HL7 PT FHIR Implementation Guide: Community Health, published by HL7 Portugal. This guide is not an authorized publication; it is the continuous build for version 1.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/AnaCeciliaCoimbra/community-health-ig/ and changes regularly. See the Directory of published versions

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Resource Profile: CarePlan - Plano de tratamento

Este perfil define as restrições para o recurso CarePlan, padronizando a documentação de planos de cuidado. O plano de cuidados pode incluir diferentes tipos de tarefas, cada uma direcionada para abordar aspetos específicos da condição do paciente: Tarefas não farmacológicas: Focam-se em intervenções que não envolvem o uso de medicação, como alterações no estilo de vida ou outras abordagens terapêuticas. Tarefas de ServiceRequest: Estas tarefas definem uma data de reavaliação, especificando quando o episódio de cuidados deve ser reavaliado para determinar o progresso do paciente e os próximos passos no tratamento. O plano de cuidados inclui também uma secção de notas, onde o profissional de saúde pode registar observações, ideias ou instruções importantes. Esta secção permite documentar qualquer detalhe relevante para a gestão do cuidado.

Usage:

• Examples for this Resource Profile: CarePlan/exemplo-carePlan-plano-de-tratamento-fecho-caso, CarePlan/exemplo-carePlan-plano-de-tratamento-seguimento-com-medicacao and CarePlan/exemplo-carePlan-plano-de-tratamento-seguimento

Formal Views of Profile Content

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

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

This structure is derived from CarePlan

Name	Flags	Card.	Type	Description & Constraints
CarePlan		0..*	CarePlan	Healthcare plan for patient or group
status	S	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown
intent	S	1..1	code	proposal | plan | order | option Binding: CarePlanIntent (required)
subject	S	1..1	Reference(Patient - TCCS Patient)	Who the care plan is for
period
start	S	1..1	dateTime	Starting time with inclusive boundary
activity	S	0..*	BackboneElement	Action to occur as part of plan
detail		1..1	BackboneElement	In-line definition of activity
kind	S	1..1	code	Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription Binding: CarePlanActivityKind (required)
code
coding	S	0..*	Coding	Code defined by a terminology system
system		0..1	uri	Identity of the terminology system Binding: https://ehr.testing.p5.pt/api/fhir/ValueSet/care-plan-activity-type (required)
status	S	1..1	code	not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error Binding: CarePlanActivityStatus (required)
scheduled[x]		0..1	Period	When activity is to occur
note	S	0..*	Annotation	Comments about the plan
text	S	1..1	markdown	The annotation - text content (as markdown)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
CarePlan.intent	required	CarePlanIntent http://hl7.org/fhir/ValueSet/care-plan-intent from the FHIR Standard
CarePlan.activity.detail.kind	required	CarePlanActivityKind http://hl7.org/fhir/ValueSet/care-plan-activity-kind from the FHIR Standard
CarePlan.activity.detail.code.coding.system	required	https://ehr.testing.p5.pt/api/fhir/ValueSet/care-plan-activity-type https://ehr.testing.p5.pt/api/fhir/ValueSet/care-plan-activity-type
CarePlan.activity.detail.status	required	CarePlanActivityStatus http://hl7.org/fhir/ValueSet/care-plan-activity-status from the FHIR Standard

Name	Flags	Card.	Type	Description & Constraints
CarePlan		0..*	CarePlan	Healthcare plan for patient or group 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
status	?!SΣ	1..1	code	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. ele-1: All FHIR elements must have a @value or children
intent	?!SΣ	1..1	code	proposal | plan | order | option Binding: CarePlanIntent (required) ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(Patient - TCCS Patient)	Who the care plan is for ele-1: All FHIR elements must have a @value or children
period	Σ	0..1	Period	Time period plan covers ele-1: All FHIR elements must have a @value or children
start	SΣC	1..1	dateTime	Starting time with inclusive boundary ele-1: All FHIR elements must have a @value or children
activity	SC	0..*	BackboneElement	Action to occur as part of plan cpl-3: Provide a reference or detail, not both ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
detail	C	1..1	BackboneElement	In-line definition of activity ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
kind	S	1..1	code	Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription Binding: CarePlanActivityKind (required) ele-1: All FHIR elements must have a @value or children
code		0..1	CodeableConcept	Detail type of activity Binding: ProcedureCodes(SNOMEDCT) (example): Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter. ele-1: All FHIR elements must have a @value or children
coding	SΣ	0..*	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
system	Σ	0..1	uri	Identity of the terminology system Binding: https://ehr.testing.p5.pt/api/fhir/ValueSet/care-plan-activity-type (required) ele-1: All FHIR elements must have a @value or children
status	?!S	1..1	code	not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error Binding: CarePlanActivityStatus (required) ele-1: All FHIR elements must have a @value or children
doNotPerform	?!	0..1	boolean	If true, activity is prohibiting action ele-1: All FHIR elements must have a @value or children
scheduled[x]		0..1	Period	When activity is to occur ele-1: All FHIR elements must have a @value or children
note	S	0..*	Annotation	Comments about the plan ele-1: All FHIR elements must have a @value or children
text	SΣ	1..1	markdown	The annotation - text content (as markdown) ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CarePlan.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 from the FHIR Standard
CarePlan.intent	required	CarePlanIntent http://hl7.org/fhir/ValueSet/care-plan-intent from the FHIR Standard
CarePlan.activity.detail.kind	required	CarePlanActivityKind http://hl7.org/fhir/ValueSet/care-plan-activity-kind from the FHIR Standard
CarePlan.activity.detail.code	example	ProcedureCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-code from the FHIR Standard
CarePlan.activity.detail.code.coding.system	required	https://ehr.testing.p5.pt/api/fhir/ValueSet/care-plan-activity-type https://ehr.testing.p5.pt/api/fhir/ValueSet/care-plan-activity-type
CarePlan.activity.detail.status	required	CarePlanActivityStatus http://hl7.org/fhir/ValueSet/care-plan-activity-status from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cpl-3	error	CarePlan.activity	Provide a reference or detail, not both : detail.empty() or reference.empty()
dom-2	error	CarePlan	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CarePlan	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 : 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-4	error	CarePlan	If 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-5	error	CarePlan	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CarePlan	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints
CarePlan		0..*	CarePlan	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 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 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	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	proposal | plan | order | option Binding: CarePlanIntent (required)
category	Σ	0..*	CodeableConcept	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.
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(Patient - TCCS Patient)	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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	1..1	dateTime	Starting time with inclusive boundary
end	ΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
created	Σ	0..1	dateTime	Date record was first recorded
author	Σ	0..1	Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam)	Who is the designated responsible party
contributor		0..*	Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam)	Who provided the content of the care plan
careTeam		0..*	Reference(CareTeam)	Who's involved in plan?
addresses	Σ	0..*	Reference(Condition)	Health issues this plan addresses
supportingInfo		0..*	Reference(Resource)	Information considered as part of plan
goal		0..*	Reference(Goal)	Desired outcome of plan
activity	SC	0..*	BackboneElement	Action to occur as part of plan 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		0..*	Reference(Resource)	Appointment, Encounter, Procedure, etc.
progress		0..*	Annotation	Comments about the activity status/progress
reference	C	0..1	Reference(Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription | RequestGroup)	Activity details defined in specific resource
detail	C	1..1	BackboneElement	In-line definition of activity
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
kind	S	1..1	code	Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription Binding: CarePlanActivityKind (required)
instantiatesCanonical		0..*	canonical(PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition)	Instantiates FHIR protocol or definition
instantiatesUri		0..*	uri	Instantiates external protocol or definition
code		0..1	CodeableConcept	Detail type of activity Binding: ProcedureCodes(SNOMEDCT) (example): Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Binding: https://ehr.testing.p5.pt/api/fhir/ValueSet/care-plan-activity-type (required)
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
reasonCode		0..*	CodeableConcept	Why activity should be done or why activity was prohibited Binding: SNOMEDCTClinicalFindings (example): Identifies why a care plan activity is needed. Can include any health condition codes as well as such concepts as "general wellness", prophylaxis, surgical preparation, etc.
reasonReference		0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Why activity is needed
goal		0..*	Reference(Goal)	Goals this activity relates to
status	?!S	1..1	code	not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error Binding: CarePlanActivityStatus (required)
statusReason		0..1	CodeableConcept	Reason for current status
doNotPerform	?!	0..1	boolean	If true, activity is prohibiting action
scheduled[x]		0..1	Period	When activity is to occur
location		0..1	Reference(Location)	Where it should happen
performer		0..*	Reference(Practitioner | PractitionerRole | Organization | RelatedPerson | Patient | CareTeam | HealthcareService | Device)	Who will be responsible?
product[x]		0..1		What is to be administered/supplied Binding: SNOMEDCTMedicationCodes (example): A product supplied or administered as part of a care plan activity.
productCodeableConcept			CodeableConcept
productReference			Reference(Medication | Substance)
dailyAmount		0..1	SimpleQuantity	How to consume/day?
quantity		0..1	SimpleQuantity	How much to administer/supply/consume
description		0..1	string	Extra info describing activity to perform
note	S	0..*	Annotation	Comments about the plan
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
author[x]	Σ	0..1		Individual responsible for the annotation
authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
authorString			string
time	Σ	0..1	dateTime	When the annotation was made
text	SΣ	1..1	markdown	The annotation - text content (as markdown)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CarePlan.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
CarePlan.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 from the FHIR Standard
CarePlan.intent	required	CarePlanIntent http://hl7.org/fhir/ValueSet/care-plan-intent from the FHIR Standard
CarePlan.category	example	CarePlanCategory http://hl7.org/fhir/ValueSet/care-plan-category from the FHIR Standard
CarePlan.activity.outcomeCodeableConcept	example	CarePlanActivityOutcome http://hl7.org/fhir/ValueSet/care-plan-activity-outcome from the FHIR Standard
CarePlan.activity.detail.kind	required	CarePlanActivityKind http://hl7.org/fhir/ValueSet/care-plan-activity-kind from the FHIR Standard
CarePlan.activity.detail.code	example	ProcedureCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-code from the FHIR Standard
CarePlan.activity.detail.code.coding.system	required	https://ehr.testing.p5.pt/api/fhir/ValueSet/care-plan-activity-type https://ehr.testing.p5.pt/api/fhir/ValueSet/care-plan-activity-type
CarePlan.activity.detail.reasonCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard
CarePlan.activity.detail.status	required	CarePlanActivityStatus http://hl7.org/fhir/ValueSet/care-plan-activity-status from the FHIR Standard
CarePlan.activity.detail.product[x]	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cpl-3	error	CarePlan.activity	Provide a reference or detail, not both : detail.empty() or reference.empty()
dom-2	error	CarePlan	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CarePlan	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 : 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-4	error	CarePlan	If 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-5	error	CarePlan	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CarePlan	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from CarePlan

Summary

Mandatory: 0 element(3 nested mandatory elements)
Must-Support: 10 elements

Structures

This structure refers to these other structures:

• Patient - TCCS Patient (https://hl7.pt/fhir/community-health/StructureDefinition/patient-tccs)

Differential View

This structure is derived from CarePlan

Name	Flags	Card.	Type	Description & Constraints
CarePlan		0..*	CarePlan	Healthcare plan for patient or group
status	S	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown
intent	S	1..1	code	proposal | plan | order | option Binding: CarePlanIntent (required)
subject	S	1..1	Reference(Patient - TCCS Patient)	Who the care plan is for
period
start	S	1..1	dateTime	Starting time with inclusive boundary
activity	S	0..*	BackboneElement	Action to occur as part of plan
detail		1..1	BackboneElement	In-line definition of activity
kind	S	1..1	code	Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription Binding: CarePlanActivityKind (required)
code
coding	S	0..*	Coding	Code defined by a terminology system
system		0..1	uri	Identity of the terminology system Binding: https://ehr.testing.p5.pt/api/fhir/ValueSet/care-plan-activity-type (required)
status	S	1..1	code	not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error Binding: CarePlanActivityStatus (required)
scheduled[x]		0..1	Period	When activity is to occur
note	S	0..*	Annotation	Comments about the plan
text	S	1..1	markdown	The annotation - text content (as markdown)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
CarePlan.intent	required	CarePlanIntent http://hl7.org/fhir/ValueSet/care-plan-intent from the FHIR Standard
CarePlan.activity.detail.kind	required	CarePlanActivityKind http://hl7.org/fhir/ValueSet/care-plan-activity-kind from the FHIR Standard
CarePlan.activity.detail.code.coding.system	required	https://ehr.testing.p5.pt/api/fhir/ValueSet/care-plan-activity-type https://ehr.testing.p5.pt/api/fhir/ValueSet/care-plan-activity-type
CarePlan.activity.detail.status	required	CarePlanActivityStatus http://hl7.org/fhir/ValueSet/care-plan-activity-status from the FHIR Standard

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
CarePlan		0..*	CarePlan	Healthcare plan for patient or group 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
status	?!SΣ	1..1	code	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. ele-1: All FHIR elements must have a @value or children
intent	?!SΣ	1..1	code	proposal | plan | order | option Binding: CarePlanIntent (required) ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(Patient - TCCS Patient)	Who the care plan is for ele-1: All FHIR elements must have a @value or children
period	Σ	0..1	Period	Time period plan covers ele-1: All FHIR elements must have a @value or children
start	SΣC	1..1	dateTime	Starting time with inclusive boundary ele-1: All FHIR elements must have a @value or children
activity	SC	0..*	BackboneElement	Action to occur as part of plan cpl-3: Provide a reference or detail, not both ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
detail	C	1..1	BackboneElement	In-line definition of activity ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
kind	S	1..1	code	Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription Binding: CarePlanActivityKind (required) ele-1: All FHIR elements must have a @value or children
code		0..1	CodeableConcept	Detail type of activity Binding: ProcedureCodes(SNOMEDCT) (example): Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter. ele-1: All FHIR elements must have a @value or children
coding	SΣ	0..*	Coding	Code defined by a terminology system ele-1: All FHIR elements must have a @value or children
system	Σ	0..1	uri	Identity of the terminology system Binding: https://ehr.testing.p5.pt/api/fhir/ValueSet/care-plan-activity-type (required) ele-1: All FHIR elements must have a @value or children
status	?!S	1..1	code	not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error Binding: CarePlanActivityStatus (required) ele-1: All FHIR elements must have a @value or children
doNotPerform	?!	0..1	boolean	If true, activity is prohibiting action ele-1: All FHIR elements must have a @value or children
scheduled[x]		0..1	Period	When activity is to occur ele-1: All FHIR elements must have a @value or children
note	S	0..*	Annotation	Comments about the plan ele-1: All FHIR elements must have a @value or children
text	SΣ	1..1	markdown	The annotation - text content (as markdown) ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CarePlan.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 from the FHIR Standard
CarePlan.intent	required	CarePlanIntent http://hl7.org/fhir/ValueSet/care-plan-intent from the FHIR Standard
CarePlan.activity.detail.kind	required	CarePlanActivityKind http://hl7.org/fhir/ValueSet/care-plan-activity-kind from the FHIR Standard
CarePlan.activity.detail.code	example	ProcedureCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-code from the FHIR Standard
CarePlan.activity.detail.code.coding.system	required	https://ehr.testing.p5.pt/api/fhir/ValueSet/care-plan-activity-type https://ehr.testing.p5.pt/api/fhir/ValueSet/care-plan-activity-type
CarePlan.activity.detail.status	required	CarePlanActivityStatus http://hl7.org/fhir/ValueSet/care-plan-activity-status from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cpl-3	error	CarePlan.activity	Provide a reference or detail, not both : detail.empty() or reference.empty()
dom-2	error	CarePlan	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CarePlan	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 : 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-4	error	CarePlan	If 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-5	error	CarePlan	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CarePlan	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
CarePlan		0..*	CarePlan	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 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 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	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	proposal | plan | order | option Binding: CarePlanIntent (required)
category	Σ	0..*	CodeableConcept	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.
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(Patient - TCCS Patient)	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
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	1..1	dateTime	Starting time with inclusive boundary
end	ΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
created	Σ	0..1	dateTime	Date record was first recorded
author	Σ	0..1	Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam)	Who is the designated responsible party
contributor		0..*	Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam)	Who provided the content of the care plan
careTeam		0..*	Reference(CareTeam)	Who's involved in plan?
addresses	Σ	0..*	Reference(Condition)	Health issues this plan addresses
supportingInfo		0..*	Reference(Resource)	Information considered as part of plan
goal		0..*	Reference(Goal)	Desired outcome of plan
activity	SC	0..*	BackboneElement	Action to occur as part of plan 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		0..*	Reference(Resource)	Appointment, Encounter, Procedure, etc.
progress		0..*	Annotation	Comments about the activity status/progress
reference	C	0..1	Reference(Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription | RequestGroup)	Activity details defined in specific resource
detail	C	1..1	BackboneElement	In-line definition of activity
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
kind	S	1..1	code	Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription Binding: CarePlanActivityKind (required)
instantiatesCanonical		0..*	canonical(PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition)	Instantiates FHIR protocol or definition
instantiatesUri		0..*	uri	Instantiates external protocol or definition
code		0..1	CodeableConcept	Detail type of activity Binding: ProcedureCodes(SNOMEDCT) (example): Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Binding: https://ehr.testing.p5.pt/api/fhir/ValueSet/care-plan-activity-type (required)
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
reasonCode		0..*	CodeableConcept	Why activity should be done or why activity was prohibited Binding: SNOMEDCTClinicalFindings (example): Identifies why a care plan activity is needed. Can include any health condition codes as well as such concepts as "general wellness", prophylaxis, surgical preparation, etc.
reasonReference		0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Why activity is needed
goal		0..*	Reference(Goal)	Goals this activity relates to
status	?!S	1..1	code	not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error Binding: CarePlanActivityStatus (required)
statusReason		0..1	CodeableConcept	Reason for current status
doNotPerform	?!	0..1	boolean	If true, activity is prohibiting action
scheduled[x]		0..1	Period	When activity is to occur
location		0..1	Reference(Location)	Where it should happen
performer		0..*	Reference(Practitioner | PractitionerRole | Organization | RelatedPerson | Patient | CareTeam | HealthcareService | Device)	Who will be responsible?
product[x]		0..1		What is to be administered/supplied Binding: SNOMEDCTMedicationCodes (example): A product supplied or administered as part of a care plan activity.
productCodeableConcept			CodeableConcept
productReference			Reference(Medication | Substance)
dailyAmount		0..1	SimpleQuantity	How to consume/day?
quantity		0..1	SimpleQuantity	How much to administer/supply/consume
description		0..1	string	Extra info describing activity to perform
note	S	0..*	Annotation	Comments about the plan
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
author[x]	Σ	0..1		Individual responsible for the annotation
authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
authorString			string
time	Σ	0..1	dateTime	When the annotation was made
text	SΣ	1..1	markdown	The annotation - text content (as markdown)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CarePlan.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
CarePlan.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 from the FHIR Standard
CarePlan.intent	required	CarePlanIntent http://hl7.org/fhir/ValueSet/care-plan-intent from the FHIR Standard
CarePlan.category	example	CarePlanCategory http://hl7.org/fhir/ValueSet/care-plan-category from the FHIR Standard
CarePlan.activity.outcomeCodeableConcept	example	CarePlanActivityOutcome http://hl7.org/fhir/ValueSet/care-plan-activity-outcome from the FHIR Standard
CarePlan.activity.detail.kind	required	CarePlanActivityKind http://hl7.org/fhir/ValueSet/care-plan-activity-kind from the FHIR Standard
CarePlan.activity.detail.code	example	ProcedureCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-code from the FHIR Standard
CarePlan.activity.detail.code.coding.system	required	https://ehr.testing.p5.pt/api/fhir/ValueSet/care-plan-activity-type https://ehr.testing.p5.pt/api/fhir/ValueSet/care-plan-activity-type
CarePlan.activity.detail.reasonCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard
CarePlan.activity.detail.status	required	CarePlanActivityStatus http://hl7.org/fhir/ValueSet/care-plan-activity-status from the FHIR Standard
CarePlan.activity.detail.product[x]	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cpl-3	error	CarePlan.activity	Provide a reference or detail, not both : detail.empty() or reference.empty()
dom-2	error	CarePlan	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CarePlan	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 : 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-4	error	CarePlan	If 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-5	error	CarePlan	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CarePlan	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from CarePlan

Summary

Mandatory: 0 element(3 nested mandatory elements)
Must-Support: 10 elements

Structures

This structure refers to these other structures:

• Patient - TCCS Patient (https://hl7.pt/fhir/community-health/StructureDefinition/patient-tccs)

Other representations of profile: CSV, Excel, Schematron