This page is part of the Advance Care Planning (PZP) (v1.0.0-rc1: Release 1) based on FHIR (HL7® FHIR® Standard) R4. No current official version has been published yet. For a full list of available versions, see the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON
• TTL

Resource Profile: Advance Care Planning Procedure

Advance Care Planning procedure. Based on nl-core-Procedure-event profile and HCIM Procedure.

Usages:

• Examples for this Profile: Procedure/F1-ACP-Procedure-01-10-2020, Procedure/P2-ACP-Procedure-07-08-2025 and Procedure/P2-ACP-Procedure-28-07-2024

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure		0..*	NlcoreProcedureevent	Procedure
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
extension:procedureMethod		0..*	CodeableConcept	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-Procedure.ProcedureMethod Binding: VerrichtingMethodeCodelijst (required) Constraints: ext-1
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Slice: Unordered, Open by value:url Constraints: ext-1
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
code	OΣ	1..1	CodeableConcept	ProcedureType Binding: VerrichtingTypeCodelijsten (2020-09-01T00:00:00) (required): A code to identify a specific procedure . Required Pattern: At least the following Obligations Actor SHALL:populate-if-known ACP Actor Provider SHALL:no-error ACP Actor Consulter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 713603004
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	OΣC	1..1	Reference(Patient(1.0.0-rc1))	Who the procedure was performed on Constraints: ref-1 Obligations Actor SHALL:populate-if-known ACP Actor Provider SHALL:no-error ACP Actor Consulter
encounter	OΣC	0..1	Reference(Encounter(1.0.0-rc1))	Encounter created as part of Constraints: ref-1 Obligations Actor SHALL:populate-if-known ACP Actor Provider SHALL:no-error ACP Actor Consulter
Slices for performed[x]	Σ	0..1		When the procedure was performed Slice: Unordered, Open by type:$this
performedDateTime			dateTime
performedPeriod			Period
performedString			string
performedAge			Age
performedRange			Range
performed[x]:performedPeriod	Σ	0..1	Period	When the procedure was performed
start	ΣC	0..1	dateTime	ProcedureStartDate
end	ΣC	0..1	dateTime	ProcedureEndDate
performed[x]:performedDateTime	Σ	0..1	dateTime	ProcedureStartDate
bodySite	Σ	0..1	NlcoreAnatomicalLocation	Location Binding: LocatieCodelijsten (2020-09-01T00:00:00) (required): Codes describing anatomical locations. May include laterality.
Slices for report	C	0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Any report resulting from the procedure Slice: Unordered, Open by profile:resolve() Constraints: ref-1
report:textResult	C	0..*	Reference(nl core TextResult)	TextResult Constraints: ref-1
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 From the FHIR Standard
Procedure.code	required	Pattern Value: SNOMED-CT Code 713603004 http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.19--20200901000000|2020-09-01T00:00:00
Procedure.bodySite	required	LocatieCodelijsten http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.11--20200901000000|2020-09-01T00:00:00

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Procedure	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Procedure	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	Procedure.implicitRules, Procedure.extension:procedureMethod, Procedure.modifierExtension, Procedure.status, Procedure.code, Procedure.subject, Procedure.encounter, Procedure.performed[x], Procedure.performed[x]:performedPeriod, Procedure.performed[x]:performedPeriod.start, Procedure.performed[x]:performedPeriod.end, Procedure.performed[x]:performedDateTime, Procedure.bodySite, Procedure.report, Procedure.report:textResult	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	Procedure.extension:procedureMethod, Procedure.modifierExtension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ref-1	error	Procedure.subject, Procedure.encounter, Procedure.report, Procedure.report:textResult	SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

This structure is derived from NlcoreProcedureevent

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure		0..*	NlcoreProcedureevent	Procedure
code	O	1..1	CodeableConcept	ProcedureType Required Pattern: At least the following Obligations Actor SHALL:populate-if-known ACP Actor Provider SHALL:no-error ACP Actor Consulter
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 713603004
subject	O	1..1	Reference(Patient(1.0.0-rc1))	Who the procedure was performed on Obligations Actor SHALL:populate-if-known ACP Actor Provider SHALL:no-error ACP Actor Consulter
encounter	O	0..1	Reference(Encounter(1.0.0-rc1))	Encounter created as part of Obligations Actor SHALL:populate-if-known ACP Actor Provider SHALL:no-error ACP Actor Consulter
performer
actor		1..1	Reference(HealthProfessional PractitionerRole(1.0.0-rc1) | ContactPerson(1.0.0-rc1) | Patient(1.0.0-rc1))	Performer
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure		0..*	NlcoreProcedureevent	Procedure
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
extension:procedureMethod		0..*	CodeableConcept	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-Procedure.ProcedureMethod Binding: VerrichtingMethodeCodelijst (required) Constraints: ext-1
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Slice: Unordered, Open by value:url Constraints: ext-1
identifier	Σ	0..*	Identifier	External Identifiers for this procedure
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	ΣC	0..*	Reference(CarePlan | ServiceRequest | nl core Procedure request)	A request for this procedure Constraints: ref-1
partOf	ΣC	0..*	Reference(Procedure | Observation | MedicationAdministration)	Part of referenced event Constraints: ref-1
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
statusReason	Σ	0..1	CodeableConcept	Reason for current status Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.
category	Σ	0..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes.
code	OΣ	1..1	CodeableConcept	ProcedureType Binding: VerrichtingTypeCodelijsten (2020-09-01T00:00:00) (required): A code to identify a specific procedure . Required Pattern: At least the following Obligations Actor SHALL:populate-if-known ACP Actor Provider SHALL:no-error ACP Actor Consulter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 713603004
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	OΣC	1..1	Reference(Patient(1.0.0-rc1))	Who the procedure was performed on Constraints: ref-1 Obligations Actor SHALL:populate-if-known ACP Actor Provider SHALL:no-error ACP Actor Consulter
encounter	OΣC	0..1	Reference(Encounter(1.0.0-rc1))	Encounter created as part of Constraints: ref-1 Obligations Actor SHALL:populate-if-known ACP Actor Provider SHALL:no-error ACP Actor Consulter
Slices for performed[x]	Σ	0..1		When the procedure was performed Slice: Unordered, Open by type:$this
performedDateTime			dateTime
performedPeriod			Period
performedString			string
performedAge			Age
performedRange			Range
performed[x]:performedPeriod	Σ	0..1	Period	When the procedure was performed
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
start	ΣC	0..1	dateTime	ProcedureStartDate
end	ΣC	0..1	dateTime	ProcedureEndDate
performed[x]:performedDateTime	Σ	0..1	dateTime	ProcedureStartDate
recorder	ΣC	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Who recorded the procedure Constraints: ref-1
asserter	ΣC	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Person who asserts this procedure Constraints: ref-1
performer	Σ	0..*	BackboneElement	The people who performed the procedure
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
actor	ΣC	1..1	Reference(HealthProfessional PractitionerRole(1.0.0-rc1) | ContactPerson(1.0.0-rc1) | Patient(1.0.0-rc1))	Performer Constraints: ref-1
onBehalfOf	C	0..1	Reference(Organization)	Organization the device or practitioner was acting for Constraints: ref-1
location	ΣC	0..1	Reference(Location | nl core HealthcareProvider)	Location Constraints: ref-1
reasonCode	Σ	0..*	CodeableConcept	Coded reason procedure performed Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required.
reasonReference	ΣC	0..*	Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference | nl core Problem)	Indication Constraints: ref-1
bodySite	Σ	0..1	NlcoreAnatomicalLocation	Location Binding: LocatieCodelijsten (2020-09-01T00:00:00) (required): Codes describing anatomical locations. May include laterality.
outcome	Σ	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
Slices for report	C	0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Any report resulting from the procedure Slice: Unordered, Open by profile:resolve() Constraints: ref-1
report:textResult	C	0..*	Reference(nl core TextResult)	TextResult Constraints: ref-1
complication		0..*	CodeableConcept	Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
complicationDetail	C	0..*	Reference(Condition)	A condition that is a result of the procedure Constraints: ref-1
followUp		0..*	CodeableConcept	Instructions for follow up Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.
note		0..*	Annotation	Additional information about the procedure
focalDevice		0..*	BackboneElement	Manipulated, implanted, or removed device
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
action		0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.
manipulated	C	1..1	Reference(Device)	Device that was changed Constraints: ref-1
usedReference	C	0..*	Reference(Device | Medication | Substance)	Items used during procedure Constraints: ref-1
usedCode		0..*	CodeableConcept	Coded items used during the procedure Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Procedure.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages|4.0.1 From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 From the FHIR Standard
Procedure.statusReason	example	ProcedureNotPerformedReason(SNOMED-CT) http://hl7.org/fhir/ValueSet/procedure-not-performed-reason|4.0.1 From the FHIR Standard
Procedure.category	example	ProcedureCategoryCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-category|4.0.1 From the FHIR Standard
Procedure.code	required	Pattern Value: SNOMED-CT Code 713603004 http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.19--20200901000000|2020-09-01T00:00:00
Procedure.performer.function	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role|4.0.1 From the FHIR Standard
Procedure.reasonCode	example	ProcedureReasonCodes http://hl7.org/fhir/ValueSet/procedure-reason|4.0.1 From the FHIR Standard
Procedure.bodySite	required	LocatieCodelijsten http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.11--20200901000000|2020-09-01T00:00:00
Procedure.outcome	example	ProcedureOutcomeCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-outcome|4.0.1 From the FHIR Standard
Procedure.complication	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code|4.0.1 From the FHIR Standard
Procedure.followUp	example	ProcedureFollowUpCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-followup|4.0.1 From the FHIR Standard
Procedure.focalDevice.action	preferred	ProcedureDeviceActionCodes http://hl7.org/fhir/ValueSet/device-action|4.0.1 From the FHIR Standard
Procedure.usedCode	example	FHIRDeviceTypes http://hl7.org/fhir/ValueSet/device-kind|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Procedure	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Procedure	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	Procedure.meta, Procedure.implicitRules, Procedure.language, Procedure.text, Procedure.extension, Procedure.extension:procedureMethod, Procedure.modifierExtension, Procedure.identifier, Procedure.instantiatesCanonical, Procedure.instantiatesUri, Procedure.basedOn, Procedure.partOf, Procedure.status, Procedure.statusReason, Procedure.category, Procedure.code, Procedure.subject, Procedure.encounter, Procedure.performed[x], Procedure.performed[x]:performedPeriod, Procedure.performed[x]:performedPeriod.extension, Procedure.performed[x]:performedPeriod.start, Procedure.performed[x]:performedPeriod.end, Procedure.performed[x]:performedDateTime, Procedure.recorder, Procedure.asserter, Procedure.performer, Procedure.performer.extension, Procedure.performer.modifierExtension, Procedure.performer.function, Procedure.performer.actor, Procedure.performer.onBehalfOf, Procedure.location, Procedure.reasonCode, Procedure.reasonReference, Procedure.bodySite, Procedure.outcome, Procedure.report, Procedure.report:textResult, Procedure.complication, Procedure.complicationDetail, Procedure.followUp, Procedure.note, Procedure.focalDevice, Procedure.focalDevice.extension, Procedure.focalDevice.modifierExtension, Procedure.focalDevice.action, Procedure.focalDevice.manipulated, Procedure.usedReference, Procedure.usedCode	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	Procedure.extension, Procedure.extension:procedureMethod, Procedure.modifierExtension, Procedure.performed[x]:performedPeriod.extension, Procedure.performer.extension, Procedure.performer.modifierExtension, Procedure.focalDevice.extension, Procedure.focalDevice.modifierExtension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ref-1	error	Procedure.basedOn, Procedure.partOf, Procedure.subject, Procedure.encounter, Procedure.recorder, Procedure.asserter, Procedure.performer.actor, Procedure.performer.onBehalfOf, Procedure.location, Procedure.reasonReference, Procedure.report, Procedure.report:textResult, Procedure.complicationDetail, Procedure.focalDevice.manipulated, Procedure.usedReference	SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

This structure is derived from NlcoreProcedureevent

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

• Patient (https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ACP-Patient|1.0.0-rc1)
• Encounter (https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ACP-Encounter|1.0.0-rc1)
• HealthProfessional PractitionerRole (https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ACP-HealthProfessional-PractitionerRole|1.0.0-rc1)
• ContactPerson (https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ACP-ContactPerson|1.0.0-rc1)

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure		0..*	NlcoreProcedureevent	Procedure
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
extension:procedureMethod		0..*	CodeableConcept	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-Procedure.ProcedureMethod Binding: VerrichtingMethodeCodelijst (required) Constraints: ext-1
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Slice: Unordered, Open by value:url Constraints: ext-1
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
code	OΣ	1..1	CodeableConcept	ProcedureType Binding: VerrichtingTypeCodelijsten (2020-09-01T00:00:00) (required): A code to identify a specific procedure . Required Pattern: At least the following Obligations Actor SHALL:populate-if-known ACP Actor Provider SHALL:no-error ACP Actor Consulter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 713603004
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	OΣC	1..1	Reference(Patient(1.0.0-rc1))	Who the procedure was performed on Constraints: ref-1 Obligations Actor SHALL:populate-if-known ACP Actor Provider SHALL:no-error ACP Actor Consulter
encounter	OΣC	0..1	Reference(Encounter(1.0.0-rc1))	Encounter created as part of Constraints: ref-1 Obligations Actor SHALL:populate-if-known ACP Actor Provider SHALL:no-error ACP Actor Consulter
Slices for performed[x]	Σ	0..1		When the procedure was performed Slice: Unordered, Open by type:$this
performedDateTime			dateTime
performedPeriod			Period
performedString			string
performedAge			Age
performedRange			Range
performed[x]:performedPeriod	Σ	0..1	Period	When the procedure was performed
start	ΣC	0..1	dateTime	ProcedureStartDate
end	ΣC	0..1	dateTime	ProcedureEndDate
performed[x]:performedDateTime	Σ	0..1	dateTime	ProcedureStartDate
bodySite	Σ	0..1	NlcoreAnatomicalLocation	Location Binding: LocatieCodelijsten (2020-09-01T00:00:00) (required): Codes describing anatomical locations. May include laterality.
Slices for report	C	0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Any report resulting from the procedure Slice: Unordered, Open by profile:resolve() Constraints: ref-1
report:textResult	C	0..*	Reference(nl core TextResult)	TextResult Constraints: ref-1
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 From the FHIR Standard
Procedure.code	required	Pattern Value: SNOMED-CT Code 713603004 http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.19--20200901000000|2020-09-01T00:00:00
Procedure.bodySite	required	LocatieCodelijsten http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.11--20200901000000|2020-09-01T00:00:00

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Procedure	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Procedure	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	Procedure.implicitRules, Procedure.extension:procedureMethod, Procedure.modifierExtension, Procedure.status, Procedure.code, Procedure.subject, Procedure.encounter, Procedure.performed[x], Procedure.performed[x]:performedPeriod, Procedure.performed[x]:performedPeriod.start, Procedure.performed[x]:performedPeriod.end, Procedure.performed[x]:performedDateTime, Procedure.bodySite, Procedure.report, Procedure.report:textResult	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	Procedure.extension:procedureMethod, Procedure.modifierExtension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ref-1	error	Procedure.subject, Procedure.encounter, Procedure.report, Procedure.report:textResult	SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Differential View

This structure is derived from NlcoreProcedureevent

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure		0..*	NlcoreProcedureevent	Procedure
code	O	1..1	CodeableConcept	ProcedureType Required Pattern: At least the following Obligations Actor SHALL:populate-if-known ACP Actor Provider SHALL:no-error ACP Actor Consulter
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 713603004
subject	O	1..1	Reference(Patient(1.0.0-rc1))	Who the procedure was performed on Obligations Actor SHALL:populate-if-known ACP Actor Provider SHALL:no-error ACP Actor Consulter
encounter	O	0..1	Reference(Encounter(1.0.0-rc1))	Encounter created as part of Obligations Actor SHALL:populate-if-known ACP Actor Provider SHALL:no-error ACP Actor Consulter
performer
actor		1..1	Reference(HealthProfessional PractitionerRole(1.0.0-rc1) | ContactPerson(1.0.0-rc1) | Patient(1.0.0-rc1))	Performer
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure		0..*	NlcoreProcedureevent	Procedure
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
extension:procedureMethod		0..*	CodeableConcept	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-Procedure.ProcedureMethod Binding: VerrichtingMethodeCodelijst (required) Constraints: ext-1
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Slice: Unordered, Open by value:url Constraints: ext-1
identifier	Σ	0..*	Identifier	External Identifiers for this procedure
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	ΣC	0..*	Reference(CarePlan | ServiceRequest | nl core Procedure request)	A request for this procedure Constraints: ref-1
partOf	ΣC	0..*	Reference(Procedure | Observation | MedicationAdministration)	Part of referenced event Constraints: ref-1
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
statusReason	Σ	0..1	CodeableConcept	Reason for current status Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.
category	Σ	0..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes.
code	OΣ	1..1	CodeableConcept	ProcedureType Binding: VerrichtingTypeCodelijsten (2020-09-01T00:00:00) (required): A code to identify a specific procedure . Required Pattern: At least the following Obligations Actor SHALL:populate-if-known ACP Actor Provider SHALL:no-error ACP Actor Consulter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 713603004
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	OΣC	1..1	Reference(Patient(1.0.0-rc1))	Who the procedure was performed on Constraints: ref-1 Obligations Actor SHALL:populate-if-known ACP Actor Provider SHALL:no-error ACP Actor Consulter
encounter	OΣC	0..1	Reference(Encounter(1.0.0-rc1))	Encounter created as part of Constraints: ref-1 Obligations Actor SHALL:populate-if-known ACP Actor Provider SHALL:no-error ACP Actor Consulter
Slices for performed[x]	Σ	0..1		When the procedure was performed Slice: Unordered, Open by type:$this
performedDateTime			dateTime
performedPeriod			Period
performedString			string
performedAge			Age
performedRange			Range
performed[x]:performedPeriod	Σ	0..1	Period	When the procedure was performed
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
start	ΣC	0..1	dateTime	ProcedureStartDate
end	ΣC	0..1	dateTime	ProcedureEndDate
performed[x]:performedDateTime	Σ	0..1	dateTime	ProcedureStartDate
recorder	ΣC	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Who recorded the procedure Constraints: ref-1
asserter	ΣC	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Person who asserts this procedure Constraints: ref-1
performer	Σ	0..*	BackboneElement	The people who performed the procedure
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
actor	ΣC	1..1	Reference(HealthProfessional PractitionerRole(1.0.0-rc1) | ContactPerson(1.0.0-rc1) | Patient(1.0.0-rc1))	Performer Constraints: ref-1
onBehalfOf	C	0..1	Reference(Organization)	Organization the device or practitioner was acting for Constraints: ref-1
location	ΣC	0..1	Reference(Location | nl core HealthcareProvider)	Location Constraints: ref-1
reasonCode	Σ	0..*	CodeableConcept	Coded reason procedure performed Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required.
reasonReference	ΣC	0..*	Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference | nl core Problem)	Indication Constraints: ref-1
bodySite	Σ	0..1	NlcoreAnatomicalLocation	Location Binding: LocatieCodelijsten (2020-09-01T00:00:00) (required): Codes describing anatomical locations. May include laterality.
outcome	Σ	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
Slices for report	C	0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Any report resulting from the procedure Slice: Unordered, Open by profile:resolve() Constraints: ref-1
report:textResult	C	0..*	Reference(nl core TextResult)	TextResult Constraints: ref-1
complication		0..*	CodeableConcept	Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
complicationDetail	C	0..*	Reference(Condition)	A condition that is a result of the procedure Constraints: ref-1
followUp		0..*	CodeableConcept	Instructions for follow up Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.
note		0..*	Annotation	Additional information about the procedure
focalDevice		0..*	BackboneElement	Manipulated, implanted, or removed device
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
action		0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.
manipulated	C	1..1	Reference(Device)	Device that was changed Constraints: ref-1
usedReference	C	0..*	Reference(Device | Medication | Substance)	Items used during procedure Constraints: ref-1
usedCode		0..*	CodeableConcept	Coded items used during the procedure Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Procedure.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages|4.0.1 From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 From the FHIR Standard
Procedure.statusReason	example	ProcedureNotPerformedReason(SNOMED-CT) http://hl7.org/fhir/ValueSet/procedure-not-performed-reason|4.0.1 From the FHIR Standard
Procedure.category	example	ProcedureCategoryCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-category|4.0.1 From the FHIR Standard
Procedure.code	required	Pattern Value: SNOMED-CT Code 713603004 http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.19--20200901000000|2020-09-01T00:00:00
Procedure.performer.function	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role|4.0.1 From the FHIR Standard
Procedure.reasonCode	example	ProcedureReasonCodes http://hl7.org/fhir/ValueSet/procedure-reason|4.0.1 From the FHIR Standard
Procedure.bodySite	required	LocatieCodelijsten http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.11--20200901000000|2020-09-01T00:00:00
Procedure.outcome	example	ProcedureOutcomeCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-outcome|4.0.1 From the FHIR Standard
Procedure.complication	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code|4.0.1 From the FHIR Standard
Procedure.followUp	example	ProcedureFollowUpCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-followup|4.0.1 From the FHIR Standard
Procedure.focalDevice.action	preferred	ProcedureDeviceActionCodes http://hl7.org/fhir/ValueSet/device-action|4.0.1 From the FHIR Standard
Procedure.usedCode	example	FHIRDeviceTypes http://hl7.org/fhir/ValueSet/device-kind|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Procedure	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Procedure	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	Procedure.meta, Procedure.implicitRules, Procedure.language, Procedure.text, Procedure.extension, Procedure.extension:procedureMethod, Procedure.modifierExtension, Procedure.identifier, Procedure.instantiatesCanonical, Procedure.instantiatesUri, Procedure.basedOn, Procedure.partOf, Procedure.status, Procedure.statusReason, Procedure.category, Procedure.code, Procedure.subject, Procedure.encounter, Procedure.performed[x], Procedure.performed[x]:performedPeriod, Procedure.performed[x]:performedPeriod.extension, Procedure.performed[x]:performedPeriod.start, Procedure.performed[x]:performedPeriod.end, Procedure.performed[x]:performedDateTime, Procedure.recorder, Procedure.asserter, Procedure.performer, Procedure.performer.extension, Procedure.performer.modifierExtension, Procedure.performer.function, Procedure.performer.actor, Procedure.performer.onBehalfOf, Procedure.location, Procedure.reasonCode, Procedure.reasonReference, Procedure.bodySite, Procedure.outcome, Procedure.report, Procedure.report:textResult, Procedure.complication, Procedure.complicationDetail, Procedure.followUp, Procedure.note, Procedure.focalDevice, Procedure.focalDevice.extension, Procedure.focalDevice.modifierExtension, Procedure.focalDevice.action, Procedure.focalDevice.manipulated, Procedure.usedReference, Procedure.usedCode	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	Procedure.extension, Procedure.extension:procedureMethod, Procedure.modifierExtension, Procedure.performed[x]:performedPeriod.extension, Procedure.performer.extension, Procedure.performer.modifierExtension, Procedure.focalDevice.extension, Procedure.focalDevice.modifierExtension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ref-1	error	Procedure.basedOn, Procedure.partOf, Procedure.subject, Procedure.encounter, Procedure.recorder, Procedure.asserter, Procedure.performer.actor, Procedure.performer.onBehalfOf, Procedure.location, Procedure.reasonReference, Procedure.report, Procedure.report:textResult, Procedure.complicationDetail, Procedure.focalDevice.manipulated, Procedure.usedReference	SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

This structure is derived from NlcoreProcedureevent

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

• Patient (https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ACP-Patient|1.0.0-rc1)
• Encounter (https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ACP-Encounter|1.0.0-rc1)
• HealthProfessional PractitionerRole (https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ACP-HealthProfessional-PractitionerRole|1.0.0-rc1)
• ContactPerson (https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ACP-ContactPerson|1.0.0-rc1)

Other representations of profile: CSV, Excel, Schematron