Pharmacist Services and Summaries - FHIR (PhCP)
1.0.0 - STU Release 1.0.0 for FHIR R4
Pharmacist Services and Summaries - FHIR (PhCP)
1.0.0 - STU Release 1.0.0 for FHIR R4
This page is part of the Pharmacist Care Plan FHIR IG (v1.0.0: STU 1) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions 
| Defining URL: | http://hl7.org/fhir/us/phcp/StructureDefinition/PhCP-Instruction-Procedure |
| Version: | 1.0.0 |
| Name: | PhCPInstructionProcedure |
| Title: | PhCP Instruction Procedure |
| Status: | Draft as of 2017-07-21T14:29:48.4142999-04:00 |
| Definition: | The Instruction profile can be used in several ways, such as to record patient medication instructions or to record fill instructions for an order. The code defines the type of instruction. This profile constrains the US Core Procedure profile. It includes value sets intended for use by pharmacy systems. Everywhere it is referenced, an unconstrained US Core Procedure reference is also allowed. |
| Publisher: | HL7 Structured Documents Work Group |
| Committee: | Patient Care |
| Source Resource: | XML / JSON / Turtle |
The official URL for this profile is:
http://hl7.org/fhir/us/phcp/StructureDefinition/PhCP-Instruction-Procedure
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from USCoreProcedureProfile
This structure is derived from USCoreProcedureProfile
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Procedure | 0..* | USCoreProcedureProfile | An action that is being or was performed on a patient | |
  code | S | 1..1 | CodeableConcept | Procedure codes from SNOMED CT, CPT, HCPCS II, ICD-10PC, or CDT Binding: VSAC 2.16.840.1.113762.1.4.1096.214 (preferred) |
 performer | ||||
  actor | S | 1..1 | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) | The reference to the practitioner |
 onBehalfOf | S | 0..1 | Reference(US Core Organization Profile) | Organization the device or practitioner was acting for |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Procedure | 0..* | USCoreProcedureProfile | An action that is being or was performed on a patient | |
 id | Σ | 0..1 | string | Logical id of this artifact |
 meta | Σ | 0..1 | Meta | Metadata about the resource |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | |
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
| contained | 0..* | Resource | Contained, inline Resources | |
 extension | 0..* | Extension | Additional content defined by implementations | |
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| identifier | Σ | 0..* | Identifier | External Identifiers for this procedure |
| instantiatesCanonical | Σ | 0..* | canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire) | Instantiates FHIR protocol or definition |
| instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition |
| basedOn | Σ | 0..* | Reference(CarePlan | ServiceRequest) | A request for this procedure |
| partOf | Σ | 0..* | Reference(Procedure | Observation | MedicationAdministration) | Part of referenced event |
| status | ?!SΣ | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required) |
| statusReason | Σ | 0..1 | CodeableConcept | Reason for current status Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed. |
| category | Σ | 0..1 | CodeableConcept | Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes. |
| code | SΣ | 1..1 | CodeableConcept | Procedure codes from SNOMED CT, CPT, HCPCS II, ICD-10PC, or CDT Binding: VSAC 2.16.840.1.113762.1.4.1096.214 (preferred) |
| subject | SΣ | 1..1 | Reference(US Core Patient Profile) | Who the procedure was performed on |
| encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of |
  performed[x] | SΣ | 1..1 | When the procedure was performed | |
 performedDateTime | dateTime | |||
| performedPeriod | Period | |||
| recorder | Σ | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Who recorded the procedure |
| asserter | Σ | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Person who asserts this procedure |
| performer | Σ | 0..* | BackboneElement | The people who performed the procedure |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| function | Σ | 0..1 | CodeableConcept | Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure. |
| actor | SΣ | 1..1 | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) | The reference to the practitioner |
| onBehalfOf | S | 0..1 | Reference(US Core Organization Profile) | Organization the device or practitioner was acting for |
| location | Σ | 0..1 | Reference(Location) | Where the procedure happened |
| reasonCode | Σ | 0..* | CodeableConcept | Coded reason procedure performed Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required. |
| reasonReference | Σ | 0..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) | The justification that the procedure was performed |
| bodySite | Σ | 0..* | CodeableConcept | Target body sites Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. |
| outcome | Σ | 0..1 | CodeableConcept | The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise. |
| report | 0..* | Reference(DiagnosticReport | DocumentReference | Composition) | Any report resulting from the procedure | |
| complication | 0..* | CodeableConcept | Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure. | |
| complicationDetail | 0..* | Reference(Condition) | A condition that is a result of the procedure | |
| followUp | 0..* | CodeableConcept | Instructions for follow up Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures. | |
| note | 0..* | Annotation | Additional information about the procedure | |
| focalDevice | 0..* | BackboneElement | Manipulated, implanted, or removed device | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| action | 0..1 | CodeableConcept | Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure. | |
| manipulated | 1..1 | Reference(Device) | Device that was changed | |
| usedReference | 0..* | Reference(Device | Medication | Substance) | Items used during procedure | |
| usedCode | 0..* | CodeableConcept | Coded items used during the procedure Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure. | |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Procedure | 0..* | USCoreProcedureProfile | An action that is being or was performed on a patient | |
| status | ?!Σ | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required) |
| code | Σ | 1..1 | CodeableConcept | Procedure codes from SNOMED CT, CPT, HCPCS II, ICD-10PC, or CDT Binding: VSAC 2.16.840.1.113762.1.4.1096.214 (preferred) |
| subject | Σ | 1..1 | Reference(US Core Patient Profile) | Who the procedure was performed on |
| performed[x] | Σ | 1..1 | When the procedure was performed | |
| performedDateTime | dateTime | |||
| performedPeriod | Period | |||
| performer | Σ | 0..* | BackboneElement | The people who performed the procedure |
| actor | Σ | 1..1 | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) | The reference to the practitioner |
| onBehalfOf | 0..1 | Reference(US Core Organization Profile) | Organization the device or practitioner was acting for | |
| Documentation for this format | ||||
This structure is derived from USCoreProcedureProfile
Differential View
This structure is derived from USCoreProcedureProfile
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Procedure | 0..* | USCoreProcedureProfile | An action that is being or was performed on a patient | |
| code | S | 1..1 | CodeableConcept | Procedure codes from SNOMED CT, CPT, HCPCS II, ICD-10PC, or CDT Binding: VSAC 2.16.840.1.113762.1.4.1096.214 (preferred) |
| performer | ||||
| actor | S | 1..1 | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) | The reference to the practitioner |
| onBehalfOf | S | 0..1 | Reference(US Core Organization Profile) | Organization the device or practitioner was acting for |
| Documentation for this format | ||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Procedure | 0..* | USCoreProcedureProfile | An action that is being or was performed on a patient | |
| id | Σ | 0..1 | string | Logical id of this artifact |
| meta | Σ | 0..1 | Meta | Metadata about the resource |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | |
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
| contained | 0..* | Resource | Contained, inline Resources | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| identifier | Σ | 0..* | Identifier | External Identifiers for this procedure |
| instantiatesCanonical | Σ | 0..* | canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire) | Instantiates FHIR protocol or definition |
| instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition |
| basedOn | Σ | 0..* | Reference(CarePlan | ServiceRequest) | A request for this procedure |
| partOf | Σ | 0..* | Reference(Procedure | Observation | MedicationAdministration) | Part of referenced event |
| status | ?!SΣ | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required) |
| statusReason | Σ | 0..1 | CodeableConcept | Reason for current status Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed. |
| category | Σ | 0..1 | CodeableConcept | Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes. |
| code | SΣ | 1..1 | CodeableConcept | Procedure codes from SNOMED CT, CPT, HCPCS II, ICD-10PC, or CDT Binding: VSAC 2.16.840.1.113762.1.4.1096.214 (preferred) |
| subject | SΣ | 1..1 | Reference(US Core Patient Profile) | Who the procedure was performed on |
| encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of |
| performed[x] | SΣ | 1..1 | When the procedure was performed | |
| performedDateTime | dateTime | |||
| performedPeriod | Period | |||
| recorder | Σ | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Who recorded the procedure |
| asserter | Σ | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Person who asserts this procedure |
| performer | Σ | 0..* | BackboneElement | The people who performed the procedure |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| function | Σ | 0..1 | CodeableConcept | Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure. |
| actor | SΣ | 1..1 | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) | The reference to the practitioner |
| onBehalfOf | S | 0..1 | Reference(US Core Organization Profile) | Organization the device or practitioner was acting for |
| location | Σ | 0..1 | Reference(Location) | Where the procedure happened |
| reasonCode | Σ | 0..* | CodeableConcept | Coded reason procedure performed Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required. |
| reasonReference | Σ | 0..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) | The justification that the procedure was performed |
| bodySite | Σ | 0..* | CodeableConcept | Target body sites Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. |
| outcome | Σ | 0..1 | CodeableConcept | The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise. |
| report | 0..* | Reference(DiagnosticReport | DocumentReference | Composition) | Any report resulting from the procedure | |
| complication | 0..* | CodeableConcept | Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure. | |
| complicationDetail | 0..* | Reference(Condition) | A condition that is a result of the procedure | |
| followUp | 0..* | CodeableConcept | Instructions for follow up Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures. | |
| note | 0..* | Annotation | Additional information about the procedure | |
| focalDevice | 0..* | BackboneElement | Manipulated, implanted, or removed device | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| action | 0..1 | CodeableConcept | Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure. | |
| manipulated | 1..1 | Reference(Device) | Device that was changed | |
| usedReference | 0..* | Reference(Device | Medication | Substance) | Items used during procedure | |
| usedCode | 0..* | CodeableConcept | Coded items used during the procedure Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure. | |
| Documentation for this format | ||||
Other representations of profile: Schematron
| Path | Conformance | ValueSet |
| Procedure.language | preferred | CommonLanguages Max Binding: AllLanguages |
| Procedure.status | required | EventStatus |
| Procedure.statusReason | example | ProcedureNotPerformedReason(SNOMED-CT) |
| Procedure.category | example | ProcedureCategoryCodes(SNOMEDCT) |
| Procedure.code | preferred | http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1096.214 |
| Procedure.performer.function | example | ProcedurePerformerRoleCodes |
| Procedure.reasonCode | example | ProcedureReasonCodes |
| Procedure.bodySite | example | SNOMEDCTBodyStructures |
| Procedure.outcome | example | ProcedureOutcomeCodes(SNOMEDCT) |
| Procedure.complication | example | Condition/Problem/DiagnosisCodes |
| Procedure.followUp | example | ProcedureFollowUpCodes(SNOMEDCT) |
| Procedure.focalDevice.action | preferred | ProcedureDeviceActionCodes |
| Procedure.usedCode | example | FHIRDeviceTypes |
| Id | Path | Details | Requirements |
| dom-2 | Procedure | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | Procedure | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | Procedure | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | Procedure | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | Procedure | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | Procedure.meta | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.implicitRules | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.language | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | Procedure.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | Procedure.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | Procedure.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | Procedure.identifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.instantiatesCanonical | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.instantiatesUri | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.basedOn | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.partOf | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.status | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.statusReason | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.category | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.subject | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.encounter | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.performed[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.recorder | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.asserter | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.performer | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.performer.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | Procedure.performer.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | Procedure.performer.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | Procedure.performer.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | Procedure.performer.function | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.performer.actor | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.performer.onBehalfOf | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.location | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.reasonCode | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.reasonReference | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.bodySite | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.outcome | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.report | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.complication | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.complicationDetail | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.followUp | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.note | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.focalDevice | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.focalDevice.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | Procedure.focalDevice.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | Procedure.focalDevice.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | Procedure.focalDevice.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | Procedure.focalDevice.action | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.focalDevice.manipulated | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.usedReference | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | Procedure.usedCode | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
IG © 2021+ HL7 Structured Documents Work Group. Package hl7.fhir.us.phcp#1.0.0 based on FHIR 4.0.1. Generated 2021-02-11
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