US Public Health Profiles Library, published by HL7 Public Health Work Group. 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-ph-library/ and changes regularly. See the Directory of published versions

Guidance

Relationship to US Core

The US Public Health Profiles Library will be revised and published in close conjunction with US Core and have an analogous process for implementation, moderation, review, and approval. The US Public Health Profiles Library will defer as much as possible to US Core and only add constraints / profiles when necessary for public health use.

If a US Core profile is added that duplicates the concepts represented in a US Public Health Profiles Library profile (e.g. due to United States Core Data Interoperability (USCDI) promotion) then, as long as there are no additional constraints needed, the US Public Health Profiles Library profile would be retired in favor of the US Core profile.

If constraints are added to a US Core profile that duplicate constraint(s) in a current USPHPL profile that is based on that US Core profile (e.g. US Public Health Patient profile which is based on the US Core Patient profile) then:

• either (all US PH constraints duplicated in the US Core profile) the USPHPL profile would be retired in favor of the US Core profile
• or (some US PH constraints duplicated in the US Core profile) the USPHPL profile would be updated to remove any duplicate constraints.

The US Public Health Profiles Library will strive to update to/synchronize with new releases of US Core.

The US Public Health Profiles Library will evolve over time and may be supported by an adjunct profiles registry that includes developing and informational profiles for public health use.

Work Information

This library does not include profiles to implement support for Occupational Data for Health (ODH). Use the profiles defined in the Occupational Data for Health (ODH) to describe structured work information primarily designed to facilitate clinical care, including population health and value-based care. ODH also can be used to support public health reporting.

Conformance

Conformance Verbs

The conformance verbs - SHALL, SHOULD, MAY - used in this guide are defined in [FHIR Conformance Rules].

US Public Health Profiles Library Conformance Artifacts

The artifacts summary page lists the US Public Health Profiles. The StructureDefinitions define the minimum elements, extensions, vocabularies and value sets which SHALL be present when using the profile.

The Profile elements consist of both Mandatory and Must Support elements. Mandatory elements are elements with an minimum cardinality of 1 (min=1). The base FHIR Must Support guidance requires specifications to define exactly the support expected for profile elements labeled Must Support. Many profiles in the US Public Health Library are based on US Core profiles and this library is dependent on, and will be instituted, in close conjunction with US Core. This IG will follow the guidance in US Core Must Support Section which illustrates how these elements are displayed and defines the rules for interpreting profile elements and subelements labeled Mandatory and Must Support for requesters and responders.

Principles and Criteria of Library Inclusion and Use

Profile Reuse and Determination Principles

1. New profiles, that are not based on US Core, will only be included in the US Public Health Profiles Library when there is a clear public health need (see Profile Inclusion Criteria below). As things now stand, all non-US Core profiles are approved by the Cross-Group Projects
2. Similarly, new public health FHIR US Realm implementation guides will not create new profiles that are not based on either the US Public Health Library or US Core without the approval of the Public Health Working Group and notification of US Realm Steering Committee
3. The Public Health Work Group, the FHIR Management Group, and FHIR QA Tooling (TBD) will enforce the principles above and criteria below

Profile Inclusion Criteria

A Proposed Content or Architecture Profile Must Meet One or More of the Following Criteria for Inclusion in US Public Health Library

1. The profile concept is live in production and operations for three or more public health conditions/use cases and has been tested in at least one Connectathon
2. The profile concept is captured and is in production use in at least one EHR or public health system
3. The profile supports a nationally accepted approach based on proposed US regulations or multiple local, tribal, territorial, and states' laws, policies, rulemaking, or well-established practices.

A variance process modeled after the US Core Variance process will be instituted. The process will strive for the automated identification of non-USCore, non-US Public Health Profiles Library profiles and their processing with the Public Health Work Group. The Public Health Work Group will review, discuss, and approve/deny variance requests at regularly scheduled work group calls/meetings.

Related Responsibilities of the Public Health Working Group

• Determine initial and subsequent population of profiles in the US Public Health Profiles Library
• Review and approve variant profiles
• Be the steward for the library content

Profile Use

Implementation Guides may support (reuse) one or more US Public Health Profiles Library profiles to represent public health architecture and clinical information needs.

The US Public Health Profile Library profiles have been developed and tested using logical FHIR ids. Therefore a reference to a US Public Health Profiles Library profile SHOULD include a logical id (Reference.reference), not an identifier (Reference.identifier).

Implementation Guides that currently contain copies of the US Public Health Profiles are expected to replace those profiles with references to the analogous US Public Health Profiles Library profile during their next ballot/update cycle.