Example Usage Scenarios:

The following are example usage scenarios for this profile:

• Query for a Patient’s CareTeam
• Record or update a Patient’s CareTeam

Mandatory and Must Support Data Elements

The following data elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each CareTeam Must Have:

1. a patient
2. a participant role for each careteam member
3. a reference to each careteam member, which can be:
   • a practitioner or practitioner type (doctor, nurse, therapist)*
   • a relative, friend, or guardian

*See below for how practitioner members are represented in this Profile.

Each CareTeam Must Support:

1. a status code

Profile Specific Implementation Guidance:

In order to access care team member’s names, identifiers, locations, and contact information, the CareTeam profile supports several types of care team participants. They are represented as references to other profiles and include the following three profiles, which are marked as Must Support:

1. US Core Practitioner Profile
2. US Core PractitionerRole Profile
3. US Core RelatedPerson Profile

• Although both US Core Practitioner Profile and US Core PractitionerRole are Must Support, the server system is not required to support references to both, but SHALL support at least one of them.
• The client application SHALL support all three profile references.
• Because the US Core PractitionerRole Profile supplies the provider’s location and contact information and a reference to the Practitioner, server systems SHOULD reference it instead of the US Core Practitioner Profile. The quick start section below shows an example of how to access the practitioner name and identifier.
• Servers that support only US Core Practitioner Profile and do not support the US Core PractitionerRole Profile SHALL provide implementation-specific guidance on how to access a provider’s location and contact information using only the Practitioner resource.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from CareTeam

Name	Flags	Card.	Type	Description & Constraints
CareTeam		0..*	CareTeam	Planned participants in the coordination and delivery of care for a patient or group
status	S	0..1	code	proposed | active | suspended | inactive | entered-in-error Binding: CareTeamStatus (required): Indicates whether the team is current , represents future intentions or is now a historical record.
subject	S	1..1	Reference(US Core Patient Profile S | Group)	Who care team is for
participant	S	1..*	BackboneElement	Members of the team
role	S	1..1	CodeableConcept	Type of involvement Binding: Care Team Member Function (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
member	S	1..1	Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile S | US Core CareTeam Profile | US Core RelatedPerson Profile S)	Who is involved
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
CareTeam.status	required	CareTeamStatus http://hl7.org/fhir/ValueSet/care-team-status from the FHIR Standard
CareTeam.participant.role	extensible	CareTeamMemberFunction http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30 from https://vsac.nlm.nih.gov

Name	Flags	Card.	Type	Description & Constraints
CareTeam		0..*	CareTeam	Planned participants in the coordination and delivery of care for a patient or group
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	0..1	code	proposed | active | suspended | inactive | entered-in-error Binding: CareTeamStatus (required): Indicates whether the team is current , represents future intentions or is now a historical record.
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who care team is for
participant	SC	1..*	BackboneElement	Members of the team ctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role	SΣ	1..1	CodeableConcept	Type of involvement Binding: Care Team Member Function (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
member	SΣ	1..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile)	Who is involved
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CareTeam.status	required	CareTeamStatus http://hl7.org/fhir/ValueSet/care-team-status from the FHIR Standard
CareTeam.participant.role	extensible	CareTeamMemberFunction http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30 from https://vsac.nlm.nih.gov

Name	Flags	Card.	Type	Description & Constraints
CareTeam		0..*	CareTeam	Planned participants in the coordination and delivery of care for a patient or group
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Ids for this team
status	?!SΣ	0..1	code	proposed | active | suspended | inactive | entered-in-error Binding: CareTeamStatus (required): Indicates whether the team is current , represents future intentions or is now a historical record.
category	Σ	0..*	CodeableConcept	Type of team Binding: CareTeamCategory (example): Indicates the type of care team.
name	Σ	0..1	string	Name of the team, such as crisis assessment team
subject	SΣ	1..1	Reference(US Core Patient Profile S | Group)	Who care team is for
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
period	Σ	0..1	Period	Time period team covers
participant	SC	1..*	BackboneElement	Members of the team ctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role	SΣ	1..1	CodeableConcept	Type of involvement Binding: Care Team Member Function (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
member	SΣ	1..1	Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile S | US Core CareTeam Profile | US Core RelatedPerson Profile S)	Who is involved
onBehalfOf	Σ	0..1	Reference(Organization)	Organization of the practitioner
period		0..1	Period	Time period of participant
reasonCode		0..*	CodeableConcept	Why the care team exists Binding: SNOMEDCTClinicalFindings (example): Indicates the reason for the care team.
reasonReference		0..*	Reference(Condition)	Why the care team exists
managingOrganization	Σ	0..*	Reference(Organization)	Organization responsible for the care team
telecom		0..*	ContactPoint	A contact detail for the care team (that applies to all members)
note		0..*	Annotation	Comments made about the CareTeam
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CareTeam.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
CareTeam.status	required	CareTeamStatus http://hl7.org/fhir/ValueSet/care-team-status from the FHIR Standard
CareTeam.category	example	CareTeamCategory http://hl7.org/fhir/ValueSet/care-team-category from the FHIR Standard
CareTeam.participant.role	extensible	CareTeamMemberFunction http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30 from https://vsac.nlm.nih.gov
CareTeam.reasonCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard

Differential View

This structure is derived from CareTeam

Name	Flags	Card.	Type	Description & Constraints
CareTeam		0..*	CareTeam	Planned participants in the coordination and delivery of care for a patient or group
status	S	0..1	code	proposed | active | suspended | inactive | entered-in-error Binding: CareTeamStatus (required): Indicates whether the team is current , represents future intentions or is now a historical record.
subject	S	1..1	Reference(US Core Patient Profile S | Group)	Who care team is for
participant	S	1..*	BackboneElement	Members of the team
role	S	1..1	CodeableConcept	Type of involvement Binding: Care Team Member Function (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
member	S	1..1	Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile S | US Core CareTeam Profile | US Core RelatedPerson Profile S)	Who is involved
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
CareTeam.status	required	CareTeamStatus http://hl7.org/fhir/ValueSet/care-team-status from the FHIR Standard
CareTeam.participant.role	extensible	CareTeamMemberFunction http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30 from https://vsac.nlm.nih.gov

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
CareTeam		0..*	CareTeam	Planned participants in the coordination and delivery of care for a patient or group
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	0..1	code	proposed | active | suspended | inactive | entered-in-error Binding: CareTeamStatus (required): Indicates whether the team is current , represents future intentions or is now a historical record.
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who care team is for
participant	SC	1..*	BackboneElement	Members of the team ctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role	SΣ	1..1	CodeableConcept	Type of involvement Binding: Care Team Member Function (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
member	SΣ	1..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile)	Who is involved
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CareTeam.status	required	CareTeamStatus http://hl7.org/fhir/ValueSet/care-team-status from the FHIR Standard
CareTeam.participant.role	extensible	CareTeamMemberFunction http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30 from https://vsac.nlm.nih.gov

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
CareTeam		0..*	CareTeam	Planned participants in the coordination and delivery of care for a patient or group
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Ids for this team
status	?!SΣ	0..1	code	proposed | active | suspended | inactive | entered-in-error Binding: CareTeamStatus (required): Indicates whether the team is current , represents future intentions or is now a historical record.
category	Σ	0..*	CodeableConcept	Type of team Binding: CareTeamCategory (example): Indicates the type of care team.
name	Σ	0..1	string	Name of the team, such as crisis assessment team
subject	SΣ	1..1	Reference(US Core Patient Profile S | Group)	Who care team is for
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
period	Σ	0..1	Period	Time period team covers
participant	SC	1..*	BackboneElement	Members of the team ctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role	SΣ	1..1	CodeableConcept	Type of involvement Binding: Care Team Member Function (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
member	SΣ	1..1	Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile S | US Core CareTeam Profile | US Core RelatedPerson Profile S)	Who is involved
onBehalfOf	Σ	0..1	Reference(Organization)	Organization of the practitioner
period		0..1	Period	Time period of participant
reasonCode		0..*	CodeableConcept	Why the care team exists Binding: SNOMEDCTClinicalFindings (example): Indicates the reason for the care team.
reasonReference		0..*	Reference(Condition)	Why the care team exists
managingOrganization	Σ	0..*	Reference(Organization)	Organization responsible for the care team
telecom		0..*	ContactPoint	A contact detail for the care team (that applies to all members)
note		0..*	Annotation	Comments made about the CareTeam
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CareTeam.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
CareTeam.status	required	CareTeamStatus http://hl7.org/fhir/ValueSet/care-team-status from the FHIR Standard
CareTeam.category	example	CareTeamCategory http://hl7.org/fhir/ValueSet/care-team-category from the FHIR Standard
CareTeam.participant.role	extensible	CareTeamMemberFunction http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30 from https://vsac.nlm.nih.gov
CareTeam.reasonCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard

This structure is derived from CareTeam

Summary

Mandatory: 4 elements
Must-Support: 5 elements

Structures

This structure refers to these other structures:

• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
• US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
• US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)
• US Core PractitionerRole Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole)
• US Core CareTeam Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam)
• US Core RelatedPerson Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson)

Maturity: 3

Quick Start

Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile’s information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

• See the Scopes Format section for a description of the SMART scopes syntax.
• See the Search Syntax section for a description of the US Core search syntax.
• See the General Requirements section for additional rules and expectations when a server requires status parameters.
• See the General Guidance section for additional guidance on searching for multiple patients.

US Core Scopes

Servers providing access to careteam data SHALL support these US Core SMART Scopes:

• resource level scopes: <patient|user|system>/CareTeam.rs

Mandatory Search Parameters:

The following search parameters and search parameter combinations SHALL be supported:

1. SHALL support searching using the combination of the patient and status search parameters:
   • including optional support for these _include parameters: CareTeam:participant:PractitionerRole,CareTeam:participant:Practitioner,CareTeam:participant:Patient,CareTeam:participant:RelatedPerson
   • including optional support for OR search on status (e.g.status={system|}[code],{system|}[code],...)

   GET [base]/CareTeam?patient={Type/}[id]&status=active

   Example:

   1. GET [base]/CareTeam?patient=1137192&status=active
   2. GET [base]/CareTeam?patient=1137192&status=active&_include=CareTeam:participant:RelatedPerson&_include=CareTeam:participant:Patient&_include=CareTeam:participant:Practitioner&_include=CareTeam:participant:PractitionerRole

   Implementation Notes: Fetches a bundle of all CareTeam resources for the specified patient and status =active and may include CareTeam Patient, RelatedPerson and Practitioner and PractitionerRole participants.
   To get Practitioner name and identifier using PractitionerRole:
   1) Search for the careteam PractitionerRole: GET [base]/CareTeam?patient=[id]&status=active&_include=CareTeam:participant:PractitionerRole 2) Use the FHIR _id from the PractitionerRole.practitioner element, to fetch the Practitioner resources using GET [base]/Practitioner?_id=[id] (how to search by reference and how to search by token)

Optional Search Parameters:

The following search parameter combinations SHOULD be supported:

1. SHOULD support searching using the combination of the patient and role search parameters:
   • including optional support for these _include parameters: CareTeam:participant:PractitionerRole,CareTeam:participant:Practitioner,CareTeam:participant:Patient,CareTeam:participant:RelatedPerson
   • including optional support for OR search on role (e.g.role={system|}[code],{system|}[code],...)

   GET [base]/CareTeam?patient={Type/}[id]&role={system|}[code]{,{system|}[code],...}

   Example:

   1. GET [base]/CareTeam?patient=1137192&role=http://snomed.info/sct|17561000

   Implementation Notes: Fetches a bundle of all CareTeam resources for the specified patient and participant role (how to search by reference and how to search by token)