My Health Record FHIR IG
1.2.0 - active Australia flag

My Health Record FHIR IG - Local Development build (v1.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: MHRProcedureMCV - Detailed Descriptions

Active as of 2024-09-19

Definitions for the dh-procedure-mcv-1 resource profile.

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

0. Procedure
ShortA procedure in the context of electronic exchange of health information for the Medical COnditions View
2. Procedure.id
Control1..?
4. Procedure.status
Obligations
    ObligationsActor
    SHALL:handleMHR Gateway Requester
    Fixed Valuecompleted
    6. Procedure.code
    BindingUnless not suitable, these codes SHALL be taken from Procedure .
    (extensible to https://healthterminologies.gov.au/fhir/ValueSet/procedure-1)
    Obligations
      ObligationsActor
      SHALL:handleMHR Gateway Requester
      8. Procedure.subject
      TypeReference(MHR Patient)
      Obligations
        ObligationsActor
        SHALL:handleMHR Gateway Requester
        10. Procedure.performedDateTime
        Control1..?
        Must Supporttrue
        Obligations
          ObligationsActor
          SHALL:handleMHR Gateway Requester
          12. Procedure.note
          Must Supporttrue
          Obligations
            ObligationsActor
            SHALL:handleMHR Gateway Requester

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

            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.

            ShortA procedure in the context of electronic exchange of health information for the Medical COnditions ViewAn action that is being or was performed on a patient
            Control0..*
            Is Modifierfalse
            Summaryfalse
            Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
            dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
            dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
            dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
            dom-6: A resource should have narrative for robust management (text.`div`.exists())
            2. Procedure.id
            Definition

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

            ShortLogical id of this artifact
            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.

            Control10..1
            Typeidstring
            Is Modifierfalse
            Summarytrue
            4. 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.

            ShortA 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.

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

            The target body site used for this procedure. Multiple locations are allowed.

            ShortThe target point for this procedure
            Control0..*
            TypeExtension(Procedure Target Body Structure) (Extension Type: Reference(BodyStructure))
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            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())
            8. 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).

            ShortExtensions 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.

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

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

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

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

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

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

            A code specifying the state of the procedure.

            Typecode
            Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Obligations
              ObligationsActor
              SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
              SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
              SHALL:handleMHR Gateway Requester
              Summarytrue
              Fixed Valuecompleted
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              12. 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").

              ShortIdentification of the procedure
              Control10..1
              BindingUnless not suitable, these codes SHALL be taken from For example codes, see Procedure .http://hl7.org/fhir/ValueSet/procedure-code
              (extensible to https://healthterminologies.gov.au/fhir/ValueSet/procedure-1)
              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Obligations
                ObligationsActor
                SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                SHALL:handleMHR Gateway Requester
                Summarytrue
                Requirements

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

                Alternate Namestype
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                14. Procedure.subject
                Definition

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

                ShortWho the procedure was performed on
                Control1..1
                TypeReference(MHR Patient, Patient, Group)
                Is Modifierfalse
                Must Supporttrue
                Obligations
                  ObligationsActor
                  SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                  SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                  SHALL:handleMHR Gateway Requester
                  Summarytrue
                  Alternate Namespatient
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  16. Procedure.encounter
                  Definition

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

                  ShortEncounter created as part of
                  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.

                  Control0..1
                  TypeReference(AU Core Encounter, Encounter)
                  Is Modifierfalse
                  Must Supporttrue
                  Obligations
                    ObligationsActor
                    SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                    SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    18. 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.

                    ShortWhen 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.

                    Control10..1
                    TypedateTime, string, Period, Range, Age
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Obligations
                      ObligationsActor
                      SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                      SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      SlicingThis element introduces a set of slices on Procedure.performed[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                      • type @ $this
                      • 20. Procedure.performed[x]:performedDateTime
                        Slice NameperformedDateTime
                        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.

                        ShortWhen 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.

                        Control10..1
                        TypedateTime, string, Period, Range, Age
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Obligations
                          ObligationsActor
                          SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                          SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                          SHALL:handleMHR Gateway Requester
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          22. Procedure.reasonCode
                          Definition

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

                          ShortCoded reason procedure performed
                          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.

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

                          A code that identifies the reason a procedure is required.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supporttrue
                          Obligations
                            ObligationsActor
                            SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                            SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            24. Procedure.reasonReference
                            Definition

                            The justification of why the procedure was performed.

                            ShortThe 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.

                            Control0..*
                            TypeReference(AU Core Condition, Observation, AU Core Procedure, DocumentReference, Condition, Procedure, DiagnosticReport)
                            Is Modifierfalse
                            Must Supporttrue
                            Must Support TypesNo must-support rules about the choice of types/profiles
                            Obligations
                              ObligationsActor
                              SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                              SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              26. Procedure.note
                              Definition

                              Any other notes and comments about the procedure.

                              ShortAdditional information about the procedure
                              Control0..*
                              TypeAnnotation
                              Is Modifierfalse
                              Must Supporttrue
                              Obligations
                                ObligationsActor
                                SHALL:handleMHR Gateway Requester
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

                                0. Procedure
                                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.

                                ShortA procedure in the context of electronic exchange of health information for the Medical COnditions View
                                Control0..*
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                                dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                                dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                2. Procedure.id
                                Definition

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

                                ShortLogical id of this artifact
                                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.

                                Control1..1
                                Typeid
                                Is Modifierfalse
                                Summarytrue
                                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.

                                ShortMetadata about the resource
                                Control0..1
                                TypeMeta
                                Is Modifierfalse
                                Summarytrue
                                Invariantsele-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.

                                ShortA 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.

                                Control0..1
                                Typeuri
                                Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Invariantsele-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.

                                ShortLanguage 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).

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

                                A human language.

                                Additional BindingsPurpose
                                AllLanguagesMax Binding
                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summaryfalse
                                Invariantsele-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.

                                ShortText 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.

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

                                ShortContained, 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.

                                Control0..*
                                TypeResource
                                Is Modifierfalse
                                Summaryfalse
                                Alternate Namesinline resources, anonymous resources, contained resources
                                14. Procedure.extension
                                Definition

                                An Extension

                                ShortExtension
                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on Procedure.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 16. Procedure.extension:targetBodyStructure
                                  Slice NametargetBodyStructure
                                  Definition

                                  The target body site used for this procedure. Multiple locations are allowed.

                                  ShortThe target point for this procedure
                                  Control0..*
                                  TypeExtension(Procedure Target Body Structure) (Extension Type: Reference(BodyStructure))
                                  Is Modifierfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  18. Procedure.modifierExtension
                                  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).

                                  ShortExtensions 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.

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

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

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

                                  ShortExternal 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.

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

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

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

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

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

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

                                  ShortInstantiates external protocol or definition
                                  Comments

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

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

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

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

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

                                  ShortPart 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).

                                  Control0..*
                                  TypeReference(Procedure, Observation, MedicationAdministration)
                                  Is Modifierfalse
                                  Summarytrue
                                  Alternate Namescontainer
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  30. Procedure.status
                                  Definition

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

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

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

                                  A code specifying the state of the procedure.

                                  Typecode
                                  Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Obligations
                                    ObligationsActor
                                    SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                                    SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                                    SHALL:handleMHR Gateway Requester
                                    Summarytrue
                                    Fixed Valuecompleted
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    32. Procedure.statusReason
                                    Definition

                                    Captures the reason for the current state of the procedure.

                                    ShortReason 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.

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

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

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

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

                                    ShortClassification of the procedure
                                    Control0..1
                                    BindingFor example codes, see ProcedureCategoryCodes(SNOMEDCT)
                                    (example to http://hl7.org/fhir/ValueSet/procedure-category)

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

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    36. 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").

                                    ShortIdentification of the procedure
                                    Control1..1
                                    BindingUnless not suitable, these codes SHALL be taken from Procedure .
                                    (extensible to https://healthterminologies.gov.au/fhir/ValueSet/procedure-1)
                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Obligations
                                      ObligationsActor
                                      SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                                      SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                                      SHALL:handleMHR Gateway Requester
                                      Summarytrue
                                      Requirements

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

                                      Alternate Namestype
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      38. Procedure.subject
                                      Definition

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

                                      ShortWho the procedure was performed on
                                      Control1..1
                                      TypeReference(MHR Patient)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Obligations
                                        ObligationsActor
                                        SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                                        SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                                        SHALL:handleMHR Gateway Requester
                                        Summarytrue
                                        Alternate Namespatient
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        40. Procedure.encounter
                                        Definition

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

                                        ShortEncounter created as part of
                                        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.

                                        Control0..1
                                        TypeReference(AU Core Encounter)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Obligations
                                          ObligationsActor
                                          SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                                          SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                                          Summarytrue
                                          Invariantsele-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.

                                          ShortWhen 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.

                                          Control1..1
                                          TypedateTime
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Obligations
                                            ObligationsActor
                                            SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                                            SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            SlicingThis element introduces a set of slices on Procedure.performed[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                            • type @ $this
                                            • 44. Procedure.performed[x]:performedDateTime
                                              Slice NameperformedDateTime
                                              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.

                                              ShortWhen 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.

                                              Control1..1
                                              TypedateTime
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Obligations
                                                ObligationsActor
                                                SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                                                SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                                                SHALL:handleMHR Gateway Requester
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                46. Procedure.recorder
                                                Definition

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

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

                                                Individual who is making the procedure statement.

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

                                                Limited to "real" people rather than equipment.

                                                ShortThe people who performed the procedure
                                                Control0..*
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                52. 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.

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                54. 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.

                                                ShortAdditional 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.

                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                Summaryfalse
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                56. 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).

                                                ShortExtensions 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.

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

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

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

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

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

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

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summarytrue
                                                Requirements

                                                Allows disambiguation of the types of involvement of different performers.

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

                                                The practitioner who was involved in the procedure.

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

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

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

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

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

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

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

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

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

                                                Ties a procedure to where the records are likely kept.

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

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

                                                ShortCoded reason procedure performed
                                                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.

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

                                                A code that identifies the reason a procedure is required.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Obligations
                                                  ObligationsActor
                                                  SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                                                  SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  68. Procedure.reasonReference
                                                  Definition

                                                  The justification of why the procedure was performed.

                                                  ShortThe 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.

                                                  Control0..*
                                                  TypeReference(AU Core Condition, Observation, AU Core Procedure, DocumentReference)
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                                  Obligations
                                                    ObligationsActor
                                                    SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                                                    SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    70. Procedure.bodySite
                                                    Definition

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

                                                    ShortTarget 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.

                                                    Control0..*
                                                    This element is affected by the following invariants: au-core-pro-04
                                                    BindingUnless not suitable, these codes SHALL be taken from Body Site .
                                                    (extensible to https://healthterminologies.gov.au/fhir/ValueSet/body-site-1)
                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Obligations
                                                      ObligationsActor
                                                      SHALL:populate-if-knownhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-responder
                                                      SHALL:no-errorhttp://hl7.org.au/fhir/core/ActorDefinition/au-core-actor-requester
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      au-core-pro-04: If a coded body site is provided, at least one code shall be from SNOMED CT (coding.exists() implies coding.where(system='http://snomed.info/sct').exists())
                                                      72. Procedure.outcome
                                                      Definition

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

                                                      ShortThe result of procedure
                                                      Comments

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

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

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

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

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

                                                      ShortAny 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.

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

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

                                                      ShortComplication following the procedure
                                                      Comments

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

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

                                                      Codes describing complications that resulted from a procedure.

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

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

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

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

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

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

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

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

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

                                                      Any other notes and comments about the procedure.

                                                      ShortAdditional information about the procedure
                                                      Control0..*
                                                      TypeAnnotation
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Obligations
                                                        ObligationsActor
                                                        SHALL:handleMHR Gateway Requester
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        84. Procedure.focalDevice
                                                        Definition

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

                                                        ShortManipulated, implanted, or removed device
                                                        Control0..*
                                                        TypeBackboneElement
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        86. 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.

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        88. 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.

                                                        ShortAdditional 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.

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        90. 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).

                                                        ShortExtensions 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.

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

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

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

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

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

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

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

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

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

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

                                                        ShortItems used during procedure
                                                        Comments

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

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

                                                        Used for tracking contamination, etc.

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

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

                                                        ShortCoded items used during the procedure
                                                        Comments

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

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

                                                        Codes describing items used during a procedure.

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