Nictiz FHIR NL STU3 Zib2017
1.3.15 - CI Build

Nictiz FHIR NL STU3 Zib2017 - Local Development build (v1.3.15) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Zib FreedomRestrictingMeasures - Detailed Descriptions

Active as of 2024-04-09

Definitions for the zib-FreedomRestrictingMeasures resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Procedure
Definition

Root concept of the FreedomRestrictingMeasures information model. This root concept contains all data elements of the FreedomRestrictingMeasures information model.

ShortProcedure
Alternate NamesVrijheidsbeperkendeMaatregelen
2. Procedure.extension
SlicingThis element introduces a set of slices on Procedure.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Procedure.extension:legalStatus
    Slice NamelegalStatus
    Definition

    The legal situation that applies to the patient during the intervention.

    ShortLegalStatus
    TypeExtension(Patient LegalSatus) (Extension Type: CodeableConcept)
    Alternate NamesJuridischeStatus
    6. Procedure.extension:legalStatus.valueCodeableConcept:valueCodeableConcept
    Slice NamevalueCodeableConcept
    Control1..?
    8. Procedure.extension:legalStatus.valueCodeableConcept:valueCodeableConcept.coding
    Control1..?
    10. Procedure.extension:legalStatus.valueCodeableConcept:valueCodeableConcept.coding.system
    Control1..?
    12. Procedure.extension:legalStatus.valueCodeableConcept:valueCodeableConcept.coding.code
    Control1..?
    14. Procedure.extension:legallyCapable
    Slice NamelegallyCapable
    TypeExtension(HCIM FreedomRestrictingMeasures LegallyCapable) (Complex Extension)
    16. Procedure.extension:legallyCapable.extension:LegallyCapableIndicator
    Slice NameLegallyCapableIndicator
    Definition

    Indicator stating whether the patient is deemed capable of overseeing the consequences of a certain procedure, situation or decision.

    ShortLegallyCapableIndicator
    Alternate NamesWilsbekwaam
    18. Procedure.extension:legallyCapable.extension:LegallyCapableComment
    Slice NameLegallyCapableComment
    Alternate NamesWilsbekwaamToelichting
    20. Procedure.extension:permission
    Slice Namepermission
    TypeExtension(HCIM FreedomrestrictingMeasures Permission) (Extension Type: CodeableConcept)
    22. Procedure.extension:permission.valueCodeableConcept:valueCodeableConcept
    Slice NamevalueCodeableConcept
    Control1..?
    24. Procedure.extension:permission.valueCodeableConcept:valueCodeableConcept.coding
    Control1..?
    SlicingThis element introduces a set of slices on Procedure.extension.valueCodeableConcept.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • value @ code
    • 26. Procedure.extension:permission.valueCodeableConcept:valueCodeableConcept.coding:ArgusPermissionCode
      Slice NameArgusPermissionCode
      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from ArgusInstemmingCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.5--20171231000000)

      ArgusInstemmingCodelijst

      28. Procedure.extension:permission.valueCodeableConcept:valueCodeableConcept.coding:ArgusPermissionCode.system
      Control1..?
      30. Procedure.extension:permission.valueCodeableConcept:valueCodeableConcept.coding:ArgusPermissionCode.code
      Control1..?
      32. Procedure.extension:permission.valueCodeableConcept:valueCodeableConcept.coding:permissionCode
      Slice NamepermissionCode
      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from ToestemmingCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.1--20171231000000)

      ToestemmingCodelijst

      34. Procedure.extension:permission.valueCodeableConcept:valueCodeableConcept.coding:permissionCode.system
      Control1..?
      36. Procedure.extension:permission.valueCodeableConcept:valueCodeableConcept.coding:permissionCode.code
      Control1..?
      38. Procedure.identifier
      NoteThis is a business identifier, not a resource identifier (see discussion)
      40. Procedure.category
      Control1..?
      42. Procedure.category.coding
      Control1..?
      SlicingThis element introduces a set of slices on Procedure.category.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • value @ code
      • 44. Procedure.category.coding:freedomRestrictingMeasuresCode
        Slice NamefreedomRestrictingMeasuresCode
        Control1..1
        46. Procedure.category.coding:freedomRestrictingMeasuresCode.system
        Control1..?
        Fixed Valuehttp://snomed.info/sct
        48. Procedure.category.coding:freedomRestrictingMeasuresCode.code
        Control1..?
        Fixed Value225214000
        50. Procedure.category.coding:freedomRestrictingMeasuresCode.display
        Default ValueProcedures relating to control, restraint, seclusion and segregation (procedure)
        52. Procedure.code
        Control1..?
        54. Procedure.code.coding
        Control1..?
        SlicingThis element introduces a set of slices on Procedure.code.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • value @ code
        • 56. Procedure.code.coding:typeOfInterventionCode
          Slice NametypeOfInterventionCode
          Control0..1
          BindingUnless not suitable, these codes SHALL be taken from SoortInterventieCodelijst
          (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.3--20171231000000)

          TypeOfInterventionCodelist

          58. Procedure.code.coding:typeOfInterventionCode.system
          Control1..?
          60. Procedure.code.coding:typeOfInterventionCode.code
          Control1..?
          62. Procedure.code.coding:argusTypeOfInterventionCode
          Slice NameargusTypeOfInterventionCode
          Control0..1
          BindingUnless not suitable, these codes SHALL be taken from ArgusInterventieCodelijst
          (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.4--20171231000000)

          ArgusTypeOfInterventionCodelist

          64. Procedure.code.coding:argusTypeOfInterventionCode.system
          Control1..?
          66. Procedure.code.coding:argusTypeOfInterventionCode.code
          Control1..?
          68. Procedure.subject
          TypeReference(Group, nl-core-patient)
          70. Procedure.performedPeriod:performedPeriod
          Slice NameperformedPeriod
          TypePeriod
          72. Procedure.performedPeriod:performedPeriod.start
          Definition

          The date and time at which the restraints started

          ShortStartEpisode
          Alternate NamesAanvangEpisode
          74. Procedure.performedPeriod:performedPeriod.end
          Definition

          The date and time at which the restraints ended.

          ShortEndOfEpisode
          Alternate NamesEindeEpisode

          Guidance on how to interpret the contents of this table can be found here

          0. Procedure
          Definition

          Root concept of the FreedomRestrictingMeasures information model. This root concept contains all data elements of the FreedomRestrictingMeasures information model.


          An action that is or was performed on a patient. This can be a physical intervention like an operation, or less invasive like counseling or hypnotherapy.

          ShortProcedureAn action that is being or was performed on a patient
          Control0..*
          Alternate NamesVrijheidsbeperkendeMaatregelen
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
          dom-4: 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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
          pro-1: Reason not done is only permitted if notDone indicator is true (notDoneReason.empty() or notDone = true)
          dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
          dom-4: 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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
          pro-1: Reason not done is only permitted if notDone indicator is true (notDoneReason.empty() or notDone = true)
          2. Procedure.implicitRules
          Definition

          A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

          ShortA set of rules under which this content was created
          Comments

          Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

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

          Control0..1
          Typeuri
          Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          4. Procedure.extension
          Definition

          An Extension


          May be used to represent additional information that is not part of the basic definition of the resource. 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.

          ShortExtensionAdditional Content defined by implementations
          Comments

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

          Control0..*
          TypeExtension
          Alternate Namesextensions, user content
          SlicingThis element introduces a set of slices on Procedure.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 6. Procedure.extension:legalStatus
            Slice NamelegalStatus
            Definition

            The legal situation that applies to the patient during the intervention.

            ShortLegalStatus
            Comments

            The concept LegalStatus of the Zib FreedomRestrictingMeasures plays an importand role in the context of mental healthcare (GGZ). This concept will become an independent Zib with the next release of Zibs (2018 release).

            The LegalStatus concept and associated valueset will be split in two concepts: legalstatus and representative. These concept are currently captured in one valueset. It is possible to have a legalstatus AND a representative. Therefore, we allow this extension to have a cardinality of 0..2.

            Control0..2
            This element is affected by the following invariants: ele-1
            TypeExtension(Patient LegalSatus) (Extension Type: CodeableConcept)
            Alternate NamesJuridischeStatus
            8. Procedure.extension:legalStatus.url
            Definition

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

            Shortidentifies the meaning of the extension
            Comments

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

            Control1..1
            Typeuri
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-patient-legalstatus
            10. Procedure.extension:legalStatus.value[x]
            Definition

            Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

            ShortValue of extension
            Control0..1
            TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            SlicingThis element introduces a set of slices on Procedure.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
            • type @ $this
            • 12. Procedure.extension:legalStatus.value[x]:valueCodeableConcept
              Slice NamevalueCodeableConcept
              Definition

              The legal situation that applies to the patient during the intervention. The code of the legal status is based on the Vektis/AZR code list COD232-VEKT Legal Status.


              Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

              ShortLegalStatusValue of extension
              Control10..1
              BindingUnless not suitable, these codes SHALL be taken from For codes, see JuridischeStatusCodelijst
              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.2--20171231000000)
              TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
              [x] NoteSee Choice of Data Types for further information about how to use [x]
              Alternate NamesJuridischeStatus
              14. Procedure.extension:legalStatus.value[x]:valueCodeableConcept.coding
              Definition

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              Comments

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

              Control10..*
              TypeCoding
              Summarytrue
              Requirements

              Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

              16. Procedure.extension:legalStatus.value[x]:valueCodeableConcept.coding.system
              Definition

              The identification of the code system that defines the meaning of the symbol in the code.

              ShortIdentity of the terminology system
              Comments

              The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

              Control10..1
              Typeuri
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Need to be unambiguous about the source of the definition of the symbol.

              18. Procedure.extension:legalStatus.value[x]:valueCodeableConcept.coding.code
              Definition

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

              ShortSymbol in syntax defined by the system
              Control10..1
              Typecode
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Need to refer to a particular code in the system.

              20. Procedure.extension:legallyCapable
              Slice NamelegallyCapable
              Definition

              Indicator stating whether the patient is deemed capable of overseeing the consequences of a certain procedure, situation or decision.

              ShortLegallyCapable
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(HCIM FreedomRestrictingMeasures LegallyCapable) (Complex Extension)
              22. Procedure.extension:legallyCapable.extension
              Definition

              An Extension


              May be used to represent additional information that is not part of the basic definition of the element. 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.

              ShortExtensionAdditional Content defined by implementations
              Comments

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

              Control10..*
              TypeExtension
              Alternate Namesextensions, user content
              SlicingThis element introduces a set of slices on Procedure.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 24. Procedure.extension:legallyCapable.extension:LegallyCapableIndicator
                Slice NameLegallyCapableIndicator
                Definition

                Indicator stating whether the patient is deemed capable of overseeing the consequences of a certain procedure, situation or decision.

                ShortLegallyCapableIndicatorAdditional Content defined by implementations
                Control10..1*
                TypeExtension
                Alternate NamesWilsbekwaam
                26. Procedure.extension:legallyCapable.extension:LegallyCapableIndicator.url
                Definition

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

                Shortidentifies the meaning of the extension
                Comments

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

                Control1..1
                Typeuri
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed ValueLegallyCapableIndicator
                28. Procedure.extension:legallyCapable.extension:LegallyCapableIndicator.value[x]
                Definition

                Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                ShortValue of extension
                Control0..1
                Typeboolean, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
                [x] NoteSee Choice of Data Types for further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                SlicingThis element introduces a set of slices on Procedure.extension.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                • type @ $this
                • 30. Procedure.extension:legallyCapable.extension:LegallyCapableIndicator.value[x]:valueBoolean
                  Slice NamevalueBoolean
                  Definition

                  Indicator stating whether the patient is deemed capable of overseeing the consequences of a certain procedure, situation or decision.


                  Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                  ShortLegallyCapableValue of extension
                  Control0..1
                  Typeboolean, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
                  [x] NoteSee Choice of Data Types for further information about how to use [x]
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Alternate NamesWilsbekwaam
                  32. Procedure.extension:legallyCapable.extension:LegallyCapableComment
                  Slice NameLegallyCapableComment
                  Definition

                  An Extension

                  ShortExtensionAdditional Content defined by implementations
                  Control0..1*
                  TypeExtension
                  Alternate NamesWilsbekwaamToelichting
                  34. Procedure.extension:legallyCapable.extension:LegallyCapableComment.url
                  Definition

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

                  Shortidentifies the meaning of the extension
                  Comments

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

                  Control1..1
                  Typeuri
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Fixed ValueLegallyCapableComment
                  36. Procedure.extension:legallyCapable.extension:LegallyCapableComment.value[x]
                  Definition

                  Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                  ShortValue of extension
                  Control0..1
                  Typestring, date, dateTime, Meta, code, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
                  [x] NoteSee Choice of Data Types for further information about how to use [x]
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  SlicingThis element introduces a set of slices on Procedure.extension.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                  • type @ $this
                  • 38. Procedure.extension:legallyCapable.extension:LegallyCapableComment.value[x]:valueString
                    Slice NamevalueString
                    Definition

                    Comment on the decisions which the patient is legally capable of making.


                    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                    ShortLegallyCapableCommentValue of extension
                    Control0..1
                    Typestring, date, dateTime, Meta, code, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Alternate NamesWilsbekwaamToelichting
                    40. Procedure.extension:legallyCapable.url
                    Definition

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

                    Shortidentifies the meaning of the extension
                    Comments

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

                    Control1..1
                    Typeuri
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-FreedomRestrictingMeasures-LegallyCapable
                    42. Procedure.extension:legallyCapable.value[x]
                    Definition

                    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                    ShortValue of extension
                    Control0..01
                    TypeChoice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    44. Procedure.extension:permission
                    Slice Namepermission
                    Definition

                    The permission given to the health professional(s) by the patient or legal representative to implement medical restraints.

                    ShortPermission
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(HCIM FreedomrestrictingMeasures Permission) (Extension Type: CodeableConcept)
                    Alternate NamesToestemming
                    46. Procedure.extension:permission.url
                    Definition

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

                    Shortidentifies the meaning of the extension
                    Comments

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

                    Control1..1
                    Typeuri
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-FreedomRestrictingMeasures-Permission
                    48. Procedure.extension:permission.value[x]
                    Definition

                    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                    ShortValue of extension
                    Control0..1
                    TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                    SlicingThis element introduces a set of slices on Procedure.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                    • type @ $this
                    • 50. Procedure.extension:permission.value[x]:valueCodeableConcept
                      Slice NamevalueCodeableConcept
                      Definition

                      The legal situation that applies to the patient during the intervention. The code of the legal status is based on the Vektis/AZR code list COD232-VEKT Legal Status.


                      Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                      ShortPermissionValue of extension
                      Control10..1
                      TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
                      [x] NoteSee Choice of Data Types for further information about how to use [x]
                      52. Procedure.extension:permission.value[x]:valueCodeableConcept.coding
                      Definition

                      A reference to a code defined by a terminology system.

                      ShortCode defined by a terminology system
                      Comments

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

                      Control10..*
                      TypeCoding
                      Summarytrue
                      Requirements

                      Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                      SlicingThis element introduces a set of slices on Procedure.extension.value[x].coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
                      • value @ code
                      • 54. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:ArgusPermissionCode
                        Slice NameArgusPermissionCode
                        Definition

                        A reference to a code defined by a terminology system.

                        ShortCode defined by a terminology system
                        Comments

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

                        Control0..1*
                        BindingUnless not suitable, these codes SHALL be taken from For codes, see ArgusInstemmingCodelijst
                        (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.5--20171231000000)

                        ArgusInstemmingCodelijst

                        TypeCoding
                        Summarytrue
                        Requirements

                        Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                        56. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:ArgusPermissionCode.system
                        Definition

                        The identification of the code system that defines the meaning of the symbol in the code.

                        ShortIdentity of the terminology system
                        Comments

                        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

                        Control10..1
                        Typeuri
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Need to be unambiguous about the source of the definition of the symbol.

                        58. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:ArgusPermissionCode.code
                        Definition

                        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                        ShortSymbol in syntax defined by the system
                        Control10..1
                        Typecode
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Need to refer to a particular code in the system.

                        60. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:permissionCode
                        Slice NamepermissionCode
                        Definition

                        A reference to a code defined by a terminology system.

                        ShortCode defined by a terminology system
                        Comments

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

                        Control0..1*
                        BindingUnless not suitable, these codes SHALL be taken from For codes, see ToestemmingCodelijst
                        (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.1--20171231000000)

                        ToestemmingCodelijst

                        TypeCoding
                        Summarytrue
                        Requirements

                        Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                        62. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:permissionCode.system
                        Definition

                        The identification of the code system that defines the meaning of the symbol in the code.

                        ShortIdentity of the terminology system
                        Comments

                        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

                        Control10..1
                        Typeuri
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Need to be unambiguous about the source of the definition of the symbol.

                        64. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:permissionCode.code
                        Definition

                        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                        ShortSymbol in syntax defined by the system
                        Control10..1
                        Typecode
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Need to refer to a particular code in the system.

                        66. Procedure.modifierExtension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. 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.

                        ShortExtensions that cannot be ignored
                        Comments

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

                        Control0..*
                        TypeExtension
                        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                        Alternate Namesextensions, user content
                        68. Procedure.identifier
                        Definition

                        This records identifiers associated with this procedure that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).

                        ShortExternal Identifiers for this procedure
                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control0..*
                        TypeIdentifier
                        Summarytrue
                        Requirements

                        Need to allow connection to a wider workflow.

                        70. Procedure.status
                        Definition

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

                        Shortpreparation | in-progress | suspended | aborted | completed | entered-in-error | unknown
                        Comments

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

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

                        Control1..1
                        BindingThe codes SHALL be taken from EventStatushttp://hl7.org/fhir/ValueSet/event-status
                        (required to http://hl7.org/fhir/ValueSet/event-status)

                        A code specifying the state of the procedure.

                        Typecode
                        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        72. Procedure.notDone
                        Definition

                        Set this to true if the record is saying that the procedure was NOT performed.

                        ShortTrue if procedure was not performed as scheduled
                        Comments

                        If true, it means the procedure did not occur as described. Typically it would be accompanied by attributes describing the type of activity. It might also be accompanied by body site information or time information (i.e. no procedure was done to the left arm or no procedure was done in this 2-year period). Specifying additional information such as performer, outcome, etc. is generally inappropriate. For example, it's not that useful to say "There was no appendectomy done at 12:03pm June 6th by Dr. Smith with a successful outcome" as it implies that there could have been an appendectomy done at any other time, by any other clinician or with any other outcome.

                        This element is labeled as a modifier because it indicates that a procedure didn't happen.

                        Control0..1
                        Typeboolean
                        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Default Valuefalse
                        74. Procedure.category
                        Definition

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

                        ShortClassification of the procedure
                        Control10..1
                        BindingFor example codes, see Procedure Category Codes (SNOMED CT)http://hl7.org/fhir/ValueSet/procedure-category
                        (example to http://hl7.org/fhir/ValueSet/procedure-category)

                        A code that classifies a procedure for searching, sorting and display purposes.

                        TypeCodeableConcept
                        Summarytrue
                        76. Procedure.category.coding
                        Definition

                        A reference to a code defined by a terminology system.

                        ShortCode defined by a terminology system
                        Comments

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

                        Control10..*
                        TypeCoding
                        Summarytrue
                        Requirements

                        Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                        SlicingThis element introduces a set of slices on Procedure.category.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
                        • value @ code
                        • 78. Procedure.category.coding:freedomRestrictingMeasuresCode
                          Slice NamefreedomRestrictingMeasuresCode
                          Definition

                          A reference to a code defined by a terminology system.

                          ShortCode defined by a terminology system
                          Comments

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

                          Control10..1*
                          TypeCoding
                          Summarytrue
                          Requirements

                          Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                          80. Procedure.category.coding:freedomRestrictingMeasuresCode.system
                          Definition

                          The identification of the code system that defines the meaning of the symbol in the code.

                          ShortIdentity of the terminology system
                          Comments

                          The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

                          Control10..1
                          Typeuri
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Need to be unambiguous about the source of the definition of the symbol.

                          Fixed Valuehttp://snomed.info/sct
                          82. Procedure.category.coding:freedomRestrictingMeasuresCode.code
                          Definition

                          A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                          ShortSymbol in syntax defined by the system
                          Control10..1
                          Typecode
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Need to refer to a particular code in the system.

                          Fixed Value225214000
                          84. Procedure.category.coding:freedomRestrictingMeasuresCode.display
                          Definition

                          A representation of the meaning of the code in the system, following the rules of the system.

                          ShortRepresentation defined by the system
                          Control0..1
                          Typestring
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                          86. Procedure.code
                          Definition

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

                          ShortIdentification of the procedure
                          Control10..1
                          BindingFor example codes, see Procedure Codes (SNOMED CT)http://hl7.org/fhir/ValueSet/procedure-code
                          (example to http://hl7.org/fhir/ValueSet/procedure-code)

                          A code to identify a specific procedure .

                          TypeCodeableConcept
                          Summarytrue
                          Requirements

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

                          Alternate Namestype
                          88. Procedure.code.coding
                          Definition

                          A reference to a code defined by a terminology system.

                          ShortCode defined by a terminology system
                          Comments

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

                          Control10..*
                          TypeCoding
                          Summarytrue
                          Requirements

                          Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                          SlicingThis element introduces a set of slices on Procedure.code.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
                          • value @ code
                          • 90. Procedure.code.coding:typeOfInterventionCode
                            Slice NametypeOfInterventionCode
                            Definition

                            A reference to a code defined by a terminology system.

                            ShortCode defined by a terminology system
                            Comments

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

                            Control0..1*
                            BindingUnless not suitable, these codes SHALL be taken from For codes, see SoortInterventieCodelijst
                            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.3--20171231000000)

                            TypeOfInterventionCodelist

                            TypeCoding
                            Summarytrue
                            Requirements

                            Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                            92. Procedure.code.coding:typeOfInterventionCode.system
                            Definition

                            The identification of the code system that defines the meaning of the symbol in the code.

                            ShortIdentity of the terminology system
                            Comments

                            The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

                            Control10..1
                            Typeuri
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need to be unambiguous about the source of the definition of the symbol.

                            94. Procedure.code.coding:typeOfInterventionCode.code
                            Definition

                            A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                            ShortSymbol in syntax defined by the system
                            Control10..1
                            Typecode
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need to refer to a particular code in the system.

                            96. Procedure.code.coding:argusTypeOfInterventionCode
                            Slice NameargusTypeOfInterventionCode
                            Definition

                            A reference to a code defined by a terminology system.

                            ShortCode defined by a terminology system
                            Comments

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

                            Control0..1*
                            BindingUnless not suitable, these codes SHALL be taken from For codes, see ArgusInterventieCodelijst
                            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.4--20171231000000)

                            ArgusTypeOfInterventionCodelist

                            TypeCoding
                            Summarytrue
                            Requirements

                            Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                            98. Procedure.code.coding:argusTypeOfInterventionCode.system
                            Definition

                            The identification of the code system that defines the meaning of the symbol in the code.

                            ShortIdentity of the terminology system
                            Comments

                            The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

                            Control10..1
                            Typeuri
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need to be unambiguous about the source of the definition of the symbol.

                            100. Procedure.code.coding:argusTypeOfInterventionCode.code
                            Definition

                            A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                            ShortSymbol in syntax defined by the system
                            Control10..1
                            Typecode
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need to refer to a particular code in the system.

                            102. Procedure.subject
                            Definition

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

                            ShortWho the procedure was performed on
                            Control1..1
                            TypeReference(Group, nl-core-patient, Patient)
                            Summarytrue
                            Alternate Namespatient
                            104. Procedure.performed[x]
                            Definition

                            The date(time)/period over which the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.

                            ShortDate/Period the procedure was performed
                            Control0..1
                            TypePeriod, dateTime
                            [x] NoteSee Choice of Data Types for further information about how to use [x]
                            Summarytrue
                            SlicingThis element introduces a set of slices on Procedure.performed[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                            • type @ $this
                            • 106. Procedure.performed[x]:performedPeriod
                              Slice NameperformedPeriod
                              Definition

                              The date(time)/period over which the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.

                              ShortDate/Period the procedure was performed
                              Control0..1
                              TypePeriod, dateTime
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Summarytrue

                              Guidance on how to interpret the contents of this table can be found here

                              0. Procedure
                              Definition

                              Root concept of the FreedomRestrictingMeasures information model. This root concept contains all data elements of the FreedomRestrictingMeasures information model.

                              ShortProcedure
                              Control0..*
                              Alternate NamesVrijheidsbeperkendeMaatregelen
                              Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                              dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
                              dom-4: 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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
                              pro-1: Reason not done is only permitted if notDone indicator is true (notDoneReason.empty() or notDone = true)
                              2. Procedure.id
                              Definition

                              The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                              ShortLogical id of this artifact
                              Comments

                              The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                              Control0..1
                              Typeid
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              4. Procedure.meta
                              Definition

                              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.

                              ShortMetadata about the resource
                              Control0..1
                              TypeMeta
                              Summarytrue
                              6. Procedure.implicitRules
                              Definition

                              A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

                              ShortA set of rules under which this content was created
                              Comments

                              Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

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

                              Control0..1
                              Typeuri
                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              8. Procedure.language
                              Definition

                              The base language in which the resource is written.

                              ShortLanguage of the resource content
                              Comments

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

                              Control0..1
                              BindingUnless not suitable, these codes SHALL be taken from Common Languages
                              (extensible to http://hl7.org/fhir/ValueSet/languages)

                              A human language.

                              Additional BindingsPurpose
                              AllLanguagesMax Binding
                              Typecode
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              10. Procedure.text
                              Definition

                              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.

                              ShortText summary of the resource, for human interpretation
                              Comments

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

                              Control0..1
                              This element is affected by the following invariants: dom-1
                              TypeNarrative
                              Alternate Namesnarrative, html, xhtml, display
                              12. Procedure.contained
                              Definition

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

                              ShortContained, inline Resources
                              Comments

                              This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

                              Control0..*
                              TypeResource
                              Alternate Namesinline resources, anonymous resources, contained resources
                              14. Procedure.extension
                              Definition

                              An Extension

                              ShortExtension
                              Control0..*
                              TypeExtension
                              SlicingThis element introduces a set of slices on Procedure.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 16. Procedure.extension:legalStatus
                                Slice NamelegalStatus
                                Definition

                                The legal situation that applies to the patient during the intervention.

                                ShortLegalStatus
                                Comments

                                The concept LegalStatus of the Zib FreedomRestrictingMeasures plays an importand role in the context of mental healthcare (GGZ). This concept will become an independent Zib with the next release of Zibs (2018 release).

                                The LegalStatus concept and associated valueset will be split in two concepts: legalstatus and representative. These concept are currently captured in one valueset. It is possible to have a legalstatus AND a representative. Therefore, we allow this extension to have a cardinality of 0..2.

                                Control0..2
                                This element is affected by the following invariants: ele-1
                                TypeExtension(Patient LegalSatus) (Extension Type: CodeableConcept)
                                Alternate NamesJuridischeStatus
                                18. Procedure.extension:legalStatus.id
                                Definition

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

                                Shortxml:id (or equivalent in JSON)
                                Control0..1
                                Typestring
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                XML FormatIn the XML format, this property is represented as an attribute.
                                20. Procedure.extension:legalStatus.extension
                                Definition

                                May be used to represent additional information that is not part of the basic definition of the element. 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.

                                ShortAdditional Content defined by implementations
                                Comments

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

                                Control0..*
                                TypeExtension
                                Alternate Namesextensions, user content
                                SlicingThis element introduces a set of slices on Procedure.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 22. Procedure.extension:legalStatus.url
                                  Definition

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

                                  Shortidentifies the meaning of the extension
                                  Comments

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

                                  Control1..1
                                  Typeuri
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-patient-legalstatus
                                  24. Procedure.extension:legalStatus.value[x]
                                  Definition

                                  Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                  ShortValue of extension
                                  Control0..1
                                  TypeCodeableConcept
                                  [x] NoteSee Choice of Data Types for further information about how to use [x]
                                  SlicingThis element introduces a set of slices on Procedure.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                                  • type @ $this
                                  • 26. Procedure.extension:legalStatus.value[x]:valueCodeableConcept
                                    Slice NamevalueCodeableConcept
                                    Definition

                                    The legal situation that applies to the patient during the intervention. The code of the legal status is based on the Vektis/AZR code list COD232-VEKT Legal Status.

                                    ShortLegalStatus
                                    Control1..1
                                    BindingUnless not suitable, these codes SHALL be taken from JuridischeStatusCodelijst
                                    (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.2--20171231000000)
                                    TypeCodeableConcept
                                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                                    Alternate NamesJuridischeStatus
                                    28. Procedure.extension:legalStatus.value[x]:valueCodeableConcept.id
                                    Definition

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

                                    Shortxml:id (or equivalent in JSON)
                                    Control0..1
                                    Typestring
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    30. Procedure.extension:legalStatus.value[x]:valueCodeableConcept.extension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element. 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.

                                    ShortAdditional Content defined by implementations
                                    Comments

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

                                    Control0..*
                                    TypeExtension
                                    Alternate Namesextensions, user content
                                    SlicingThis element introduces a set of slices on Procedure.extension.value[x].extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 32. Procedure.extension:legalStatus.value[x]:valueCodeableConcept.coding
                                      Definition

                                      A reference to a code defined by a terminology system.

                                      ShortCode defined by a terminology system
                                      Comments

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

                                      Control1..*
                                      TypeCoding
                                      Summarytrue
                                      Requirements

                                      Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                      34. Procedure.extension:legalStatus.value[x]:valueCodeableConcept.coding.id
                                      Definition

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

                                      Shortxml:id (or equivalent in JSON)
                                      Control0..1
                                      Typestring
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      36. Procedure.extension:legalStatus.value[x]:valueCodeableConcept.coding.extension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element. 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.

                                      ShortAdditional Content defined by implementations
                                      Comments

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

                                      Control0..*
                                      TypeExtension
                                      Alternate Namesextensions, user content
                                      SlicingThis element introduces a set of slices on Procedure.extension.value[x].coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 38. Procedure.extension:legalStatus.value[x]:valueCodeableConcept.coding.system
                                        Definition

                                        The identification of the code system that defines the meaning of the symbol in the code.

                                        ShortIdentity of the terminology system
                                        Comments

                                        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

                                        Control1..1
                                        Typeuri
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        Need to be unambiguous about the source of the definition of the symbol.

                                        40. Procedure.extension:legalStatus.value[x]:valueCodeableConcept.coding.version
                                        Definition

                                        The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                        ShortVersion of the system - if relevant
                                        Comments

                                        Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                        NoteThis is a business versionId, not a resource version id (see discussion)
                                        Control0..1
                                        Typestring
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        42. Procedure.extension:legalStatus.value[x]:valueCodeableConcept.coding.code
                                        Definition

                                        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                        ShortSymbol in syntax defined by the system
                                        Control1..1
                                        Typecode
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        Need to refer to a particular code in the system.

                                        44. Procedure.extension:legalStatus.value[x]:valueCodeableConcept.coding.display
                                        Definition

                                        A representation of the meaning of the code in the system, following the rules of the system.

                                        ShortRepresentation defined by the system
                                        Control0..1
                                        Typestring
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                        46. Procedure.extension:legalStatus.value[x]:valueCodeableConcept.coding.userSelected
                                        Definition

                                        Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                                        ShortIf this coding was chosen directly by the user
                                        Comments

                                        Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                        Control0..1
                                        Typeboolean
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                        48. Procedure.extension:legalStatus.value[x]:valueCodeableConcept.text
                                        Definition

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

                                        ShortPlain text representation of the concept
                                        Comments

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

                                        Control0..1
                                        Typestring
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

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

                                        50. Procedure.extension:legallyCapable
                                        Slice NamelegallyCapable
                                        Definition

                                        Indicator stating whether the patient is deemed capable of overseeing the consequences of a certain procedure, situation or decision.

                                        ShortLegallyCapable
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension(HCIM FreedomRestrictingMeasures LegallyCapable) (Complex Extension)
                                        52. Procedure.extension:legallyCapable.id
                                        Definition

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

                                        Shortxml:id (or equivalent in JSON)
                                        Control0..1
                                        Typestring
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        54. Procedure.extension:legallyCapable.extension
                                        Definition

                                        An Extension

                                        ShortExtension
                                        Control1..*
                                        TypeExtension
                                        SlicingThis element introduces a set of slices on Procedure.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 56. Procedure.extension:legallyCapable.extension:LegallyCapableIndicator
                                          Slice NameLegallyCapableIndicator
                                          Definition

                                          Indicator stating whether the patient is deemed capable of overseeing the consequences of a certain procedure, situation or decision.

                                          ShortLegallyCapableIndicator
                                          Control1..1
                                          TypeExtension
                                          Alternate NamesWilsbekwaam
                                          58. Procedure.extension:legallyCapable.extension:LegallyCapableIndicator.id
                                          Definition

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

                                          Shortxml:id (or equivalent in JSON)
                                          Control0..1
                                          Typestring
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          60. Procedure.extension:legallyCapable.extension:LegallyCapableIndicator.extension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element. 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.

                                          ShortAdditional Content defined by implementations
                                          Comments

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

                                          Control0..*
                                          TypeExtension
                                          Alternate Namesextensions, user content
                                          SlicingThis element introduces a set of slices on Procedure.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 62. Procedure.extension:legallyCapable.extension:LegallyCapableIndicator.url
                                            Definition

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

                                            Shortidentifies the meaning of the extension
                                            Comments

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

                                            Control1..1
                                            Typeuri
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Fixed ValueLegallyCapableIndicator
                                            64. Procedure.extension:legallyCapable.extension:LegallyCapableIndicator.value[x]
                                            Definition

                                            Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                            ShortValue of extension
                                            Control0..1
                                            Typeboolean
                                            [x] NoteSee Choice of Data Types for further information about how to use [x]
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            SlicingThis element introduces a set of slices on Procedure.extension.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                                            • type @ $this
                                            • 66. Procedure.extension:legallyCapable.extension:LegallyCapableIndicator.value[x]:valueBoolean
                                              Slice NamevalueBoolean
                                              Definition

                                              Indicator stating whether the patient is deemed capable of overseeing the consequences of a certain procedure, situation or decision.

                                              ShortLegallyCapable
                                              Control0..1
                                              Typeboolean
                                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Alternate NamesWilsbekwaam
                                              68. Procedure.extension:legallyCapable.extension:LegallyCapableComment
                                              Slice NameLegallyCapableComment
                                              Definition

                                              An Extension

                                              ShortExtension
                                              Control0..1
                                              TypeExtension
                                              Alternate NamesWilsbekwaamToelichting
                                              70. Procedure.extension:legallyCapable.extension:LegallyCapableComment.id
                                              Definition

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

                                              Shortxml:id (or equivalent in JSON)
                                              Control0..1
                                              Typestring
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              72. Procedure.extension:legallyCapable.extension:LegallyCapableComment.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element. 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.

                                              ShortAdditional Content defined by implementations
                                              Comments

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

                                              Control0..*
                                              TypeExtension
                                              Alternate Namesextensions, user content
                                              SlicingThis element introduces a set of slices on Procedure.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 74. Procedure.extension:legallyCapable.extension:LegallyCapableComment.url
                                                Definition

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

                                                Shortidentifies the meaning of the extension
                                                Comments

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

                                                Control1..1
                                                Typeuri
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Fixed ValueLegallyCapableComment
                                                76. Procedure.extension:legallyCapable.extension:LegallyCapableComment.value[x]
                                                Definition

                                                Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                ShortValue of extension
                                                Control0..1
                                                Typestring
                                                [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                SlicingThis element introduces a set of slices on Procedure.extension.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                                                • type @ $this
                                                • 78. Procedure.extension:legallyCapable.extension:LegallyCapableComment.value[x]:valueString
                                                  Slice NamevalueString
                                                  Definition

                                                  Comment on the decisions which the patient is legally capable of making.

                                                  ShortLegallyCapableComment
                                                  Control0..1
                                                  Typestring
                                                  [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Alternate NamesWilsbekwaamToelichting
                                                  80. Procedure.extension:legallyCapable.url
                                                  Definition

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

                                                  Shortidentifies the meaning of the extension
                                                  Comments

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

                                                  Control1..1
                                                  Typeuri
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-FreedomRestrictingMeasures-LegallyCapable
                                                  82. Procedure.extension:legallyCapable.value[x]
                                                  Definition

                                                  Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                  ShortValue of extension
                                                  Control0..0
                                                  TypeChoice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  84. Procedure.extension:permission
                                                  Slice Namepermission
                                                  Definition

                                                  The permission given to the health professional(s) by the patient or legal representative to implement medical restraints.

                                                  ShortPermission
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypeExtension(HCIM FreedomrestrictingMeasures Permission) (Extension Type: CodeableConcept)
                                                  Alternate NamesToestemming
                                                  86. Procedure.extension:permission.id
                                                  Definition

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

                                                  Shortxml:id (or equivalent in JSON)
                                                  Control0..1
                                                  Typestring
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  88. Procedure.extension:permission.extension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element. 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.

                                                  ShortAdditional Content defined by implementations
                                                  Comments

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

                                                  Control0..*
                                                  TypeExtension
                                                  Alternate Namesextensions, user content
                                                  SlicingThis element introduces a set of slices on Procedure.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 90. Procedure.extension:permission.url
                                                    Definition

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

                                                    Shortidentifies the meaning of the extension
                                                    Comments

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

                                                    Control1..1
                                                    Typeuri
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-FreedomRestrictingMeasures-Permission
                                                    92. Procedure.extension:permission.value[x]
                                                    Definition

                                                    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                    ShortValue of extension
                                                    Control0..1
                                                    TypeCodeableConcept
                                                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                    SlicingThis element introduces a set of slices on Procedure.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                                                    • type @ $this
                                                    • 94. Procedure.extension:permission.value[x]:valueCodeableConcept
                                                      Slice NamevalueCodeableConcept
                                                      Definition

                                                      The legal situation that applies to the patient during the intervention. The code of the legal status is based on the Vektis/AZR code list COD232-VEKT Legal Status.

                                                      ShortPermission
                                                      Control1..1
                                                      TypeCodeableConcept
                                                      [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                      96. Procedure.extension:permission.value[x]:valueCodeableConcept.id
                                                      Definition

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

                                                      Shortxml:id (or equivalent in JSON)
                                                      Control0..1
                                                      Typestring
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      98. Procedure.extension:permission.value[x]:valueCodeableConcept.extension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element. 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.

                                                      ShortAdditional Content defined by implementations
                                                      Comments

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

                                                      Control0..*
                                                      TypeExtension
                                                      Alternate Namesextensions, user content
                                                      SlicingThis element introduces a set of slices on Procedure.extension.value[x].extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 100. Procedure.extension:permission.value[x]:valueCodeableConcept.coding
                                                        Definition

                                                        A reference to a code defined by a terminology system.

                                                        ShortCode defined by a terminology system
                                                        Comments

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

                                                        Control1..*
                                                        TypeCoding
                                                        Summarytrue
                                                        Requirements

                                                        Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                        SlicingThis element introduces a set of slices on Procedure.extension.value[x].coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ code
                                                        • 102. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:ArgusPermissionCode
                                                          Slice NameArgusPermissionCode
                                                          Definition

                                                          A reference to a code defined by a terminology system.

                                                          ShortCode defined by a terminology system
                                                          Comments

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

                                                          Control0..1
                                                          BindingUnless not suitable, these codes SHALL be taken from ArgusInstemmingCodelijst
                                                          (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.5--20171231000000)

                                                          ArgusInstemmingCodelijst

                                                          TypeCoding
                                                          Summarytrue
                                                          Requirements

                                                          Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                          104. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:ArgusPermissionCode.id
                                                          Definition

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

                                                          Shortxml:id (or equivalent in JSON)
                                                          Control0..1
                                                          Typestring
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          106. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:ArgusPermissionCode.extension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element. 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.

                                                          ShortAdditional Content defined by implementations
                                                          Comments

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

                                                          Control0..*
                                                          TypeExtension
                                                          Alternate Namesextensions, user content
                                                          SlicingThis element introduces a set of slices on Procedure.extension.value[x].coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 108. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:ArgusPermissionCode.system
                                                            Definition

                                                            The identification of the code system that defines the meaning of the symbol in the code.

                                                            ShortIdentity of the terminology system
                                                            Comments

                                                            The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

                                                            Control1..1
                                                            Typeuri
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Requirements

                                                            Need to be unambiguous about the source of the definition of the symbol.

                                                            110. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:ArgusPermissionCode.version
                                                            Definition

                                                            The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                            ShortVersion of the system - if relevant
                                                            Comments

                                                            Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                            NoteThis is a business versionId, not a resource version id (see discussion)
                                                            Control0..1
                                                            Typestring
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            112. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:ArgusPermissionCode.code
                                                            Definition

                                                            A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                            ShortSymbol in syntax defined by the system
                                                            Control1..1
                                                            Typecode
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Requirements

                                                            Need to refer to a particular code in the system.

                                                            114. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:ArgusPermissionCode.display
                                                            Definition

                                                            A representation of the meaning of the code in the system, following the rules of the system.

                                                            ShortRepresentation defined by the system
                                                            Control0..1
                                                            Typestring
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Requirements

                                                            Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                            116. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:ArgusPermissionCode.userSelected
                                                            Definition

                                                            Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                                                            ShortIf this coding was chosen directly by the user
                                                            Comments

                                                            Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                            Control0..1
                                                            Typeboolean
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Requirements

                                                            This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                                            118. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:permissionCode
                                                            Slice NamepermissionCode
                                                            Definition

                                                            A reference to a code defined by a terminology system.

                                                            ShortCode defined by a terminology system
                                                            Comments

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

                                                            Control0..1
                                                            BindingUnless not suitable, these codes SHALL be taken from ToestemmingCodelijst
                                                            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.1--20171231000000)

                                                            ToestemmingCodelijst

                                                            TypeCoding
                                                            Summarytrue
                                                            Requirements

                                                            Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                            120. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:permissionCode.id
                                                            Definition

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

                                                            Shortxml:id (or equivalent in JSON)
                                                            Control0..1
                                                            Typestring
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            122. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:permissionCode.extension
                                                            Definition

                                                            May be used to represent additional information that is not part of the basic definition of the element. 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.

                                                            ShortAdditional Content defined by implementations
                                                            Comments

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

                                                            Control0..*
                                                            TypeExtension
                                                            Alternate Namesextensions, user content
                                                            SlicingThis element introduces a set of slices on Procedure.extension.value[x].coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 124. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:permissionCode.system
                                                              Definition

                                                              The identification of the code system that defines the meaning of the symbol in the code.

                                                              ShortIdentity of the terminology system
                                                              Comments

                                                              The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

                                                              Control1..1
                                                              Typeuri
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Requirements

                                                              Need to be unambiguous about the source of the definition of the symbol.

                                                              126. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:permissionCode.version
                                                              Definition

                                                              The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                              ShortVersion of the system - if relevant
                                                              Comments

                                                              Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                              NoteThis is a business versionId, not a resource version id (see discussion)
                                                              Control0..1
                                                              Typestring
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              128. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:permissionCode.code
                                                              Definition

                                                              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                              ShortSymbol in syntax defined by the system
                                                              Control1..1
                                                              Typecode
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Requirements

                                                              Need to refer to a particular code in the system.

                                                              130. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:permissionCode.display
                                                              Definition

                                                              A representation of the meaning of the code in the system, following the rules of the system.

                                                              ShortRepresentation defined by the system
                                                              Control0..1
                                                              Typestring
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Requirements

                                                              Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                              132. Procedure.extension:permission.value[x]:valueCodeableConcept.coding:permissionCode.userSelected
                                                              Definition

                                                              Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                                                              ShortIf this coding was chosen directly by the user
                                                              Comments

                                                              Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                              Control0..1
                                                              Typeboolean
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Requirements

                                                              This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                                              134. Procedure.extension:permission.value[x]:valueCodeableConcept.text
                                                              Definition

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

                                                              ShortPlain text representation of the concept
                                                              Comments

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

                                                              Control0..1
                                                              Typestring
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Requirements

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

                                                              136. Procedure.modifierExtension
                                                              Definition

                                                              May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. 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.

                                                              ShortExtensions that cannot be ignored
                                                              Comments

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

                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                              Alternate Namesextensions, user content
                                                              138. Procedure.identifier
                                                              Definition

                                                              This records identifiers associated with this procedure that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).

                                                              ShortExternal Identifiers for this procedure
                                                              NoteThis is a business identifier, not a resource identifier (see discussion)
                                                              Control0..*
                                                              TypeIdentifier
                                                              Summarytrue
                                                              Requirements

                                                              Need to allow connection to a wider workflow.

                                                              140. Procedure.definition
                                                              Definition

                                                              A protocol, guideline, orderset or other definition that was adhered to in whole or in part by this procedure.

                                                              ShortInstantiates protocol or definition
                                                              Control0..*
                                                              TypeReference(PlanDefinition, ActivityDefinition, HealthcareService)
                                                              Summarytrue
                                                              142. Procedure.basedOn
                                                              Definition

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

                                                              ShortA request for this procedure
                                                              Control0..*
                                                              TypeReference(CarePlan, ProcedureRequest, ReferralRequest)
                                                              Summarytrue
                                                              Alternate Namesfulfills
                                                              144. Procedure.partOf
                                                              Definition

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

                                                              ShortPart of referenced event
                                                              Comments

                                                              The MedicationAdministration has a partOf reference to Procedure, but this is not a circular reference. For a surgical procedure, the anesthesia related medicationAdministration is part of the procedure. For an IV medication administration, the procedure to insert the IV port is part of the medication administration.

                                                              Control0..*
                                                              TypeReference(Procedure, Observation, MedicationAdministration)
                                                              Summarytrue
                                                              Alternate Namescontainer
                                                              146. Procedure.status
                                                              Definition

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

                                                              Shortpreparation | in-progress | suspended | aborted | completed | entered-in-error | unknown
                                                              Comments

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

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

                                                              Control1..1
                                                              BindingThe codes SHALL be taken from EventStatus
                                                              (required to http://hl7.org/fhir/ValueSet/event-status)

                                                              A code specifying the state of the procedure.

                                                              Typecode
                                                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              148. Procedure.notDone
                                                              Definition

                                                              Set this to true if the record is saying that the procedure was NOT performed.

                                                              ShortTrue if procedure was not performed as scheduled
                                                              Comments

                                                              If true, it means the procedure did not occur as described. Typically it would be accompanied by attributes describing the type of activity. It might also be accompanied by body site information or time information (i.e. no procedure was done to the left arm or no procedure was done in this 2-year period). Specifying additional information such as performer, outcome, etc. is generally inappropriate. For example, it's not that useful to say "There was no appendectomy done at 12:03pm June 6th by Dr. Smith with a successful outcome" as it implies that there could have been an appendectomy done at any other time, by any other clinician or with any other outcome.

                                                              This element is labeled as a modifier because it indicates that a procedure didn't happen.

                                                              Control0..1
                                                              Typeboolean
                                                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Default Valuefalse
                                                              150. Procedure.notDoneReason
                                                              Definition

                                                              A code indicating why the procedure was not performed.

                                                              ShortReason procedure was not performed
                                                              Control0..1
                                                              This element is affected by the following invariants: pro-1
                                                              BindingFor example codes, see Procedure Not Performed Reason (SNOMED-CT)
                                                              (example to http://hl7.org/fhir/ValueSet/procedure-not-performed-reason)

                                                              A code that identifies the reason a procedure was not performed.

                                                              TypeCodeableConcept
                                                              Summarytrue
                                                              152. Procedure.category
                                                              Definition

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

                                                              ShortClassification of the procedure
                                                              Control1..1
                                                              BindingFor example codes, see Procedure Category Codes (SNOMED CT)
                                                              (example to http://hl7.org/fhir/ValueSet/procedure-category)

                                                              A code that classifies a procedure for searching, sorting and display purposes.

                                                              TypeCodeableConcept
                                                              Summarytrue
                                                              154. Procedure.category.id
                                                              Definition

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

                                                              Shortxml:id (or equivalent in JSON)
                                                              Control0..1
                                                              Typestring
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              156. Procedure.category.extension
                                                              Definition

                                                              May be used to represent additional information that is not part of the basic definition of the element. 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.

                                                              ShortAdditional Content defined by implementations
                                                              Comments

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

                                                              Control0..*
                                                              TypeExtension
                                                              Alternate Namesextensions, user content
                                                              SlicingThis element introduces a set of slices on Procedure.category.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 158. Procedure.category.coding
                                                                Definition

                                                                A reference to a code defined by a terminology system.

                                                                ShortCode defined by a terminology system
                                                                Comments

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

                                                                Control1..*
                                                                TypeCoding
                                                                Summarytrue
                                                                Requirements

                                                                Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                                SlicingThis element introduces a set of slices on Procedure.category.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ code
                                                                • 160. Procedure.category.coding:freedomRestrictingMeasuresCode
                                                                  Slice NamefreedomRestrictingMeasuresCode
                                                                  Definition

                                                                  A reference to a code defined by a terminology system.

                                                                  ShortCode defined by a terminology system
                                                                  Comments

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

                                                                  Control1..1
                                                                  TypeCoding
                                                                  Summarytrue
                                                                  Requirements

                                                                  Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                                  162. Procedure.category.coding:freedomRestrictingMeasuresCode.id
                                                                  Definition

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

                                                                  Shortxml:id (or equivalent in JSON)
                                                                  Control0..1
                                                                  Typestring
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  164. Procedure.category.coding:freedomRestrictingMeasuresCode.extension
                                                                  Definition

                                                                  May be used to represent additional information that is not part of the basic definition of the element. 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.

                                                                  ShortAdditional Content defined by implementations
                                                                  Comments

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

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Alternate Namesextensions, user content
                                                                  SlicingThis element introduces a set of slices on Procedure.category.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ url
                                                                  • 166. Procedure.category.coding:freedomRestrictingMeasuresCode.system
                                                                    Definition

                                                                    The identification of the code system that defines the meaning of the symbol in the code.

                                                                    ShortIdentity of the terminology system
                                                                    Comments

                                                                    The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

                                                                    Control1..1
                                                                    Typeuri
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Requirements

                                                                    Need to be unambiguous about the source of the definition of the symbol.

                                                                    Fixed Valuehttp://snomed.info/sct
                                                                    168. Procedure.category.coding:freedomRestrictingMeasuresCode.version
                                                                    Definition

                                                                    The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                                    ShortVersion of the system - if relevant
                                                                    Comments

                                                                    Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                                    NoteThis is a business versionId, not a resource version id (see discussion)
                                                                    Control0..1
                                                                    Typestring
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    170. Procedure.category.coding:freedomRestrictingMeasuresCode.code
                                                                    Definition

                                                                    A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                                    ShortSymbol in syntax defined by the system
                                                                    Control1..1
                                                                    Typecode
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Requirements

                                                                    Need to refer to a particular code in the system.

                                                                    Fixed Value225214000
                                                                    172. Procedure.category.coding:freedomRestrictingMeasuresCode.display
                                                                    Definition

                                                                    A representation of the meaning of the code in the system, following the rules of the system.

                                                                    ShortRepresentation defined by the system
                                                                    Control0..1
                                                                    Typestring
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Requirements

                                                                    Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                    174. Procedure.category.coding:freedomRestrictingMeasuresCode.userSelected
                                                                    Definition

                                                                    Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                                                                    ShortIf this coding was chosen directly by the user
                                                                    Comments

                                                                    Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                                    Control0..1
                                                                    Typeboolean
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Requirements

                                                                    This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                                                    176. Procedure.category.text
                                                                    Definition

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

                                                                    ShortPlain text representation of the concept
                                                                    Comments

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

                                                                    Control0..1
                                                                    Typestring
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Requirements

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

                                                                    178. Procedure.code
                                                                    Definition

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

                                                                    ShortIdentification of the procedure
                                                                    Control1..1
                                                                    BindingFor example codes, see Procedure Codes (SNOMED CT)
                                                                    (example to http://hl7.org/fhir/ValueSet/procedure-code)

                                                                    A code to identify a specific procedure .

                                                                    TypeCodeableConcept
                                                                    Summarytrue
                                                                    Requirements

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

                                                                    Alternate Namestype
                                                                    180. Procedure.code.id
                                                                    Definition

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

                                                                    Shortxml:id (or equivalent in JSON)
                                                                    Control0..1
                                                                    Typestring
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    182. Procedure.code.extension
                                                                    Definition

                                                                    May be used to represent additional information that is not part of the basic definition of the element. 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.

                                                                    ShortAdditional Content defined by implementations
                                                                    Comments

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

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Alternate Namesextensions, user content
                                                                    SlicingThis element introduces a set of slices on Procedure.code.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                    • value @ url
                                                                    • 184. Procedure.code.coding
                                                                      Definition

                                                                      A reference to a code defined by a terminology system.

                                                                      ShortCode defined by a terminology system
                                                                      Comments

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

                                                                      Control1..*
                                                                      TypeCoding
                                                                      Summarytrue
                                                                      Requirements

                                                                      Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                                      SlicingThis element introduces a set of slices on Procedure.code.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                      • value @ code
                                                                      • 186. Procedure.code.coding:typeOfInterventionCode
                                                                        Slice NametypeOfInterventionCode
                                                                        Definition

                                                                        A reference to a code defined by a terminology system.

                                                                        ShortCode defined by a terminology system
                                                                        Comments

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

                                                                        Control0..1
                                                                        BindingUnless not suitable, these codes SHALL be taken from SoortInterventieCodelijst
                                                                        (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.3--20171231000000)

                                                                        TypeOfInterventionCodelist

                                                                        TypeCoding
                                                                        Summarytrue
                                                                        Requirements

                                                                        Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                                        188. Procedure.code.coding:typeOfInterventionCode.id
                                                                        Definition

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

                                                                        Shortxml:id (or equivalent in JSON)
                                                                        Control0..1
                                                                        Typestring
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        190. Procedure.code.coding:typeOfInterventionCode.extension
                                                                        Definition

                                                                        May be used to represent additional information that is not part of the basic definition of the element. 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.

                                                                        ShortAdditional Content defined by implementations
                                                                        Comments

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

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Alternate Namesextensions, user content
                                                                        SlicingThis element introduces a set of slices on Procedure.code.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ url
                                                                        • 192. Procedure.code.coding:typeOfInterventionCode.system
                                                                          Definition

                                                                          The identification of the code system that defines the meaning of the symbol in the code.

                                                                          ShortIdentity of the terminology system
                                                                          Comments

                                                                          The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

                                                                          Control1..1
                                                                          Typeuri
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          Need to be unambiguous about the source of the definition of the symbol.

                                                                          194. Procedure.code.coding:typeOfInterventionCode.version
                                                                          Definition

                                                                          The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                                          ShortVersion of the system - if relevant
                                                                          Comments

                                                                          Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                                          NoteThis is a business versionId, not a resource version id (see discussion)
                                                                          Control0..1
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          196. Procedure.code.coding:typeOfInterventionCode.code
                                                                          Definition

                                                                          A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                                          ShortSymbol in syntax defined by the system
                                                                          Control1..1
                                                                          Typecode
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          Need to refer to a particular code in the system.

                                                                          198. Procedure.code.coding:typeOfInterventionCode.display
                                                                          Definition

                                                                          A representation of the meaning of the code in the system, following the rules of the system.

                                                                          ShortRepresentation defined by the system
                                                                          Control0..1
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                          200. Procedure.code.coding:typeOfInterventionCode.userSelected
                                                                          Definition

                                                                          Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                                                                          ShortIf this coding was chosen directly by the user
                                                                          Comments

                                                                          Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                                          Control0..1
                                                                          Typeboolean
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                                                          202. Procedure.code.coding:argusTypeOfInterventionCode
                                                                          Slice NameargusTypeOfInterventionCode
                                                                          Definition

                                                                          A reference to a code defined by a terminology system.

                                                                          ShortCode defined by a terminology system
                                                                          Comments

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

                                                                          Control0..1
                                                                          BindingUnless not suitable, these codes SHALL be taken from ArgusInterventieCodelijst
                                                                          (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.3.4--20171231000000)

                                                                          ArgusTypeOfInterventionCodelist

                                                                          TypeCoding
                                                                          Summarytrue
                                                                          Requirements

                                                                          Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                                          204. Procedure.code.coding:argusTypeOfInterventionCode.id
                                                                          Definition

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

                                                                          Shortxml:id (or equivalent in JSON)
                                                                          Control0..1
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          206. Procedure.code.coding:argusTypeOfInterventionCode.extension
                                                                          Definition

                                                                          May be used to represent additional information that is not part of the basic definition of the element. 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.

                                                                          ShortAdditional Content defined by implementations
                                                                          Comments

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

                                                                          Control0..*
                                                                          TypeExtension
                                                                          Alternate Namesextensions, user content
                                                                          SlicingThis element introduces a set of slices on Procedure.code.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 208. Procedure.code.coding:argusTypeOfInterventionCode.system
                                                                            Definition

                                                                            The identification of the code system that defines the meaning of the symbol in the code.

                                                                            ShortIdentity of the terminology system
                                                                            Comments

                                                                            The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

                                                                            Control1..1
                                                                            Typeuri
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Requirements

                                                                            Need to be unambiguous about the source of the definition of the symbol.

                                                                            210. Procedure.code.coding:argusTypeOfInterventionCode.version
                                                                            Definition

                                                                            The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                                            ShortVersion of the system - if relevant
                                                                            Comments

                                                                            Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                                            NoteThis is a business versionId, not a resource version id (see discussion)
                                                                            Control0..1
                                                                            Typestring
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            212. Procedure.code.coding:argusTypeOfInterventionCode.code
                                                                            Definition

                                                                            A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                                            ShortSymbol in syntax defined by the system
                                                                            Control1..1
                                                                            Typecode
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Requirements

                                                                            Need to refer to a particular code in the system.

                                                                            214. Procedure.code.coding:argusTypeOfInterventionCode.display
                                                                            Definition

                                                                            A representation of the meaning of the code in the system, following the rules of the system.

                                                                            ShortRepresentation defined by the system
                                                                            Control0..1
                                                                            Typestring
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Requirements

                                                                            Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                            216. Procedure.code.coding:argusTypeOfInterventionCode.userSelected
                                                                            Definition

                                                                            Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                                                                            ShortIf this coding was chosen directly by the user
                                                                            Comments

                                                                            Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                                                            Control0..1
                                                                            Typeboolean
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Requirements

                                                                            This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                                                            218. Procedure.code.text
                                                                            Definition

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

                                                                            ShortPlain text representation of the concept
                                                                            Comments

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

                                                                            Control0..1
                                                                            Typestring
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Requirements

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

                                                                            220. Procedure.subject
                                                                            Definition

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

                                                                            ShortWho the procedure was performed on
                                                                            Control1..1
                                                                            TypeReference(Group, nl-core-patient)
                                                                            Summarytrue
                                                                            Alternate Namespatient
                                                                            222. Procedure.context
                                                                            Definition

                                                                            The encounter during which the procedure was performed.

                                                                            ShortEncounter or episode associated with the procedure
                                                                            Control0..1
                                                                            TypeReference(Encounter, EpisodeOfCare)
                                                                            Summarytrue
                                                                            Alternate Namesencounter
                                                                            224. Procedure.performed[x]
                                                                            Definition

                                                                            The date(time)/period over which the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.

                                                                            ShortDate/Period the procedure was performed
                                                                            Control0..1
                                                                            TypePeriod
                                                                            [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                                            Summarytrue
                                                                            SlicingThis element introduces a set of slices on Procedure.performed[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                                                                            • type @ $this
                                                                            • 226. Procedure.performed[x]:performedPeriod
                                                                              Slice NameperformedPeriod
                                                                              Definition

                                                                              The date(time)/period over which the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.

                                                                              ShortDate/Period the procedure was performed
                                                                              Control0..1
                                                                              TypePeriod
                                                                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                                              Summarytrue
                                                                              228. Procedure.performed[x]:performedPeriod.id
                                                                              Definition

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

                                                                              Shortxml:id (or equivalent in JSON)
                                                                              Control0..1
                                                                              Typestring
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              230. Procedure.performed[x]:performedPeriod.extension
                                                                              Definition

                                                                              May be used to represent additional information that is not part of the basic definition of the element. 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.

                                                                              ShortAdditional Content defined by implementations
                                                                              Comments

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

                                                                              Control0..*
                                                                              TypeExtension
                                                                              Alternate Namesextensions, user content
                                                                              SlicingThis element introduces a set of slices on Procedure.performed[x].extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 232. Procedure.performed[x]:performedPeriod.start
                                                                                Definition

                                                                                The date and time at which the restraints started

                                                                                ShortStartEpisode
                                                                                Comments

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

                                                                                Control0..1
                                                                                This element is affected by the following invariants: per-1
                                                                                TypedateTime
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summarytrue
                                                                                Alternate NamesAanvangEpisode
                                                                                234. Procedure.performed[x]:performedPeriod.end
                                                                                Definition

                                                                                The date and time at which the restraints ended.

                                                                                ShortEndOfEpisode
                                                                                Comments

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

                                                                                Control0..1
                                                                                This element is affected by the following invariants: per-1
                                                                                TypedateTime
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summarytrue
                                                                                Alternate NamesEindeEpisode
                                                                                Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                                                                236. Procedure.performer
                                                                                Definition

                                                                                Limited to 'real' people rather than equipment.

                                                                                ShortThe people who performed the procedure
                                                                                Control0..*
                                                                                TypeBackboneElement
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                                238. Procedure.performer.id
                                                                                Definition

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

                                                                                Shortxml:id (or equivalent in JSON)
                                                                                Control0..1
                                                                                Typestring
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                240. Procedure.performer.extension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element. 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.

                                                                                ShortAdditional Content defined by implementations
                                                                                Comments

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

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Alternate Namesextensions, user content
                                                                                242. Procedure.performer.modifierExtension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element 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.

                                                                                ShortExtensions that cannot be ignored
                                                                                Comments

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

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                                                Summarytrue
                                                                                Alternate Namesextensions, user content, modifiers
                                                                                244. Procedure.performer.role
                                                                                Definition

                                                                                For example: surgeon, anaethetist, endoscopist.

                                                                                ShortThe role the actor was in
                                                                                Control0..1
                                                                                BindingFor example codes, see Procedure Performer Role Codes
                                                                                (example to http://hl7.org/fhir/ValueSet/performer-role)

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

                                                                                TypeCodeableConcept
                                                                                Summarytrue
                                                                                246. Procedure.performer.actor
                                                                                Definition

                                                                                The practitioner who was involved in the procedure.

                                                                                ShortThe reference to the practitioner
                                                                                Control1..1
                                                                                TypeReference(Practitioner, Organization, Patient, RelatedPerson, Device)
                                                                                Summarytrue
                                                                                Requirements

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

                                                                                248. Procedure.performer.onBehalfOf
                                                                                Definition

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

                                                                                ShortOrganization the device or practitioner was acting for
                                                                                Control0..1
                                                                                TypeReference(Organization)
                                                                                Requirements

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

                                                                                250. Procedure.location
                                                                                Definition

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

                                                                                ShortWhere the procedure happened
                                                                                Control0..1
                                                                                TypeReference(Location)
                                                                                Summarytrue
                                                                                Requirements

                                                                                Ties a procedure to where the records are likely kept.

                                                                                252. Procedure.reasonCode
                                                                                Definition

                                                                                The coded reason why the procedure was performed. This may be coded entity of some type, or may simply be present as text.

                                                                                ShortCoded reason procedure performed
                                                                                Control0..*
                                                                                BindingFor example codes, see Procedure Reason Codes
                                                                                (example to http://hl7.org/fhir/ValueSet/procedure-reason)

                                                                                A code that identifies the reason a procedure is required.

                                                                                TypeCodeableConcept
                                                                                Summarytrue
                                                                                254. Procedure.reasonReference
                                                                                Definition

                                                                                The condition that is the reason why the procedure was performed.

                                                                                ShortCondition that is the reason the procedure performed
                                                                                Comments

                                                                                e.g. endoscopy for dilatation and biopsy, combination diagnosis and therapeutic.

                                                                                Control0..*
                                                                                TypeReference(Condition, Observation)
                                                                                Summarytrue
                                                                                256. Procedure.bodySite
                                                                                Definition

                                                                                Detailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion.

                                                                                ShortTarget body sites
                                                                                Control0..*
                                                                                BindingFor example codes, see SNOMED CT Body Structures
                                                                                (example to http://hl7.org/fhir/ValueSet/body-site)

                                                                                Codes describing anatomical locations. May include laterality.

                                                                                TypeCodeableConcept
                                                                                Summarytrue
                                                                                258. Procedure.outcome
                                                                                Definition

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

                                                                                ShortThe result of procedure
                                                                                Comments

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

                                                                                Control0..1
                                                                                BindingFor example codes, see Procedure Outcome Codes (SNOMED CT)
                                                                                (example to http://hl7.org/fhir/ValueSet/procedure-outcome)

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

                                                                                TypeCodeableConcept
                                                                                Summarytrue
                                                                                260. Procedure.report
                                                                                Definition

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

                                                                                ShortAny report resulting from the procedure
                                                                                Comments

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

                                                                                Control0..*
                                                                                TypeReference(DiagnosticReport)
                                                                                262. Procedure.complication
                                                                                Definition

                                                                                Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues.

                                                                                ShortComplication following the procedure
                                                                                Comments

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

                                                                                Control0..*
                                                                                BindingFor example codes, see Condition/Problem/Diagnosis Codes
                                                                                (example to http://hl7.org/fhir/ValueSet/condition-code)

                                                                                Codes describing complications that resulted from a procedure.

                                                                                TypeCodeableConcept
                                                                                264. Procedure.complicationDetail
                                                                                Definition

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

                                                                                ShortA condition that is a result of the procedure
                                                                                Control0..*
                                                                                TypeReference(Condition)
                                                                                Requirements

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

                                                                                266. Procedure.followUp
                                                                                Definition

                                                                                If the procedure required specific follow up - e.g. removal of sutures. The followup may be represented as a simple note, or could potentially be more complex in which case the CarePlan resource can be used.

                                                                                ShortInstructions for follow up
                                                                                Control0..*
                                                                                BindingFor example codes, see Procedure Follow up Codes (SNOMED CT)
                                                                                (example to http://hl7.org/fhir/ValueSet/procedure-followup)

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

                                                                                TypeCodeableConcept
                                                                                268. Procedure.note
                                                                                Definition

                                                                                Any other notes about the procedure. E.g. the operative notes.

                                                                                ShortAdditional information about the procedure
                                                                                Control0..*
                                                                                TypeAnnotation
                                                                                270. Procedure.focalDevice
                                                                                Definition

                                                                                A device that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure.

                                                                                ShortDevice changed in procedure
                                                                                Control0..*
                                                                                TypeBackboneElement
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                                272. Procedure.focalDevice.id
                                                                                Definition

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

                                                                                Shortxml:id (or equivalent in JSON)
                                                                                Control0..1
                                                                                Typestring
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                274. Procedure.focalDevice.extension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element. 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.

                                                                                ShortAdditional Content defined by implementations
                                                                                Comments

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

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Alternate Namesextensions, user content
                                                                                276. Procedure.focalDevice.modifierExtension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element 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.

                                                                                ShortExtensions that cannot be ignored
                                                                                Comments

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

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                                                Summarytrue
                                                                                Alternate Namesextensions, user content, modifiers
                                                                                278. Procedure.focalDevice.action
                                                                                Definition

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

                                                                                ShortKind of change to device
                                                                                Control0..1
                                                                                BindingThe codes SHOULD be taken from Procedure Device Action Codes
                                                                                (preferred to http://hl7.org/fhir/ValueSet/device-action)

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

                                                                                TypeCodeableConcept
                                                                                280. Procedure.focalDevice.manipulated
                                                                                Definition

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

                                                                                ShortDevice that was changed
                                                                                Control1..1
                                                                                TypeReference(Device)
                                                                                282. Procedure.usedReference
                                                                                Definition

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

                                                                                ShortItems used during procedure
                                                                                Comments

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

                                                                                Control0..*
                                                                                TypeReference(Device, Medication, Substance)
                                                                                Requirements

                                                                                Used for tracking contamination, etc.

                                                                                284. Procedure.usedCode
                                                                                Definition

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

                                                                                ShortCoded items used during the procedure
                                                                                Comments

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

                                                                                Control0..*
                                                                                BindingFor example codes, see FHIR Device Types
                                                                                (example to http://hl7.org/fhir/ValueSet/device-kind)

                                                                                Codes describing items used during a procedure

                                                                                TypeCodeableConcept