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FHIR Osiris Implementation Guide
1.1.0 - trial-implementation

This page is part of the OSIRIS FHIR Implementation Guide (v1.1.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: RadiotherapyPhase - Detailed Descriptions

Draft as of 2025-04-03

Definitions for the radiotherapy-phase resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Procedure
Définition

An action that is or was performed on or for a patient. This can be a physical intervention like an operation, or less invasive like long term services, counseling, or hypnotherapy.

ShortAn action that is being or was performed on a patient
Control0..*
Is Modifierfalse
Résuméfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Procedure.implicitRules
Définition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Commentaires

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Résumétrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Procedure.extension
Définition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Commentaires

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control10..*
TypeExtension
Is Modifierfalse
Résuméfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Procedure.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Procedure.extension:numberOfFractions
    Nom de la slicenumberOfFractions
    Définition

    Number of Fractions. If delivred, it should be extracted from MOSAIQ/ARIA Record and Verify. If planned, it corresponds to Dicom Tag (300A,0078)

    ShortNumber of Fractions
    Control1..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Number of Fractions) (Extension Type: unsignedInt)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. Procedure.modifierExtension
    Définition

    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored
    Commentaires

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Résuméfalse
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. Procedure.partOf
    Définition

    A larger event of which this particular procedure is a component or step.

    ShortShould Reference a Radiotherapy Treatment CoursePart of referenced event
    Commentaires

    The MedicationAdministration resource has a partOf reference to Procedure, but this is not a circular reference. For example, the anesthesia MedicationAdministration is part of the surgical Procedure (MedicationAdministration.partOf = Procedure). For example, the procedure to insert the IV port for an IV medication administration is part of the medication administration (Procedure.partOf = MedicationAdministration).

    Control10..1*
    TypeReference(Radiotherapy course Summary, Procedure, Observation, MedicationAdministration)
    Is Modifierfalse
    Résumétrue
    Alternate Namescontainer
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. Procedure.status
    Définition

    A code specifying the state of the procedure. Generally, this will be the in-progress or completed state.

    Shortpreparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
    Commentaires

    The "unknown" code is not to be used to convey other statuses. The "unknown" code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.

    This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

    Control1..1
    BindingThe codes SHALL be taken from EventStatushttp://hl7.org/fhir/ValueSet/event-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/event-status|4.0.1)

    A code specifying the state of the procedure.

    Typecode
    Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Résumétrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. Procedure.category
    Définition

    Type (planned or delivered)


    A code that classifies the procedure for searching, sorting and display purposes (e.g. "Surgical Procedure").

    ShortType (planned or delivered)Classification of the procedure
    Control10..1
    BindingFor example codes, see ProcedureCategoryCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-category
    (example to http://hl7.org/fhir/ValueSet/procedure-category)

    A code that classifies a procedure for searching, sorting and display purposes.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Résumétrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. Procedure.category.coding
    Définition

    A reference to a code defined by a terminology system.

    ShortCode defined by a terminology system
    Commentaires

    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

    Control0..*
    TypeCoding
    Is Modifierfalse
    Résumétrue
    Requirements

    Allows for alternative encodings within a code system, and translations to other code systems.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. Procedure.category.coding.code
    Définition

    A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

    ShortSymbol in syntax defined by the system
    Control10..1
    BindingThe codes SHALL be taken from For codes, see Radiotherapy Category
    (required to https://ig-osiris.cancer.fr/ig/osiris/ValueSet/vs-radiotherapy-category)
    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Résumétrue
    Requirements

    Need to refer to a particular code in the system.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. Procedure.code
    Définition

    The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. "Laparoscopic Appendectomy").

    ShortIdentification of the procedure
    Control10..1
    BindingFor example codes, see ProcedureCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-code
    (example to http://hl7.org/fhir/ValueSet/procedure-code)

    A code to identify a specific procedure .

    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Résumétrue
    Requirements

    0..1 to account for primarily narrative only resources.

    Alternate Namestype
    Pattern Value{
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "1222565005"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. Procedure.subject
    Définition

    The person, animal or group on which the procedure was performed.

    ShortWho the procedure was performed on
    Control1..1
    TypeReference(Oncology Patient, Patient, Group)
    Is Modifierfalse
    Must Supporttrue
    Résumétrue
    Alternate Namespatient
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. Procedure.performed[x]
    Définition

    The start and end period


    Estimated or actual date, date-time, period, or age when the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.

    ShortWhen the procedure was performed
    Commentaires

    Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old. dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone.

    Control10..1
    TypePeriod, dateTime, string, Range, Age
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Must Supporttrue
    Résumétrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. Procedure.performed[x].start
    Définition

    Start date and time. They should be extracted from MOSAIQ/ARIA Record and Verify.


    The start of the period. The boundary is inclusive.

    ShortStart dateStarting time with inclusive boundary
    Commentaires

    If the low element is missing, the meaning is that the low boundary is not known.

    Control10..1
    This element is affected by the following invariants: per-1
    TypedateTime
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Résumétrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. Procedure.performed[x].end
    Définition

    End date and time. They should be extracted from MOSAIQ/ARIA Record and Verify.


    The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

    ShortEnd dateEnd time with inclusive boundary, if not ongoing
    Commentaires

    The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

    Control10..1
    This element is affected by the following invariants: per-1
    TypedateTime
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Résumétrue
    Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

    Guidance on how to interpret the contents of this table can be found here

    0. Procedure
    2. Procedure.extension
    Control1..?
    SlicingThis element introduces a set of slices on Procedure.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 4. Procedure.extension:numberOfFractions
      Nom de la slicenumberOfFractions
      Définition

      Number of Fractions. If delivred, it should be extracted from MOSAIQ/ARIA Record and Verify. If planned, it corresponds to Dicom Tag (300A,0078)

      ShortNumber of Fractions
      Control1..1
      TypeExtension(Number of Fractions) (Extension Type: unsignedInt)
      Must Supporttrue
      6. Procedure.partOf
      ShortShould Reference a Radiotherapy Treatment Course
      Control1..1
      TypeReference(Radiotherapy course Summary)
      8. Procedure.category
      Définition

      Type (planned or delivered)

      ShortType (planned or delivered)
      Control1..?
      Must Supporttrue
      10. Procedure.category.coding
      12. Procedure.category.coding.code
      Control1..?
      BindingThe codes SHALL be taken from Radiotherapy Category
      (required to https://ig-osiris.cancer.fr/ig/osiris/ValueSet/vs-radiotherapy-category)
      Must Supporttrue
      14. Procedure.code
      Control1..?
      Must Supporttrue
      Pattern Value{
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "1222565005"
        }]
      }
      16. Procedure.code.coding
      18. Procedure.code.coding.display
      Pattern ValueRadiotherapy treatment phase (regime/therapy)
      20. Procedure.subject
      TypeReference(Oncology Patient)
      Must Supporttrue
      22. Procedure.performed[x]
      Définition

      The start and end period

      Control1..?
      TypePeriod, dateTime, string, Range, Age
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Must Supporttrue
      24. Procedure.performed[x].start
      Définition

      Start date and time. They should be extracted from MOSAIQ/ARIA Record and Verify.

      ShortStart date
      Control1..?
      Must Supporttrue
      26. Procedure.performed[x].end
      Définition

      End date and time. They should be extracted from MOSAIQ/ARIA Record and Verify.

      ShortEnd date
      Control1..?
      Must Supporttrue

      Guidance on how to interpret the contents of this table can be found here

      0. Procedure
      Définition

      An action that is or was performed on or for a patient. This can be a physical intervention like an operation, or less invasive like long term services, counseling, or hypnotherapy.

      ShortAn action that is being or was performed on a patient
      Control0..*
      Is Modifierfalse
      Résuméfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. Procedure.id
      Définition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Commentaires

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control0..1
      Typeid
      Is Modifierfalse
      Résumétrue
      4. Procedure.meta
      Définition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Résumétrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. Procedure.implicitRules
      Définition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Commentaires

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Résumétrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. Procedure.language
      Définition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Commentaires

      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

      Control0..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Bindings AdditionnelsBut
      AllLanguagesBinding Max
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Résuméfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Procedure.text
      Définition

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Commentaires

      Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Résuméfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Procedure.contained
      Définition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

      ShortContained, inline Resources
      Commentaires

      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

      Control0..*
      TypeResource
      Is Modifierfalse
      Résuméfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. Procedure.extension
      Définition

      An Extension

      ShortExtension
      Control1..*
      TypeExtension
      Is Modifierfalse
      Résuméfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Procedure.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. Procedure.extension:numberOfFractions
        Nom de la slicenumberOfFractions
        Définition

        Number of Fractions. If delivred, it should be extracted from MOSAIQ/ARIA Record and Verify. If planned, it corresponds to Dicom Tag (300A,0078)

        ShortNumber of Fractions
        Control1..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Number of Fractions) (Extension Type: unsignedInt)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        18. Procedure.modifierExtension
        Définition

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored
        Commentaires

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Résuméfalse
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        20. Procedure.identifier
        Définition

        Business identifiers assigned to this procedure by the performer or other systems which remain constant as the resource is updated and is propagated from server to server.

        ShortExternal Identifiers for this procedure
        Commentaires

        This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and Person resource instances might share the same social insurance number.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Résumétrue
        Requirements

        Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. Procedure.instantiatesCanonical
        Définition

        The URL pointing to a FHIR-defined protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure.

        ShortInstantiates FHIR protocol or definition
        Control0..*
        Typecanonical(PlanDefinition, ActivityDefinition, Measure, OperationDefinition, Questionnaire)
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Résumétrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. Procedure.instantiatesUri
        Définition

        The URL pointing to an externally maintained protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure.

        ShortInstantiates external protocol or definition
        Commentaires

        This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

        Control0..*
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Résumétrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. Procedure.basedOn
        Définition

        A reference to a resource that contains details of the request for this procedure.

        ShortA request for this procedure
        Control0..*
        TypeReference(CarePlan, ServiceRequest)
        Is Modifierfalse
        Résumétrue
        Alternate Namesfulfills
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. Procedure.partOf
        Définition

        A larger event of which this particular procedure is a component or step.

        ShortShould Reference a Radiotherapy Treatment Course
        Commentaires

        The MedicationAdministration resource has a partOf reference to Procedure, but this is not a circular reference. For example, the anesthesia MedicationAdministration is part of the surgical Procedure (MedicationAdministration.partOf = Procedure). For example, the procedure to insert the IV port for an IV medication administration is part of the medication administration (Procedure.partOf = MedicationAdministration).

        Control1..1
        TypeReference(Radiotherapy course Summary)
        Is Modifierfalse
        Résumétrue
        Alternate Namescontainer
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. Procedure.status
        Définition

        A code specifying the state of the procedure. Generally, this will be the in-progress or completed state.

        Shortpreparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
        Commentaires

        The "unknown" code is not to be used to convey other statuses. The "unknown" code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.

        This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

        Control1..1
        BindingThe codes SHALL be taken from EventStatus
        (required to http://hl7.org/fhir/ValueSet/event-status|4.0.1)

        A code specifying the state of the procedure.

        Typecode
        Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Résumétrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. Procedure.statusReason
        Définition

        Captures the reason for the current state of the procedure.

        ShortReason for current status
        Commentaires

        This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here.

        Control0..1
        BindingFor example codes, see ProcedureNotPerformedReason(SNOMED-CT)
        (example to http://hl7.org/fhir/ValueSet/procedure-not-performed-reason)

        A code that identifies the reason a procedure was not performed.

        TypeCodeableConcept
        Is Modifierfalse
        Résumétrue
        Alternate NamesSuspended Reason, Cancelled Reason
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. Procedure.category
        Définition

        Type (planned or delivered)

        ShortType (planned or delivered)
        Control1..1
        BindingFor example codes, see ProcedureCategoryCodes(SNOMEDCT)
        (example to http://hl7.org/fhir/ValueSet/procedure-category)

        A code that classifies a procedure for searching, sorting and display purposes.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Résumétrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. Procedure.category.id
        Définition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Résuméfalse
        38. Procedure.category.extension
        Définition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Commentaires

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Résuméfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Procedure.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 40. Procedure.category.coding
          Définition

          A reference to a code defined by a terminology system.

          ShortCode defined by a terminology system
          Commentaires

          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

          Control0..*
          TypeCoding
          Is Modifierfalse
          Résumétrue
          Requirements

          Allows for alternative encodings within a code system, and translations to other code systems.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. Procedure.category.coding.id
          Définition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Résuméfalse
          44. Procedure.category.coding.extension
          Définition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Commentaires

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Résuméfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Procedure.category.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 46. Procedure.category.coding.system
            Définition

            The identification of the code system that defines the meaning of the symbol in the code.

            ShortIdentity of the terminology system
            Commentaires

            The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

            Control0..1
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Résumétrue
            Requirements

            Need to be unambiguous about the source of the definition of the symbol.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            48. Procedure.category.coding.version
            Définition

            The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

            ShortVersion of the system - if relevant
            Commentaires

            Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

            NoteThis is a business version Id, not a resource version Id (see discussion)
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Résumétrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            50. Procedure.category.coding.code
            Définition

            A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

            ShortSymbol in syntax defined by the system
            Control1..1
            BindingThe codes SHALL be taken from Radiotherapy Category
            (required to https://ig-osiris.cancer.fr/ig/osiris/ValueSet/vs-radiotherapy-category)
            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Résumétrue
            Requirements

            Need to refer to a particular code in the system.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            52. Procedure.category.coding.display
            Définition

            A representation of the meaning of the code in the system, following the rules of the system.

            ShortRepresentation defined by the system
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Résumétrue
            Requirements

            Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            54. Procedure.category.coding.userSelected
            Définition

            Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

            ShortIf this coding was chosen directly by the user
            Commentaires

            Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

            Control0..1
            Typeboolean
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Résumétrue
            Requirements

            This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            56. Procedure.category.text
            Définition

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

            ShortPlain text representation of the concept
            Commentaires

            Very often the text is the same as a displayName of one of the codings.

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Résumétrue
            Requirements

            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. Procedure.code
            Définition

            The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. "Laparoscopic Appendectomy").

            ShortIdentification of the procedure
            Control1..1
            BindingFor example codes, see ProcedureCodes(SNOMEDCT)
            (example to http://hl7.org/fhir/ValueSet/procedure-code)

            A code to identify a specific procedure .

            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Résumétrue
            Requirements

            0..1 to account for primarily narrative only resources.

            Alternate Namestype
            Pattern Value{
              "coding" : [{
                "system" : "http://snomed.info/sct",
                "code" : "1222565005"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            60. Procedure.code.id
            Définition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Résuméfalse
            62. Procedure.code.extension
            Définition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Commentaires

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Résuméfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Procedure.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 64. Procedure.code.coding
              Définition

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              Commentaires

              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

              Control0..*
              TypeCoding
              Is Modifierfalse
              Résumétrue
              Requirements

              Allows for alternative encodings within a code system, and translations to other code systems.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              66. Procedure.code.coding.id
              Définition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Résuméfalse
              68. Procedure.code.coding.extension
              Définition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Commentaires

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Résuméfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on Procedure.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 70. Procedure.code.coding.system
                Définition

                The identification of the code system that defines the meaning of the symbol in the code.

                ShortIdentity of the terminology system
                Commentaires

                The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                Control0..1
                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Résumétrue
                Requirements

                Need to be unambiguous about the source of the definition of the symbol.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                72. Procedure.code.coding.version
                Définition

                The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                ShortVersion of the system - if relevant
                Commentaires

                Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                NoteThis is a business version Id, not a resource version Id (see discussion)
                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Résumétrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                74. Procedure.code.coding.code
                Définition

                A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                ShortSymbol in syntax defined by the system
                Control0..1
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Résumétrue
                Requirements

                Need to refer to a particular code in the system.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                76. Procedure.code.coding.display
                Définition

                A representation of the meaning of the code in the system, following the rules of the system.

                ShortRepresentation defined by the system
                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Résumétrue
                Requirements

                Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                Pattern ValueRadiotherapy treatment phase (regime/therapy)
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                78. Procedure.code.coding.userSelected
                Définition

                Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                ShortIf this coding was chosen directly by the user
                Commentaires

                Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                Control0..1
                Typeboolean
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Résumétrue
                Requirements

                This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                80. Procedure.code.text
                Définition

                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                ShortPlain text representation of the concept
                Commentaires

                Very often the text is the same as a displayName of one of the codings.

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Résumétrue
                Requirements

                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                82. Procedure.subject
                Définition

                The person, animal or group on which the procedure was performed.

                ShortWho the procedure was performed on
                Control1..1
                TypeReference(Oncology Patient)
                Is Modifierfalse
                Must Supporttrue
                Résumétrue
                Alternate Namespatient
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                84. Procedure.encounter
                Définition

                The Encounter during which this Procedure was created or performed or to which the creation of this record is tightly associated.

                ShortEncounter created as part of
                Commentaires

                This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

                Control0..1
                TypeReference(Encounter)
                Is Modifierfalse
                Résumétrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                86. Procedure.performed[x]
                Définition

                The start and end period

                ShortWhen the procedure was performed
                Commentaires

                Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old. dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone.

                Control1..1
                TypePeriod
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Must Supporttrue
                Résumétrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                88. Procedure.performed[x].id
                Définition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Résuméfalse
                90. Procedure.performed[x].extension
                Définition

                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortAdditional content defined by implementations
                Commentaires

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Résuméfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on Procedure.performed[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 92. Procedure.performed[x].start
                  Définition

                  Start date and time. They should be extracted from MOSAIQ/ARIA Record and Verify.

                  ShortStart date
                  Commentaires

                  If the low element is missing, the meaning is that the low boundary is not known.

                  Control1..1
                  This element is affected by the following invariants: per-1
                  TypedateTime
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Résumétrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  94. Procedure.performed[x].end
                  Définition

                  End date and time. They should be extracted from MOSAIQ/ARIA Record and Verify.

                  ShortEnd date
                  Commentaires

                  The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                  Control1..1
                  This element is affected by the following invariants: per-1
                  TypedateTime
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Résumétrue
                  Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  96. Procedure.recorder
                  Définition

                  Individual who recorded the record and takes responsibility for its content.

                  ShortWho recorded the procedure
                  Control0..1
                  TypeReference(Patient, RelatedPerson, Practitioner, PractitionerRole)
                  Is Modifierfalse
                  Résumétrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  98. Procedure.asserter
                  Définition

                  Individual who is making the procedure statement.

                  ShortPerson who asserts this procedure
                  Control0..1
                  TypeReference(Patient, RelatedPerson, Practitioner, PractitionerRole)
                  Is Modifierfalse
                  Résumétrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  100. Procedure.performer
                  Définition

                  Limited to "real" people rather than equipment.

                  ShortThe people who performed the procedure
                  Control0..*
                  TypeBackboneElement
                  Is Modifierfalse
                  Résumétrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  102. Procedure.performer.id
                  Définition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Résuméfalse
                  104. Procedure.performer.extension
                  Définition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Commentaires

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Résuméfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  106. Procedure.performer.modifierExtension
                  Définition

                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Commentaires

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Résumétrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  108. Procedure.performer.function
                  Définition

                  Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist.

                  ShortType of performance
                  Control0..1
                  BindingFor example codes, see ProcedurePerformerRoleCodes
                  (example to http://hl7.org/fhir/ValueSet/performer-role)

                  A code that identifies the role of a performer of the procedure.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Résumétrue
                  Requirements

                  Allows disambiguation of the types of involvement of different performers.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  110. Procedure.performer.actor
                  Définition

                  The practitioner who was involved in the procedure.

                  ShortThe reference to the practitioner
                  Control1..1
                  TypeReference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
                  Is Modifierfalse
                  Résumétrue
                  Requirements

                  A reference to Device supports use cases, such as pacemakers.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  112. Procedure.performer.onBehalfOf
                  Définition

                  The organization the device or practitioner was acting on behalf of.

                  ShortOrganization the device or practitioner was acting for
                  Control0..1
                  TypeReference(Organization)
                  Is Modifierfalse
                  Résuméfalse
                  Requirements

                  Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  114. Procedure.location
                  Définition

                  The location where the procedure actually happened. E.g. a newborn at home, a tracheostomy at a restaurant.

                  ShortWhere the procedure happened
                  Control0..1
                  TypeReference(Location)
                  Is Modifierfalse
                  Résumétrue
                  Requirements

                  Ties a procedure to where the records are likely kept.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  116. Procedure.reasonCode
                  Définition

                  The coded reason why the procedure was performed. This may be a coded entity of some type, or may simply be present as text.

                  ShortCoded reason procedure performed
                  Commentaires

                  Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

                  Control0..*
                  BindingFor example codes, see ProcedureReasonCodes
                  (example to http://hl7.org/fhir/ValueSet/procedure-reason)

                  A code that identifies the reason a procedure is required.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Résumétrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  118. Procedure.reasonReference
                  Définition

                  The justification of why the procedure was performed.

                  ShortThe justification that the procedure was performed
                  Commentaires

                  It is possible for a procedure to be a reason (such as C-Section) for another procedure (such as an epidural). Other examples include endoscopy for dilatation and biopsy (a combination of diagnostic and therapeutic use). Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

                  Control0..*
                  TypeReference(Condition, Observation, Procedure, DiagnosticReport, DocumentReference)
                  Is Modifierfalse
                  Résumétrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  120. Procedure.bodySite
                  Définition

                  Detailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion.

                  ShortTarget body sites
                  Commentaires

                  If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension procedure-targetbodystructure.

                  Control0..*
                  BindingFor example codes, see SNOMEDCTBodyStructures
                  (example to http://hl7.org/fhir/ValueSet/body-site)

                  Codes describing anatomical locations. May include laterality.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Résumétrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  122. Procedure.outcome
                  Définition

                  The outcome of the procedure - did it resolve the reasons for the procedure being performed?

                  ShortThe result of procedure
                  Commentaires

                  If outcome contains narrative text only, it can be captured using the CodeableConcept.text.

                  Control0..1
                  BindingFor example codes, see ProcedureOutcomeCodes(SNOMEDCT)
                  (example to http://hl7.org/fhir/ValueSet/procedure-outcome)

                  An outcome of a procedure - whether it was resolved or otherwise.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Résumétrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  124. Procedure.report
                  Définition

                  This could be a histology result, pathology report, surgical report, etc.

                  ShortAny report resulting from the procedure
                  Commentaires

                  There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports.

                  Control0..*
                  TypeReference(DiagnosticReport, DocumentReference, Composition)
                  Is Modifierfalse
                  Résuméfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  126. Procedure.complication
                  Définition

                  Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues.

                  ShortComplication following the procedure
                  Commentaires

                  If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.

                  Control0..*
                  BindingFor example codes, see Condition/Problem/DiagnosisCodes
                  (example to http://hl7.org/fhir/ValueSet/condition-code)

                  Codes describing complications that resulted from a procedure.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Résuméfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  128. Procedure.complicationDetail
                  Définition

                  Any complications that occurred during the procedure, or in the immediate post-performance period.

                  ShortA condition that is a result of the procedure
                  Control0..*
                  TypeReference(Condition)
                  Is Modifierfalse
                  Résuméfalse
                  Requirements

                  This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  130. Procedure.followUp
                  Définition

                  If the procedure required specific follow up - e.g. removal of sutures. The follow up may be represented as a simple note or could potentially be more complex, in which case the CarePlan resource can be used.

                  ShortInstructions for follow up
                  Control0..*
                  BindingFor example codes, see ProcedureFollowUpCodes(SNOMEDCT)
                  (example to http://hl7.org/fhir/ValueSet/procedure-followup)

                  Specific follow up required for a procedure e.g. removal of sutures.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Résuméfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  132. Procedure.note
                  Définition

                  Any other notes and comments about the procedure.

                  ShortAdditional information about the procedure
                  Control0..*
                  TypeAnnotation
                  Is Modifierfalse
                  Résuméfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  134. Procedure.focalDevice
                  Définition

                  A device that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure.

                  ShortManipulated, implanted, or removed device
                  Control0..*
                  TypeBackboneElement
                  Is Modifierfalse
                  Résuméfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  136. Procedure.focalDevice.id
                  Définition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Résuméfalse
                  138. Procedure.focalDevice.extension
                  Définition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Commentaires

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Résuméfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  140. Procedure.focalDevice.modifierExtension
                  Définition

                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Commentaires

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Résumétrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  142. Procedure.focalDevice.action
                  Définition

                  The kind of change that happened to the device during the procedure.

                  ShortKind of change to device
                  Control0..1
                  BindingThe codes SHOULD be taken from ProcedureDeviceActionCodes
                  (preferred to http://hl7.org/fhir/ValueSet/device-action)

                  A kind of change that happened to the device during the procedure.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Résuméfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  144. Procedure.focalDevice.manipulated
                  Définition

                  The device that was manipulated (changed) during the procedure.

                  ShortDevice that was changed
                  Control1..1
                  TypeReference(Device)
                  Is Modifierfalse
                  Résuméfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  146. Procedure.usedReference
                  Définition

                  Identifies medications, devices and any other substance used as part of the procedure.

                  ShortItems used during procedure
                  Commentaires

                  For devices actually implanted or removed, use Procedure.device.

                  Control0..*
                  TypeReference(Device, Medication, Substance)
                  Is Modifierfalse
                  Résuméfalse
                  Requirements

                  Used for tracking contamination, etc.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  148. Procedure.usedCode
                  Définition

                  Identifies coded items that were used as part of the procedure.

                  ShortCoded items used during the procedure
                  Commentaires

                  For devices actually implanted or removed, use Procedure.device.

                  Control0..*
                  BindingFor example codes, see FHIRDeviceTypes
                  (example to http://hl7.org/fhir/ValueSet/device-kind)

                  Codes describing items used during a procedure.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Résuméfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))