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.

Use Cases:

Record surgical procedures and their outcomes
Document therapy sessions and counseling activities
Track diagnostic procedures and their results
Support quality reporting and clinical analytics
Coordinate care across providers and settings

Relationships:

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

Resource Schema

Key Fields:

Field	Type	Description	Required
id	string	Unique identifier for the resource	Yes
status	code	Preparation, in-progress, not-done, on-hold, stopped, completed, entered-in-error, unknown	Yes
code	CodeableConcept	Identification of the procedure	Yes
subject	Reference(Patient)	Who the procedure was performed on	Yes
identifier	Identifier[]	External identifiers for the procedure	No
basedOn	Reference(ServiceRequest / CarePlan)[]	Request fulfilled by this procedure	No
partOf	Reference(Procedure / Observation / MedicationAdministration)[]	Part of referenced event	No
statusReason	CodeableConcept	Reason for current status	No
category	CodeableConcept	Classification of the procedure	No
encounter	Reference(Encounter)	Encounter created as part of	No
performedDateTime	dateTime	When the procedure was performed	No
performedPeriod	Period	When the procedure was performed	No
recorder	Reference(Patient / RelatedPerson / Practitioner / PractitionerRole)	Who recorded the procedure	No
asserter	Reference(Patient / RelatedPerson / Practitioner / PractitionerRole)	Person who asserts this procedure	No
performer	BackboneElement[]	The people who performed the procedure	No
location	Reference(Location)	Where the procedure happened	No
reasonCode	CodeableConcept[]	Coded reason procedure performed	No
reasonReference	Reference(Condition / Observation / Procedure / DocumentReference / DiagnosticReport)[]	Condition that is the reason the procedure performed	No
bodySite	CodeableConcept[]	Target body sites	No
outcome	CodeableConcept	Result of procedure	No
report	Reference(DiagnosticReport / DocumentReference / Composition)[]	Any report resulting from the procedure	No
complication	CodeableConcept[]	Complication following the procedure	No
complicationDetail	Reference(Condition)[]	A condition that is a result of the procedure	No
followUp	CodeableConcept[]	Instructions for follow up	No
note	Annotation[]	Additional information about the procedure	No
focalDevice	BackboneElement[]	Manipulated, implanted, or removed device	No
usedReference	Reference(Device / Medication / Substance)[]	Items used during procedure	No
usedCode	CodeableConcept[]	Coded items used during procedure	No

JSON Example:

{
  "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"
  }]
}

Operations

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

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

Create

Create a new Procedure resource. The resource must include all required elements (status, code, subject).

POST /Procedure

Read

Retrieve a specific Procedure resource by its unique identifier.

GET /Procedure/{id}

Update

Update an existing Procedure resource by its ID. The full resource must be provided in the request body, including the resource id.

PUT /Procedure/{id}

Search

Search for procedures using various criteria.

POST Method

Use POST for searches with form-encoded parameters. POST is recommended as it keeps PHI out of URLs and server logs.

POST /Procedure/_search

GET Method

Use GET for simple searches with parameters in the query string.

GET /Procedure?parameter=value

info

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

Search Parameters

Patient-based Search:

Parameter	Type	Required	Description	Example
`patient`	reference	Yes	Unique identifier of the patient	`patient=Patient/123`
`date`	date	No	When the procedure was performed (i.e., Start Date/Time). Include the parameter twice to set upper and lower bounds. Supported date format: `yyyy-mm-dd[Thh:mm:ss[Z\|(+\|-)hh:mm]]`. Supported prefixes: eq (=), ge (>=), gt (>), le (<=), and lt (<). The prefix may be excluded for eq searches.	`date=ge2024-01-01`
`end`	date	No	Deprecated. Use `date` parameter with `le` prefix instead. Observed date/time range end on the Period Start field.	`end=2024-12-31`
`performer`	reference	No	Unique identifier of the Practitioner	`performer=Practitioner/67890`
`start`	date	No	Deprecated. Use `date` parameter with `ge` prefix instead. Observed date/time range start on the Period Start field.	`start=2024-01-01`
`page`	string	No	One-based (1-based) page index	`page=2`

ID-based Search:

Parameter	Type	Required	Description	Example
`_id`	string	Yes	The ID of the resource	`_id=12345`
`page`	string	No	One-based (1-based) page index	`page=2`

Examples

Create a Procedure

Production
Preview

Create a Procedure
curl -X POST https://fhir.netsmartcloud.com/v4/Procedure \
    -H "Authorization: Bearer {token}" \
    -H "Accept: application/fhir+json" \
    -H "Content-Type: application/fhir+json" \
    -d '{
  "resourceType": "Procedure",
  "status": "completed",
  "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",
  "performer": [{
    "actor": {
      "reference": "Practitioner/67890",
      "display": "Dr. Jane Surgeon"
    }
  }],
  "reasonCode": [{
    "coding": [{
      "system": "http://snomed.info/sct",
      "code": "74400008",
      "display": "Appendicitis"
    }]
  }]
}'

Create a Procedure
curl -X POST https://fhirtest.netsmartcloud.com/v4/Procedure \
    -H "Authorization: Bearer {token}" \
    -H "Accept: application/fhir+json" \
    -H "Content-Type: application/fhir+json" \
    -d '{
  "resourceType": "Procedure",
  "status": "completed",
  "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",
  "performer": [{
    "actor": {
      "reference": "Practitioner/67890",
      "display": "Dr. Jane Surgeon"
    }
  }],
  "reasonCode": [{
    "coding": [{
      "system": "http://snomed.info/sct",
      "code": "74400008",
      "display": "Appendicitis"
    }]
  }]
}'

Read Procedure by ID

Production
Preview

Read Procedure by ID
curl -X GET https://fhir.netsmartcloud.com/v4/Procedure/12345 \
    -H "Authorization: Bearer {token}" \
    -H "Accept: application/fhir+json"

Read Procedure by ID
curl -X GET https://fhirtest.netsmartcloud.com/v4/Procedure/12345 \
    -H "Authorization: Bearer {token}" \
    -H "Accept: application/fhir+json"

Update a Procedure

Production
Preview

Update a Procedure
curl -X PUT https://fhir.netsmartcloud.com/v4/Procedure/12345 \
    -H "Authorization: Bearer {token}" \
    -H "Content-Type: application/fhir+json" \
    -d '{
  "resourceType": "Procedure",
  "id": "12345",
  "status": "completed",
  "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",
  "performer": [{
    "actor": {
      "reference": "Practitioner/67890",
      "display": "Dr. Jane Surgeon"
    }
  }],
  "outcome": {
    "coding": [{
      "system": "http://snomed.info/sct",
      "code": "385669000",
      "display": "Successful"
    }]
  },
  "note": [{
    "text": "Laparoscopic appendectomy completed without complications"
  }]
}'

Update a Procedure
curl -X PUT https://fhirtest.netsmartcloud.com/v4/Procedure/12345 \
    -H "Authorization: Bearer {token}" \
    -H "Content-Type: application/fhir+json" \
    -d '{
  "resourceType": "Procedure",
  "id": "12345",
  "status": "completed",
  "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",
  "performer": [{
    "actor": {
      "reference": "Practitioner/67890",
      "display": "Dr. Jane Surgeon"
    }
  }],
  "outcome": {
    "coding": [{
      "system": "http://snomed.info/sct",
      "code": "385669000",
      "display": "Successful"
    }]
  },
  "note": [{
    "text": "Laparoscopic appendectomy completed without complications"
  }]
}'

Search by Patient

Production
Preview

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-www-form-urlencoded" \
    -d "patient=Patient/123"

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-www-form-urlencoded" \
    -d "patient=Patient/123"

Search by Patient and Date Range

Production
Preview

Search by Patient and Date Range
curl -X POST https://fhir.netsmartcloud.com/v4/Procedure/_search \
    -H "Authorization: Bearer {token}" \
    -H "Accept: application/fhir+json" \
    -H "Content-Type: application/x-www-form-urlencoded" \
    -d "patient=Patient/123" \
    -d "date=ge2024-01-01" \
    -d "date=le2024-12-31"

Search by Patient and Date Range
curl -X POST https://fhirtest.netsmartcloud.com/v4/Procedure/_search \
    -H "Authorization: Bearer {token}" \
    -H "Accept: application/fhir+json" \
    -H "Content-Type: application/x-www-form-urlencoded" \
    -d "patient=Patient/123" \
    -d "date=ge2024-01-01" \
    -d "date=le2024-12-31"

Integration Patterns

Common Workflows:

Retrieve all procedure records for a patient to build surgical history
Filter procedures by date range for clinical documentation
Search by performer to track provider activity
Cross-reference with Encounter and Condition resources for comprehensive clinical context

Related Resources:

Patient - 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
Observation - Clinical observations related to procedures

Error Handling

For detailed error codes and handling procedures, see the Error Handling Guide.

Supported Profiles

This resource supports the following FHIR profiles as defined in the CapabilityStatement:

HL7 FHIR R4 Procedure

Overview​

Resource Schema​

Operations​

Create​

Read​

Update​

Search​

POST Method​

GET Method​

Search Parameters​

Examples​

Create a Procedure​

Read Procedure by ID​

Update a Procedure​

Search by Patient​

Search by Patient and Date Range​

Integration Patterns​

Error Handling​

Supported Profiles​