QI-Core Implementation Guide

QI-Core Implementation Guide: STU 4 (v4.0.0 for FHIR 4.0.1)

QI-Core Implementation Guide - This is the current published version.. See the Directory of published versions

D.4.1 StructureDefinition-qicore-procedurenotdone

Introduction:


define "No VTE Prophylaxis Device Applied":
  ["Procedure": "Device Application"] DeviceApplied
    let DeviceNotDoneTiming: Global.GetExtension(DeviceApplied, 'qicore-recorded').value
    where (DeviceApplied.usedCode in "Intermittent pneumatic compression devices (IPC)"
      or DeviceApplied.usedCode in "Venous foot pumps (VFP)"
      or DeviceApplied.usedCode in "Graduated compression stockings (GCS)"
    )
      and  DeviceApplied.status = 'not-done'
    return {id: DeviceApplied.id, requestStatusReason: DeviceApplied.statusReason, authoredOn: DeviceNotDoneTiming}

See the patterns page for implementation and usage patterns.

Examples:

Negation Example

D.4.1.1 Formal Views of Profile Content

The official URL for this profile is:

http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedurenotdone

Profile of Procedure for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

This profile builds on Procedure.

This profile was published on Wed Aug 22 00:00:00 UTC 2018 as a draft by Health Level Seven, Inc. - CQI WG.

Description of Profiles, Differentials, and Snapshots.

Text Summary
Differential Table
Snapshot Table
All

Summary

Mandatory: 3 elements (1 nested mandatory element)
Must-Support: 7 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	Procedure
qicore-recorded	S	1..1	dateTime	Extension URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded
status	S	1..1	code	Fixed Value: not-done
statusReason	S	1..1	CodeableConcept	Binding: Negation Reason Codes (extensible)
code	S	0..1	CodeableConcept
coding
valueset-reference	S	1..1	uri	What was not performed URL: http://hl7.org/fhir/StructureDefinition/valueset-reference
subject	S	1..1	Reference(QICorePatient)
encounter	S	0..1	Reference(QICoreEncounter)
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Procedure	I	0..*	Procedure	An action that is being or was performed on a patient
id	Σ	0..1	string	Logical id of this artifact
meta	ΣI	0..1	Meta	Metadata about the resource
implicitRules	?!ΣI	0..1	uri	A set of rules under which this content was created
language	I	0..1	code	Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages
text	I	0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension	I	0..*	Extension	Extension Slice: Unordered, Open by value:url
qicore-recorded	SI	1..1	dateTime	Extension URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded
modifierExtension	?!I	0..*	Extension	Extensions that cannot be ignored
identifier	ΣI	0..*	Identifier	External Identifiers for this procedure
instantiatesCanonical	ΣI	0..*	canonical(PlanDefinition \| ActivityDefinition \| Measure \| OperationDefinition \| Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	ΣI	0..*	uri	Instantiates external protocol or definition
basedOn	ΣI	0..*	Reference(CarePlan \| ServiceRequest)	A request for this procedure
partOf	ΣI	0..*	Reference(Procedure \| Observation \| MedicationAdministration)	Part of referenced event
status	?!SΣI	1..1	code	preparation \| in-progress \| not-done \| on-hold \| stopped \| completed \| entered-in-error \| unknown Binding: EventStatus (required) Fixed Value: not-done
statusReason	SΣI	1..1	CodeableConcept	Reason for current status Binding: Negation Reason Codes (extensible)
category	ΣI	0..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example)
code	SΣI	0..1	CodeableConcept	Identification of the procedure Binding: ProcedureCodes(SNOMEDCT) (example)
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	ΣI	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
valueset-reference	SI	1..1	uri	What was not performed URL: http://hl7.org/fhir/StructureDefinition/valueset-reference
system	ΣI	0..1	uri	Identity of the terminology system
version	ΣI	0..1	string	Version of the system - if relevant
code	ΣI	0..1	code	Symbol in syntax defined by the system
display	ΣI	0..1	string	Representation defined by the system
userSelected	ΣI	0..1	boolean	If this coding was chosen directly by the user
text	ΣI	0..1	string	Plain text representation of the concept
subject	SΣI	1..1	Reference(QICorePatient)	Who the procedure was performed on
encounter	SΣI	0..1	Reference(QICoreEncounter)	Encounter created as part of
performed[x]	ΣI	0..1		When the procedure was performed
performedDateTime			dateTime
performedPeriod			Period
performedString			string
performedAge			Age
performedRange			Range
recorder	ΣI	0..1	Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole)	Who recorded the procedure
asserter	ΣI	0..1	Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole)	Person who asserts this procedure
performer	ΣI	0..*	BackboneElement	The people who performed the procedure
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations
modifierExtension	?!ΣI	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	ΣI	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example)
actor	ΣI	1..1	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device)	The reference to the practitioner
onBehalfOf	I	0..1	Reference(Organization)	Organization the device or practitioner was acting for
location	ΣI	0..1	Reference(Location)	Where the procedure happened
reasonCode	ΣI	0..*	CodeableConcept	Coded reason procedure performed Binding: ProcedureReasonCodes (example)
reasonReference	ΣI	0..*	Reference(Condition \| Observation \| Procedure \| DiagnosticReport \| DocumentReference)	The justification that the procedure was performed
bodySite	ΣI	0..*	CodeableConcept	Target body sites Binding: SNOMEDCTBodyStructures (example)
outcome	ΣI	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (example)
report	I	0..*	Reference(DiagnosticReport \| DocumentReference \| Composition)	Any report resulting from the procedure
complication	I	0..*	CodeableConcept	Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example)
complicationDetail	I	0..*	Reference(Condition)	A condition that is a result of the procedure
followUp	I	0..*	CodeableConcept	Instructions for follow up Binding: ProcedureFollowUpCodes(SNOMEDCT) (example)
note	I	0..*	Annotation	Additional information about the procedure
focalDevice	I	0..*	BackboneElement	Manipulated, implanted, or removed device
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations
modifierExtension	?!ΣI	0..*	Extension	Extensions that cannot be ignored even if unrecognized
action	I	0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred)
manipulated	I	1..1	Reference(Device)	Device that was changed
usedReference	I	0..*	Reference(Device \| Medication \| Substance)	Items used during procedure
usedCode	I	0..*	CodeableConcept	Coded items used during the procedure Binding: FHIRDeviceTypes (example)
Documentation for this format

Summary

Mandatory: 3 elements (1 nested mandatory element)
Must-Support: 7 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Differential View

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	Procedure
qicore-recorded	S	1..1	dateTime	Extension URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded
status	S	1..1	code	Fixed Value: not-done
statusReason	S	1..1	CodeableConcept	Binding: Negation Reason Codes (extensible)
code	S	0..1	CodeableConcept
coding
valueset-reference	S	1..1	uri	What was not performed URL: http://hl7.org/fhir/StructureDefinition/valueset-reference
subject	S	1..1	Reference(QICorePatient)
encounter	S	0..1	Reference(QICoreEncounter)
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Procedure	I	0..*	Procedure	An action that is being or was performed on a patient
id	Σ	0..1	string	Logical id of this artifact
meta	ΣI	0..1	Meta	Metadata about the resource
implicitRules	?!ΣI	0..1	uri	A set of rules under which this content was created
language	I	0..1	code	Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages
text	I	0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension	I	0..*	Extension	Extension Slice: Unordered, Open by value:url
qicore-recorded	SI	1..1	dateTime	Extension URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded
modifierExtension	?!I	0..*	Extension	Extensions that cannot be ignored
identifier	ΣI	0..*	Identifier	External Identifiers for this procedure
instantiatesCanonical	ΣI	0..*	canonical(PlanDefinition \| ActivityDefinition \| Measure \| OperationDefinition \| Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	ΣI	0..*	uri	Instantiates external protocol or definition
basedOn	ΣI	0..*	Reference(CarePlan \| ServiceRequest)	A request for this procedure
partOf	ΣI	0..*	Reference(Procedure \| Observation \| MedicationAdministration)	Part of referenced event
status	?!SΣI	1..1	code	preparation \| in-progress \| not-done \| on-hold \| stopped \| completed \| entered-in-error \| unknown Binding: EventStatus (required) Fixed Value: not-done
statusReason	SΣI	1..1	CodeableConcept	Reason for current status Binding: Negation Reason Codes (extensible)
category	ΣI	0..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example)
code	SΣI	0..1	CodeableConcept	Identification of the procedure Binding: ProcedureCodes(SNOMEDCT) (example)
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	ΣI	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
valueset-reference	SI	1..1	uri	What was not performed URL: http://hl7.org/fhir/StructureDefinition/valueset-reference
system	ΣI	0..1	uri	Identity of the terminology system
version	ΣI	0..1	string	Version of the system - if relevant
code	ΣI	0..1	code	Symbol in syntax defined by the system
display	ΣI	0..1	string	Representation defined by the system
userSelected	ΣI	0..1	boolean	If this coding was chosen directly by the user
text	ΣI	0..1	string	Plain text representation of the concept
subject	SΣI	1..1	Reference(QICorePatient)	Who the procedure was performed on
encounter	SΣI	0..1	Reference(QICoreEncounter)	Encounter created as part of
performed[x]	ΣI	0..1		When the procedure was performed
performedDateTime			dateTime
performedPeriod			Period
performedString			string
performedAge			Age
performedRange			Range
recorder	ΣI	0..1	Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole)	Who recorded the procedure
asserter	ΣI	0..1	Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole)	Person who asserts this procedure
performer	ΣI	0..*	BackboneElement	The people who performed the procedure
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations
modifierExtension	?!ΣI	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	ΣI	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example)
actor	ΣI	1..1	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| RelatedPerson \| Device)	The reference to the practitioner
onBehalfOf	I	0..1	Reference(Organization)	Organization the device or practitioner was acting for
location	ΣI	0..1	Reference(Location)	Where the procedure happened
reasonCode	ΣI	0..*	CodeableConcept	Coded reason procedure performed Binding: ProcedureReasonCodes (example)
reasonReference	ΣI	0..*	Reference(Condition \| Observation \| Procedure \| DiagnosticReport \| DocumentReference)	The justification that the procedure was performed
bodySite	ΣI	0..*	CodeableConcept	Target body sites Binding: SNOMEDCTBodyStructures (example)
outcome	ΣI	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (example)
report	I	0..*	Reference(DiagnosticReport \| DocumentReference \| Composition)	Any report resulting from the procedure
complication	I	0..*	CodeableConcept	Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example)
complicationDetail	I	0..*	Reference(Condition)	A condition that is a result of the procedure
followUp	I	0..*	CodeableConcept	Instructions for follow up Binding: ProcedureFollowUpCodes(SNOMEDCT) (example)
note	I	0..*	Annotation	Additional information about the procedure
focalDevice	I	0..*	BackboneElement	Manipulated, implanted, or removed device
id		0..1	string	Unique id for inter-element referencing
extension	I	0..*	Extension	Additional content defined by implementations
modifierExtension	?!ΣI	0..*	Extension	Extensions that cannot be ignored even if unrecognized
action	I	0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred)
manipulated	I	1..1	Reference(Device)	Device that was changed
usedReference	I	0..*	Reference(Device \| Medication \| Substance)	Items used during procedure
usedCode	I	0..*	CodeableConcept	Coded items used during the procedure Binding: FHIRDeviceTypes (example)
Documentation for this format

D.4.1.2 Terminology Bindings

Terminology Bindings

Path	Conformance	ValueSet / Code
Procedure.language	preferred	CommonLanguages Max Binding: AllLanguages
Procedure.status	required	Fixed Value: not-done
Procedure.statusReason	extensible	NegationReasonCodes
Procedure.category	example	ProcedureCategoryCodes(SNOMEDCT)
Procedure.code	example	ProcedureCodes(SNOMEDCT)
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

D.4.1.3 Constraints

Constraints

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.extension:recorded	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	Procedure.extension:recorded	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.code.extension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	Procedure.code.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Procedure.code.coding	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Procedure.code.coding.extension	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	Procedure.code.coding.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Procedure.code.coding.extension:notDoneValueSet	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	Procedure.code.coding.extension:notDoneValueSet	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Procedure.code.coding.system	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Procedure.code.coding.version	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Procedure.code.coding.code	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Procedure.code.coding.display	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Procedure.code.coding.userSelected	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ele-1	Procedure.code.text	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())