Profile qicore-procedurerequest

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="qicore-procedurerequest"/>
  <url
       value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-procedurerequest"/>
  <name value="Profile qicore-procedurerequest"/>
  <status value="draft"/>
  <publisher
             value="Health Level Seven International (Clinical Quality Information - QICore)"/>
  <contact>
    <telecom>
      <system value="other"/>
      <value value="http://hl7.org/special/committees/CQI"/>
    </telecom>
  </contact>
  <date value="2015-02-27"/>
  <mapping>
    <identity value="qdm"/>
    <uri value="http://www.healthit.gov/quality-data-model"/>
    <name value="Quality Data Model"/>
  </mapping>
  <mapping>
    <identity value="qidam"/>
    <uri
         value="http://www.hl7.org/implement/standards/product_brief.cfm?product_id=378"/>
    <name value="Quality Improvement Domain Analysis Model"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/w5"/>
    <name value="W5 Mapping"/>
  </mapping>
  <mapping>
    <identity value="quick"/>
    <uri value="http://wiki.siframework.org/CQF"/>
    <name value="Quality Improvement and Clinical Knowledge (QUICK)"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="ProcedureRequest"/>
  <baseDefinition
                  value="http://hl7.org/fhir/StructureDefinition/ProcedureRequest"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="ProcedureRequest:qicore-procedurerequest">
      <path value="ProcedureRequest"/>
      <name value="QICore-ProcedureRequest"/>
      <short value="A request for a procedure to be performed"/>
      <definition
                  value="A request for a procedure to be performed. May be a proposal or an order."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ProcedureRequest"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
      </constraint>
      <constraint>
        <key value="dom-1"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain any narrative"/>
        <expression value="contained.text.empty()"/>
        <xpath value="not(parent::f:contained and f:text)"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource"/>
        <expression
                    value="contained.where(('#'+id in %resource.descendants().reference).not()).empty()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))"/>
      </constraint>
      <mustSupport value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="clinical.general"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map
             value=""Intervention, Order" (when ProcedureRequest.status="requested"); "Intervention, Recommended" (when ProcedureRequest.status="proposed"); "Procedure, Order"; "Procedure, Recommended" (when ProcedureRequest.status="proposed")"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.id">
      <path value="ProcedureRequest.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comments
                value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.meta">
      <path value="ProcedureRequest.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.implicitRules">
      <path value="ProcedureRequest.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content."/>
      <comments
                value="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 as much as possible."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.language">
      <path value="ProcedureRequest.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comments
                value="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)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference value="http://hl7.org/fhir/ValueSet/all-languages"/>
          </valueReference>
        </extension>
        <strength value="extensible"/>
        <description value="A human language."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/languages"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.text">
      <path value="ProcedureRequest.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="A human-readable narrative that contains a summary of the resource, and may 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."/>
      <comments
                value="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 in formation is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.contained">
      <path value="ProcedureRequest.contained"/>
      <short value="Contained, inline Resources"/>
      <definition
                  value="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."/>
      <comments
                value="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."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.extension">
      <path value="ProcedureRequest.extension"/>
      <slicing id="14">
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element
             id="ProcedureRequest:qicore-procedurerequest.extension:procedurerequestreasonrefused$procedurerequest-reasonRefused">
      <path value="ProcedureRequest.extension"/>
      <name value="ProcedureRequest.reasonRefused"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/procedurerequest-reasonRefused"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="children().count() > id.count()"/>
        <xpath value="@value|f:*|h:div"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
      </constraint>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="example"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/procedure-not-performed-reason"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="qdm"/>
        <map
             value="negation rationale (when ProcedureRequest.status="rejected")"/>
      </mapping>
    </element>
    <element
             id="ProcedureRequest:qicore-procedurerequest.extension:procedurerequestapproachbodysite$procedurerequest-approachBodySite">
      <path value="ProcedureRequest.extension"/>
      <name value="ProcedureRequest.approachBodySite"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/procedurerequest-approachBodySite"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="children().count() > id.count()"/>
        <xpath value="@value|f:*|h:div"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
      </constraint>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="qidam"/>
        <map
             value="Not in QIDAM, but should have been included because the procedure request might include a requested approach, for example, to distinguish between urethral and supra-pubic urinary catheterization."/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="anatomical approach site"/>
      </mapping>
    </element>
    <element
             id="ProcedureRequest:qicore-procedurerequest.extension:procedurerequestappropriatenessscore$qicore-procedurerequest-appropriatenessScore">
      <path value="ProcedureRequest.extension"/>
      <name value="ProcedureRequest.appropriatenessScore"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-procedurerequest-appropriatenessScore"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="required"/>
        <description
                     value="The RAND scoring for appropriateness of the procedure."/>
      </binding>
      <mapping>
        <identity value="qidam"/>
        <map
             value="Not in QIDAM, but added because of a persuasive ballot comment (May 2015)."/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.modifierExtension">
      <path value="ProcedureRequest.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="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. Usually modifier elements provide negation or qualification. In order 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."/>
      <comments
                value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.identifier">
      <path value="ProcedureRequest.identifier"/>
      <short value="Unique identifier for the request"/>
      <definition
                  value="Identifiers assigned to this order by the order or by the receiver."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ProcedureRequest.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="quick"/>
        <map value="ClinicalStatement.identifier"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.subject">
      <path value="ProcedureRequest.subject"/>
      <short value="Who the procedure should be done to"/>
      <definition
                  value="The person, animal or group that should receive the procedure."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ProcedureRequest.subject"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Group"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="quick"/>
        <map value="ClinicalStatement.subject"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.code">
      <path value="ProcedureRequest.code"/>
      <short value="What procedure to perform"/>
      <definition
                  value="The specific procedure that is ordered. Use text if the exact nature of the procedure cannot be coded."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ProcedureRequest.code"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="false"/>
      <binding>
        <strength value="preferred"/>
        <description value="Codes describing the Procedure Type"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/daf/ValueSet/daf-procedure-type"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="quick"/>
        <map value="Procedure.procedureCode"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="class"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="primary code"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.bodySite">
      <path value="ProcedureRequest.bodySite"/>
      <short value="What part of body to perform on"/>
      <definition
                  value="Indicates the sites on the subject's body where the procedure should be performed (I.e. the target sites)."/>
      <comments
                value="Only used if not implicit in the code found in ProcedureRequest.type."/>
      <requirements
                    value="Knowing where the procedure is made is important for tracking if multiple sites are possible."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ProcedureRequest.bodySite"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="false"/>
      <binding>
        <strength value="example"/>
        <description value="A code that identifies the anatomical location."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/body-site"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="targetSiteCode"/>
      </mapping>
      <mapping>
        <identity value="quick"/>
        <map value="Procedure.targetBodySite"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="anatomical location site"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.reason[x]">
      <path value="ProcedureRequest.reason[x]"/>
      <short value="Why procedure should occur"/>
      <definition
                  value="The reason why the procedure is being proposed or ordered. This procedure request may be motivated by a Condition for instance."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ProcedureRequest.reason[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="false"/>
      <binding>
        <strength value="example"/>
        <description
                     value="A code that explains the reason why a procedure is  required."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/procedure-reason"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="quick"/>
        <map value="Action.indication.reason"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="reason"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.scheduled[x]">
      <path value="ProcedureRequest.scheduled[x]"/>
      <short value="When procedure should occur"/>
      <definition
                  value="The timing schedule for the proposed or ordered procedure. The Schedule data type allows many different expressions.  E.g. "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013"."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ProcedureRequest.scheduled[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <type>
        <code value="Timing"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="quick"/>
        <map value="Procedure.procedureSchedule"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.planned"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="start datetime, stop datetime"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.encounter">
      <path value="ProcedureRequest.encounter"/>
      <short
             value="An interaction during which services are provided to the patient"/>
      <definition
                  value="An interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient."/>
      <alias value="Visit"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ProcedureRequest.encounter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-encounter"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Encounter[@moodCode='EVN']"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="workflow.encounter"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="Encounter, Active or Performed"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.performer">
      <path value="ProcedureRequest.performer"/>
      <short value="Who should perform the procedure"/>
      <definition
                  value="For example, the surgeon, anaethetist, endoscopist, etc."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ProcedureRequest.performer"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-organization"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-relatedperson"/>
      </type>
      <mustSupport value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="w5"/>
        <map value="who.actor"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.status">
      <path value="ProcedureRequest.status"/>
      <short
             value="proposed | draft | requested | received | accepted | in-progress | completed | suspended | rejected | aborted"/>
      <definition value="The status of the order."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ProcedureRequest.status"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="true"/>
      <isSummary value="false"/>
      <binding>
        <strength value="required"/>
        <description value="The status of the request."/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/procedure-request-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="quick"/>
        <map value="Action.currentStatus"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map
             value="negation rationale (when ProcedureRequest.status="rejected")"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.notes">
      <path value="ProcedureRequest.notes"/>
      <short value="Additional information about desired procedure"/>
      <definition
                  value="Any other notes associated with this proposal or order - e.g. provider instructions."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ProcedureRequest.notes"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Annotation"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="quick"/>
        <map value="ClinicalStatement.additionalText"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.asNeeded[x]">
      <path value="ProcedureRequest.asNeeded[x]"/>
      <short value="Preconditions for procedure"/>
      <definition
                  value="If a CodeableConcept is present, it indicates the pre-condition for performing the procedure."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ProcedureRequest.asNeeded[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="false"/>
      <binding>
        <strength value="example"/>
        <description
                     value="A coded concept identifying the pre-condition that should hold prior to performing a procedure.  For example "pain", "on flare-up", etc."/>
      </binding>
      <mapping>
        <identity value="quick"/>
        <map value="Proposal.prnReason.reason"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.orderedOn">
      <path value="ProcedureRequest.orderedOn"/>
      <short value="When request was created"/>
      <definition value="The time when the request was made."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ProcedureRequest.orderedOn"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="quick"/>
        <map value="Proposal.proposedAtTime"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.recorded"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="start datetime, stop datetime"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.orderer">
      <path value="ProcedureRequest.orderer"/>
      <short value="Who made request"/>
      <definition
                  value="The healthcare professional responsible for proposing or ordering the procedure."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ProcedureRequest.orderer"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-relatedperson"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-device"/>
      </type>
      <mustSupport value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="quick"/>
        <map value="ClinicalStatement.statementAuthor"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.author"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.priority">
      <path value="ProcedureRequest.priority"/>
      <short value="routine | urgent | stat | asap"/>
      <definition value="The clinical priority associated with this order."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ProcedureRequest.priority"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <description value="The priority of the request."/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/procedure-request-priority"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="quick"/>
        <map value="Proposal.urgency"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="grade"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="ProcedureRequest:qicore-procedurerequest">
      <path value="ProcedureRequest"/>
      <name value="QICore-ProcedureRequest"/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="qdm"/>
        <map
             value=""Intervention, Order" (when ProcedureRequest.status="requested"); "Intervention, Recommended" (when ProcedureRequest.status="proposed"); "Procedure, Order"; "Procedure, Recommended" (when ProcedureRequest.status="proposed")"/>
      </mapping>
    </element>
    <element
             id="ProcedureRequest:qicore-procedurerequest.extension:procedurerequestreasonrefused$procedurerequest-reasonRefused">
      <path value="ProcedureRequest.extension"/>
      <name value="ProcedureRequest.reasonRefused"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/procedurerequest-reasonRefused"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="example"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/procedure-not-performed-reason"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="qdm"/>
        <map
             value="negation rationale (when ProcedureRequest.status="rejected")"/>
      </mapping>
    </element>
    <element
             id="ProcedureRequest:qicore-procedurerequest.extension:procedurerequestapproachbodysite$procedurerequest-approachBodySite">
      <path value="ProcedureRequest.extension"/>
      <name value="ProcedureRequest.approachBodySite"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/procedurerequest-approachBodySite"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="qidam"/>
        <map
             value="Not in QIDAM, but should have been included because the procedure request might include a requested approach, for example, to distinguish between urethral and supra-pubic urinary catheterization."/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="anatomical approach site"/>
      </mapping>
    </element>
    <element
             id="ProcedureRequest:qicore-procedurerequest.extension:procedurerequestappropriatenessscore$qicore-procedurerequest-appropriatenessScore">
      <path value="ProcedureRequest.extension"/>
      <name value="ProcedureRequest.appropriatenessScore"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-procedurerequest-appropriatenessScore"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="required"/>
        <description
                     value="The RAND scoring for appropriateness of the procedure."/>
      </binding>
      <mapping>
        <identity value="qidam"/>
        <map
             value="Not in QIDAM, but added because of a persuasive ballot comment (May 2015)."/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.subject">
      <path value="ProcedureRequest.subject"/>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Group"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.code">
      <path value="ProcedureRequest.code"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="preferred"/>
        <description value="Codes describing the Procedure Type"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/daf/ValueSet/daf-procedure-type"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="qdm"/>
        <map value="primary code"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.bodySite">
      <path value="ProcedureRequest.bodySite"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="qdm"/>
        <map value="anatomical location site"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.reason[x]">
      <path value="ProcedureRequest.reason[x]"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="qdm"/>
        <map value="reason"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.scheduled[x]">
      <path value="ProcedureRequest.scheduled[x]"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="qdm"/>
        <map value="start datetime, stop datetime"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.encounter">
      <path value="ProcedureRequest.encounter"/>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-encounter"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.performer">
      <path value="ProcedureRequest.performer"/>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-organization"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-relatedperson"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.status">
      <path value="ProcedureRequest.status"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="qdm"/>
        <map
             value="negation rationale (when ProcedureRequest.status="rejected")"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.asNeeded[x]">
      <path value="ProcedureRequest.asNeeded[x]"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.orderedOn">
      <path value="ProcedureRequest.orderedOn"/>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="qdm"/>
        <map value="start datetime, stop datetime"/>
      </mapping>
    </element>
    <element id="ProcedureRequest:qicore-procedurerequest.orderer">
      <path value="ProcedureRequest.orderer"/>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-relatedperson"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile
                 value="http://hl7.org/fhir/qicore/StructureDefinition/qicore-device"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
  </differential>
</StructureDefinition>