Standard Health Record FHIR Implementation Guide

SHR SurgicalProcedurePerformed Profile


<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="shr-procedure-SurgicalProcedurePerformed"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
  <p><b>SHR SurgicalProcedurePerformed Profile</b></p>
  <p/>
  <p><b>SHR Mapping Summary</b></p>
  <p><pre>shr.procedure.SurgicalProcedurePerformed maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure:
  DirectSite maps to http://hl7.org/fhir/StructureDefinition/procedure-targetBodySite
  IndirectSite maps to http://hl7.org/fhir/StructureDefinition/procedure-approachBodySite
  SurgicalApproach maps to http://hl7.org/fhir/StructureDefinition/procedure-approachBodySite
</pre></p>
</div>
  </text>
  <url
       value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-SurgicalProcedurePerformed"/>
  <identifier>
    <system value="http://standardhealthrecord.org"/>
    <value value="shr.procedure.SurgicalProcedurePerformed"/>
  </identifier>
  <version value="0.0.1"/>
  <name value="SHR SurgicalProcedurePerformed Profile"/>
  <status value="draft"/>
  <date value="2018-02-27"/>
  <publisher value="The MITRE Corporation: Standard Health Record Collaborative"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://standardhealthrecord.org"/>
    </telecom>
  </contact>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States Minor Outlying Islands (the)"/>
    </coding>
  </jurisdiction>
  <fhirVersion value="3.0.1"/>
  <mapping>
    <identity value="argonaut-dq-dstu2"/>
    <uri value="http://unknown.org/Argonaut DQ DSTU2"/>
    <name value="Argonaut DQ DSTU2"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/w5"/>
    <name value="W5 Mapping"/>
  </mapping>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2 Mapping"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="Procedure"/>
  <baseDefinition
                  value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed">
      <path value="Procedure"/>
      <short value="SHR SurgicalProcedurePerformed Profile"/>
      <definition
                  value="The US Core Condition Profile is based upon the core FHIR Procedure Resource and created to meet the 2015 Edition Common Clinical Data Set &#39;Procedures&#39; requirements."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-1"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain any narrative"/>
        <expression value="contained.text.empty()"/>
        <xpath value="not(parent::f:contained and f:text)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource"/>
        <expression
                    value="contained.where((&#39;#&#39;+id in %resource.descendants().reference).not()).empty()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $id))]))"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="pro-1"/>
        <severity value="error"/>
        <human
               value="Reason not done is only permitted if notDone indicator is true"/>
        <expression value="notDoneReason.empty() or notDone = true"/>
        <xpath value="not(exists(f:notDoneReason)) or f:notDone/@value=true()"/>
        <source value="Procedure"/>
      </constraint>
      <mustSupport value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Procedure[moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="clinical.general"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Procedure"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.id">
      <path value="Procedure.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comment
               value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.meta">
      <path value="Procedure.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.implicitRules">
      <path value="Procedure.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content."/>
      <comment
               value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. 

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it&#39;s meaning or interpretation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.language">
      <path value="Procedure.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comment
               value="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)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference value="http://hl7.org/fhir/ValueSet/all-languages"/>
          </valueReference>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="extensible"/>
        <description value="A human language."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/languages"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.text">
      <path value="Procedure.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
      <comment
               value="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 &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded in formation is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.contained">
      <path value="Procedure.contained"/>
      <short value="Contained, inline Resources"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension">
      <path value="Procedure.extension"/>
      <slicing id="1">
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:surgicalapproach">
      <path value="Procedure.extension"/>
      <sliceName value="indirectsite"/>
      <definition value="The indirect site for this procedure."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/procedure-approachBodySite"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:directsite">
      <path value="Procedure.extension"/>
      <sliceName value="directsite"/>
      <definition value="The site where the procedure is performed."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/procedure-targetBodySite"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:relatedencounter">
      <path value="Procedure.extension"/>
      <sliceName value="relatedencounter"/>
      <definition
                  value="If content was generated during a patient encounter, related encounter is the encounter where the information was gained."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RelatedEncounter-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:author">
      <path value="Procedure.extension"/>
      <sliceName value="author"/>
      <definition
                  value="The person or organization who created the entry and is responsible for (and may certify) the content."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Author-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:informant">
      <path value="Procedure.extension"/>
      <sliceName value="informant"/>
      <definition
                  value="The person or entity that provided the information in the entry, as distinct from who created the entry, e.g. the subject (patient), medical professional, family member, device or software program."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Informant-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:type">
      <path value="Procedure.extension"/>
      <sliceName value="type"/>
      <definition
                  value="The most specific code (lowest level term) describing the kind or sort of thing being represented."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-Type-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:type.id">
      <path value="Procedure.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:type.extension:extension">
      <path value="Procedure.extension.extension"/>
      <sliceName value="extension"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:type.url">
      <path value="Procedure.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comment
               value="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."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <fixedUri
                value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-Type-extension"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:type.valueCodeableConcept">
      <path value="Procedure.extension.valueCodeableConcept"/>
      <short value="Value of extension"/>
      <definition
                  value="Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <strength value="extensible"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:category">
      <path value="Procedure.extension"/>
      <sliceName value="category"/>
      <definition
                  value="A class or division of people or things having particular shared characteristics"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Category-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:performedcontext">
      <path value="Procedure.extension"/>
      <sliceName value="performedcontext"/>
      <definition
                  value="ActionContext indicating actual performance or execution of a healthcare-related action, e.g., 3rd dose of Hepatitis B vaccine administered on Dec 4th 2012, appendectomy performed today."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-action-PerformedContext-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:subject">
      <path value="Procedure.extension"/>
      <sliceName value="subject"/>
      <definition
                  value="The person or thing that this entry relates to, usually the Person of Record. However, not all entries have health information specifically about the patient, but in different contexts, could refer to a fetus, family member (living or dead), device, location, organization, finding, condition, or intervention."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Subject-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:subject.id">
      <path value="Procedure.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:subject.extension">
      <path value="Procedure.extension.extension"/>
      <slicing id="1">
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:subject.extension:patient">
      <path value="Procedure.extension.extension"/>
      <sliceName value="patient"/>
      <definition
                  value="A person in the role of a patient, including extended demographic information about the subject of this health record."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Extension.extension"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-Patient-extension"/>
      </type>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:subject.extension:group">
      <path value="Procedure.extension.extension"/>
      <sliceName value="group"/>
      <definition
                  value="A set of entities (personnel, material, or places) to be considered together. May be a pool of like-type resources, a team, or combination of personnel, material and places."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Extension.extension"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-Group-extension"/>
      </type>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:subject.extension:device">
      <path value="Procedure.extension.extension"/>
      <sliceName value="device"/>
      <definition
                  value="A specific durable physical device used in diagnosis or treatment. The value is the coding for a type of device, for example, a CPAP machine. The same device might be used on multiple patients."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Extension.extension"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-device-Device-extension"/>
      </type>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:subject.extension:location">
      <path value="Procedure.extension.extension"/>
      <sliceName value="location"/>
      <definition
                  value="A position, site, or point in space where something can be found."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Extension.extension"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Location-extension"/>
      </type>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:subject.extension:relatedperson">
      <path value="Procedure.extension.extension"/>
      <sliceName value="relatedperson"/>
      <definition
                  value="A person in a role defined in relationship to a patient"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Extension.extension"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-RelatedPerson-extension"/>
      </type>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:subject.extension:organization">
      <path value="Procedure.extension.extension"/>
      <sliceName value="organization"/>
      <definition value="A social or legal structure formed by human beings."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Extension.extension"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-Organization-extension"/>
      </type>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:subject.url">
      <path value="Procedure.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comment
               value="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."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <fixedUri
                value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Subject-extension"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:subject.value[x]">
      <path value="Procedure.extension.value[x]"/>
      <short value="Value of extension"/>
      <definition
                  value="Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list)."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="base64Binary"/>
      </type>
      <type>
        <code value="boolean"/>
      </type>
      <type>
        <code value="code"/>
      </type>
      <type>
        <code value="date"/>
      </type>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="decimal"/>
      </type>
      <type>
        <code value="id"/>
      </type>
      <type>
        <code value="instant"/>
      </type>
      <type>
        <code value="integer"/>
      </type>
      <type>
        <code value="markdown"/>
      </type>
      <type>
        <code value="oid"/>
      </type>
      <type>
        <code value="positiveInt"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <type>
        <code value="time"/>
      </type>
      <type>
        <code value="unsignedInt"/>
      </type>
      <type>
        <code value="uri"/>
      </type>
      <type>
        <code value="Address"/>
      </type>
      <type>
        <code value="Age"/>
      </type>
      <type>
        <code value="Annotation"/>
      </type>
      <type>
        <code value="Attachment"/>
      </type>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Coding"/>
      </type>
      <type>
        <code value="ContactPoint"/>
      </type>
      <type>
        <code value="Count"/>
      </type>
      <type>
        <code value="Distance"/>
      </type>
      <type>
        <code value="Duration"/>
      </type>
      <type>
        <code value="HumanName"/>
      </type>
      <type>
        <code value="Identifier"/>
      </type>
      <type>
        <code value="Money"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <type>
        <code value="Quantity"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="Ratio"/>
      </type>
      <type>
        <code value="Reference"/>
      </type>
      <type>
        <code value="SampledData"/>
      </type>
      <type>
        <code value="Signature"/>
      </type>
      <type>
        <code value="Timing"/>
      </type>
      <type>
        <code value="Meta"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:bodysite">
      <path value="Procedure.extension"/>
      <sliceName value="bodysite"/>
      <definition
                  value="A location or structure in the body, including tissues, regions, cavities, and spaces, for example, right elbow, or left ventricle of the heart."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-BodySite-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:associatedstudy">
      <path value="Procedure.extension"/>
      <sliceName value="associatedstudy"/>
      <definition
                  value="The clinical trial or other formal study related to this procedure."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-AssociatedStudy-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:partof">
      <path value="Procedure.extension"/>
      <sliceName value="partof"/>
      <definition value="The larger entity that this is a portion of."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-PartOf-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:partof.id">
      <path value="Procedure.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:partof.extension">
      <path value="Procedure.extension.extension"/>
      <slicing id="1">
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:partof.extension:content">
      <path value="Procedure.extension.extension"/>
      <sliceName value="content"/>
      <definition
                  value="An item that can constitute the payload of an Entry, aka an EntryElement."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.extension"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Content-extension"/>
      </type>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:partof.extension:content.id">
      <path value="Procedure.extension.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:partof.extension:content.extension">
      <path value="Procedure.extension.extension.extension"/>
      <slicing id="1">
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:partof.extension:content.extension:relatedencounter">
      <path value="Procedure.extension.extension.extension"/>
      <sliceName value="relatedencounter"/>
      <definition
                  value="If content was generated during a patient encounter, related encounter is the encounter where the information was gained."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Extension.extension"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RelatedEncounter-extension"/>
      </type>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:partof.extension:content.extension:author">
      <path value="Procedure.extension.extension.extension"/>
      <sliceName value="author"/>
      <definition
                  value="The person or organization who created the entry and is responsible for (and may certify) the content."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Extension.extension"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Author-extension"/>
      </type>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:partof.extension:content.extension:informant">
      <path value="Procedure.extension.extension.extension"/>
      <sliceName value="informant"/>
      <definition
                  value="The person or entity that provided the information in the entry, as distinct from who created the entry, e.g. the subject (patient), medical professional, family member, device or software program."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Extension.extension"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Informant-extension"/>
      </type>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:partof.extension:content.url">
      <path value="Procedure.extension.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comment
               value="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."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <fixedUri
                value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Content-extension"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:partof.extension:content.value[x]">
      <path value="Procedure.extension.extension.value[x]"/>
      <short value="Value of extension"/>
      <definition
                  value="Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list)."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="base64Binary"/>
      </type>
      <type>
        <code value="boolean"/>
      </type>
      <type>
        <code value="code"/>
      </type>
      <type>
        <code value="date"/>
      </type>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="decimal"/>
      </type>
      <type>
        <code value="id"/>
      </type>
      <type>
        <code value="instant"/>
      </type>
      <type>
        <code value="integer"/>
      </type>
      <type>
        <code value="markdown"/>
      </type>
      <type>
        <code value="oid"/>
      </type>
      <type>
        <code value="positiveInt"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <type>
        <code value="time"/>
      </type>
      <type>
        <code value="unsignedInt"/>
      </type>
      <type>
        <code value="uri"/>
      </type>
      <type>
        <code value="Address"/>
      </type>
      <type>
        <code value="Age"/>
      </type>
      <type>
        <code value="Annotation"/>
      </type>
      <type>
        <code value="Attachment"/>
      </type>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Coding"/>
      </type>
      <type>
        <code value="ContactPoint"/>
      </type>
      <type>
        <code value="Count"/>
      </type>
      <type>
        <code value="Distance"/>
      </type>
      <type>
        <code value="Duration"/>
      </type>
      <type>
        <code value="HumanName"/>
      </type>
      <type>
        <code value="Identifier"/>
      </type>
      <type>
        <code value="Money"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <type>
        <code value="Quantity"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="Ratio"/>
      </type>
      <type>
        <code value="Reference"/>
      </type>
      <type>
        <code value="SampledData"/>
      </type>
      <type>
        <code value="Signature"/>
      </type>
      <type>
        <code value="Timing"/>
      </type>
      <type>
        <code value="Meta"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:partof.url">
      <path value="Procedure.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comment
               value="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."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <fixedUri
                value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-PartOf-extension"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:partof.value[x]">
      <path value="Procedure.extension.value[x]"/>
      <short value="Value of extension"/>
      <definition
                  value="Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list)."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="base64Binary"/>
      </type>
      <type>
        <code value="boolean"/>
      </type>
      <type>
        <code value="code"/>
      </type>
      <type>
        <code value="date"/>
      </type>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="decimal"/>
      </type>
      <type>
        <code value="id"/>
      </type>
      <type>
        <code value="instant"/>
      </type>
      <type>
        <code value="integer"/>
      </type>
      <type>
        <code value="markdown"/>
      </type>
      <type>
        <code value="oid"/>
      </type>
      <type>
        <code value="positiveInt"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <type>
        <code value="time"/>
      </type>
      <type>
        <code value="unsignedInt"/>
      </type>
      <type>
        <code value="uri"/>
      </type>
      <type>
        <code value="Address"/>
      </type>
      <type>
        <code value="Age"/>
      </type>
      <type>
        <code value="Annotation"/>
      </type>
      <type>
        <code value="Attachment"/>
      </type>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Coding"/>
      </type>
      <type>
        <code value="ContactPoint"/>
      </type>
      <type>
        <code value="Count"/>
      </type>
      <type>
        <code value="Distance"/>
      </type>
      <type>
        <code value="Duration"/>
      </type>
      <type>
        <code value="HumanName"/>
      </type>
      <type>
        <code value="Identifier"/>
      </type>
      <type>
        <code value="Money"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <type>
        <code value="Quantity"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="Ratio"/>
      </type>
      <type>
        <code value="Reference"/>
      </type>
      <type>
        <code value="SampledData"/>
      </type>
      <type>
        <code value="Signature"/>
      </type>
      <type>
        <code value="Timing"/>
      </type>
      <type>
        <code value="Meta"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:annotation">
      <path value="Procedure.extension"/>
      <sliceName value="annotation"/>
      <definition
                  value="An added or follow-up note, often after the fact, that contains metadata about who made the statement and when."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Annotation-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:directsitecode">
      <path value="Procedure.extension"/>
      <sliceName value="directsitecode"/>
      <definition value="The site where the procedure is performed."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-DirectSiteCode-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:indirectsitecode">
      <path value="Procedure.extension"/>
      <sliceName value="indirectsitecode"/>
      <definition value="The indirect site for this procedure."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-IndirectSiteCode-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:access">
      <path value="Procedure.extension"/>
      <sliceName value="access"/>
      <definition
                  value="The route used to access the site of a procedure. It is used to distinguish open, closed, and percutaneous procedures."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-Access-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:usingdevice">
      <path value="Procedure.extension"/>
      <sliceName value="usingdevice"/>
      <definition value="The device used to perform the procedure."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-UsingDevice-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:usingdevicecode">
      <path value="Procedure.extension"/>
      <sliceName value="usingdevicecode"/>
      <definition value="The device used to perform the procedure."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-UsingDeviceCode-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:usingaccessdevice">
      <path value="Procedure.extension"/>
      <sliceName value="usingaccessdevice"/>
      <definition value="The access device used to perform the procedure."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-UsingAccessDevice-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:usingaccessdevicecode">
      <path value="Procedure.extension"/>
      <sliceName value="usingaccessdevicecode"/>
      <definition value="The access device used to perform the procedure."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-UsingAccessDeviceCode-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:indirectdevice">
      <path value="Procedure.extension"/>
      <sliceName value="indirectdevice"/>
      <definition value="An indirect device used for this procedure."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-IndirectDevice-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:indirectdevicecode">
      <path value="Procedure.extension"/>
      <sliceName value="indirectdevicecode"/>
      <definition value="An indirect device used for this procedure."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-IndirectDeviceCode-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.modifierExtension">
      <path value="Procedure.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.identifier">
      <path value="Procedure.identifier"/>
      <short value="External Identifiers for this procedure"/>
      <definition
                  value="This records identifiers associated with this procedure that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation)."/>
      <requirements value="Need to allow connection to a wider workflow."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map
             value="Some combination of ORC-2 / ORC-3 / OBR-2 / OBR-3 / IPC-1 / IPC-2 / IPC-3 / IPC-4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.definition">
      <path value="Procedure.definition"/>
      <short value="Instantiates protocol or definition"/>
      <definition
                  value="A protocol, guideline, orderset or other definition that was adhered to in whole or in part by this procedure."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.definition"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/PlanDefinition"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/ActivityDefinition"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/HealthcareService"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=DEFN].target"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.basedOn">
      <path value="Procedure.basedOn"/>
      <short value="A request for this procedure"/>
      <definition
                  value="A reference to a resource that contains details of the request for this procedure."/>
      <alias value="fulfills"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.basedOn"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/ProcedureRequest"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/ReferralRequest"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=FLFS].target[classCode=(various e.g. PROC, OBS, PCPR, ACT,  moodCode=RQO].code"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.partOf">
      <path value="Procedure.partOf"/>
      <short value="Part of referenced event"/>
      <definition
                  value="A larger event of which this particular procedure is a component or step."/>
      <comment
               value="The MedicationAdministration has a partOf reference to Procedure, but this is not a circular reference.  For a surgical procedure, the anesthesia related medicationAdministration is part of the procedure.  For an IV medication administration,  the procedure to insert the IV port is part of the medication administration."/>
      <alias value="container"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.partOf"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Observation"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=COMP].source[classCode=SBADM or PROC or OBS, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.status">
      <path value="Procedure.status"/>
      <short
             value="preparation | in-progress | suspended | aborted | completed | entered-in-error | unknown"/>
      <definition
                  value="A code specifying the state of the procedure. Generally this will be in-progress or completed state."/>
      <comment
               value="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&#39;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."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Procedure.status"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/event-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="statusCode"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Procedure.status"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.notDone">
      <path value="Procedure.notDone"/>
      <short value="True if procedure was not performed as scheduled"/>
      <definition
                  value="Set this to true if the record is saying that the procedure was NOT performed."/>
      <comment
               value="If true, it means the procedure did not occur as described.  Typically it would be accompanied by attributes describing the type of activity.  It might also be accompanied by body site information or time information (i.e. no procedure was done to the left arm or no procedure was done in this 2-year period).  Specifying additional information such as performer, outcome, etc. is generally inappropriate.  For example, it&#39;s not that useful to say &quot;There was no appendectomy done at 12:03pm June 6th by Dr. Smith with a successful outcome&quot; as it implies that there *could* have been an appendectomy done at any other time, by any other clinician or with any other outcome.

This element is labeled as a modifier because it indicates that a procedure didn&#39;t happen."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.notDone"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <defaultValueBoolean value="false"/>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".actionNegationInd"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.notDoneReason">
      <path value="Procedure.notDoneReason"/>
      <short value="Reason procedure was not performed"/>
      <definition value="A code indicating why the procedure was not performed."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.notDoneReason"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="pro-1"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ProcedureNegationReason"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A code that identifies the reason a procedure was not performed."/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/procedure-not-performed-reason"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".reason.Observation.value"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.category">
      <path value="Procedure.category"/>
      <short value="Classification of the procedure"/>
      <definition
                  value="A code that classifies the procedure for searching, sorting and display purposes (e.g. &quot;Surgical Procedure&quot;)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.category"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ProcedureCategory"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A code that classifies a procedure for searching, sorting and display purposes."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/procedure-category"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=&quot;COMP].target[classCode=&quot;LIST&quot;, moodCode=&quot;EVN&quot;].code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="class"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.code">
      <path value="Procedure.code"/>
      <short value="SNOMED-CT | ICD-10 | CPT-4"/>
      <definition
                  value="The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. &quot;Laparoscopic Appendectomy&quot;)."/>
      <requirements
                    value="0..1 to account for primarily narrative only resources."/>
      <alias value="type"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Procedure.code"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference
                       value="http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code"/>
          </valueReference>
        </extension>
        <strength value="extensible"/>
        <description value="Codes describing the type of  Procedure"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-44/OBR-45"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="what"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Procedure.code"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.subject">
      <path value="Procedure.subject"/>
      <short value="Who the procedure was performed on"/>
      <definition
                  value="The person, animal or group on which the procedure was performed."/>
      <alias value="patient"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Procedure.subject"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Procedure.subject"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.context">
      <path value="Procedure.context"/>
      <short value="Encounter or episode associated with the procedure"/>
      <definition
                  value="The encounter during which the procedure was performed."/>
      <alias value="encounter"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.context"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PV1-19"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="context"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.performed[x]">
      <path value="Procedure.performed[x]"/>
      <short value="Date/Period the procedure was performed"/>
      <definition
                  value="The date(time)/period over which the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Procedure.performed[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".effectiveTime"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.done"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Procedure.performed[x]"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.performer">
      <path value="Procedure.performer"/>
      <short value="The people who performed the procedure"/>
      <definition
                  value="Limited to &#39;real&#39; people rather than equipment."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.performer"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRF]"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.performer.id">
      <path value="Procedure.performer.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.performer.extension">
      <path value="Procedure.performer.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.performer.modifierExtension">
      <path value="Procedure.performer.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.performer.role">
      <path value="Procedure.performer.role"/>
      <short value="The role the actor was in"/>
      <definition value="For example: surgeon, anaethetist, endoscopist."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.performer.role"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ProcedurePerformerRole"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A code that identifies the role of a performer of the procedure."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/performer-role"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map
             value="Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".functionCode"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.performer.actor">
      <path value="Procedure.performer.actor"/>
      <short value="The reference to the practitioner"/>
      <definition value="The practitioner who was involved in the procedure."/>
      <requirements
                    value="A reference to Device supports use cases, such as pacemakers."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Procedure.performer.actor"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="ORC-19/PRT-5"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.actor"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.performer.onBehalfOf">
      <path value="Procedure.performer.onBehalfOf"/>
      <short value="Organization the device or practitioner was acting for"/>
      <definition
                  value="The organization the device or practitioner was acting on behalf of."/>
      <requirements
                    value="Practitioners and Devices can be associated with multiple organizations.  This element indicates which organization they were acting on behalf of when performing the action."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.performer.onBehalfOf"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".scoper"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.location">
      <path value="Procedure.location"/>
      <short value="Where the procedure happened"/>
      <definition
                  value="The location where the procedure actually happened.  E.g. a newborn at home, a tracheostomy at a restaurant."/>
      <requirements
                    value="Ties a procedure to where the records are likely kept."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.location"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=LOC].role[classCode=SDLOC]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="where"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.reasonCode">
      <path value="Procedure.reasonCode"/>
      <short value="Coded reason procedure performed"/>
      <definition
                  value="The coded reason why the procedure was performed. This may be coded entity of some type, or may simply be present as text."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.reasonCode"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ProcedureReason"/>
        </extension>
        <strength value="example"/>
        <description
                     value="A code that identifies the reason a procedure is  required."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/procedure-reason"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".reasonCode"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="why"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.reasonReference">
      <path value="Procedure.reasonReference"/>
      <short value="Condition that is the reason the procedure performed"/>
      <definition
                  value="The condition that is the reason why the procedure was performed."/>
      <comment
               value="e.g. endoscopy for dilatation and biopsy, combination diagnosis and therapeutic."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.reasonReference"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Observation"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".reasonCode"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="why"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.bodySite">
      <path value="Procedure.bodySite"/>
      <short value="Target body sites"/>
      <definition
                  value="Detailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.bodySite"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="BodySite"/>
        </extension>
        <strength value="example"/>
        <description
                     value="Codes describing anatomical locations. May include laterality."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/body-site"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX-20"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".targetSiteCode"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.outcome">
      <path value="Procedure.outcome"/>
      <short value="The result of procedure"/>
      <definition
                  value="The outcome of the procedure - did it resolve reasons for the procedure being performed?"/>
      <comment
               value="If outcome contains narrative text only, it can be captured using the CodeableConcept.text."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.outcome"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ProcedureOutcome"/>
        </extension>
        <strength value="example"/>
        <description
                     value="An outcome of a procedure - whether it was resolved or otherwise."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/procedure-outcome"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=OUT].target.text"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.report">
      <path value="Procedure.report"/>
      <short value="Any report resulting from the procedure"/>
      <definition
                  value="This could be a histology result, pathology report, surgical report, etc.."/>
      <comment
               value="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."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.report"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN]"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.complication">
      <path value="Procedure.complication"/>
      <short value="Complication following the procedure"/>
      <definition
                  value="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 &#39;post procedure&#39; issues."/>
      <comment
               value="If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.complication"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ProcedureComplication"/>
        </extension>
        <strength value="example"/>
        <description
                     value="Codes describing complications that resulted from a procedure."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/condition-code"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code=&quot;complication&quot;, moodCode=EVN].value"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.complicationDetail">
      <path value="Procedure.complicationDetail"/>
      <short value="A condition that is a result of the procedure"/>
      <definition
                  value="Any complications that occurred during the procedure, or in the immediate post-performance period."/>
      <requirements
                    value="This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.complicationDetail"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code=&quot;complication&quot;, moodCode=EVN].value"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.followUp">
      <path value="Procedure.followUp"/>
      <short value="Instructions for follow up"/>
      <definition
                  value="If the procedure required specific follow up - e.g. removal of sutures. The followup may be represented as a simple note, or could potentially be more complex in which case the CarePlan resource can be used."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.followUp"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ProcedureFollowUp"/>
        </extension>
        <strength value="example"/>
        <description
                     value="Specific follow up required for a procedure e.g. removal of sutures."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/procedure-followup"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=COMP].target[classCode=ACT, moodCode=INT].code"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.note">
      <path value="Procedure.note"/>
      <short value="Additional information about the procedure"/>
      <definition
                  value="Any other notes about the procedure.  E.g. the operative notes."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.note"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Annotation"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="NTE"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;annotation&quot;].value"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.focalDevice">
      <path value="Procedure.focalDevice"/>
      <short value="Device changed in procedure"/>
      <definition
                  value="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."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.focalDevice"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=DEV].role[classCode=MANU]"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.focalDevice.id">
      <path value="Procedure.focalDevice.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.focalDevice.extension">
      <path value="Procedure.focalDevice.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.focalDevice.modifierExtension">
      <path value="Procedure.focalDevice.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.focalDevice.action">
      <path value="Procedure.focalDevice.action"/>
      <short value="Kind of change to device"/>
      <definition
                  value="The kind of change that happened to the device during the procedure."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Procedure.focalDevice.action"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DeviceActionKind"/>
        </extension>
        <strength value="preferred"/>
        <description
                     value="A kind of change that happened to the device during the procedure."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/device-action"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;procedure device action&quot;].value=:procedure device action codes"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.focalDevice.manipulated">
      <path value="Procedure.focalDevice.manipulated"/>
      <short value="Device that was changed"/>
      <definition
                  value="The device that was manipulated (changed) during the procedure."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Procedure.focalDevice.manipulated"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=DEV].role[classCode=SDLOC]"/>
      </mapping>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.usedReference">
      <path value="Procedure.usedReference"/>
      <short value="Items used during procedure"/>
      <definition
                  value="Identifies medications, devices and any other substance used as part of the procedure."/>
      <comment
               value="For devices actually implanted or removed, use Procedure.device."/>
      <requirements value="Used for tracking contamination, etc."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.usedReference"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Medication"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Substance"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map
             value=".participation[typeCode=DEV].role[classCode=MANU] or
.participation[typeCode=CSM].role[classCode=ADMM] (for Medication or Substance)"/>
      </mapping>
    </element>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed.usedCode">
      <path value="Procedure.usedCode"/>
      <short value="Coded items used during the procedure"/>
      <definition
                  value="Identifies coded items that were used as part of the procedure."/>
      <comment
               value="For devices actually implanted or removed, use Procedure.device."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Procedure.usedCode"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ProcedureUsed"/>
        </extension>
        <strength value="example"/>
        <description value="Codes describing items used during a procedure"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/device-kind"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=Dev].role[classCode=MANU]"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="Procedure:shr-procedure-SurgicalProcedurePerformed">
      <path value="Procedure"/>
      <short value="SHR SurgicalProcedurePerformed Profile"/>
      <definition
                  value="The US Core Condition Profile is based upon the core FHIR Procedure Resource and created to meet the 2015 Edition Common Clinical Data Set &#39;Procedures&#39; requirements."/>
      <mustSupport value="false"/>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:surgicalapproach">
      <path value="Procedure.extension"/>
      <sliceName value="indirectsite"/>
      <definition value="The indirect site for this procedure."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/procedure-approachBodySite"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:directsite">
      <path value="Procedure.extension"/>
      <sliceName value="directsite"/>
      <definition value="The site where the procedure is performed."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/procedure-targetBodySite"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:relatedencounter">
      <path value="Procedure.extension"/>
      <sliceName value="relatedencounter"/>
      <definition
                  value="If content was generated during a patient encounter, related encounter is the encounter where the information was gained."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RelatedEncounter-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:author">
      <path value="Procedure.extension"/>
      <sliceName value="author"/>
      <definition
                  value="The person or organization who created the entry and is responsible for (and may certify) the content."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Author-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:informant">
      <path value="Procedure.extension"/>
      <sliceName value="informant"/>
      <definition
                  value="The person or entity that provided the information in the entry, as distinct from who created the entry, e.g. the subject (patient), medical professional, family member, device or software program."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Informant-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:type">
      <path value="Procedure.extension"/>
      <sliceName value="type"/>
      <definition
                  value="The most specific code (lowest level term) describing the kind or sort of thing being represented."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-Type-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:type.valueCodeableConcept">
      <path value="Procedure.extension.valueCodeableConcept"/>
      <binding>
        <strength value="extensible"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code"/>
        </valueSetReference>
      </binding>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:category">
      <path value="Procedure.extension"/>
      <sliceName value="category"/>
      <definition
                  value="A class or division of people or things having particular shared characteristics"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Category-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:performedcontext">
      <path value="Procedure.extension"/>
      <sliceName value="performedcontext"/>
      <definition
                  value="ActionContext indicating actual performance or execution of a healthcare-related action, e.g., 3rd dose of Hepatitis B vaccine administered on Dec 4th 2012, appendectomy performed today."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-action-PerformedContext-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:subject">
      <path value="Procedure.extension"/>
      <sliceName value="subject"/>
      <definition
                  value="The person or thing that this entry relates to, usually the Person of Record. However, not all entries have health information specifically about the patient, but in different contexts, could refer to a fetus, family member (living or dead), device, location, organization, finding, condition, or intervention."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Subject-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:bodysite">
      <path value="Procedure.extension"/>
      <sliceName value="bodysite"/>
      <definition
                  value="A location or structure in the body, including tissues, regions, cavities, and spaces, for example, right elbow, or left ventricle of the heart."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-BodySite-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:associatedstudy">
      <path value="Procedure.extension"/>
      <sliceName value="associatedstudy"/>
      <definition
                  value="The clinical trial or other formal study related to this procedure."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-AssociatedStudy-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:partof">
      <path value="Procedure.extension"/>
      <sliceName value="partof"/>
      <definition value="The larger entity that this is a portion of."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-PartOf-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:annotation">
      <path value="Procedure.extension"/>
      <sliceName value="annotation"/>
      <definition
                  value="An added or follow-up note, often after the fact, that contains metadata about who made the statement and when."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Annotation-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:directsitecode">
      <path value="Procedure.extension"/>
      <sliceName value="directsitecode"/>
      <definition value="The site where the procedure is performed."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-DirectSiteCode-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:indirectsitecode">
      <path value="Procedure.extension"/>
      <sliceName value="indirectsitecode"/>
      <definition value="The indirect site for this procedure."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-IndirectSiteCode-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:access">
      <path value="Procedure.extension"/>
      <sliceName value="access"/>
      <definition
                  value="The route used to access the site of a procedure. It is used to distinguish open, closed, and percutaneous procedures."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-Access-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:usingdevice">
      <path value="Procedure.extension"/>
      <sliceName value="usingdevice"/>
      <definition value="The device used to perform the procedure."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-UsingDevice-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:usingdevicecode">
      <path value="Procedure.extension"/>
      <sliceName value="usingdevicecode"/>
      <definition value="The device used to perform the procedure."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-UsingDeviceCode-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:usingaccessdevice">
      <path value="Procedure.extension"/>
      <sliceName value="usingaccessdevice"/>
      <definition value="The access device used to perform the procedure."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-UsingAccessDevice-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:usingaccessdevicecode">
      <path value="Procedure.extension"/>
      <sliceName value="usingaccessdevicecode"/>
      <definition value="The access device used to perform the procedure."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-UsingAccessDeviceCode-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:indirectdevice">
      <path value="Procedure.extension"/>
      <sliceName value="indirectdevice"/>
      <definition value="An indirect device used for this procedure."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-IndirectDevice-extension"/>
      </type>
    </element>
    <element
             id="Procedure:shr-procedure-SurgicalProcedurePerformed.extension:indirectdevicecode">
      <path value="Procedure.extension"/>
      <sliceName value="indirectdevicecode"/>
      <definition value="An indirect device used for this procedure."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-procedure-IndirectDeviceCode-extension"/>
      </type>
    </element>
  </differential>
</StructureDefinition>