US Core Implementation Guide
8.0.0 - STU 8 United States of America flag

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 8.0.0 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

Resource Profile: US Core Practitioner Profile

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner Version: 8.0.0
Standards status: Trial-use Computable Name: USCorePractitionerProfile
Other Identifiers: OID:2.16.840.1.113883.4.642.40.2.42.50

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

The US Core Practitioner Profile inherits from the FHIR Practitioner resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the Practitioner resource to record, search, and fetch basic demographics and administrative information about an individual practitioner. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.

Example Usage Scenarios:

The following are example usage scenarios for this profile:

  • Query for a practitioner by name or NPI
  • Reference from other Resources

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 Practitioner Must Have:

  1. An identifier that Must Support an NPI if available.
  2. A name

Each PractitionerRole Must Support:

  1. Contact information*
  2. An address*

* see guidance below

Profile Specific Implementation Guidance:

  • *The Practitioner and PractitionerRole directly and indirectly communicate the address(es) and contact information of the practitioner. Servers that support only the 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.
    • Although Practitioner.address is marked as Must Support, the Server system is not required to support it if they support the US Core PractitionerRole Profile, but SHALL support it if they do not support the US Core PractitionerRole Profile. The Client application SHALL support both.
  • It is important to balance the privacy of healthcare workers with the patient's right to access information. Only professional/work contact information about the practitioner SHOULD be available to the patient (such as a work address or office telephone number).
  • This profile may be referenced by different capability statements, such as the Conformance requirements for the US Core Server or a provider directory capability statement.
  • * Systems SHOULD follow the Project US@ Technical Specification for Patient Addresses Final Version 1.0 as the standard style guide for Practitioner.address.line and  Practitioner.address.city.

Usage:

Changes since version 7.0.0:

  • No changes

    • Formal Views of Profile Content

    Description of Profiles, Differentials, Snapshots and how the different presentations work.

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Practitioner 0..* Practitioner A person with a formal responsibility in the provisioning of healthcare or related services
    dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    dom-6: A resource should have narrative for robust management
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ele-1: All FHIR elements must have a @value or children
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ... Slices for identifier SΣ 1..* Identifier An identifier for the person as this agent
    Slice: Unordered, Open by value:$this
    ele-1: All FHIR elements must have a @value or children
    .... identifier:All Slices Content/Rules for all slices
    ..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
    Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


    ele-1: All FHIR elements must have a @value or children
    ..... system SΣ 1..1 uri The namespace for the identifier value
    ele-1: All FHIR elements must have a @value or children
    Example General: http://www.acme.com/identifiers/patient
    ..... value SΣ 1..1 string The value that is unique
    ele-1: All FHIR elements must have a @value or children
    Example General: 123456
    .... identifier:NPI SΣC 0..* Identifier An identifier for the person as this agent
    ele-1: All FHIR elements must have a @value or children
    us-core-16: NPI must be 10 digits
    us-core-17: NPI check digit must be valid (Luhn algorithm check)

    Required Pattern: At least the following
    ..... system 1..1 uri The namespace for the identifier value
    Fixed Value: http://hl7.org/fhir/sid/us-npi
    ..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
    Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


    ele-1: All FHIR elements must have a @value or children
    ..... system SΣ 1..1 uri The namespace for the identifier value
    ele-1: All FHIR elements must have a @value or children
    Example General: http://www.acme.com/identifiers/patient
    ..... value SΣ 1..1 string The value that is unique
    ele-1: All FHIR elements must have a @value or children
    Example General: 123456
    ... name SΣ 1..* HumanName The name(s) associated with the practitioner
    ele-1: All FHIR elements must have a @value or children
    .... use ?!Σ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
    Binding: NameUse (required): The use of a human name.


    ele-1: All FHIR elements must have a @value or children
    .... family SΣ 1..1 string Family name (often called 'Surname')
    ele-1: All FHIR elements must have a @value or children
    ... telecom SΣ 0..* ContactPoint A contact detail for the practitioner (that apply to all roles)
    ele-1: All FHIR elements must have a @value or children
    .... system SΣC 0..1 code phone | fax | email | pager | url | sms | other
    Binding: ContactPointSystem (required): Telecommunications form for contact point.


    ele-1: All FHIR elements must have a @value or children
    .... value SΣ 0..1 string The actual contact point details
    ele-1: All FHIR elements must have a @value or children
    .... use ?!Σ 0..1 code home | work | temp | old | mobile - purpose of this contact point
    Binding: ContactPointUse (required): Use of contact point.


    ele-1: All FHIR elements must have a @value or children
    ... address SΣ 0..* Address Address(es) of the practitioner
    ele-1: All FHIR elements must have a @value or children
    .... use ?!Σ 0..1 code home | work | temp | old | billing - purpose of this address
    Binding: AddressUse (required): The use of an address.


    ele-1: All FHIR elements must have a @value or children
    Example General: home
    .... line SΣ 0..4 string Street name, number, direction & P.O. Box etc.
    ele-1: All FHIR elements must have a @value or children
    This repeating element order: The order in which lines should appear in an address label
    Example General: 137 Nowhere Street
    Example General: 49 MEADOW ST
    .... city SΣ 0..1 string Name of city, town etc.
    ele-1: All FHIR elements must have a @value or children
    Example General: Erewhon
    Example General: EVERYTOWN
    .... state SΣ 0..1 string Sub-unit of country (abbreviations ok)
    Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.


    ele-1: All FHIR elements must have a @value or children
    Example General: OK
    .... postalCode SΣ 0..1 string US Zip Codes
    ele-1: All FHIR elements must have a @value or children
    Example General: 9132
    Example General: 74047
    .... country SΣ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)
    ele-1: All FHIR elements must have a @value or children

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    Practitioner.identifier.userequiredIdentifierUse
    http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
    from the FHIR Standard
    Practitioner.identifier:NPI.userequiredIdentifierUse
    http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
    from the FHIR Standard
    Practitioner.name.userequiredNameUse
    http://hl7.org/fhir/ValueSet/name-use|4.0.1
    from the FHIR Standard
    Practitioner.telecom.systemrequiredContactPointSystem
    http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
    from the FHIR Standard
    Practitioner.telecom.userequiredContactPointUse
    http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
    from the FHIR Standard
    Practitioner.address.userequiredAddressUse
    http://hl7.org/fhir/ValueSet/address-use|4.0.1
    from the FHIR Standard
    Practitioner.address.stateextensibleUspsTwoLetterAlphabeticCodes (a valid code from https://www.usps.com/)
    http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state
    from this IG

    Constraints

    IdGradePath(s)DetailsRequirements
    us-core-16errorPractitioner.identifier:NPINPI must be 10 digits
    : value.matches('^[0-9]{10}$')
    us-core-17errorPractitioner.identifier:NPINPI check digit must be valid (Luhn algorithm check)
    : (((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger()) + 24)mod 10=0)

     

    Other representations of profile: CSV, Excel, Schematron

    Notes:

    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 practitioner data SHALL support these US Core SMART Scopes:

    Mandatory Search Parameters:

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

    1. SHALL support searching for a practitioner by a string match of any part of name using the name search parameter:

      GET [base]/Practitioner?name=[string]

      Example:

      1. GET [base]/Practitioner?name=Smith

      Implementation Notes: Fetches a bundle of all Practitioner resources matching the name (how to search by string)

    2. SHALL support searching a practitioner by an identifier such as an NPI using the identifier search parameter:

      GET [base]/Practitioner?identifier={system|}[code]

      Example:

      1. GET [base]/Practitioner?dentifier=http://hl7.org/fhir/sid/us-npi|97860456

      Implementation Notes: Fetches a bundle containing any Practitioner resources matching the identifier (how to search by token)

    Optional Search Parameters:

    The following search parameter combinations SHOULD be supported:

    1. SHOULD support both read Practitioner by id AND Practitioner search using the _id search parameter:

      GET [base]/Practitioner/[id] or GET [base]/Practitioner?_id=[id]

      Example:

      1. GET [base]/Practitioner/practitioner-1
      2. GET [base]/Practitioner?_id=practitioner-1

      Implementation Notes: (how to search by the logical id of the resource)