A FHIR Implementation Guide for the intra-procedural anesthesia record designed for use by developers, clinicians, researchers and payors. The IG provides guidance on how the anesthesia record may be reendered, using FHIR resources, to provide a persistent electronic clinical document. Problem: Weiser et al. (2016) have estimated that between 2005 and 2012 the annual volume of surgical procedures in the 66 Member States of the World Health Organization was around 150M.  The associated anesthesia records are required medico-legal documents and increasingly, anesthesiologists are using electronic anesthesia information management systems (AIMS) to create them. Each record holds detailed time-referenced data from patient-connected devices, events, procedures, medications, and a variety of clinical and procedural observations. In aggregate this represents a huge potential resource for clinical governance, quality improvement and research. Minimum and desirable, practice standards in anesthesia (particularly for monitoring) have been defined by various national professional bodies and international organizations including AAGBI (UK and Eire), ANZCA (Australia and New Zealand), ASA (US), CAS (Canada), EBA (Europe) and WHO-WFSA (International: Gelb et al, 2018). However, there is no international standard that defines the detailed content of anesthesia records nor how persistent e-records should be represented. A separate project, P1153  “HL7 Domain Analysis Model: Intra-Procedure Anesthesia, R1” has aimed to provide a general model for content based on a number of general and specific use cases and a content analysis of around 30 US and international guidelines and anesthesia records. This also provides example bindings to the term set defined by the IOTA group that was originally sponsored by the Anesthesia Patient Safety Foundation (APSF) and that is currently maintained by the SNOMED CT Anaesthesia Clinical Reference Group (CRG). Scope and purpose: The proposed project is to build on the existing HL7 artefacts HL7_DAM_ANESTH_R1_I1_2020FEB /  V3DAM_DCM4MEDDEV_R1_I1_2011MAY / V3DAM_DCM4MEDDEV_R2_I1_MAY_2018  to create an FHIR R4 implementation guide for the electronic anesthesia record.  The implementation guide will fully to reference the ISO/IEEE 11073 family of base standards for Health informatics and medical / health device communication, including the IEEE 11073 Service-oriented Device Connectivity (SDC) standards and the related Gemini SES MDI program's Service-oriented Device Point-of-care Interoperability (SDPi) profiles that includes an anesthesia workstation specialization, and the related HL7 FHIR Point[-of-Care Devices (PoCD) Implementation Guide.  This electronic anesthesia record FHIR implementation guide would be intended primarily for use by systems developers and researchers, internationally. The IG provides guidance on how the anesthesia record may be rendered, using FHIR resources, to provide a persistent electronic clinical document. References Gelb, Adrian W., et al. “World Health Organization-World Federation of Societies of Anaesthesiologists (WHO-WFSA) International Standards for a Safe Practice of Anesthesia.” Canadian Journal of Anesthesia/Journal Canadien D’anesthésie, vol. 65, no. 6, 7 May 2018, pp. 698–708, 10.1007/s12630-018-1111-5. Accessed 4 Feb. 2020. Weiser, Thomas G, et al. “Size and Distribution of the Global Volume of Surgery in 2012.” Bulletin of the World Health Organization, vol. 94, no. 3, 1 Mar. 2016, pp. 201–209F, www.ncbi.nlm.nih.gov/pmc/articles/PMC4773932/, 10.2471/blt.15.159293. Accessed 3 Dec. 2019.