2026 US Quality Core Implementation Guide
0.5.0 - cibuild US

2026 US Quality Core Implementation Guide, published by Office of the National Coordinator for Health Information Technology (ONC). This guide is not an authorized publication; it is the continuous build for version 0.5.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/FHIR/us-quality-core/ and changes regularly. See the Directory of published versions

## Extension: USQualityCoreUSCDIQualityExtension - XML Profile

Active as of 2026-05-15

XML representation of the uscdiplusquality extension.

Raw xml | Download

    <StructureDefinition xmlns="http://hl7.org/fhir">
      <id value="uscdiplusquality"/>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml">US Quality Core USCDI+ Quality Extension</div>
      </text>
      <url
           value="http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality"/>
      <version value="0.5.0"/>
      <name value="USQualityCoreUSCDIQualityExtension"/>
      <title value="US Quality Core USCDI+ Quality Extension"/>
      <status value="active"/>
      <date value="2026-05-15"/>
      <publisher
                 value="Office of the National Coordinator for Health Information Technology (ONC)"/>
      <contact>
        <name
              value="Office of the National Coordinator for Health Information Technology (ONC)"/>
        <telecom>
          <system value="url"/>
          <value value="https://www.healthit.gov/feedback"/>
        </telecom>
      </contact>
      <description
                   value="This extension is only used in the US Quality Core Implementation Guide's Profile StructureDefinition elements."/>
      <jurisdiction>
        <coding>
          <system value="urn:iso:std:iso:3166"/>
          <code value="US"/>
          <display value="United States of America"/>
        </coding>
        <text value="USA"/>
      </jurisdiction>
      <fhirVersion value="4.0.1"/>
      <mapping>
        <identity value="rim"/>
        <uri value="http://hl7.org/v3"/>
        <name value="RIM Mapping"/>
      </mapping>
      <kind value="complex-type"/>
      <abstract value="false"/>
      <context>
        <type value="element"/>
        <expression value="ElementDefinition"/>
      </context>
      <context>
        <type value="element"/>
        <expression value="ElementDefinition.type.targetProfile"/>
      </context>
      <context>
        <type value="element"/>
        <expression value="ElementDefinition.type"/>
      </context>
      <type value="Extension"/>
      <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      <derivation value="constraint"/>
      <snapshot>
        <extension
                   url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version">
          <valueString value="4.0.1"/>
        </extension>
        <element id="Extension">
          <path value="Extension"/>
          <short
                 value="USCDI+ Quality Element Flag: ONLY USED FOR US Quality Core Profile StructureDefinitions"/>
          <definition
                      value="**This extension is only used on US Quality Core Profile StructureDefinition elements**."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <condition value="ele-1"/>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <mapping>
            <identity value="v2"/>
            <map value="No v2 equivalent"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="No RIM equivalent"/>
          </mapping>
        </element>
        <element id="Extension.id">
          <path value="Extension.id"/>
          <representation value="xmlAttr"/>
          <short value="Unique id for inter-element referencing"/>
          <definition
                      value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
          <min value="0"/>
          <max value="1"/>
          <base>
            <path value="Element.id"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="string"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Extension.extension">
          <path value="Extension.extension"/>
          <slicing>
            <discriminator>
              <type value="value"/>
              <path value="url"/>
            </discriminator>
            <description value="Extensions are always sliced by (at least) url"/>
            <rules value="open"/>
          </slicing>
          <short value="Additional content defined by implementations"/>
          <definition
                      value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
          <comment
                   value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
          <alias value="extensions"/>
          <alias value="user content"/>
          <min value="0"/>
          <max value="*"/>
          <base>
            <path value="Element.extension"/>
            <min value="0"/>
            <max value="*"/>
          </base>
          <type>
            <code value="Extension"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <constraint>
            <key value="ext-1"/>
            <severity value="error"/>
            <human value="Must have either extensions or value[x], not both"/>
            <expression value="extension.exists() != value.exists()"/>
            <xpath
                   value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="n/a"/>
          </mapping>
        </element>
        <element id="Extension.url">
          <path value="Extension.url"/>
          <representation value="xmlAttr"/>
          <short value="identifies the meaning of the extension"/>
          <definition
                      value="Source of the definition for the extension code - a logical name or a URL."/>
          <comment
                   value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Extension.url"/>
            <min value="1"/>
            <max value="1"/>
          </base>
          <type>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
              <valueUrl value="uri"/>
            </extension>
            <code value="http://hl7.org/fhirpath/System.String"/>
          </type>
          <fixedUri
                    value="http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality"/>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
        <element id="Extension.value[x]">
          <path value="Extension.value[x]"/>
          <short value="Value of extension"/>
          <definition
                      value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list)."/>
          <min value="1"/>
          <max value="1"/>
          <base>
            <path value="Extension.value[x]"/>
            <min value="0"/>
            <max value="1"/>
          </base>
          <type>
            <code value="boolean"/>
          </type>
          <constraint>
            <key value="ele-1"/>
            <severity value="error"/>
            <human value="All FHIR elements must have a @value or children"/>
            <expression
                        value="hasValue() or (children().count() &gt; id.count())"/>
            <xpath value="@value|f:*|h:div"/>
            <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
          </constraint>
          <isModifier value="false"/>
          <isSummary value="false"/>
          <mapping>
            <identity value="rim"/>
            <map value="N/A"/>
          </mapping>
        </element>
      </snapshot>
      <differential>
        <element id="Extension">
          <path value="Extension"/>
          <short
                 value="USCDI+ Quality Element Flag: ONLY USED FOR US Quality Core Profile StructureDefinitions"/>
          <definition
                      value="**This extension is only used on US Quality Core Profile StructureDefinition elements**."/>
          <min value="0"/>
          <max value="1"/>
          <isModifier value="false"/>
          <mapping>
            <identity value="v2"/>
            <map value="No v2 equivalent"/>
          </mapping>
          <mapping>
            <identity value="rim"/>
            <map value="No RIM equivalent"/>
          </mapping>
        </element>
        <element id="Extension.url">
          <path value="Extension.url"/>
          <fixedUri
                    value="http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality"/>
        </element>
        <element id="Extension.value[x]">
          <path value="Extension.value[x]"/>
          <min value="1"/>
          <max value="1"/>
          <type>
            <code value="boolean"/>
          </type>
        </element>
      </differential>
    </StructureDefinition>