Published

Medical Procedure

vr.wm-act-047 · wm-act-047-medical-procedure

Represent one source-qualified medical procedure occurrence or explicit non-performance so agents can distinguish request, preparation, performed technique, status, immediate outcome, outputs and safety links without conflating the event with its plan, subjects or consequences.

World Models Activities and processes ACT.HCR

Bundle → Layer → Finding → Questions Classifiers What it is Why it exists Distinguishing features What robots and AI may and may not do Moral aspects Owners Links to other meta-models Identity and identifiers Direct properties Recognition Capabilities and actions Hazards and failure modes Standards and interfaces Context of use Sources

Bundle → Layer → Finding → Questions Filled

6 bundles · 12 layers · 24 findings · 72 questions

Procedure occurrence identity, boundary and authority Groups governed procedure-occurrence context for procedure occurrence identity, boundary and authority.

Occurrence profile, identity, source and lineage

Groups source-qualified procedure context for occurrence profile, identity, source and lineage.

Procedure occurrence profile, kind, scope, specialty and event boundary

Records procedure occurrence profile, kind, scope, specialty and event boundary as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish procedure occurrence profile, kind, scope, specialty and event boundary? classification
Who requested, authorized, performed, assisted, recorded or reported procedure occurrence profile, kind, scope, specialty and event boundary, using which evidence, competence and delegated authority? process
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to procedure occurrence profile, kind, scope, specialty and event boundary, and how may it be validated, challenged, corrected or retained? provenance

Occurrence identifier, source, version, predecessor, successor and lineage

Records occurrence identifier, source, version, predecessor, successor and lineage as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish occurrence identifier, source, version, predecessor, successor and lineage? identity
Who requested, authorized, performed, assisted, recorded or reported occurrence identifier, source, version, predecessor, successor and lineage, using which evidence, competence and delegated authority? temporal
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to occurrence identifier, source, version, predecessor, successor and lineage, and how may it be validated, challenged, corrected or retained? privacy

Request, plan, consent, indication and authorization

Groups source-qualified procedure context for request, plan, consent, indication and authorization.

Service request, care plan, appointment, task, protocol and priority binding

Records service request, care plan, appointment, task, protocol and priority binding as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish service request, care plan, appointment, task, protocol and priority binding? relationship
Who requested, authorized, performed, assisted, recorded or reported service request, care plan, appointment, task, protocol and priority binding, using which evidence, competence and delegated authority? event
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to service request, care plan, appointment, task, protocol and priority binding, and how may it be validated, challenged, corrected or retained? retention

Indication, goal, consent, capacity, authorization, urgency and decision basis

Records indication, goal, consent, capacity, authorization, urgency and decision basis as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish indication, goal, consent, capacity, authorization, urgency and decision basis? authority
Who requested, authorized, performed, assisted, recorded or reported indication, goal, consent, capacity, authorization, urgency and decision basis, using which evidence, competence and delegated authority? measurement
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to indication, goal, consent, capacity, authorization, urgency and decision basis, and how may it be validated, challenged, corrected or retained? interoperability

Procedure definition, components, participants and resources Groups governed procedure-occurrence context for procedure definition, components, participants and resources.

Code, method, site, approach, focus and intent

Groups source-qualified procedure context for code, method, site, approach, focus and intent.

Procedure code, category, intent, target, action, means and recipient

Records procedure code, category, intent, target, action, means and recipient as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish procedure code, category, intent, target, action, means and recipient? definition
Who requested, authorized, performed, assisted, recorded or reported procedure code, category, intent, target, action, means and recipient, using which evidence, competence and delegated authority? evidence
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to procedure code, category, intent, target, action, means and recipient, and how may it be validated, challenged, corrected or retained? quality

Method, technique, approach, access, body site, morphology, focus and laterality

Records method, technique, approach, access, body site, morphology, focus and laterality as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish method, technique, approach, access, body site, morphology, focus and laterality? composition
Who requested, authorized, performed, assisted, recorded or reported method, technique, approach, access, body site, morphology, focus and laterality, using which evidence, competence and delegated authority? state
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to method, technique, approach, access, body site, morphology, focus and laterality, and how may it be validated, challenged, corrected or retained? security

Performers, devices, substances, specimens and components

Groups source-qualified procedure context for performers, devices, substances, specimens and components.

Performer, assistant, anesthesia, device, care team, organization and role period

Records performer, assistant, anesthesia, device, care team, organization and role period as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish performer, assistant, anesthesia, device, care team, organization and role period? ownership
Who requested, authorized, performed, assisted, recorded or reported performer, assistant, anesthesia, device, care team, organization and role period, using which evidence, competence and delegated authority? exception
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to performer, assistant, anesthesia, device, care team, organization and role period, and how may it be validated, challenged, corrected or retained? decision

Used device, focal device, implant, explant, substance, medication, specimen and lot

Records used device, focal device, implant, explant, substance, medication, specimen and lot as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish used device, focal device, implant, explant, substance, medication, specimen and lot? relationship
Who requested, authorized, performed, assisted, recorded or reported used device, focal device, implant, explant, substance, medication, specimen and lot, using which evidence, competence and delegated authority? provenance
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to used device, focal device, implant, explant, substance, medication, specimen and lot, and how may it be validated, challenged, corrected or retained? lifecycle

Preparation, verification, performance and deviation Groups governed procedure-occurrence context for preparation, verification, performance and deviation.

Readiness, patient, site, procedure and team verification

Groups source-qualified procedure context for readiness, patient, site, procedure and team verification.

Subject identity, procedure, site, consent, equipment and document verification

Records subject identity, procedure, site, consent, equipment and document verification as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish subject identity, procedure, site, consent, equipment and document verification? validation
Who requested, authorized, performed, assisted, recorded or reported subject identity, procedure, site, consent, equipment and document verification, using which evidence, competence and delegated authority? privacy
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to subject identity, procedure, site, consent, equipment and document verification, and how may it be validated, challenged, corrected or retained? identity

Team briefing, time-out, anesthesia, allergy, infection, bleeding and readiness check

Records team briefing, time-out, anesthesia, allergy, infection, bleeding and readiness check as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish team briefing, time-out, anesthesia, allergy, infection, bleeding and readiness check? process
Who requested, authorized, performed, assisted, recorded or reported team briefing, time-out, anesthesia, allergy, infection, bleeding and readiness check, using which evidence, competence and delegated authority? retention
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to team briefing, time-out, anesthesia, allergy, infection, bleeding and readiness check, and how may it be validated, challenged, corrected or retained? classification

Occurrence time, location, steps, components and deviations

Groups source-qualified procedure context for occurrence time, location, steps, components and deviations.

Occurrence start, end, duration, location, encounter, performer period and setting

Records occurrence start, end, duration, location, encounter, performer period and setting as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish occurrence start, end, duration, location, encounter, performer period and setting? temporal
Who requested, authorized, performed, assisted, recorded or reported occurrence start, end, duration, location, encounter, performer period and setting, using which evidence, competence and delegated authority? interoperability
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to occurrence start, end, duration, location, encounter, performer period and setting, and how may it be validated, challenged, corrected or retained? relationship

Performed step, component, part-of, sequence, technique change and deviation

Records performed step, component, part-of, sequence, technique change and deviation as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish performed step, component, part-of, sequence, technique change and deviation? event
Who requested, authorized, performed, assisted, recorded or reported performed step, component, part-of, sequence, technique change and deviation, using which evidence, competence and delegated authority? quality
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to performed step, component, part-of, sequence, technique change and deviation, and how may it be validated, challenged, corrected or retained? authority

Outcome, outputs, reports, complications and follow-up Groups governed procedure-occurrence context for outcome, outputs, reports, complications and follow-up.

Immediate outcome, output, observation, report and specimen

Groups source-qualified procedure context for immediate outcome, output, observation, report and specimen.

Completion, result, immediate outcome, goal attainment and uncertainty

Records completion, result, immediate outcome, goal attainment and uncertainty as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish completion, result, immediate outcome, goal attainment and uncertainty? measurement
Who requested, authorized, performed, assisted, recorded or reported completion, result, immediate outcome, goal attainment and uncertainty, using which evidence, competence and delegated authority? security
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to completion, result, immediate outcome, goal attainment and uncertainty, and how may it be validated, challenged, corrected or retained? composition

Observation, diagnostic report, document, image, specimen, product and evidence output

Records observation, diagnostic report, document, image, specimen, product and evidence output as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish observation, diagnostic report, document, image, specimen, product and evidence output? relationship
Who requested, authorized, performed, assisted, recorded or reported observation, diagnostic report, document, image, specimen, product and evidence output, using which evidence, competence and delegated authority? decision
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to observation, diagnostic report, document, image, specimen, product and evidence output, and how may it be validated, challenged, corrected or retained? ownership

Complication, adverse event, sequela, recovery and follow-up

Groups source-qualified procedure context for complication, adverse event, sequela, recovery and follow-up.

Complication, adverse event, near miss, severity, causality and condition reference

Records complication, adverse event, near miss, severity, causality and condition reference as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish complication, adverse event, near miss, severity, causality and condition reference? evidence
Who requested, authorized, performed, assisted, recorded or reported complication, adverse event, near miss, severity, causality and condition reference, using which evidence, competence and delegated authority? lifecycle
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to complication, adverse event, near miss, severity, causality and condition reference, and how may it be validated, challenged, corrected or retained? validation

Follow-up instruction, monitoring, recovery, rehabilitation, escalation and handoff

Records follow-up instruction, monitoring, recovery, rehabilitation, escalation and handoff as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish follow-up instruction, monitoring, recovery, rehabilitation, escalation and handoff? process
Who requested, authorized, performed, assisted, recorded or reported follow-up instruction, monitoring, recovery, rehabilitation, escalation and handoff, using which evidence, competence and delegated authority? identity
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to follow-up instruction, monitoring, recovery, rehabilitation, escalation and handoff, and how may it be validated, challenged, corrected or retained? process

Status, non-performance, correction, composition and safe use Groups governed procedure-occurrence context for status, non-performance, correction, composition and safe use.

Event status, reason, suspension, stopping and non-performance

Groups source-qualified procedure context for event status, reason, suspension, stopping and non-performance.

Preparation, in-progress, on-hold, stopped, completed, error, unknown and status reason

Records preparation, in-progress, on-hold, stopped, completed, error, unknown and status reason as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish preparation, in-progress, on-hold, stopped, completed, error, unknown and status reason? state
Who requested, authorized, performed, assisted, recorded or reported preparation, in-progress, on-hold, stopped, completed, error, unknown and status reason, using which evidence, competence and delegated authority? classification
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to preparation, in-progress, on-hold, stopped, completed, error, unknown and status reason, and how may it be validated, challenged, corrected or retained? temporal

Not-done, cancelled, postponed, aborted, refused, contraindicated and replanned

Records not-done, cancelled, postponed, aborted, refused, contraindicated and replanned as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish not-done, cancelled, postponed, aborted, refused, contraindicated and replanned? exception
Who requested, authorized, performed, assisted, recorded or reported not-done, cancelled, postponed, aborted, refused, contraindicated and replanned, using which evidence, competence and delegated authority? relationship
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to not-done, cancelled, postponed, aborted, refused, contraindicated and replanned, and how may it be validated, challenged, corrected or retained? event

Part-of, repeat, revision, reporting and correction lineage

Groups source-qualified procedure context for part-of, repeat, revision, reporting and correction lineage.

Parent-child, combined, routine component, repeat, revision and care-plan membership

Records parent-child, combined, routine component, repeat, revision and care-plan membership as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish parent-child, combined, routine component, repeat, revision and care-plan membership? composition
Who requested, authorized, performed, assisted, recorded or reported parent-child, combined, routine component, repeat, revision and care-plan membership, using which evidence, competence and delegated authority? authority
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to parent-child, combined, routine component, repeat, revision and care-plan membership, and how may it be validated, challenged, corrected or retained? measurement

Primary, reported, duplicate, amended, corrected, entered-in-error and replacement

Records primary, reported, duplicate, amended, corrected, entered-in-error and replacement as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish primary, reported, duplicate, amended, corrected, entered-in-error and replacement? provenance
Who requested, authorized, performed, assisted, recorded or reported primary, reported, duplicate, amended, corrected, entered-in-error and replacement, using which evidence, competence and delegated authority? composition
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to primary, reported, duplicate, amended, corrected, entered-in-error and replacement, and how may it be validated, challenged, corrected or retained? evidence

Quality, provenance, privacy, retention, interoperability and agents Groups governed procedure-occurrence context for quality, provenance, privacy, retention, interoperability and agents.

Source quality, safety, access, consent and confidentiality

Groups source-qualified procedure context for source quality, safety, access, consent and confidentiality.

Source record, actor, tool, protocol, evidence, quality, safety and derivation

Records source record, actor, tool, protocol, evidence, quality, safety and derivation as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish source record, actor, tool, protocol, evidence, quality, safety and derivation? provenance
Who requested, authorized, performed, assisted, recorded or reported source record, actor, tool, protocol, evidence, quality, safety and derivation, using which evidence, competence and delegated authority? ownership
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to source record, actor, tool, protocol, evidence, quality, safety and derivation, and how may it be validated, challenged, corrected or retained? state

Sensitivity, consent, purpose, access, redaction, break-glass, disclosure and audit

Records sensitivity, consent, purpose, access, redaction, break-glass, disclosure and audit as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish sensitivity, consent, purpose, access, redaction, break-glass, disclosure and audit? privacy
Who requested, authorized, performed, assisted, recorded or reported sensitivity, consent, purpose, access, redaction, break-glass, disclosure and audit, using which evidence, competence and delegated authority? validation
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to sensitivity, consent, purpose, access, redaction, break-glass, disclosure and audit, and how may it be validated, challenged, corrected or retained? exception

Retention, projection, validation and safe agent operation

Groups source-qualified procedure context for retention, projection, validation and safe agent operation.

Retention, hold, disposition, tombstone, correction duty and external record policy

Records retention, hold, disposition, tombstone, correction duty and external record policy as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish retention, hold, disposition, tombstone, correction duty and external record policy? retention
Who requested, authorized, performed, assisted, recorded or reported retention, hold, disposition, tombstone, correction duty and external record policy, using which evidence, competence and delegated authority? process
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to retention, hold, disposition, tombstone, correction duty and external record policy, and how may it be validated, challenged, corrected or retained? provenance

FHIR, openEHR, SNOMED, ICHI, OMOP, UDI projection, version, loss and round-trip

Records fhir, openehr, snomed, ichi, omop, udi projection, version, loss and round-trip as source-qualified procedure-occurrence context while preserving external clinical masters and the separation among request, performance, result, report and adverse event.

Which stable identities, procedure classes, performed values and explicit unknowns establish fhir, openehr, snomed, ichi, omop, udi projection, version, loss and round-trip? interoperability
Who requested, authorized, performed, assisted, recorded or reported fhir, openehr, snomed, ichi, omop, udi projection, version, loss and round-trip, using which evidence, competence and delegated authority? temporal
Which scheduled, occurrence, performer, recorded, reported and knowledge times apply to fhir, openehr, snomed, ichi, omop, udi projection, version, loss and round-trip, and how may it be validated, challenged, corrected or retained? privacy

Classifiers Filled

Family: World Models
Category: Activities and processes
Entry kind: event
Navigation path: NAV.ACT.HCR
Domain: ACT.HCR
Industry: Cross-industry
Tags: medicalprocedureact.hcr

What it is Filled

Owns occurrence identity and lineage, procedure classification, request and plan bindings, status, subject and focus references, performers, occurrence timing and location, method, site, approach, components, used and focal-item references, safety checks, deviations, immediate outcome, output and report links, complication and follow-up links, corrections, provenance, privacy, retention and interoperability. Definitions, requests, plans, appointments, tasks, encounters, consent, people, organizations, locations, devices, substances, specimens, observations, reports, conditions, adverse events, claims, audit and record masters remain external.

In scope

Procedure occurrence profile, identity, source, subject, request and authorization bindings, status, participants, timing, location, performed meaning, resources, safety and deviations
Immediate outcome, output, report, complication, adverse-event and follow-up links, correction, provenance, privacy, retention and version-pinned projections

Out of scope

Independent reusable procedure definition, ServiceRequest, CarePlan, Appointment, workflow Task, Encounter, Consent, Patient, Practitioner, Organization, Location, Device, Substance, Medication, Specimen, Observation, DiagnosticReport, Condition, AdverseEvent, Claim, Audit or Record lifecycles
Treating an order as performance, scheduling as start, completion as success, complication as proven causation, reported history as primary evidence or billing code as performed technique
Providing medical advice, authorizing or controlling real-time procedures, performing clinical actions, deciding malpractice or universally defining professional and legal duties

Why it exists Filled

Distinguishing features Filled

Models one performed or attempted procedure occurrence, not the order, plan or procedure definition.
Separates order, readiness, performance, completion, success and complications.
Records safety checks, deviations and non-performance as part of the occurrence.
Links adverse events and reports that keep their own identity.

What robots and AI may and may not do Filled

Must not

Start, stop or perform any procedure.
Record a procedure as successful from completed status alone.
Edit a signed procedure record without an amendment.
Omit deviations or complications from the record.
Disclose procedure details outside the care and consent context.

Only with a human decision

Consent, indication and the decision to perform a procedure.
Signing the procedure record and reporting adverse events.

May

Record performed components, devices and timings from clinical systems.
Check consent, site marking and time-out completion before start.
Link reports, complications and adverse events.
Prepare procedure summaries for clinician sign-off.

Moral aspects Filled

Procedures are invasive; consent and bodily integrity must be respected.
Accurate recording of complications is needed for patient safety and learning.
Some procedures reveal sensitive information about reproduction or identity.

Who is affected

Patients
Surgeons, nurses and other performers
Families and carers

Owners Filled

Steward

Dimension owner and medical-procedure governance mandate

Roles

Procedure occurrence steward: Own occurrence boundary, profile, namespace, lifecycle and quality rules.
Requester or care-plan owner: Own external request, indication, priority and intended outcome.
Responsible performer: Own performed scope, technique, status, deviations and immediate outcome within competence.
Procedure team member: Own role-qualified participation and safety-check evidence.
Recorder or reporter: Preserve source fidelity and distinguish primary performance evidence from reported history.
Clinical safety reviewer: Own readiness, complication, adverse-event and correction impact review.
Terminology and device steward: Own versioned code, UDI and projection mappings with loss declarations.
Privacy, records and assurance steward: Own protected views, disclosures, holds, retention and auditability.

Links to other meta-models Filled

references

WM-ACT-049 Care Plan / Episode - Record candidate inverse containment and planning context without approving the ledger edge or cascade semantics.
WM-ACT-014 Health Care Delivery, WM-ACT-018 Encounter, ServiceRequest, Appointment, Task, Consent and Procedure Definition models - Bind system context, intent, scheduling, workflow and authority while their masters retain lifecycle.
Patient, Practitioner, Organization, Care Team, Location, Device, Substance, Medication, Specimen and product models - Resolve authoritative subjects, performers, sites and used or manipulated items without copying them.
WM-ACT-046 Clinical Observation / Diagnosis, DiagnosticReport, Condition, AdverseEvent, follow-up, evidence, provenance, consent, audit and record models - Bind outputs, safety consequences, evidence and governance without lifecycle or causality cascade.

aligned

FHIR R5, openEHR RM 1.1.0, SNOMED CT, ICHI, OMOP CDM 5.4 and UDI - Project version-pinned clinical, workflow, classifier, analytic and device views with maturity, jurisdiction and information-loss declarations.

neighbor

WM-ACT-049 Care Plan / Episode - A care plan may contain intended or performed procedure references, but owns its goals and planning lifecycle. The ledger containment relation is candidate and creates no cascade behavior.
WM-ACT-014 Health Care Delivery and WM-ACT-018 Encounter - Care-delivery and Encounter masters own system, visit, service and participant context. The procedure occurrence binds them without absorbing their lifecycle.
ServiceRequest, Appointment, Task, Consent and Procedure Definition - These masters own intent, scheduling, workflow fulfillment, authorization and reusable protocol. This event records what was actually attempted or done and the source-qualified links back.
WM-ACT-046 Clinical Observation / Diagnosis, DiagnosticReport and Condition - Observations and reports own measured results and interpretations; Condition owns complication or diagnosis assertions. This event owns output links and only a bounded immediate outcome statement.
Adverse Event and safety incident - An external adverse-event case owns potential harm, severity, reporting and evolving causality. The procedure occurrence records a typed association without deciding causation.
Device, Medication, Substance, Biologically Derived Product and Specimen - External masters own item identity and lifecycle. The occurrence records role-qualified use, manipulation, implantation, removal and specimen outputs with exact identifiers where available.

parent

WM-ACT-014

What else AI and robots need to interact with it Filled

Sources Filled

FHIR R5 Procedure - Health Level Seven International
FHIR R5 ServiceRequest - Health Level Seven International
FHIR R5 CarePlan - Health Level Seven International
FHIR R5 AdverseEvent - Health Level Seven International
FHIR R5 Observation - Health Level Seven International
openEHR Reference Model EHR Information Model - openEHR Foundation
SNOMED CT Concept Model - SNOMED International
SNOMED CT Procedure Modeling - SNOMED International
International Classification of Health Interventions Reference Guide - World Health Organization
WHO Surgical Safety Checklist tools and resources - World Health Organization
Universal Protocol: Pre-procedure Verification - Joint Commission
OMOP Common Data Model v5.4 - Observational Health Data Sciences and Informatics
UDI Basics - United States Food and Drug Administration
Regulation (EU) 2016/679 General Data Protection Regulation - European Union
PROV-O: The PROV Ontology - World Wide Web Consortium
Date and Time on the Internet: Timestamps - Internet Engineering Task Force

Open questions

Approve or reject the WM-ACT-049 containment edge and define cardinality, plan membership, performed-activity binding and non-cascade semantics.
Create specialty profiles for surgery, anesthesia, imaging, laboratory, rehabilitation, counseling, obstetric, dental, device and transfusion procedures.
Create jurisdiction and institution profiles for consent, performer qualification, safety verification, reporting, correction, retention and access.
Test release-pinned FHIR, openEHR, SNOMED CT, ICHI, OMOP CDM and UDI mappings with mapping-loss and round-trip evidence.
Obtain supplemental Claude or Grok review and resolve any material challenge before canonical promotion.
Claude and Grok each timed out on one bounded attempt; no independent external result was admitted.
WM-ACT-049 Care Plan / Episode CONTAINS WM-ACT-047 is candidate metadata and not an approved composition edge.
Surgery, anesthesia, imaging, laboratory, rehabilitation, counseling, obstetric, dental, device, transfusion and other procedure families require specialty profiles.
FHIR R5 Procedure, ServiceRequest, CarePlan and AdverseEvent are Trial Use at varied maturity; ICHI is a current development publication and full SNOMED, OMOP and UDI interoperability requires release-pinned testing.

Machine files

Card as JSON Specification AGENTS.md Source Card backlog vercy.card/1

Provenance

world-models research · reviewable-draft

Built from: models/wm-act-047-medical-procedure/spec.yaml, ver-cy/world-models/card-supplements/wm-act-047-medical-procedure.json