SDOH Clinical Care
2.3.0 - STU 2.3
SDOH Clinical Care
2.3.0 - STU 2.3
This page is part of the SDOH Clinical Care for Multiple Domains (v2.3.0: STU 2.3) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions
| Official URL: http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-Procedure | Version: 2.3.0 | |||
| Standards status: Trial-use | Maturity Level: 2 | Computable Name: SDOHCCProcedure | ||
Profile for interventions that address Social Determinants of Health.
SDOHCC Procedure is generally intended to represent a procedure performed to address an identified social risk or need (e.g., SDOHCC Condition, SDOHCC Observation Screening Response, SDOHCC Observation Assessment). SDOHCC Procedure can be based on an SDOHCC ServiceRequest, pertain to an SDOHCC Goal, or be the output of an SDOHCC Task For Referral Management. See the Data Modeling Framework for more detail on the relationships between SDOHCC Procedure and the other profiles in this IG.
Procedure.code has a binding to US Core Procedure Codes (required). Procedure.code also has additional bindings to SDOH domain-specific value sets (e.g., for Food Insecurity) which are determined by the value selected for Procedure.category. When Procedure.category is a value from SDOHCC ValueSet SDOH Category (e.g., food-insecurity), Procedure.code SHALL be selected from the corresponding domain-specific value set found in Additional Bindings (i.e. Food Insecurity Procedures). If more than one value is selected from SDOHCC ValueSet SDOH Category (e.g., food-insecurity and financial-insecurity) for Procedure.category, then Procedure.code SHALL be selected from at least one of the corresponding domain-specific value sets found in Additional Bindings (e.g. Food Insecurity Procedures).
Of note, Gravity Project is continuously developing terminology for new SDOH domains. For new SDOH domains where the Gravity terminology development cycle is in progress, domain-specific value sets may not yet be available in VSAC. If a domain-specific value set is not yet available in VSAC, the Additional Binding is the default binding for the profile element. Additionally, sometimes a domain-specific value set for a new domain is available in VSAC but does not yet include all standardized codes identified during the domain’s terminology development cycle. In this case, the value set’s “Description” tab in VSAC will state, “In progress”. If a domain-specific value set is available in VSAC but does not yet include all standardized codes identified during the domain’s terminology development cycle, the value set’s VSAC “Description” tab will state, “In progress”. Additional information related to Gravity value sets is provided on the Social Risk Terminology Value Sets page on the Gravity Project Confluence site.
Additionally, some SDOH domains may not yet be represented in SDOHCC ValueSet SDOH Category. In this case, Procedure.category: sdoh-category-unspecified can be used so that the Procedure instance can still be categorized as SDOH-related. If desired, category.text can also be used to further specify the domain. For example, at the time of publication of this IG, “disability-status” is not yet included in SDOHCC ValueSet SDOH Category. In this case, Procedure.category: sdoh-category-unspecified can be used along with category.text: Disability Status. For Procedure.category: sdoh-category-unspecified, there will not be domain-specific value sets and Additional Bindings for Procedure.code will designate the default binding to US Core Procedure Codes (required).
For more information on the correlation between Procedure.category and the domain-specific value sets in Additional Bindings for Procedure.code, see Gravity Project Value Sets.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Procedure |
C | 0..* | Procedure | An action that is being or was performed on a patient dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management us-core-7: Performed SHALL be present if the status is 'completed' or 'in-progress' |
  implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children |
  Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
   extension:pertainsToGoal |
S | 0..* | (Complex) | Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
  extension |
0..0 | |||
| url |
1..1 | uri | "http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal" | |
  value[x] |
S | 1..1 | Reference(SDOHCC Goal) | Value of extension ele-1: All FHIR elements must have a @value or children |
 modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
 Slices for basedOn |
SΣ | 0..* | Reference(CarePlan | ServiceRequest) | A request for this procedure Slice: Unordered, Open by profile:resolve() ele-1: All FHIR elements must have a @value or children |
 basedOn:SupportedBasedOn |
SΣ | 0..* | Reference(SDOHCC ServiceRequest | US Core CarePlan Profile(7.0.0)) | An SDOH service request or US Core Care Plan for this procedure ele-1: All FHIR elements must have a @value or children |
| status |
?!SΣC | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required) ele-1: All FHIR elements must have a @value or children |
 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. ele-1: All FHIR elements must have a @value or children |
 Slices for coding |
SΣ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this ele-1: All FHIR elements must have a @value or children |
| coding:SDOHCC |
SΣ | 0..1 | Coding | e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories. ele-1: All FHIR elements must have a @value or children |
| code |
SΣ | 1..1 | CodeableConcept | Identification of the procedure Binding: USCoreProcedureCodes (7.0.0) (required): Codes describing the type of Procedure ele-1: All FHIR elements must have a @value or children |
| subject |
SΣ | 1..1 | Reference(US Core Patient Profile(7.0.0)) | Who the procedure was performed on ele-1: All FHIR elements must have a @value or children |
| encounter |
SΣ | 0..1 | Reference(US Core Encounter Profile(7.0.0)) | Encounter associated with the procedure ele-1: All FHIR elements must have a @value or children |
 performed[x] |
SΣC | 0..1 | When the procedure was performed ele-1: All FHIR elements must have a @value or children | |
 performedDateTime |
dateTime | |||
| reasonCode |
Σ | 0..* | CodeableConcept | Coded reason procedure performed Binding: USCoreConditionCodes (7.0.0) (extensible) ele-1: All FHIR elements must have a @value or children |
| Slices for reasonReference |
Σ | 0..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) | The justification that the procedure was performed Slice: Unordered, Open by profile:resolve() ele-1: All FHIR elements must have a @value or children |
| reasonReference:SupportedReasonReference |
SΣ | 0..* | Reference(SDOHCC Condition | SDOHCC Observation Screening Response | SDOHCC Observation Assessment) | The justification that the procedure was performed ele-1: All FHIR elements must have a @value or children |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| Procedure.status | required | EventStatushttp://hl7.org/fhir/ValueSet/event-statusfrom the FHIR Standard | |
| Procedure.category | example | ProcedureCategoryCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-categoryfrom the FHIR Standard | |
| Procedure.category.coding:SDOHCC | required | SDOHCCValueSetSDOHCategoryhttp://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategoryfrom this IG | |
| Procedure.code | required | USCoreProcedureCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code|7.0.0 | |
| Procedure.reasonCode | extensible | USCoreConditionCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0 |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | Procedure | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | 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 | error | 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 | error | Procedure | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Procedure | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| us-core-7 | error | Procedure | Performed SHALL be present if the status is 'completed' or 'in-progress' : (status='completed' or status='in-progress') implies performed.exists() |
This structure is derived from Procedure
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Procedure |
C | 0..* | Procedure | An action that is being or was performed on a patient us-core-7: Performed SHALL be present if the status is 'completed' or 'in-progress' |
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:pertainsToGoal |
S | 0..* | (Complex) | Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal |
| value[x] |
S | 1..1 | Reference(SDOHCC Goal) | Value of extension |
| Slices for basedOn |
S | 0..* | Reference(CarePlan | ServiceRequest) | A request for this procedure Slice: Unordered, Open by profile:resolve() |
| basedOn:SupportedBasedOn |
S | 0..* | Reference(SDOHCC ServiceRequest | US Core CarePlan Profile(7.0.0)) | An SDOH service request or US Core Care Plan for this procedure |
 status |
SC | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required) |
| category |
0..1 | CodeableConcept | Classification of the procedure | |
| Slices for coding |
S | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this |
| coding:SDOHCC |
S | 0..1 | Coding | e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories. |
| code |
S | 1..1 | CodeableConcept | Identification of the procedure Binding: USCoreProcedureCodes (7.0.0) (required): Codes describing the type of Procedure |
| subject |
S | 1..1 | Reference(US Core Patient Profile(7.0.0)) | Who the procedure was performed on |
| encounter |
S | 0..1 | Reference(US Core Encounter Profile(7.0.0)) | Encounter associated with the procedure |
| performed[x] |
SC | 0..1 | When the procedure was performed | |
| performedDateTime |
dateTime S | |||
| performedPeriod |
Period | |||
| performedString |
string | |||
| performedAge |
Age | |||
| performedRange |
Range | |||
| reasonCode |
0..* | CodeableConcept | Coded reason procedure performed Binding: USCoreConditionCodes (7.0.0) (extensible) | |
| Slices for reasonReference |
0..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) | The justification that the procedure was performed Slice: Unordered, Open by profile:resolve() | |
| reasonReference:SupportedReasonReference |
S | 0..* | Reference(SDOHCC Condition | SDOHCC Observation Screening Response | SDOHCC Observation Assessment) | The justification that the procedure was performed |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| Procedure.status | required | EventStatushttp://hl7.org/fhir/ValueSet/event-statusfrom the FHIR Standard | |
| Procedure.category.coding:SDOHCC | required | SDOHCCValueSetSDOHCategoryhttp://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategoryfrom this IG | |
| Procedure.code | required | USCoreProcedureCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code|7.0.0 | |
| Procedure.reasonCode | extensible | USCoreConditionCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0 |
| Id | Grade | Path(s) | Details | Requirements |
| us-core-7 | error | Procedure | Performed SHALL be present if the status is 'completed' or 'in-progress' : (status='completed' or status='in-progress') implies performed.exists() |
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| Procedure |
C | 0..* | Procedure | An action that is being or was performed on a patient us-core-7: Performed SHALL be present if the status is 'completed' or 'in-progress' | ||||
| id |
Σ | 0..1 | id | 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): A human language.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
| extension:pertainsToGoal |
S | 0..* | (Complex) | Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal | ||||
| id |
0..1 | id | Unique id for inter-element referencing | |||||
| extension |
0..0 | |||||||
| url |
1..1 | uri | "http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal" | |||||
| value[x] |
S | 1..1 | Reference(SDOHCC Goal) | Value of extension | ||||
| 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 | ||||
| Slices for basedOn |
SΣ | 0..* | Reference(CarePlan | ServiceRequest) | A request for this procedure Slice: Unordered, Open by profile:resolve() | ||||
| basedOn:SupportedBasedOn |
SΣ | 0..* | Reference(SDOHCC ServiceRequest | US Core CarePlan Profile(7.0.0)) | An SDOH service request or US Core Care Plan for this procedure | ||||
| partOf |
Σ | 0..* | Reference(Procedure | Observation | MedicationAdministration) | Part of referenced event | ||||
| status |
?!SΣC | 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. | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| Slices for coding |
SΣ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this | ||||
| coding:SDOHCC |
SΣ | 0..1 | Coding | e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories. | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| code |
SΣ | 1..1 | CodeableConcept | Identification of the procedure Binding: USCoreProcedureCodes (7.0.0) (required): Codes describing the type of Procedure | ||||
| subject |
SΣ | 1..1 | Reference(US Core Patient Profile(7.0.0)) | Who the procedure was performed on | ||||
| encounter |
SΣ | 0..1 | Reference(US Core Encounter Profile(7.0.0)) | Encounter associated with the procedure | ||||
| performed[x] |
SΣC | 0..1 | When the procedure was performed | |||||
| performedDateTime |
dateTime S | |||||||
| performedPeriod |
Period | |||||||
| performedString |
string | |||||||
| performedAge |
Age | |||||||
| performedRange |
Range | |||||||
| 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 |
Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | The reference to the practitioner | ||||
| onBehalfOf |
0..1 | Reference(Organization) | 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: USCoreConditionCodes (7.0.0) (extensible) | ||||
| Slices for reasonReference |
Σ | 0..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) | The justification that the procedure was performed Slice: Unordered, Open by profile:resolve() | ||||
| reasonReference:SupportedReasonReference |
SΣ | 0..* | Reference(SDOHCC Condition | SDOHCC Observation Screening Response | SDOHCC Observation Assessment) | 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 | ||||||||
| Path | Conformance | ValueSet | URI | |||
| Procedure.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard
| ||||
| Procedure.status | required | EventStatushttp://hl7.org/fhir/ValueSet/event-statusfrom the FHIR Standard | ||||
| Procedure.statusReason | example | ProcedureNotPerformedReason(SNOMED-CT)http://hl7.org/fhir/ValueSet/procedure-not-performed-reasonfrom the FHIR Standard | ||||
| Procedure.category | example | ProcedureCategoryCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-categoryfrom the FHIR Standard | ||||
| Procedure.category.coding:SDOHCC | required | SDOHCCValueSetSDOHCategoryhttp://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategoryfrom this IG | ||||
| Procedure.code | required | USCoreProcedureCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code|7.0.0 | ||||
| Procedure.performer.function | example | ProcedurePerformerRoleCodeshttp://hl7.org/fhir/ValueSet/performer-rolefrom the FHIR Standard | ||||
| Procedure.reasonCode | extensible | USCoreConditionCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0 | ||||
| Procedure.bodySite | example | SNOMEDCTBodyStructureshttp://hl7.org/fhir/ValueSet/body-sitefrom the FHIR Standard | ||||
| Procedure.outcome | example | ProcedureOutcomeCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-outcomefrom the FHIR Standard | ||||
| Procedure.complication | example | Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-codefrom the FHIR Standard | ||||
| Procedure.followUp | example | ProcedureFollowUpCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-followupfrom the FHIR Standard | ||||
| Procedure.focalDevice.action | preferred | ProcedureDeviceActionCodeshttp://hl7.org/fhir/ValueSet/device-actionfrom the FHIR Standard | ||||
| Procedure.usedCode | example | FHIRDeviceTypeshttp://hl7.org/fhir/ValueSet/device-kindfrom the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | Procedure | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | 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 | error | 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 | error | Procedure | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Procedure | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| us-core-7 | error | Procedure | Performed SHALL be present if the status is 'completed' or 'in-progress' : (status='completed' or status='in-progress') implies performed.exists() |
This structure is derived from Procedure
Summary
Mandatory: 1 element
Must-Support: 12 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
Maturity: 2
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Procedure |
C | 0..* | Procedure | An action that is being or was performed on a patient dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management us-core-7: Performed SHALL be present if the status is 'completed' or 'in-progress' |
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children |
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
| extension:pertainsToGoal |
S | 0..* | (Complex) | Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
| extension |
0..0 | |||
| url |
1..1 | uri | "http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal" | |
| value[x] |
S | 1..1 | Reference(SDOHCC Goal) | Value of extension ele-1: All FHIR elements must have a @value or children |
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
| Slices for basedOn |
SΣ | 0..* | Reference(CarePlan | ServiceRequest) | A request for this procedure Slice: Unordered, Open by profile:resolve() ele-1: All FHIR elements must have a @value or children |
| basedOn:SupportedBasedOn |
SΣ | 0..* | Reference(SDOHCC ServiceRequest | US Core CarePlan Profile(7.0.0)) | An SDOH service request or US Core Care Plan for this procedure ele-1: All FHIR elements must have a @value or children |
| status |
?!SΣC | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required) ele-1: All FHIR elements must have a @value or children |
| 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. ele-1: All FHIR elements must have a @value or children |
| Slices for coding |
SΣ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this ele-1: All FHIR elements must have a @value or children |
| coding:SDOHCC |
SΣ | 0..1 | Coding | e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories. ele-1: All FHIR elements must have a @value or children |
| code |
SΣ | 1..1 | CodeableConcept | Identification of the procedure Binding: USCoreProcedureCodes (7.0.0) (required): Codes describing the type of Procedure ele-1: All FHIR elements must have a @value or children |
| subject |
SΣ | 1..1 | Reference(US Core Patient Profile(7.0.0)) | Who the procedure was performed on ele-1: All FHIR elements must have a @value or children |
| encounter |
SΣ | 0..1 | Reference(US Core Encounter Profile(7.0.0)) | Encounter associated with the procedure ele-1: All FHIR elements must have a @value or children |
| performed[x] |
SΣC | 0..1 | When the procedure was performed ele-1: All FHIR elements must have a @value or children | |
| performedDateTime |
dateTime | |||
| reasonCode |
Σ | 0..* | CodeableConcept | Coded reason procedure performed Binding: USCoreConditionCodes (7.0.0) (extensible) ele-1: All FHIR elements must have a @value or children |
| Slices for reasonReference |
Σ | 0..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) | The justification that the procedure was performed Slice: Unordered, Open by profile:resolve() ele-1: All FHIR elements must have a @value or children |
| reasonReference:SupportedReasonReference |
SΣ | 0..* | Reference(SDOHCC Condition | SDOHCC Observation Screening Response | SDOHCC Observation Assessment) | The justification that the procedure was performed ele-1: All FHIR elements must have a @value or children |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| Procedure.status | required | EventStatushttp://hl7.org/fhir/ValueSet/event-statusfrom the FHIR Standard | |
| Procedure.category | example | ProcedureCategoryCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-categoryfrom the FHIR Standard | |
| Procedure.category.coding:SDOHCC | required | SDOHCCValueSetSDOHCategoryhttp://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategoryfrom this IG | |
| Procedure.code | required | USCoreProcedureCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code|7.0.0 | |
| Procedure.reasonCode | extensible | USCoreConditionCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0 |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | Procedure | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | 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 | error | 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 | error | Procedure | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Procedure | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| us-core-7 | error | Procedure | Performed SHALL be present if the status is 'completed' or 'in-progress' : (status='completed' or status='in-progress') implies performed.exists() |
Differential View
This structure is derived from Procedure
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Procedure |
C | 0..* | Procedure | An action that is being or was performed on a patient us-core-7: Performed SHALL be present if the status is 'completed' or 'in-progress' |
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:pertainsToGoal |
S | 0..* | (Complex) | Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal |
| value[x] |
S | 1..1 | Reference(SDOHCC Goal) | Value of extension |
| Slices for basedOn |
S | 0..* | Reference(CarePlan | ServiceRequest) | A request for this procedure Slice: Unordered, Open by profile:resolve() |
| basedOn:SupportedBasedOn |
S | 0..* | Reference(SDOHCC ServiceRequest | US Core CarePlan Profile(7.0.0)) | An SDOH service request or US Core Care Plan for this procedure |
| status |
SC | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required) |
| category |
0..1 | CodeableConcept | Classification of the procedure | |
| Slices for coding |
S | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this |
| coding:SDOHCC |
S | 0..1 | Coding | e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories. |
| code |
S | 1..1 | CodeableConcept | Identification of the procedure Binding: USCoreProcedureCodes (7.0.0) (required): Codes describing the type of Procedure |
| subject |
S | 1..1 | Reference(US Core Patient Profile(7.0.0)) | Who the procedure was performed on |
| encounter |
S | 0..1 | Reference(US Core Encounter Profile(7.0.0)) | Encounter associated with the procedure |
| performed[x] |
SC | 0..1 | When the procedure was performed | |
| performedDateTime |
dateTime S | |||
| performedPeriod |
Period | |||
| performedString |
string | |||
| performedAge |
Age | |||
| performedRange |
Range | |||
| reasonCode |
0..* | CodeableConcept | Coded reason procedure performed Binding: USCoreConditionCodes (7.0.0) (extensible) | |
| Slices for reasonReference |
0..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) | The justification that the procedure was performed Slice: Unordered, Open by profile:resolve() | |
| reasonReference:SupportedReasonReference |
S | 0..* | Reference(SDOHCC Condition | SDOHCC Observation Screening Response | SDOHCC Observation Assessment) | The justification that the procedure was performed |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| Procedure.status | required | EventStatushttp://hl7.org/fhir/ValueSet/event-statusfrom the FHIR Standard | |
| Procedure.category.coding:SDOHCC | required | SDOHCCValueSetSDOHCategoryhttp://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategoryfrom this IG | |
| Procedure.code | required | USCoreProcedureCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code|7.0.0 | |
| Procedure.reasonCode | extensible | USCoreConditionCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0 |
| Id | Grade | Path(s) | Details | Requirements |
| us-core-7 | error | Procedure | Performed SHALL be present if the status is 'completed' or 'in-progress' : (status='completed' or status='in-progress') implies performed.exists() |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| Procedure |
C | 0..* | Procedure | An action that is being or was performed on a patient us-core-7: Performed SHALL be present if the status is 'completed' or 'in-progress' | ||||
| id |
Σ | 0..1 | id | 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): A human language.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
| extension:pertainsToGoal |
S | 0..* | (Complex) | Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal | ||||
| id |
0..1 | id | Unique id for inter-element referencing | |||||
| extension |
0..0 | |||||||
| url |
1..1 | uri | "http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal" | |||||
| value[x] |
S | 1..1 | Reference(SDOHCC Goal) | Value of extension | ||||
| 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 | ||||
| Slices for basedOn |
SΣ | 0..* | Reference(CarePlan | ServiceRequest) | A request for this procedure Slice: Unordered, Open by profile:resolve() | ||||
| basedOn:SupportedBasedOn |
SΣ | 0..* | Reference(SDOHCC ServiceRequest | US Core CarePlan Profile(7.0.0)) | An SDOH service request or US Core Care Plan for this procedure | ||||
| partOf |
Σ | 0..* | Reference(Procedure | Observation | MedicationAdministration) | Part of referenced event | ||||
| status |
?!SΣC | 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. | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| Slices for coding |
SΣ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this | ||||
| coding:SDOHCC |
SΣ | 0..1 | Coding | e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories. | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| code |
SΣ | 1..1 | CodeableConcept | Identification of the procedure Binding: USCoreProcedureCodes (7.0.0) (required): Codes describing the type of Procedure | ||||
| subject |
SΣ | 1..1 | Reference(US Core Patient Profile(7.0.0)) | Who the procedure was performed on | ||||
| encounter |
SΣ | 0..1 | Reference(US Core Encounter Profile(7.0.0)) | Encounter associated with the procedure | ||||
| performed[x] |
SΣC | 0..1 | When the procedure was performed | |||||
| performedDateTime |
dateTime S | |||||||
| performedPeriod |
Period | |||||||
| performedString |
string | |||||||
| performedAge |
Age | |||||||
| performedRange |
Range | |||||||
| 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 |
Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | The reference to the practitioner | ||||
| onBehalfOf |
0..1 | Reference(Organization) | 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: USCoreConditionCodes (7.0.0) (extensible) | ||||
| Slices for reasonReference |
Σ | 0..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) | The justification that the procedure was performed Slice: Unordered, Open by profile:resolve() | ||||
| reasonReference:SupportedReasonReference |
SΣ | 0..* | Reference(SDOHCC Condition | SDOHCC Observation Screening Response | SDOHCC Observation Assessment) | 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 | ||||||||
| Path | Conformance | ValueSet | URI | |||
| Procedure.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard
| ||||
| Procedure.status | required | EventStatushttp://hl7.org/fhir/ValueSet/event-statusfrom the FHIR Standard | ||||
| Procedure.statusReason | example | ProcedureNotPerformedReason(SNOMED-CT)http://hl7.org/fhir/ValueSet/procedure-not-performed-reasonfrom the FHIR Standard | ||||
| Procedure.category | example | ProcedureCategoryCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-categoryfrom the FHIR Standard | ||||
| Procedure.category.coding:SDOHCC | required | SDOHCCValueSetSDOHCategoryhttp://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategoryfrom this IG | ||||
| Procedure.code | required | USCoreProcedureCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code|7.0.0 | ||||
| Procedure.performer.function | example | ProcedurePerformerRoleCodeshttp://hl7.org/fhir/ValueSet/performer-rolefrom the FHIR Standard | ||||
| Procedure.reasonCode | extensible | USCoreConditionCodeshttp://hl7.org/fhir/us/core/ValueSet/us-core-condition-code|7.0.0 | ||||
| Procedure.bodySite | example | SNOMEDCTBodyStructureshttp://hl7.org/fhir/ValueSet/body-sitefrom the FHIR Standard | ||||
| Procedure.outcome | example | ProcedureOutcomeCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-outcomefrom the FHIR Standard | ||||
| Procedure.complication | example | Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-codefrom the FHIR Standard | ||||
| Procedure.followUp | example | ProcedureFollowUpCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-followupfrom the FHIR Standard | ||||
| Procedure.focalDevice.action | preferred | ProcedureDeviceActionCodeshttp://hl7.org/fhir/ValueSet/device-actionfrom the FHIR Standard | ||||
| Procedure.usedCode | example | FHIRDeviceTypeshttp://hl7.org/fhir/ValueSet/device-kindfrom the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | Procedure | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | 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 | error | 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 | error | Procedure | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Procedure | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| us-core-7 | error | Procedure | Performed SHALL be present if the status is 'completed' or 'in-progress' : (status='completed' or status='in-progress') implies performed.exists() |
This structure is derived from Procedure
Summary
Mandatory: 1 element
Must-Support: 12 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
Maturity: 2
Other representations of profile: CSV, Excel, Schematron
IG © 2021+ HL7 International / Patient Care. Package hl7.fhir.us.sdoh-clinicalcare#2.3.0 based on FHIR 4.0.1. Generated 2025-05-15
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