MCC eCare Plan Implementation Guide
1.0.0 - STU1 United States of America flag

MCC eCare Plan Implementation Guide, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-mcc/ and changes regularly. See the Directory of published versions

Resource Profile: Multiple Chronic Care Condition Care Plan

Official URL: http://hl7.org/fhir/us/mcc/StructureDefinition/mccCarePlan Version: 1.0.0
Active as of 2022-04-13 Computable Name: MCCCarePlan

This profile constrains the US Core FHIR Care Plan Resource to represent the requirements of a care plan for patients with multiple chronic conditions.

A Care Plan is a consensus-driven dynamic plan that represents a patient’s and Care Team Members’ prioritized concerns, goals, and planned interventions. It serves as a blueprint shared by all Care Team Members (including the patient, their caregivers, and providers), to guide the patient’s care. A Care Plan integrates multiple interventions proposed by multiple providers and disciplines for multiple conditions. A Care Plan may represent one or more Care Plans and serves to reconcile and resolve conflicts between the various plans developed for a specific patient by different providers. It supports the following use cases:

  • Query for patient data across providers and compile into a consolidated care plan representation.
  • Encourage capture of and communication of a patient’s health concerns and related goals, interventions, and outcomes.
  • Gather and aggregate patient data for uses beyond the point of care (e.g. public health, population health, quality measurement, risk adjustment, quality improvement, and research.)

Important Implementation guidance

See Structure and Design considerations

Usage:

Formal Views of Profile Content

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

This structure is derived from USCoreCarePlanProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. CarePlan 0..* USCoreCarePlanProfile Healthcare plan for patient or group
... Slices for extension Content/Rules for all slices
.... custodian 0..1 Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team) When populated, the custodian is responsible for the care and maintenance of the care plan. The care plan is attributed to the custodian. The custodian might or might not be a contributor. This CarePlan.custodian extension should be used instead of CarePlan.author which in R4 is currently identified as the designated responsible party and in R5 has been removed.
URL: http://hl7.org/fhir/us/mcc/StructureDefinition/custodian
... author 0..1 Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam) Use the CarePlan custodian extension instead. Use of CarePlan.author is discouraged, it is removed in R5.
... contributor S 0..* Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team) Who provided the content of the care plan
... addresses S 0..* Reference(MCC Chronic Condition and Health Concern Profile | US Core Condition Encounter Diagnosis Profile) Health issues this plan addresses
... supportingInfo S 0..* Reference(US Core Blood Pressure Profile | US Core BMI Profile | US Core Body Weight Profile | MCC Chronic Condition and Health Concern Profile | Multiple Chronic Condition Care Plan Laboratory Result Observation | Multiple Chronic Condition Care Plan Diagnostic Report and Note | Multiple Chronic Condition Care Plan Procedure | US Core Immunization Profile | Multiple Chronic Condition Care Plan Family History | Document Reference to Patient's Personal Advance Care Plan (Advance Directive) | SDC Questionnaire Response | Multiple Chronic Condition Care Plan Symptom Observation | Multiple Chronic Condition Care Plan Service Request | Multiple Chronic Condition Care Plan Observation SDOH Assessment | Multiple Chronic Condition Care Plan Immunization | Multiple Chronic Condition Care Plan Nutrition Order | Multiple Chronic Condition Care Plan Clinical Impression | Multiple Chronic Condition Care Plan Patient/Caregiver Condition Status Observation | Multiple Chronic Condition Care Plan Questionnaire Response | Multiple Chronic Condition Care Plan Caregiver Considerations Observation | Multiple Chronic Condition Care Plan Clinical Test Observation | US Core RelatedPerson Profile | US Core Observation Occupation Profile | Resource) Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.supportingInfo
... goal 0..* Reference(Multiple Chronic Condition Care Plan Goal) This Goal represents one or more overarching goal applicable to the entire care plan
... activity S 0..* BackboneElement Action to occur as part of plan. This is the backbone element of the care plan that is the root of care coordination activities. While there can be many activities in a care plan, each activity has only one planned.activityRefence
.... outcomeReference S 0..* Reference(Multiple Chronic Condition Care Plan Procedure | Multiple Chronic Condition Care Plan Laboratory Result Observation | US Core Immunization Profile | Multiple Chronic Condition Care Plan Diagnostic Report and Note | US Core Immunization Profile | Multiple Chronic Condition Care Plan Medication Request | MCC Chronic Condition and Health Concern Profile | US Core Body Weight Profile | US Core Blood Pressure Profile | Multiple Chronic Condition Care Plan Goal | US Core BMI Profile | Multiple Chronic Condition Care Plan Symptom Observation | Resource) This CarePlan element represents a PERFORMED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.outcomeReference
.... reference S 0..1 Reference(NutritionOrder | Multiple Chronic Condition Care Plan Medication Request | CommunicationRequest | DeviceRequest | Task | ServiceRequest | VisionPrescription | RequestGroup | Appointment) This CarePlan element represents a PLANNED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.reference
.... detail 0..0

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. CarePlan 0..* USCoreCarePlanProfile Healthcare plan for patient or group
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text S 0..1 Narrative (USCDI) Text summary of the resource, for human interpretation
.... status S 1..1 code (USCDI) generated | extensions | additional | empty
Binding: US Core Narrative Status (required): Constrained value set of narrative statuses.

.... div SC 1..1 xhtml (USCDI) Limited xhtml content
txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes
txt-2: The narrative SHALL have some non-whitespace content
... Slices for extension Content/Rules for all slices
.... custodian 0..1 Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team) When populated, the custodian is responsible for the care and maintenance of the care plan. The care plan is attributed to the custodian. The custodian might or might not be a contributor. This CarePlan.custodian extension should be used instead of CarePlan.author which in R4 is currently identified as the designated responsible party and in R5 has been removed.
URL: http://hl7.org/fhir/us/mcc/StructureDefinition/custodian
... status ?!SΣ 1..1 code (USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.

... intent ?!SΣ 1..1 code (USCDI) proposal | plan | order | option
Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan

... Slices for category SΣ 1..* CodeableConcept (USCDI) Type of plan
Slice: Unordered, Open by pattern:$this
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.


.... category:AssessPlan SΣ 1..1 CodeableConcept (USCDI) Type of plan
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.



Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/careplan-category
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: assess-plan
... subject SΣ 1..1 Reference(US Core Patient Profile) (USCDI) Who the care plan is for
... author Σ 0..1 Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam) Use the CarePlan custodian extension instead. Use of CarePlan.author is discouraged, it is removed in R5.
... contributor S 0..* Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team) Who provided the content of the care plan
... careTeam S 0..* Reference(Multiple Chronic Condition Care Plan Care Team) Who's involved in plan?
... addresses SΣ 0..* Reference(MCC Chronic Condition and Health Concern Profile | US Core Condition Encounter Diagnosis Profile) Health issues this plan addresses
... supportingInfo S 0..* Reference(US Core Blood Pressure Profile | US Core BMI Profile | US Core Body Weight Profile | MCC Chronic Condition and Health Concern Profile | Multiple Chronic Condition Care Plan Laboratory Result Observation | Multiple Chronic Condition Care Plan Diagnostic Report and Note | Multiple Chronic Condition Care Plan Procedure | US Core Immunization Profile | Multiple Chronic Condition Care Plan Family History | Document Reference to Patient's Personal Advance Care Plan (Advance Directive) | SDC Questionnaire Response | Multiple Chronic Condition Care Plan Symptom Observation | Multiple Chronic Condition Care Plan Service Request | Multiple Chronic Condition Care Plan Observation SDOH Assessment | Multiple Chronic Condition Care Plan Immunization | Multiple Chronic Condition Care Plan Nutrition Order | Multiple Chronic Condition Care Plan Clinical Impression | Multiple Chronic Condition Care Plan Patient/Caregiver Condition Status Observation | Multiple Chronic Condition Care Plan Questionnaire Response | Multiple Chronic Condition Care Plan Caregiver Considerations Observation | Multiple Chronic Condition Care Plan Clinical Test Observation | US Core RelatedPerson Profile | US Core Observation Occupation Profile | Resource) Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.supportingInfo
... goal 0..* Reference(Multiple Chronic Condition Care Plan Goal) This Goal represents one or more overarching goal applicable to the entire care plan
... activity SC 0..* BackboneElement Action to occur as part of plan. This is the backbone element of the care plan that is the root of care coordination activities. While there can be many activities in a care plan, each activity has only one planned.activityRefence
cpl-3: Provide a reference or detail, not both
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... outcomeReference S 0..* Reference(Multiple Chronic Condition Care Plan Procedure | Multiple Chronic Condition Care Plan Laboratory Result Observation | US Core Immunization Profile | Multiple Chronic Condition Care Plan Diagnostic Report and Note | US Core Immunization Profile | Multiple Chronic Condition Care Plan Medication Request | MCC Chronic Condition and Health Concern Profile | US Core Body Weight Profile | US Core Blood Pressure Profile | Multiple Chronic Condition Care Plan Goal | US Core BMI Profile | Multiple Chronic Condition Care Plan Symptom Observation | Resource) This CarePlan element represents a PERFORMED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.outcomeReference
.... reference SC 0..1 Reference(NutritionOrder | Multiple Chronic Condition Care Plan Medication Request | CommunicationRequest | DeviceRequest | Task | ServiceRequest | VisionPrescription | RequestGroup | Appointment) This CarePlan element represents a PLANNED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.reference

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
CarePlan.text.statusrequiredNarrativeStatus
http://hl7.org/fhir/us/core/ValueSet/us-core-narrative-status
CarePlan.statusrequiredRequestStatus
http://hl7.org/fhir/ValueSet/request-status
from the FHIR Standard
CarePlan.intentrequiredCarePlanIntent
http://hl7.org/fhir/ValueSet/care-plan-intent
from the FHIR Standard
CarePlan.categoryexampleCarePlanCategory
http://hl7.org/fhir/ValueSet/care-plan-category
from the FHIR Standard
CarePlan.category:AssessPlanexamplePattern: assess-plan
http://hl7.org/fhir/ValueSet/care-plan-category
from the FHIR Standard
CarePlan.activity.detail.statusrequiredCarePlanActivityStatus
http://hl7.org/fhir/ValueSet/care-plan-activity-status|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
cpl-3errorCarePlan.activityProvide a reference or detail, not both
: detail.empty() or reference.empty()
dom-2errorCarePlanIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCarePlanIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorCarePlanIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorCarePlanIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCarePlanA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
txt-1errorCarePlan.text.divThe narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes
: htmlChecks()
txt-2errorCarePlan.text.divThe narrative SHALL have some non-whitespace content
: htmlChecks()
NameFlagsCard.TypeDescription & Constraintsdoco
.. CarePlan 0..* USCoreCarePlanProfile Healthcare plan for 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 BindingsPurpose
AllLanguages Max Binding
... text S 0..1 Narrative (USCDI) Text summary of the resource, for human interpretation
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... status S 1..1 code (USCDI) generated | extensions | additional | empty
Binding: US Core Narrative Status (required): Constrained value set of narrative statuses.

.... div SC 1..1 xhtml (USCDI) Limited xhtml content
txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes
txt-2: The narrative SHALL have some non-whitespace content
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... custodian 0..1 Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team) When populated, the custodian is responsible for the care and maintenance of the care plan. The care plan is attributed to the custodian. The custodian might or might not be a contributor. This CarePlan.custodian extension should be used instead of CarePlan.author which in R4 is currently identified as the designated responsible party and in R5 has been removed.
URL: http://hl7.org/fhir/us/mcc/StructureDefinition/custodian
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External Ids for this plan
... instantiatesCanonical Σ 0..* canonical(PlanDefinition | Questionnaire | Measure | ActivityDefinition | OperationDefinition) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan) Fulfills CarePlan
... replaces Σ 0..* Reference(CarePlan) CarePlan replaced by this CarePlan
... partOf Σ 0..* Reference(CarePlan) Part of referenced CarePlan
... status ?!SΣ 1..1 code (USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.

... intent ?!SΣ 1..1 code (USCDI) proposal | plan | order | option
Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan

... Slices for category SΣ 1..* CodeableConcept (USCDI) Type of plan
Slice: Unordered, Open by pattern:$this
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.


.... category:AssessPlan SΣ 1..1 CodeableConcept (USCDI) Type of plan
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.



Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/careplan-category
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: assess-plan
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
... title Σ 0..1 string Human-friendly name for the care plan
... description Σ 0..1 string Summary of nature of plan
... subject SΣ 1..1 Reference(US Core Patient Profile) (USCDI) Who the care plan is for
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... period Σ 0..1 Period Time period plan covers
... created Σ 0..1 dateTime Date record was first recorded
... author Σ 0..1 Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam) Use the CarePlan custodian extension instead. Use of CarePlan.author is discouraged, it is removed in R5.
... contributor S 0..* Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team) Who provided the content of the care plan
... careTeam S 0..* Reference(Multiple Chronic Condition Care Plan Care Team S | US Core CareTeam Profile) Who's involved in plan?
... addresses SΣ 0..* Reference(MCC Chronic Condition and Health Concern Profile | US Core Condition Encounter Diagnosis Profile) Health issues this plan addresses
... supportingInfo S 0..* Reference(US Core Blood Pressure Profile | US Core BMI Profile | US Core Body Weight Profile | MCC Chronic Condition and Health Concern Profile | Multiple Chronic Condition Care Plan Laboratory Result Observation | Multiple Chronic Condition Care Plan Diagnostic Report and Note | Multiple Chronic Condition Care Plan Procedure | US Core Immunization Profile | Multiple Chronic Condition Care Plan Family History | Document Reference to Patient's Personal Advance Care Plan (Advance Directive) | SDC Questionnaire Response | Multiple Chronic Condition Care Plan Symptom Observation | Multiple Chronic Condition Care Plan Service Request | Multiple Chronic Condition Care Plan Observation SDOH Assessment | Multiple Chronic Condition Care Plan Immunization | Multiple Chronic Condition Care Plan Nutrition Order | Multiple Chronic Condition Care Plan Clinical Impression | Multiple Chronic Condition Care Plan Patient/Caregiver Condition Status Observation | Multiple Chronic Condition Care Plan Questionnaire Response | Multiple Chronic Condition Care Plan Caregiver Considerations Observation | Multiple Chronic Condition Care Plan Clinical Test Observation | US Core RelatedPerson Profile | US Core Observation Occupation Profile | Resource) Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.supportingInfo
... goal 0..* Reference(Multiple Chronic Condition Care Plan Goal) This Goal represents one or more overarching goal applicable to the entire care plan
... activity SC 0..* BackboneElement Action to occur as part of plan. This is the backbone element of the care plan that is the root of care coordination activities. While there can be many activities in a care plan, each activity has only one planned.activityRefence
cpl-3: Provide a reference or detail, not both
.... 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
.... outcomeCodeableConcept 0..* CodeableConcept Results of the activity
Binding: CarePlanActivityOutcome (example): Identifies the results of the activity.


.... outcomeReference S 0..* Reference(Multiple Chronic Condition Care Plan Procedure | Multiple Chronic Condition Care Plan Laboratory Result Observation | US Core Immunization Profile | Multiple Chronic Condition Care Plan Diagnostic Report and Note | US Core Immunization Profile | Multiple Chronic Condition Care Plan Medication Request | MCC Chronic Condition and Health Concern Profile | US Core Body Weight Profile | US Core Blood Pressure Profile | Multiple Chronic Condition Care Plan Goal | US Core BMI Profile | Multiple Chronic Condition Care Plan Symptom Observation | Resource) This CarePlan element represents a PERFORMED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.outcomeReference
.... progress 0..* Annotation Comments about the activity status/progress
.... reference SC 0..1 Reference(NutritionOrder | Multiple Chronic Condition Care Plan Medication Request | CommunicationRequest | DeviceRequest | Task | ServiceRequest | VisionPrescription | RequestGroup | Appointment) This CarePlan element represents a PLANNED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.reference
... note 0..* Annotation Comments about the plan

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
CarePlan.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
CarePlan.text.statusrequiredNarrativeStatus
http://hl7.org/fhir/us/core/ValueSet/us-core-narrative-status
CarePlan.statusrequiredRequestStatus
http://hl7.org/fhir/ValueSet/request-status
from the FHIR Standard
CarePlan.intentrequiredCarePlanIntent
http://hl7.org/fhir/ValueSet/care-plan-intent
from the FHIR Standard
CarePlan.categoryexampleCarePlanCategory
http://hl7.org/fhir/ValueSet/care-plan-category
from the FHIR Standard
CarePlan.category:AssessPlanexamplePattern: assess-plan
http://hl7.org/fhir/ValueSet/care-plan-category
from the FHIR Standard
CarePlan.activity.outcomeCodeableConceptexampleCarePlanActivityOutcome
http://hl7.org/fhir/ValueSet/care-plan-activity-outcome
from the FHIR Standard
CarePlan.activity.detail.kindrequiredCarePlanActivityKind
http://hl7.org/fhir/ValueSet/care-plan-activity-kind|4.0.1
from the FHIR Standard
CarePlan.activity.detail.codeexampleProcedureCodes(SNOMEDCT)
http://hl7.org/fhir/ValueSet/procedure-code
from the FHIR Standard
CarePlan.activity.detail.reasonCodeexampleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
from the FHIR Standard
CarePlan.activity.detail.statusrequiredCarePlanActivityStatus
http://hl7.org/fhir/ValueSet/care-plan-activity-status|4.0.1
from the FHIR Standard
CarePlan.activity.detail.product[x]exampleSNOMEDCTMedicationCodes
http://hl7.org/fhir/ValueSet/medication-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
cpl-3errorCarePlan.activityProvide a reference or detail, not both
: detail.empty() or reference.empty()
dom-2errorCarePlanIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCarePlanIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorCarePlanIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorCarePlanIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCarePlanA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
txt-1errorCarePlan.text.divThe narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes
: htmlChecks()
txt-2errorCarePlan.text.divThe narrative SHALL have some non-whitespace content
: htmlChecks()

This structure is derived from USCoreCarePlanProfile

Summary

Must-Support: 7 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Differential View

This structure is derived from USCoreCarePlanProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. CarePlan 0..* USCoreCarePlanProfile Healthcare plan for patient or group
... Slices for extension Content/Rules for all slices
.... custodian 0..1 Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team) When populated, the custodian is responsible for the care and maintenance of the care plan. The care plan is attributed to the custodian. The custodian might or might not be a contributor. This CarePlan.custodian extension should be used instead of CarePlan.author which in R4 is currently identified as the designated responsible party and in R5 has been removed.
URL: http://hl7.org/fhir/us/mcc/StructureDefinition/custodian
... author 0..1 Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam) Use the CarePlan custodian extension instead. Use of CarePlan.author is discouraged, it is removed in R5.
... contributor S 0..* Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team) Who provided the content of the care plan
... addresses S 0..* Reference(MCC Chronic Condition and Health Concern Profile | US Core Condition Encounter Diagnosis Profile) Health issues this plan addresses
... supportingInfo S 0..* Reference(US Core Blood Pressure Profile | US Core BMI Profile | US Core Body Weight Profile | MCC Chronic Condition and Health Concern Profile | Multiple Chronic Condition Care Plan Laboratory Result Observation | Multiple Chronic Condition Care Plan Diagnostic Report and Note | Multiple Chronic Condition Care Plan Procedure | US Core Immunization Profile | Multiple Chronic Condition Care Plan Family History | Document Reference to Patient's Personal Advance Care Plan (Advance Directive) | SDC Questionnaire Response | Multiple Chronic Condition Care Plan Symptom Observation | Multiple Chronic Condition Care Plan Service Request | Multiple Chronic Condition Care Plan Observation SDOH Assessment | Multiple Chronic Condition Care Plan Immunization | Multiple Chronic Condition Care Plan Nutrition Order | Multiple Chronic Condition Care Plan Clinical Impression | Multiple Chronic Condition Care Plan Patient/Caregiver Condition Status Observation | Multiple Chronic Condition Care Plan Questionnaire Response | Multiple Chronic Condition Care Plan Caregiver Considerations Observation | Multiple Chronic Condition Care Plan Clinical Test Observation | US Core RelatedPerson Profile | US Core Observation Occupation Profile | Resource) Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.supportingInfo
... goal 0..* Reference(Multiple Chronic Condition Care Plan Goal) This Goal represents one or more overarching goal applicable to the entire care plan
... activity S 0..* BackboneElement Action to occur as part of plan. This is the backbone element of the care plan that is the root of care coordination activities. While there can be many activities in a care plan, each activity has only one planned.activityRefence
.... outcomeReference S 0..* Reference(Multiple Chronic Condition Care Plan Procedure | Multiple Chronic Condition Care Plan Laboratory Result Observation | US Core Immunization Profile | Multiple Chronic Condition Care Plan Diagnostic Report and Note | US Core Immunization Profile | Multiple Chronic Condition Care Plan Medication Request | MCC Chronic Condition and Health Concern Profile | US Core Body Weight Profile | US Core Blood Pressure Profile | Multiple Chronic Condition Care Plan Goal | US Core BMI Profile | Multiple Chronic Condition Care Plan Symptom Observation | Resource) This CarePlan element represents a PERFORMED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.outcomeReference
.... reference S 0..1 Reference(NutritionOrder | Multiple Chronic Condition Care Plan Medication Request | CommunicationRequest | DeviceRequest | Task | ServiceRequest | VisionPrescription | RequestGroup | Appointment) This CarePlan element represents a PLANNED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.reference
.... detail 0..0

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. CarePlan 0..* USCoreCarePlanProfile Healthcare plan for patient or group
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text S 0..1 Narrative (USCDI) Text summary of the resource, for human interpretation
.... status S 1..1 code (USCDI) generated | extensions | additional | empty
Binding: US Core Narrative Status (required): Constrained value set of narrative statuses.

.... div SC 1..1 xhtml (USCDI) Limited xhtml content
txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes
txt-2: The narrative SHALL have some non-whitespace content
... Slices for extension Content/Rules for all slices
.... custodian 0..1 Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team) When populated, the custodian is responsible for the care and maintenance of the care plan. The care plan is attributed to the custodian. The custodian might or might not be a contributor. This CarePlan.custodian extension should be used instead of CarePlan.author which in R4 is currently identified as the designated responsible party and in R5 has been removed.
URL: http://hl7.org/fhir/us/mcc/StructureDefinition/custodian
... status ?!SΣ 1..1 code (USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.

... intent ?!SΣ 1..1 code (USCDI) proposal | plan | order | option
Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan

... Slices for category SΣ 1..* CodeableConcept (USCDI) Type of plan
Slice: Unordered, Open by pattern:$this
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.


.... category:AssessPlan SΣ 1..1 CodeableConcept (USCDI) Type of plan
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.



Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/careplan-category
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: assess-plan
... subject SΣ 1..1 Reference(US Core Patient Profile) (USCDI) Who the care plan is for
... author Σ 0..1 Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam) Use the CarePlan custodian extension instead. Use of CarePlan.author is discouraged, it is removed in R5.
... contributor S 0..* Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team) Who provided the content of the care plan
... careTeam S 0..* Reference(Multiple Chronic Condition Care Plan Care Team) Who's involved in plan?
... addresses SΣ 0..* Reference(MCC Chronic Condition and Health Concern Profile | US Core Condition Encounter Diagnosis Profile) Health issues this plan addresses
... supportingInfo S 0..* Reference(US Core Blood Pressure Profile | US Core BMI Profile | US Core Body Weight Profile | MCC Chronic Condition and Health Concern Profile | Multiple Chronic Condition Care Plan Laboratory Result Observation | Multiple Chronic Condition Care Plan Diagnostic Report and Note | Multiple Chronic Condition Care Plan Procedure | US Core Immunization Profile | Multiple Chronic Condition Care Plan Family History | Document Reference to Patient's Personal Advance Care Plan (Advance Directive) | SDC Questionnaire Response | Multiple Chronic Condition Care Plan Symptom Observation | Multiple Chronic Condition Care Plan Service Request | Multiple Chronic Condition Care Plan Observation SDOH Assessment | Multiple Chronic Condition Care Plan Immunization | Multiple Chronic Condition Care Plan Nutrition Order | Multiple Chronic Condition Care Plan Clinical Impression | Multiple Chronic Condition Care Plan Patient/Caregiver Condition Status Observation | Multiple Chronic Condition Care Plan Questionnaire Response | Multiple Chronic Condition Care Plan Caregiver Considerations Observation | Multiple Chronic Condition Care Plan Clinical Test Observation | US Core RelatedPerson Profile | US Core Observation Occupation Profile | Resource) Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.supportingInfo
... goal 0..* Reference(Multiple Chronic Condition Care Plan Goal) This Goal represents one or more overarching goal applicable to the entire care plan
... activity SC 0..* BackboneElement Action to occur as part of plan. This is the backbone element of the care plan that is the root of care coordination activities. While there can be many activities in a care plan, each activity has only one planned.activityRefence
cpl-3: Provide a reference or detail, not both
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... outcomeReference S 0..* Reference(Multiple Chronic Condition Care Plan Procedure | Multiple Chronic Condition Care Plan Laboratory Result Observation | US Core Immunization Profile | Multiple Chronic Condition Care Plan Diagnostic Report and Note | US Core Immunization Profile | Multiple Chronic Condition Care Plan Medication Request | MCC Chronic Condition and Health Concern Profile | US Core Body Weight Profile | US Core Blood Pressure Profile | Multiple Chronic Condition Care Plan Goal | US Core BMI Profile | Multiple Chronic Condition Care Plan Symptom Observation | Resource) This CarePlan element represents a PERFORMED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.outcomeReference
.... reference SC 0..1 Reference(NutritionOrder | Multiple Chronic Condition Care Plan Medication Request | CommunicationRequest | DeviceRequest | Task | ServiceRequest | VisionPrescription | RequestGroup | Appointment) This CarePlan element represents a PLANNED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.reference

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
CarePlan.text.statusrequiredNarrativeStatus
http://hl7.org/fhir/us/core/ValueSet/us-core-narrative-status
CarePlan.statusrequiredRequestStatus
http://hl7.org/fhir/ValueSet/request-status
from the FHIR Standard
CarePlan.intentrequiredCarePlanIntent
http://hl7.org/fhir/ValueSet/care-plan-intent
from the FHIR Standard
CarePlan.categoryexampleCarePlanCategory
http://hl7.org/fhir/ValueSet/care-plan-category
from the FHIR Standard
CarePlan.category:AssessPlanexamplePattern: assess-plan
http://hl7.org/fhir/ValueSet/care-plan-category
from the FHIR Standard
CarePlan.activity.detail.statusrequiredCarePlanActivityStatus
http://hl7.org/fhir/ValueSet/care-plan-activity-status|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
cpl-3errorCarePlan.activityProvide a reference or detail, not both
: detail.empty() or reference.empty()
dom-2errorCarePlanIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCarePlanIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorCarePlanIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorCarePlanIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCarePlanA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
txt-1errorCarePlan.text.divThe narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes
: htmlChecks()
txt-2errorCarePlan.text.divThe narrative SHALL have some non-whitespace content
: htmlChecks()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. CarePlan 0..* USCoreCarePlanProfile Healthcare plan for 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 BindingsPurpose
AllLanguages Max Binding
... text S 0..1 Narrative (USCDI) Text summary of the resource, for human interpretation
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... status S 1..1 code (USCDI) generated | extensions | additional | empty
Binding: US Core Narrative Status (required): Constrained value set of narrative statuses.

.... div SC 1..1 xhtml (USCDI) Limited xhtml content
txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes
txt-2: The narrative SHALL have some non-whitespace content
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... custodian 0..1 Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team) When populated, the custodian is responsible for the care and maintenance of the care plan. The care plan is attributed to the custodian. The custodian might or might not be a contributor. This CarePlan.custodian extension should be used instead of CarePlan.author which in R4 is currently identified as the designated responsible party and in R5 has been removed.
URL: http://hl7.org/fhir/us/mcc/StructureDefinition/custodian
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External Ids for this plan
... instantiatesCanonical Σ 0..* canonical(PlanDefinition | Questionnaire | Measure | ActivityDefinition | OperationDefinition) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan) Fulfills CarePlan
... replaces Σ 0..* Reference(CarePlan) CarePlan replaced by this CarePlan
... partOf Σ 0..* Reference(CarePlan) Part of referenced CarePlan
... status ?!SΣ 1..1 code (USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.

... intent ?!SΣ 1..1 code (USCDI) proposal | plan | order | option
Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan

... Slices for category SΣ 1..* CodeableConcept (USCDI) Type of plan
Slice: Unordered, Open by pattern:$this
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.


.... category:AssessPlan SΣ 1..1 CodeableConcept (USCDI) Type of plan
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.



Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/careplan-category
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: assess-plan
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
... title Σ 0..1 string Human-friendly name for the care plan
... description Σ 0..1 string Summary of nature of plan
... subject SΣ 1..1 Reference(US Core Patient Profile) (USCDI) Who the care plan is for
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... period Σ 0..1 Period Time period plan covers
... created Σ 0..1 dateTime Date record was first recorded
... author Σ 0..1 Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam) Use the CarePlan custodian extension instead. Use of CarePlan.author is discouraged, it is removed in R5.
... contributor S 0..* Reference(US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core CareTeam Profile | US Core Organization Profile | RelatedPerson | Device | Multiple Chronic Condition Care Plan Care Team) Who provided the content of the care plan
... careTeam S 0..* Reference(Multiple Chronic Condition Care Plan Care Team S | US Core CareTeam Profile) Who's involved in plan?
... addresses SΣ 0..* Reference(MCC Chronic Condition and Health Concern Profile | US Core Condition Encounter Diagnosis Profile) Health issues this plan addresses
... supportingInfo S 0..* Reference(US Core Blood Pressure Profile | US Core BMI Profile | US Core Body Weight Profile | MCC Chronic Condition and Health Concern Profile | Multiple Chronic Condition Care Plan Laboratory Result Observation | Multiple Chronic Condition Care Plan Diagnostic Report and Note | Multiple Chronic Condition Care Plan Procedure | US Core Immunization Profile | Multiple Chronic Condition Care Plan Family History | Document Reference to Patient's Personal Advance Care Plan (Advance Directive) | SDC Questionnaire Response | Multiple Chronic Condition Care Plan Symptom Observation | Multiple Chronic Condition Care Plan Service Request | Multiple Chronic Condition Care Plan Observation SDOH Assessment | Multiple Chronic Condition Care Plan Immunization | Multiple Chronic Condition Care Plan Nutrition Order | Multiple Chronic Condition Care Plan Clinical Impression | Multiple Chronic Condition Care Plan Patient/Caregiver Condition Status Observation | Multiple Chronic Condition Care Plan Questionnaire Response | Multiple Chronic Condition Care Plan Caregiver Considerations Observation | Multiple Chronic Condition Care Plan Clinical Test Observation | US Core RelatedPerson Profile | US Core Observation Occupation Profile | Resource) Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.supportingInfo
... goal 0..* Reference(Multiple Chronic Condition Care Plan Goal) This Goal represents one or more overarching goal applicable to the entire care plan
... activity SC 0..* BackboneElement Action to occur as part of plan. This is the backbone element of the care plan that is the root of care coordination activities. While there can be many activities in a care plan, each activity has only one planned.activityRefence
cpl-3: Provide a reference or detail, not both
.... 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
.... outcomeCodeableConcept 0..* CodeableConcept Results of the activity
Binding: CarePlanActivityOutcome (example): Identifies the results of the activity.


.... outcomeReference S 0..* Reference(Multiple Chronic Condition Care Plan Procedure | Multiple Chronic Condition Care Plan Laboratory Result Observation | US Core Immunization Profile | Multiple Chronic Condition Care Plan Diagnostic Report and Note | US Core Immunization Profile | Multiple Chronic Condition Care Plan Medication Request | MCC Chronic Condition and Health Concern Profile | US Core Body Weight Profile | US Core Blood Pressure Profile | Multiple Chronic Condition Care Plan Goal | US Core BMI Profile | Multiple Chronic Condition Care Plan Symptom Observation | Resource) This CarePlan element represents a PERFORMED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.outcomeReference
.... progress 0..* Annotation Comments about the activity status/progress
.... reference SC 0..1 Reference(NutritionOrder | Multiple Chronic Condition Care Plan Medication Request | CommunicationRequest | DeviceRequest | Task | ServiceRequest | VisionPrescription | RequestGroup | Appointment) This CarePlan element represents a PLANNED ACTIVITY. Please see the libraries of available value sets pertinent for use with the appropriate Multiple Chronic Condition Care Plan Profile for use within the referenced profiles at CarePlan.activity.reference
... note 0..* Annotation Comments about the plan

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
CarePlan.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
CarePlan.text.statusrequiredNarrativeStatus
http://hl7.org/fhir/us/core/ValueSet/us-core-narrative-status
CarePlan.statusrequiredRequestStatus
http://hl7.org/fhir/ValueSet/request-status
from the FHIR Standard
CarePlan.intentrequiredCarePlanIntent
http://hl7.org/fhir/ValueSet/care-plan-intent
from the FHIR Standard
CarePlan.categoryexampleCarePlanCategory
http://hl7.org/fhir/ValueSet/care-plan-category
from the FHIR Standard
CarePlan.category:AssessPlanexamplePattern: assess-plan
http://hl7.org/fhir/ValueSet/care-plan-category
from the FHIR Standard
CarePlan.activity.outcomeCodeableConceptexampleCarePlanActivityOutcome
http://hl7.org/fhir/ValueSet/care-plan-activity-outcome
from the FHIR Standard
CarePlan.activity.detail.kindrequiredCarePlanActivityKind
http://hl7.org/fhir/ValueSet/care-plan-activity-kind|4.0.1
from the FHIR Standard
CarePlan.activity.detail.codeexampleProcedureCodes(SNOMEDCT)
http://hl7.org/fhir/ValueSet/procedure-code
from the FHIR Standard
CarePlan.activity.detail.reasonCodeexampleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
from the FHIR Standard
CarePlan.activity.detail.statusrequiredCarePlanActivityStatus
http://hl7.org/fhir/ValueSet/care-plan-activity-status|4.0.1
from the FHIR Standard
CarePlan.activity.detail.product[x]exampleSNOMEDCTMedicationCodes
http://hl7.org/fhir/ValueSet/medication-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
cpl-3errorCarePlan.activityProvide a reference or detail, not both
: detail.empty() or reference.empty()
dom-2errorCarePlanIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCarePlanIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorCarePlanIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorCarePlanIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCarePlanA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
txt-1errorCarePlan.text.divThe narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes
: htmlChecks()
txt-2errorCarePlan.text.divThe narrative SHALL have some non-whitespace content
: htmlChecks()

This structure is derived from USCoreCarePlanProfile

Summary

Must-Support: 7 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

 

Other representations of profile: CSV, Excel, Schematron