Radiotherapy Treated Phase - Definitions - CodeX Radiation Therapy v2.0.0-ballot

Is Modifier false

Summary true

4. Procedure.meta

Definition

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

Short Metadata about the resource

Control 0..1

Meta

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

6. Procedure.implicitRules

Definition

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

Short A set of rules under which this content was created

Comments

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

Control 0..1

Is Modifier true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

8. Procedure.language

Definition

The base language in which the resource is written.

Short Language of the resource content

Comments

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

Control 0..1

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

A human language.

Additional Bindings

Purpose

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

10. Procedure.text

Definition

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

Short Text summary of the resource, for human interpretation

Comments

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

Control 0..1

Narrative

Is Modifier false

Summary false

Alternate Names narrative, html, xhtml, display

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

12. Procedure.contained

Definition

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

Short Contained, inline Resources

Comments

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

Control 0..*

Resource

Is Modifier false

Summary false

Alternate Names inline resources, anonymous resources, contained resources

14. Procedure.extension

Definition

An Extension

Short Extension

Control 0..*

Is Modifier false

Summary false

This element introduces a set of slices on Procedure.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:

value @ url

16. Procedure.extension:modalityAndTechnique

Slice Name modalityAndTechnique

Definition

Extension capturing modality and technique of a given radiotherapy procedure. The allowed combinations of modality and technique are constrained by invariants, one per modality.

Short Radiotherapy Modality And Technique Extension

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Radiotherapy Modality And Technique Extension) (Complex Extension)

Is Modifier false

Must Support true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
TechniquesForNeutronBeamModality: Allowed Techniques for Neutron Beam Modality (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '80347004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '169317000' or code = '1162782007'))
TechniquesForPhotonBeamModality: Allowed Techniques for Photon Beam Modality (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156506007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '441799006' or code = '1156530009' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1156530009' or code = '1163157007'))
TechniquesForElectronBeamModality: Allowed Techniques for Electron Beam Modality (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '45643008') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1163157007'))
TechniquesForCarbonIonBeamModality: Allowed Techniques for Carbon Ion Beam Modality (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156505006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code='1204242009'))
TechniquesForProtonBeamModality: Allowed Techniques for Proton Beam Modality (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '10611004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code = '1204242009' or code = '1163157007'))
TechniquesForInternalRadiotherapyPermanentSeeds: Allowed Techniques for Internal Radiotherapy - Permanent Seeds (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '169359004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '113120007'))
TechniquesForLowDoseRateUsingTempRadSource: Allowed Techniques for Low Dose Rate Using Temp Radiation Source (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156708005') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007' or code = '14473006'))
TechniquesForPulsedDoseRate: Allowed Techniques for Pulsed Dose Rate (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156384006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156384006'))
TechniquesForHighDoseRate: Allowed Techniques for High Dose Rate (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '394902000') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '394902000'))
TechniquesForHighDoseRateElectronic: Allowed Techniques for High Dose Rate Electronic (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '438629002') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = '384691004' or code = '168524008' or code = '14473006'))
TechniquesForRadioPharmaceutical: Allowed Techniques for Radiopharmaceutical (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '440252007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '16560241000119104' or code = '1156383000' or code = '384692006' or code = '113120007'))
ModalityTextRequiredForOther: Require a text literal for code other (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.text.exists())
TechniqueTextRequiredForOther: Require a text literal for code other (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.text.exists())

18. Procedure.extension:modalityAndTechnique.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

20. Procedure.extension:modalityAndTechnique.extension

Definition

An Extension

Short Extension

Control 1..*

Is Modifier false

Summary false

This element introduces a set of slices on Procedure.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:

value @ url

22. Procedure.extension:modalityAndTechnique.extension:modality

Slice Name modality

Definition

Extension capturing a modality of external beam or brachytherapy radiation procedures.

Short Radiotherapy Modality Extension

Control 1..1

Type Extension(Radiotherapy Modality Extension) (Extension Type: CodeableConcept)

Is Modifier false

Must Support true

Summary false

24. Procedure.extension:modalityAndTechnique.extension:modality.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

26. Procedure.extension:modalityAndTechnique.extension:modality.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Procedure.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:

value @ url

28. Procedure.extension:modalityAndTechnique.extension:modality.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality

30. Procedure.extension:modalityAndTechnique.extension:modality.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 1..1

Binding The codes SHALL be taken from Radiotherapy Modality Value Set
(required to http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs)

[x] Note See Choice of Data Types for further information about how to use [x]

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

32. Procedure.extension:modalityAndTechnique.extension:technique

Slice Name technique

Definition

Extension capturing a technique of external beam or brachytherapy radiation procedures.

Short Radiotherapy Technique Extension

Control 0..*

Type Extension(Radiotherapy Technique Extension) (Extension Type: CodeableConcept)

Is Modifier false

Must Support true

Summary false

34. Procedure.extension:modalityAndTechnique.extension:technique.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

36. Procedure.extension:modalityAndTechnique.extension:technique.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Procedure.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:

value @ url

38. Procedure.extension:modalityAndTechnique.extension:technique.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique

40. Procedure.extension:modalityAndTechnique.extension:technique.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 1..1

Binding The codes SHALL be taken from Radiotherapy Technique Value Set
(required to http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-technique-vs)

[x] Note See Choice of Data Types for further information about how to use [x]

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

42. Procedure.extension:modalityAndTechnique.extension:radiotherapyEnergyOrIsotope

Slice Name radiotherapyEnergyOrIsotope

Definition

The radiation energy used for radiotherapy. The energy spectrum is characterized by the maximum energy, the maximum accelaration voltage, or the used isotope.

Short Radiotherapy Energy or Isotope

Control 0..*

Type Extension(Energy or Isotope) (Extension Type: Choice of: CodeableConcept, Quantity(SimpleQuantity))

Is Modifier false

Must Support true

Summary false

44. Procedure.extension:modalityAndTechnique.extension:radiotherapyTreatmentApplicatorType

Slice Name radiotherapyTreatmentApplicatorType

Definition

Radiotherapy Treatment Applicator Type.

Short Radiotherapy Treatment Applicator Type

Control 0..*

Type Extension(Treatment Applicator Type) (Extension Type: CodeableConcept)

Is Modifier false

Must Support true

Summary false

46. Procedure.extension:modalityAndTechnique.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique

48. Procedure.extension:modalityAndTechnique.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 0..0

Type Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

50. Procedure.extension:imageGuidedRadiotherapyModality

Slice Name imageGuidedRadiotherapyModality

Definition

The modality and associated energy used for imaging in Image Guided Radiotherapy (IGRT)

Short Image Guided Radiotherapy Modality

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Image Guided Radiotherapy Modality) (Complex Extension)

Is Modifier false

Must Support true

52. Procedure.extension:fractionsDelivered

Slice Name fractionsDelivered

Definition

The number of fractions delivered during this phase.

Short Number of Fractions Delivered

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Number of Delivered Fractions) (Extension Type: unsignedInt)

Is Modifier false

Must Support true

54. Procedure.extension:doseDeliveredToVolume

Slice Name doseDeliveredToVolume

Definition

Dose delivered to a given radiotherapy volume.

Short Radiotherapy Dose Delivered To Volume Extension

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Radiotherapy Dose Delivered To Volume Extension) (Complex Extension)

Is Modifier false

Must Support true

56. Procedure.extension:doseDeliveredToVolume.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

58. Procedure.extension:doseDeliveredToVolume.extension

Definition

An Extension

Short Extension

Control 1..*

Is Modifier false

Summary false

This element introduces a set of slices on Procedure.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:

value @ url

60. Procedure.extension:doseDeliveredToVolume.extension:volume

Slice Name volume

Definition

A BodyStructure resource representing volume in the body where radiation was delivered, for example, Chest Wall Lymph Nodes.

Short Volume in the body where radiation was delivered

Control 1..1

Is Modifier false

Must Support true

Summary false

62. Procedure.extension:doseDeliveredToVolume.extension:volume.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

64. Procedure.extension:doseDeliveredToVolume.extension:volume.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Procedure.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:

value @ url

66. Procedure.extension:doseDeliveredToVolume.extension:volume.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value volume

68. Procedure.extension:doseDeliveredToVolume.extension:volume.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 0..1

Type Reference(Radiotherapy Volume Profile)

[x] Note See Choice of Data Types for further information about how to use [x]

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

70. Procedure.extension:doseDeliveredToVolume.extension:totalDoseDelivered

Slice Name totalDoseDelivered

Definition

The total amount of radiation delivered to this volume within the scope of this phase, not including dose from any other phase. For summary over multiple phases, see Radiotherapy Course Summary.

Short Extension

Control 0..1

Is Modifier false

Must Support true

Summary false

72. Procedure.extension:doseDeliveredToVolume.extension:totalDoseDelivered.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

74. Procedure.extension:doseDeliveredToVolume.extension:totalDoseDelivered.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on Procedure.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:

value @ url

76. Procedure.extension:doseDeliveredToVolume.extension:totalDoseDelivered.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value totalDoseDelivered

78. Procedure.extension:doseDeliveredToVolume.extension:totalDoseDelivered.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 0..1

Quantity

[x] Note See Choice of Data Types for further information about how to use [x]

Is Modifier false

Summary false

Pattern Value { "system" : "http://unitsofmeasure.org", "code" : "cGy" }

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

80. Procedure.extension:doseDeliveredToVolume.extension:fractionsDelivered

Slice Name fractionsDelivered

Definition

Record the fractions delivered in this phase in the top-level extension also named fractionDelivered.

Short Not used in this profile.

Control 0..0

Is Modifier false

Must Support true

Summary false

86. Procedure.extension:doseDeliveredToVolume.extension:pointDose

Slice Name pointDose

Definition

This flag is true if the dose is determined at a single point. Point doses are often used to check dose at a specific point in a calculated 3D dose distribution. Since point doses mostly have a technical role, high-level summaries may decide to exclude them from displays.

Short Point Dose

Control 0..1

Type Extension(Point Dose) (Extension Type: boolean)

Is Modifier false

Must Support true

Summary false

88. Procedure.extension:doseDeliveredToVolume.extension:primaryPlanDose

Slice Name primaryPlanDose

Definition

This flag is true if the dose is the primary plan dose in a radiotherapy treatment plan. For a single treatment plan, the primary plan dose serves as the main dose value for tracking delivered dose vs. planned dose. In summaries over multiple treatment plans, the flag indicates that the dose is a primary plan dose in any of the summarized plans.

Short Primary Plan Dose

Control 0..1

Type Extension(Primary Plan Dose) (Extension Type: boolean)

Is Modifier false

Must Support true

Summary false

90. Procedure.extension:doseDeliveredToVolume.extension:radiobiologicMetric

Slice Name radiobiologicMetric

Definition

Extension providing radiobiologic dose metric using a regular expression: BED, CGE, RBE, RBE(factor = <decimal>), EQD2Gy, EQD2Gy(a/b = <decimal>).

Short Radiotherapy Biologically Effective Dose

Control 0..*

Type Extension(Radiobiologic Metric) (Extension Type: Quantity)

Is Modifier false

Must Support true

Summary false

92. Procedure.extension:doseDeliveredToVolume.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume

94. Procedure.extension:doseDeliveredToVolume.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 0..0

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

96. Procedure.extension:radiotherapyReasonForRevisionOrAdaptation

Slice Name radiotherapyReasonForRevisionOrAdaptation

Definition

The reason a planned or prescribed radiotherapy treatment was revised, superceded, or adapted.

Short Reason for Revision or Adaptation

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Reason for Revision or Adaptation) (Extension Type: CodeableConcept)

Is Modifier false

Must Support true

98. Procedure.extension:respiratoryMotionManagement

Slice Name respiratoryMotionManagement

Definition

Method applied to manage respiratory motion.

Short Respiratory Motion Management

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Respiratory Motion Management) (Extension Type: CodeableConcept)

Is Modifier false

Must Support true

100. Procedure.extension:freeBreathingMotionManagementTechnique

Slice Name freeBreathingMotionManagementTechnique

Definition

Technique to manage respiratory motion with free-breathing. Only allowed if respiratory motion management is free-breathing.

Short Free-Breathing Motion Management Technique

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Free-Breathing Motion Management Technique) (Extension Type: CodeableConcept)

Is Modifier false

Must Support true

102. Procedure.extension:intrafractionVerification

Slice Name intrafractionVerification

Definition

Verification of the patient or target position during a treatment fraction.

Short Intrafraction Verification

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Intrafraction Verification) (Complex Extension)

Is Modifier false

Must Support true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
IntrafractionVerificationQualifierAllowed: Qualifier is only allowed for X-Ray procedure. (extension.where(url = 'qualifier').exists() implies (extension.where(url = 'procedure').exists() and extension.where(url = 'procedure').value.exists() and extension.where(url = 'procedure').value.coding.all( (system = 'http://snomed.info/sct') and (code = '168537006') ) ))

104. Procedure.modifierExtension

Definition

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

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

Short Extensions that cannot be ignored

Comments

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

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

Summary false

Requirements

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

Alternate Names extensions, user content

106. Procedure.identifier

Definition

SHALL have a display name with use = usual and at least one globally unique technical identifier, for example, the Conceptual Volume UID used in DICOM.

Short External Identifiers for this procedure

Comments

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

Note This is a business identifier, not a resource identifier (see discussion)

Control 2..*

Identifier

Is Modifier false

Must Support true

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Procedure.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:

value @ use

108. Procedure.identifier:displayName

Slice Name displayName

Definition

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

Short The name that is displayed to the user.

Comments

Note This is a business identifier, not a resource identifier (see discussion)

Control 1..1

Identifier

Is Modifier false

Must Support true

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

110. Procedure.identifier:displayName.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

112. Procedure.identifier:displayName.extension

Definition

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

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Procedure.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:

value @ url

114. Procedure.identifier:displayName.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control 1..1

The codes SHALL be taken from IdentifierUse
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

code

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Pattern Value usual

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

116. Procedure.identifier:displayName.type

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Short Description of identifier

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Control 0..1

Unless not suitable, these codes SHALL be taken from Identifier Type Codes
(extensible to http://hl7.org/fhir/ValueSet/identifier-type)

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Is Modifier false

Summary true

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

118. Procedure.identifier:displayName.system

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Short The namespace for the identifier value

Comments

Identifier.system is always case sensitive.

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example General:http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

120. Procedure.identifier:displayName.value

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Short The value that is unique

Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Example General:123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

122. Procedure.identifier:displayName.period

Definition

Time period during which identifier is/was valid for use.

Short Time period when id is/was valid for use

Control 0..1

Period

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

124. Procedure.identifier:displayName.assigner

Definition

Organization that issued/manages the identifier.

Short Organization that issued id (may be just text)

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

126. Procedure.identifier:official

Slice Name official

Definition

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

Short A business identifier for the request or procedure, which is independent of its FHIR representation, such as a GUID or DICOM UID.

Comments

Note This is a business identifier, not a resource identifier (see discussion)

Control 1..*

Identifier

Is Modifier false

Must Support true

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

128. Procedure.identifier:official.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

130. Procedure.identifier:official.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Procedure.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:

value @ url

132. Procedure.identifier:official.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control 1..1

The codes SHALL be taken from IdentifierUse
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

code

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Pattern Value official

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

134. Procedure.identifier:official.type

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Short Description of identifier

Comments

Control 0..1

Unless not suitable, these codes SHALL be taken from Identifier Type Codes
(extensible to http://hl7.org/fhir/ValueSet/identifier-type)

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Is Modifier false

Summary true

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

136. Procedure.identifier:official.system

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Short The namespace for the identifier value

Comments

Identifier.system is always case sensitive.

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example General:http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

138. Procedure.identifier:official.value

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Short The value that is unique

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Example General:123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

140. Procedure.identifier:official.period

Definition

Time period during which identifier is/was valid for use.

Short Time period when id is/was valid for use

Control 0..1

Period

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

142. Procedure.identifier:official.assigner

Definition

Organization that issued/manages the identifier.

Short Organization that issued id (may be just text)

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

144. 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.

Short Instantiates FHIR protocol or definition

Control 0..*

Type canonical(PlanDefinition, ActivityDefinition, Measure, OperationDefinition, Questionnaire)

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

146. 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.

Short Instantiates external protocol or definition

Comments

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

Control 0..*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

148. Procedure.basedOn

Definition

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

Short A request for this procedure

Control 0..*

Type Reference(CarePlan, ServiceRequest)

Is Modifier false

Summary true

Alternate Names fulfills

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Procedure.basedOn. The slices are unordered and Open, and can be differentiated using the following discriminators:

profile @ $this.resolve()

150. Procedure.basedOn:planned-phase

Slice Name planned-phase

Definition

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

Short Radiotherapy Planned Phase that planned the treatment summarized in this Radiotherapy Treated Phase.

Control 0..1

Type Reference(Radiotherapy Planned Phase)

Is Modifier false

Must Support true

Summary true

Alternate Names fulfills

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

152. Procedure.basedOn:phase-prescription

Slice Name phase-prescription

Definition

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

Short Radiotherapy Phase Prescription that prescribed the treatment summarized in this Radiotherapy Treated Phase.

Control 0..1

Type Reference(Radiotherapy Phase Prescription)

Is Modifier false

Must Support true

Summary true

Alternate Names fulfills

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

154. Procedure.partOf

Definition

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

Short Part of referenced event

Comments

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

Control 0..*

Type Reference(Procedure, Observation, MedicationAdministration)

Is Modifier false

Summary true

Alternate Names container

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Procedure.partOf. The slices are unordered and Open, and can be differentiated using the following discriminators:

profile @ $this.resolve()

156. Procedure.partOf:course-summary

Slice Name course-summary

Definition

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

Short Radiotherapy Course Summary that summarizes the course of which this Radiotherapy Treated Phase is a part.

Comments

Control 0..1

Type Reference(Radiotherapy Course Summary)

Is Modifier false

Must Support true

Summary true

Alternate Names container

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

158. Procedure.status

Definition

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

Comments

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

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

Control 1..1
This element is affected by the following invariants: us-core-7

Binding The codes SHALL be taken from EventStatus
(required to http://hl7.org/fhir/ValueSet/event-status)

code

Is Modifier true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

160. Procedure.statusReason

Definition

Captures the reason for the current state of the procedure.

Short Reason for current status

Comments

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

Control 0..1

For 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.

Is Modifier false

Summary true

Alternate Names Suspended Reason, Cancelled Reason

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

162. Procedure.category

Definition

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

Short Classification of the procedure

Control 1..1

Binding The codes SHALL be taken from Radiotherapy Category Code Max Value Set
(required to http://hl7.org/fhir/us/codex-radiation-therapy/ValueSet/codexrt-radiotherapy-category-vs)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

164. Procedure.code

Definition

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

Short Identification of the procedure

Control 1..1

Unless not suitable, these codes SHALL be taken from US Core Procedure Codes
(extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code)

Codes describing the type of Procedure

Is Modifier false

Must Support true

Summary true

Requirements

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

Alternate Names type

Pattern Value { "coding" : [{ "system" : "http://snomed.info/sct", "code" : "1222565005", "display" : "Radiotherapy treatment phase (regime/therapy)" }] }

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

166. Procedure.subject

Definition

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

Short Who the procedure was performed on

Control 1..1

Type Reference(Cancer Patient Profile)

Is Modifier false

Must Support true

Summary true

Alternate Names patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

168. Procedure.encounter

Definition

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

Short Encounter created as part of

Comments

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

Control 0..1

Type Reference(Encounter)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

170. Procedure.performed[x]

Definition

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

Short When the procedure was performed

Comments

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

Control 0..1
This element is affected by the following invariants: us-core-7

Period

[x] Note See Choice of Data Types for further information about how to use [x]

Is Modifier false

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

172. Procedure.performed[x].id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

174. Procedure.performed[x].extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Procedure.performed[x].extension. The slices are unordered and Open, and can be differentiated using the following discriminators:

value @ url

176. Procedure.performed[x].start

Definition

The start of the period. The boundary is inclusive.

Short The date and time when the first therapeutic radiation was delivered.

Comments

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

Control 0..1
This element is affected by the following invariants: per-1

dateTime

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

178. Procedure.performed[x].end

Definition

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

Short An end date is expected if the status is 'stopped' or 'completed'

Comments

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

Control 0..1
This element is affected by the following invariants: per-1

dateTime

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Meaning if Missing If the end of the period is missing, it means that the period is ongoing

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

180. Procedure.recorder

Definition

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

Short Who recorded the procedure

Control 0..1

Type Reference(Patient, RelatedPerson, Practitioner, PractitionerRole)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

182. Procedure.asserter

Definition

Individual who is making the procedure statement.

Short Person who asserts this procedure

Control 0..1

Type Reference(Patient, RelatedPerson, Practitioner, PractitionerRole)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

184. Procedure.performer

Definition

Limited to "real" people rather than equipment.

Short The people who performed the procedure

Control 0..*

Is Modifier false

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Procedure.performer. The slices are unordered and Open, and can be differentiated using the following discriminators:

profile @ actor.resolve()

186. Procedure.performer.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

188. Procedure.performer.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

190. Procedure.performer.modifierExtension

Definition

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

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

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

192. Procedure.performer.function

Definition

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

Short Type of performance

Control 0..1

For example codes, see ProcedurePerformerRoleCodes
(example to http://hl7.org/fhir/ValueSet/performer-role)

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

Is Modifier false

Summary true

Requirements

Allows disambiguation of the types of involvement of different performers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

194. Procedure.performer.actor

Definition

The practitioner who was involved in the procedure.

Short The reference to the practitioner

Control 1..1

Type Reference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)

Is Modifier false

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

196. Procedure.performer.onBehalfOf

Definition

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

Short Organization the device or practitioner was acting for

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

198. Procedure.performer:organization

Slice Name organization

Definition

Limited to "real" people rather than equipment.

Short The people who performed the procedure

Control 0..*

Is Modifier false

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

200. Procedure.performer:organization.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

202. Procedure.performer:organization.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

204. Procedure.performer:organization.modifierExtension

Definition

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

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

206. Procedure.performer:organization.function

Definition

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

Short Type of performance

Control 0..1

For example codes, see ProcedurePerformerRoleCodes
(example to http://hl7.org/fhir/ValueSet/performer-role)

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

Is Modifier false

Summary true

Requirements

Allows disambiguation of the types of involvement of different performers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

208. Procedure.performer:organization.actor

Definition

The practitioner who was involved in the procedure.

Short Organization that provided the radiotherapy treatment.

Control 1..1

Type Reference(US Core Organization Profile)

Is Modifier false

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

210. Procedure.performer:organization.onBehalfOf

Definition

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

Short Organization the device or practitioner was acting for

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

212. Procedure.location

Definition

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

Short Location where the radiotherapy treatment was performed.

Control 0..1

Type Reference(US Core Location Profile)

Is Modifier false

Must Support true

Summary true

Requirements

Ties a procedure to where the records are likely kept.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

214. 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.

Short Coded reason procedure performed

Comments

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

Control 0..*

Binding Unless not suitable, these codes SHALL be taken from Cancer Disorder Value Set
(extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs)

Is Modifier false

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

216. Procedure.reasonReference

Definition

The justification of why the procedure was performed.

Short The justification that the procedure was performed

Comments

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

Control 0..*

Type Reference(Condition, Observation, Procedure, DiagnosticReport, DocumentReference)

Is Modifier false

Must Support true

Must Support Types No must-support rules about the choice of types/profiles

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

218. Procedure.bodySite

Definition

Coded body structure(s) treated with this radiotherapy treatment procedure. These codes represent general locations. For additional detail, refer to the BodyStructures references in the doseDeliveredToVolume extension.

Short All body structure(s) treated with this procedure.

Comments

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

Control 0..*

Binding Unless not suitable, these codes SHALL be taken from Radiotherapy Treatment Location Value Set
(extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-treatment-location-vs)

Is Modifier false

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

220. Procedure.bodySite.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

222. Procedure.bodySite.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on Procedure.bodySite.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:

value @ url

224. Procedure.bodySite.extension:locationQualifier

Slice Name locationQualifier

Definition

General location qualifier (excluding laterality) for this bodySite

Short General location qualifier (excluding laterality) for this bodySite

Control 0..*

Type Extension(Body Location Qualifier Extension) (Extension Type: CodeableConcept)

Is Modifier false

Summary false

226. Procedure.bodySite.extension:lateralityQualifier

Slice Name lateralityQualifier

Definition

Laterality qualifier for this bodySite

Short Laterality qualifier for this bodySite

Control 0..1

Type Extension(Laterality Qualifier Extension) (Extension Type: CodeableConcept)

Is Modifier false

Summary false

228. Procedure.bodySite.coding

Definition

A reference to a code defined by a terminology system.

Short Code defined by a terminology system

Comments

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

Control 0..*

Coding

Is Modifier false

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

230. Procedure.bodySite.text

Definition

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

Short Plain text representation of the concept

Comments

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

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

232. Procedure.outcome

Definition

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

Short The result of procedure

Comments

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

Control 0..1

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

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

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

234. Procedure.report

Definition

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

Short Any report resulting from the procedure

Comments

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

Control 0..*

Type Reference(DiagnosticReport, DocumentReference, Composition)

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

236. 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.

Short Complication following the procedure

Comments

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

Control 0..*

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

Codes describing complications that resulted from a procedure.

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

238. Procedure.complicationDetail

Definition

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

Short A condition that is a result of the procedure

Control 0..*

Type Reference(Condition)

Is Modifier false

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

240. 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.

Short Instructions for follow up

Control 0..*

For example codes, see ProcedureFollowUpCodes(SNOMEDCT)
(example to http://hl7.org/fhir/ValueSet/procedure-followup)

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

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

242. Procedure.note

Definition

Any other notes and comments about the procedure.

Short Additional information about the procedure

Control 0..*

Annotation

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

244. 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.

Short Manipulated, implanted, or removed device

Control 0..*

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Procedure.focalDevice. The slices are unordered and Open, and can be differentiated using the following discriminators:

profile @ manipulated.resolve()

246. Procedure.focalDevice.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

248. Procedure.focalDevice.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

250. Procedure.focalDevice.modifierExtension

Definition

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

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

252. Procedure.focalDevice.action

Definition

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

Short Kind of change to device

Control 0..1

The codes SHOULD be taken from ProcedureDeviceActionCodes
(preferred to http://hl7.org/fhir/ValueSet/device-action)

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

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

254. Procedure.focalDevice.manipulated

Definition

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

Short Device that was changed

Control 1..1

Type Reference(Device)

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

256. Procedure.focalDevice:seedDevice

Slice Name seedDevice

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.

Short Radiotherapy Seed Device used as part of therapy.

Control 0..*

Is Modifier false

Must Support true

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

258. Procedure.focalDevice:seedDevice.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

260. Procedure.focalDevice:seedDevice.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

262. Procedure.focalDevice:seedDevice.modifierExtension

Definition

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

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

264. Procedure.focalDevice:seedDevice.action

Definition

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

Short Kind of change to device

Control 0..1

The codes SHOULD be taken from ProcedureDeviceActionCodes
(preferred to http://hl7.org/fhir/ValueSet/device-action)

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

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

266. Procedure.focalDevice:seedDevice.manipulated

Definition

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

Short Device that was changed

Control 1..1

Type Reference(Radiotherapy Seed Device)

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

268. Procedure.usedReference

Definition

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

Short Items used during procedure

Comments

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

Control 0..*

Type Reference(Device, Medication, Substance)

Is Modifier false

Must Support true

Must Support Types No must-support rules about the choice of types/profiles

Summary false

Requirements

Used for tracking contamination, etc.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on Procedure.usedReference. The slices are unordered and Open, and can be differentiated using the following discriminators:

profile @ $this.resolve()

270. Procedure.usedReference:treatmentDevice

Slice Name treatmentDevice

Definition

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

Short Radiotherapy Treatment Device used as part of therapy.

Comments

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

Control 0..*

Type Reference(Radiotherapy Treatment Device)

Is Modifier false

Must Support true

Summary false

Requirements

Used for tracking contamination, etc.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

272. Procedure.usedCode

Definition

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

Short Coded items used during the procedure

Comments

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

Control 0..*

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

Codes describing items used during a procedure.