US Core Implementation Guide
9.0.0 - CI Build
US Core Implementation Guide
9.0.0 - CI Build
US Core Implementation Guide, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 9.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/US-Core/ and changes regularly. See the Directory of published versions
| Page standards status: Trial-use | Maturity Level: 3 |
<Requirements xmlns="http://hl7.org/fhir">
<id value="us-core-certifying-system"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<p>These requirements apply to the actor: <i><strong>US Core Certifying System</strong></i></p>
<table class="grid">
<thead>
<tr>
<th>Key</th>
<th>Conformance</th>
<th>Requirement</th>
</tr>
</thead>
<tbody>
<tr>
<td>CONF-0011</td>
<td style="text-align: center;">SHALL<br/>(conditional)</td>
<td><div><p>A Server that certifies to the <a href="https://www.federalregister.gov/d/2020-07419/p-1177">21st Century Cures Act for accessing patient data</a> <strong>SHALL</strong> implement all components in the USCDI [<a href="https://www.healthit.gov/isp/united-states-core-data-interoperability-uscdi">USCDI link</a>]</p>
</div></td>
</tr>
<tr>
<td>CONF-0012</td>
<td style="text-align: center;">SHALL<br/>(conditional)</td>
<td><div><p>A Server that certifies to the <a href="https://www.federalregister.gov/d/2020-07419/p-1177">21st Century Cures Act for accessing patient data</a> <strong>SHALL</strong> implement all components in the ... the US Core CapabilityStatement [<a href="https://hl7.org/fhir/us/core/CapabilityStatement-us-core-Server.html">Definition</a>] .</p>
</div></td>
</tr>
<tr>
<td>CONF-0873</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>If an element is marked as <em>Additional USCDI</em> and defined by a pattern [as described by <a href="http://hl7.org/fhir/R4/elementdefinition-definitions.html#ElementDefinition.pattern_x_">ElementDefinition.pattern</a>], then the pattern defines the elements <em>and</em> element values that the Certifying System <strong>SHALL</strong> be capable of providing.</p>
</div></td>
</tr>
<tr>
<td>CONF-0874</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>If [an element is] ... marked as <em>Additional USCDI</em>, then the Certifying System <strong>SHALL</strong> be capable of providing the element value to meet the <em>Additional USCDI</em> requirement.</p>
</div></td>
</tr>
<tr>
<td>CONF-0875</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>For any complex element marked as <em>Additional USCDI</em>, the Certifying System <strong>SHALL</strong> be capable of providing at least one of the sub-element values</p>
</div></td>
</tr>
<tr>
<td>CONF-0876</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[For any complex element marked as <em>Additional USCDI</em>]. If any sub-element is marked as <em>Additional USCDI</em>, [the Certifying System <strong>SHALL</strong>] ... meet the <em>Additional USCDI</em> requirements and satisfy the <em>Additional USCDI</em> requirements for the parent element.</p>
</div></td>
</tr>
<tr>
<td>CONF-0878</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>When a Reference type element is labeled as <em>Additional USCDI</em> and has a single target profile referenced, the target profile <strong>SHALL</strong> be supported for Certifying Systems.</p>
</div></td>
</tr>
<tr>
<td>CONF-0880</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>When a Reference type element labeled as <em>Additional USCDI</em>, has multiple target profiles referenced, and specific targets are labeled as <em>Must Support</em>, the <em>Must Support</em> target profile(s) <strong>SHALL</strong> be supported by Certifying Systems</p>
</div></td>
</tr>
<tr>
<td>CONF-0883</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>When a Reference element is labeled as <em>Additional USCDI</em> has multiple target profiles referenced, but none are labeled as <em>Must Support</em>, <em>at least one</em> target profile <strong>SHALL</strong> be supported by Certifying Systems.</p>
</div></td>
</tr>
<tr>
<td>CONF-0884</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>If an <em>Additional USCDI</em> element has a choice of datatypes for its content, the datatypes the Certifying System <strong>SHALL</strong> support are labeled as <em>Must Support</em>.</p>
</div></td>
</tr>
</tbody>
</table>
</div>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
<valueCode value="cgp"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
<valueInteger value="3">
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
<valueCanonical
value="http://hl7.org/fhir/us/core/ImplementationGuide/hl7.fhir.us.core"/>
</extension>
</valueInteger>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
<valueCode value="trial-use">
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
<valueCanonical
value="http://hl7.org/fhir/us/core/ImplementationGuide/hl7.fhir.us.core"/>
</extension>
</valueCode>
</extension>
<url
value="http://hl7.org/fhir/us/core/Requirements/us-core-certifying-system"/>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:oid:2.16.840.1.113883.4.642.40.2.36.1"/>
</identifier>
<version value="9.0.0"/>
<name value="USCoreCertifyingSystemRequirements"/>
<title value="US Core Certifying System Requirements"/>
<status value="draft"/>
<date value="2026-02-27T00:08:25+00:00"/>
<publisher value="HL7 International / Cross-Group Projects"/>
<contact>
<name value="HL7 International / Cross-Group Projects"/>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/cgp"/>
</telecom>
<telecom>
<system value="email"/>
<value value="cgp@lists.HL7.org"/>
</telecom>
</contact>
<description
value="This [Requirements](https://hl7.org/fhir/R5/requirements.html) resource lists the *additional requirements* for systems certifying for ASTP Health IT Certification (g(10) certification. These requirements represent the regulatory and technical specifications that design artifacts must meet to ensure interoperability. See the [US Core Server Requirements](Requirements-us-core-server.html) for the US Core Responder (Server) requirements defined in the US Core Implementation Guide narrative sections."/>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="US"/>
</coding>
</jurisdiction>
<copyright
value="Used by permission of HL7 International, all rights reserved Creative Commons License"/>
<actor>
<extension url="http://hl7.org/fhir/StructureDefinition/display">
<valueString value="US Core Certifying System"/>
</extension>
</actor>
<statement>
<key value="CONF-0011"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="A Server that certifies to the [21st Century Cures Act for accessing patient data](https://www.federalregister.gov/d/2020-07419/p-1177) **SHALL** implement all components in the USCDI [[USCDI link](https://www.healthit.gov/isp/united-states-core-data-interoperability-uscdi)]"/>
</statement>
<statement>
<key value="CONF-0012"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="A Server that certifies to the [21st Century Cures Act for accessing patient data](https://www.federalregister.gov/d/2020-07419/p-1177) **SHALL** implement all components in the ... the US Core CapabilityStatement [[Definition](https://hl7.org/fhir/us/core/CapabilityStatement-us-core-Server.html)] ."/>
</statement>
<statement>
<key value="CONF-0873"/>
<conformance value="SHALL"/>
<requirement
value="If an element is marked as *Additional USCDI* and defined by a pattern [as described by [ElementDefinition.pattern](http://hl7.org/fhir/R4/elementdefinition-definitions.html#ElementDefinition.pattern_x_)], then the pattern defines the elements *and* element values that the Certifying System **SHALL** be capable of providing."/>
</statement>
<statement>
<key value="CONF-0874"/>
<conformance value="SHALL"/>
<requirement
value="If [an element is] ... marked as *Additional USCDI*, then the Certifying System **SHALL** be capable of providing the element value to meet the *Additional USCDI* requirement."/>
</statement>
<statement>
<key value="CONF-0875"/>
<conformance value="SHALL"/>
<requirement
value="For any complex element marked as *Additional USCDI*, the Certifying System **SHALL** be capable of providing at least one of the sub-element values"/>
</statement>
<statement>
<key value="CONF-0876"/>
<conformance value="SHALL"/>
<requirement
value="[For any complex element marked as *Additional USCDI*]. If any sub-element is marked as *Additional USCDI*, [the Certifying System **SHALL**] ... meet the *Additional USCDI* requirements and satisfy the *Additional USCDI* requirements for the parent element."/>
</statement>
<statement>
<key value="CONF-0878"/>
<conformance value="SHALL"/>
<requirement
value="When a Reference type element is labeled as *Additional USCDI* and has a single target profile referenced, the target profile **SHALL** be supported for Certifying Systems."/>
</statement>
<statement>
<key value="CONF-0880"/>
<conformance value="SHALL"/>
<requirement
value="When a Reference type element labeled as *Additional USCDI*, has multiple target profiles referenced, and specific targets are labeled as *Must Support*, the *Must Support* target profile(s) **SHALL** be supported by Certifying Systems"/>
</statement>
<statement>
<key value="CONF-0883"/>
<conformance value="SHALL"/>
<requirement
value="When a Reference element is labeled as *Additional USCDI* has multiple target profiles referenced, but none are labeled as *Must Support*, *at least one* target profile **SHALL** be supported by Certifying Systems."/>
</statement>
<statement>
<key value="CONF-0884"/>
<conformance value="SHALL"/>
<requirement
value="If an *Additional USCDI* element has a choice of datatypes for its content, the datatypes the Certifying System **SHALL** support are labeled as *Must Support*."/>
</statement>
</Requirements>
IG © 2026+ HL7 International / Cross-Group Projects. Package hl7.fhir.us.core#9.0.0 based on FHIR 4.0.1. Generated 2026-02-27
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