for all slices
extension:locationQualifier		0..*	(Complex)	Body Location Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
value[x]		1..1	CodeableConcept	Value of extension Binding: Surgery Location Qualifier (required)
extension:lateralityQualifier		0..1	(Complex)	Laterality Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Site Laterality Qualifier (required)
outcome		0..1	CodeableConcept	The result of procedure Binding: Treatment Response (required)
note		0..*	Annotation	Additional information about the Radiotherapy
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Procedure.reasonCode	required	VsReIrradiationReasonI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/re-irradiation-reason-eu-i4rc From this IG
Procedure.bodySite	required	VsRadiotherapySiteI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/radiotherapy-site-eu-i4rc From this IG
Procedure.bodySite.extension:locationQualifier.value[x]	required	VsSurgeryLocationQualifierI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/surgery-location-qualifier-eu-i4rc From this IG
Procedure.bodySite.extension:lateralityQualifier.value[x]	required	VsRadioTherapySiteLateralityQualifierI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/radiotherapy-site-laterality-qualifier-eu-i4rc From this IG
Procedure.outcome	required	VsTreatmentResponseI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/treatment-response-eu-i4rc From this IG

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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:adaptive		0..1	(Complex)	Adaptive URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/adaptive
extension:sameHospital		0..1	boolean	Same Hospital URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/same-hospital
extension:procedureCategoryR5		0..*	base64Binary, boolean, canonical(), code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference(), SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Procedure.category
extension:modalityAndTechnique		0..*	(Complex)	Radiotherapy Modality And Technique Extension URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality-and-technique
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:modality		1..1	(Complex)	Modality of external beam or brachytherapy radiation procedures URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Modality Value Set (preferred)
extension:technique		0..*	(Complex)	Technique of external beam or brachytherapy radiation procedures URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-technique
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-technique"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Technique Value Set (preferred)
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality-and-technique"
extension:doseToVolume		0..1	(Complex)	Radiotherapy Dose Delivered To Volume Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
extension:terminationReason		0..*	CodeableConcept	Treatment Termination Reason Extension (deprecated) URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason Binding: Treatment Termination Reason Value Set (extensible)
extension:procedureIntent		0..1	CodeableConcept	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible)
extension:settings		0..1	CodeableConcept	Radiotherapy Setting URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/radiotherapy-settings Binding: Setting Radiotherapy (preferred)
extension:totalHighDoseDelivered		0..1	(Complex)	Total High Dose Delivered URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/total-high-dose-delivered
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Identifiers for this radiotherapy / boost
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	Procedure status 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	1..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 108290001
display		1..1	string	Representation defined by the system Fixed Value: Radiotherapy
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	Σ	1..1	CodeableConcept	ADD VOC BINDING Binding: ProcedureCodes(SNOMEDCT) (example): A code to identify a specific procedure .
subject	Σ	1..1	Reference(Patient: IDEA4RC)	Who the procedure was performed on
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
Slices for performed[x]	Σ	1..1	Period	When the procedure was performed Slice: Unordered, Closed by type:$this
performed[x]:performedPeriod	Σ	1..1	Period	When the procedure was performed
recorder	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Who recorded the procedure
asserter	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Person who asserts this procedure
performer	Σ	0..*	BackboneElement	The people who performed the procedure
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
location	Σ	0..1	Reference(Location)	Where the procedure happened
reasonCode	Σ	0..*	CodeableConcept	Coded reason procedure performed Binding: Re-irradiation reason (required)
reasonReference	Σ	1..*	Reference(Condition: Primary Cancer)	The justification that the procedure was performed
bodySite	Σ	0..*	CodeableConcept	required for Brachytherapy and External beam Binding: Radiotherapy Sites (required)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:locationQualifier		0..*	(Complex)	Body Location Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Surgery Location Qualifier (required)
extension:lateralityQualifier		0..1	(Complex)	Laterality Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Site Laterality Qualifier (required)
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
outcome	Σ	0..1	CodeableConcept	The result of procedure Binding: Treatment Response (required)
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 Radiotherapy
focalDevice		0..*	BackboneElement	Manipulated, implanted, or removed device
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
action		0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.
manipulated		1..1	Reference(Device)	Device that was changed
usedReference		0..*	Reference(Device | Medication | Substance)	Items used during procedure
usedCode		0..*	CodeableConcept	Coded items used during the procedure Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	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.extension:modalityAndTechnique.extension:modality.value[x]	preferred	RadiotherapyModalityVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs
Procedure.extension:modalityAndTechnique.extension:technique.value[x]	preferred	RadiotherapyTechniqueVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-technique-vs
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 From the FHIR Standard
Procedure.statusReason	example	ProcedureNotPerformedReason(SNOMED-CT) http://hl7.org/fhir/ValueSet/procedure-not-performed-reason|4.0.1 From the FHIR Standard
Procedure.category	example	Pattern Value: SNOMED-CT Code 108290001("Radiotherapy") http://hl7.org/fhir/ValueSet/procedure-category|4.0.1 From the FHIR Standard
Procedure.code	example	ProcedureCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-code|4.0.1 From the FHIR Standard
Procedure.performer.function	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role|4.0.1 From the FHIR Standard
Procedure.reasonCode	required	VsReIrradiationReasonI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/re-irradiation-reason-eu-i4rc From this IG
Procedure.bodySite	required	VsRadiotherapySiteI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/radiotherapy-site-eu-i4rc From this IG
Procedure.bodySite.extension:locationQualifier.value[x]	required	VsSurgeryLocationQualifierI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/surgery-location-qualifier-eu-i4rc From this IG
Procedure.bodySite.extension:lateralityQualifier.value[x]	required	VsRadioTherapySiteLateralityQualifierI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/radiotherapy-site-laterality-qualifier-eu-i4rc From this IG
Procedure.outcome	required	VsTreatmentResponseI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/treatment-response-eu-i4rc From this IG
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()

This structure is derived from Procedure

Summary

Mandatory: 5 elements

Structures

This structure refers to these other structures:

• Patient: IDEA4RC (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/patient-eu-i4rc)
• Condition: Primary Cancer (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/Condition-primaryCancer-eu-i4rc)

Extensions

This structure refers to these extensions:

• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/adaptive
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/same-hospital
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Procedure.category
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality-and-technique
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/radiotherapy-settings
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/total-high-dose-delivered
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Procedure.performed[x]

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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:adaptive		0..1	(Complex)	Adaptive URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/adaptive
extension:sameHospital		0..1	boolean	Same Hospital URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/same-hospital
extension:procedureCategoryR5		0..*	base64Binary, boolean, canonical(), code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference(), SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Procedure.category
extension:modalityAndTechnique		0..*	(Complex)	Radiotherapy Modality And Technique Extension URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality-and-technique
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:modality		1..1	(Complex)	Modality of external beam or brachytherapy radiation procedures URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Modality Value Set (preferred)
extension:technique		0..*	(Complex)	Technique of external beam or brachytherapy radiation procedures URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-technique
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-technique"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Technique Value Set (preferred)
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality-and-technique"
extension:doseToVolume		0..1	(Complex)	Radiotherapy Dose Delivered To Volume Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
extension:terminationReason		0..*	CodeableConcept	Treatment Termination Reason Extension (deprecated) URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason Binding: Treatment Termination Reason Value Set (extensible)
extension:procedureIntent		0..1	CodeableConcept	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible)
extension:settings		0..1	CodeableConcept	Radiotherapy Setting URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/radiotherapy-settings Binding: Setting Radiotherapy (preferred)
extension:totalHighDoseDelivered		0..1	(Complex)	Total High Dose Delivered URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/total-high-dose-delivered
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Identifiers for this radiotherapy / boost
status	?!Σ	1..1	code	Procedure status Binding: EventStatus (required): A code specifying the state of the procedure.
category	Σ	1..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 108290001
display		1..1	string	Representation defined by the system Fixed Value: Radiotherapy
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	Σ	1..1	CodeableConcept	ADD VOC BINDING Binding: ProcedureCodes(SNOMEDCT) (example): A code to identify a specific procedure .
subject	Σ	1..1	Reference(Patient: IDEA4RC)	Who the procedure was performed on
Slices for performed[x]	Σ	1..1	Period	When the procedure was performed Slice: Unordered, Closed by type:$this
performed[x]:performedPeriod	Σ	1..1	Period	When the procedure was performed
reasonCode	Σ	0..*	CodeableConcept	Coded reason procedure performed Binding: Re-irradiation reason (required)
reasonReference	Σ	1..*	Reference(Condition: Primary Cancer)	The justification that the procedure was performed
bodySite	Σ	0..*	CodeableConcept	required for Brachytherapy and External beam Binding: Radiotherapy Sites (required)
Slices for extension				Content/Rules for all slices
extension:locationQualifier		0..*	(Complex)	Body Location Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Surgery Location Qualifier (required)
extension:lateralityQualifier		0..1	(Complex)	Laterality Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Site Laterality Qualifier (required)
outcome	Σ	0..1	CodeableConcept	The result of procedure Binding: Treatment Response (required)
note		0..*	Annotation	Additional information about the Radiotherapy
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Procedure.extension:modalityAndTechnique.extension:modality.value[x]	preferred	RadiotherapyModalityVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs
Procedure.extension:modalityAndTechnique.extension:technique.value[x]	preferred	RadiotherapyTechniqueVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-technique-vs
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 From the FHIR Standard
Procedure.category	example	Pattern Value: SNOMED-CT Code 108290001("Radiotherapy") http://hl7.org/fhir/ValueSet/procedure-category|4.0.1 From the FHIR Standard
Procedure.code	example	ProcedureCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-code|4.0.1 From the FHIR Standard
Procedure.reasonCode	required	VsReIrradiationReasonI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/re-irradiation-reason-eu-i4rc From this IG
Procedure.bodySite	required	VsRadiotherapySiteI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/radiotherapy-site-eu-i4rc From this IG
Procedure.bodySite.extension:locationQualifier.value[x]	required	VsSurgeryLocationQualifierI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/surgery-location-qualifier-eu-i4rc From this IG
Procedure.bodySite.extension:lateralityQualifier.value[x]	required	VsRadioTherapySiteLateralityQualifierI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/radiotherapy-site-laterality-qualifier-eu-i4rc From this IG
Procedure.outcome	required	VsTreatmentResponseI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/treatment-response-eu-i4rc From this IG

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()

Differential View

This structure is derived from Procedure

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure			Procedure
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:adaptive		0..1	(Complex)	Adaptive URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/adaptive
extension:sameHospital		0..1	boolean	Same Hospital URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/same-hospital
extension:procedureCategoryR5		0..*	base64Binary, boolean, canonical(), code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference(), SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Procedure.category
extension:modalityAndTechnique		0..*	(Complex)	Radiotherapy Modality And Technique Extension URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality-and-technique
Slices for extension				Content/Rules for all slices
extension:modality		1..1	RadiotherapyModality	Modality of external beam or brachytherapy radiation procedures
extension:technique		0..*	RadiotherapyTechnique	Technique of external beam or brachytherapy radiation procedures
extension:doseToVolume		0..1	(Complex)	Radiotherapy Dose Delivered To Volume Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
extension:terminationReason		0..*	CodeableConcept	Treatment Termination Reason Extension (deprecated) URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason Binding: Treatment Termination Reason Value Set (extensible)
extension:procedureIntent		0..1	CodeableConcept	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible)
extension:settings		0..1	CodeableConcept	Radiotherapy Setting URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/radiotherapy-settings Binding: Setting Radiotherapy (preferred)
extension:totalHighDoseDelivered		0..1	(Complex)	Total High Dose Delivered URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/total-high-dose-delivered
identifier		0..*	Identifier	External Identifiers for this radiotherapy / boost
status		1..1	code	Procedure status
category		1..1	CodeableConcept	Classification of the procedure Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 108290001
display		1..1	string	Representation defined by the system Fixed Value: Radiotherapy
code		1..1	CodeableConcept	ADD VOC BINDING
subject		1..1	Reference(Patient: IDEA4RC)	Who the procedure was performed on
Slices for performed[x]		1..1	Period	When the procedure was performed Slice: Unordered, Open by type:$this
performed[x]:performedPeriod		1..1	Period	When the procedure was performed
reasonCode		0..*	CodeableConcept	Coded reason procedure performed Binding: Re-irradiation reason (required)
reasonReference		1..*	Reference(Condition: Primary Cancer)	The justification that the procedure was performed
bodySite		0..*	CodeableConcept	required for Brachytherapy and External beam Binding: Radiotherapy Sites (required)
Slices for extension				Content/Rules for all slices
extension:locationQualifier		0..*	(Complex)	Body Location Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
value[x]		1..1	CodeableConcept	Value of extension Binding: Surgery Location Qualifier (required)
extension:lateralityQualifier		0..1	(Complex)	Laterality Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Site Laterality Qualifier (required)
outcome		0..1	CodeableConcept	The result of procedure Binding: Treatment Response (required)
note		0..*	Annotation	Additional information about the Radiotherapy
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Procedure.reasonCode	required	VsReIrradiationReasonI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/re-irradiation-reason-eu-i4rc From this IG
Procedure.bodySite	required	VsRadiotherapySiteI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/radiotherapy-site-eu-i4rc From this IG
Procedure.bodySite.extension:locationQualifier.value[x]	required	VsSurgeryLocationQualifierI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/surgery-location-qualifier-eu-i4rc From this IG
Procedure.bodySite.extension:lateralityQualifier.value[x]	required	VsRadioTherapySiteLateralityQualifierI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/radiotherapy-site-laterality-qualifier-eu-i4rc From this IG
Procedure.outcome	required	VsTreatmentResponseI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/treatment-response-eu-i4rc From this IG

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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:adaptive		0..1	(Complex)	Adaptive URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/adaptive
extension:sameHospital		0..1	boolean	Same Hospital URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/same-hospital
extension:procedureCategoryR5		0..*	base64Binary, boolean, canonical(), code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference(), SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta	Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Procedure.category
extension:modalityAndTechnique		0..*	(Complex)	Radiotherapy Modality And Technique Extension URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality-and-technique
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:modality		1..1	(Complex)	Modality of external beam or brachytherapy radiation procedures URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Modality Value Set (preferred)
extension:technique		0..*	(Complex)	Technique of external beam or brachytherapy radiation procedures URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-technique
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-technique"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Technique Value Set (preferred)
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality-and-technique"
extension:doseToVolume		0..1	(Complex)	Radiotherapy Dose Delivered To Volume Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
extension:terminationReason		0..*	CodeableConcept	Treatment Termination Reason Extension (deprecated) URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason Binding: Treatment Termination Reason Value Set (extensible)
extension:procedureIntent		0..1	CodeableConcept	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible)
extension:settings		0..1	CodeableConcept	Radiotherapy Setting URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/radiotherapy-settings Binding: Setting Radiotherapy (preferred)
extension:totalHighDoseDelivered		0..1	(Complex)	Total High Dose Delivered URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/total-high-dose-delivered
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Identifiers for this radiotherapy / boost
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	Procedure status 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	1..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 108290001
display		1..1	string	Representation defined by the system Fixed Value: Radiotherapy
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	Σ	1..1	CodeableConcept	ADD VOC BINDING Binding: ProcedureCodes(SNOMEDCT) (example): A code to identify a specific procedure .
subject	Σ	1..1	Reference(Patient: IDEA4RC)	Who the procedure was performed on
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
Slices for performed[x]	Σ	1..1	Period	When the procedure was performed Slice: Unordered, Closed by type:$this
performed[x]:performedPeriod	Σ	1..1	Period	When the procedure was performed
recorder	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Who recorded the procedure
asserter	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Person who asserts this procedure
performer	Σ	0..*	BackboneElement	The people who performed the procedure
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
location	Σ	0..1	Reference(Location)	Where the procedure happened
reasonCode	Σ	0..*	CodeableConcept	Coded reason procedure performed Binding: Re-irradiation reason (required)
reasonReference	Σ	1..*	Reference(Condition: Primary Cancer)	The justification that the procedure was performed
bodySite	Σ	0..*	CodeableConcept	required for Brachytherapy and External beam Binding: Radiotherapy Sites (required)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:locationQualifier		0..*	(Complex)	Body Location Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Surgery Location Qualifier (required)
extension:lateralityQualifier		0..1	(Complex)	Laterality Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Site Laterality Qualifier (required)
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
outcome	Σ	0..1	CodeableConcept	The result of procedure Binding: Treatment Response (required)
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 Radiotherapy
focalDevice		0..*	BackboneElement	Manipulated, implanted, or removed device
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
action		0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.
manipulated		1..1	Reference(Device)	Device that was changed
usedReference		0..*	Reference(Device | Medication | Substance)	Items used during procedure
usedCode		0..*	CodeableConcept	Coded items used during the procedure Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	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.extension:modalityAndTechnique.extension:modality.value[x]	preferred	RadiotherapyModalityVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs
Procedure.extension:modalityAndTechnique.extension:technique.value[x]	preferred	RadiotherapyTechniqueVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-technique-vs
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 From the FHIR Standard
Procedure.statusReason	example	ProcedureNotPerformedReason(SNOMED-CT) http://hl7.org/fhir/ValueSet/procedure-not-performed-reason|4.0.1 From the FHIR Standard
Procedure.category	example	Pattern Value: SNOMED-CT Code 108290001("Radiotherapy") http://hl7.org/fhir/ValueSet/procedure-category|4.0.1 From the FHIR Standard
Procedure.code	example	ProcedureCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-code|4.0.1 From the FHIR Standard
Procedure.performer.function	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role|4.0.1 From the FHIR Standard
Procedure.reasonCode	required	VsReIrradiationReasonI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/re-irradiation-reason-eu-i4rc From this IG
Procedure.bodySite	required	VsRadiotherapySiteI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/radiotherapy-site-eu-i4rc From this IG
Procedure.bodySite.extension:locationQualifier.value[x]	required	VsSurgeryLocationQualifierI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/surgery-location-qualifier-eu-i4rc From this IG
Procedure.bodySite.extension:lateralityQualifier.value[x]	required	VsRadioTherapySiteLateralityQualifierI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/radiotherapy-site-laterality-qualifier-eu-i4rc From this IG
Procedure.outcome	required	VsTreatmentResponseI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/treatment-response-eu-i4rc From this IG
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()

This structure is derived from Procedure

Summary

Mandatory: 5 elements

Structures

This structure refers to these other structures:

• Patient: IDEA4RC (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/patient-eu-i4rc)
• Condition: Primary Cancer (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/Condition-primaryCancer-eu-i4rc)

Extensions

This structure refers to these extensions:

• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/adaptive
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/same-hospital
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Procedure.category
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-radiotherapy-modality-and-technique
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/radiotherapy-settings
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/total-high-dose-delivered
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Procedure.performed[x]

Other representations of profile: CSV, Excel, Schematron