FHIR Osiris Implementation Guide
2.1.0 - ci-build

FHIR Osiris Implementation Guide - Local Development build (v2.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: RadiotherapyPlan - Detailed Descriptions

Draft as of 2024-03-21

Definitions for the radiotherapy-plan resource profile.

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

0. Procedure
2. Procedure.extension
Control2..?
4. Procedure.extension:basedOn
Slice NamebasedOn
Control0..3
TypeExtension(Connection with the imaging module) (Complex Extension)
Must Supporttrue
6. Procedure.extension:basedOn.extension:seriesUID
Slice NameseriesUID
8. Procedure.extension:basedOn.extension:rtStructUID
Slice NamertStructUID
10. Procedure.extension:doseToVolume
Slice NamedoseToVolume
Control0..*
TypeExtension(Dose To Volume) (Complex Extension)
Must Supporttrue
12. Procedure.extension:doseToVolume.extension:fractionDose
Slice NamefractionDose
14. Procedure.extension:doseToVolume.extension:numberOfFractions
Slice NamenumberOfFractions
16. Procedure.extension:doseToVolume.extension:totalDose
Slice NametotalDose
18. Procedure.extension:doseToVolume.extension:rtDoseUID
Slice NamertDoseUID
20. Procedure.extension:modalityAndTechnique
Slice NamemodalityAndTechnique
Control0..*
TypeExtension(Modality And Technique) (Complex Extension)
Must Supporttrue
22. Procedure.extension:modalityAndTechnique.extension:radiotherapyModality
Slice NameradiotherapyModality
24. Procedure.extension:modalityAndTechnique.extension:radiotherapyTechnique
Slice NameradiotherapyTechnique
26. Procedure.extension:modalityAndTechnique.extension:radiotherapyTreatmentMachinePlanned
Slice NameradiotherapyTreatmentMachinePlanned
28. Procedure.extension:energyOrIsotope
Slice NameenergyOrIsotope
Control0..*
TypeExtension(Energy Or Isotope) (Complex Extension)
Must Supporttrue
30. Procedure.extension:energyOrIsotope.extension:quantityEnergyOrIsotope
Slice NamequantityEnergyOrIsotope
32. Procedure.extension:energyOrIsotope.extension:nameEnergyOrIsotope
Slice NamenameEnergyOrIsotope
34. Procedure.extension:numberOfFractions
Slice NamenumberOfFractions
Definition

Number of Fractions. If delivred, it should be extracted from MOSAIQ/ARIA Record and Verify. If planned, it corresponds to Dicom Tag (300A,0078)

ShortNumber of Fractions
Control1..1
TypeExtension(Number of Fractions) (Extension Type: unsignedInt)
Must Supporttrue
36. Procedure.extension:reasonReplanification
Slice NamereasonReplanification
Definition

Reason Replanification. It should be extracted from MOSAIQ/ARIA Record and Verify.

ShortReason Replanification
Control0..1
TypeExtension(Reason Replanification) (Extension Type: CodeableConcept)
Must Supporttrue
38. Procedure.extension:algorithmName
Slice NamealgorithmName
Definition

Name of the algorithm. Dicom Tag (0066,0036)

ShortName of the algorithm
Control1..1
TypeExtension(Algorith mName) (Extension Type: string)
Must Supporttrue
40. Procedure.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..?
SlicingThis element introduces a set of slices on Procedure.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ type
  • 42. Procedure.identifier:rtPlanUID
    Slice NamertPlanUID
    Definition

    Reference SOP Instance UID of the RT Plan. Dicom Tag (0008,1155)

    ShortUID RT Plan
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control1..1
    Must Supporttrue
    44. Procedure.identifier:rtPlanUID.type
    Control1..?
    Pattern Value{
      "coding" : [{
        "code" : "MR"
      }]
    }
    46. Procedure.partOf
    ShortShould Reference a Radiotherapy Treatment Phase
    Control1..1
    TypeReference(Radiotherapy Phase)
    48. Procedure.category
    Definition

    Type (planned or delivered)

    ShortType (planned or delivered)
    Control1..?
    Must Supporttrue
    50. Procedure.category.coding
    52. Procedure.category.coding.code
    Control1..?
    BindingThe codes SHALL be taken from Radiotherapy Category
    (required to https://build.fhir.org/ig/arkhn/arkhn-ig-osiris/ValueSet/vs-radiotherapy-category)
    Must Supporttrue
    54. Procedure.code
    Control1..?
    Must Supporttrue
    Pattern Value{
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "1255724003"
      }]
    }
    56. Procedure.code.coding
    58. Procedure.code.coding.display
    Pattern ValueRadiotherapy treatment plan (regime/therapy)
    60. Procedure.subject
    TypeReference(Oncology Patient)
    Must Supporttrue
    62. Procedure.performed[x]
    Definition

    The start and end period

    Control1..?
    TypePeriod, dateTime, string, Range, Age
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    64. Procedure.performed[x].start
    Definition

    Start date and time. They should be extracted from MOSAIQ/ARIA Record and Verify.

    ShortStart date
    Control1..?
    Must Supporttrue
    66. Procedure.performed[x].end
    Definition

    End date and time. They should be extracted from MOSAIQ/ARIA Record and Verify.

    ShortEnd date
    Control1..?
    Must Supporttrue

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

    0. Procedure
    Definition

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

    ShortAn action that is being or was performed on a patient
    Control0..*
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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 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-6: A resource should have narrative for robust management (text.`div`.exists())
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

    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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

    Control0..1
    This element is affected by the following invariants: ele-1
    Typeuri
    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    4. Procedure.extension
    Definition

    An Extension


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

    Control20..*
    This element is affected by the following invariants: ele-1
    TypeExtension
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    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:basedOn
      Slice NamebasedOn
      Definition

      Connection with the imaging module (ImagingStudy and ROI Segmentation)

      ShortConnection with the imaging module
      Control0..3
      This element is affected by the following invariants: ele-1
      TypeExtension(Connection with the imaging module) (Complex Extension)
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      8. Procedure.extension:basedOn.extension:imagingStudyRef
      Slice NameimagingStudyRef
      Definition

      Imaging Study to which the reference series (UID series) belong

      ShortImaging Study ReferenceAdditional content defined by implementations
      Control0..1*
      This element is affected by the following invariants: ele-1
      TypeExtension
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      10. Procedure.extension:basedOn.extension:imagingStudyRef.extension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..0*
      This element is affected by the following invariants: ele-1
      TypeExtension
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      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
      • 12. Procedure.extension:basedOn.extension:imagingStudyRef.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
        XML FormatIn the XML format, this property is represented as an attribute.
        Fixed ValueimagingStudyRef
        14. Procedure.extension:basedOn.extension:seriesUID
        Slice NameseriesUID
        Definition

        An Extension

        ShortExtensionAdditional content defined by implementations
        Control0..1*
        This element is affected by the following invariants: ele-1
        TypeExtension
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        16. Procedure.extension:basedOn.extension:seriesUID.extension
        Definition

        An Extension


        May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..0*
        This element is affected by the following invariants: ele-1
        TypeExtension
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        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
        • 18. Procedure.extension:basedOn.extension:seriesUID.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
          XML FormatIn the XML format, this property is represented as an attribute.
          Fixed ValueseriesUID
          20. Procedure.extension:basedOn.extension:rtStructUID
          Slice NamertStructUID
          Definition

          An Extension

          ShortExtensionAdditional content defined by implementations
          Control0..1*
          This element is affected by the following invariants: ele-1
          TypeExtension
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          22. Procedure.extension:basedOn.extension:rtStructUID.extension
          Definition

          An Extension


          May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..0*
          This element is affected by the following invariants: ele-1
          TypeExtension
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          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
          • 24. Procedure.extension:basedOn.extension:rtStructUID.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
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed ValuertStructUID
            26. Procedure.extension:basedOn.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
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed Valuehttps://build.fhir.org/ig/arkhn/arkhn-ig-osiris/StructureDefinition/basedOn
            28. Procedure.extension:basedOn.value[x]
            Definition

            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

            ShortValue of extension
            Control0..01
            This element is affected by the following invariants: ele-1
            TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            30. Procedure.extension:doseToVolume
            Slice NamedoseToVolume
            Definition

            Dose To Volume

            ShortDose To Volume
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(Dose To Volume) (Complex Extension)
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            32. Procedure.extension:doseToVolume.extension
            Definition

            An Extension


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

            Control40..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            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
            • 34. Procedure.extension:doseToVolume.extension:volume
              Slice Namevolume
              Definition

              The volume targeted by the dose.

              ShortVolume targetedAdditional content defined by implementations
              Control10..*
              This element is affected by the following invariants: ele-1
              TypeExtension
              Must Supporttrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              36. Procedure.extension:doseToVolume.extension:volume.extension
              Definition

              An Extension


              May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..0*
              This element is affected by the following invariants: ele-1
              TypeExtension
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              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
              • 38. Procedure.extension:doseToVolume.extension:volume.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
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed Valuevolume
                40. Procedure.extension:doseToVolume.extension:volume.value[x]
                Definition

                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                ShortValue of extension
                Control10..1
                This element is affected by the following invariants: ele-1
                TypeReference(Radiotherapy Volume Profile), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                [x] NoteSee Choice of Data Types for further information about how to use [x]
                Must Supporttrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                42. Procedure.extension:doseToVolume.extension:fractionDose
                Slice NamefractionDose
                Definition

                An Extension

                ShortExtensionAdditional content defined by implementations
                Control10..1*
                This element is affected by the following invariants: ele-1
                TypeExtension
                Must Supporttrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                44. Procedure.extension:doseToVolume.extension:fractionDose.extension
                Definition

                An Extension


                May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..0*
                This element is affected by the following invariants: ele-1
                TypeExtension
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                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
                • 46. Procedure.extension:doseToVolume.extension:fractionDose.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
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Fixed ValuefractionDose
                  48. Procedure.extension:doseToVolume.extension:fractionDose.value[x]
                  Definition

                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                  ShortValue of extension
                  Control10..1
                  This element is affected by the following invariants: ele-1
                  Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                  [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
                  Must Supporttrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  50. Procedure.extension:doseToVolume.extension:numberOfFractions
                  Slice NamenumberOfFractions
                  Definition

                  An Extension

                  ShortExtensionAdditional content defined by implementations
                  Control10..1*
                  This element is affected by the following invariants: ele-1
                  TypeExtension
                  Must Supporttrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  52. Procedure.extension:doseToVolume.extension:numberOfFractions.extension
                  Definition

                  An Extension


                  May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..0*
                  This element is affected by the following invariants: ele-1
                  TypeExtension
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  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
                  • 54. Procedure.extension:doseToVolume.extension:numberOfFractions.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
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed ValuenumberOfFractions
                    56. Procedure.extension:doseToVolume.extension:numberOfFractions.value[x]
                    Definition

                    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                    ShortValue of extension
                    Control10..1
                    This element is affected by the following invariants: ele-1
                    TypeunsignedInt, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, time
                    [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
                    Must Supporttrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    58. Procedure.extension:doseToVolume.extension:totalDose
                    Slice NametotalDose
                    Definition

                    An Extension

                    ShortExtensionAdditional content defined by implementations
                    Control10..1*
                    This element is affected by the following invariants: ele-1
                    TypeExtension
                    Must Supporttrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    60. Procedure.extension:doseToVolume.extension:totalDose.extension
                    Definition

                    An Extension


                    May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..0*
                    This element is affected by the following invariants: ele-1
                    TypeExtension
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    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:doseToVolume.extension:totalDose.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
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Fixed ValuetotalDose
                      64. Procedure.extension:doseToVolume.extension:totalDose.value[x]
                      Definition

                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                      ShortValue of extension
                      Control10..1
                      This element is affected by the following invariants: ele-1
                      Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                      [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
                      Must Supporttrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      66. Procedure.extension:doseToVolume.extension:rtDoseUID
                      Slice NamertDoseUID
                      Definition

                      An Extension

                      ShortExtensionAdditional content defined by implementations
                      Control0..1*
                      This element is affected by the following invariants: ele-1
                      TypeExtension
                      Must Supporttrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      68. Procedure.extension:doseToVolume.extension:rtDoseUID.extension
                      Definition

                      An Extension


                      May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..0*
                      This element is affected by the following invariants: ele-1
                      TypeExtension
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      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
                      • 70. Procedure.extension:doseToVolume.extension:rtDoseUID.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
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Fixed ValuertDoseUID
                        72. Procedure.extension:doseToVolume.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
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Fixed Valuehttps://build.fhir.org/ig/arkhn/arkhn-ig-osiris/StructureDefinition/doseToVolume
                        74. Procedure.extension:doseToVolume.value[x]
                        Definition

                        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                        ShortValue of extension
                        Control0..01
                        This element is affected by the following invariants: ele-1
                        TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        76. Procedure.extension:modalityAndTechnique
                        Slice NamemodalityAndTechnique
                        Definition

                        Modality And Technique

                        ShortModality And Technique
                        Control0..*
                        This element is affected by the following invariants: ele-1
                        TypeExtension(Modality And Technique) (Complex Extension)
                        Must Supporttrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        78. Procedure.extension:modalityAndTechnique.extension
                        Definition

                        An Extension


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

                        Control20..*
                        This element is affected by the following invariants: ele-1
                        TypeExtension
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        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
                        • 80. Procedure.extension:modalityAndTechnique.extension:radiotherapyModality
                          Slice NameradiotherapyModality
                          Definition

                          An Extension

                          ShortExtensionAdditional content defined by implementations
                          Control10..1*
                          This element is affected by the following invariants: ele-1
                          TypeExtension
                          Must Supporttrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          82. Procedure.extension:modalityAndTechnique.extension:radiotherapyModality.extension
                          Definition

                          An Extension


                          May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..0*
                          This element is affected by the following invariants: ele-1
                          TypeExtension
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          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
                          • 84. Procedure.extension:modalityAndTechnique.extension:radiotherapyModality.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
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Fixed ValueradiotherapyModality
                            86. Procedure.extension:modalityAndTechnique.extension:radiotherapyModality.value[x]
                            Definition

                            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                            ShortValue of extension
                            Control10..1
                            This element is affected by the following invariants: ele-1
                            BindingThe codes SHALL be taken from For codes, see http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs
                            (required to http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs)
                            TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                            [x] NoteSee Choice of Data Types for further information about how to use [x]
                            Must Supporttrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            88. Procedure.extension:modalityAndTechnique.extension:radiotherapyTechnique
                            Slice NameradiotherapyTechnique
                            Definition

                            An Extension

                            ShortExtensionAdditional content defined by implementations
                            Control10..1*
                            This element is affected by the following invariants: ele-1
                            TypeExtension
                            Must Supporttrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            90. Procedure.extension:modalityAndTechnique.extension:radiotherapyTechnique.extension
                            Definition

                            An Extension


                            May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..0*
                            This element is affected by the following invariants: ele-1
                            TypeExtension
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            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
                            • 92. Procedure.extension:modalityAndTechnique.extension:radiotherapyTechnique.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
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Fixed ValueradiotherapyTechnique
                              94. Procedure.extension:modalityAndTechnique.extension:radiotherapyTechnique.value[x]
                              Definition

                              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                              ShortValue of extension
                              Control10..1
                              This element is affected by the following invariants: ele-1
                              BindingThe codes SHALL be taken from For codes, see http://hl7.org/fhir/us/mcode/ValueSet/mcode-teleradiotherapy-photon-beam-technique-vs
                              (required to http://hl7.org/fhir/us/mcode/ValueSet/mcode-teleradiotherapy-photon-beam-technique-vs)
                              TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                              [x] NoteSee Choice of Data Types for further information about how to use [x]
                              Must Supporttrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              96. Procedure.extension:modalityAndTechnique.extension:radiotherapyTreatmentMachinePlanned
                              Slice NameradiotherapyTreatmentMachinePlanned
                              Definition

                              An Extension

                              ShortExtensionAdditional content defined by implementations
                              Control0..1*
                              This element is affected by the following invariants: ele-1
                              TypeExtension
                              Must Supporttrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              98. Procedure.extension:modalityAndTechnique.extension:radiotherapyTreatmentMachinePlanned.extension
                              Definition

                              An Extension


                              May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..0*
                              This element is affected by the following invariants: ele-1
                              TypeExtension
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              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
                              • 100. Procedure.extension:modalityAndTechnique.extension:radiotherapyTreatmentMachinePlanned.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
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Fixed ValueradiotherapyTreatmentMachinePlanned
                                102. Procedure.extension:modalityAndTechnique.extension:radiotherapyTreatmentMachinePlanned.value[x]
                                Definition

                                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                ShortValue of extension
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                                [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
                                Must Supporttrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                104. Procedure.extension:modalityAndTechnique.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
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Fixed Valuehttps://build.fhir.org/ig/arkhn/arkhn-ig-osiris/StructureDefinition/modalityAndTechnique
                                106. Procedure.extension:modalityAndTechnique.value[x]
                                Definition

                                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                ShortValue of extension
                                Control0..01
                                This element is affected by the following invariants: ele-1
                                TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                108. Procedure.extension:energyOrIsotope
                                Slice NameenergyOrIsotope
                                Definition

                                Energy Or Isotope

                                ShortEnergy Or Isotope
                                Control0..*
                                This element is affected by the following invariants: ele-1
                                TypeExtension(Energy Or Isotope) (Complex Extension)
                                Must Supporttrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                110. Procedure.extension:energyOrIsotope.extension
                                Definition

                                An Extension


                                May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..*
                                This element is affected by the following invariants: ele-1
                                TypeExtension
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                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
                                • 112. Procedure.extension:energyOrIsotope.extension:quantityEnergyOrIsotope
                                  Slice NamequantityEnergyOrIsotope
                                  Definition

                                  An Extension

                                  ShortExtensionAdditional content defined by implementations
                                  Control10..1*
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension
                                  Must Supporttrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  114. Procedure.extension:energyOrIsotope.extension:quantityEnergyOrIsotope.extension
                                  Definition

                                  An Extension


                                  May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..0*
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  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
                                  • 116. Procedure.extension:energyOrIsotope.extension:quantityEnergyOrIsotope.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
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Fixed ValuequantityEnergyOrIsotope
                                    118. Procedure.extension:energyOrIsotope.extension:quantityEnergyOrIsotope.value[x]
                                    Definition

                                    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                    ShortValue of extension
                                    Control10..1
                                    This element is affected by the following invariants: ele-1
                                    TypeQuantity, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                                    Must Supporttrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    120. Procedure.extension:energyOrIsotope.extension:nameEnergyOrIsotope
                                    Slice NamenameEnergyOrIsotope
                                    Definition

                                    An Extension

                                    ShortExtensionAdditional content defined by implementations
                                    Control0..1*
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension
                                    Must Supporttrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    122. Procedure.extension:energyOrIsotope.extension:nameEnergyOrIsotope.extension
                                    Definition

                                    An Extension


                                    May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..0*
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension
                                    Alternate Namesextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    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
                                    • 124. Procedure.extension:energyOrIsotope.extension:nameEnergyOrIsotope.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
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Fixed ValuenameEnergyOrIsotope
                                      126. Procedure.extension:energyOrIsotope.extension:nameEnergyOrIsotope.value[x]
                                      Definition

                                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                      ShortValue of extension
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                                      [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
                                      Must Supporttrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      128. Procedure.extension:energyOrIsotope.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
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Fixed Valuehttps://build.fhir.org/ig/arkhn/arkhn-ig-osiris/StructureDefinition/energyOrIsotope
                                      130. Procedure.extension:energyOrIsotope.value[x]
                                      Definition

                                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                      ShortValue of extension
                                      Control0..01
                                      This element is affected by the following invariants: ele-1
                                      TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      132. Procedure.extension:numberOfFractions
                                      Slice NamenumberOfFractions
                                      Definition

                                      Number of Fractions. If delivred, it should be extracted from MOSAIQ/ARIA Record and Verify. If planned, it corresponds to Dicom Tag (300A,0078)

                                      ShortNumber of Fractions
                                      Control1..1
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(Number of Fractions) (Extension Type: unsignedInt)
                                      Must Supporttrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      134. Procedure.extension:reasonReplanification
                                      Slice NamereasonReplanification
                                      Definition

                                      Reason Replanification. It should be extracted from MOSAIQ/ARIA Record and Verify.

                                      ShortReason Replanification
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(Reason Replanification) (Extension Type: CodeableConcept)
                                      Must Supporttrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      136. Procedure.extension:algorithmName
                                      Slice NamealgorithmName
                                      Definition

                                      Name of the algorithm. Dicom Tag (0066,0036)

                                      ShortName of the algorithm
                                      Control1..1
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(Algorith mName) (Extension Type: string)
                                      Must Supporttrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      138. 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                      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..*
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                      Standards StatusNormative (from Trial Use)
                                      Requirements

                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingThis element introduces a set of slices on Procedure.modifierExtension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 140. Procedure.identifier
                                        Definition

                                        Business identifiers assigned to this procedure by the performer or other systems which remain constant as the resource is updated and is propagated from server to server.

                                        ShortExternal Identifiers for this procedure
                                        Comments

                                        This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and Person resource instances might share the same social insurance number.

                                        NoteThis is a business identifier, not a resource identifier (see discussion)
                                        Control10..*
                                        This element is affected by the following invariants: ele-1
                                        TypeIdentifier
                                        Summarytrue
                                        Requirements

                                        Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        SlicingThis element introduces a set of slices on Procedure.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                        • pattern @ type
                                        • 142. Procedure.identifier:rtPlanUID
                                          Slice NamertPlanUID
                                          Definition

                                          Reference SOP Instance UID of the RT Plan. Dicom Tag (0008,1155)


                                          Business identifiers assigned to this procedure by the performer or other systems which remain constant as the resource is updated and is propagated from server to server.

                                          ShortUID RT PlanExternal Identifiers for this procedure
                                          Comments

                                          This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and Person resource instances might share the same social insurance number.

                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                          Control10..1*
                                          This element is affected by the following invariants: ele-1
                                          TypeIdentifier
                                          Must Supporttrue
                                          Summarytrue
                                          Requirements

                                          Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          144. Procedure.identifier:rtPlanUID.use
                                          Definition

                                          The purpose of this identifier.

                                          Shortusual | official | temp | secondary | old (If known)
                                          Comments

                                          Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
                                          (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                          Identifies the purpose for this identifier, if known .

                                          Typecode
                                          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Requirements

                                          Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          146. Procedure.identifier:rtPlanUID.type
                                          Definition

                                          A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                          ShortDescription of identifier
                                          Comments

                                          This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                          Control10..1
                                          This element is affected by the following invariants: ele-1
                                          BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type
                                          (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                                          A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                          TypeCodeableConcept
                                          Summarytrue
                                          Requirements

                                          Allows users to make use of identifiers when the identifier system is not known.

                                          Pattern Value{
                                            "coding" : [{
                                              "code" : "MR"
                                            }]
                                          }
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          148. Procedure.partOf
                                          Definition

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

                                          ShortShould Reference a Radiotherapy Treatment PhasePart of referenced event
                                          Comments

                                          The MedicationAdministration resource has a partOf reference to Procedure, but this is not a circular reference. For example, the anesthesia MedicationAdministration is part of the surgical Procedure (MedicationAdministration.partOf = Procedure). For example, the procedure to insert the IV port for an IV medication administration is part of the medication administration (Procedure.partOf = MedicationAdministration).

                                          Control10..1*
                                          This element is affected by the following invariants: ele-1
                                          TypeReference(Radiotherapy Phase, Procedure, Observation, MedicationAdministration)
                                          Summarytrue
                                          Alternate Namescontainer
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ref-1: 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')))
                                          150. Procedure.status
                                          Definition

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

                                          Shortpreparation | in-progress | not-done | on-hold | stopped | 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
                                          This element is affected by the following invariants: ele-1
                                          BindingThe codes SHALL be taken from EventStatushttp://hl7.org/fhir/ValueSet/event-status|4.0.1
                                          (required to http://hl7.org/fhir/ValueSet/event-status|4.0.1)

                                          A code specifying the state of the procedure.

                                          Typecode
                                          Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          152. Procedure.category
                                          Definition

                                          Type (planned or delivered)


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

                                          ShortType (planned or delivered)Classification of the procedure
                                          Comments

                                          Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                          Control10..1
                                          This element is affected by the following invariants: ele-1
                                          BindingFor example codes, see ProcedureCategoryCodes(SNOMEDCT)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
                                          Must Supporttrue
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          154. 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.

                                          Control0..*
                                          This element is affected by the following invariants: ele-1
                                          TypeCoding
                                          Summarytrue
                                          Requirements

                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          156. Procedure.category.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
                                          Comments

                                          Note that FHIR strings SHALL NOT exceed 1MB in size

                                          Control10..1
                                          This element is affected by the following invariants: ele-1
                                          BindingThe codes SHALL be taken from For codes, see Radiotherapy Category
                                          (required to https://build.fhir.org/ig/arkhn/arkhn-ig-osiris/ValueSet/vs-radiotherapy-category)
                                          Typecode
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Summarytrue
                                          Requirements

                                          Need to refer to a particular code in the system.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          158. 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
                                          Comments

                                          Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                          Control10..1
                                          This element is affected by the following invariants: ele-1
                                          BindingFor example codes, see ProcedureCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-code
                                          (example to http://hl7.org/fhir/ValueSet/procedure-code)

                                          A code to identify a specific procedure .

                                          TypeCodeableConcept
                                          Must Supporttrue
                                          Summarytrue
                                          Requirements

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

                                          Alternate Namestype
                                          Pattern Value{
                                            "coding" : [{
                                              "system" : "http://snomed.info/sct",
                                              "code" : "1255724003"
                                            }]
                                          }
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          160. Procedure.subject
                                          Definition

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

                                          ShortWho the procedure was performed on
                                          Comments

                                          References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                          Control1..1
                                          This element is affected by the following invariants: ele-1
                                          TypeReference(Oncology Patient, Patient, Group)
                                          Must Supporttrue
                                          Summarytrue
                                          Alternate Namespatient
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ref-1: 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')))
                                          162. Procedure.performed[x]
                                          Definition

                                          The start and end period


                                          Estimated or actual date, date-time, period, or age when 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.

                                          ShortWhen the procedure was performed
                                          Comments

                                          Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old. dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone.

                                          Control10..1
                                          This element is affected by the following invariants: ele-1
                                          TypePeriod, dateTime, string, Range, Age
                                          [x] NoteSee Choice of Data Types for further information about how to use [x]
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          164. Procedure.performed[x].start
                                          Definition

                                          Start date and time. They should be extracted from MOSAIQ/ARIA Record and Verify.


                                          The start of the period. The boundary is inclusive.

                                          ShortStart dateStarting time with inclusive boundary
                                          Comments

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

                                          Control10..1
                                          This element is affected by the following invariants: ele-1, per-1
                                          TypedateTime
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          166. Procedure.performed[x].end
                                          Definition

                                          End date and time. They should be extracted from MOSAIQ/ARIA Record and Verify.


                                          The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                          ShortEnd dateEnd time with inclusive boundary, if not ongoing
                                          Comments

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

                                          Control10..1
                                          This element is affected by the following invariants: ele-1, per-1
                                          TypedateTime
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Summarytrue
                                          Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

                                          0. Procedure
                                          Definition

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

                                          ShortAn action that is being or was performed on a patient
                                          Control0..*
                                          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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 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-6: A resource should have narrative for robust management (text.`div`.exists())
                                          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                          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
                                          Summarytrue
                                          4. Procedure.meta
                                          Definition

                                          The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                                          ShortMetadata about the resource
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          TypeMeta
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                          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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          Typeuri
                                          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          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
                                          This element is affected by the following invariants: ele-1
                                          BindingThe codes SHOULD be taken from CommonLanguages
                                          (preferred 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
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          10. Procedure.text
                                          Definition

                                          A human-readable narrative that contains a summary of the resource and can 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 information is added later.

                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          TypeNarrative
                                          Alternate Namesnarrative, html, xhtml, display
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

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

                                          An Extension

                                          ShortExtension
                                          Control2..*
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          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:basedOn
                                            Slice NamebasedOn
                                            Definition

                                            Connection with the imaging module (ImagingStudy and ROI Segmentation)

                                            ShortConnection with the imaging module
                                            Control0..3
                                            This element is affected by the following invariants: ele-1
                                            TypeExtension(Connection with the imaging module) (Complex Extension)
                                            Must Supporttrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            18. Procedure.extension:basedOn.id
                                            Definition

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            20. Procedure.extension:basedOn.extension
                                            Definition

                                            May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..*
                                            This element is affected by the following invariants: ele-1
                                            TypeExtension
                                            Standards StatusNormative (from Trial Use)
                                            Alternate Namesextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            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:basedOn.extension:imagingStudyRef
                                              Slice NameimagingStudyRef
                                              Definition

                                              Imaging Study to which the reference series (UID series) belong

                                              ShortImaging Study Reference
                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension
                                              Must Supporttrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              24. Procedure.extension:basedOn.extension:imagingStudyRef.id
                                              Definition

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

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typestring
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              26. Procedure.extension:basedOn.extension:imagingStudyRef.extension
                                              Definition

                                              An Extension

                                              ShortExtension
                                              Control0..0
                                              This element is affected by the following invariants: ele-1
                                              TypeExtension
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              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
                                              • 28. Procedure.extension:basedOn.extension:imagingStudyRef.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
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Fixed ValueimagingStudyRef
                                                30. Procedure.extension:basedOn.extension:imagingStudyRef.value[x]
                                                Definition

                                                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                ShortValue of extension
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeReference(Imaging Study)
                                                [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                32. Procedure.extension:basedOn.extension:seriesUID
                                                Slice NameseriesUID
                                                Definition

                                                An Extension

                                                ShortExtension
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension
                                                Must Supporttrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                34. Procedure.extension:basedOn.extension:seriesUID.id
                                                Definition

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                36. Procedure.extension:basedOn.extension:seriesUID.extension
                                                Definition

                                                An Extension

                                                ShortExtension
                                                Control0..0
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                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
                                                • 38. Procedure.extension:basedOn.extension:seriesUID.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
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Fixed ValueseriesUID
                                                  40. Procedure.extension:basedOn.extension:seriesUID.value[x]
                                                  Definition

                                                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                  ShortValue of extension
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-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
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  42. Procedure.extension:basedOn.extension:rtStructUID
                                                  Slice NamertStructUID
                                                  Definition

                                                  An Extension

                                                  ShortExtension
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypeExtension
                                                  Must Supporttrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  44. Procedure.extension:basedOn.extension:rtStructUID.id
                                                  Definition

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

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  Typestring
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  46. Procedure.extension:basedOn.extension:rtStructUID.extension
                                                  Definition

                                                  An Extension

                                                  ShortExtension
                                                  Control0..0
                                                  This element is affected by the following invariants: ele-1
                                                  TypeExtension
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  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
                                                  • 48. Procedure.extension:basedOn.extension:rtStructUID.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
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Fixed ValuertStructUID
                                                    50. Procedure.extension:basedOn.extension:rtStructUID.value[x]
                                                    Definition

                                                    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                    ShortValue of extension
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeReference(ROI segmentation)
                                                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    52. Procedure.extension:basedOn.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
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Fixed Valuehttps://build.fhir.org/ig/arkhn/arkhn-ig-osiris/StructureDefinition/basedOn
                                                    54. Procedure.extension:basedOn.value[x]
                                                    Definition

                                                    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                    ShortValue of extension
                                                    Control0..0
                                                    This element is affected by the following invariants: ele-1
                                                    TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    56. Procedure.extension:doseToVolume
                                                    Slice NamedoseToVolume
                                                    Definition

                                                    Dose To Volume

                                                    ShortDose To Volume
                                                    Control0..*
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension(Dose To Volume) (Complex Extension)
                                                    Must Supporttrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    58. Procedure.extension:doseToVolume.id
                                                    Definition

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

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    Typestring
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    60. Procedure.extension:doseToVolume.extension
                                                    Definition

                                                    An Extension

                                                    ShortExtension
                                                    Control4..*
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    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
                                                    • 62. Procedure.extension:doseToVolume.extension:volume
                                                      Slice Namevolume
                                                      Definition

                                                      The volume targeted by the dose.

                                                      ShortVolume targeted
                                                      Control1..*
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension
                                                      Must Supporttrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      64. Procedure.extension:doseToVolume.extension:volume.id
                                                      Definition

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

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      Typestring
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      66. Procedure.extension:doseToVolume.extension:volume.extension
                                                      Definition

                                                      An Extension

                                                      ShortExtension
                                                      Control0..0
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      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
                                                      • 68. Procedure.extension:doseToVolume.extension:volume.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
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Fixed Valuevolume
                                                        70. Procedure.extension:doseToVolume.extension:volume.value[x]
                                                        Definition

                                                        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                        ShortValue of extension
                                                        Control1..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypeReference(Radiotherapy Volume Profile)
                                                        [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                        Must Supporttrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        72. Procedure.extension:doseToVolume.extension:fractionDose
                                                        Slice NamefractionDose
                                                        Definition

                                                        An Extension

                                                        ShortExtension
                                                        Control1..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension
                                                        Must Supporttrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        74. Procedure.extension:doseToVolume.extension:fractionDose.id
                                                        Definition

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

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        Typestring
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        76. Procedure.extension:doseToVolume.extension:fractionDose.extension
                                                        Definition

                                                        An Extension

                                                        ShortExtension
                                                        Control0..0
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        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
                                                        • 78. Procedure.extension:doseToVolume.extension:fractionDose.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
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Fixed ValuefractionDose
                                                          80. Procedure.extension:doseToVolume.extension:fractionDose.value[x]
                                                          Definition

                                                          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                          ShortValue of extension
                                                          Control1..1
                                                          This element is affected by the following invariants: ele-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
                                                          Must Supporttrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          82. Procedure.extension:doseToVolume.extension:numberOfFractions
                                                          Slice NamenumberOfFractions
                                                          Definition

                                                          An Extension

                                                          ShortExtension
                                                          Control1..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension
                                                          Must Supporttrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          84. Procedure.extension:doseToVolume.extension:numberOfFractions.id
                                                          Definition

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

                                                          ShortUnique id for inter-element referencing
                                                          Control0..1
                                                          Typestring
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          86. Procedure.extension:doseToVolume.extension:numberOfFractions.extension
                                                          Definition

                                                          An Extension

                                                          ShortExtension
                                                          Control0..0
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          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
                                                          • 88. Procedure.extension:doseToVolume.extension:numberOfFractions.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
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Fixed ValuenumberOfFractions
                                                            90. Procedure.extension:doseToVolume.extension:numberOfFractions.value[x]
                                                            Definition

                                                            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                            ShortValue of extension
                                                            Control1..1
                                                            This element is affected by the following invariants: ele-1
                                                            TypeunsignedInt
                                                            [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
                                                            Must Supporttrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            92. Procedure.extension:doseToVolume.extension:totalDose
                                                            Slice NametotalDose
                                                            Definition

                                                            An Extension

                                                            ShortExtension
                                                            Control1..1
                                                            This element is affected by the following invariants: ele-1
                                                            TypeExtension
                                                            Must Supporttrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            94. Procedure.extension:doseToVolume.extension:totalDose.id
                                                            Definition

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

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            Typestring
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            96. Procedure.extension:doseToVolume.extension:totalDose.extension
                                                            Definition

                                                            An Extension

                                                            ShortExtension
                                                            Control0..0
                                                            This element is affected by the following invariants: ele-1
                                                            TypeExtension
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            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
                                                            • 98. Procedure.extension:doseToVolume.extension:totalDose.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
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Fixed ValuetotalDose
                                                              100. Procedure.extension:doseToVolume.extension:totalDose.value[x]
                                                              Definition

                                                              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                              ShortValue of extension
                                                              Control1..1
                                                              This element is affected by the following invariants: ele-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
                                                              Must Supporttrue
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              102. Procedure.extension:doseToVolume.extension:rtDoseUID
                                                              Slice NamertDoseUID
                                                              Definition

                                                              An Extension

                                                              ShortExtension
                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1
                                                              TypeExtension
                                                              Must Supporttrue
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              104. Procedure.extension:doseToVolume.extension:rtDoseUID.id
                                                              Definition

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

                                                              ShortUnique id for inter-element referencing
                                                              Control0..1
                                                              Typestring
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              106. Procedure.extension:doseToVolume.extension:rtDoseUID.extension
                                                              Definition

                                                              An Extension

                                                              ShortExtension
                                                              Control0..0
                                                              This element is affected by the following invariants: ele-1
                                                              TypeExtension
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              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
                                                              • 108. Procedure.extension:doseToVolume.extension:rtDoseUID.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
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Fixed ValuertDoseUID
                                                                110. Procedure.extension:doseToVolume.extension:rtDoseUID.value[x]
                                                                Definition

                                                                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                ShortValue of extension
                                                                Control0..1
                                                                This element is affected by the following invariants: ele-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
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                112. Procedure.extension:doseToVolume.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
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Fixed Valuehttps://build.fhir.org/ig/arkhn/arkhn-ig-osiris/StructureDefinition/doseToVolume
                                                                114. Procedure.extension:doseToVolume.value[x]
                                                                Definition

                                                                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                ShortValue of extension
                                                                Control0..0
                                                                This element is affected by the following invariants: ele-1
                                                                TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                116. Procedure.extension:modalityAndTechnique
                                                                Slice NamemodalityAndTechnique
                                                                Definition

                                                                Modality And Technique

                                                                ShortModality And Technique
                                                                Control0..*
                                                                This element is affected by the following invariants: ele-1
                                                                TypeExtension(Modality And Technique) (Complex Extension)
                                                                Must Supporttrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                118. Procedure.extension:modalityAndTechnique.id
                                                                Definition

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

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                Typestring
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                120. Procedure.extension:modalityAndTechnique.extension
                                                                Definition

                                                                An Extension

                                                                ShortExtension
                                                                Control2..*
                                                                This element is affected by the following invariants: ele-1
                                                                TypeExtension
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                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
                                                                • 122. Procedure.extension:modalityAndTechnique.extension:radiotherapyModality
                                                                  Slice NameradiotherapyModality
                                                                  Definition

                                                                  An Extension

                                                                  ShortExtension
                                                                  Control1..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeExtension
                                                                  Must Supporttrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  124. Procedure.extension:modalityAndTechnique.extension:radiotherapyModality.id
                                                                  Definition

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

                                                                  ShortUnique id for inter-element referencing
                                                                  Control0..1
                                                                  Typestring
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  126. Procedure.extension:modalityAndTechnique.extension:radiotherapyModality.extension
                                                                  Definition

                                                                  An Extension

                                                                  ShortExtension
                                                                  Control0..0
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeExtension
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  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
                                                                  • 128. Procedure.extension:modalityAndTechnique.extension:radiotherapyModality.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
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Fixed ValueradiotherapyModality
                                                                    130. Procedure.extension:modalityAndTechnique.extension:radiotherapyModality.value[x]
                                                                    Definition

                                                                    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                    ShortValue of extension
                                                                    Control1..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    BindingThe codes SHALL be taken from http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs
                                                                    (required to http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs)
                                                                    TypeCodeableConcept
                                                                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                                    Must Supporttrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    132. Procedure.extension:modalityAndTechnique.extension:radiotherapyTechnique
                                                                    Slice NameradiotherapyTechnique
                                                                    Definition

                                                                    An Extension

                                                                    ShortExtension
                                                                    Control1..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    TypeExtension
                                                                    Must Supporttrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    134. Procedure.extension:modalityAndTechnique.extension:radiotherapyTechnique.id
                                                                    Definition

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

                                                                    ShortUnique id for inter-element referencing
                                                                    Control0..1
                                                                    Typestring
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    136. Procedure.extension:modalityAndTechnique.extension:radiotherapyTechnique.extension
                                                                    Definition

                                                                    An Extension

                                                                    ShortExtension
                                                                    Control0..0
                                                                    This element is affected by the following invariants: ele-1
                                                                    TypeExtension
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    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
                                                                    • 138. Procedure.extension:modalityAndTechnique.extension:radiotherapyTechnique.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
                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                      Fixed ValueradiotherapyTechnique
                                                                      140. Procedure.extension:modalityAndTechnique.extension:radiotherapyTechnique.value[x]
                                                                      Definition

                                                                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                      ShortValue of extension
                                                                      Control1..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      BindingThe codes SHALL be taken from http://hl7.org/fhir/us/mcode/ValueSet/mcode-teleradiotherapy-photon-beam-technique-vs
                                                                      (required to http://hl7.org/fhir/us/mcode/ValueSet/mcode-teleradiotherapy-photon-beam-technique-vs)
                                                                      TypeCodeableConcept
                                                                      [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                                      Must Supporttrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      142. Procedure.extension:modalityAndTechnique.extension:radiotherapyTreatmentMachinePlanned
                                                                      Slice NameradiotherapyTreatmentMachinePlanned
                                                                      Definition

                                                                      An Extension

                                                                      ShortExtension
                                                                      Control0..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypeExtension
                                                                      Must Supporttrue
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      144. Procedure.extension:modalityAndTechnique.extension:radiotherapyTreatmentMachinePlanned.id
                                                                      Definition

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

                                                                      ShortUnique id for inter-element referencing
                                                                      Control0..1
                                                                      Typestring
                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                      146. Procedure.extension:modalityAndTechnique.extension:radiotherapyTreatmentMachinePlanned.extension
                                                                      Definition

                                                                      An Extension

                                                                      ShortExtension
                                                                      Control0..0
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypeExtension
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      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
                                                                      • 148. Procedure.extension:modalityAndTechnique.extension:radiotherapyTreatmentMachinePlanned.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
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        Fixed ValueradiotherapyTreatmentMachinePlanned
                                                                        150. Procedure.extension:modalityAndTechnique.extension:radiotherapyTreatmentMachinePlanned.value[x]
                                                                        Definition

                                                                        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                        ShortValue of extension
                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-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
                                                                        Must Supporttrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        152. Procedure.extension:modalityAndTechnique.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
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        Fixed Valuehttps://build.fhir.org/ig/arkhn/arkhn-ig-osiris/StructureDefinition/modalityAndTechnique
                                                                        154. Procedure.extension:modalityAndTechnique.value[x]
                                                                        Definition

                                                                        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                        ShortValue of extension
                                                                        Control0..0
                                                                        This element is affected by the following invariants: ele-1
                                                                        TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        156. Procedure.extension:energyOrIsotope
                                                                        Slice NameenergyOrIsotope
                                                                        Definition

                                                                        Energy Or Isotope

                                                                        ShortEnergy Or Isotope
                                                                        Control0..*
                                                                        This element is affected by the following invariants: ele-1
                                                                        TypeExtension(Energy Or Isotope) (Complex Extension)
                                                                        Must Supporttrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        158. Procedure.extension:energyOrIsotope.id
                                                                        Definition

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

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        Typestring
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        160. Procedure.extension:energyOrIsotope.extension
                                                                        Definition

                                                                        An Extension

                                                                        ShortExtension
                                                                        Control1..*
                                                                        This element is affected by the following invariants: ele-1
                                                                        TypeExtension
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        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
                                                                        • 162. Procedure.extension:energyOrIsotope.extension:quantityEnergyOrIsotope
                                                                          Slice NamequantityEnergyOrIsotope
                                                                          Definition

                                                                          An Extension

                                                                          ShortExtension
                                                                          Control1..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypeExtension
                                                                          Must Supporttrue
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          164. Procedure.extension:energyOrIsotope.extension:quantityEnergyOrIsotope.id
                                                                          Definition

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

                                                                          ShortUnique id for inter-element referencing
                                                                          Control0..1
                                                                          Typestring
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          166. Procedure.extension:energyOrIsotope.extension:quantityEnergyOrIsotope.extension
                                                                          Definition

                                                                          An Extension

                                                                          ShortExtension
                                                                          Control0..0
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypeExtension
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          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
                                                                          • 168. Procedure.extension:energyOrIsotope.extension:quantityEnergyOrIsotope.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
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            Fixed ValuequantityEnergyOrIsotope
                                                                            170. Procedure.extension:energyOrIsotope.extension:quantityEnergyOrIsotope.value[x]
                                                                            Definition

                                                                            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                            ShortValue of extension
                                                                            Control1..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            TypeQuantity
                                                                            [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                                            Must Supporttrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            172. Procedure.extension:energyOrIsotope.extension:nameEnergyOrIsotope
                                                                            Slice NamenameEnergyOrIsotope
                                                                            Definition

                                                                            An Extension

                                                                            ShortExtension
                                                                            Control0..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            TypeExtension
                                                                            Must Supporttrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            174. Procedure.extension:energyOrIsotope.extension:nameEnergyOrIsotope.id
                                                                            Definition

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

                                                                            ShortUnique id for inter-element referencing
                                                                            Control0..1
                                                                            Typestring
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            176. Procedure.extension:energyOrIsotope.extension:nameEnergyOrIsotope.extension
                                                                            Definition

                                                                            An Extension

                                                                            ShortExtension
                                                                            Control0..0
                                                                            This element is affected by the following invariants: ele-1
                                                                            TypeExtension
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            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
                                                                            • 178. Procedure.extension:energyOrIsotope.extension:nameEnergyOrIsotope.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
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Fixed ValuenameEnergyOrIsotope
                                                                              180. Procedure.extension:energyOrIsotope.extension:nameEnergyOrIsotope.value[x]
                                                                              Definition

                                                                              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                              ShortValue of extension
                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-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
                                                                              Must Supporttrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              182. Procedure.extension:energyOrIsotope.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
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Fixed Valuehttps://build.fhir.org/ig/arkhn/arkhn-ig-osiris/StructureDefinition/energyOrIsotope
                                                                              184. Procedure.extension:energyOrIsotope.value[x]
                                                                              Definition

                                                                              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                              ShortValue of extension
                                                                              Control0..0
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              186. Procedure.extension:numberOfFractions
                                                                              Slice NamenumberOfFractions
                                                                              Definition

                                                                              Number of Fractions. If delivred, it should be extracted from MOSAIQ/ARIA Record and Verify. If planned, it corresponds to Dicom Tag (300A,0078)

                                                                              ShortNumber of Fractions
                                                                              Control1..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeExtension(Number of Fractions) (Extension Type: unsignedInt)
                                                                              Must Supporttrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              188. Procedure.extension:reasonReplanification
                                                                              Slice NamereasonReplanification
                                                                              Definition

                                                                              Reason Replanification. It should be extracted from MOSAIQ/ARIA Record and Verify.

                                                                              ShortReason Replanification
                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeExtension(Reason Replanification) (Extension Type: CodeableConcept)
                                                                              Must Supporttrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              190. Procedure.extension:algorithmName
                                                                              Slice NamealgorithmName
                                                                              Definition

                                                                              Name of the algorithm. Dicom Tag (0066,0036)

                                                                              ShortName of the algorithm
                                                                              Control1..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeExtension(Algorith mName) (Extension Type: string)
                                                                              Must Supporttrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              192. 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

                                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                              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..*
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeExtension
                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                                                              Standards StatusNormative (from Trial Use)
                                                                              Requirements

                                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                              Alternate Namesextensions, user content
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              SlicingThis element introduces a set of slices on Procedure.modifierExtension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 194. Procedure.identifier
                                                                                Definition

                                                                                Business identifiers assigned to this procedure by the performer or other systems which remain constant as the resource is updated and is propagated from server to server.

                                                                                ShortExternal Identifiers for this procedure
                                                                                Comments

                                                                                This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and Person resource instances might share the same social insurance number.

                                                                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                Control1..*
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeIdentifier
                                                                                Summarytrue
                                                                                Requirements

                                                                                Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                SlicingThis element introduces a set of slices on Procedure.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                • pattern @ type
                                                                                • 196. Procedure.identifier:rtPlanUID
                                                                                  Slice NamertPlanUID
                                                                                  Definition

                                                                                  Reference SOP Instance UID of the RT Plan. Dicom Tag (0008,1155)

                                                                                  ShortUID RT Plan
                                                                                  Comments

                                                                                  This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and Person resource instances might share the same social insurance number.

                                                                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                  Control1..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeIdentifier
                                                                                  Must Supporttrue
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  198. Procedure.identifier:rtPlanUID.id
                                                                                  Definition

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

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  200. Procedure.identifier:rtPlanUID.extension
                                                                                  Definition

                                                                                  May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..*
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension
                                                                                  Standards StatusNormative (from Trial Use)
                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  SlicingThis element introduces a set of slices on Procedure.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ url
                                                                                  • 202. Procedure.identifier:rtPlanUID.use
                                                                                    Definition

                                                                                    The purpose of this identifier.

                                                                                    Shortusual | official | temp | secondary | old (If known)
                                                                                    Comments

                                                                                    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    BindingThe codes SHALL be taken from IdentifierUse
                                                                                    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                                                                    Identifies the purpose for this identifier, if known .

                                                                                    Typecode
                                                                                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    204. Procedure.identifier:rtPlanUID.type
                                                                                    Definition

                                                                                    A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                                                                    ShortDescription of identifier
                                                                                    Comments

                                                                                    This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                                                                    Control1..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                                                                                    A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                                                                    TypeCodeableConcept
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Allows users to make use of identifiers when the identifier system is not known.

                                                                                    Pattern Value{
                                                                                      "coding" : [{
                                                                                        "code" : "MR"
                                                                                      }]
                                                                                    }
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    206. Procedure.identifier:rtPlanUID.system
                                                                                    Definition

                                                                                    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                                                                    ShortThe namespace for the identifier value
                                                                                    Comments

                                                                                    Identifier.system is always case sensitive.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    Typeuri
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                                                                    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    208. Procedure.identifier:rtPlanUID.value
                                                                                    Definition

                                                                                    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                                                                    ShortThe value that is unique
                                                                                    Comments

                                                                                    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    Typestring
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Example<br/><b>General</b>:123456
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    210. Procedure.identifier:rtPlanUID.period
                                                                                    Definition

                                                                                    Time period during which identifier is/was valid for use.

                                                                                    ShortTime period when id is/was valid for use
                                                                                    Comments

                                                                                    A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                                    Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypePeriod
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                                                                    212. Procedure.identifier:rtPlanUID.assigner
                                                                                    Definition

                                                                                    Organization that issued/manages the identifier.

                                                                                    ShortOrganization that issued id (may be just text)
                                                                                    Comments

                                                                                    The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeReference(Organization)
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ref-1: 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')))
                                                                                    214. Procedure.instantiatesCanonical
                                                                                    Definition

                                                                                    The URL pointing to a FHIR-defined protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure.

                                                                                    ShortInstantiates FHIR protocol or definition
                                                                                    Comments

                                                                                    see Canonical References

                                                                                    Control0..*
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    Typecanonical(PlanDefinition, ActivityDefinition, Measure, OperationDefinition, Questionnaire)
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    216. Procedure.instantiatesUri
                                                                                    Definition

                                                                                    The URL pointing to an externally maintained protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure.

                                                                                    ShortInstantiates external protocol or definition
                                                                                    Comments

                                                                                    This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

                                                                                    Control0..*
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    Typeuri
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    218. Procedure.basedOn
                                                                                    Definition

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

                                                                                    ShortA request for this procedure
                                                                                    Comments

                                                                                    References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                                                    Control0..*
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeReference(CarePlan, ServiceRequest)
                                                                                    Summarytrue
                                                                                    Alternate Namesfulfills
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ref-1: 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')))
                                                                                    220. Procedure.partOf
                                                                                    Definition

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

                                                                                    ShortShould Reference a Radiotherapy Treatment Phase
                                                                                    Comments

                                                                                    The MedicationAdministration resource has a partOf reference to Procedure, but this is not a circular reference. For example, the anesthesia MedicationAdministration is part of the surgical Procedure (MedicationAdministration.partOf = Procedure). For example, the procedure to insert the IV port for an IV medication administration is part of the medication administration (Procedure.partOf = MedicationAdministration).

                                                                                    Control1..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeReference(Radiotherapy Phase)
                                                                                    Summarytrue
                                                                                    Alternate Namescontainer
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ref-1: 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')))
                                                                                    222. Procedure.status
                                                                                    Definition

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

                                                                                    Shortpreparation | in-progress | not-done | on-hold | stopped | 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
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    BindingThe codes SHALL be taken from EventStatus
                                                                                    (required to http://hl7.org/fhir/ValueSet/event-status|4.0.1)

                                                                                    A code specifying the state of the procedure.

                                                                                    Typecode
                                                                                    Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    224. Procedure.statusReason
                                                                                    Definition

                                                                                    Captures the reason for the current state of the procedure.

                                                                                    ShortReason for current status
                                                                                    Comments

                                                                                    This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    BindingFor example codes, see ProcedureNotPerformedReason(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
                                                                                    Alternate NamesSuspended Reason, Cancelled Reason
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    226. Procedure.category
                                                                                    Definition

                                                                                    Type (planned or delivered)

                                                                                    ShortType (planned or delivered)
                                                                                    Comments

                                                                                    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                    Control1..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    BindingFor example codes, see ProcedureCategoryCodes(SNOMEDCT)
                                                                                    (example to http://hl7.org/fhir/ValueSet/procedure-category)

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

                                                                                    TypeCodeableConcept
                                                                                    Must Supporttrue
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    228. 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.

                                                                                    ShortUnique id for inter-element referencing
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    230. Procedure.category.extension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..*
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeExtension
                                                                                    Standards StatusNormative (from Trial Use)
                                                                                    Alternate Namesextensions, user content
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    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
                                                                                    • 232. 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.

                                                                                      Control0..*
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      TypeCoding
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      234. Procedure.category.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.

                                                                                      ShortUnique id for inter-element referencing
                                                                                      Control0..1
                                                                                      Typestring
                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                      236. Procedure.category.coding.extension
                                                                                      Definition

                                                                                      May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..*
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      TypeExtension
                                                                                      Standards StatusNormative (from Trial Use)
                                                                                      Alternate Namesextensions, user content
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      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
                                                                                      • 238. Procedure.category.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 reference to some definition that establishes the system clearly and unambiguously.

                                                                                        Control0..1
                                                                                        This element is affected by the following invariants: ele-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.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        240. Procedure.category.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
                                                                                        This element is affected by the following invariants: ele-1
                                                                                        Typestring
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summarytrue
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        242. Procedure.category.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
                                                                                        Comments

                                                                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                        Control1..1
                                                                                        This element is affected by the following invariants: ele-1
                                                                                        BindingThe codes SHALL be taken from Radiotherapy Category
                                                                                        (required to https://build.fhir.org/ig/arkhn/arkhn-ig-osiris/ValueSet/vs-radiotherapy-category)
                                                                                        Typecode
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Must Supporttrue
                                                                                        Summarytrue
                                                                                        Requirements

                                                                                        Need to refer to a particular code in the system.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        244. Procedure.category.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
                                                                                        Comments

                                                                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                        Control0..1
                                                                                        This element is affected by the following invariants: ele-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.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        246. Procedure.category.coding.userSelected
                                                                                        Definition

                                                                                        Indicates that this coding was chosen by a user directly - e.g. 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
                                                                                        This element is affected by the following invariants: ele-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.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        248. 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
                                                                                        This element is affected by the following invariants: ele-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.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        250. 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
                                                                                        Comments

                                                                                        Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                        Control1..1
                                                                                        This element is affected by the following invariants: ele-1
                                                                                        BindingFor example codes, see ProcedureCodes(SNOMEDCT)
                                                                                        (example to http://hl7.org/fhir/ValueSet/procedure-code)

                                                                                        A code to identify a specific procedure .

                                                                                        TypeCodeableConcept
                                                                                        Must Supporttrue
                                                                                        Summarytrue
                                                                                        Requirements

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

                                                                                        Alternate Namestype
                                                                                        Pattern Value{
                                                                                          "coding" : [{
                                                                                            "system" : "http://snomed.info/sct",
                                                                                            "code" : "1255724003"
                                                                                          }]
                                                                                        }
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        252. 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.

                                                                                        ShortUnique id for inter-element referencing
                                                                                        Control0..1
                                                                                        Typestring
                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                        254. Procedure.code.extension
                                                                                        Definition

                                                                                        May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..*
                                                                                        This element is affected by the following invariants: ele-1
                                                                                        TypeExtension
                                                                                        Standards StatusNormative (from Trial Use)
                                                                                        Alternate Namesextensions, user content
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                        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
                                                                                        • 256. 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.

                                                                                          Control0..*
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          TypeCoding
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          258. Procedure.code.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.

                                                                                          ShortUnique id for inter-element referencing
                                                                                          Control0..1
                                                                                          Typestring
                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                          260. Procedure.code.coding.extension
                                                                                          Definition

                                                                                          May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..*
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          TypeExtension
                                                                                          Standards StatusNormative (from Trial Use)
                                                                                          Alternate Namesextensions, user content
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                          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
                                                                                          • 262. Procedure.code.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 reference to some definition that establishes the system clearly and unambiguously.

                                                                                            Control0..1
                                                                                            This element is affected by the following invariants: ele-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.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            264. Procedure.code.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
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            Typestring
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Summarytrue
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            266. Procedure.code.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
                                                                                            Comments

                                                                                            Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                            Control0..1
                                                                                            This element is affected by the following invariants: ele-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.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            268. Procedure.code.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
                                                                                            Comments

                                                                                            Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                            Control0..1
                                                                                            This element is affected by the following invariants: ele-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.

                                                                                            Pattern ValueRadiotherapy treatment plan (regime/therapy)
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            270. Procedure.code.coding.userSelected
                                                                                            Definition

                                                                                            Indicates that this coding was chosen by a user directly - e.g. 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
                                                                                            This element is affected by the following invariants: ele-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.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            272. 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
                                                                                            This element is affected by the following invariants: ele-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.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            274. Procedure.subject
                                                                                            Definition

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

                                                                                            ShortWho the procedure was performed on
                                                                                            Comments

                                                                                            References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                                                            Control1..1
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            TypeReference(Oncology Patient)
                                                                                            Must Supporttrue
                                                                                            Summarytrue
                                                                                            Alternate Namespatient
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            ref-1: 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')))
                                                                                            276. Procedure.encounter
                                                                                            Definition

                                                                                            The Encounter during which this Procedure was created or performed or to which the creation of this record is tightly associated.

                                                                                            ShortEncounter created as part of
                                                                                            Comments

                                                                                            This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

                                                                                            Control0..1
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            TypeReference(Encounter)
                                                                                            Summarytrue
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            ref-1: 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')))
                                                                                            278. Procedure.performed[x]
                                                                                            Definition

                                                                                            The start and end period

                                                                                            ShortWhen the procedure was performed
                                                                                            Comments

                                                                                            Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old. dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone.

                                                                                            Control1..1
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            TypePeriod
                                                                                            [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                                                            Summarytrue
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            280. Procedure.performed[x].id
                                                                                            Definition

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

                                                                                            ShortUnique id for inter-element referencing
                                                                                            Control0..1
                                                                                            Typestring
                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                            282. Procedure.performed[x].extension
                                                                                            Definition

                                                                                            May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..*
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            TypeExtension
                                                                                            Standards StatusNormative (from Trial Use)
                                                                                            Alternate Namesextensions, user content
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                            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
                                                                                            • 284. Procedure.performed[x].start
                                                                                              Definition

                                                                                              Start date and time. They should be extracted from MOSAIQ/ARIA Record and Verify.

                                                                                              ShortStart date
                                                                                              Comments

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

                                                                                              Control1..1
                                                                                              This element is affected by the following invariants: ele-1, per-1
                                                                                              TypedateTime
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Must Supporttrue
                                                                                              Summarytrue
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              286. Procedure.performed[x].end
                                                                                              Definition

                                                                                              End date and time. They should be extracted from MOSAIQ/ARIA Record and Verify.

                                                                                              ShortEnd date
                                                                                              Comments

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

                                                                                              Control1..1
                                                                                              This element is affected by the following invariants: ele-1, per-1
                                                                                              TypedateTime
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Must Supporttrue
                                                                                              Summarytrue
                                                                                              Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              288. Procedure.recorder
                                                                                              Definition

                                                                                              Individual who recorded the record and takes responsibility for its content.

                                                                                              ShortWho recorded the procedure
                                                                                              Comments

                                                                                              References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                                                              Control0..1
                                                                                              This element is affected by the following invariants: ele-1
                                                                                              TypeReference(Patient, RelatedPerson, Practitioner, PractitionerRole)
                                                                                              Summarytrue
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              ref-1: 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')))
                                                                                              290. Procedure.asserter
                                                                                              Definition

                                                                                              Individual who is making the procedure statement.

                                                                                              ShortPerson who asserts this procedure
                                                                                              Comments

                                                                                              References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                                                              Control0..1
                                                                                              This element is affected by the following invariants: ele-1
                                                                                              TypeReference(Patient, RelatedPerson, Practitioner, PractitionerRole)
                                                                                              Summarytrue
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              ref-1: 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')))
                                                                                              292. Procedure.performer
                                                                                              Definition

                                                                                              Limited to "real" people rather than equipment.

                                                                                              ShortThe people who performed the procedure
                                                                                              Control0..*
                                                                                              This element is affected by the following invariants: ele-1
                                                                                              TypeBackboneElement
                                                                                              Summarytrue
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              294. 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.

                                                                                              ShortUnique id for inter-element referencing
                                                                                              Control0..1
                                                                                              Typestring
                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                              296. Procedure.performer.extension
                                                                                              Definition

                                                                                              May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..*
                                                                                              This element is affected by the following invariants: ele-1
                                                                                              TypeExtension
                                                                                              Standards StatusNormative (from Trial Use)
                                                                                              Alternate Namesextensions, user content
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                              SlicingThis element introduces a set of slices on Procedure.performer.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                              • value @ url
                                                                                              • 298. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                                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..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                TypeExtension
                                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                Alternate Namesextensions, user content, modifiers
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                300. Procedure.performer.function
                                                                                                Definition

                                                                                                Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist.

                                                                                                ShortType of performance
                                                                                                Comments

                                                                                                Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                                Control0..1
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                BindingFor example codes, see ProcedurePerformerRoleCodes
                                                                                                (example to http://hl7.org/fhir/ValueSet/performer-role)

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

                                                                                                TypeCodeableConcept
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Allows disambiguation of the types of involvement of different performers.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                302. Procedure.performer.actor
                                                                                                Definition

                                                                                                The practitioner who was involved in the procedure.

                                                                                                ShortThe reference to the practitioner
                                                                                                Comments

                                                                                                References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                                                                Control1..1
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                TypeReference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
                                                                                                Summarytrue
                                                                                                Requirements

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

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                ref-1: 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')))
                                                                                                304. Procedure.performer.onBehalfOf
                                                                                                Definition

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

                                                                                                ShortOrganization the device or practitioner was acting for
                                                                                                Comments

                                                                                                References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                                                                Control0..1
                                                                                                This element is affected by the following invariants: ele-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.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                ref-1: 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')))
                                                                                                306. 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
                                                                                                Comments

                                                                                                References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                                                                Control0..1
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                TypeReference(Location)
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Ties a procedure to where the records are likely kept.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                ref-1: 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')))
                                                                                                308. Procedure.reasonCode
                                                                                                Definition

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

                                                                                                ShortCoded reason procedure performed
                                                                                                Comments

                                                                                                Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                BindingFor example codes, see ProcedureReasonCodes
                                                                                                (example to http://hl7.org/fhir/ValueSet/procedure-reason)

                                                                                                A code that identifies the reason a procedure is required.

                                                                                                TypeCodeableConcept
                                                                                                Summarytrue
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                310. Procedure.reasonReference
                                                                                                Definition

                                                                                                The justification of why the procedure was performed.

                                                                                                ShortThe justification that the procedure was performed
                                                                                                Comments

                                                                                                It is possible for a procedure to be a reason (such as C-Section) for another procedure (such as an epidural). Other examples include endoscopy for dilatation and biopsy (a combination of diagnostic and therapeutic use). Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                TypeReference(Condition, Observation, Procedure, DiagnosticReport, DocumentReference)
                                                                                                Summarytrue
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                ref-1: 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')))
                                                                                                312. Procedure.bodySite
                                                                                                Definition

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

                                                                                                ShortTarget body sites
                                                                                                Comments

                                                                                                If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension procedure-targetbodystructure.

                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                BindingFor example codes, see SNOMEDCTBodyStructures
                                                                                                (example to http://hl7.org/fhir/ValueSet/body-site)

                                                                                                Codes describing anatomical locations. May include laterality.

                                                                                                TypeCodeableConcept
                                                                                                Summarytrue
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                314. Procedure.outcome
                                                                                                Definition

                                                                                                The outcome of the procedure - did it resolve the 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
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                BindingFor example codes, see ProcedureOutcomeCodes(SNOMEDCT)
                                                                                                (example to http://hl7.org/fhir/ValueSet/procedure-outcome)

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

                                                                                                TypeCodeableConcept
                                                                                                Summarytrue
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                316. 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..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                TypeReference(DiagnosticReport, DocumentReference, Composition)
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                ref-1: 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')))
                                                                                                318. 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..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                BindingFor example codes, see Condition/Problem/DiagnosisCodes
                                                                                                (example to http://hl7.org/fhir/ValueSet/condition-code)

                                                                                                Codes describing complications that resulted from a procedure.

                                                                                                TypeCodeableConcept
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                320. 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
                                                                                                Comments

                                                                                                References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                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.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                ref-1: 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')))
                                                                                                322. Procedure.followUp
                                                                                                Definition

                                                                                                If the procedure required specific follow up - e.g. removal of sutures. The follow up 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
                                                                                                Comments

                                                                                                Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                BindingFor example codes, see ProcedureFollowUpCodes(SNOMEDCT)
                                                                                                (example to http://hl7.org/fhir/ValueSet/procedure-followup)

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

                                                                                                TypeCodeableConcept
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                324. Procedure.note
                                                                                                Definition

                                                                                                Any other notes and comments about the procedure.

                                                                                                ShortAdditional information about the procedure
                                                                                                Comments

                                                                                                For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                TypeAnnotation
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                326. 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.

                                                                                                ShortManipulated, implanted, or removed device
                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                TypeBackboneElement
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                328. 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.

                                                                                                ShortUnique id for inter-element referencing
                                                                                                Control0..1
                                                                                                Typestring
                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                330. Procedure.focalDevice.extension
                                                                                                Definition

                                                                                                May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                TypeExtension
                                                                                                Standards StatusNormative (from Trial Use)
                                                                                                Alternate Namesextensions, user content
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                SlicingThis element introduces a set of slices on Procedure.focalDevice.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                                • value @ url
                                                                                                • 332. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                                  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..*
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  TypeExtension
                                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                  Alternate Namesextensions, user content, modifiers
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                  334. Procedure.focalDevice.action
                                                                                                  Definition

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

                                                                                                  ShortKind of change to device
                                                                                                  Comments

                                                                                                  Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                                  Control0..1
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  BindingThe codes SHOULD be taken from ProcedureDeviceActionCodes
                                                                                                  (preferred to http://hl7.org/fhir/ValueSet/device-action)

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

                                                                                                  TypeCodeableConcept
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  336. Procedure.focalDevice.manipulated
                                                                                                  Definition

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

                                                                                                  ShortDevice that was changed
                                                                                                  Comments

                                                                                                  References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                                                                  Control1..1
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  TypeReference(Device)
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  ref-1: 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')))
                                                                                                  338. 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..*
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  TypeReference(Device, Medication, Substance)
                                                                                                  Requirements

                                                                                                  Used for tracking contamination, etc.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  ref-1: 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')))
                                                                                                  340. 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..*
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  BindingFor example codes, see FHIRDeviceTypes
                                                                                                  (example to http://hl7.org/fhir/ValueSet/device-kind)

                                                                                                  Codes describing items used during a procedure.

                                                                                                  TypeCodeableConcept
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))