US Core Implementation Guide
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US Core Implementation Guide, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 9.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/US-Core/ and changes regularly. See the Directory of published versions

Requirements: US Core Certifying System Requirements

Official URL: http://hl7.org/fhir/us/core/Requirements/us-core-certifying-system Version: 9.0.0
Standards status: Trial-use Maturity Level: 3 Computable Name: USCoreCertifyingSystemRequirements
Other Identifiers: OID:2.16.840.1.113883.4.642.40.2.36.1

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

This Requirements resource lists the additional requirements for systems certifying for ASTP Health IT Certification (g(10) certification. These requirements represent the regulatory and technical specifications that design artifacts must meet to ensure interoperability. See the US Core Server Requirements for the US Core Responder (Server) requirements defined in the US Core Implementation Guide narrative sections.

These requirements apply to the actor: US Core Certifying System

Legend:

  • Key: An identifier for the requirement.
  • Context: The name and link to the narrative section that pertains to the requirement. There can be more than one narrative section that references the same requirement.
  • Conformance: The conformance verb of the requirement: SHALL, SHOULD, MAY, SHALL-NOT, or SHOULD-NOT.
  • Requirement: The actual requirements statement, which is a direct quote from the IG and may include helpful context in square brackets. Note that statements in the narrative section that contain multiple requirements in a single context are split into individual requirement statements.
Key Context Conformance Requirement
CONF-0011 general-requirements.html#profile-support--interaction-support
SHALL

A Server that certifies to the 21st Century Cures Act for accessing patient data SHALL implement all components in the USCDI [USCDI link]

CONF-0012 general-requirements.html#profile-support--interaction-support
SHALL

A Server that certifies to the 21st Century Cures Act for accessing patient data SHALL implement all components in the ... the US Core CapabilityStatement [Definition] .

CONF-0124 scopes.html#smart-scopes
SHALL

Implementations meeting US EHR certification [of the ONC IT Health Certification program] requirements must support all US Core’s required scopes.

CONF-0391 StructureDefinition-us-core-immunization.html#profile-specific-implementation-guidance
SHALL

[For organization participating in the ONC Health IT Certification program] CVX vaccine codes are required

CONF-0392 StructureDefinition-us-core-immunization.html#profile-specific-implementation-guidance
SHOULD

NDC vaccine codes SHOULD be supported as an additional code [of CVX Vaccine Codes]

CONF-0405 StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance
SHALL

[For organization participating in the ONC Health IT Certification program Servers SHALL support the additional USCDI requirement:], The reason or indication for the prescription

CONF-0406 StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance
SHALL

[For organization participating in the ONC Health IT Certification program Servers SHALL support the additional USCDI requirement:] reported adherence to prescribed medication instructions

CONF-0411 StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance
SHALL

Although both MedicationRequest.reasonCode and MedicationRequest.reasonReference are marked as Additional USCDI Requirements [which are required for organizations participating in the ONC Health IT Certification program]. The certifying Server system is not required to support both, but SHALL support at least one of these elements

CONF-0414 StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance
SHALL

[For organizations participating in the ONC Health IT Certification program and supporting MedicationRequest.reasonReference,] Servers SHALL support at least one target resource in MedicationRequest.reasonReference

CONF-0444 StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance
SHALL

Although none of the Observation.derivedFrom references are flagged as Must Support, the Certifying System SHALL* support at least one of them

CONF-0465 StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance
SHALL

Although Patient.deceased[x] is marked as additional USCDI, certifying systems are not required to support both [boolean and dateTime data types], but SHALL support [at] least Patient.deceasedDateTime

CONF-0469 StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance
SHALL

Certifying systems [, those that are participating in the ONC Health IT certification program,] SHALL... follow the Project US@ Technical Specification for Patient Addresses Final Version 1.0 as the standard style guide for Patient.address.line and Patient.address.city for new and updated records.

CONF-0482 StructureDefinition-us-core-procedure.html#profile-specific-implementation-guidance
SHALL

[For organizations participating in the ONC Health IT Certification program] Servers … SHALL support ... US Core Procedure Profile for communicating the reason or justification for a referral as Additional USCDI Requirements

CONF-0484 StructureDefinition-us-core-procedure.html#profile-specific-implementation-guidance
SHALL

[For organizations participating in the ONC Health IT Certification program,] although both Procedure.reasonCode and Procedure.reasonReference are marked as Additional USCDI Requirements, the certifying Server system is not required to support both, but SHALL support at least one of these elements.

CONF-0516 StructureDefinition-us-core-servicerequest.html#profile-specific-implementation-guidance
SHALL

[For organizations participating in the ONC Health IT Certification program] Servers … SHALL support ... US Core Service Request Profile for communicating the reason or justification for a referral as Additional USCDI Requirements

CONF-0518 StructureDefinition-us-core-servicerequest.html#profile-specific-implementation-guidance
SHALL

[For organizations participating in the ONC Health IT Certification program,] although both ServiceRequest.reasonCode and ServiceRequest.reasonReference are marked as Additional USCDI Requirements, the certifying Server system is not required to support both, but SHALL support at least one of these elements.

CONF-0520 StructureDefinition-us-core-servicerequest.html#profile-specific-implementation-guidance
SHALL

[For organizations participating in the ONC Health IT Certification program,] when using ServiceRequest.reasonReference Servers SHALL support at least one target resource in ServiceRequest.reasonReference

CONF-0522 StructureDefinition-us-core-servicerequest.html#profile-specific-implementation-guidance
SHOULD

[For organizations participating in the ONC Health IT Certification program,] when using ServiceRequest.reasonReference …The referenced resources SHOULD be a US Core Profile as documented in Referencing US Core Profiles

CONF-0801 must-support.html#defined-pattern-elements
SHALL

If an element is marked as Additional USCDI and defined by a pattern [as described by ElementDefinition.pattern], then the pattern defines the elements and element values that the Certifying System SHALL be capable of providing.

CONF-0802 must-support.html#must-support---primitive-elements
SHALL

Primitive elements are single elements with a primitive value…. If they are marked as Additional USCDI, then the Certifying System SHALL be capable of providing the element value to meet the Additional USCDI requirement.

CONF-0803 must-support.html#must-support---complex-elements
SHALL

For any complex element marked as Additional USCDI, the Certifying System SHALL be capable of providing at least one of the sub-element values.

CONF-0805 must-support.html#must-support---complex-elements
SHALL

[I]f any sub-element is marked as Additional USCDI [for a complex element] and the parent element is not… [and] the parent element is represented in the structure, Certifying System SHALL support the sub-elements labeled as Additional USCDI.

CONF-0809 must-support.html#must-support-targets-for-us-core-profiles
SHALL

When a Reference type element is labeled as Additional USCDI and has a single target profile referenced, the target profile SHALL be supported for Certifying Systems.

CONF-0811 must-support.html#must-support-targets-for-us-core-profiles
SHALL

When a Reference type element labeled as Additional USCDI, has multiple target profiles referenced, and specific targets are labeled as Must Support, the Must Support target profile(s) SHALL be supported by Certifying Systems.

CONF-0812 must-support.html#must-support---slices
SHALL

[I]f a slice is labeled as ... Must Support/Additional USCDI and the slicer element is not labeled as ... Additional USCDI, then if the ... certifying system supports the element, it must support the slice's definition. There are no examples of this structure in US Core.

CONF-0814 must-support.html#must-support---slices
SHALL

[I]f a slice is labeled as … Must Support and the slicer element is ... labeled as … Must Support/Additional USCDI, then … certifying system [SHALL support] the element[ and] the slice's definition.

CONF-0833 StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance
SHALL

Certifying Systems SHALL support, a category of "sdoh"

CONF-0834 StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance
SHOULD

Certifying Systems ... SHOULD support the ... US Core Simple Observation Category codes

CONF-0835 StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance
MAY

Certifying Systems ... MAY support other categories

CONF-0846 StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance
SHALL

[For the US Core Observation Screening Assessment Profile,] Certifying Systems SHALL support, the US Core Screening Assessment Observation Category codes

CONF-0847 StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance
SHOULD

[For the US Core Observation Screening Assessment Profile,] Certifying Systems SHOULD support, the US Core Screening Assessment Observation Maximum Category codes

CONF-0848 StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance
MAY

[For the US Core Observation Screening Assessment Profile,] Certifying Systems MAY support other codes.

CONF-0852 StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance
SHALL

Although the [US Core Interpreter Needed Extension] is marked as an Additional USCDI Requirement on both US Core Patient and US Core Encounter Profiles, the certifying Server system is not required to support the extension on both profiles but SHALL support the extension on at least one.

CONF-0861 StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance
SHOULD
CONF-0862 StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance
SHALL
CONF-0863 StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance
MAY
CONF-0872 must-support.html#must-support---slices
SHALL

[I]f a slice is labeled as Additional USCDI... and the slicer element is ... labeled as Must Support/Additional USCDI..., then ... the Certifying System... [SHALL support] the element[ and] the slice's definition.

CONF-0883 must-support.html#must-support---resource-references
SHALL

When a Reference element is labeled as Additional USCDI has multiple target profiles referenced, but none are labeled as Must Support, at least one target profile SHALL be supported by Certifying Systems.

CONF-0884 must-support.html#must-support---choice-of-data-types
SHALL

If an Additional USCDI element has a choice of datatypes for its content, the datatypes the Certifying System SHALL support are labeled as Must Support.

CONF-0902 StructureDefinition-us-core-location.html#profile-specific-implementation-guidance
MAY

Healthcare Service Location Codes (HSLOC) and SNOMED-CT Healthcare Facility Type value sets meet the USCDI applicable vocabulary standard for the Encounter Location Data Element. Certifying Systems MAY use a code from either vocabulary.