US Core Implementation Guide
8.0.0-ballot - Ballot
US Core Implementation Guide
8.0.0-ballot - Ballot
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-ballot 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
The January 2025 ballot addresses the following
We have updated US Core to include the new U.S. Core Data for Interoperability (USCDI) v5 Data Elements and Classes that the Office of the National Coordinator (ONC) published in July of 2024:
We have added the USCDI Clinical Notes Operative Note and Emergency Department Note data elements to US Core's "Common Clinical Notes" list and to the US Core Clinical Note Type value set.
For the USCDI Immunization Lot Number data element, we added Immunization.lotNumber to the US Core Immunization Profile as a Must Support element.
For the USCDI Route of Administration data element, we added MedicationRequest.dosageInstruction.route to the US Core MedicationRequest Profile and MedicationDispense.dosageInstruction.route to the US Core MedicationDispense Profile as Must Support elements and use an extensible value set of SNOMED CT and NCI Thesaurus SPL codes.
ServiceRequest.category and ServiceRequest.code elements.Patient.name.use Additional USCDI element supports the USCDI Name to Use data element.For the USCDI Provenance Author and Author Role data elements, because systems typically do not use the Provenance Resource to represent this information at an individual level (in other words, activities by the patient or provider), We updated the Basic Provenance page to document the various FHIR resource elements that track the "small p provenance" information at the individual level. Based on current usage, we added these Must Support elements to the following profiles:
Observation.performer to US Core Vitals SignsObservation.performer to US Core Average Blood Pressure Profileand these Additional USCDI elements to the following profiles:
Procedure.performer.actor to US Core ProcedureLocation.type binding to US Core Location Type to support:
Where possible, new and updated pre-publishing content is highlighted with green text and background- This highlighting will be removed prior to publication.
Key updates and detailed changes between this and prior versions are available on the US Core Change Log and Changes Between Versions pages.
This guide and the US Core profiles have become the foundation for US Realm FHIR implementation guides. This annual release reflects changes to U.S. Core Data for Interoperability (USCDI) and comments and requests from the US Realm FHIR community. (The Future of US Core page outlines this approach to yearly updates.) US Core has benefitted from testing and guidance by the Argonaut Project Team. Their feedback continues to lay the groundwork for documenting the US Core Profile design, interactions, requirements, and guidelines for patient data access and ONC Certification testing. Under the guidance of HL7 and the HL7 US Realm Steering Committee, the content will expand in future versions to meet the needs specific to the US Realm.
The US Core Implementation Guide is based on FHIR Version R4. It defines the minimum constraints on the FHIR resources to create the US Core Profiles. The elements, extensions, vocabularies, and value sets that SHALL be present are identified, and how they are used is defined. It also documents the minimum FHIR RESTful interactions for each US Core Profiles to access patient data. Establishing the "floor" of standards to promote interoperability and adoption through common implementation allows for further standards development evolution for specific use cases. There are two different ways to implement US Core:
For a detailed description of these different usages of US Core, see the Conformance Requirements page.
The US Core requirements were initially developed, balloted, and published in FHIR DSTU2 as part of the Office of the National Coordinator for Health Information Technology (ONC) sponsored Data Access Framework (DAF) project. The Argonaut Data Query Implementation Guide superseded DAF and documented security and authorization and the querying of the 2015 Edition Common Clinical Data Set (CCDS) and static documents. US Core descended directly from the Argonaut guide to support FHIR Version STU3 and eventually FHIR R4 and The ONC U.S. Core Data for Interoperability (USCDI).
This Guide is divided into several pages, which are listed at the top of each page in the menu bar.
The following actors are part of the US Core IG:
A US Core Requester is an application that initiates a data access request to retrieve patient data. The US Core Requestor is the client in a client-server interaction. The terms "US Core Requestor" and "Client" are used interchangeably throughout this guide and are not meant to limit this actor to only patient and provider apps. For example, payers and other users can use the same technology. These terms are a short-hand notation for "user application".
A US Core Responder is a system that responds to the data access request providing patient data. The US Core responder is the server in a client-server interaction. The terms "US Core Responder", "Server", and "EHR" are used interchangeably throughout this guide and are not meant to limit this actor to electronic health record systems. For example, HIEs, care coordination platforms, population health systems, etc., can use the same technology. These terms are a short-hand notation for "interoperable healthcare platform".
Below is the list of US Core Profiles. Each profile identifies which core elements, extensions, vocabularies, and ValueSets SHALL be present in the resource when using this profile. Together, they promote interoperability and adoption through common implementation and provide the floor for standards development for specific use cases. See the USCDI page, for a mapping to the U.S. Core Data for Interoperability (USCDI).
A simple narrative summary gives each profile's requirements and guidance. A formal hierarchical table presents a logical view of the content in both a differential and snapshot view, and provides references to appropriate terminologies and examples.
For systems that support the US Core Profile content structure and the RESTful interactions defined for a resource, the requirements are formally defined in the US Core CapabilityStatements. In addition, each profile page has a Quick Start Section that documents the required FHIR RESTful search and read operations. These sections demonstrate how to access a patient's clinical and administrative data:
See the FHIR specification for details on FHIR RESTful Search API and the SMART App Launch for how an application gets access to a patient record.
Primary Authors: Brett Marquard, Eric Haas, Gay Dolin
IG © 2024+ HL7 International / Cross-Group Projects. Package hl7.fhir.us.core#8.0.0-ballot based on FHIR 4.0.1. Generated 2024-11-17
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