Procedure

Overview

The Procedure resource represents actions performed on or for patients, including physical interventions like operations, as well as less invasive services such as counseling, therapy, or long-term care services.

Important: Always validate Procedure resource support and available operations by retrieving the current CapabilityStatement from /metadata before implementing integrations.

Resource Schema

The Procedure resource follows the HL7 FHIR R4 Procedure specification.

Key elements include:

• identifier - External identifiers for the procedure
• instantiatesCanonical - Instantiates FHIR protocol or definition
• instantiatesUri - Instantiates external protocol or definition
• basedOn - Request fulfilled by this procedure
• partOf - Part of referenced event
• status - Preparation, in-progress, not-done, on-hold, stopped, completed, entered-in-error, unknown
• statusReason - Reason for current status
• category - Classification of the procedure
• code - Identification of the procedure
• subject - Who the procedure was performed on
• encounter - Encounter created as part of
• performedDateTime - When the procedure was performed
• performedPeriod - When the procedure was performed
• recorder - Who recorded the procedure
• asserter - Person who asserts this procedure
• performer - The people who performed the procedure
• location - Where the procedure happened
• reasonCode - Coded reason procedure performed
• reasonReference - Condition that is the reason the procedure performed
• bodySite - Target body sites
• outcome - Result of procedure
• report - Any report resulting from the procedure
• complication - Complication following the procedure
• complicationDetail - A condition that is a result of the procedure
• followUp - Instructions for follow up
• note - Additional information about the procedure
• focalDevice - Manipulated, implanted, or removed device
• usedReference - Items used during procedure
• usedCode - Coded items used during procedure

Example Procedure Resource

{
  "resourceType": "Procedure",
  "id": "12345",
  "identifier": [{
    "use": "official",
    "system": "http://hospital.example.org/procedures",
    "value": "PROC-2024-001"
  }],
  "status": "completed",
  "category": {
    "coding": [{
      "system": "http://snomed.info/sct",
      "code": "387713003",
      "display": "Surgical procedure"
    }]
  },
  "code": {
    "coding": [{
      "system": "http://snomed.info/sct",
      "code": "80146002",
      "display": "Appendectomy"
    }]
  },
  "subject": {
    "reference": "Patient/12345"
  },
  "encounter": {
    "reference": "Encounter/67890"
  },
  "performedDateTime": "2024-01-15T14:30:00Z",
  "recorder": {
    "reference": "Practitioner/recorder-123"
  },
  "performer": [{
    "function": {
      "coding": [{
        "system": "http://snomed.info/sct",
        "code": "304292004",
        "display": "Surgeon"
      }]
    },
    "actor": {
      "reference": "Practitioner/67890",
      "display": "Dr. Jane Surgeon"
    }
  }],
  "location": {
    "reference": "Location/or-1",
    "display": "Operating Room 1"
  },
  "reasonCode": [{
    "coding": [{
      "system": "http://snomed.info/sct",
      "code": "74400008",
      "display": "Appendicitis"
    }]
  }],
  "bodySite": [{
    "coding": [{
      "system": "http://snomed.info/sct",
      "code": "66754008",
      "display": "Appendix structure"
    }]
  }],
  "outcome": {
    "coding": [{
      "system": "http://snomed.info/sct",
      "code": "385669000",
      "display": "Successful"
    }]
  },
  "note": [{
    "text": "Laparoscopic appendectomy completed without complications"
  }]
}

Supported Profiles

This API supports the following FHIR profiles:

• HL7 FHIR R4 Procedure

Operations

The General Purpose FHIR R4 Procedure resource supports the following standard operations. However, support varies by the targeted CareRecord or solution.

CareRecord / Solution	Create	Read	Update	Search
GEHRIMED	-	Yes	-	Yes
myAvatar	-	Yes	-	Yes
myEvolv	-	Yes	-	Yes
myUnity	-	Yes	-	Yes

Search

info

Not all Netsmart solutions support Procedure search. See supported operations table above and consult your target solution's documentation for more information.

This operation retrieves a list of resources by these query parameters.

Standard Parameters

Name	Type	Description
date	date	When the procedure was performed
patient	reference	REQUIRED Search by subject - a patient
performer	reference	The reference to the practitioner

Custom Parameters

Name	Type	Description
end	date	Deprecated. Use date parameter with le prefix instead.
start	date	Deprecated. Use date parameter with ge prefix instead.

Search Examples

Via POST

The POST method is recommended as it keeps health information out of the URL.

Production

Search by Patient

curl -X POST https://fhir.netsmartcloud.com/v4/Procedure/_search \
    -H "Authorization: {Bearer Token}" \
    -H "Accept: application/fhir+json" \
    -H "Content-Type: application/x-form-urlencoded" \
    -d "patient=Patient/123"

Preview

Search by Patient

curl -X POST https://fhirtest.netsmartcloud.com/v4/Procedure/_search \
    -H "Authorization: {Bearer Token}" \
    -H "Accept: application/fhir+json" \
    -H "Content-Type: application/x-form-urlencoded" \
    -d "patient=Patient/123"

Via GET

Production

Search by Patient

curl -X GET https://fhir.netsmartcloud.com/v4/Procedure?patient=Patient/123 \
    -H "Authorization: {Bearer Token}" \
    -H "Accept: application/fhir+json"

Preview

Search by Patient

curl -X GET https://fhirtest.netsmartcloud.com/v4/Procedure?patient=Patient/123 \
    -H "Authorization: {Bearer Token}" \
    -H "Accept: application/fhir+json"

Error Handling

For information about error responses when working with Procedure resources, see Common Errors.

Common Procedure-related errors include:

• Missing required patient reference
• Invalid procedure codes or SNOMED CT codes
• Malformed procedure dates
• Invalid performer or location references

Integration Patterns

Surgical History

Retrieve patient's procedure history:

# Get all procedures for patient
curl -X GET "https://fhir.netsmartcloud.com/v4/Procedure?patient=12345" \
    -H "Authorization: Bearer {token}" \
    -H "Accept: application/fhir+json"

Clinical Documentation

Track procedures by date range:

# Get recent procedures
curl -X GET "https://fhir.netsmartcloud.com/v4/Procedure?patient=12345&date=ge2024-01-01" \
    -H "Authorization: Bearer {token}" \
    -H "Accept: application/fhir+json"

Provider Performance

Track procedures by performer:

# Get procedures by surgeon
curl -X GET "https://fhir.netsmartcloud.com/v4/Procedure?performer=Practitioner/67890" \
    -H "Authorization: Bearer {token}" \
    -H "Accept: application/fhir+json"

Quality Reporting

Analyze procedure outcomes:

# Get completed procedures
curl -X GET "https://fhir.netsmartcloud.com/v4/Procedure?patient=12345&status=completed" \
    -H "Authorization: Bearer {token}" \
    -H "Accept: application/fhir+json"

Relationships to Other Resources

The Procedure resource connects to many clinical and administrative resources:

• Patient - The individual who underwent the procedure
• Practitioner - Healthcare providers performing procedures
• Encounter - Clinical encounters during which procedures occurred
• Location - Where procedures were performed
• Condition - Health conditions addressed by procedures
• Device - Medical devices used or implanted during procedures
• Observation - Clinical observations related to procedures
• Organization - Healthcare organizations where procedures occurred

Support

For questions about Procedure resource implementation or surgical workflow integration, contact Netsmart support through your designated support channels.