US Quality Core Implementation Guide
0.1.0 - cibuild

US Quality Core Implementation Guide, published by ASTP. This guide is not an authorized publication; it is the continuous build for version 0.1.0 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

## CapabilityStatement: US Quality Core Client CapabilityStatement

Official URL: http://fhir.org/guides/astp/us-quality-core/CapabilityStatement/us-quality-core-client | Version: 0.1.0
Active as of 2026-03-31 | Computable Name: USQualityCoreClientCapabilityStatement

This capability statement describes the expected capabilities of the US Quality Core Client which is responsible for initiating queries for USCDI+ Quality V1 data from US Quality Core Servers. The set of FHIR RESTful operations and search parameters required to be supported by US Quality Core Servers is provided in the US Quality Core Server Capability Statement. US Quality Core Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

Raw OpenAPI-Swagger Definition file | Download

## US Quality Core Client CapabilityStatement

- Implementation Guide Version: 0.1.0
- FHIR Version: 4.0.1
- Supported Formats: `json`
- Published on: 2026-03-31
- Published by: ASTP

> Note to Implementers: FHIR Capabilities

> Any FHIR capability may be 'allowed' by the system unless explicitly marked as 'SHALL NOT'. A few items are marked as MAY in the Implementation Guide to highlight their potential relevance to the use case.

### SHALL Support the Following Implementation Guides

- http://fhir.org/guides/astp/us-quality-core

## FHIR RESTful Capabilities

### Mode: `client`

The US Quality Core Client SHALL:

1. Support fetching and querying US Quality Core profiles that contain at least one USCDI+ Quality flagged element, using the supported RESTful interactions and search parameters declared in the US Quality Core Server CapabilityStatement
2. Recognize and process all MustSupport and USCDI+ Quality flagged elements in US Quality Core
3. Treat all modifying attributes as MustSupport, even if not explicitly declared
4. SHALL NOT process resource instances that include unknown modifying attributes
5. Be simultaneously conformant with US Quality Core profiles and US Core profiles. As such, the more restrictive bindings between US Core and US Quality Core SHALL be adhered to. For example, all value sets that are required in US Core SHALL be required by US Quality Core, regardless of the binding strength in US Quality Core.

NOTE: US Core SearchParameters referenced in this CapabilityStatement that are derived from standard FHIR SearchParameters are only defined to document Server and Client expectations, such as comparator expectations, and to support generation tooling. They SHALL NOT be interpreted as search parameters for searching. Servers and Clients SHOULD use the standard FHIR SearchParameters.

Summary of System-wide Interactions

- MAY support the `transaction`interaction.
- MAY support the `batch`interaction.
- MAY support the `search-system`interaction.
- MAY support the `history-system`interaction.

### Capabilities by Resource/Profile

#### Summary

The summary table lists the resources that are part of this configuration, and for each resource it lists:

- The relevant profiles (if any)
- The interactions supported by each resource (Read, Search, Update, and Create, are always shown, while VRead, Patch, Delete, History on Instance, or History on Type are only present if at least one of the resources has support for them.
- The required, recommended, and some optional search parameters (if any).
- The linked resources enabled for `_include`
- The other resources enabled for `_revinclude`
- The operations on the resource (if any)

Resource Type | Profile | R | S | U | C | Searches | `_include` | `_revinclude` | Operations
--- | --- | --- | --- | --- | --- | --- | --- | --- | ---
AdverseEvent | Supported Profiles US Quality Core AdverseEvent | Y | Y |  |  | subject, event, recordedDate, subject+event, subject+recordedDate |  |  |
AllergyIntolerance | Supported Profiles US Quality Core AllergyIntolerance | Y | Y |  |  | patient |  |  |
CarePlan | Supported Profiles US Quality Core CarePlan | Y | Y |  |  | patient, category, patient+category |  |  |
CareTeam | Supported Profiles US Quality Core CareTeam | Y | Y |  |  | patient, status, patient+status |  |  |
Claim | Supported Profiles US Quality Core Claim | Y | Y |  |  | patient |  |  |
Condition | Supported Profiles US Quality Core Condition Encounter Diagnosis US Quality Core Condition Problems Health Concerns | Y | Y |  |  | patient, category, code, onset-date, abatement-date, patient+abatement-date, patient+category, patient+code, patient+onset-date |  |  |
Coverage | Supported Profiles US Quality Core Coverage | Y | Y |  |  | patient |  |  |
DeviceRequest | Supported Profiles US Quality Core DeviceRequest US Quality Core Device Not Requested | Y | Y |  |  | patient, code, patient+code |  |  |
DiagnosticReport | Supported Profiles US Quality Core DiagnosticReport Profile for Report and Note Exchange US Quality Core DiagnosticReport Profile for Laboratory Results Reporting | Y | Y |  |  | patient, category, code, date, patient+category, patient+category+date, patient+code |  |  |
Encounter | Supported Profiles US Quality Core Encounter | Y | Y |  |  | _id, patient, type, date, patient+type, patient+date |  |  |
FamilyMemberHistory | Supported Profiles US Quality Core FamilyMemberHistory | Y | Y |  |  | patient |  |  |
Goal | Supported Profiles US Quality Core Goal | Y | Y |  |  | patient |  |  |
Immunization | Supported Profiles US Quality Core Immunization US Quality Core Immunization Not Done | Y | Y |  |  | patient, status, date, patient+date, patient+status |  |  |
Location | Supported Profiles US Quality Core Location | Y | Y |  |  | _id |  |  |
Medication | Supported Profiles US Quality Core Medication | Y | Y |  |  | code |  |  |
MedicationAdministration | Supported Profiles US Quality Core MedicationAdministration US Quality Core MedicationAdministration Not Done | Y | Y |  |  | patient, status, code, effective-time, patient+status, patient+code, patient+effective-time |  |  |
MedicationDispense | Supported Profiles US Quality Core MedicationDispense US Quality Core MedicationDispense Declined | Y | Y |  |  | patient, status, patient+status |  |  |
MedicationRequest | Supported Profiles US Quality Core MedicationRequest US Quality Core Medication Not Requested | Y | Y |  |  | patient, intent, patient+intent |  |  |
Observation | Supported Profiles US Quality Core Observation Clinical Result US Quality Core Simple Observation US Quality Core Observation Screening Assessment US Quality Core Observation Cancelled US Quality Core Laboratory Result Observation | Y | Y |  |  | patient, category, code, date, patient+category, patient+category+date, patient+code |  |  |
Organization | Supported Profiles US Quality Core Organization | Y | y? |  |  |  |  |  |
Patient | Supported Profiles US Quality Core Patient | Y | Y |  |  | _id |  |  |
Practitioner | Supported Profiles US Quality Core Practitioner | Y | Y |  |  | _id |  |  |
PractitionerRole | Supported Profiles US Quality Core PractitionerRole | Y | Y |  |  | _id |  |  |
Procedure | Supported Profiles US Quality Core Procedure US Quality Core Procedure Not Done | Y | Y |  |  | patient, status, date, patient+status, patient+date |  |  |
RelatedPerson | Supported Profiles US Quality Core RelatedPerson | Y | Y |  |  | _id, patient |  |  |
ServiceRequest | Supported Profiles US Quality Core ServiceRequest US Quality Core Service Not Requested | Y | Y |  |  | _id, patient, category, code, authored, patient+category, patient+category+authored, patient+code |  |  |
Task | Supported Profiles US Quality Core Task US Quality Core Task Rejected | Y | Y |  |  | patient, status, code, patient+status, patient+code |  |  |

#### Resource Conformance: SHALLAdverseEvent

Core FHIR Resource
AdverseEvent
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core AdverseEvent

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | subject | `reference` | The client SHALL provide an id value for the reference.
MAY | event | `token` | The client MAY provide a code value.
MAY | recordedDate | `date` | The client MAY provide a date value.

Combined Search Parameters

Conformance | Parameters | Types
--- | --- | ---
SHALL | subject+event | `reference`+`token`
SHALL | subject+recordedDate | `reference`+`date`

#### Resource Conformance: SHALLAllergyIntolerance

Core FHIR Resource
AllergyIntolerance
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core AllergyIntolerance

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | patient | `reference` | The client SHALL provide an id value for the reference.

#### Resource Conformance: SHALLCarePlan

Core FHIR Resource
CarePlan
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core CarePlan

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
MAY | patient | `reference` | The client SHALL provide an id value for the reference.
MAY | category | `token` | The client MAY provide a code value.

Combined Search Parameters

Conformance | Parameters | Types
--- | --- | ---
SHALL | patient+category | `reference`+`token`

#### Resource Conformance: SHALLCareTeam

Core FHIR Resource
CareTeam
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core CareTeam

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
MAY | patient | `reference` | The client SHALL provide an id value for the reference.
MAY | status | `token` | The client MAY provide a code value.

Combined Search Parameters

Conformance | Parameters | Types
--- | --- | ---
SHALL | patient+status | `reference`+`token`

#### Resource Conformance: SHALLClaim

Core FHIR Resource
Claim
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core Claim

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | patient | `reference` | The client SHALL provide an id value for the reference.

#### Resource Conformance: SHALLCondition

Core FHIR Resource
Condition
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core Condition Encounter Diagnosis
US Quality Core Condition Problems Health Concerns

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | patient | `reference` | The client SHALL provide an id value for the reference.
MAY | category | `token` | The client MAY provide a category.
MAY | code | `token` | The client MAY provide a code value.
MAY | onset-date | `date` | The client MAY provide a date value.
MAY | abatement-date | `date` | The client MAY provide a date value.

Combined Search Parameters

Conformance | Parameters | Types
--- | --- | ---
SHALL | patient+category | `reference`+`token`
SHOULD | patient+abatement-date | `reference`+`date`
SHOULD | patient+code | `reference`+`token`
SHOULD | patient+onset-date | `reference`+`date`

#### Resource Conformance: SHALLCoverage

Core FHIR Resource
Coverage
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core Coverage

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | patient | `reference` | The client SHALL provide an id value for the reference.

#### Resource Conformance: SHALLDeviceRequest

Core FHIR Resource
DeviceRequest
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core DeviceRequest
US Quality Core Device Not Requested

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | patient | `reference` | The client SHALL provide an id value for the reference.
MAY | code | `token` | The client MAY provide a code value.

Combined Search Parameters

Conformance | Parameters | Types
--- | --- | ---
SHALL | patient+code | `reference`+`token`

#### Resource Conformance: SHALLDiagnosticReport

Core FHIR Resource
DiagnosticReport
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core DiagnosticReport Profile for Report and Note Exchange
US Quality Core DiagnosticReport Profile for Laboratory Results Reporting

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | patient | `reference` | The client SHALL provide an id value for the reference.
MAY | category | `token` | The client MAY provide a category.
MAY | code | `token` | The client MAY provide a code value.
MAY | date | `date` | The client MAY provide a date value.

Combined Search Parameters

Conformance | Parameters | Types
--- | --- | ---
SHALL | patient+category | `reference`+`token`
SHALL | patient+category+date | `reference`+`token`+`date`
SHALL | patient+code | `reference`+`token`

#### Resource Conformance: SHALLEncounter

Core FHIR Resource
Encounter
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core Encounter

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | _id | `token` | The client SHALL provide an id value.
SHALL | patient | `reference` | The client SHALL provide an id value for the reference.
MAY | type | `token` | The client MAY provide a code value.
MAY | date | `date` | The client MAY provide a date value.

Combined Search Parameters

Conformance | Parameters | Types
--- | --- | ---
SHALL | patient+type | `reference`+`token`
SHALL | patient+date | `reference`+`date`

#### Resource Conformance: SHALLFamilyMemberHistory

Core FHIR Resource
FamilyMemberHistory
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core FamilyMemberHistory

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | patient | `reference` | The client SHALL provide an id value for the reference.

#### Resource Conformance: SHALLGoal

Core FHIR Resource
Goal
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core Goal

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | patient | `reference` | The client SHALL provide an id value for the reference.

#### Resource Conformance: SHALLImmunization

Core FHIR Resource
Immunization
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core Immunization
US Quality Core Immunization Not Done

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | patient | `reference` | The client SHALL provide an id value for the reference.
MAY | status | `token` | The client MAY provide a status.
MAY | date | `date` | The client MAY provide a date value.

Combined Search Parameters

Conformance | Parameters | Types
--- | --- | ---
SHALL | patient+status | `reference`+`token`
SHOULD | patient+date | `reference`+`date`

#### Resource Conformance: SHALLLocation

Core FHIR Resource
Location
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core Location

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | _id | `token` | The client SHALL provide an id value.

#### Resource Conformance: SHALLMedication

Core FHIR Resource
Medication
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core Medication

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | code | `token` | The client SHALL provide a code value.

#### Resource Conformance: SHALLMedicationAdministration

Core FHIR Resource
MedicationAdministration
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core MedicationAdministration
US Quality Core MedicationAdministration Not Done

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | patient | `reference` | The client SHALL provide an id value for the reference.
MAY | status | `token` | The client MAY provide a status.
MAY | code | `token` | The client MAY provide a code value.
MAY | effective-time | `date` | The client MAY provide a date value.

Combined Search Parameters

Conformance | Parameters | Types
--- | --- | ---
SHALL | patient+status | `reference`+`token`
SHALL | patient+code | `reference`+`token`
SHALL | patient+effective-time | `reference`+`date`

#### Resource Conformance: SHALLMedicationDispense

Core FHIR Resource
MedicationDispense
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core MedicationDispense
US Quality Core MedicationDispense Declined

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | patient | `reference` | The client SHALL provide an id value for the reference.
MAY | status | `token` | The client MAY provide a status.

Combined Search Parameters

Conformance | Parameters | Types
--- | --- | ---
SHALL | patient+status | `reference`+`token`

#### Resource Conformance: SHALLMedicationRequest

Core FHIR Resource
MedicationRequest
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core MedicationRequest
US Quality Core Medication Not Requested

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
MAY | patient | `reference` | The client SHALL provide an id value for the reference.
MAY | intent | `token` | The client MAY provide a token value.

Combined Search Parameters

Conformance | Parameters | Types
--- | --- | ---
SHALL | patient+intent | `reference`+`token`

#### Resource Conformance: SHALLObservation

Core FHIR Resource
Observation
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core Observation Clinical Result
US Quality Core Simple Observation
US Quality Core Observation Screening Assessment
US Quality Core Observation Cancelled
US Quality Core Laboratory Result Observation

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
MAY | patient | `reference` | The client SHALL provide an id value for the reference.
MAY | category | `token` | The client MAY provide a category.
MAY | code | `token` | The client MAY provide a code value.
MAY | date | `date` | The client MAY provide a date value.

Combined Search Parameters

Conformance | Parameters | Types
--- | --- | ---
SHALL | patient+category | `reference`+`token`
SHALL | patient+category+date | `reference`+`token`+`date`
SHALL | patient+code | `reference`+`token`

#### Resource Conformance: SHALLOrganization

Core FHIR Resource
Organization
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`.
- MAY support `search-type`.

Supported Profiles

US Quality Core Organization

#### Resource Conformance: SHALLPatient

Core FHIR Resource
Patient
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core Patient

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | _id | `token` | The client SHALL provide an id value.

#### Resource Conformance: SHALLPractitioner

Core FHIR Resource
Practitioner
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core Practitioner

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | _id | `token` | The client SHALL provide an id value.

#### Resource Conformance: SHALLPractitionerRole

Core FHIR Resource
PractitionerRole
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core PractitionerRole

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | _id | `token` | The client SHALL provide an id value.

#### Resource Conformance: SHALLProcedure

Core FHIR Resource
Procedure
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core Procedure
US Quality Core Procedure Not Done

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | patient | `reference` | The client SHALL provide an id value for the reference.
MAY | status | `token` | The client MAY provide a status.
MAY | date | `date` | The client MAY provide a date value.

Combined Search Parameters

Conformance | Parameters | Types
--- | --- | ---
SHALL | patient+status | `reference`+`token`
SHALL | patient+date | `reference`+`date`

#### Resource Conformance: SHALLRelatedPerson

Core FHIR Resource
RelatedPerson
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core RelatedPerson

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | _id | `token` | The client SHALL provide an id value.
SHALL | patient | `reference` | The client SHALL provide an id value for the reference.

#### Resource Conformance: SHALLServiceRequest

Core FHIR Resource
ServiceRequest
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core ServiceRequest
US Quality Core Service Not Requested

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | _id | `token` | The client SHALL provide an id value.
SHALL | patient | `reference` | The client SHALL provide an id value for the reference.
MAY | category | `token` | The client MAY provide a category.
MAY | code | `token` | The client MAY provide a code value.
MAY | authored | `date` | The client MAY provide a date value.

Combined Search Parameters

Conformance | Parameters | Types
--- | --- | ---
SHALL | patient+category | `reference`+`token`
SHALL | patient+category+authored | `reference`+`token`+`date`
SHALL | patient+code | `reference`+`token`

#### Resource Conformance: SHALLTask

Core FHIR Resource
Task
Reference Policy
`resolves`
Interaction summary

- SHALL support `read`, `search-type`.

Supported Profiles

US Quality Core Task
US Quality Core Task Rejected

Search Parameters

Conformance | Parameter | Type | Documentation
--- | --- | --- | ---
SHALL | patient | `reference` | The client SHALL provide an id value for the reference.
MAY | status | `token` | The client MAY provide a status.
MAY | code | `token` | The client MAY provide a code value.

Combined Search Parameters

Conformance | Parameters | Types
--- | --- | ---
SHALL | patient+status | `reference`+`token`
SHALL | patient+code | `reference`+`token`