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

## Resource Profile: US Quality Core DeviceUseStatement

Official URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-deviceusestatement | Version: 0.5.0
Active as of 2026-05-15 | Computable Name: USQualityCoreDeviceUseStatement

Profile of DeviceUseStatement for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

Usage

See the patterns page for implementation and usage patterns.

### Examples

ECG Monitor Use by a Patient Example

Usages:

- Examples for this Profile: DeviceUseStatement/example

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DeviceUseStatement |  | 0..* | DeviceUseStatement | Record of use of a device
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | active | completed | entered-in-error + Binding: DeviceUseStatementStatus (required): A coded concept indicating the current status of the Device Usage.
subject | Σ | 1..1 | Reference(US Quality Core Patient) | Patient using device
timing[x] | Σ | 0..1 |  | How often the device was used
timingTiming |  |  | Timing |
timingPeriod |  |  | Period |
timingDateTime |  |  | dateTime |
recordedOn | Σ | 0..1 | dateTime | When statement was recorded
device | Σ | 1..1 | Reference(US Quality Core Device | US Core Implantable Device Profile(6.1.0)) | Reference to device used
bodySite | Σ | 0..1 | CodeableConcept | Target body site Binding: SNOMEDCTBodyStructures (preferred): Codes describing anatomical locations. May include laterality.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DeviceUseStatement.status | Base | required | DeviceUseStatementStatus | 📍4.0.1 | FHIR Std.
DeviceUseStatement.bodySite | Base | preferred | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DeviceUseStatement | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DeviceUseStatement | 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 | DeviceUseStatement | 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 | DeviceUseStatement | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DeviceUseStatement | 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 DeviceUseStatement

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DeviceUseStatement |  | 0..* | DeviceUseStatement | Record of use of a device
status |  | 1..1 | code | active | completed | entered-in-error +
subject |  | 1..1 | Reference(US Quality Core Patient) | Patient using device
timing[x] |  | 0..1 | Timing, Period, dateTime | How often the device was used
recordedOn |  | 0..1 | dateTime | When statement was recorded
device |  | 1..1 | Reference(US Quality Core Device | US Core Implantable Device Profile(6.1.0)) | Reference to device used
bodySite |  | 0..1 | CodeableConcept | Target body site Binding: SNOMEDCTBodyStructures (preferred): Codes describing anatomical locations. May include laterality.
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
DeviceUseStatement.bodySite | Base | preferred | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DeviceUseStatement |  | 0..* | DeviceUseStatement | Record of use of a device
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
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 identifier for this record
basedOn | Σ | 0..* | Reference(ServiceRequest) | Fulfills plan, proposal or order
status | ?!Σ | 1..1 | code | active | completed | entered-in-error + Binding: DeviceUseStatementStatus (required): A coded concept indicating the current status of the Device Usage.
subject | Σ | 1..1 | Reference(US Quality Core Patient) | Patient using device
derivedFrom | Σ | 0..* | Reference(ServiceRequest | Procedure | Claim | Observation | QuestionnaireResponse | DocumentReference) | Supporting information
timing[x] | Σ | 0..1 |  | How often the device was used
timingTiming |  |  | Timing |
timingPeriod |  |  | Period |
timingDateTime |  |  | dateTime |
recordedOn | Σ | 0..1 | dateTime | When statement was recorded
source | Σ | 0..1 | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson) | Who made the statement
device | Σ | 1..1 | Reference(US Quality Core Device | US Core Implantable Device Profile(6.1.0)) | Reference to device used
reasonCode | Σ | 0..* | CodeableConcept | Why device was used
reasonReference | Σ | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference | Media) | Why was DeviceUseStatement performed?
bodySite | Σ | 0..1 | CodeableConcept | Target body site Binding: SNOMEDCTBodyStructures (preferred): Codes describing anatomical locations. May include laterality.
note |  | 0..* | Annotation | Addition details (comments, instructions)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DeviceUseStatement.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
DeviceUseStatement.status | Base | required | DeviceUseStatementStatus | 📍4.0.1 | FHIR Std.
DeviceUseStatement.bodySite | Base | preferred | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DeviceUseStatement | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DeviceUseStatement | 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 | DeviceUseStatement | 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 | DeviceUseStatement | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DeviceUseStatement | 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 DeviceUseStatement

Summary

Structures

This structure refers to these other structures:

- US Quality Core Patient (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient)
- US Quality Core Device (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-device)
- US Core Implantable Device Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-implantable-device|6.1.0)

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DeviceUseStatement |  | 0..* | DeviceUseStatement | Record of use of a device
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | active | completed | entered-in-error + Binding: DeviceUseStatementStatus (required): A coded concept indicating the current status of the Device Usage.
subject | Σ | 1..1 | Reference(US Quality Core Patient) | Patient using device
timing[x] | Σ | 0..1 |  | How often the device was used
timingTiming |  |  | Timing |
timingPeriod |  |  | Period |
timingDateTime |  |  | dateTime |
recordedOn | Σ | 0..1 | dateTime | When statement was recorded
device | Σ | 1..1 | Reference(US Quality Core Device | US Core Implantable Device Profile(6.1.0)) | Reference to device used
bodySite | Σ | 0..1 | CodeableConcept | Target body site Binding: SNOMEDCTBodyStructures (preferred): Codes describing anatomical locations. May include laterality.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DeviceUseStatement.status | Base | required | DeviceUseStatementStatus | 📍4.0.1 | FHIR Std.
DeviceUseStatement.bodySite | Base | preferred | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DeviceUseStatement | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DeviceUseStatement | 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 | DeviceUseStatement | 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 | DeviceUseStatement | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DeviceUseStatement | 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()`

Differential View

This structure is derived from DeviceUseStatement

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DeviceUseStatement |  | 0..* | DeviceUseStatement | Record of use of a device
status |  | 1..1 | code | active | completed | entered-in-error +
subject |  | 1..1 | Reference(US Quality Core Patient) | Patient using device
timing[x] |  | 0..1 | Timing, Period, dateTime | How often the device was used
recordedOn |  | 0..1 | dateTime | When statement was recorded
device |  | 1..1 | Reference(US Quality Core Device | US Core Implantable Device Profile(6.1.0)) | Reference to device used
bodySite |  | 0..1 | CodeableConcept | Target body site Binding: SNOMEDCTBodyStructures (preferred): Codes describing anatomical locations. May include laterality.
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
DeviceUseStatement.bodySite | Base | preferred | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DeviceUseStatement |  | 0..* | DeviceUseStatement | Record of use of a device
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
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 identifier for this record
basedOn | Σ | 0..* | Reference(ServiceRequest) | Fulfills plan, proposal or order
status | ?!Σ | 1..1 | code | active | completed | entered-in-error + Binding: DeviceUseStatementStatus (required): A coded concept indicating the current status of the Device Usage.
subject | Σ | 1..1 | Reference(US Quality Core Patient) | Patient using device
derivedFrom | Σ | 0..* | Reference(ServiceRequest | Procedure | Claim | Observation | QuestionnaireResponse | DocumentReference) | Supporting information
timing[x] | Σ | 0..1 |  | How often the device was used
timingTiming |  |  | Timing |
timingPeriod |  |  | Period |
timingDateTime |  |  | dateTime |
recordedOn | Σ | 0..1 | dateTime | When statement was recorded
source | Σ | 0..1 | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson) | Who made the statement
device | Σ | 1..1 | Reference(US Quality Core Device | US Core Implantable Device Profile(6.1.0)) | Reference to device used
reasonCode | Σ | 0..* | CodeableConcept | Why device was used
reasonReference | Σ | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference | Media) | Why was DeviceUseStatement performed?
bodySite | Σ | 0..1 | CodeableConcept | Target body site Binding: SNOMEDCTBodyStructures (preferred): Codes describing anatomical locations. May include laterality.
note |  | 0..* | Annotation | Addition details (comments, instructions)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DeviceUseStatement.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
DeviceUseStatement.status | Base | required | DeviceUseStatementStatus | 📍4.0.1 | FHIR Std.
DeviceUseStatement.bodySite | Base | preferred | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DeviceUseStatement | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DeviceUseStatement | 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 | DeviceUseStatement | 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 | DeviceUseStatement | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DeviceUseStatement | 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 DeviceUseStatement

Summary

Structures

This structure refers to these other structures:

- US Quality Core Patient (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient)
- US Quality Core Device (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-device)
- US Core Implantable Device Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-implantable-device|6.1.0)

Other representations of profile: CSV, Excel, Schematron