CarePlan and Procedure/ProcedureRequest - relations

We are trying to use CarePlan in our domain and as part of this careplan there could be 1 or more surgical Procedures. We would like to relate those Procedures under the same careplan activities.

Procedure can be requested by both ProcedureRequest or CarePlan. Assumption is if we go with CarePlan as the request for Procedure then we would not need ProcedureRequest (as per the FHIR structure below)


Procedure -> request 0…1 (CarePlan | ProcedureRequest…)

CarePlan has activity and it can be referenced to ProcedureRequest but not Procedure.


CarePlan -> activity.reference 0…1 (ProcedureRequest)

My question here is,

How can we access Procedure from a CarePlan?

below is the current way,

CarePlan.activity -----> ProcedureRequest.request -----> Procedure

Is there any better way to get Procedure from CarePlan?

please help me if I am missing something here.


In STU 3, Procedure (and all other “event” resources) will have the ability to point to the “request” resource that was the basis for them, whether CarePlan, ReferralRequest or ProcedureRequest. In STU 2, you’ll need to use an extension to establish this relationship. However, you can also use CarePlan.activity.actionResulting to point to the fulfilling activity. Whether this bi-directional capability will be retained going forward, I don’t know.

Thanks Lloyd, it helps.