Onconova Implementation Guide
0.2.0 - ci-build
Onconova Implementation Guide - Local Development build (v0.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Active as of 2026-03-18 |
Definitions for the onconova-radiotherapy-summary resource profile.
Guidance on how to interpret the contents of this table can be foundhere
| 0. Procedure | |||||||
| Definition | - 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. | ||||||
| Short | An action that is being or was performed on a patient | ||||||
| Comments | - | ||||||
| Control | 0..* | ||||||
| Is Modifier | false | ||||||
| Must Support | false | ||||||
| Summary | false | ||||||
| Invariants | dom-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()) us-core-7: Performed SHALL be present if the status is 'completed' or 'in-progress' ( (status='completed' or status='in-progress') implies performed.exists())termination-reason-code-invariant: When status is stopped, only certain statusReason values are allowed ( status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')))termination-reason-invariant: Certain statusReason values are allowed only when status is stopped ( statusReason.exists() and statusReason.coding.exists(
system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or
code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped')mcode-reason-required: One of reasonCode or reasonReference SHALL be present ( reasonCode.exists() or reasonReference.exists())o-rad-req-1: The subject element is required and must be provided. ( subject.exists())o-rad-req-2: The performedPeriod element is required and must be provided. ( performedPeriod.exists())o-rad-req-3: The actualNumberOfSessions extension is required and must be provided. ( extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions').exists())o-rad-req-4: The treatmentIntent extension is required and must be provided. ( extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent').exists()) | ||||||
| 2. Procedure.implicitRules | |||||||
| Definition | 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. | ||||||
| Short | A set of rules under which this content was created | ||||||
| Comments | 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. | ||||||
| Control | 0..1 | ||||||
| Type | uri | ||||||
| Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 4. Procedure.extension | |||||||
| Definition | 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. | ||||||
| Short | ExtensionAdditional content defined by implementations | ||||||
| Comments | 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. | ||||||
| Control | 20..* | ||||||
| Type | Extension | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Summary | false | ||||||
| Alternate Names | extensions, user content | ||||||
| Invariants | ele-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()) | ||||||
| Slicing | This element introduces a set of slices on Procedure.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||||
| 6. Procedure.extension:treatmentIntent | |||||||
| Slice Name | treatmentIntent | ||||||
| Definition | The purpose of a treatment, medication, or procedure. | ||||||
| Short | Procedure Intent Extension | ||||||
| Control | 1..1 This element is affected by the following invariants: ele-1 | ||||||
| Type | Extension(Procedure Intent Extension) (Extension Type: CodeableConcept) | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Obligations |
| ||||||
| Invariants | ele-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.extension:treatmentIntent.extension | |||||||
| Definition | An Extension 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. | ||||||
| Short | ExtensionAdditional content defined by implementations | ||||||
| Comments | 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. | ||||||
| Control | 0..0* | ||||||
| Type | Extension | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Alternate Names | extensions, user content | ||||||
| Invariants | ele-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()) | ||||||
| Slicing | This element introduces a set of slices on Procedure.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||||
| 10. Procedure.extension:treatmentIntent.url | |||||||
| Definition | Source of the definition for the extension code - a logical name or a URL. | ||||||
| Short | identifies the meaning of the extension | ||||||
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. | ||||||
| Control | 1..1 | ||||||
| Type | uri | ||||||
| Is Modifier | false | ||||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||||
| Summary | false | ||||||
| Fixed Value | http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent | ||||||
| 12. Procedure.extension:treatmentIntent.value[x] | |||||||
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | ||||||
| Short | Value of extension | ||||||
| Control | 10..1 | ||||||
| Binding | The codes SHALL be taken from For codes, see Treatment Intents Value Set (required to http://onconova.github.io/fhir/ValueSet/onconova-vs-treatment-intents) | ||||||
| Type | CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time | ||||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 14. Procedure.extension:terminationReason | |||||||
| Slice Name | terminationReason | ||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
| Type | Extension(Treatment Termination Reason Extension (deprecated)) (Extension Type: CodeableConcept) | ||||||
| Is Modifier | false | ||||||
| Invariants | ele-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()) | ||||||
| 16. Procedure.extension:modalityAndTechnique | |||||||
| Slice Name | modalityAndTechnique | ||||||
| Definition | Extension capturing modality and technique of a given radiotherapy procedure. The allowed combinations of modality and technique are constrained by invariants, one per modality. | ||||||
| Short | Radiotherapy Modality And Technique Extension | ||||||
| Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
| Type | Extension(Radiotherapy Modality And Technique Extension) (Complex Extension) | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Obligations |
| ||||||
| Invariants | ele-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())TechniquesForNeutronBeamModality: Allowed Techniques for Neutron Beam Modality ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '80347004')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '169317000' or code = '1162782007'))TechniquesForPhotonBeamModality: Allowed Techniques for Photon Beam Modality ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156506007')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '441799006' or code = '1156530009' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1156530009' or code = '1163157007'))TechniquesForElectronBeamModality: Allowed Techniques for Electron Beam Modality ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '45643008')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1163157007'))TechniquesForCarbonIonBeamModality: Allowed Techniques for Carbon Ion Beam Modality ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156505006')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code='1204242009'))TechniquesForProtonBeamModality: Allowed Techniques for Proton Beam Modality ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '10611004')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code = '1204242009' or code = '1163157007'))TechniquesForInternalRadiotherapyPermanentSeeds: Allowed Techniques for Internal Radiotherapy - Permanent Seeds ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '169359004')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '113120007'))TechniquesForLowDoseRateUsingTempRadSource: Allowed Techniques for Low Dose Rate Using Temp Radiation Source ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156708005')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007' or code = '14473006'))TechniquesForPulsedDoseRate: Allowed Techniques for Pulsed Dose Rate ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156384006')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007'))TechniquesForHighDoseRate: Allowed Techniques for High Dose Rate ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '394902000')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = ' 1156383000' or code = '384691004' or code = '168524008' or code = '14473006'))TechniquesForHighDoseRateElectronic: Allowed Techniques for High Dose Rate Electronic ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '438629002')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = '384691004' or code = '168524008' or code = '14473006'))TechniquesForRadioPharmaceutical: Allowed Techniques for Radiopharmaceutical ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '440252007')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '16560241000119104' or code = '1156383000' or code = '384692006' or code = '113120007'))ModalityTextRequiredForOther: Require a text literal for code other ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.text.exists())TechniqueTextRequiredForOther: Require a text literal for code other ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.text.exists()) | ||||||
| 18. Procedure.extension:actualNumberOfSessions | |||||||
| Slice Name | actualNumberOfSessions | ||||||
| Definition | The number of sessions in a course of radiotherapy. | ||||||
| Short | Radiotherapy Number of Sessions Extension | ||||||
| Control | 1..1 This element is affected by the following invariants: ele-1 | ||||||
| Type | Extension(Radiotherapy Number of Sessions Extension) (Extension Type: unsignedInt) | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Obligations |
| ||||||
| Invariants | ele-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()) | ||||||
| 20. Procedure.extension:doseDeliveredToVolume | |||||||
| Slice Name | doseDeliveredToVolume | ||||||
| Definition | Dose delivered to a given radiotherapy volume. | ||||||
| Short | Radiotherapy Dose Delivered To Volume Extension | ||||||
| Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
| Type | Extension(Radiotherapy Dose Delivered To Volume Extension) (Complex Extension) | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Obligations |
| ||||||
| Invariants | ele-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()) | ||||||
| 22. Procedure.extension:therapyLine | |||||||
| Slice Name | therapyLine | ||||||
| Definition | A reference to the therapy line associated with this treatment. | ||||||
| Short | Reference to the therapy line associated with this treatment | ||||||
| Control | 0..1 | ||||||
| Type | Extension(Therapy Line Reference) (Extension Type: Reference(Therapy Line Profile)) | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Obligations |
| ||||||
| Summary | false | ||||||
| Invariants | ele-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()) | ||||||
| 24. Procedure.modifierExtension | |||||||
| Definition | 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). | ||||||
| Short | Extensions that cannot be ignored | ||||||
| Comments | 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. | ||||||
| Control | 0..* | ||||||
| Type | Extension | ||||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them | ||||||
| Summary | false | ||||||
| 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 Names | extensions, user content | ||||||
| Invariants | ele-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()) | ||||||
| 26. Procedure.instantiatesCanonical | |||||||
| Definition | Not used in this profile 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. | ||||||
| Short | Not used in this profileInstantiates FHIR protocol or definition | ||||||
| Control | 0..* | ||||||
| Type | canonical(PlanDefinition, ActivityDefinition, Measure, OperationDefinition, Questionnaire, PlanDefinition, ActivityDefinition, Measure, OperationDefinition, Questionnaire) | ||||||
| Is Modifier | false | ||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 28. Procedure.instantiatesUri | |||||||
| Definition | Not used in this profile 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. | ||||||
| Short | Not used in this profileInstantiates external protocol or definition | ||||||
| Comments | This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier. | ||||||
| Control | 0..* | ||||||
| Type | uri | ||||||
| Is Modifier | false | ||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 30. Procedure.basedOn | |||||||
| Definition | Not used in this profile A reference to a resource that contains details of the request for this procedure. | ||||||
| Short | Not used in this profileA request for this procedure | ||||||
| Control | 0..* | ||||||
| Type | Reference(US Core CarePlan Profile, US Core ServiceRequest Profile, CarePlan, ServiceRequest) | ||||||
| Is Modifier | false | ||||||
| Must Support | false | ||||||
| Summary | true | ||||||
| Alternate Names | fulfills | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 32. Procedure.partOf | |||||||
| Definition | Not used in this profile A larger event of which this particular procedure is a component or step. | ||||||
| Short | Not used in this profilePart of referenced event | ||||||
| Comments | 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). | ||||||
| Control | 0..* | ||||||
| Type | Reference(Procedure, Observation, MedicationAdministration, Procedure, Observation, MedicationAdministration) | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Alternate Names | container | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 34. Procedure.status | |||||||
| Definition | Not used in this profile A code specifying the state of the procedure. Generally, this will be the in-progress or completed state. | ||||||
| Short | Not used in this profilepreparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown | ||||||
| Comments | 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. | ||||||
| Control | 1..1 This element is affected by the following invariants: us-core-7 | ||||||
| Binding | The codes SHALL be taken from EventStatushttp://hl7.org/fhir/ValueSet/event-status|4.0.1 (required to http://hl7.org/fhir/ValueSet/event-status) | ||||||
| Type | code | ||||||
| Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
| Must Support | true | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 36. Procedure.statusReason | |||||||
| Definition | Captures the reason for the current state of the procedure. | ||||||
| Short | Reason for current status | ||||||
| Comments | 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. | ||||||
| Control | 0..1 | ||||||
| Binding | The codes SHALL be taken from For example codes, see Treatment Termination Reasons Value Sethttp://hl7.org/fhir/ValueSet/procedure-not-performed-reason|4.0.1 (required to http://onconova.github.io/fhir/ValueSet/onconova-vs-treatment-termination-reasons) | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Obligations |
| ||||||
| Summary | true | ||||||
| Alternate Names | Suspended Reason, Cancelled Reason | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 38. Procedure.code | |||||||
| Definition | The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. "Laparoscopic Appendectomy"). | ||||||
| Short | (USCDI) Identification of the procedureIdentification of the procedure | ||||||
| Control | 10..1 | ||||||
| Binding | Unless not suitable, these codes SHALL be taken from For example codes, see US Core Procedure Codeshttp://hl7.org/fhir/ValueSet/procedure-code|4.0.1 (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code)Codes describing the type of Procedure A code to identify a specific procedure . | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Summary | true | ||||||
| Requirements | 0..1 to account for primarily narrative only resources. | ||||||
| Alternate Names | type | ||||||
| Pattern Value | { | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 40. Procedure.subject | |||||||
| Definition | The patient on whom the procedure was performed. The person, animal or group on which the procedure was performed. | ||||||
| Short | (USCDI) Who the procedure was performed onWho the procedure was performed on | ||||||
| Control | 1..1 | ||||||
| Type | Reference(Cancer Patient Profile, Patient, Group) | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Obligations |
| ||||||
| Summary | true | ||||||
| Alternate Names | patient | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 42. Procedure.performed[x] | |||||||
| Definition | 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. | ||||||
| Short | The time period over which the radiotherapy course was performedWhen the procedure was performed | ||||||
| Comments | 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. | ||||||
| Control | 0..1 This element is affected by the following invariants: us-core-7 | ||||||
| Type | Period, dateTime, string, Range, Age | ||||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Obligations |
| ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 44. Procedure.recorder | |||||||
| Definition | Not used in this profile Individual who recorded the record and takes responsibility for its content. | ||||||
| Short | Not used in this profileWho recorded the procedure | ||||||
| Control | 0..1 | ||||||
| Type | Reference(Patient, RelatedPerson, Practitioner, PractitionerRole, Patient, RelatedPerson, Practitioner, PractitionerRole) | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 46. Procedure.asserter | |||||||
| Definition | Not used in this profile Individual who is making the procedure statement. | ||||||
| Short | Not used in this profilePerson who asserts this procedure | ||||||
| Control | 0..1 | ||||||
| Type | Reference(Patient, RelatedPerson, Practitioner, PractitionerRole, Patient, RelatedPerson, Practitioner, PractitionerRole) | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 48. Procedure.performer | |||||||
| Definition | Not used in this profile Limited to "real" people rather than equipment. | ||||||
| Short | Not used in this profileThe people who performed the procedure | ||||||
| Control | 0..* | ||||||
| Type | BackboneElement | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 50. Procedure.performer.modifierExtension | |||||||
| Definition | 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). | ||||||
| Short | Extensions that cannot be ignored even if unrecognized | ||||||
| Comments | 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. | ||||||
| Control | 0..* | ||||||
| Type | Extension | ||||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||||
| Summary | true | ||||||
| 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 Names | extensions, user content, modifiers | ||||||
| Invariants | ele-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()) | ||||||
| 52. Procedure.performer.actor | |||||||
| Definition | The practitioner who was involved in the procedure. | ||||||
| Short | The reference to the practitioner | ||||||
| Control | 1..1 | ||||||
| Type | Reference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device) | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Requirements | A reference to Device supports use cases, such as pacemakers. | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 54. Procedure.location | |||||||
| Definition | Not used in this profile The location where the procedure actually happened. E.g. a newborn at home, a tracheostomy at a restaurant. | ||||||
| Short | Not used in this profileWhere the procedure happened | ||||||
| Control | 0..1 | ||||||
| Type | Reference(Location, Location) | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Requirements | Ties a procedure to where the records are likely kept. | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 56. Procedure.reasonCode | |||||||
| Definition | Not used in this profile The coded reason why the procedure was performed. This may be a coded entity of some type, or may simply be present as text. | ||||||
| Short | Not used in this profileCoded reason procedure performed | ||||||
| Comments | 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. | ||||||
| Control | 0..* | ||||||
| Binding | Unless not suitable, these codes SHALL be taken from For example codes, see Cancer Disorder Value Sethttp://hl7.org/fhir/ValueSet/procedure-reason|4.0.1 (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs) | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 58. Procedure.reasonReference | |||||||
| Definition | The justification of why the procedure was performed. | ||||||
| Short | The condition(s) that motivated the radiotherapy treatmentThe justification that the procedure was performed | ||||||
| Comments | 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. | ||||||
| Control | 10..* | ||||||
| Type | Reference(Primary Cancer Condition Profile, Secondary Cancer Condition Profile, Condition, Observation, Procedure, DiagnosticReport, DocumentReference) | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Must Support Types | No must-support rules about the choice of types/profiles | ||||||
| Obligations |
| ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 60. Procedure.bodySite | |||||||
| Definition | Not used in this profile Detailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion. | ||||||
| Short | Not used in this profileTarget body sites | ||||||
| Comments | If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension procedure-targetbodystructure. | ||||||
| Control | 0..* | ||||||
| Binding | Unless not suitable, these codes SHALL be taken from For example codes, see Radiotherapy Treatment Location Value Sethttp://hl7.org/fhir/ValueSet/body-site|4.0.1 (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-treatment-location-vs) | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 62. Procedure.bodySite.extension:locationQualifier | |||||||
| Slice Name | locationQualifier | ||||||
| Definition | General location qualifier (excluding laterality) for this bodySite | ||||||
| Short | General location qualifier (excluding laterality) for this bodySite | ||||||
| Control | 0..* | ||||||
| Type | Extension(Body Location Qualifier Extension) (Extension Type: CodeableConcept) | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-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()) | ||||||
| 64. Procedure.bodySite.extension:lateralityQualifier | |||||||
| Slice Name | lateralityQualifier | ||||||
| Definition | Laterality qualifier for this bodySite | ||||||
| Short | Laterality qualifier for this bodySite | ||||||
| Control | 0..1 | ||||||
| Type | Extension(Laterality Qualifier Extension) (Extension Type: CodeableConcept) | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-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()) | ||||||
| 66. Procedure.outcome | |||||||
| Definition | Not used in this profile The outcome of the procedure - did it resolve the reasons for the procedure being performed? | ||||||
| Short | Not used in this profileThe result of procedure | ||||||
| Comments | If outcome contains narrative text only, it can be captured using the CodeableConcept.text. | ||||||
| Control | 0..1 | ||||||
| Binding | For example codes, see ProcedureOutcomeCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-outcome|4.0.1 (example to http://hl7.org/fhir/ValueSet/procedure-outcome)An outcome of a procedure - whether it was resolved or otherwise. | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 68. Procedure.report | |||||||
| Definition | Not used in this profile This could be a histology result, pathology report, surgical report, etc. | ||||||
| Short | Not used in this profileAny report resulting from the procedure | ||||||
| Comments | 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. | ||||||
| Control | 0..* | ||||||
| Type | Reference(DiagnosticReport, DocumentReference, Composition, DiagnosticReport, DocumentReference, Composition) | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 70. Procedure.complication | |||||||
| Definition | Not used in this profile 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. | ||||||
| Short | Not used in this profileComplication following the procedure | ||||||
| Comments | If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text. | ||||||
| Control | 0..* | ||||||
| Binding | For example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code|4.0.1 (example to http://hl7.org/fhir/ValueSet/condition-code)Codes describing complications that resulted from a procedure. | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 72. Procedure.complicationDetail | |||||||
| Definition | Not used in this profile Any complications that occurred during the procedure, or in the immediate post-performance period. | ||||||
| Short | Not used in this profileA condition that is a result of the procedure | ||||||
| Control | 0..* | ||||||
| Type | Reference(Condition, Condition) | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| 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. | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 74. Procedure.followUp | |||||||
| Definition | Not used in this profile 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. | ||||||
| Short | Not used in this profileInstructions for follow up | ||||||
| Control | 0..* | ||||||
| Binding | For example codes, see ProcedureFollowUpCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-followup|4.0.1 (example to http://hl7.org/fhir/ValueSet/procedure-followup)Specific follow up required for a procedure e.g. removal of sutures. | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 76. Procedure.note | |||||||
| Definition | Not used in this profile Any other notes and comments about the procedure. | ||||||
| Short | Not used in this profileAdditional information about the procedure | ||||||
| Control | 0..* | ||||||
| Type | Annotation | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 78. Procedure.focalDevice | |||||||
| Definition | Not used in this profile 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. | ||||||
| Short | Not used in this profileManipulated, implanted, or removed device | ||||||
| Control | 0..* | ||||||
| Type | BackboneElement | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 80. Procedure.focalDevice.modifierExtension | |||||||
| Definition | 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). | ||||||
| Short | Extensions that cannot be ignored even if unrecognized | ||||||
| Comments | 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. | ||||||
| Control | 0..* | ||||||
| Type | Extension | ||||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||||
| Summary | true | ||||||
| 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 Names | extensions, user content, modifiers | ||||||
| Invariants | ele-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()) | ||||||
| 82. Procedure.focalDevice.manipulated | |||||||
| Definition | The device that was manipulated (changed) during the procedure. | ||||||
| Short | Device that was changed | ||||||
| Control | 1..1 | ||||||
| Type | Reference(Device, Device) | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 84. Procedure.usedReference | |||||||
| Definition | Not used in this profile Identifies medications, devices and any other substance used as part of the procedure. | ||||||
| Short | Not used in this profileItems used during procedure | ||||||
| Comments | For devices actually implanted or removed, use Procedure.device. | ||||||
| Control | 0..* | ||||||
| Type | Reference(Device, Medication, Substance, Device, Medication, Substance) | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Requirements | Used for tracking contamination, etc. | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 86. Procedure.usedCode | |||||||
| Definition | Not used in this profile Identifies coded items that were used as part of the procedure. | ||||||
| Short | Not used in this profileCoded items used during the procedure | ||||||
| Comments | For devices actually implanted or removed, use Procedure.device. | ||||||
| Control | 0..* | ||||||
| Binding | For example codes, see FHIRDeviceTypeshttp://hl7.org/fhir/ValueSet/device-kind|4.0.1 (example to http://hl7.org/fhir/ValueSet/device-kind)Codes describing items used during a procedure. | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-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 foundhere
| 0. Procedure | |||||||
| Invariants | o-rad-req-1: The subject element is required and must be provided. (subject.exists())o-rad-req-2: The performedPeriod element is required and must be provided. ( performedPeriod.exists())o-rad-req-3: The actualNumberOfSessions extension is required and must be provided. ( extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions').exists())o-rad-req-4: The treatmentIntent extension is required and must be provided. ( extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent').exists()) | ||||||
| 2. Procedure.extension | |||||||
| Control | 2..? | ||||||
| 4. Procedure.extension:treatmentIntent | |||||||
| Slice Name | treatmentIntent | ||||||
| Control | 1..? | ||||||
| Obligations |
| ||||||
| 6. Procedure.extension:treatmentIntent.value[x] | |||||||
| Binding | The codes SHALL be taken from Treatment Intents Value Set (required to http://onconova.github.io/fhir/ValueSet/onconova-vs-treatment-intents) | ||||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||||
| 8. Procedure.extension:terminationReason | |||||||
| Slice Name | terminationReason | ||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 10. Procedure.extension:modalityAndTechnique | |||||||
| Slice Name | modalityAndTechnique | ||||||
| Obligations |
| ||||||
| 12. Procedure.extension:actualNumberOfSessions | |||||||
| Slice Name | actualNumberOfSessions | ||||||
| Control | 1..? | ||||||
| Obligations |
| ||||||
| 14. Procedure.extension:doseDeliveredToVolume | |||||||
| Slice Name | doseDeliveredToVolume | ||||||
| Obligations |
| ||||||
| 16. Procedure.extension:therapyLine | |||||||
| Slice Name | therapyLine | ||||||
| Short | Reference to the therapy line associated with this treatment | ||||||
| Control | 0..1 | ||||||
| Type | Extension(Therapy Line Reference) (Extension Type: Reference(Therapy Line Profile)) | ||||||
| Obligations |
| ||||||
| 18. Procedure.instantiatesCanonical | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 20. Procedure.instantiatesUri | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 22. Procedure.basedOn | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 24. Procedure.partOf | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 26. Procedure.status | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 28. Procedure.statusReason | |||||||
| Binding | The codes SHALL be taken from Treatment Termination Reasons Value Set (required to http://onconova.github.io/fhir/ValueSet/onconova-vs-treatment-termination-reasons) | ||||||
| Obligations |
| ||||||
| 30. Procedure.subject | |||||||
| Type | Reference(Cancer Patient Profile) | ||||||
| Obligations |
| ||||||
| 32. Procedure.performed[x] | |||||||
| Short | The time period over which the radiotherapy course was performed | ||||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||||
| Obligations |
| ||||||
| 34. Procedure.recorder | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 36. Procedure.asserter | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 38. Procedure.performer | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 40. Procedure.location | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 42. Procedure.reasonCode | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 44. Procedure.reasonReference | |||||||
| Short | The condition(s) that motivated the radiotherapy treatment | ||||||
| Control | 1..? | ||||||
| Type | Reference(Primary Cancer Condition Profile, Secondary Cancer Condition Profile) | ||||||
| Obligations |
| ||||||
| 46. Procedure.bodySite | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 48. Procedure.outcome | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 50. Procedure.report | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 52. Procedure.complication | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 54. Procedure.complicationDetail | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 56. Procedure.followUp | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 58. Procedure.note | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 60. Procedure.focalDevice | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 62. Procedure.usedReference | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| 64. Procedure.usedCode | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
Guidance on how to interpret the contents of this table can be foundhere
| 0. Procedure | |||||||
| Definition | - | ||||||
| Short | An action that is being or was performed on a patient | ||||||
| Comments | - | ||||||
| Control | 0..* | ||||||
| Is Modifier | false | ||||||
| Must Support | false | ||||||
| Summary | false | ||||||
| Invariants | dom-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())us-core-7: Performed SHALL be present if the status is 'completed' or 'in-progress' ( (status='completed' or status='in-progress') implies performed.exists())termination-reason-code-invariant: When status is stopped, only certain statusReason values are allowed ( status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')))termination-reason-invariant: Certain statusReason values are allowed only when status is stopped ( statusReason.exists() and statusReason.coding.exists(
system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or
code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped')mcode-reason-required: One of reasonCode or reasonReference SHALL be present ( reasonCode.exists() or reasonReference.exists())o-rad-req-1: The subject element is required and must be provided. ( subject.exists())o-rad-req-2: The performedPeriod element is required and must be provided. ( performedPeriod.exists())o-rad-req-3: The actualNumberOfSessions extension is required and must be provided. ( extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions').exists())o-rad-req-4: The treatmentIntent extension is required and must be provided. ( extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent').exists()) | ||||||
| 2. Procedure.id | |||||||
| Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. | ||||||
| Short | Logical id of this artifact | ||||||
| Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | ||||||
| Control | 0..1 | ||||||
| Type | id | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| 4. Procedure.meta | |||||||
| Definition | 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. | ||||||
| Short | Metadata about the resource | ||||||
| Control | 0..1 | ||||||
| Type | Meta | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 6. Procedure.implicitRules | |||||||
| Definition | 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. | ||||||
| Short | A set of rules under which this content was created | ||||||
| Comments | 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. | ||||||
| Control | 0..1 | ||||||
| Type | uri | ||||||
| Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 8. Procedure.language | |||||||
| Definition | The base language in which the resource is written. | ||||||
| Short | Language of the resource content | ||||||
| Comments | 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). | ||||||
| Control | 0..1 | ||||||
| Binding | The codes SHOULD be taken from CommonLanguages (preferred to http://hl7.org/fhir/ValueSet/languages)A human language.
| ||||||
| Type | code | ||||||
| Is Modifier | false | ||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
| Summary | false | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 10. Procedure.text | |||||||
| Definition | 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. | ||||||
| Short | Text summary of the resource, for human interpretation | ||||||
| Comments | 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. | ||||||
| Control | 0..1 | ||||||
| Type | Narrative | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Alternate Names | narrative, html, xhtml, display | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 12. Procedure.contained | |||||||
| Definition | 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. | ||||||
| Short | Contained, inline Resources | ||||||
| Comments | 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. | ||||||
| Control | 0..* | ||||||
| Type | Resource | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Alternate Names | inline resources, anonymous resources, contained resources | ||||||
| 14. Procedure.extension | |||||||
| Definition | An Extension | ||||||
| Short | Extension | ||||||
| Control | 2..* | ||||||
| Type | Extension | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Summary | false | ||||||
| Invariants | ele-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()) | ||||||
| Slicing | This element introduces a set of slices on Procedure.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||||
| 16. Procedure.extension:treatmentIntent | |||||||
| Slice Name | treatmentIntent | ||||||
| Definition | The purpose of a treatment, medication, or procedure. | ||||||
| Short | Procedure Intent Extension | ||||||
| Control | 1..1 This element is affected by the following invariants: ele-1 | ||||||
| Type | Extension(Procedure Intent Extension) (Extension Type: CodeableConcept) | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Obligations |
| ||||||
| Invariants | ele-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.extension:treatmentIntent.id | |||||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||||
| Short | Unique id for inter-element referencing | ||||||
| Control | 0..1 | ||||||
| Type | string | ||||||
| Is Modifier | false | ||||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||||
| Summary | false | ||||||
| 20. Procedure.extension:treatmentIntent.extension | |||||||
| Definition | An Extension | ||||||
| Short | Extension | ||||||
| Control | 0..0 | ||||||
| Type | Extension | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-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()) | ||||||
| Slicing | This element introduces a set of slices on Procedure.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||||
| 22. Procedure.extension:treatmentIntent.url | |||||||
| Definition | Source of the definition for the extension code - a logical name or a URL. | ||||||
| Short | identifies the meaning of the extension | ||||||
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. | ||||||
| Control | 1..1 | ||||||
| Type | uri | ||||||
| Is Modifier | false | ||||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||||
| Summary | false | ||||||
| Fixed Value | http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent | ||||||
| 24. Procedure.extension:treatmentIntent.value[x] | |||||||
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | ||||||
| Short | Value of extension | ||||||
| Control | 1..1 | ||||||
| Binding | The codes SHALL be taken from Treatment Intents Value Set (required to http://onconova.github.io/fhir/ValueSet/onconova-vs-treatment-intents) | ||||||
| Type | CodeableConcept | ||||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 26. Procedure.extension:terminationReason | |||||||
| Slice Name | terminationReason | ||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||||
| Type | Extension(Treatment Termination Reason Extension (deprecated)) (Extension Type: CodeableConcept) | ||||||
| Is Modifier | false | ||||||
| Invariants | ele-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()) | ||||||
| 28. Procedure.extension:modalityAndTechnique | |||||||
| Slice Name | modalityAndTechnique | ||||||
| Definition | Extension capturing modality and technique of a given radiotherapy procedure. The allowed combinations of modality and technique are constrained by invariants, one per modality. | ||||||
| Short | Radiotherapy Modality And Technique Extension | ||||||
| Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
| Type | Extension(Radiotherapy Modality And Technique Extension) (Complex Extension) | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Obligations |
| ||||||
| Invariants | ele-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())TechniquesForNeutronBeamModality: Allowed Techniques for Neutron Beam Modality ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '80347004')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '169317000' or code = '1162782007'))TechniquesForPhotonBeamModality: Allowed Techniques for Photon Beam Modality ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156506007')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '441799006' or code = '1156530009' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1156530009' or code = '1163157007'))TechniquesForElectronBeamModality: Allowed Techniques for Electron Beam Modality ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '45643008')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1163157007'))TechniquesForCarbonIonBeamModality: Allowed Techniques for Carbon Ion Beam Modality ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156505006')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code='1204242009'))TechniquesForProtonBeamModality: Allowed Techniques for Proton Beam Modality ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '10611004')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code = '1204242009' or code = '1163157007'))TechniquesForInternalRadiotherapyPermanentSeeds: Allowed Techniques for Internal Radiotherapy - Permanent Seeds ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '169359004')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '113120007'))TechniquesForLowDoseRateUsingTempRadSource: Allowed Techniques for Low Dose Rate Using Temp Radiation Source ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156708005')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007' or code = '14473006'))TechniquesForPulsedDoseRate: Allowed Techniques for Pulsed Dose Rate ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156384006')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007'))TechniquesForHighDoseRate: Allowed Techniques for High Dose Rate ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '394902000')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = ' 1156383000' or code = '384691004' or code = '168524008' or code = '14473006'))TechniquesForHighDoseRateElectronic: Allowed Techniques for High Dose Rate Electronic ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '438629002')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = '384691004' or code = '168524008' or code = '14473006'))TechniquesForRadioPharmaceutical: Allowed Techniques for Radiopharmaceutical ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '440252007')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '16560241000119104' or code = '1156383000' or code = '384692006' or code = '113120007'))ModalityTextRequiredForOther: Require a text literal for code other ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.text.exists())TechniqueTextRequiredForOther: Require a text literal for code other ( extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC')
implies
extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.text.exists()) | ||||||
| 30. Procedure.extension:actualNumberOfSessions | |||||||
| Slice Name | actualNumberOfSessions | ||||||
| Definition | The number of sessions in a course of radiotherapy. | ||||||
| Short | Radiotherapy Number of Sessions Extension | ||||||
| Control | 1..1 This element is affected by the following invariants: ele-1 | ||||||
| Type | Extension(Radiotherapy Number of Sessions Extension) (Extension Type: unsignedInt) | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Obligations |
| ||||||
| Invariants | ele-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()) | ||||||
| 32. Procedure.extension:doseDeliveredToVolume | |||||||
| Slice Name | doseDeliveredToVolume | ||||||
| Definition | Dose delivered to a given radiotherapy volume. | ||||||
| Short | Radiotherapy Dose Delivered To Volume Extension | ||||||
| Control | 0..* This element is affected by the following invariants: ele-1 | ||||||
| Type | Extension(Radiotherapy Dose Delivered To Volume Extension) (Complex Extension) | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Obligations |
| ||||||
| Invariants | ele-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()) | ||||||
| 34. Procedure.extension:therapyLine | |||||||
| Slice Name | therapyLine | ||||||
| Definition | A reference to the therapy line associated with this treatment. | ||||||
| Short | Reference to the therapy line associated with this treatment | ||||||
| Control | 0..1 | ||||||
| Type | Extension(Therapy Line Reference) (Extension Type: Reference(Therapy Line Profile)) | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Obligations |
| ||||||
| Summary | false | ||||||
| Invariants | ele-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()) | ||||||
| 36. Procedure.modifierExtension | |||||||
| Definition | 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). | ||||||
| Short | Extensions that cannot be ignored | ||||||
| Comments | 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. | ||||||
| Control | 0..* | ||||||
| Type | Extension | ||||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them | ||||||
| Summary | false | ||||||
| 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 Names | extensions, user content | ||||||
| Invariants | ele-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()) | ||||||
| 38. Procedure.identifier | |||||||
| Definition | 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. | ||||||
| Short | External Identifiers for this procedure | ||||||
| Comments | 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. | ||||||
| Note | This is a business identifier, not a resource identifier (see discussion) | ||||||
| Control | 0..* | ||||||
| Type | Identifier | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Requirements | Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers. | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 40. Procedure.instantiatesCanonical | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Control | 0..* | ||||||
| Type | canonical(PlanDefinition, ActivityDefinition, Measure, OperationDefinition, Questionnaire) | ||||||
| Is Modifier | false | ||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 42. Procedure.instantiatesUri | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Comments | This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier. | ||||||
| Control | 0..* | ||||||
| Type | uri | ||||||
| Is Modifier | false | ||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 44. Procedure.basedOn | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Control | 0..* | ||||||
| Type | Reference(US Core CarePlan Profile, US Core ServiceRequest Profile) | ||||||
| Is Modifier | false | ||||||
| Must Support | false | ||||||
| Summary | true | ||||||
| Alternate Names | fulfills | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 46. Procedure.partOf | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Comments | 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). | ||||||
| Control | 0..* | ||||||
| Type | Reference(Procedure, Observation, MedicationAdministration) | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Alternate Names | container | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 48. Procedure.status | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Comments | 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. | ||||||
| Control | 1..1 This element is affected by the following invariants: us-core-7 | ||||||
| Binding | The codes SHALL be taken from EventStatus (required to http://hl7.org/fhir/ValueSet/event-status) | ||||||
| Type | code | ||||||
| Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
| Must Support | true | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 50. Procedure.statusReason | |||||||
| Definition | Captures the reason for the current state of the procedure. | ||||||
| Short | Reason for current status | ||||||
| Comments | 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. | ||||||
| Control | 0..1 | ||||||
| Binding | The codes SHALL be taken from Treatment Termination Reasons Value Set (required to http://onconova.github.io/fhir/ValueSet/onconova-vs-treatment-termination-reasons) | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Obligations |
| ||||||
| Summary | true | ||||||
| Alternate Names | Suspended Reason, Cancelled Reason | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 52. Procedure.category | |||||||
| Definition | A code that classifies the procedure for searching, sorting and display purposes (e.g. "Surgical Procedure"). | ||||||
| Short | Classification of the procedure | ||||||
| Control | 0..1 | ||||||
| Binding | For 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. | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 54. Procedure.code | |||||||
| Definition | The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. "Laparoscopic Appendectomy"). | ||||||
| Short | (USCDI) Identification of the procedure | ||||||
| Control | 1..1 | ||||||
| Binding | Unless not suitable, these codes SHALL be taken from US Core Procedure Codes (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code)Codes describing the type of Procedure | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Summary | true | ||||||
| Requirements | 0..1 to account for primarily narrative only resources. | ||||||
| Alternate Names | type | ||||||
| Pattern Value | { | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 56. Procedure.subject | |||||||
| Definition | The patient on whom the procedure was performed. | ||||||
| Short | (USCDI) Who the procedure was performed on | ||||||
| Control | 1..1 | ||||||
| Type | Reference(Cancer Patient Profile) | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Obligations |
| ||||||
| Summary | true | ||||||
| Alternate Names | patient | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 58. Procedure.encounter | |||||||
| Definition | The Encounter during which this Procedure was created or performed or to which the creation of this record is tightly associated. | ||||||
| Short | Encounter created as part of | ||||||
| Comments | 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. | ||||||
| Control | 0..1 | ||||||
| Type | Reference(Encounter) | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 60. Procedure.performed[x] | |||||||
| Definition | 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. | ||||||
| Short | The time period over which the radiotherapy course was performed | ||||||
| Comments | 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. | ||||||
| Control | 0..1 This element is affected by the following invariants: us-core-7 | ||||||
| Type | Period | ||||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Obligations |
| ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 62. Procedure.recorder | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Control | 0..1 | ||||||
| Type | Reference(Patient, RelatedPerson, Practitioner, PractitionerRole) | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 64. Procedure.asserter | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Control | 0..1 | ||||||
| Type | Reference(Patient, RelatedPerson, Practitioner, PractitionerRole) | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 66. Procedure.performer | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Control | 0..* | ||||||
| Type | BackboneElement | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 68. Procedure.performer.id | |||||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||||
| Short | Unique id for inter-element referencing | ||||||
| Control | 0..1 | ||||||
| Type | string | ||||||
| Is Modifier | false | ||||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||||
| Summary | false | ||||||
| 70. Procedure.performer.extension | |||||||
| Definition | 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. | ||||||
| Short | Additional content defined by implementations | ||||||
| Comments | 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. | ||||||
| Control | 0..* | ||||||
| Type | Extension | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Alternate Names | extensions, user content | ||||||
| Invariants | ele-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()) | ||||||
| 72. Procedure.performer.modifierExtension | |||||||
| Definition | 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). | ||||||
| Short | Extensions that cannot be ignored even if unrecognized | ||||||
| Comments | 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. | ||||||
| Control | 0..* | ||||||
| Type | Extension | ||||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||||
| Summary | true | ||||||
| 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 Names | extensions, user content, modifiers | ||||||
| Invariants | ele-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()) | ||||||
| 74. Procedure.performer.function | |||||||
| Definition | Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist. | ||||||
| Short | Type of performance | ||||||
| Control | 0..1 | ||||||
| Binding | For 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. | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Requirements | Allows disambiguation of the types of involvement of different performers. | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 76. Procedure.performer.actor | |||||||
| Definition | The practitioner who was involved in the procedure. | ||||||
| Short | The reference to the practitioner | ||||||
| Control | 1..1 | ||||||
| Type | Reference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device) | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Requirements | A reference to Device supports use cases, such as pacemakers. | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 78. Procedure.performer.onBehalfOf | |||||||
| Definition | The organization the device or practitioner was acting on behalf of. | ||||||
| Short | Organization the device or practitioner was acting for | ||||||
| Control | 0..1 | ||||||
| Type | Reference(Organization) | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| 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. | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 80. Procedure.location | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Control | 0..1 | ||||||
| Type | Reference(Location) | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Requirements | Ties a procedure to where the records are likely kept. | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 82. Procedure.reasonCode | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Comments | 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. | ||||||
| Control | 0..* | ||||||
| Binding | Unless not suitable, these codes SHALL be taken from Cancer Disorder Value Set (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs) | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 84. Procedure.reasonReference | |||||||
| Definition | The justification of why the procedure was performed. | ||||||
| Short | The condition(s) that motivated the radiotherapy treatment | ||||||
| Comments | 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. | ||||||
| Control | 1..* | ||||||
| Type | Reference(Primary Cancer Condition Profile, Secondary Cancer Condition Profile) | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Must Support Types | No must-support rules about the choice of types/profiles | ||||||
| Obligations |
| ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 86. Procedure.bodySite | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Comments | If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension procedure-targetbodystructure. | ||||||
| Control | 0..* | ||||||
| Binding | Unless not suitable, these codes SHALL be taken from Radiotherapy Treatment Location Value Set (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-treatment-location-vs) | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Must Support | true | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 88. Procedure.bodySite.id | |||||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||||
| Short | Unique id for inter-element referencing | ||||||
| Control | 0..1 | ||||||
| Type | string | ||||||
| Is Modifier | false | ||||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||||
| Summary | false | ||||||
| 90. Procedure.bodySite.extension | |||||||
| Definition | 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. | ||||||
| Short | Additional content defined by implementations | ||||||
| Comments | 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. | ||||||
| Control | 0..* | ||||||
| Type | Extension | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Alternate Names | extensions, user content | ||||||
| Invariants | ele-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()) | ||||||
| Slicing | This element introduces a set of slices on Procedure.bodySite.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||||
| 92. Procedure.bodySite.extension:locationQualifier | |||||||
| Slice Name | locationQualifier | ||||||
| Definition | General location qualifier (excluding laterality) for this bodySite | ||||||
| Short | General location qualifier (excluding laterality) for this bodySite | ||||||
| Control | 0..* | ||||||
| Type | Extension(Body Location Qualifier Extension) (Extension Type: CodeableConcept) | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-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()) | ||||||
| 94. Procedure.bodySite.extension:lateralityQualifier | |||||||
| Slice Name | lateralityQualifier | ||||||
| Definition | Laterality qualifier for this bodySite | ||||||
| Short | Laterality qualifier for this bodySite | ||||||
| Control | 0..1 | ||||||
| Type | Extension(Laterality Qualifier Extension) (Extension Type: CodeableConcept) | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-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()) | ||||||
| 96. Procedure.bodySite.coding | |||||||
| Definition | A reference to a code defined by a terminology system. | ||||||
| Short | Code defined by a terminology system | ||||||
| Comments | 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. | ||||||
| Control | 0..* | ||||||
| Type | Coding | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Requirements | Allows for alternative encodings within a code system, and translations to other code systems. | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 98. Procedure.bodySite.text | |||||||
| Definition | 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. | ||||||
| Short | Plain text representation of the concept | ||||||
| Comments | Very often the text is the same as a displayName of one of the codings. | ||||||
| Control | 0..1 | ||||||
| Type | string | ||||||
| Is Modifier | false | ||||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||||
| Summary | true | ||||||
| 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. | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 100. Procedure.outcome | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Comments | If outcome contains narrative text only, it can be captured using the CodeableConcept.text. | ||||||
| Control | 0..1 | ||||||
| Binding | For 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. | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Summary | true | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 102. Procedure.report | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Comments | 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. | ||||||
| Control | 0..* | ||||||
| Type | Reference(DiagnosticReport, DocumentReference, Composition) | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 104. Procedure.complication | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Comments | If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text. | ||||||
| Control | 0..* | ||||||
| Binding | For example codes, see Condition/Problem/DiagnosisCodes (example to http://hl7.org/fhir/ValueSet/condition-code)Codes describing complications that resulted from a procedure. | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 106. Procedure.complicationDetail | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Control | 0..* | ||||||
| Type | Reference(Condition) | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| 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. | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 108. Procedure.followUp | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Control | 0..* | ||||||
| Binding | For 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. | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 110. Procedure.note | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Control | 0..* | ||||||
| Type | Annotation | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 112. Procedure.focalDevice | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Control | 0..* | ||||||
| Type | BackboneElement | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 114. Procedure.focalDevice.id | |||||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||||
| Short | Unique id for inter-element referencing | ||||||
| Control | 0..1 | ||||||
| Type | string | ||||||
| Is Modifier | false | ||||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||||
| Summary | false | ||||||
| 116. Procedure.focalDevice.extension | |||||||
| Definition | 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. | ||||||
| Short | Additional content defined by implementations | ||||||
| Comments | 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. | ||||||
| Control | 0..* | ||||||
| Type | Extension | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Alternate Names | extensions, user content | ||||||
| Invariants | ele-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()) | ||||||
| 118. Procedure.focalDevice.modifierExtension | |||||||
| Definition | 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). | ||||||
| Short | Extensions that cannot be ignored even if unrecognized | ||||||
| Comments | 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. | ||||||
| Control | 0..* | ||||||
| Type | Extension | ||||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||||
| Summary | true | ||||||
| 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 Names | extensions, user content, modifiers | ||||||
| Invariants | ele-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()) | ||||||
| 120. Procedure.focalDevice.action | |||||||
| Definition | The kind of change that happened to the device during the procedure. | ||||||
| Short | Kind of change to device | ||||||
| Control | 0..1 | ||||||
| Binding | The 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. | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 122. Procedure.focalDevice.manipulated | |||||||
| Definition | The device that was manipulated (changed) during the procedure. | ||||||
| Short | Device that was changed | ||||||
| Control | 1..1 | ||||||
| Type | Reference(Device) | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 124. Procedure.usedReference | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Comments | For devices actually implanted or removed, use Procedure.device. | ||||||
| Control | 0..* | ||||||
| Type | Reference(Device, Medication, Substance) | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Requirements | Used for tracking contamination, etc. | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||
| 126. Procedure.usedCode | |||||||
| Definition | Not used in this profile | ||||||
| Short | Not used in this profile | ||||||
| Comments | For devices actually implanted or removed, use Procedure.device. | ||||||
| Control | 0..* | ||||||
| Binding | For example codes, see FHIRDeviceTypes (example to http://hl7.org/fhir/ValueSet/device-kind)Codes describing items used during a procedure. | ||||||
| Type | CodeableConcept | ||||||
| Is Modifier | false | ||||||
| Summary | false | ||||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||||