SHINNYHRSN - Local Development build (v1.5.3) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Resource Profile: SHINNY SDOH Procedure Profile

• SHINNY HRSN: When applicable, needed for Referrals. Include in Task bundles.
• Profiled off of the SDOHCC Procedure: Profile for interventions that address Social Determinants of Health.

Usage:

• Examples for this Resource Profile: Procedure/ProcedureExample, Procedure/ScreeningProcedureExample and Procedure/TaskInProgressProcedureExample

Formal Views of Profile Content

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

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

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	SDOHCCProcedure	An action that addresses an SDOH condition, observation, or goal. dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
id	SΣ	1..1	id	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
meta	SΣ	1..1	SHINNYMeta	Metadata about the resource ele-1: All FHIR elements must have a @value or children
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
extension:pertainsToGoal	S	0..*	(Complex)	Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal"
value[x]	S	1..1	Reference(SDOHCC Goal)	Value of extension ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
Slices for basedOn	SΣ	0..*	Reference(CarePlan | ServiceRequest)	A request for this procedure Slice: Unordered, Open by profile:resolve() ele-1: All FHIR elements must have a @value or children
basedOn:SupportedBasedOn	SΣ	0..*	Reference(SDOHCC ServiceRequest)	An SDOH service request for this procedure ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required) ele-1: All FHIR elements must have a @value or children
category	Σ	0..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes. ele-1: All FHIR elements must have a @value or children
Slices for coding	SΣ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:$this ele-1: All FHIR elements must have a @value or children
coding:SDOH	SΣ	0..1	Coding	e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories. ele-1: All FHIR elements must have a @value or children
code	SΣ	1..1	CodeableConcept	Procedure codes from SNOMED CT, CPT, HCPCS II, ICD-10PC, or CDT Binding: US Core Procedure Codes (required): Codes describing the type of Procedure Additional Bindings Purpose Usage Digital Access Procedures Extensible Procedure.category = digital-access Digital Literacy Procedures Extensible Procedure.category = digital-literacy Less Than High School Education Procedures Extensible Procedure.category = educational-attainment Elder Abuse Procedures Extensible Procedure.category = elder-abuse Unemployment Procedures Extensible Procedure.category = employment-status Financial Insecurity Procedures Extensible Procedure.category = financial-insecurity Food Insecurity Procedures Extensible Procedure.category = food-insecurity Health Insurance Coverage Status Procedures Extensible Procedure.category = health-insurance-coverage-status Homelessness Procedures Extensible Procedure.category = homelessness Housing Instability Procedures Extensible Procedure.category = housing-instability Inadequate Housing Procedures Extensible Procedure.category = inadequate-housing Intimate Partner Violence Procedures Extensible Procedure.category = intimate-partner-violence Material Hardship Procedures Extensible Procedure.category = material-hardship Medical Cost Burden Procedures Extensible Procedure.category = medical-cost-burden Health Literacy Procedures Extensible Procedure.category = personal-health-literacy Social Connection Procedures Extensible Procedure.category = social-connection Stress Procedures Extensible Procedure.category = stress Transportation Insecurity Procedures Extensible Procedure.category = transportation-insecurity Utility Insecurity Procedures Extensible Procedure.category = utility-insecurity Veteran Status Procedures Extensible Procedure.category = veteran-status US Core Procedure Codes Required Procedure.category = sdoh-category-unspecified ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who the procedure was performed on ele-1: All FHIR elements must have a @value or children
encounter	SΣ	1..1	Reference(Encounter)	Encounter created as part of ele-1: All FHIR elements must have a @value or children
performed[x]	SΣ	1..1		When the procedure was performed ele-1: All FHIR elements must have a @value or children
performedDateTime			dateTime
performedPeriod			Period
Slices for reasonReference	Σ	0..*	Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference)	The justification that the procedure was performed Slice: Unordered, Open by profile:resolve() ele-1: All FHIR elements must have a @value or children
reasonReference:SupportedReasonReference	SΣ	0..*	Reference(SDOHCC Condition | SDOHCC Observation Screening Response | SDOHCC Observation Assessment)	The justification that the procedure was performed ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status from the FHIR Standard
Procedure.category	example	ProcedureCategoryCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-category from the FHIR Standard
Procedure.category.coding:SDOH	required	SDOHCCValueSetSDOHCategory http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory
Procedure.code	required	USCoreProcedureCodes http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code

Constraints

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

This structure is derived from SDOHCCProcedure

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	SDOHCCProcedure	An action that addresses an SDOH condition, observation, or goal.
id	S	1..1	id	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
meta	S	1..1	SHINNYMeta	Metadata about the resource
encounter	S	1..1	Reference(Encounter)	Encounter created as part of
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	SDOHCCProcedure	An action that addresses an SDOH condition, observation, or goal.
id	SΣ	1..1	id	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
meta	SΣ	1..1	SHINNYMeta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:pertainsToGoal	S	0..*	(Complex)	Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
id		0..1	id	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal"
value[x]	S	1..1	Reference(SDOHCC Goal)	Value of extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Identifiers for this procedure
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
Slices for basedOn	SΣ	0..*	Reference(CarePlan | ServiceRequest)	A request for this procedure Slice: Unordered, Open by profile:resolve()
basedOn:SupportedBasedOn	SΣ	0..*	Reference(SDOHCC ServiceRequest)	An SDOH service request for this procedure
partOf	Σ	0..*	Reference(Procedure | Observation | MedicationAdministration)	Part of referenced event
status	?!SΣ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required)
statusReason	Σ	0..1	CodeableConcept	Reason for current status Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.
category	Σ	0..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	SΣ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:SDOH	SΣ	0..1	Coding	e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories.
text	Σ	0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	Procedure codes from SNOMED CT, CPT, HCPCS II, ICD-10PC, or CDT Binding: US Core Procedure Codes (required): Codes describing the type of Procedure Additional Bindings Purpose Usage Digital Access Procedures Extensible Procedure.category = digital-access Digital Literacy Procedures Extensible Procedure.category = digital-literacy Less Than High School Education Procedures Extensible Procedure.category = educational-attainment Elder Abuse Procedures Extensible Procedure.category = elder-abuse Unemployment Procedures Extensible Procedure.category = employment-status Financial Insecurity Procedures Extensible Procedure.category = financial-insecurity Food Insecurity Procedures Extensible Procedure.category = food-insecurity Health Insurance Coverage Status Procedures Extensible Procedure.category = health-insurance-coverage-status Homelessness Procedures Extensible Procedure.category = homelessness Housing Instability Procedures Extensible Procedure.category = housing-instability Inadequate Housing Procedures Extensible Procedure.category = inadequate-housing Intimate Partner Violence Procedures Extensible Procedure.category = intimate-partner-violence Material Hardship Procedures Extensible Procedure.category = material-hardship Medical Cost Burden Procedures Extensible Procedure.category = medical-cost-burden Health Literacy Procedures Extensible Procedure.category = personal-health-literacy Social Connection Procedures Extensible Procedure.category = social-connection Stress Procedures Extensible Procedure.category = stress Transportation Insecurity Procedures Extensible Procedure.category = transportation-insecurity Utility Insecurity Procedures Extensible Procedure.category = utility-insecurity Veteran Status Procedures Extensible Procedure.category = veteran-status US Core Procedure Codes Required Procedure.category = sdoh-category-unspecified
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who the procedure was performed on
encounter	SΣ	1..1	Reference(Encounter)	Encounter created as part of
performed[x]	SΣ	1..1		When the procedure was performed
performedDateTime			dateTime
performedPeriod			Period
recorder	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Who recorded the procedure
asserter	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Person who asserts this procedure
performer	Σ	0..*	BackboneElement	The people who performed the procedure
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
location	Σ	0..1	Reference(Location)	Where the procedure happened
reasonCode	Σ	0..*	CodeableConcept	Coded reason procedure performed Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required.
Slices for reasonReference	Σ	0..*	Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference)	The justification that the procedure was performed Slice: Unordered, Open by profile:resolve()
reasonReference:SupportedReasonReference	SΣ	0..*	Reference(SDOHCC Condition | SDOHCC Observation Screening Response | SDOHCC Observation Assessment)	The justification that the procedure was performed
bodySite	Σ	0..*	CodeableConcept	Target body sites Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
outcome	Σ	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
report		0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Any report resulting from the procedure
complication		0..*	CodeableConcept	Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
complicationDetail		0..*	Reference(Condition)	A condition that is a result of the procedure
followUp		0..*	CodeableConcept	Instructions for follow up Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.
note		0..*	Annotation	Additional information about the procedure
focalDevice		0..*	BackboneElement	Manipulated, implanted, or removed device
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
action		0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.
manipulated		1..1	Reference(Device)	Device that was changed
usedReference		0..*	Reference(Device | Medication | Substance)	Items used during procedure
usedCode		0..*	CodeableConcept	Coded items used during the procedure Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Procedure.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status from the FHIR Standard
Procedure.statusReason	example	ProcedureNotPerformedReason(SNOMED-CT) http://hl7.org/fhir/ValueSet/procedure-not-performed-reason from the FHIR Standard
Procedure.category	example	ProcedureCategoryCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-category from the FHIR Standard
Procedure.category.coding:SDOH	required	SDOHCCValueSetSDOHCategory http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory
Procedure.code	required	USCoreProcedureCodes http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
Procedure.performer.function	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
Procedure.reasonCode	example	ProcedureReasonCodes http://hl7.org/fhir/ValueSet/procedure-reason from the FHIR Standard
Procedure.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Procedure.outcome	example	ProcedureOutcomeCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-outcome from the FHIR Standard
Procedure.complication	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
Procedure.followUp	example	ProcedureFollowUpCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-followup from the FHIR Standard
Procedure.focalDevice.action	preferred	ProcedureDeviceActionCodes http://hl7.org/fhir/ValueSet/device-action from the FHIR Standard
Procedure.usedCode	example	FHIRDeviceTypes http://hl7.org/fhir/ValueSet/device-kind from the FHIR Standard

Constraints

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

This structure is derived from SDOHCCProcedure

Summary

Mandatory: 3 elements
Must-Support: 3 elements

Structures

This structure refers to these other structures:

• SHINNYMeta (http://shinny.org/us/ny/hrsn/StructureDefinition/SHINNYMeta)

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	SDOHCCProcedure	An action that addresses an SDOH condition, observation, or goal. dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
id	SΣ	1..1	id	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
meta	SΣ	1..1	SHINNYMeta	Metadata about the resource ele-1: All FHIR elements must have a @value or children
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
extension:pertainsToGoal	S	0..*	(Complex)	Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal"
value[x]	S	1..1	Reference(SDOHCC Goal)	Value of extension ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
Slices for basedOn	SΣ	0..*	Reference(CarePlan | ServiceRequest)	A request for this procedure Slice: Unordered, Open by profile:resolve() ele-1: All FHIR elements must have a @value or children
basedOn:SupportedBasedOn	SΣ	0..*	Reference(SDOHCC ServiceRequest)	An SDOH service request for this procedure ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required) ele-1: All FHIR elements must have a @value or children
category	Σ	0..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes. ele-1: All FHIR elements must have a @value or children
Slices for coding	SΣ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:$this ele-1: All FHIR elements must have a @value or children
coding:SDOH	SΣ	0..1	Coding	e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories. ele-1: All FHIR elements must have a @value or children
code	SΣ	1..1	CodeableConcept	Procedure codes from SNOMED CT, CPT, HCPCS II, ICD-10PC, or CDT Binding: US Core Procedure Codes (required): Codes describing the type of Procedure Additional Bindings Purpose Usage Digital Access Procedures Extensible Procedure.category = digital-access Digital Literacy Procedures Extensible Procedure.category = digital-literacy Less Than High School Education Procedures Extensible Procedure.category = educational-attainment Elder Abuse Procedures Extensible Procedure.category = elder-abuse Unemployment Procedures Extensible Procedure.category = employment-status Financial Insecurity Procedures Extensible Procedure.category = financial-insecurity Food Insecurity Procedures Extensible Procedure.category = food-insecurity Health Insurance Coverage Status Procedures Extensible Procedure.category = health-insurance-coverage-status Homelessness Procedures Extensible Procedure.category = homelessness Housing Instability Procedures Extensible Procedure.category = housing-instability Inadequate Housing Procedures Extensible Procedure.category = inadequate-housing Intimate Partner Violence Procedures Extensible Procedure.category = intimate-partner-violence Material Hardship Procedures Extensible Procedure.category = material-hardship Medical Cost Burden Procedures Extensible Procedure.category = medical-cost-burden Health Literacy Procedures Extensible Procedure.category = personal-health-literacy Social Connection Procedures Extensible Procedure.category = social-connection Stress Procedures Extensible Procedure.category = stress Transportation Insecurity Procedures Extensible Procedure.category = transportation-insecurity Utility Insecurity Procedures Extensible Procedure.category = utility-insecurity Veteran Status Procedures Extensible Procedure.category = veteran-status US Core Procedure Codes Required Procedure.category = sdoh-category-unspecified ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who the procedure was performed on ele-1: All FHIR elements must have a @value or children
encounter	SΣ	1..1	Reference(Encounter)	Encounter created as part of ele-1: All FHIR elements must have a @value or children
performed[x]	SΣ	1..1		When the procedure was performed ele-1: All FHIR elements must have a @value or children
performedDateTime			dateTime
performedPeriod			Period
Slices for reasonReference	Σ	0..*	Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference)	The justification that the procedure was performed Slice: Unordered, Open by profile:resolve() ele-1: All FHIR elements must have a @value or children
reasonReference:SupportedReasonReference	SΣ	0..*	Reference(SDOHCC Condition | SDOHCC Observation Screening Response | SDOHCC Observation Assessment)	The justification that the procedure was performed ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status from the FHIR Standard
Procedure.category	example	ProcedureCategoryCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-category from the FHIR Standard
Procedure.category.coding:SDOH	required	SDOHCCValueSetSDOHCategory http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory
Procedure.code	required	USCoreProcedureCodes http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code

Constraints

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

Differential View

This structure is derived from SDOHCCProcedure

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	SDOHCCProcedure	An action that addresses an SDOH condition, observation, or goal.
id	S	1..1	id	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
meta	S	1..1	SHINNYMeta	Metadata about the resource
encounter	S	1..1	Reference(Encounter)	Encounter created as part of
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	SDOHCCProcedure	An action that addresses an SDOH condition, observation, or goal.
id	SΣ	1..1	id	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
meta	SΣ	1..1	SHINNYMeta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:pertainsToGoal	S	0..*	(Complex)	Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
id		0..1	id	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal"
value[x]	S	1..1	Reference(SDOHCC Goal)	Value of extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Identifiers for this procedure
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
Slices for basedOn	SΣ	0..*	Reference(CarePlan | ServiceRequest)	A request for this procedure Slice: Unordered, Open by profile:resolve()
basedOn:SupportedBasedOn	SΣ	0..*	Reference(SDOHCC ServiceRequest)	An SDOH service request for this procedure
partOf	Σ	0..*	Reference(Procedure | Observation | MedicationAdministration)	Part of referenced event
status	?!SΣ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required)
statusReason	Σ	0..1	CodeableConcept	Reason for current status Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.
category	Σ	0..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	SΣ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:SDOH	SΣ	0..1	Coding	e.g., food-insecurity | transportation-insecurity Binding: SDOHCC ValueSet SDOH Category (required): Codes for high-level SDOH categories.
text	Σ	0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	Procedure codes from SNOMED CT, CPT, HCPCS II, ICD-10PC, or CDT Binding: US Core Procedure Codes (required): Codes describing the type of Procedure Additional Bindings Purpose Usage Digital Access Procedures Extensible Procedure.category = digital-access Digital Literacy Procedures Extensible Procedure.category = digital-literacy Less Than High School Education Procedures Extensible Procedure.category = educational-attainment Elder Abuse Procedures Extensible Procedure.category = elder-abuse Unemployment Procedures Extensible Procedure.category = employment-status Financial Insecurity Procedures Extensible Procedure.category = financial-insecurity Food Insecurity Procedures Extensible Procedure.category = food-insecurity Health Insurance Coverage Status Procedures Extensible Procedure.category = health-insurance-coverage-status Homelessness Procedures Extensible Procedure.category = homelessness Housing Instability Procedures Extensible Procedure.category = housing-instability Inadequate Housing Procedures Extensible Procedure.category = inadequate-housing Intimate Partner Violence Procedures Extensible Procedure.category = intimate-partner-violence Material Hardship Procedures Extensible Procedure.category = material-hardship Medical Cost Burden Procedures Extensible Procedure.category = medical-cost-burden Health Literacy Procedures Extensible Procedure.category = personal-health-literacy Social Connection Procedures Extensible Procedure.category = social-connection Stress Procedures Extensible Procedure.category = stress Transportation Insecurity Procedures Extensible Procedure.category = transportation-insecurity Utility Insecurity Procedures Extensible Procedure.category = utility-insecurity Veteran Status Procedures Extensible Procedure.category = veteran-status US Core Procedure Codes Required Procedure.category = sdoh-category-unspecified
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who the procedure was performed on
encounter	SΣ	1..1	Reference(Encounter)	Encounter created as part of
performed[x]	SΣ	1..1		When the procedure was performed
performedDateTime			dateTime
performedPeriod			Period
recorder	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Who recorded the procedure
asserter	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Person who asserts this procedure
performer	Σ	0..*	BackboneElement	The people who performed the procedure
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
location	Σ	0..1	Reference(Location)	Where the procedure happened
reasonCode	Σ	0..*	CodeableConcept	Coded reason procedure performed Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required.
Slices for reasonReference	Σ	0..*	Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference)	The justification that the procedure was performed Slice: Unordered, Open by profile:resolve()
reasonReference:SupportedReasonReference	SΣ	0..*	Reference(SDOHCC Condition | SDOHCC Observation Screening Response | SDOHCC Observation Assessment)	The justification that the procedure was performed
bodySite	Σ	0..*	CodeableConcept	Target body sites Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
outcome	Σ	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
report		0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Any report resulting from the procedure
complication		0..*	CodeableConcept	Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
complicationDetail		0..*	Reference(Condition)	A condition that is a result of the procedure
followUp		0..*	CodeableConcept	Instructions for follow up Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.
note		0..*	Annotation	Additional information about the procedure
focalDevice		0..*	BackboneElement	Manipulated, implanted, or removed device
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
action		0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.
manipulated		1..1	Reference(Device)	Device that was changed
usedReference		0..*	Reference(Device | Medication | Substance)	Items used during procedure
usedCode		0..*	CodeableConcept	Coded items used during the procedure Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Procedure.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status from the FHIR Standard
Procedure.statusReason	example	ProcedureNotPerformedReason(SNOMED-CT) http://hl7.org/fhir/ValueSet/procedure-not-performed-reason from the FHIR Standard
Procedure.category	example	ProcedureCategoryCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-category from the FHIR Standard
Procedure.category.coding:SDOH	required	SDOHCCValueSetSDOHCategory http://hl7.org/fhir/us/sdoh-clinicalcare/ValueSet/SDOHCC-ValueSetSDOHCategory
Procedure.code	required	USCoreProcedureCodes http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
Procedure.performer.function	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
Procedure.reasonCode	example	ProcedureReasonCodes http://hl7.org/fhir/ValueSet/procedure-reason from the FHIR Standard
Procedure.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Procedure.outcome	example	ProcedureOutcomeCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-outcome from the FHIR Standard
Procedure.complication	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
Procedure.followUp	example	ProcedureFollowUpCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-followup from the FHIR Standard
Procedure.focalDevice.action	preferred	ProcedureDeviceActionCodes http://hl7.org/fhir/ValueSet/device-action from the FHIR Standard
Procedure.usedCode	example	FHIRDeviceTypes http://hl7.org/fhir/ValueSet/device-kind from the FHIR Standard

Constraints

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

This structure is derived from SDOHCCProcedure

Summary

Mandatory: 3 elements
Must-Support: 3 elements

Structures

This structure refers to these other structures:

• SHINNYMeta (http://shinny.org/us/ny/hrsn/StructureDefinition/SHINNYMeta)

Other representations of profile: CSV, Excel, Schematron