US Core Implementation Guide
9.0.0 - CI Build
US Core Implementation Guide
9.0.0 - CI Build
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
| Page standards status: Trial-use | Maturity Level: 3 |
<Requirements xmlns="http://hl7.org/fhir">
<id value="us-core-server"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<p>These requirements apply to the actor: <i><strong>US Core Requestor (Server)</strong></i></p>
<p><strong>Legend:</strong></p>
<ul>
<li><strong>Key:</strong> An identifier for the requirement.</li>
<li><strong>Context:</strong> 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.</li>
<li><strong>Conformance:</strong> The conformance verb of the requirement: <strong>SHALL</strong>, <strong>SHOULD</strong>, <strong>MAY</strong>, <strong>SHALL-NOT</strong>, or <strong>SHOULD-NOT</strong>.</li>
<li><strong>Requirement:</strong> 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.</li>
</ul>
<table class="grid">
<thead>
<tr>
<th>Key</th>
<th>Context</th>
<th>Conformance</th>
<th>Requirement</th>
</tr>
</thead>
<tbody>
<tr id="CONF-0001">
<td>CONF-0001</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0001">general-requirements.html#profile-only-support</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>To support a US Core Profile, a Server: <strong>SHALL</strong> Be able to populate all profile data elements that are mandatory and/or flagged as Must Support as defined by that profile’s StructureDefinition.</p>
</div></td>
</tr>
<tr id="CONF-0002">
<td>CONF-0002</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0002">general-requirements.html#profile-only-support</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>To support a US Core Profile, a Server: <strong>SHOULD</strong> declare support for a US Core Profile by including its official URL in the Server’s <code>CapabilityStatement.rest.resource.supportedProfile</code> element.</p>
</div></td>
</tr>
<tr id="CONF-0003">
<td>CONF-0003</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0003">general-requirements.html#profile-support--interaction-support</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Servers may deploy and support one or more US Core Profiles to represent clinical information</p>
</div></td>
</tr>
<tr id="CONF-0004">
<td>CONF-0004</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0004">general-requirements.html#profile-support--interaction-support</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Server may deploy and support ... the following US Core interaction: “Quick Start” defined for each Profile</p>
</div></td>
</tr>
<tr id="CONF-0005">
<td>CONF-0005</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0005">general-requirements.html#profile-support--interaction-support</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Server may deploy and support ... the following US Core interaction: <a href="https://hl7.org/fhir/us/core/clinical-notes.html">Clinical Notes</a></p>
</div></td>
</tr>
<tr id="CONF-0006">
<td>CONF-0006</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0006">general-requirements.html#profile-support--interaction-support</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Server may deploy and support ... the following US Core interaction: <a href="https://hl7.org/fhir/us/core/medication-list.html">Medication List</a></p>
</div></td>
</tr>
<tr id="CONF-0007">
<td>CONF-0007</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0007">general-requirements.html#profile-support--interaction-support</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Server may deploy and support ... the following US Core interaction: <a href="https://hl7.org/fhir/us/core/basic-provenance.html">Basic Provenance</a></p>
</div></td>
</tr>
<tr id="CONF-0008">
<td>CONF-0008</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0008">general-requirements.html#profile-support--interaction-support</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Server may deploy and support ... the following US Core interaction: <a href="https://hl7.org/fhir/us/core/screening-and-assessments.html">Screening and Assessments</a></p>
</div></td>
</tr>
<tr id="CONF-0009">
<td>CONF-0009</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0009">general-requirements.html#profile-support--interaction-support</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Servers implementing ... [clinical information representation] can claim conformance to the US Core Profile content structure ... by implementing all or parts of the US Core CapabilityStatement into their capabilities.</p>
</div></td>
</tr>
<tr id="CONF-0010">
<td>CONF-0010</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0010">general-requirements.html#profile-support--interaction-support</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Servers implementing ... [interactions] can claim conformance to the ... RESTful interactions defined by implementing all or parts of the US Core CapabilityStatement into their capabilities</p>
</div></td>
</tr>
<tr id="CONF-0013">
<td>CONF-0013</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0013">general-requirements.html#claiming-conformance-to-a-us-core-profile</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[To claim conformance to a US Core Profile] a conformant Server:</p>
<p><strong>SHALL</strong> Be able to populate all profile data elements that are mandatory and/or flagged as Must Support as defined by that profile’s StructureDefinition.</p>
</div></td>
</tr>
<tr id="CONF-0014">
<td>CONF-0014</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0014">general-requirements.html#claiming-conformance-to-a-us-core-profile</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[To claim conformance to a US Core Profile] a conformant Server:</p>
<p><strong>SHOULD</strong> declare conformance with the US <a href="https://hl7.org/fhir/us/core/CapabilityStatement-us-core-Server.html">Core Server Capability Statement</a> by including its official URL in the Server’s <code>CapabilityStatement.instantiates</code> element: <code>http://hl7.org/fhir/us/core/CapabilityStatement/us-core-Server</code></p>
</div></td>
</tr>
<tr id="CONF-0015">
<td>CONF-0015</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0015">general-requirements.html#claiming-conformance-to-a-us-core-profile</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[To claim conformance to a US Core Profile] a conformant Server:</p>
<p><strong>SHALL</strong> specify the full capability details from the US Core CapabilityStatement it claims to implement.</p>
</div></td>
</tr>
<tr id="CONF-0016">
<td>CONF-0016</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0016">general-requirements.html#claiming-conformance-to-a-us-core-profile</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[To claim conformance to a US Core Profile] a conformant Server:</p>
<p><strong>SHALL</strong>… Declare support for the US Core Profile by including its official URL in the Server’s CapabilityStatement.rest.resource.supportedProfile element.</p>
</div></td>
</tr>
<tr id="CONF-0017">
<td>CONF-0017</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0017">general-requirements.html#claiming-conformance-to-a-us-core-profile</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[To claim conformance to a US Core Profile] a conformant Server:</p>
<p><strong>SHALL</strong>… Declare support for the US Core Profile’s FHIR RESTful transactions.</p>
</div></td>
</tr>
<tr id="CONF-0018">
<td>CONF-0018</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0018">general-requirements.html#required-bindings-for-coded-elements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p><a href="http://hl7.org/fhir/R4/terminologies.html#required">Required binding</a> to a ValueSet definition means that one of the codes from the specified ValueSet <strong>SHALL</strong> be used.</p>
</div></td>
</tr>
<tr id="CONF-0019">
<td>CONF-0019</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0019">general-requirements.html#required-bindings-for-coded-elements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>For <code>CodeableConcept</code>, which permits multiple codings and a text element, this [<a href="http://hl7.org/fhir/R4/terminologies.html#required">Required binding</a> to a ValueSet definition] rule applies to at least one of the codings</p>
</div></td>
</tr>
<tr id="CONF-0020">
<td>CONF-0020</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0020">general-requirements.html#required-bindings-for-coded-elements</a><br/>
</td>
<td style="text-align: center;">SHALL-NOT</td>
<td><div><p>For a [<a href="http://hl7.org/fhir/R4/terminologies.html#required">required binding</a> to a ValueSet definition], a <code>CodeableConcept</code>which permits multiple codings and a text element … [using] only text is not valid.</p>
</div></td>
</tr>
<tr id="CONF-0021">
<td>CONF-0021</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0021">general-requirements.html#required-bindings-for-coded-elements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[When populating a coded element with a [required binding](http://hl7.org/fhir/R4/terminologies.html#required] to a ValueSet definition] US Core Responders <strong>SHALL</strong> provide a code exclusively from [the required binding] ValueSet</p>
</div></td>
</tr>
<tr id="CONF-0023">
<td>CONF-0023</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0023">general-requirements.html#extensible-binding-for-coded-elements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[Extensible binding] (http://hl7.org/fhir/R4/terminologies.html#extensible) means that one of the codes from the specified value set <strong>SHALL</strong> be used when an appropriate concept exists;…</p>
</div></td>
</tr>
<tr id="CONF-0024">
<td>CONF-0024</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0024">general-requirements.html#extensible-binding-for-coded-elements</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>[When using an [extensible Binding] (http://hl7.org/fhir/R4/terminologies.html#extensible)] If no suitable code exists in the [extensible] ValueSet, alternate code(s) <strong>MAY</strong> be used..</p>
</div></td>
</tr>
<tr id="CONF-0026">
<td>CONF-0026</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0026">general-requirements.html#extensible-binding-for-coded-elements</a><br/>
</td>
<td style="text-align: center;">SHOULD-NOT</td>
<td><div><p>For <code>CodeableConcept</code> [with an [extensible binding] (http://hl7.org/fhir/R4/terminologies.html#extensible) … Text-only representation <strong>SHOULD NOT</strong> be used - coded values are expected whenever possible to support interoperability.</p>
</div></td>
</tr>
<tr id="CONF-0027">
<td>CONF-0027</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0027">general-requirements.html#extensible-binding-for-coded-elements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>When claiming conformance to ... [to a US Core profile extensible binding rule, a] US Core Responders Shall provide:
A code from … [the] valueset 'DataElement.code.code' if the concept exists in the valueset [for a DataElement.code that has an extensible binding]
Or an alternative code if the concept does not exist in the valueset [for a DataElement.code that has an extensible binding]
Or text in ... `[DataElement.code.text]’ if only text is available [for a DataElement.code that has an extensible binding]</p>
</div></td>
</tr>
<tr id="CONF-0029">
<td>CONF-0029</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0029">general-requirements.html#translations</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Alternate codes may be provided in addition to the standard codes defined in required or extensible ValueSets. These alternate codes are called "additional codings".</p>
</div></td>
</tr>
<tr id="CONF-0030">
<td>CONF-0030</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0030">general-requirements.html#translations</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>[The additional codings] may be equivalent to or narrower in meaning than the standard concept code.</p>
</div></td>
</tr>
<tr id="CONF-0033">
<td>CONF-0033</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0033">general-requirements.html#modifier-elements</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Not all modifier elements are Mandatory or Must Support, and there is no requirement for supporting them</p>
</div></td>
</tr>
<tr id="CONF-0034">
<td>CONF-0034</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0034">general-requirements.html#modifier-elements</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Servers <strong>MAY</strong> communicate a system-wide profile in their CapabilityStatement to identify which additional elements, including modifier elements, they support</p>
</div></td>
</tr>
<tr id="CONF-0039">
<td>CONF-0039</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0039">general-requirements.html#missing-data</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>If the source system does not have data for an element with a minimum cardinality = 0 (including elements labeled Must Support), the data element <strong>SHALL</strong> be omitted from the resource.</p>
</div></td>
</tr>
<tr id="CONF-0040">
<td>CONF-0040</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0040">general-requirements.html#missing-data</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>If the data element is a Mandatory element (in other words, where the minimum cardinality is > 0), it <strong>SHALL</strong> be present even if the source system does not have data.</p>
</div></td>
</tr>
<tr id="CONF-0041">
<td>CONF-0041</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0041">general-requirements.html#missing-data</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>For [mandatory] non-coded data elements [where data is not available], use the <a href="http://hl7.org/fhir/R4/extension-data-absent-reason.html">DataAbsentReason Extension</a> in the data type ... [with] the code <code>unknown</code> - The value is expected to exist but is not known.</p>
</div></td>
</tr>
<tr id="CONF-0042">
<td>CONF-0042</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0042">general-requirements.html#missing-data</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[In situations where data is not available] for [mandatory] coded data elements … [with] <em>example</em>, <em>preferred</em>, or <em>extensible</em> binding strengths (CodeableConcept or Coding datatypes) If the source system has text but no coded data, only the text element is used.</p>
</div></td>
</tr>
<tr id="CONF-0043">
<td>CONF-0043</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0043">general-requirements.html#missing-data</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[In situations where data is not available] for [mandatory] coded data elements… [with] <em>example</em>, <em>preferred</em>, or <em>extensible</em> binding strengths (CodeableConcept or Coding datatypes):
For Coding datatypes, the text-only data is represented as a display element</p>
</div></td>
</tr>
<tr id="CONF-0044">
<td>CONF-0044</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0044">general-requirements.html#missing-data</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[In situations where data is not available] for [mandatory] coded data elements… [with] <em>example</em>, <em>preferred</em>, or <em>extensible</em> binding strengths (CodeableConcept or Coding datatypes): … If there is neither text nor coded data ... [then] use the appropriate “unknown” concept code from the ValueSet if available.</p>
</div></td>
</tr>
<tr id="CONF-0045">
<td>CONF-0045</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0045">general-requirements.html#missing-data</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[In situations where data is not available] for [mandatory] coded data elements… [with] <em>example</em>, <em>preferred</em>, or <em>extensible</em> binding strengths (CodeableConcept or Coding datatypes): … If there is neither text nor coded data ... [then] if the ValueSet does not have the appropriate “unknown” concept code, use unknown from the <a href="http://hl7.org/fhir/R4/codesystem-data-absent-reason.html">DataAbsentReason Code System</a>.</p>
</div></td>
</tr>
<tr id="CONF-0046">
<td>CONF-0046</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0046">general-requirements.html#missing-data</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[In situations where data is not available] for [mandatory] coded data elements… [with] <em>required</em> binding strength (CodeableConcept or code datatypes): use the appropriate “unknown” concept code from the ValueSet if available</p>
</div></td>
</tr>
<tr id="CONF-0047">
<td>CONF-0047</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0047">general-requirements.html#missing-data</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[In situations where data is not available] for [mandatory] coded data elements… [with] <em>required</em> binding strength (CodeableConcept or code datatypes): If the ValueSet does not have the appropriate “unknown” concept code, you must use a concept from the ValueSet. Otherwise, the instance will not be conformant</p>
</div></td>
</tr>
<tr id="CONF-0048">
<td>CONF-0048</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0048">general-requirements.html#missing-data</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[If the source system does not have data for a Mandatory element for a coded data element with <em>required</em> binding strength] If any of these status codes is missing [meaning it lacks an "unknown" or otherwise appropriate concept code from the ValueSet, a] 404 HTTP error code and an OperationOutcome <strong>SHALL</strong> be returned in response to a read transaction on the resource.</p>
</div></td>
</tr>
<tr id="CONF-0049">
<td>CONF-0049</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0049">general-requirements.html#missing-data</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[If the source system does not have data for a Mandatory element for a coded data element with <em>required</em> binding strength, and the ValueSet does not have the appropriate "unknown" concept code, then] if returning a response to a search, the problematic resource <strong>SHALL</strong> be excluded from the search set</p>
</div></td>
</tr>
<tr id="CONF-0050">
<td>CONF-0050</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0050">general-requirements.html#missing-data</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[If the source system does not have data for a Mandatory element for a coded data element with <em>required</em> binding strength, and the ValueSet does not have the appropriate "unknown" concept code, then] if returning a response to a search, … a <em>warning</em> OperationOutcome <strong>SHOULD</strong> be included indicating that other search results were found but could not be compliantly expressed and have been suppressed.</p>
</div></td>
</tr>
<tr id="CONF-0051">
<td>CONF-0051</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0051">general-requirements.html#fhir-restful-search-api-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The <a href="http://hl7.org/fhir/R4/http.html#search">FHIR RESTful Search API</a> requires that Servers that support search <strong>SHALL</strong> support the HTTP <code>POST</code>-based search.</p>
</div></td>
</tr>
<tr id="CONF-0052">
<td>CONF-0052</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0052">general-requirements.html#fhir-restful-search-api-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>For all the supported search interactions in this guide, Servers <strong>SHALL</strong> also support the <code>GET</code>-based search.</p>
</div></td>
</tr>
<tr id="CONF-0055">
<td>CONF-0055</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0055">general-requirements.html#fhir-restful-search-api-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>When searching using the <code>token</code> type searchparameter <a href="http://hl7.org/fhir/R4/search.html#token">(how to search by token)</a> The Server <strong>SHALL</strong> support both [system and code values]</p>
</div></td>
</tr>
<tr id="CONF-0058">
<td>CONF-0058</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0058">general-requirements.html#fhir-restful-search-api-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>When searching using the <code>reference</code> type searchparameter <a href="http://hl7.org/fhir/R4/search.html#reference">(how to search by reference)</a> The Server <strong>SHALL</strong> support both [id and Type values]</p>
</div></td>
</tr>
<tr id="CONF-0061">
<td>CONF-0061</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0061">general-requirements.html#fhir-restful-search-api-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>When searching using the <code>date</code> type searchparameter <a href="http://hl7.org/fhir/R4/search.html#date">(how to search by date)</a> The Server <strong>SHALL</strong> support values precise to the day for elements of datatype <code>date</code></p>
</div></td>
</tr>
<tr id="CONF-0062">
<td>CONF-0062</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0062">general-requirements.html#fhir-restful-search-api-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>When searching using the <code>date</code> type searchparameter <a href="http://hl7.org/fhir/R4/search.html#date">(how to search by date)</a> The Server <strong>SHALL</strong> support values precise … to the second + time offset for elements of <code>datatype</code> dateTime</p>
</div></td>
</tr>
<tr id="CONF-0063">
<td>CONF-0063</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0063">general-requirements.html#search-for-Servers-requiring-status</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Servers are strongly encouraged to support a query for resources without requiring a status parameter.</p>
</div></td>
</tr>
<tr id="CONF-0064">
<td>CONF-0064</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0064">general-requirements.html#search-for-Servers-requiring-status</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>If business requirements prohibit [querying a resource without a status parameter], they <strong>SHALL</strong> follow the guidelines here.</p>
</div></td>
</tr>
<tr id="CONF-0065">
<td>CONF-0065</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0065">general-requirements.html#search-for-Servers-requiring-status</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>For searches where the Client does not supply a status parameter, an implementation’s business rules may override the FHIR RESTful search expectations and require a status parameter to be provided</p>
</div></td>
</tr>
<tr id="CONF-0066">
<td>CONF-0066</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0066">general-requirements.html#search-for-Servers-requiring-status</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>For searches where the Client does not supply a status parameter, … systems [that require a status parameter to be provided] are allowed to reject such requests as follows:</p>
<p><strong>SHALL</strong> return an HTTP 400 status</p>
</div></td>
</tr>
<tr id="CONF-0067">
<td>CONF-0067</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0067">general-requirements.html#search-for-Servers-requiring-status</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>For searches where the Client does not supply a status parameter, … systems [that require a status parameter to be provided] are allowed to reject such requests as follows:</p>
<p><strong>SHALL</strong> return an <a href="http://hl7.org/fhir/R4/operationoutcome.html">OperationOutcome</a> specifying that status(es) must be present.</p>
</div></td>
</tr>
<tr id="CONF-0068">
<td>CONF-0068</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0068">general-requirements.html#search-for-Servers-requiring-status</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>For searches where the Client does not supply a status parameter, … systems [that require a status parameter to be provided] are allowed to reject such requests as follows:</p>
<p><strong>SHALL</strong> support search with status if status required</p>
</div></td>
</tr>
<tr id="CONF-0069">
<td>CONF-0069</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0069">general-requirements.html#search-for-Servers-requiring-status</a><br/>
</td>
<td style="text-align: center;">SHALL-NOT</td>
<td><div><p><strong>SHALL NOT</strong> restrict search results ( i.e., apply ‘hidden’ filters) when a Client includes status parameters in the query.</p>
</div></td>
</tr>
<tr id="CONF-0070">
<td>CONF-0070</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0070">general-requirements.html#search-for-Servers-requiring-status</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[For systems that require a status parameter to be provided,] if a system doesn’t support a specific status code value that is queried, it <strong>SHOULD</strong> return an HTTP 200 status with a search bundle.</p>
</div></td>
</tr>
<tr id="CONF-0071">
<td>CONF-0071</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0071">general-requirements.html#search-for-Servers-requiring-status</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[For systems that require a status parameter to be provided,] if a system doesn’t support a specific status code value that is queried [and returns a search bundle],... [t]he search bundle <strong>SHOULD</strong> contain resources matching the search criteria</p>
</div></td>
</tr>
<tr id="CONF-0072">
<td>CONF-0072</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0072">general-requirements.html#search-for-Servers-requiring-status</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[For systems that require a status parameter to be provided,] if a system doesn’t support a specific status code value that is queried [and returns a search bundle],... [t]he search bundle <strong>SHOULD</strong> contain ... an OperationOutcome warning the Client which status code value is not supported.</p>
</div></td>
</tr>
<tr id="CONF-0073">
<td>CONF-0073</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0073">general-requirements.html#search-for-Servers-requiring-status</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>For searches where the Client does not supply a status parameter, … systems [that require a status parameter to be provided] are allowed to reject such requests as follows:...</p>
<p><strong>SHALL</strong> document this behavior in its CapabilityStatement for the “search-type” interaction in <code>CapabilityStatement.rest.resource.interaction.documentation.</code></p>
</div></td>
</tr>
<tr id="CONF-0074">
<td>CONF-0074</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0074">must-support.html#must-support-elements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>When an element is Mandatory, the data is expected always to be present.</p>
</div></td>
</tr>
<tr id="CONF-0075">
<td>CONF-0075</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0075">must-support.html#must-support-elements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>For querying and reading US Core Profiles, Must Support on any profile data element <strong>SHALL</strong> be interpreted as follows…:</p>
<p>US Core Responders <strong>SHALL</strong> be capable of populating all data elements as part of the query results specified by the <a href="https://hl7.org/fhir/us/core/STU8/CapabilityStatement-us-core-Server.html">US Core Server Capability Statement</a>.</p>
</div></td>
</tr>
<tr id="CONF-0078">
<td>CONF-0078</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0078">must-support.html#must-support-elements</a><br/>
</td>
<td style="text-align: center;">SHALL-NOT</td>
<td><div><p><strong>SHALL NOT</strong> include the data elements in the resource instance returned as part of the query results.</p>
</div></td>
</tr>
<tr id="CONF-0080">
<td>CONF-0080</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0080">must-support.html#must-support-el+D647ements</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>For querying and reading US Core Profiles, Must Support on any profile data element <strong>SHALL</strong> be interpreted as follows…:</p>
<p>In cases where information on a specific data element is missing, and the US Core Responder knows the precise reason for the absence of data (other than suppressed data), US Core Responders <strong>SHOULD</strong> send the reason for the missing information.</p>
</div></td>
</tr>
<tr id="CONF-0081">
<td>CONF-0081</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0081">must-support.html#must-support-elements</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[When sending reason for missing information, follow] the same methdology outlined in the <a href="https://hl7.org/fhir/us/core/STU8/general-requirements.html#missing-data">Missing Data</a> section but using the appropriate reason code instead of unknown [reason code].</p>
</div></td>
</tr>
<tr id="CONF-0084">
<td>CONF-0084</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0084">must-support.html#additional-uscdi-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Implementors [US Core Responders] seeking ONC certification [in the ONC IT Health Certification program] <strong>SHALL</strong> interpret Additional USCDI Requirements as Must Support elements as documented above and below;</p>
</div></td>
</tr>
<tr id="CONF-0086">
<td>CONF-0086</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0086">must-support.html#additional-uscdi-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Implementors [US Core Responders] [not] seeking ONC certification [in the ONC IT Health Certification program] <strong>SHALL</strong> interpret Additional USCDI Requirements as … optional.</p>
</div></td>
</tr>
<tr id="CONF-0087">
<td>CONF-0087</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0087">must-support.html#defined-pattern-elements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>If an element is marked as Must Support and defined by a pattern [as described by <a href="http://hl7.org/fhir/R4/elementdefinition-definitions.html#ElementDefinition.pattern_x_">ElementDefinition.pattern</a>], then the pattern defines the elements and element values that the Server <strong>SHALL</strong> be capable of providing.</p>
</div></td>
</tr>
<tr id="CONF-0090">
<td>CONF-0090</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0090">must-support.html#must-support---primitive-elements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Primitive elements are single elements with a primitive value. If they are marked as Must Support, then the Server <strong>SHALL</strong> be capable of providing the element value to meet the Must Support requirement.</p>
</div></td>
</tr>
<tr id="CONF-0091">
<td>CONF-0091</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0091">must-support.html#must-support---primitive-elements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[W]hen claiming conformance [to a profile with a must support primitive element] … US Core responders <strong>SHALL</strong> be capable of providing the value [of the primitive element]</p>
</div></td>
</tr>
<tr id="CONF-0093">
<td>CONF-0093</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0093">must-support.html#must-support---complex-elements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>For any complex element marked as Must Support, the Server <strong>SHALL</strong> be capable of providing at least one of the sub-element values.</p>
</div></td>
</tr>
<tr id="CONF-0094">
<td>CONF-0094</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0094">must-support.html#must-support---complex-elements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>If any sub-element is marked as Must Support [for a complex element], it must also meet the Must Support requirements and satisfy the Must Support requirements for the parent element.</p>
</div></td>
</tr>
<tr id="CONF-0095">
<td>CONF-0095</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0095">must-support.html#must-support---complex-elements</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>[I]f any sub-element is marked as Must Support or Additional USCDI [for a complex element] and the parent element is not, there is no expectation that you must support the parent.</p>
</div></td>
</tr>
<tr id="CONF-0096">
<td>CONF-0096</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0096">must-support.html#must-support---complex-elements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[I]f any sub-element is marked as Must Support [for a complex element] and the parent element is not… [and] the parent element is represented in the structure, Servers <strong>SHALL</strong> support the sub-element(s) marked as Must Support.</p>
</div></td>
</tr>
<tr id="CONF-0097">
<td>CONF-0097</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0097">must-support.html#must-support---complex-elements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>When claiming conformance [to a must support complex element with no must support sub-elements] … US Core Responders <strong>SHALL</strong> be capable of providing a value in [the] sub-element</p>
</div></td>
</tr>
<tr id="CONF-0099">
<td>CONF-0099</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0099">must-support.html#must-support---complex-elements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>When claiming conformance [to a must support complex element with one or more must support sub-elements] … US Core Responders <strong>SHALL</strong> be capable of providing a value in [each must support sub-element]</p>
</div></td>
</tr>
<tr id="CONF-0101">
<td>CONF-0101</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0101">must-support.html#must-support---complex-elements</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Systems [US Core Responders] can support the other elements [of a complex element, not labeled as a Must Support], but this is not a requirement of US Core</p>
</div></td>
</tr>
<tr id="CONF-0103">
<td>CONF-0103</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0103">must-support.html#must-support---complex-elements</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>The U.S. Core Data for Interoperability (USCDI) may require additional elements, [which is a requirement for certification in the ONC IT Health Certification program, but not a requirement of US Core conformance for US Core Responders]</p>
</div></td>
</tr>
<tr id="CONF-0105">
<td>CONF-0105</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0105">must-support.html#must-support---resource-references</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>In certain profiles, only specific resource references are labeled as Must Support.</p>
<p>...</p>
<ul>
<li>US Core Responders <strong>SHALL</strong> be capable of providing [such an element] with a valid reference to [all listed Must Support profile(s).]</li>
</ul>
</div></td>
</tr>
<tr id="CONF-0107">
<td>CONF-0107</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0107">must-support.html#must-support---resource-references</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Systems [US Core Responders] can support other [resource] references [other than those labeled as Must Support], but this is not a requirement of US Core</p>
</div></td>
</tr>
<tr id="CONF-0109">
<td>CONF-0109</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0109">must-support.html#must-support---resource-references</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>In specific profiles, only a single resource reference is present on an element labeled Must Support.</p>
<p>...</p>
<ul>
<li>US Core Responders <strong>SHALL</strong> be capable of providing [such an element] with a valid reference to [the Must Support Profile.]</li>
</ul>
</div></td>
</tr>
<tr id="CONF-0111">
<td>CONF-0111</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0111">must-support.html#must-support---choice-of-data-types</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[If a profile has] a Must Support element [with] a choice of datatypes for its content [and some of] the datatypes … are labeled as Must Support
… When claiming conformance to [such a] profile:</p>
<ul>
<li>US Core Responders <strong>SHALL</strong> be capable of populating [the Must Support data type choice]</li>
</ul>
</div></td>
</tr>
<tr id="CONF-0114">
<td>CONF-0114</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0114">must-support.html#must-support---choice-of-data-types</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>[If a profile has] a Must Support element [with] a choice of datatypes for its content [and some of] the datatypes … are labeled as Must Support[, or a profile has] an Additional USCDI element [with] a choice of datatypes for its content [and some of] the datatypes … are labeled as Additional USCDI</p>
<p>…</p>
<p>[US Core Responders] <strong>MAY</strong> support populating ... other [data type] choice elements (such as Observation.effectivePeriod), but this is not a requirement of US Core.</p>
</div></td>
</tr>
<tr id="CONF-0115">
<td>CONF-0115</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0115">must-support.html#must-support---choice-of-profile-elements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>There are several instances in this Guide where there is a choice of supporting one or another profile element to meet the Must Support or Additional USCDI requirement. In such cases, the Server or Certifying System <strong>SHALL</strong> support at least one element.</p>
</div></td>
</tr>
<tr id="CONF-0117">
<td>CONF-0117</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0117">scopes.html#capability-sets</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>An individual SMART Server will publish a granular list of its capabilities, and a set of these capabilities is combined to support a specific use, a Capability Set. See SMART App Launch’s <a href="http://hl7.org/fhir/smart-app-launch/STU2/conformance.html#smart-on-fhir-oauth-authorization-endpoints-and-capabilities">FHIR OAuth authorization Endpoints and Capabilities</a> for more details. Servers <strong>MAY</strong> support ... [any] SMART on FHIR Capability Sets and capabilities [(see <a href="http://hl7.org/fhir/smart-app-launch/STU2/conformance.html#smart-on-fhir-oauth-authorization-endpoints-and-capabilities">FHIR OAuth authorization Endpoints and Capabilities</a>)]</p>
</div></td>
</tr>
<tr id="CONF-0118">
<td>CONF-0118</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0118">scopes.html#capabilities-for-implementations-supporting-user-facing-applications</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>At least one of the following SMART on FHIR Capability Sets <strong>SHOULD</strong> be supported for US Core Servers that support User-Facing Applications ...
<a href="http://hl7.org/fhir/smart-app-launch/STU2/conformance.html#patient-access-for-standalone-apps">Patient Access Standalone Apps</a>
<a href="http://hl7.org/fhir/smart-app-launch/STU2/conformance.html#clinician-access-for-standalone">Clinician Access for EHR Launch</a></p>
</div></td>
</tr>
<tr id="CONF-0119">
<td>CONF-0119</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0119">scopes.html#capabilities-for-implementations-supporting-user-facing-applications</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>For certified systems[, those participating in the ONC IT Health Certification program], both <strong>SHALL</strong> be supported:
<a href="http://hl7.org/fhir/smart-app-launch/STU2/conformance.html#patient-access-for-standalone-apps">Patient Access Standalone Apps</a>
<a href="http://hl7.org/fhir/smart-app-launch/STU2/conformance.html#clinician-access-for-standalone">Clinician Access for EHR Launch</a></p>
</div></td>
</tr>
<tr id="CONF-0120">
<td>CONF-0120</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0120">scopes.html#capabilities-for-implementations-supporting-backend-services</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Implementations [US Core Responders] supporting Backend Services ... <strong>SHALL</strong> include support for the Client-confidential-asymmetric capability.</p>
</div></td>
</tr>
<tr id="CONF-0121">
<td>CONF-0121</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0121">scopes.html#capabilities-for-implementations-supporting-backend-services</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Implementations [US Core Responders] supporting Backend Services ... <strong>SHALL</strong> include support for the ... system/scopes.</p>
</div></td>
</tr>
<tr id="CONF-0123">
<td>CONF-0123</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0123">scopes.html#us-core-Servers-shall-support-token-introspection</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>US Core Server[s] <strong>SHALL</strong> support token introspection defined by the SMART App Launch Guide. For more details and additional consideration, see SMART App Launch’s <a href="http://hl7.org/fhir/smart-app-launch/STU2/token-introspection.html#token-introspection">Token Introspection</a>.</p>
</div></td>
</tr>
<tr id="CONF-0125">
<td>CONF-0125</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0125">scopes.html#smart-scopes</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Other systems only need to support scopes for the US Core APIs they support [instead of all US Core's required scopes]</p>
</div></td>
</tr>
<tr id="CONF-0126">
<td>CONF-0126</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0126">scopes.html#smart-scopes</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Servers <strong>MAY</strong> support other scopes in addition to those listed below and in the Quick Start sections.</p>
</div></td>
</tr>
<tr id="CONF-0128">
<td>CONF-0128</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0128">scopes.html#us-core-scopes</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>For “User-Facing Applications”, a system’s support for patient-level (patient) or user-level (user) scopes depends on its published list of SMART on FHIR capabilities (see the <a href="https://hl7.org/fhir/us/core/STU8/scopes.html#capability-sets">capability sets</a> above). For example, if a Server lists permission-patient and permission-user in its capabilities, it <strong>SHALL</strong> support both patient-level and user-level required scopes</p>
</div></td>
</tr>
<tr id="CONF-0129">
<td>CONF-0129</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0129">scopes.html#us-core-scopes</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>For “User-Facing Applications”, a system’s support for patient-level (patient) or user-level (user) scopes depends on its published list of SMART on FHIR capabilities (see the <a href="https://hl7.org/fhir/us/core/STU8/scopes.html#capability-sets">capability sets</a> above). For example, if a Server lists permission-patient and permission-user in its capabilities, it ... <strong>SHOULD</strong> support both patient-level and user-level recommended best-practice scopes</p>
</div></td>
</tr>
<tr id="CONF-0130">
<td>CONF-0130</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0130">scopes.html#us-core-scopes</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>For “Backend-Services”, System-level scopes (system) describe data that a Client system is directly authorized to access. Systems that support system-level (system) scopes <strong>SHALL</strong> support the required US Core scopes</p>
</div></td>
</tr>
<tr id="CONF-0131">
<td>CONF-0131</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0131">scopes.html#us-core-scopes</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>For “Backend-Services”, System-level scopes (system) describe data that a Client system is directly authorized to access. Systems that support system-level (system) scopes <strong>SHOULD</strong> support the recommended US Core scopes</p>
</div></td>
</tr>
<tr id="CONF-0132">
<td>CONF-0132</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0132">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-allergyintolerance.html#CONF-0132">StructureDefinition-us-core-allergyintolerance.html#us-core-scopes</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] AllergyIntolerance [the] <patient|user|system>/AllergyIntolerance.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0133">
<td>CONF-0133</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0133">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] CarePlan [the] <patient|user|system>/CarePlan.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0134">
<td>CONF-0134</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0134">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] CareTeam [the] <patient|user|system>/CareTeam.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0135">
<td>CONF-0135</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0135">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] Condition [the] <patient|user|system>/Condition.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0136">
<td>CONF-0136</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0136">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] Coverage [the] <patient|user|system>/Coverage.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0137">
<td>CONF-0137</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0137">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] Device [the] <patient|user|system>/Device.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0138">
<td>CONF-0138</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0138">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] DiagnosticReport [the] <patient|user|system>/DiagnosticReport.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0139">
<td>CONF-0139</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0139">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] DocumentReference [the] <patient|user|system>/DocumentReference.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0140">
<td>CONF-0140</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0140">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] Encounter [the] <patient|user|system>/Encounter.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0141">
<td>CONF-0141</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0141">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] Goal [the] <patient|user|system>/Goal.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0142">
<td>CONF-0142</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0142">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] Immunization [the] <patient|user|system>/Immunization.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0143">
<td>CONF-0143</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0143">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] MedicationDispense [the] <patient|user|system>/MedicationDispense.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0144">
<td>CONF-0144</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0144">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] MedicationRequest [the] <patient|user|system>/MedicationRequest.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0145">
<td>CONF-0145</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0145">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] Observation [the] <patient|user|system>/Observation.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0146">
<td>CONF-0146</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0146">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] Organization [the] <patient|user|system>/Organization.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0147">
<td>CONF-0147</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0147">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] Patient [the] <patient|user|system>/Patient.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0148">
<td>CONF-0148</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0148">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] Practitioner [the] <patient|user|system>/Practitioner.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0149">
<td>CONF-0149</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0149">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] PractitionerRole [the] <patient|user|system>/PractitionerRole.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0150">
<td>CONF-0150</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0150">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] Procedure [the] <patient|user|system>/Procedure.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0151">
<td>CONF-0151</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0151">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] Provenance [the] <patient|user|system>/Provenance.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0152">
<td>CONF-0152</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0152">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] QuestionnaireResponse [the] <patient|user|system>/QuestionnaireResponse.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0153">
<td>CONF-0153</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0153">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] RelatedPerson [the] <patient|user|system>/RelatedPerson.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0154">
<td>CONF-0154</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0154">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] ServiceRequest [the] <patient|user|system>/ServiceRequest.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0155">
<td>CONF-0155</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0155">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>SHALL</strong> be supported
...
[For] Specimen [the] <patient|user|system>/Specimen.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0156">
<td>CONF-0156</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0156">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>MAY</strong> be supported
...
[For] Location [the] <patient|user|system>/Location.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0157">
<td>CONF-0157</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0157">scopes.html#scopes-for-requesting-fhir-resources-by-type</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>The following scopes that correspond directly to FHIR resource types <strong>MAY</strong> be supported
...
[For] Medication [the] <patient|user|system>/Medication.rs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0158">
<td>CONF-0158</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0158">scopes.html#granular-scopes-for-requesting-fhir-resources</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following granular scopes <strong>SHALL</strong> be supported
...
[For] Condition [the] <patient|user|system>/Condition.rs?category=http://hl7.org/fhir/us/core/CodeSystem/condition-category|health-concern [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0159">
<td>CONF-0159</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0159">scopes.html#granular-scopes-for-requesting-fhir-resources</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following granular scopes <strong>SHALL</strong> be supported
...
[For] Condition [the] <patient|user|system>/Condition.rs?category=http://terminology.hl7.org/CodeSystem/condition-category|encounter-diagnosis [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0160">
<td>CONF-0160</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0160">scopes.html#granular-scopes-for-requesting-fhir-resources</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following granular scopes <strong>SHALL</strong> be supported
...
[For] Condition [the] <patient|user|system>/Condition.rs?category=http://terminology.hl7.org/CodeSystem/condition-category|problem-list-item [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0161">
<td>CONF-0161</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0161">scopes.html#granular-scopes-for-requesting-fhir-resources</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following granular scopes <strong>SHALL</strong> be supported
...
[For] Observation [the] <patient|user|system>/Observation.rs?category=http://hl7.org/fhir/us/core/CodeSystem/us-core-category|sdoh [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0162">
<td>CONF-0162</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0162">scopes.html#granular-scopes-for-requesting-fhir-resources</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following granular scopes <strong>SHALL</strong> be supported
...
[For] Observation [the] <patient|user|system>/Observation.rs?category=http://terminology.hl7.org//CodeSystem-observation-category|social-history [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0163">
<td>CONF-0163</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0163">scopes.html#granular-scopes-for-requesting-fhir-resources</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following granular scopes <strong>SHALL</strong> be supported
...
[For] Observation [the] <patient|user|system>/Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0164">
<td>CONF-0164</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0164">scopes.html#granular-scopes-for-requesting-fhir-resources</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following granular scopes <strong>SHALL</strong> be supported
...
[For] Observation [the] <patient|user|system>/Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|survey [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0165">
<td>CONF-0165</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0165">scopes.html#granular-scopes-for-requesting-fhir-resources</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The following granular scopes <strong>SHALL</strong> be supported
...
[For] Observation [the] <patient|user|system>/Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0166">
<td>CONF-0166</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0166">scopes.html#granular-scopes-for-requesting-fhir-resources</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The following granular scopes <strong>SHOULD</strong> be supported
...
[For] DocumentReference [the] <patient|user|system>/DocumentReference.rs?category=http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category|clinical-note [see <a href="https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax">SMART Clinical Scope Syntax</a> for details on clinical data scopes]</p>
</div></td>
</tr>
<tr id="CONF-0167">
<td>CONF-0167</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0167">scopes.html#Servers-shall-support-the-following-metadata-in-their-well-knownsmart-configuration</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>In addition to the capabilities defined in the Server’s CapabilityStatement, Servers <strong>SHALL</strong> document their SMART capabilities in their <a href="https://hl7.org/fhir/smart-app-launch/STU2/conformance.html#using-well-known">Well-Known Uniform Resource Identifiers (URIs)</a> JSON file.</p>
</div></td>
</tr>
<tr id="CONF-0168">
<td>CONF-0168</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0168">scopes.html#additional-us-core-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>US Core requires ... additional metadata [to be available through the Server's <a href="https://hl7.org/fhir/smart-app-launch/STU2/conformance.html#using-well-known">Well-Known Uniform Resource Identifier (URI)</a>]: ... [in] <code>scopes_supported</code> [the] array of scopes a Client may request.... The Server <strong>SHALL</strong> list all the required US Core Scopes for the US Core Profiles they support in the scopes_supported array</p>
</div></td>
</tr>
<tr id="CONF-0169">
<td>CONF-0169</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0169">scopes.html#additional-us-core-requirements</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>US Core requires ... additional metadata [to be available through the Server's <a href="https://hl7.org/fhir/smart-app-launch/STU2/conformance.html#using-well-known">Well-Known Uniform Resource Identifier (URI)</a>]: ... [in] <code>scopes_supported</code> [the] array of scopes a Client may request. The Server [MAY support] additional scopes (so Clients should not consider … [the required scopes] an exhaustive list).</p>
</div></td>
</tr>
<tr id="CONF-0170">
<td>CONF-0170</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0170">scopes.html#additional-us-core-requirements</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>US Core requires ... additional metadata [to be available through the Server's <a href="https://hl7.org/fhir/smart-app-launch/STU2/conformance.html#using-well-known">Well-Known Uniform Resource Identifier (URI)</a>]: ... [in] <code>scopes_supported</code> [the] array of scopes a Client may request. Servers <strong>MAY</strong> limit Clients’ scopes to those configured at registration time.</p>
</div></td>
</tr>
<tr id="CONF-0171">
<td>CONF-0171</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0171">scopes.html#additional-us-core-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>US Core requires ... additional metadata [to be available through the Server's <a href="https://hl7.org/fhir/smart-app-launch/STU2/conformance.html#using-well-known">Well-Known Uniform Resource Identifier (URI)</a>]: ... [in] <code>scopes_supported</code> [the] array of scopes a Client may request. … Servers <strong>SHALL</strong> allow users to select a subset of the requested scopes at the approval time.</p>
</div></td>
</tr>
<tr id="CONF-0173">
<td>CONF-0173</td>
<td>
<span style="color: grey;">•</span><a href="scopes.html#CONF-0173">scopes.html#additional-us-core-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>US Core requires ... additional metadata [to be available through the Server's <a href="https://hl7.org/fhir/smart-app-launch/STU2/conformance.html#using-well-known">Well-Known Uniform Resource Identifier (URI)</a>]: ... [in] <code>introspection_endpoint</code> the URL to a Server’s introspection endpoint. ... Servers <strong>SHALL</strong> document this endpoint in the file</p>
</div></td>
</tr>
<tr id="CONF-0174">
<td>CONF-0174</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0174">general-guidance.html#referencing-us-core-profiles</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Therefore, a <a href="http://hl7.org/fhir/R4/references.html">reference</a> to a US Core resource <strong>SHOULD</strong> include a logical id (Reference.reference), not an identifier (Reference.identifier).</p>
</div></td>
</tr>
<tr id="CONF-0175">
<td>CONF-0175</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0175">general-guidance.html#referencing-us-core-profiles</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>For all references, US Core Responders <strong>SHOULD</strong> return resources that conform to a US Core profile if a US Core profile exists for the resource type.</p>
</div></td>
</tr>
<tr id="CONF-0176">
<td>CONF-0176</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0176">general-guidance.html#contained-resources</a><br/>
</td>
<td style="text-align: center;">SHOULD-NOT</td>
<td><div><p>When responding to a query, Servers <strong>SHOULD</strong> not use inline <a href="http://hl7.org/fhir/R4/references.html#contained">contained</a> resources to represent the returned data.</p>
</div></td>
</tr>
<tr id="CONF-0177">
<td>CONF-0177</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0177">general-guidance.html#contained-resources</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[I]f referencing a contained resource in a US Core Profile, the contained resource <strong>SHOULD</strong> be a US Core Profile if a US Core Profile exists for the resource type.</p>
</div></td>
</tr>
<tr id="CONF-0178">
<td>CONF-0178</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0178">general-guidance.html#contained-resources</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[M]asking data [where a specific piece of data is hidden for security and privacy reasons] <strong>SHOULD</strong> be handled based on implemented policies.</p>
</div></td>
</tr>
<tr id="CONF-0179">
<td>CONF-0179</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0179">general-guidance.html#contained-resources</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[When masking data] elements with a minimum cardinality = 0 (including elements labeled Must Support) [for security and privacy reasons], the element <strong>SHOULD</strong> be omitted from the resource.</p>
</div></td>
</tr>
<tr id="CONF-0180">
<td>CONF-0180</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0180">general-guidance.html#contained-resources</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[When masking] Mandatory elements (in other words, where the minimum cardinality is > 0) [for security and privacy reasons, use the code “unknown” following the guidance on Missing Data in the Conformance Sections.</p>
</div></td>
</tr>
<tr id="CONF-0181">
<td>CONF-0181</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0181">general-guidance.html#snomed-ct-united-states-edition</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>[When using SNOMED codes in US Core Profiles I]mplementers <strong>MAY</strong> use the default system URI [of <a href="http://snomed.info/sct">SNOMED CT</a>], which refers to an unspecified edition/version [of SNOMED]</p>
</div></td>
</tr>
<tr id="CONF-0182">
<td>CONF-0182</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0182">general-guidance.html#snomed-ct-united-states-edition</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[To enable] terminology Servers to be able to validate US Edition-only codes [of <a href="http://snomed.info/sct">SNOMED CT</a>], implementers <strong>SHOULD</strong> provide the accompanying system URI to describe the edition [see example 2 on <a href="https://hl7.org/fhir/us/core/STU8/general-guidance.html#snomed-ct-united-states-edition">US Core general guidance</a>]</p>
</div></td>
</tr>
<tr id="CONF-0183">
<td>CONF-0183</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0183">general-guidance.html#using-ucum-codes-in-the-quantity-datatype</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[If a] US Core Profiles binds the Quantity.code element in the Quantity datatype to the <a href="http://unitsofmeasure.org/">UCUM</a> code system, [then] systems should also use UCUM for the optional valueRange and valueRatio datatypes (which are complex datatypes with Quantity elements)</p>
</div></td>
</tr>
<tr id="CONF-0184">
<td>CONF-0184</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0184">general-guidance.html#using-ucum-codes-in-the-quantity-datatype</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[If a] US Core Profiles binds the Quantity.code element in the Quantity datatype to the <a href="http://unitsofmeasure.org/">UCUM</a> code system, [when] UCUM code [is] provided [it <strong>SHOULD</strong> be indicated in the Quantity.unit and Quantity.code elements with Quantity.system = "http://unitsofmeasure.org"]</p>
</div></td>
</tr>
<tr id="CONF-0185">
<td>CONF-0185</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0185">general-guidance.html#using-ucum-codes-in-the-quantity-datatype</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[If a] US Core Profiles binds the Quantity.code element in the Quantity datatype to the <a href="http://unitsofmeasure.org/">UCUM</a> code system, [then] if UCUM units are unavailable, represent units in the unit element</p>
</div></td>
</tr>
<tr id="CONF-0186">
<td>CONF-0186</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0186">general-guidance.html#using-ucum-codes-in-the-quantity-datatype</a><br/>
</td>
<td style="text-align: center;">SHOULD-NOT</td>
<td><div><p><strong>SHOULD NOT</strong> supply the unit field]</p>
</div></td>
</tr>
<tr id="CONF-0187">
<td>CONF-0187</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0187">general-guidance.html#representing-deleted-and-entered-in-error-information</a><br/>
</td>
<td style="text-align: center;">SHOULD-NOT</td>
<td><div><p>A FHIR Server <strong>SHOULD</strong> not delete records.</p>
</div></td>
</tr>
<tr id="CONF-0188">
<td>CONF-0188</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0188">general-guidance.html#representing-deleted-and-entered-in-error-information</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>A FHIR Server <strong>SHOULD</strong> update the appropriate resource status to entered-in-error or inactive [when requested to delete records]</p>
</div></td>
</tr>
<tr id="CONF-0189">
<td>CONF-0189</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0189">general-guidance.html#representing-deleted-and-entered-in-error-information</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>If a system supports the deletion of records, they <strong>SHOULD</strong> refer to the <a href="http://hl7.org/fhir/R4/safety.html#conformance">Deletion Safety Checks</a> in the FHIR specification.</p>
</div></td>
</tr>
<tr id="CONF-0190">
<td>CONF-0190</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0190">general-guidance.html#representing-deleted-and-entered-in-error-information</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>A FHIR Server <strong>SHOULD</strong> allow these resources [those entered in error] to be searchable by Client applications.</p>
</div></td>
</tr>
<tr id="CONF-0191">
<td>CONF-0191</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0191">general-guidance.html#representing-deleted-and-entered-in-error-information</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>If the FHIR Server has updated the resource status to entered-in-error:
For patient facing applications, A FHIR Server <strong>SHOULD</strong> remove the resource’s contents, leaving only an id and status. Note that this typically will not conform to the US Core or FHIR StructureDefinitions.</p>
</div></td>
</tr>
<tr id="CONF-0192">
<td>CONF-0192</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0192">general-guidance.html#representing-deleted-and-entered-in-error-information</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>If the FHIR Server has updated the resource status to entered-in-error:
...
For provider-facing applications, the content may be supplied with content and additional detail (such as the reason for the status change) that the patient viewing system would typically not have access to.</p>
</div></td>
</tr>
<tr id="CONF-0193">
<td>CONF-0193</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0193">general-guidance.html#language-support</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>the data provider <strong>SHOULD</strong> do their best to translate (safely) to the requested language [when accessing records in a native or requested language]</p>
</div></td>
</tr>
<tr id="CONF-0195">
<td>CONF-0195</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0195">general-guidance.html#language-support</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[When Clients request a resource in a specific language] Servers <strong>SHOULD</strong> make reasonable efforts to translate what can be safely translated.</p>
</div></td>
</tr>
<tr id="CONF-0196">
<td>CONF-0196</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0196">general-guidance.html#language-support</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[When Clients request a resource in a specific language] Servers <strong>SHOULD</strong> populate the Resource’s language element with a code based on the underlying language of record, not the requested language.</p>
</div></td>
</tr>
<tr id="CONF-0197">
<td>CONF-0197</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0197">general-guidance.html#language-support</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[When Clients request a resource in a specific language] Servers <strong>SHOULD</strong> … [use] the <a href="http://hl7.org/fhir/R4/extension-language.html">Human Language</a> Extension when the language of a display, etc, is known to differ from the stated (or inferred) language.</p>
</div></td>
</tr>
<tr id="CONF-0198">
<td>CONF-0198</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0198">general-guidance.html#language-support</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[When Clients request a resource in a specific language] [Servers <strong>SHOULD</strong> use] the <a href="http://hl7.org/fhir/R4/extension-translation.html">Translation</a> Extension when the Server provides additional translations by its own choice or in response to a different Accept-Language than what the resource is stored in.</p>
</div></td>
</tr>
<tr id="CONF-0199">
<td>CONF-0199</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0199">general-guidance.html#language-support</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[When Clients request a resource in a specific language] Servers <strong>SHOULD</strong> make it known what languages are supported in their CapabilityStatement(s) using this extension:
http://hl7.org/fhir/5.0/StructureDefinition/extension-CapablilityStatement.acceptLanguage [<a href="https://hl7.org/fhir/R5/capabilitystatement-definitions.html#CapabilityStatement.acceptLanguage">definition</a>]</p>
</div></td>
</tr>
<tr id="CONF-0200">
<td>CONF-0200</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0200">general-guidance.html#searching-using-lastupdated</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Servers <strong>SHOULD</strong> support the <a href="http://hl7.org/fhir/R4/search.html#lastUpdated">_lastUpdated</a> search parameter for US Core Profiles</p>
</div></td>
</tr>
<tr id="CONF-0201">
<td>CONF-0201</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0201">general-guidance.html#searching-using-lastupdated</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Servers ... <strong>SHOULD</strong> populate <a href="http://hl7.org/fhir/R4/resource.html#Meta">Resource.meta.lastUpdated</a> for US Core Profiles as accurately as possible.</p>
</div></td>
</tr>
<tr id="CONF-0202">
<td>CONF-0202</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0202">general-guidance.html#searching-using-lastupdated</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers <strong>SHALL</strong> document in CapabilityStatement.rest.resource.searchParam.documentation the types of changes that can be detected using the _lastUpdated search parameter</p>
</div></td>
</tr>
<tr id="CONF-0203">
<td>CONF-0203</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0203">general-guidance.html#compartment-based-search</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>US Core Servers [MAY support compartment based searchs, but] are not required to support patient <a href="http://hl7.org/fhir/R4/compartmentdefinition.html">compartment</a> based searches.</p>
</div></td>
</tr>
<tr id="CONF-0204">
<td>CONF-0204</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0204">general-guidance.html#across-platform-searches</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>US Core Servers [MAY resolve absolute URLs, but] are not required to resolve absolute URLs external to their environment.</p>
</div></td>
</tr>
<tr id="CONF-0205">
<td>CONF-0205</td>
<td>
<span style="color: grey;">•</span><a href="general-guidance.html#CONF-0205">general-guidance.html#limiting-the-number-of-search-results</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Servers can [MAY] choose to return the results in a series of pages to manage the number of search results returned.</p>
</div></td>
</tr>
<tr id="CONF-0206">
<td>CONF-0206</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0206">clinical-notes.html#clinical-notes</a><br/>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0206">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers <strong>SHALL</strong> support, at minimum, these … "Common Clinical Notes":
<a href="https://loinc.org/11488-4.html">Consultation Note (11488-4)</a></p>
</div></td>
</tr>
<tr id="CONF-0207">
<td>CONF-0207</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0207">clinical-notes.html#clinical-notes</a><br/>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0207">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers <strong>SHALL</strong> support, at minimum, these … "Common Clinical Notes":
<a href="https://loinc.org/18842-5.html">Discharge Summary (18842-5)</a></p>
</div></td>
</tr>
<tr id="CONF-0208">
<td>CONF-0208</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0208">clinical-notes.html#clinical-notes</a><br/>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0208">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers <strong>SHALL</strong> support, at minimum, these … "Common Clinical Notes":
<a href="https://loinc.org/34117-2.html">History & Physical Note (34117-2)</a></p>
</div></td>
</tr>
<tr id="CONF-0209">
<td>CONF-0209</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0209">clinical-notes.html#clinical-notes</a><br/>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0209">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers <strong>SHALL</strong> support, at minimum, these … "Common Clinical Notes":
<a href="https://loinc.org/28570-0.html">Procedures Note (28570-0)</a></p>
</div></td>
</tr>
<tr id="CONF-0210">
<td>CONF-0210</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0210">clinical-notes.html#clinical-notes</a><br/>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0210">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers <strong>SHALL</strong> support, at minimum, these … "Common Clinical Notes":
<a href="https://loinc.org/11506-3.html">Progress Note (11506-3)</a></p>
</div></td>
</tr>
<tr id="CONF-0211">
<td>CONF-0211</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0211">clinical-notes.html#clinical-notes</a><br/>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0211">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers <strong>SHALL</strong> support, at minimum, these … "Common Clinical Notes":
<a href="https://loinc.org/18748-4.html">Imaging Narrative (18748-4)</a></p>
</div></td>
</tr>
<tr id="CONF-0212">
<td>CONF-0212</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0212">clinical-notes.html#clinical-notes</a><br/>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0212">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers <strong>SHALL</strong> support, at minimum, these … "Common Clinical Notes":
<a href="https://loinc.org/11502-2.html">Laboratory Report Narrative (11502-2)</a></p>
</div></td>
</tr>
<tr id="CONF-0213">
<td>CONF-0213</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0213">clinical-notes.html#clinical-notes</a><br/>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0213">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers <strong>SHALL</strong> support, at minimum, these … "Common Clinical Notes":
<a href="https://loinc.org/11526-1.html">Pathology Report Narrative (11526-1)</a></p>
</div></td>
</tr>
<tr id="CONF-0214">
<td>CONF-0214</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0214">clinical-notes.html#clinical-notes</a><br/>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0214">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers <strong>SHALL</strong> support, at minimum, these … DiagnosticReport categories:
<a href="https://loinc.org/LP29708-2">Cardiology (LP29708-2)</a></p>
</div></td>
</tr>
<tr id="CONF-0215">
<td>CONF-0215</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0215">clinical-notes.html#clinical-notes</a><br/>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0215">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers <strong>SHALL</strong> support, at minimum, these … DiagnosticReport categories:
<a href="https://loinc.org/LP7839-6">Pathology (LP7839-6)</a></p>
</div></td>
</tr>
<tr id="CONF-0216">
<td>CONF-0216</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0216">clinical-notes.html#clinical-notes</a><br/>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0216">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers <strong>SHALL</strong> support, at minimum, these … DiagnosticReport categories:
<a href="https://loinc.org/LP29684-5">Radiology (LP29684-5)</a></p>
</div></td>
</tr>
<tr id="CONF-0217">
<td>CONF-0217</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0217">clinical-notes.html#clinical-notes</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>systems are encouraged to support other common notes types, such as:
<a href="https://loinc.org/57133-1.html">Referral Note (57133-1)</a></p>
</div></td>
</tr>
<tr id="CONF-0219">
<td>CONF-0219</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0219">clinical-notes.html#clinical-notes</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>systems are encouraged to support other common notes types, such as:
<a href="https://loinc.org/34746-8.html">Nurse Note (34746-8)</a></p>
</div></td>
</tr>
<tr id="CONF-0220">
<td>CONF-0220</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0220">clinical-notes.html#fhir-resources-to-exchange-clinical-notes</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>To enable consistent access to scanned DiagnosticReport clinical reports, the FHIR Server <strong>SHALL</strong> expose these overlapping scanned or narrative-only reports through both DiagnosticReport and DocumentReference by representing the same attachment URL [as] DocumentReference.content.attachment.url [and]
DiagnosticReport.presentedForm.url</p>
</div></td>
</tr>
<tr id="CONF-0221">
<td>CONF-0221</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0221">clinical-notes.html#fhir-resources-to-exchange-clinical-notes</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>when DiagnosticReport.presentedForm.url references a Scan (PDF), that Attachment <strong>SHALL</strong> also be accessible through DocumentReference.content.attachment.url</p>
</div></td>
</tr>
<tr id="CONF-0222">
<td>CONF-0222</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0222">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Systems [Servers] may extend their capabilities [around types of clinical notes] to the complete US Core DocumentReference Type Value Set.</p>
</div></td>
</tr>
<tr id="CONF-0223">
<td>CONF-0223</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0223">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>This guide requires [Server] systems to implement the <a href="https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-documentreference.html">US Core DocumentReference Profile</a></p>
</div></td>
</tr>
<tr id="CONF-0224">
<td>CONF-0224</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0224">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>This guide requires [Server] systems to implement the <a href="https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-diagnosticreport-note.html">US Core DiagnosticReport Profile for Report and Note exchange</a></p>
</div></td>
</tr>
<tr id="CONF-0225">
<td>CONF-0225</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0225">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Systems [Servers] may support other [DiagnosticReport] categories as well.</p>
</div></td>
</tr>
<tr id="CONF-0227">
<td>CONF-0227</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0227">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The following <strong>SHOULD</strong> be exposed via DiagnosticReport: Imaging Narrative</p>
</div></td>
</tr>
<tr id="CONF-0228">
<td>CONF-0228</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0228">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The following <strong>SHOULD</strong> be exposed via DiagnosticReport: Laboratory Report Narrative</p>
</div></td>
</tr>
<tr id="CONF-0229">
<td>CONF-0229</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0229">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The following <strong>SHOULD</strong> be exposed via DiagnosticReport: Pathology Report Narrative</p>
</div></td>
</tr>
<tr id="CONF-0230">
<td>CONF-0230</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0230">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The following <strong>SHOULD</strong> be exposed via DiagnosticReport: Procedure Note</p>
</div></td>
</tr>
<tr id="CONF-0231">
<td>CONF-0231</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0231">clinical-notes.html#support-requirements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers that support DiagnosticReport will include the clinical note narrative content in <code>DiagnosticReport.presentedForm</code></p>
</div></td>
</tr>
<tr id="CONF-0233">
<td>CONF-0233</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0233">clinical-notes.html#using-expand</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>FHIR Server claiming support to this guide <strong>SHOULD</strong> support the $expand operation [<a href="http://hl7.org/fhir/R4/valueset-operation-expand.html">operation link</a> to provide information to Clients requesting information on the note and report types the Server supports]</p>
</div></td>
</tr>
<tr id="CONF-0234">
<td>CONF-0234</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0234">clinical-notes.html#using-expand</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[If Servers support the <a href="http://hl7.org/fhir/R4/valueset-operation-expand.html">$expand</a> operation for discovering note and report types, then Servers <strong>SHALL</strong> support] the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note#DiagnosticReport.category&contextDirection=outgoing for DiagnosticReport report category discovery [for read operations]</p>
</div></td>
</tr>
<tr id="CONF-0235">
<td>CONF-0235</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0235">clinical-notes.html#using-expand</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[If Servers support the <a href="http://hl7.org/fhir/R4/valueset-operation-expand.html">$expand</a> operation for discovering note and report types, then Servers <strong>SHALL</strong> support] the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note#DiagnosticReport.category&contextDirection=incoming for DiagnosticReport report category discovery [for write operations]</p>
</div></td>
</tr>
<tr id="CONF-0236">
<td>CONF-0236</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0236">clinical-notes.html#using-expand</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[If Servers support the <a href="http://hl7.org/fhir/R4/valueset-operation-expand.html">$expand</a> operation for discovering note and report types, then Servers <strong>SHALL</strong> support] the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note#DiagnosticReport.code&contextDirection=outgoing for DiagnosticReport report type discovery [for read operations]</p>
</div></td>
</tr>
<tr id="CONF-0237">
<td>CONF-0237</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0237">clinical-notes.html#using-expand</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[If Servers support the <a href="http://hl7.org/fhir/R4/valueset-operation-expand.html">$expand</a> operation for discovering note and report types, then Servers <strong>SHALL</strong> support] the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note#DiagnosticReport.code&contextDirection=incoming for DiagnosticReport report type discovery [for write operations]</p>
</div></td>
</tr>
<tr id="CONF-0238">
<td>CONF-0238</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0238">clinical-notes.html#using-expand</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[If Servers support the <a href="http://hl7.org/fhir/R4/valueset-operation-expand.html">$expand</a> operation for discovering note and report types, then Servers <strong>SHALL</strong> support] the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference#DocumentReference.category&contextDirection=outgoing for DocumentReference note category discovery [for read operations]</p>
</div></td>
</tr>
<tr id="CONF-0239">
<td>CONF-0239</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0239">clinical-notes.html#using-expand</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[If Servers support the <a href="http://hl7.org/fhir/R4/valueset-operation-expand.html">$expand</a> operation for discovering note and report types, then Servers <strong>SHALL</strong> support] the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference#DocumentReference.category&contextDirection=incoming for DocumentReference note category discovery [for write operations]</p>
</div></td>
</tr>
<tr id="CONF-0240">
<td>CONF-0240</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0240">clinical-notes.html#using-expand</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[If Servers support the <a href="http://hl7.org/fhir/R4/valueset-operation-expand.html">$expand</a> operation for discovering note and report types, then Servers <strong>SHALL</strong> support] the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference#DocumentReference.type&contextDirection=outgoing for DocumentReference note type discovery [for read operations]</p>
</div></td>
</tr>
<tr id="CONF-0241">
<td>CONF-0241</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0241">clinical-notes.html#using-expand</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[If Servers support the <a href="http://hl7.org/fhir/R4/valueset-operation-expand.html">$expand</a> operation for discovering note and report types, then Servers <strong>SHALL</strong> support] the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference#DocumentReference.type&contextDirection=incoming for DocumentReference note type discovery [for write operations]</p>
</div></td>
</tr>
<tr id="CONF-0242">
<td>CONF-0242</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0242">clinical-notes.html#discovering-Server-read-and-write-formats</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[If Servers support the <a href="http://hl7.org/fhir/R4/valueset-operation-expand.html">$expand</a> operation then] the note and report types for a particular Server [SHOULD be] discovered by invoking the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note#DiagnosticReport.presentedForm.contentType&contextDirection=outgoing for DiagnosticReport report content type discovery [for read operations]</p>
</div></td>
</tr>
<tr id="CONF-0243">
<td>CONF-0243</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0243">clinical-notes.html#discovering-Server-read-and-write-formats</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[If Servers support the <a href="http://hl7.org/fhir/R4/valueset-operation-expand.html">$expand</a> operation then] the note and report types for a particular Server [SHOULD be] discovered by invoking the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note#DiagnosticReport.presentedForm.contentType&contextDirection=incoming for DiagnosticReport report content type discovery [for write operations]</p>
</div></td>
</tr>
<tr id="CONF-0244">
<td>CONF-0244</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0244">clinical-notes.html#discovering-Server-read-and-write-formats</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[If Servers support the <a href="http://hl7.org/fhir/R4/valueset-operation-expand.html">$expand</a> operation then] the note and report types for a particular Server [SHOULD be] discovered by invoking the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference#DocumentReference.content.attachment.contentType&contextDirection=outgoing for DocumentReference note content type discovery [for read operations]</p>
</div></td>
</tr>
<tr id="CONF-0245">
<td>CONF-0245</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0245">clinical-notes.html#discovering-Server-read-and-write-formats</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[If Servers support the <a href="http://hl7.org/fhir/R4/valueset-operation-expand.html">$expand</a> operation then] the note and report types for a particular Server [SHOULD be] discovered by invoking the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference#DocumentReference.content.attachment.contentType&contextDirection=incoming for DocumentReference note content type discovery [for write operations]</p>
</div></td>
</tr>
<tr id="CONF-0246">
<td>CONF-0246</td>
<td>
<span style="color: grey;">•</span><a href="medication-list.html#CONF-0246">medication-list.html#background-on-the-fhir-medications-resources</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>[The <a href="http://hl7.org/fhir/R4/medicationadministration.html">MedicationAdministration</a> and <a href="http://hl7.org/fhir/R4/medicationstatement.html">MedicationStatement</a>] medication resources are not profiled by US Core, and systems that support US Core are permitted to use them</p>
</div></td>
</tr>
<tr id="CONF-0247">
<td>CONF-0247</td>
<td>
<span style="color: grey;">•</span><a href="medication-list.html#CONF-0247">medication-list.html#options-for-representing-medication</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>When using a code [to represent a medication][, the code <strong>SHALL</strong> follow the <a href="http://hl7.org/fhir/R4/terminologies.html#extensible">extensible</a> binding rules to <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1010.4/expansion">Medication Clinical Drug (RxNorm)</a> - i.e., unless RxNorm does not cover the concept, the RxNorm code <strong>SHALL</strong> be used.</p>
</div></td>
</tr>
<tr id="CONF-0248">
<td>CONF-0248</td>
<td>
<span style="color: grey;">•</span><a href="medication-list.html#CONF-0248">medication-list.html#options-for-representing-medication</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>USCDI recommends the <a href="https://www.fda.gov/drugs/drug-approvals-and-databases/national-drug-code-directory">National Drug Codes (NDC)</a> as an optional medication terminology. They can be supplied as an additional coding element [when representing a medication]</p>
</div></td>
</tr>
<tr id="CONF-0249">
<td>CONF-0249</td>
<td>
<span style="color: grey;">•</span><a href="medication-list.html#CONF-0249">medication-list.html#options-for-representing-medication</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>When referencing the Medication resource, the resource may be included in the returned bundle, as an external resource, or as a <a href="http://hl7.org/fhir/R4/references.html#contained">contained</a> resource if it can’t stand alone. … The Server application <strong>MAY</strong> choose any combination of these methods</p>
</div></td>
</tr>
<tr id="CONF-0250">
<td>CONF-0250</td>
<td>
<span style="color: grey;">•</span><a href="medication-list.html#CONF-0250">medication-list.html#options-for-representing-medication</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>if an external reference to Medication is used, the Server <strong>SHALL</strong> support the <a href="http://hl7.org/fhir/R4/search.html#include">_include</a> parameter for searching this element</p>
</div></td>
</tr>
<tr id="CONF-0252">
<td>CONF-0252</td>
<td>
<span style="color: grey;">•</span><a href="medication-list.html#CONF-0252">medication-list.html#fetching-all-medications-active-medications-and-all-medications-for-an-encounter</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Requirements to access “all medications” [all historical, active, and future prescribed medications and medications entered in error and whose status is unknown.] and “all active medications” [all medications with an active status. Active medications do not include past, future, unknown status, and entered-in-error medications.] for a patient:
A MedicationRequest resource query <strong>SHALL</strong> be all that is required to access "all medications" or "all active medications" for a patient. (In other words, no other medication resource type needs to be fetched)</p>
</div></td>
</tr>
<tr id="CONF-0253">
<td>CONF-0253</td>
<td>
<span style="color: grey;">•</span><a href="medication-list.html#CONF-0253">medication-list.html#fetching-all-medications-active-medications-and-all-medications-for-an-encounter</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Requirements to access “all medications” [all historical, active, and future prescribed medications and medications entered in error and whose status is unknown.] and “all active medications” [all medications with an active status. Active medications do not include past, future, unknown status, and entered-in-error medications.] for a patient:
The [MedicationRequest resource] query result <strong>SHALL</strong> include all MedicationRequest resources with a <code>MedicationRequest.intent</code> = "order" representing authorized medication orders directly derived from the system's orders.</p>
</div></td>
</tr>
<tr id="CONF-0254">
<td>CONF-0254</td>
<td>
<span style="color: grey;">•</span><a href="medication-list.html#CONF-0254">medication-list.html#fetching-all-medications-active-medications-and-all-medications-for-an-encounter</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Requirements to access “all medications” [all historical, active, and future prescribed medications and medications entered in error and whose status is unknown.] and “all active medications” [all medications with an active status. Active medications do not include past, future, unknown status, and entered-in-error medications.] for a patient:
The [MedicationRequest resource] query result <strong>SHALL</strong> include all prescribed and "self-prescribed" MedicationRequest resources with a <code>MedicationRequest.intent</code> = "plan" representing reported medications.</p>
</div></td>
</tr>
<tr id="CONF-0256">
<td>CONF-0256</td>
<td>
<span style="color: grey;">•</span><a href="medication-list.html#CONF-0256">medication-list.html#fetching-all-medications-active-medications-and-all-medications-for-an-encounter</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Requirements to access “all medications” [all historical, active, and future prescribed medications and medications entered in error and whose status is unknown.] and “all active medications” [all medications with an active status. Active medications do not include past, future, unknown status, and entered-in-error medications.] for a patient:
Servers <strong>SHALL</strong> use the <code>MedicationRequest.reported[x]</code> element to indicate that the MedicationRequest record was captured as a secondary "reported" record rather than an original primary source-of-truth record.</p>
</div></td>
</tr>
<tr id="CONF-0257">
<td>CONF-0257</td>
<td>
<span style="color: grey;">•</span><a href="medication-list.html#CONF-0257">medication-list.html#fetching-all-medications-active-medications-and-all-medications-for-an-encounter</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Requirements to access “all medications” [all historical, active, and future prescribed medications and medications entered in error and whose status is unknown.] and “all active medications” [all medications with an active status. Active medications do not include past, future, unknown status, and entered-in-error medications.] for a patient:
Servers [MAY] use the <code>MedicationRequest.reported[x]</code> element to indicate ... the source of the report.</p>
</div></td>
</tr>
<tr id="CONF-0258">
<td>CONF-0258</td>
<td>
<span style="color: grey;">•</span><a href="medication-list.html#CONF-0258">medication-list.html#fetching-all-medications-active-medications-and-all-medications-for-an-encounter</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Requirements to access “all medications” [all historical, active, and future prescribed medications and medications entered in error and whose status is unknown.] and “all active medications” [all medications with an active status. Active medications do not include past, future, unknown status, and entered-in-error medications.] for a patient:
When recording "self-prescribed" medication, Servers <strong>SHOULD</strong> use the <code>MedicationRequest.requester</code> element to indicate the Patient or RelatedPerson is the prescriber.</p>
</div></td>
</tr>
<tr id="CONF-0259">
<td>CONF-0259</td>
<td>
<span style="color: grey;">•</span><a href="medication-list.html#CONF-0259">medication-list.html#fetching-all-medications-active-medications-and-all-medications-for-an-encounter</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Requirements to access “all medications” [all historical, active, and future prescribed medications and medications entered in error and whose status is unknown.] and “all active medications” [all medications with an active status. Active medications do not include past, future, unknown status, and entered-in-error medications.] for a patient:
Servers <strong>SHOULD</strong> support the encounter search parameter.</p>
</div></td>
</tr>
<tr id="CONF-0260">
<td>CONF-0260</td>
<td>
<span style="color: grey;">•</span><a href="medication-list.html#CONF-0260">medication-list.html#fetching-all-medications-active-medications-and-all-medications-for-an-encounter</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Requirements to access “all medications” [all historical, active, and future prescribed medications and medications entered in error and whose status is unknown.] and “all active medications” [all medications with an active status. Active medications do not include past, future, unknown status, and entered-in-error medications.] for a patient:
[If Servers support the encounter search parameter, s]earching by encounter will return all medications ordered during that encounter, including medications administered in the hospital and prescribed or discharge medications intended to be taken at home.</p>
</div></td>
</tr>
<tr id="CONF-0262">
<td>CONF-0262</td>
<td>
<span style="color: grey;">•</span><a href="medication-list.html#CONF-0262">medication-list.html#fetching-all-medications-active-medications-and-all-medications-for-an-encounter</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Requirements to access “all medications” [all historical, active, and future prescribed medications and medications entered in error and whose status is unknown.] and “all active medications” [all medications with an active status. Active medications do not include past, future, unknown status, and entered-in-error medications.] for a patient:
Servers <strong>MAY</strong> support the search parameters <code>category</code>and <code>encounter</code>. This search will return all medications ordered during an encounter for a given MedicationRequest.category such as "inpatient".</p>
</div></td>
</tr>
<tr id="CONF-0263">
<td>CONF-0263</td>
<td>
<span style="color: grey;">•</span><a href="medication-list.html#CONF-0263">medication-list.html#de-duplication-of-data</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>To provide a list of a patient’s medications, it may be necessary to “de-duplicate” them. The de-duplication activity <strong>MAY</strong> be supplied by the Server</p>
</div></td>
</tr>
<tr id="CONF-0267">
<td>CONF-0267</td>
<td>
<span style="color: grey;">•</span><a href="basic-provenance.html#CONF-0267">basic-provenance.html#hie-transformation</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>An agent.type=”assembler”, agent.type=”transmitter”, or other agents from <a href="https://hl7.org/fhir/us/core/STU8/ValueSet-us-core-provenance-participant-type.html">Provenance Agent Type</a> value set <strong>MAY</strong> also be included.</p>
</div></td>
</tr>
<tr id="CONF-0268">
<td>CONF-0268</td>
<td>
<span style="color: grey;">•</span><a href="screening-and-assessments.html#CONF-0268">screening-and-assessments.html#introduction</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>implementers [of US Core's framework of Screening and Assessments] <strong>SHOULD</strong> consider more constrained, domain-specific profiles derived from the US Core Profiles to meet the needs of their respective use cases.</p>
</div></td>
</tr>
<tr id="CONF-0269">
<td>CONF-0269</td>
<td>
<span style="color: grey;">•</span><a href="screening-and-assessments.html#CONF-0269">screening-and-assessments.html#clinical-judgments</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Every Server that supports the USDCI Data Class “Health Status/Assessments”:</p>
<p><strong>SHALL</strong> support representing clinical judgments using <a href="https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-condition-problems-health-concerns.html">US Core Condition Problems and Health Concerns Profile</a> or <a href="https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-simple-observation.html">US Core Simple Observation Profile</a>.</p>
</div></td>
</tr>
<tr id="CONF-0270">
<td>CONF-0270</td>
<td>
<span style="color: grey;">•</span><a href="screening-and-assessments.html#CONF-0270">screening-and-assessments.html#clinical-judgments</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Every Server that supports the USDCI Data Class “Health Status/Assessments”:
...
The US Core Simple Observation Profile's Observation.derivedFrom element <strong>SHOULD</strong> reference the <a href="https://hl7.org/fhir/us/core/STU8/screening-and-assessments.html#structured-screening-and-assessments">Structured Screening and Assessment</a> upon which clinical judgment observations are made</p>
</div></td>
</tr>
<tr id="CONF-0271">
<td>CONF-0271</td>
<td>
<span style="color: grey;">•</span><a href="screening-and-assessments.html#CONF-0271">screening-and-assessments.html#clinical-judgments</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Every Server that supports the USDCI Data Class “Health Status/Assessments”:
...
the US Core Condition Profile's Condition.evidence.detail element <strong>SHOULD</strong> reference the <a href="https://hl7.org/fhir/us/core/STU8/screening-and-assessments.html#structured-screening-and-assessments">Structured Screening and Assessment</a> which assist in diagnosing problems or health concerns.</p>
</div></td>
</tr>
<tr id="CONF-0272">
<td>CONF-0272</td>
<td>
<span style="color: grey;">•</span><a href="screening-and-assessments.html#CONF-0272">screening-and-assessments.html#choosing-between-questionnaireresponse-and-observation</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>For API developers using US Core, it’s important to understand when to use the QuestionnaireResponse versus Observation to represent structured assessments and surveys. Here are some guidelines to help choose the appropriate profile:
Observations represent specific point-in-time facts that need to be searched, trended, the subject of statistical analysis, and directly referenced in support of other actions ... anything that meets one of the preceding criteria must be surfaced as an Observation.</p>
</div></td>
</tr>
<tr id="CONF-0280">
<td>CONF-0280</td>
<td>
<span style="color: grey;">•</span><a href="screening-and-assessments.html#CONF-0280">screening-and-assessments.html#uscdi-health-assessments-data-element-value-sets</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Implementers <strong>SHOULD</strong> treat these [USCDI Health Status Assessments Data Element] value sets as having an <a href="http://hl7.org/fhir/R4/terminologies.html#extensible">extensible</a> binding.</p>
</div></td>
</tr>
<tr id="CONF-0281">
<td>CONF-0281</td>
<td>
<span style="color: grey;">•</span><a href="screening-and-assessments.html#CONF-0281">screening-and-assessments.html#uscdi-health-assessments-data-element-value-sets</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>when recording SDOH data [with] US Core Profiles, Servers <strong>SHOULD</strong> use … <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1196.788/expansion">Social Determinants of Health Conditions Value Set</a>, <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1196.789/expansion">Social Determinants of Health Procedures Value Set</a>, <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1247.71/expansion">Social Determinants of Health Goals Value Set</a>, [and] <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1196.790/expansion">Social Determinants of Health Service Requests Value Set</a></p>
</div></td>
</tr>
<tr id="CONF-0287">
<td>CONF-0287</td>
<td>
<span style="color: grey;">•</span><a href="changes-between-versions.html#CONF-0287">changes-between-versions.html#no-guarantee-that-resource-ids-are-preserved</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Servers <strong>SHOULD</strong> maintain a stable common identifier for a resource across [FHIR] versions.</p>
</div></td>
</tr>
<tr id="CONF-0288">
<td>CONF-0288</td>
<td>
<span style="color: grey;">•</span><a href="changes-between-versions.html#CONF-0288">changes-between-versions.html#expectation-that-data-is-preserved-between-versions</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>In an upgraded R4 endpoint, any data in FHIR DSTU2 <strong>SHOULD</strong> be in FHIR R4.</p>
</div></td>
</tr>
<tr id="CONF-0289">
<td>CONF-0289</td>
<td>
<span style="color: grey;">•</span><a href="changes-between-versions.html#CONF-0289">changes-between-versions.html#expectation-that-data-is-preserved-between-versions</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The FHIR RESTful resource types supported in a DSTU2 implementation <strong>SHOULD</strong> be supported in a R4 implementation</p>
</div></td>
</tr>
<tr id="CONF-0290">
<td>CONF-0290</td>
<td>
<span style="color: grey;">•</span><a href="changes-between-versions.html#CONF-0290">changes-between-versions.html#expectation-that-data-is-preserved-between-versions</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The FHIR RESTful resource types supported in a DSTU2 implementation <strong>SHOULD</strong> be supported in a R4 implementation [with the] exception [of]
MedicationStatement may be deprecated, and the data <strong>SHOULD</strong> be mapped to MedicationRequest.</p>
</div></td>
</tr>
<tr id="CONF-0291">
<td>CONF-0291</td>
<td>
<span style="color: grey;">•</span><a href="changes-between-versions.html#CONF-0291">changes-between-versions.html#expectation-that-data-is-preserved-between-versions</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The FHIR RESTful resource types supported in a DSTU2 implementation <strong>SHOULD</strong> be supported in a R4 implementation [with the] exception [of]
Care teams as represented by CarePlan in DSTU2 <strong>SHOULD</strong> be replaced by and the data mapped to CareTeam in R4</p>
</div></td>
</tr>
<tr id="CONF-0295">
<td>CONF-0295</td>
<td>
<span style="color: grey;">•</span><a href="changes-between-versions.html#CONF-0295">changes-between-versions.html#expectation-that-data-is-preserved-between-versions</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Servers <strong>SHOULD</strong> make available the same information in DSTU2 and R4 where the more recent standard allows.</p>
</div></td>
</tr>
<tr id="CONF-0296">
<td>CONF-0296</td>
<td>
<span style="color: grey;">•</span><a href="changes-between-versions.html#CONF-0296">changes-between-versions.html#expectation-that-data-is-preserved-between-versions</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Servers <strong>SHOULD</strong> make available the same information in DSTU2 and R4 where the more recent standard allows … [with the] exception [of]
MedicationStatement data [should be] mapped to MedicationRequest</p>
</div></td>
</tr>
<tr id="CONF-0297">
<td>CONF-0297</td>
<td>
<span style="color: grey;">•</span><a href="changes-between-versions.html#CONF-0297">changes-between-versions.html#expectation-that-data-is-preserved-between-versions</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Servers <strong>SHOULD</strong> make available the same information in DSTU2 and R4 where the more recent standard allows … [with the] exception [of]
care teams, as represented by CarePlan, <strong>SHOULD</strong> be mapped to CareTeam in R4</p>
</div></td>
</tr>
<tr id="CONF-0298">
<td>CONF-0298</td>
<td>
<span style="color: grey;">•</span><a href="changes-between-versions.html#CONF-0298">changes-between-versions.html#expectation-that-data-is-preserved-between-versions</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Data <strong>SHOULD</strong> be maintained between [FHIR] versions (i.e., not be degraded).</p>
</div></td>
</tr>
<tr id="CONF-0300">
<td>CONF-0300</td>
<td>
<span style="color: grey;">•</span><a href="changes-between-versions.html#CONF-0300">changes-between-versions.html#authorization-across-versions</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>To allow Clients to use a single authorization token when accessing resources from multiple version-specific endpoints, Servers <strong>SHOULD</strong> use the same base authorization endpoint across versions.</p>
</div></td>
</tr>
<tr id="CONF-0302">
<td>CONF-0302</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-allergyintolerance.html#CONF-0302">StructureDefinition-us-core-allergyintolerance.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[The clinical status of the allergy] <strong>SHALL</strong> be present if verification status is not “entered-in-error”</p>
</div></td>
</tr>
<tr id="CONF-0303">
<td>CONF-0303</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-allergyintolerance.html#CONF-0303">StructureDefinition-us-core-allergyintolerance.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL-NOT</td>
<td><div><p>[The clinical status of the allergy] <strong>SHALL NOT</strong> be present if verification Status is “entered-in-error”</p>
</div></td>
</tr>
<tr id="CONF-0305">
<td>CONF-0305</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-allergyintolerance.html#CONF-0305">StructureDefinition-us-core-allergyintolerance.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Profile Specific Implementation Guidance:</p>
<p>No Known Allergies may be represented using the US Core-AllergyIntolerance profile</p>
</div></td>
</tr>
<tr id="CONF-0306">
<td>CONF-0306</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-allergyintolerance.html#CONF-0306">StructureDefinition-us-core-allergyintolerance.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[When used No Known Allergies is documented the system Shall use an] appropriate negation code in AllergyIntolerence.code</p>
</div></td>
</tr>
<tr id="CONF-0307">
<td>CONF-0307</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-allergyintolerance.html#CONF-0307">StructureDefinition-us-core-allergyintolerance.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[When used No Known Allergies is documented the system Shall use an] verification status in AllergyIntolerance.verificationStatus</p>
</div></td>
</tr>
<tr id="CONF-0308">
<td>CONF-0308</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-allergyintolerance.html#CONF-0308">StructureDefinition-us-core-allergyintolerance.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>If a patient has not been asked about their allergies, this would be represented as:
AllergyIntolerance.code = “1631000175102” (Patient not asked (contextual qualifier) (qualifier value))
AllergyIntolerance.verificationStatus = “unconfirmed” or empty (in other words, then element omitted)</p>
</div></td>
</tr>
<tr id="CONF-0309">
<td>CONF-0309</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-allergyintolerance.html#CONF-0309">StructureDefinition-us-core-allergyintolerance.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>If a patient has been asked, but has indicated they have no known allergies, this would be represented as:
AllergyIntolerance.code = “716186003” (No known allergy (situation))
AllergyIntolerance.verificationStatus = “confirmed”</p>
</div></td>
</tr>
<tr id="CONF-0310">
<td>CONF-0310</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-careplan.html#CONF-0310">StructureDefinition-us-core-careplan.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Considerations for systems aligning with <a href="http://www.hl7.org/implement/standards/product_brief.cfm?product_id=492">HL7 Consolidated (C-CDA)</a> Care Plan requirements: US Core Goal <strong>SHOULD</strong> be present in CarePlan.goal</p>
</div></td>
</tr>
<tr id="CONF-0311">
<td>CONF-0311</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-careplan.html#CONF-0311">StructureDefinition-us-core-careplan.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Considerations for systems aligning with [HL7 Consolidated (C-CDA)] (http://www.hl7.org/implement/standards/product_brief.cfm?product_id=492) Care Plan requirements: ... US Core Condition <strong>SHOULD</strong> be present in CarePlan.addresses</p>
</div></td>
</tr>
<tr id="CONF-0312">
<td>CONF-0312</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-careplan.html#CONF-0312">StructureDefinition-us-core-careplan.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Considerations for systems aligning with [HL7 Consolidated (C-CDA)] (http://www.hl7.org/implement/standards/product_brief.cfm?product_id=492) Care Plan requirements: Assessment and Plan <strong>MAY</strong> be included as narrative in CarePlan.text</p>
</div></td>
</tr>
<tr id="CONF-0313">
<td>CONF-0313</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-careteam.html#CONF-0313">StructureDefinition-us-core-careteam.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Although both US Core Practitioner Profile and US Core PractitionerRole are Must Support, ... Server system[s conforming to the US Core CareTeam profile are] ... not required to support references to both, but <strong>SHALL</strong> support at least one of them</p>
</div></td>
</tr>
<tr id="CONF-0317">
<td>CONF-0317</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-careteam.html#CONF-0317">StructureDefinition-us-core-careteam.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[When conforming to the US Core CareTeam profile] Because the US Core PractitionerRole Profile supplies the provider’s location and contact information and a reference to the Practitioner, Server systems [conforming to the US Core CareTeam profile] <strong>SHOULD</strong> reference it instead of the US Core Practitioner Profile [when conforming to the US Core CareTeam profile] .</p>
</div></td>
</tr>
<tr id="CONF-0318">
<td>CONF-0318</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-careteam.html#CONF-0318">StructureDefinition-us-core-careteam.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers [conforming to the US Core CareTeam profile] that support only US Core Practitioner Profile and do not support the US Core PractitionerRole Profile <strong>SHALL</strong> provide implementation-specific guidance on how to access a provider’s location ... information using only the Practitioner resource.</p>
</div></td>
</tr>
<tr id="CONF-0319">
<td>CONF-0319</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-careteam.html#CONF-0319">StructureDefinition-us-core-careteam.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers [conforming to the US Core CareTeam profile] that support only US Core Practitioner Profile and do not support the US Core PractitionerRole Profile <strong>SHALL</strong> provide implementation-specific guidance on how to access a provider’s ... contact information using only the Practitioner resource.</p>
</div></td>
</tr>
<tr id="CONF-0320">
<td>CONF-0320</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-condition-encounter-diagnosis.html#CONF-0320">StructureDefinition-us-core-condition-encounter-diagnosis.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>For Problems and Health Concerns [records, systems <strong>SHOULD</strong>] use the <a href="https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-condition-problems-health-concerns.html">US Core Condition Problems and Health Concerns Profile</a>.</p>
</div></td>
</tr>
<tr id="CONF-0323">
<td>CONF-0323</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-condition-encounter-diagnosis.html#CONF-0323">StructureDefinition-us-core-condition-encounter-diagnosis.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-condition-problems-health-concerns.html#CONF-0323">StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>USCDI’s applicable vocabulary standards for Encounter Diagnosis are SNOMED CT and ICD-10-CM. The US Core Condition Codes only supports ICD-9-CM for historical purposes. When using ICD codes, only non-header ICD-10-CM codes <strong>SHOULD</strong> be used as the primary code for current encounter diagnoses.</p>
</div></td>
</tr>
<tr id="CONF-0324">
<td>CONF-0324</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-condition-encounter-diagnosis.html#CONF-0324">StructureDefinition-us-core-condition-encounter-diagnosis.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[A US Core Condition Encounter Diagnosis] encounter <strong>SHOULD</strong> always be referenced in Condition.encounter.</p>
</div></td>
</tr>
<tr id="CONF-0330">
<td>CONF-0330</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-condition-problems-health-concerns.html#CONF-0330">StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>For Encounter Diagnosis [records, systems <strong>SHOULD</strong>] use the <a href="https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-condition-encounter-diagnosis.html">US Core Condition Encounter Diagnosis Profile</a>.</p>
</div></td>
</tr>
<tr id="CONF-0331">
<td>CONF-0331</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-condition-problems-health-concerns.html#CONF-0331">StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>If the category is "problem-list-item", Condition.clinicalStatus <strong>SHOULD</strong> be present.</p>
</div></td>
</tr>
<tr id="CONF-0332">
<td>CONF-0332</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-condition-problems-health-concerns.html#CONF-0332">StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Updates to .meta.lastUpdated <strong>SHOULD</strong> reflect: New problems and health concerns</p>
</div></td>
</tr>
<tr id="CONF-0333">
<td>CONF-0333</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-condition-problems-health-concerns.html#CONF-0333">StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Updates to .meta.lastUpdated <strong>SHOULD</strong> reflect:
Changes in the clinical status or verifications status of problems or health concerns.</p>
</div></td>
</tr>
<tr id="CONF-0334">
<td>CONF-0334</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-coverage.html#CONF-0334">StructureDefinition-us-core-coverage.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>A coverage.type of “81” (Self-pay) <strong>MAY</strong> be used to imply that the patient has no coverage or that an individual or organization other than an insurer is taking responsibility for payment for a portion of the health care costs.</p>
</div></td>
</tr>
<tr id="CONF-0335">
<td>CONF-0335</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-coverage.html#CONF-0335">StructureDefinition-us-core-coverage.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Implementers should refer to the <a href="https://www.nahdo.org/sites/default/files/2020-12/SourceofPaymentTypologyUsersGuideVersion9.2December2020.pdf">PHDSC Payer Type Committee User’s Guide</a> for the Source of Payment Typology when selecting codes.</p>
</div></td>
</tr>
<tr id="CONF-0336">
<td>CONF-0336</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-coverage.html#CONF-0336">StructureDefinition-us-core-coverage.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>To differentiate Medicare Parts A, B, C, and D systems can use the following codes [when sending Coverage.type]: [For] Part A and B [use] 121 (Medicare Fee For Service)</p>
</div></td>
</tr>
<tr id="CONF-0337">
<td>CONF-0337</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-coverage.html#CONF-0337">StructureDefinition-us-core-coverage.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>To differentiate Medicare Parts A, B, C, and D systems can use the following codes: [For] Part C (Medicare Advantage Plan) [use] 111 (Medicare HMO), 112 (Medicare PPO), 113 (Medicare POS)</p>
</div></td>
</tr>
<tr id="CONF-0338">
<td>CONF-0338</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-coverage.html#CONF-0338">StructureDefinition-us-core-coverage.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>To differentiate Medicare Parts A, B, C, and D systems can use the following codes: [For] Part D [use] 122 (Medicare Drug Benefit)</p>
</div></td>
</tr>
<tr id="CONF-0339">
<td>CONF-0339</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-coverage.html#CONF-0339">StructureDefinition-us-core-coverage.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>If Insurers issue unique member IDs for dependents, then the memberId Coverage.identifier should be used [with the unique dependent ID] instead of Coverage.dependent to uniquely refer to the dependent with respect to their insurance.</p>
</div></td>
</tr>
<tr id="CONF-0341">
<td>CONF-0341</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-device.html#CONF-0341">StructureDefinition-us-core-device.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Implementers are encouraged to use the FDA Global UDI Database (GUDID) and associated APIs to parse and validate the [unique device ID] UDI</p>
</div></td>
</tr>
<tr id="CONF-0342">
<td>CONF-0342</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-device.html#CONF-0342">StructureDefinition-us-core-device.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Medical devices with UDI information <strong>SHALL</strong> represent the UDI code in Device.udiCarrier.carrierHRF</p>
</div></td>
</tr>
<tr id="CONF-0343">
<td>CONF-0343</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-device.html#CONF-0343">StructureDefinition-us-core-device.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>UDI-PI elements present [in Device.udiCarrier.carrierHRF] <strong>SHALL</strong> be represented in the corresponding US Core Device Profile elements</p>
</div></td>
</tr>
<tr id="CONF-0344">
<td>CONF-0344</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-device.html#CONF-0344">StructureDefinition-us-core-device.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>If UDI is not present and the manufacturer … is available, … [it] <strong>SHOULD</strong> be included to support historical reports of implantable medical devices [where] manufacturer [is sent in] Device.manufacturer</p>
</div></td>
</tr>
<tr id="CONF-0345">
<td>CONF-0345</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-device.html#CONF-0345">StructureDefinition-us-core-device.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>If UDI is not present and the ... model number information is available, … [it] <strong>SHOULD</strong> be included to support historical reports of implantable medical devices [where] model [is sent in] Device.model</p>
</div></td>
</tr>
<tr id="CONF-0347">
<td>CONF-0347</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-device.html#CONF-0347">StructureDefinition-us-core-device.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Records of implanted devices <strong>MAY</strong> be queried against UDI data, including: UDI HRF string (udi-carrier)</p>
</div></td>
</tr>
<tr id="CONF-0348">
<td>CONF-0348</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-device.html#CONF-0348">StructureDefinition-us-core-device.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Records of implanted devices <strong>MAY</strong> be queried against UDI data, including:UDI Device Identifier (udi-di)</p>
</div></td>
</tr>
<tr id="CONF-0349">
<td>CONF-0349</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-device.html#CONF-0349">StructureDefinition-us-core-device.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Records of implanted devices <strong>MAY</strong> be queried against UDI data, including: Manufacturer (manufacturer)</p>
</div></td>
</tr>
<tr id="CONF-0350">
<td>CONF-0350</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-device.html#CONF-0350">StructureDefinition-us-core-device.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Records of implanted devices <strong>MAY</strong> be queried against UDI data, including: Model number (model)</p>
</div></td>
</tr>
<tr id="CONF-0351">
<td>CONF-0351</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-device.html#CONF-0351">StructureDefinition-us-core-device.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Implementers <strong>MAY</strong> also adopt custom SearchParameters for searching by lot numbers</p>
</div></td>
</tr>
<tr id="CONF-0352">
<td>CONF-0352</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-device.html#CONF-0352">StructureDefinition-us-core-device.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Implementers <strong>MAY</strong> also adopt custom SearchParameters for searching by serial number</p>
</div></td>
</tr>
<tr id="CONF-0353">
<td>CONF-0353</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-device.html#CONF-0353">StructureDefinition-us-core-device.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Implementers <strong>MAY</strong> also adopt custom SearchParameters for searching by expiration date</p>
</div></td>
</tr>
<tr id="CONF-0354">
<td>CONF-0354</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-device.html#CONF-0354">StructureDefinition-us-core-device.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Implementers <strong>MAY</strong> also adopt custom SearchParameters for searching by manufacture date</p>
</div></td>
</tr>
<tr id="CONF-0355">
<td>CONF-0355</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-device.html#CONF-0355">StructureDefinition-us-core-device.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Implementers <strong>MAY</strong> also adopt custom SearchParameters for searching by distinct identifier</p>
</div></td>
</tr>
<tr id="CONF-0356">
<td>CONF-0356</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-diagnosticreport-lab.html#CONF-0356">StructureDefinition-us-core-diagnosticreport-lab.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-diagnosticreport-note.html#CONF-0356">StructureDefinition-us-core-diagnosticreport-note.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The diagnostically relevant time (known as the “effective time” and typically the time of specimen collection) … <strong>SHALL</strong> be present if status [of the diagnostic report] is ‘partial’, ‘preliminary’, ‘final’, ‘amended’, ‘corrected’, or ‘appended’.</p>
</div></td>
</tr>
<tr id="CONF-0357">
<td>CONF-0357</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-diagnosticreport-lab.html#CONF-0357">StructureDefinition-us-core-diagnosticreport-lab.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>When the report was released … <strong>SHALL</strong> be present if status [of the diagnostic report] is ‘partial’, ‘preliminary’, ‘final’, ‘amended’, ‘corrected’, or ‘appended’.</p>
</div></td>
</tr>
<tr id="CONF-0358">
<td>CONF-0358</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-diagnosticreport-lab.html#CONF-0358">StructureDefinition-us-core-diagnosticreport-lab.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Updates to .meta.lastUpdated <strong>SHOULD</strong> reflect New laboratory reports.</p>
</div></td>
</tr>
<tr id="CONF-0359">
<td>CONF-0359</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-diagnosticreport-lab.html#CONF-0359">StructureDefinition-us-core-diagnosticreport-lab.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Updates to .meta.lastUpdated <strong>SHOULD</strong> reflect changes in the status of laboratory reports, including events that trigger the same status (e.g., amended → amended).</p>
</div></td>
</tr>
<tr id="CONF-0360">
<td>CONF-0360</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-diagnosticreport-note.html#CONF-0360">StructureDefinition-us-core-diagnosticreport-note.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The DiagnosticReport.category binding Must Support, at a minimum, the US Core DiagnosticReport Category Codes of Cardiology, Radiology, and Pathology</p>
</div></td>
</tr>
<tr id="CONF-0361">
<td>CONF-0361</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-diagnosticreport-note.html#CONF-0361">StructureDefinition-us-core-diagnosticreport-note.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Other [diagnostic report] categories may be supported [when using US Core DiagnosticReport Profile for Report and Note Exchange]</p>
</div></td>
</tr>
<tr id="CONF-0362">
<td>CONF-0362</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-diagnosticreport-note.html#CONF-0362">StructureDefinition-us-core-diagnosticreport-note.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>[L]inkages between specific LOINC codes and the LP-type codes may be used as guidance [for a Server's categorization of diagnostic reports]</p>
</div></td>
</tr>
<tr id="CONF-0364">
<td>CONF-0364</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-diagnosticreport-note.html#CONF-0364">StructureDefinition-us-core-diagnosticreport-note.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>For Diagnostic Imaging Reports systems <strong>SHOULD</strong> support using the subset of LOINC codes listed Table 4: LOINC® Document Type Codes in <em>HL7 Standard for CDA® Release 2: Imaging Integration; Basic Imaging Reports in CDA and DICOM, Release 1</em></p>
</div></td>
</tr>
<tr id="CONF-0365">
<td>CONF-0365</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-documentreference.html#CONF-0365">StructureDefinition-us-core-documentreference.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The DocumentReference.type binding Must Support, at a minimum, the 10 <a href="https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-documentreference.html#mandatory-and-must-support-data-elements">Common Clinical Notes</a></p>
</div></td>
</tr>
<tr id="CONF-0366">
<td>CONF-0366</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-documentreference.html#CONF-0366">StructureDefinition-us-core-documentreference.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>The DocumentReference.type binding may extend to the whole <a href="https://hl7.org/fhir/us/core/STU8/ValueSet-us-core-documentreference-type.html">US Core DocumentReference Type Value Set</a></p>
</div></td>
</tr>
<tr id="CONF-0367">
<td>CONF-0367</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-documentreference.html#CONF-0367">StructureDefinition-us-core-documentreference.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>[DocumentReference.type may also use] other category schemes such as the LOINC-based <a href="http://hl7.org/fhir/R4/valueset-document-classcodes.html">Document Class Value Set</a> and <a href="https://wiki.ihe.net/index.php/XDS_classCode_Metadata_Coding_System">IHE XDSclassCode</a></p>
</div></td>
</tr>
<tr id="CONF-0368">
<td>CONF-0368</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-documentreference.html#CONF-0368">StructureDefinition-us-core-documentreference.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Although both [DocumentReference.attachment.url and DocumentReference.attachment.data] are marked as Must Support, the Server system is not required to support an address and inline base64 encoded data, but <strong>SHALL</strong> support at least one of these elements.</p>
</div></td>
</tr>
<tr id="CONF-0372">
<td>CONF-0372</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-documentreference.html#CONF-0372">StructureDefinition-us-core-documentreference.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>If there are multiple DocumentReference.content element repetitions, these <strong>SHALL</strong> all represent the same document in different formats or attachment metadata</p>
</div></td>
</tr>
<tr id="CONF-0373">
<td>CONF-0373</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-documentreference.html#CONF-0373">StructureDefinition-us-core-documentreference.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL-NOT</td>
<td><div><p>The [documentReference.content] element <strong>SHALL NOT</strong> contain different versions of the same content.</p>
</div></td>
</tr>
<tr id="CONF-0374">
<td>CONF-0374</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-documentreference.html#CONF-0374">StructureDefinition-us-core-documentreference.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The organization responsible for the DocumentReference <strong>SHALL</strong> be present either in DocumentReference.custodian or accessible in the Provenance resource targeting the DocumentReference using Provenance.agent.who or Provenance.agent.onBehalfOf</p>
</div></td>
</tr>
<tr id="CONF-0375">
<td>CONF-0375</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-encounter.html#CONF-0375">StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Although ... marked as Must Support, Servers are not required to support both [an Encounter.reasonCode or a reference with Encounter.reasonReference], but they <strong>SHALL</strong> support at least one of these elements.</p>
</div></td>
</tr>
<tr id="CONF-0378">
<td>CONF-0378</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-encounter.html#CONF-0378">StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>If Encounter.reasonReference references an Observation, it <strong>SHOULD</strong> conform to a US Core Observation [profile applicable to the observation being made]</p>
</div></td>
</tr>
<tr id="CONF-0379">
<td>CONF-0379</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-encounter.html#CONF-0379">StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Although … marked as Must Support, Servers are not required to support both Encounter.location.location and Encounter.serviceProvider, but they <strong>SHALL</strong> support at least one of these elements.</p>
</div></td>
</tr>
<tr id="CONF-0382">
<td>CONF-0382</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-encounter.html#CONF-0382">StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-location.html#CONF-0382">StructureDefinition-us-core-location.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>If the event facility/location differs from the Encounter.location, systems <strong>SHOULD</strong> reference it directly</p>
</div></td>
</tr>
<tr id="CONF-0383">
<td>CONF-0383</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-encounter.html#CONF-0383">StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-location.html#CONF-0383">StructureDefinition-us-core-location.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>If the event facility/location differs from the Encounter.location, … systems <strong>SHALL</strong> use the location element for all resources where the element is available.</p>
</div></td>
</tr>
<tr id="CONF-0384">
<td>CONF-0384</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-encounter.html#CONF-0384">StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-location.html#CONF-0384">StructureDefinition-us-core-location.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>If the event facility/location differs from the Encounter.location … systems <strong>MAY</strong> use the standard <a href="http://hl7.org/fhir/StructureDefinition/event-location">Event Location Extension</a> for US Core DiagnosticReport Profile for Laboratory Results Reporting and US Core Observation Clinical Result Profile.</p>
</div></td>
</tr>
<tr id="CONF-0385">
<td>CONF-0385</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-encounter.html#CONF-0385">StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Updates to .meta.lastUpdated <strong>SHOULD</strong> reflect New encounters/visits</p>
</div></td>
</tr>
<tr id="CONF-0386">
<td>CONF-0386</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-encounter.html#CONF-0386">StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Updates to .meta.lastUpdated <strong>SHOULD</strong> reflect changes in the status of encounters, including events that trigger the same status (e.g., in-progress → in-progress).</p>
</div></td>
</tr>
<tr id="CONF-0387">
<td>CONF-0387</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-goal.html#CONF-0387">StructureDefinition-us-core-goal.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Although both Goal.startDate and Goal.target.dueDate are marked as Must Support, the Server system is not required to support both, but <strong>SHALL</strong> support at least one of these elements.</p>
</div></td>
</tr>
<tr id="CONF-0390">
<td>CONF-0390</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-immunization.html#CONF-0390">StructureDefinition-us-core-immunization.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[Servers shall] use the status code: not-done to represent that an immunization was not given.</p>
</div></td>
</tr>
<tr id="CONF-0393">
<td>CONF-0393</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-immunization.html#CONF-0393">StructureDefinition-us-core-immunization.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The preferred code system identifier … is <a href="http://hl7.org/fhir/sid/cvx">http://hl7.org/fhir/sid/cvx</a> for CVX [vaccine codes]</p>
</div></td>
</tr>
<tr id="CONF-0394">
<td>CONF-0394</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-immunization.html#CONF-0394">StructureDefinition-us-core-immunization.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The preferred code system identifier … is <a href="http://hl7.org/fhir/sid/ndc">http://hl7.org/fhir/sid/ndc</a> for NDC vaccine codes]</p>
</div></td>
</tr>
<tr id="CONF-0397">
<td>CONF-0397</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-medicationdispense.html#CONF-0397">StructureDefinition-us-core-medicationdispense.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-medicationrequest.html#CONF-0397">StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>When using a code [to represent a medication for a medication dispense], RXNorm concepts are used.</p>
</div></td>
</tr>
<tr id="CONF-0398">
<td>CONF-0398</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-medicationdispense.html#CONF-0398">StructureDefinition-us-core-medicationdispense.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-medicationrequest.html#CONF-0398">StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>When using a code [to represent a medication for a medication dispense], USCDI recommends the <a href="https://www.fda.gov/drugs/drug-approvals-and-databases/national-drug-code-directory">National Drug Codes (NDC)</a> as an <em>optional</em> terminology. They can be supplied as an additional coding element.</p>
</div></td>
</tr>
<tr id="CONF-0399">
<td>CONF-0399</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-medicationdispense.html#CONF-0399">StructureDefinition-us-core-medicationdispense.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-medicationrequest.html#CONF-0399">StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>When referencing a Medication resource in .medicationReference, the resource may be <a href="http://hl7.org/fhir/R4/references.html#contained">contained</a></p>
</div></td>
</tr>
<tr id="CONF-0400">
<td>CONF-0400</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-medicationdispense.html#CONF-0400">StructureDefinition-us-core-medicationdispense.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-medicationrequest.html#CONF-0400">StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>When referencing a Medication resource in .medicationReference, the resource may be an external resource</p>
</div></td>
</tr>
<tr id="CONF-0401">
<td>CONF-0401</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-medicationdispense.html#CONF-0401">StructureDefinition-us-core-medicationdispense.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-medicationrequest.html#CONF-0401">StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The Server systems are not required to support both a [medication] code and a reference [when sending medicationDispense], but <strong>SHALL</strong> support at least one of these methods</p>
</div></td>
</tr>
<tr id="CONF-0402">
<td>CONF-0402</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-medicationdispense.html#CONF-0402">StructureDefinition-us-core-medicationdispense.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-medicationrequest.html#CONF-0402">StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>If an external reference to a Medication resource is used, the Server <strong>SHALL</strong> support the <a href="http://hl7.org/fhir/R4/search.html#include">_include</a> parameter for searching this element.</p>
</div></td>
</tr>
<tr id="CONF-0407">
<td>CONF-0407</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-medicationrequest.html#CONF-0407">StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>When recording “self-prescribed” medication, requester <strong>SHOULD</strong> be used to indicate the Patient or RelatedPerson as the prescriber</p>
</div></td>
</tr>
<tr id="CONF-0408">
<td>CONF-0408</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-medicationrequest.html#CONF-0408">StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Although [medicationRequest.reportedBoolean and MedicationRequest.reportedReference] are both marked as Must Support, the Server system is not required to support both, but <strong>SHALL</strong> support at least one of these elements</p>
</div></td>
</tr>
<tr id="CONF-0416">
<td>CONF-0416</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-medicationrequest.html#CONF-0416">StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[For organizations participating in the ONC Health IT Certification program,] the referenced resources <strong>SHOULD</strong> be a US Core Profile as documented in <a href="https://hl7.org/fhir/us/core/STU8/general-guidance.html#referencing-us-core-profiles">Referencing US Core Profiles</a>.</p>
</div></td>
</tr>
<tr id="CONF-0417">
<td>CONF-0417</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-medicationrequest.html#CONF-0417">StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Source EHR identifiers <strong>SHOULD</strong> be included to support deduplication across MedicationRequest resources.</p>
</div></td>
</tr>
<tr id="CONF-0419">
<td>CONF-0419</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-average-blood-pressure.html#CONF-0419">StructureDefinition-us-core-average-blood-pressure.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-vital-signs.html#CONF-0419">StructureDefinition-us-core-vital-signs.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-treatment-intervention-preference.html#CONF-0419">StructureDefinition-us-core-treatment-intervention-preference.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>The observations <strong>MAY</strong> have additional codes that translate or map to the Observation code or category codes [such as] … local system-specific codes [and] …more specific codes</p>
</div></td>
</tr>
<tr id="CONF-0420">
<td>CONF-0420</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-average-blood-pressure.html#CONF-0420">StructureDefinition-us-core-average-blood-pressure.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-vital-signs.html#CONF-0420">StructureDefinition-us-core-vital-signs.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-treatment-intervention-preference.html#CONF-0420">StructureDefinition-us-core-treatment-intervention-preference.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[For an Observation a] code system value <strong>SHOULD</strong> be supplied for each additional code</p>
</div></td>
</tr>
<tr id="CONF-0421">
<td>CONF-0421</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-average-blood-pressure.html#CONF-0421">StructureDefinition-us-core-average-blood-pressure.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Because the blood pressure values are communicated in the mandatory systolic and diastolic components [when using the US Core Average Blood Pressure Profile,] the Observation.value[x] element <strong>SHALL</strong> be omitted</p>
</div></td>
</tr>
<tr id="CONF-0422">
<td>CONF-0422</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-care-experience-preference.html#CONF-0422">StructureDefinition-us-core-care-experience-preference.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The context or precondition of a patient’s [care experience] preference <strong>SHOULD</strong> be supplied in the Observation.valueString or in an extension</p>
</div></td>
</tr>
<tr id="CONF-0423">
<td>CONF-0423</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-clinical-result.html#CONF-0423">StructureDefinition-us-core-observation-clinical-result.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Servers <strong>SHOULD</strong> use the base FHIR [Observation Category Codes] (http://hl7.org/fhir/R4/valueset-observation-category.html) [in Observation.category]</p>
</div></td>
</tr>
<tr id="CONF-0424">
<td>CONF-0424</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-clinical-result.html#CONF-0424">StructureDefinition-us-core-observation-clinical-result.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-lab.html#CONF-0424">StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Systems <strong>SHOULD</strong> support Observation.effectivePeriod to accurately represent measurements over time</p>
</div></td>
</tr>
<tr id="CONF-0425">
<td>CONF-0425</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-clinical-result.html#CONF-0425">StructureDefinition-us-core-observation-clinical-result.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-lab.html#CONF-0425">StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0425">StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-lab.html#CONF-0425">StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>An Observation.component without a value, <strong>SHALL</strong> include a reason why the data is absent</p>
</div></td>
</tr>
<tr id="CONF-0426">
<td>CONF-0426</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-clinical-result.html#CONF-0426">StructureDefinition-us-core-observation-clinical-result.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-lab.html#CONF-0426">StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0426">StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-vital-signs.html#CONF-0426">StructureDefinition-us-core-vital-signs.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Systems that never provide a component observation without a component value … [MAY choose not] to support Observation.component.dataAbsentReason</p>
</div></td>
</tr>
<tr id="CONF-0427">
<td>CONF-0427</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-clinical-result.html#CONF-0427">StructureDefinition-us-core-observation-clinical-result.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-lab.html#CONF-0427">StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0427">StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-vital-signs.html#CONF-0427">StructureDefinition-us-core-vital-signs.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-simple-observation.html#CONF-0427">StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>An Observation without a value, <strong>SHALL</strong> include a reason why the data is absent</p>
</div></td>
</tr>
<tr id="CONF-0428">
<td>CONF-0428</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-clinical-result.html#CONF-0428">StructureDefinition-us-core-observation-clinical-result.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-lab.html#CONF-0428">StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0428">StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-vital-signs.html#CONF-0428">StructureDefinition-us-core-vital-signs.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-simple-observation.html#CONF-0428">StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>[For] an Observation without a value … [Systems <strong>MAY</strong> choose not to] include a reason why the data is absent … [if] there are component observations or … reporting panel observations using Observation.hasMember</p>
</div></td>
</tr>
<tr id="CONF-0429">
<td>CONF-0429</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-clinical-result.html#CONF-0429">StructureDefinition-us-core-observation-clinical-result.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-lab.html#CONF-0429">StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0429">StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-vital-signs.html#CONF-0429">StructureDefinition-us-core-vital-signs.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-simple-observation.html#CONF-0429">StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Systems that never provide an observation without a value ... [MAY choose not] to support Observation.dataAbsentReason</p>
</div></td>
</tr>
<tr id="CONF-0430">
<td>CONF-0430</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-lab.html#CONF-0430">StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[When sending US Core Laboratory Results Observation Profile] updates to .meta.lastUpdated <strong>SHOULD</strong> reflect new laboratory observations</p>
</div></td>
</tr>
<tr id="CONF-0431">
<td>CONF-0431</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-lab.html#CONF-0431">StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[When sending US Core Laboratory Results Observation Profile] updates to .meta.lastUpdated <strong>SHOULD</strong> reflect changes in the status of laboratory observations, including events that trigger the same status (e.g., amended → amended)</p>
</div></td>
</tr>
<tr id="CONF-0432">
<td>CONF-0432</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-occupation.html#CONF-0432">StructureDefinition-us-core-observation-occupation.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[When sending US Core Observation Occupation Profile] for … [a] current job, [Servers SHALL] omit observation.effectivePeriod.end to indicate it is ongoing.</p>
</div></td>
</tr>
<tr id="CONF-0433">
<td>CONF-0433</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-occupation.html#CONF-0433">StructureDefinition-us-core-observation-occupation.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>When the industry is known, but the occupation is not, [Servers SHALL] use the value “unknown” from the <a href="http://hl7.org/fhir/R4/codesystem-data-absent-reason.html">DataAbsentReason Code System</a></p>
</div></td>
</tr>
<tr id="CONF-0434">
<td>CONF-0434</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-occupation.html#CONF-0434">StructureDefinition-us-core-observation-occupation.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>when the occupation is known but the industry is not, [Servers SHALL] omit the industry Observation.component</p>
</div></td>
</tr>
<tr id="CONF-0435">
<td>CONF-0435</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-pregnancyintent.html#CONF-0435">StructureDefinition-us-core-observation-pregnancyintent.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>To represent the patient’s pregnancy status, [Servers SHALL] use the <a href="https://hl7.org/fhir/us/core/StructureDefinition-us-core-observation-pregnancystatus.html">US Core Observation Pregnancy Status Profile</a>.</p>
</div></td>
</tr>
<tr id="CONF-0436">
<td>CONF-0436</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-pregnancystatus.html#CONF-0436">StructureDefinition-us-core-observation-pregnancystatus.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>To represent the patient’s intent to become pregnant, [Servers SHALL] use the <a href="https://hl7.org/fhir/us/core/StructureDefinition-us-core-observation-pregnancyintent.html">US Core Observation Pregnancy Intent Profile</a>.</p>
</div></td>
</tr>
<tr id="CONF-0437">
<td>CONF-0437</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0437">StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[For] multi-question surveys or assessments Observation.code is an overarching assessment or screening code, and the Observation.value element <strong>SHOULD</strong> be empty</p>
</div></td>
</tr>
<tr id="CONF-0438">
<td>CONF-0438</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0438">StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>A practitioner’s clinical observation or assertion about a patient’s health status, which is not a response to a screening or assessment question, <strong>SHOULD</strong> use the <a href="https://hl7.org/fhir/us/core/StructureDefinition-us-core-simple-observation.html">US Core Simple Observation Profile</a> instead [of the US Core Observation Screening Assessment Profile]</p>
</div></td>
</tr>
<tr id="CONF-0439">
<td>CONF-0439</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0439">StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>the Server system ... <strong>SHALL</strong> support [either] Reference(US Core Observation Screening Assessment Profile) or Reference(US Core QuestionnaireResponse Profile) for Observation.derivedFrom</p>
</div></td>
</tr>
<tr id="CONF-0441">
<td>CONF-0441</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-simple-observation.html#CONF-0441">StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Observations formally part of an assessment tool or survey <strong>SHOULD</strong> use the <a href="https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-observation-screening-assessment.html">US Core Observation Screening Assessment Profile</a>.</p>
</div></td>
</tr>
<tr id="CONF-0442">
<td>CONF-0442</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-simple-observation.html#CONF-0442">StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>An assertion or determination derived from screening and assessment tools <strong>SHOULD</strong> reference them using Observation.derivedFrom</p>
</div></td>
</tr>
<tr id="CONF-0443">
<td>CONF-0443</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-simple-observation.html#CONF-0443">StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>When using `Observation.derivedFrom’ to reference an Observation, the referenced Observation <strong>SHOULD</strong> be a US Core Observation</p>
</div></td>
</tr>
<tr id="CONF-0445">
<td>CONF-0445</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-treatment-intervention-preference.html#CONF-0445">StructureDefinition-us-core-treatment-intervention-preference.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>[US Core] treatment intervention preferences expressed by a patient may be documented in narrative (text) form or the result of selecting from a list of options provided by the content creator/implementer.</p>
</div></td>
</tr>
<tr id="CONF-0446">
<td>CONF-0446</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-treatment-intervention-preference.html#CONF-0446">StructureDefinition-us-core-treatment-intervention-preference.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[When using US Core Treatment Intervention Preference Profile] the context or precondition of a patient’s preference <strong>SHOULD</strong> be supplied in the Observation.valueString ... or an extension</p>
</div></td>
</tr>
<tr id="CONF-0447">
<td>CONF-0447</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-vital-signs.html#CONF-0447">StructureDefinition-us-core-vital-signs.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>[US Core Vital Signs] observations <strong>MAY</strong> have <a href="http://hl7.org/fhir/R4/observation.html#gr-comp">component</a> observations … [see] FHIR core specification <a href="http://hl7.org/fhir/R4/observation-vitalsigns.html#vitals-table">vital signs table</a> for examples</p>
</div></td>
</tr>
<tr id="CONF-0448">
<td>CONF-0448</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-pediatric-bmi-for-age.html#CONF-0448">StructureDefinition-pediatric-bmi-for-age.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-pediatric-weight-for-height.html#CONF-0448">StructureDefinition-pediatric-weight-for-height.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-head-occipital-frontal-circumference-percentile.html#CONF-0448">StructureDefinition-head-occipital-frontal-circumference-percentile.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Information about the growth chart tables used to determine percentiles <strong>SHOULD</strong> be supplied in Observation.note.text</p>
</div></td>
</tr>
<tr id="CONF-0449">
<td>CONF-0449</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-blood-pressure.html#CONF-0449">StructureDefinition-us-core-blood-pressure.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[In the US Core Blood Pressure Profile] because the blood pressure values are communicated in the mandatory systolic and diastolic components[,] the Observation.value[x] element <strong>SHOULD</strong> be omitted</p>
</div></td>
</tr>
<tr id="CONF-0450">
<td>CONF-0450</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-blood-pressure.html#CONF-0450">StructureDefinition-us-core-blood-pressure.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[In the US Core Blood Pressure Profile] because the blood pressure values are communicated in the mandatory systolic and diastolic components[,] an Observation without a systolic or diastolic result value, <strong>SHALL</strong> include a reason why the data is absent in Observation.component.dataAbsentReason</p>
</div></td>
</tr>
<tr id="CONF-0451">
<td>CONF-0451</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-blood-pressure.html#CONF-0451">StructureDefinition-us-core-blood-pressure.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[In the US Core Blood Pressure Profile] because the blood pressure values are communicated in the mandatory systolic and diastolic components[,] All Server systems - including those that never provide a component observation without a value - <strong>SHALL</strong> support Observation.component.dataAbsentReason for the components.</p>
</div></td>
</tr>
<tr id="CONF-0452">
<td>CONF-0452</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-pulse-oximetry.html#CONF-0452">StructureDefinition-us-core-pulse-oximetry.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Inspired oxygen therapy may be represented with <a href="http://hl7.org/fhir/R4/observation.html#gr-comp">component</a> observations when measured at the same time as the pulse oximetry measurements [in the US Core Pulse Oximetry profile]</p>
</div></td>
</tr>
<tr id="CONF-0453">
<td>CONF-0453</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-pulse-oximetry.html#CONF-0453">StructureDefinition-us-core-pulse-oximetry.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Many pulse oximetry readings are taken while the patient is breathing room air. The concept of “room air” (unmodified, ambient air) <strong>SHOULD</strong> be represented as an inhaled oxygen flow rate of 0 liters/min</p>
</div></td>
</tr>
<tr id="CONF-0454">
<td>CONF-0454</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-pulse-oximetry.html#CONF-0454">StructureDefinition-us-core-pulse-oximetry.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>A pulse oximetry reading without inspired oxygen component observations may imply that the measurement was performed while the patient was breathing room air or that the inspired oxygen reading was omitted. To remove this uncertainty, the inspired oxygen <a href="http://hl7.org/fhir/R4/observation.html#gr-comp">component</a> observations <strong>SHOULD</strong> be used [when using the US Core Pulse Oximetry profile.]</p>
</div></td>
</tr>
<tr id="CONF-0455">
<td>CONF-0455</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-organization.html#CONF-0455">StructureDefinition-us-core-organization.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Systems <strong>SHALL</strong> support National Provider Identifier (NPI) for organizations</p>
</div></td>
</tr>
<tr id="CONF-0456">
<td>CONF-0456</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-organization.html#CONF-0456">StructureDefinition-us-core-organization.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Systems … <strong>SHOULD</strong> the National Association of Insurance Commissioners NAIC Company code (sometimes called “NAIC Number” or “cocode”) for payers.</p>
</div></td>
</tr>
<tr id="CONF-0457">
<td>CONF-0457</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-organization.html#CONF-0457">StructureDefinition-us-core-organization.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Systems … <strong>SHOULD</strong> support Clinical Laboratory Improvement Amendments (CLIA) for laboratories</p>
</div></td>
</tr>
<tr id="CONF-0461">
<td>CONF-0461</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-patient.html#CONF-0461">StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-race.html#CONF-0461">StructureDefinition-us-core-race.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>The Complex [Extension] for Race ... allow[s] for one or more codes of which <strong>MAY</strong> include additional codes from the detailed ethnicity ... value sets drawn from the <a href="https://phinvads.cdc.gov/vads/ViewCodeSystem.action?id=2.16.840.1.113883.6.238">Race & Ethnicity - CDC (CDCREC)</a> code system [when using the [US Core Race Extension] (https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-race.html)]</p>
</div></td>
</tr>
<tr id="CONF-0462">
<td>CONF-0462</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-patient.html#CONF-0462">StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-ethnicity.html#CONF-0462">StructureDefinition-us-core-ethnicity.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The Complex [Extension] for Race ... allow[s] for one or more codes of which <strong>SHALL</strong> include a text description [of category codes when using the [US Core Race Extension] (https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-race.html)]</p>
</div></td>
</tr>
<tr id="CONF-0463">
<td>CONF-0463</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-patient.html#CONF-0463">StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-race.html#CONF-0463">StructureDefinition-us-core-race.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>The Complex [Extension] for ... Ethnicity allow[s] for one or more codes of which <strong>MAY</strong> include additional codes from the detailed ... race value sets drawn from the <a href="https://phinvads.cdc.gov/vads/ViewCodeSystem.action?id=2.16.840.1.113883.6.238">Race & Ethnicity - CDC (CDCREC)</a> code system [when using the [US Core Race Extension] (https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-race.html)]</p>
</div></td>
</tr>
<tr id="CONF-0464">
<td>CONF-0464</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-patient.html#CONF-0464">StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-ethnicity.html#CONF-0464">StructureDefinition-us-core-ethnicity.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The Complex [Extension] for ... Ethnicity allow[s] for one or more codes of which <strong>SHALL</strong> include a text description [of category codes when using the [US Core Ethnicity Extension] (https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-ethnicity.html)]</p>
</div></td>
</tr>
<tr id="CONF-0466">
<td>CONF-0466</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-patient.html#CONF-0466">StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Previous name is represented by setting Patient.name.use to “old” or providing an end date in Patient.name.period or doing both</p>
</div></td>
</tr>
<tr id="CONF-0467">
<td>CONF-0467</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-patient.html#CONF-0467">StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Previous address is represented by setting Patient.address.use to “old” or providing an end date in Patient.address.period or doing both.</p>
</div></td>
</tr>
<tr id="CONF-0470">
<td>CONF-0470</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-patient.html#CONF-0470">StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Non-certifying systems[, systems that are not participating in the ONC Health IT certification program,] <strong>SHOULD</strong> follow the <a href="https://asapnet.org/wp-content/uploads/2022/03/Project_US_FINAL_Technical_Specification_Version_1.0.pdf">Project US@ Technical Specification for Patient Addresses Final Version 1.0</a> as the standard style guide for Patient.address.line and Patient.address.city for new and updated records.</p>
</div></td>
</tr>
<tr id="CONF-0471">
<td>CONF-0471</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-patient.html#CONF-0471">StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>[For systems participating in the ONC Health IT certification program,] this requirement [to follow the <a href="https://asapnet.org/wp-content/uploads/2022/03/Project_US_FINAL_Technical_Specification_Version_1.0.pdf">Project US@ Technical Specification for Patient Addresses Final Version 1.0</a> for Patient.address.line and Patient.address.city] does not apply to historical records or documents that are exposed through FHIR-based APIs. [Organizations <strong>MAY</strong> choose not to use use Project US@ Technical Specification for Patient Addresses Final Version 1.0 when sending historical records]</p>
</div></td>
</tr>
<tr id="CONF-0472">
<td>CONF-0472</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-patient.html#CONF-0472">StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD-NOT</td>
<td><div><p><strong>SHOULD NOT</strong> be used as a patient identifier in Patient.identifier.value</p>
</div></td>
</tr>
<tr id="CONF-0473">
<td>CONF-0473</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-practitioner.html#CONF-0473">StructureDefinition-us-core-practitioner.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers that support only the US Core Practitioner Profile and do not support the <a href="https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-practitionerrole.html">US Core PractitionerRole Profile</a> <strong>SHALL</strong> provide implementation-specific guidance on how to access a provider’s location and contact information using only the Practitioner resource.</p>
</div></td>
</tr>
<tr id="CONF-0474">
<td>CONF-0474</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-practitioner.html#CONF-0474">StructureDefinition-us-core-practitioner.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Although Practitioner.address is marked as Must Support, the Server system … [<strong>MAY</strong> choose not to] support it if they support the US Core PractitionerRole Profile</p>
</div></td>
</tr>
<tr id="CONF-0475">
<td>CONF-0475</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-practitioner.html#CONF-0475">StructureDefinition-us-core-practitioner.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[When using the US Core Practioner Profile] Practitioner.address … <strong>SHALL</strong>[be supported] if … [the Server does] not support the US Core PractitionerRole Profile</p>
</div></td>
</tr>
<tr id="CONF-0477">
<td>CONF-0477</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-practitioner.html#CONF-0477">StructureDefinition-us-core-practitioner.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Only professional/work contact information about the practitioner <strong>SHOULD</strong> be available to the patient</p>
</div></td>
</tr>
<tr id="CONF-0480">
<td>CONF-0480</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-procedure.html#CONF-0480">StructureDefinition-us-core-procedure.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[If using LOINC codes in procedure.code] only LOINC concepts that reflect actual procedures <strong>SHOULD</strong> be used</p>
</div></td>
</tr>
<tr id="CONF-0486">
<td>CONF-0486</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-procedure.html#CONF-0486">StructureDefinition-us-core-procedure.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[For organizations participating in the ONC Health IT Certification program,] when using Procedure.reasonReference Servers <strong>SHALL</strong> support at least one target resource in Procedure.reasonReference</p>
</div></td>
</tr>
<tr id="CONF-0488">
<td>CONF-0488</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-procedure.html#CONF-0488">StructureDefinition-us-core-procedure.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[For organizations participating in the ONC Health IT Certification program,] when using Procedure.reasonReference …The referenced resources <strong>SHOULD</strong> be a US Core Profile as documented in <a href="https://hl7.org/fhir/us/core/STU8/general-guidance.html#referencing-us-core-profiles">Referencing US Core Profiles</a></p>
</div></td>
</tr>
<tr id="CONF-0489">
<td>CONF-0489</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-provenance.html#CONF-0489">StructureDefinition-us-core-provenance.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>The US Core Provenance resource <strong>SHALL</strong> be supported for these US Core resource types:
AllergyIntolerance, CarePlan, CareTeam, Condition, Coverage, Device, DiagnosticReport, DocumentReference, Encounter, Goal, Immunization, MedicationDispense, MedicationRequest, Observation, Patient, Procedure, QuestionnaireResponse, RelatedPerson, ServiceRequest</p>
</div></td>
</tr>
<tr id="CONF-0508">
<td>CONF-0508</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-provenance.html#CONF-0508">StructureDefinition-us-core-provenance.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>If a system receives a provider in Provenance.agent.who as free text, they must capture [the organization] who sent them the information [and upon] request ... <strong>SHALL</strong> provide this organization as the source</p>
</div></td>
</tr>
<tr id="CONF-0509">
<td>CONF-0509</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-provenance.html#CONF-0509">StructureDefinition-us-core-provenance.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>If a system receives a provider in Provenance.agent.who as free text, … [upon request they] <strong>MAY</strong> include the free text provider.</p>
</div></td>
</tr>
<tr id="CONF-0514">
<td>CONF-0514</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-servicerequest.html#CONF-0514">StructureDefinition-us-core-servicerequest.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>The Must Support <code>ServiceRequest.category</code> is bound, at a minimum, to the <a href="https://hl7.org/fhir/us/core/STU8/ValueSet-us-core-servicerequest-category.html">US Core ServiceRequest Category Codes</a>, and other category codes can be used.</p>
</div></td>
</tr>
<tr id="CONF-0515">
<td>CONF-0515</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-servicerequest.html#CONF-0515">StructureDefinition-us-core-servicerequest.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The ServiceRequest.code value ... <strong>SHOULD</strong> be constrained to a subset for a particular use case or domain</p>
</div></td>
</tr>
<tr id="CONF-0523">
<td>CONF-0523</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-specimen.html#CONF-0523">StructureDefinition-us-core-specimen.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Since the binding [for Specimen.type and additional USCDI elements] is <a href="http://hl7.org/fhir/R4/terminologies.html#extensible">extensible</a> when a code is unavailable, just text is allowed [and conformant].</p>
</div></td>
</tr>
<tr id="CONF-0524">
<td>CONF-0524</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-specimen.html#CONF-0524">StructureDefinition-us-core-specimen.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Although both Specimen.identifier and Specimen.accessionIdentifier are marked as Must Support, the Server system is not required to support both, but <strong>SHALL</strong> support at least one of these elements.</p>
</div></td>
</tr>
<tr id="CONF-0550">
<td>CONF-0550</td>
<td>
<span style="color: grey;">•</span><a href="security.html#CONF-0550">security.html#patient-privacy-and-security</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Systems <strong>SHALL</strong> establish a risk analysis and management regime that conforms with HIPAA security regulatory requirements</p>
</div></td>
</tr>
<tr id="CONF-0552">
<td>CONF-0552</td>
<td>
<span style="color: grey;">•</span><a href="security.html#CONF-0552">security.html#patient-privacy-and-security</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>US Federal systems <strong>SHOULD</strong> conform with the risk management and mitigation requirements defined in NIST 800 series documents.</p>
</div></td>
</tr>
<tr id="CONF-0554">
<td>CONF-0554</td>
<td>
<span style="color: grey;">•</span><a href="security.html#CONF-0554">security.html#patient-privacy-and-security</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>US Federal systems … <strong>SHOULD</strong> include security category assignment following NIST 800-60 vol. 2 Appendix D.14.</p>
</div></td>
</tr>
<tr id="CONF-0556">
<td>CONF-0556</td>
<td>
<span style="color: grey;">•</span><a href="security.html#CONF-0556">security.html#patient-privacy-and-security</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The coordination of risk management and the related security and privacy controls … <strong>SHOULD</strong> be defined in the Business Associate Agreement when available.</p>
</div></td>
</tr>
<tr id="CONF-0558">
<td>CONF-0558</td>
<td>
<span style="color: grey;">•</span><a href="security.html#CONF-0558">security.html#patient-privacy-and-security</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Systems <strong>SHALL</strong> reference a single time source to establish a common time base for security auditing and clinical data records among computing systems.</p>
</div></td>
</tr>
<tr id="CONF-0560">
<td>CONF-0560</td>
<td>
<span style="color: grey;">•</span><a href="security.html#CONF-0560">security.html#patient-privacy-and-security</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The selected time service <strong>SHOULD</strong> be documented in the Business Associate Agreement when available.</p>
</div></td>
</tr>
<tr id="CONF-0562">
<td>CONF-0562</td>
<td>
<span style="color: grey;">•</span><a href="security.html#CONF-0562">security.html#patient-privacy-and-security</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Systems <strong>SHALL</strong> keep audit logs of the various transactions.</p>
</div></td>
</tr>
<tr id="CONF-0564">
<td>CONF-0564</td>
<td>
<span style="color: grey;">•</span><a href="security.html#CONF-0564">security.html#patient-privacy-and-security</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Systems <strong>SHALL</strong> use TLS version 1.2 or higher for all transmissions not taking place over a secure network connection.</p>
</div></td>
</tr>
<tr id="CONF-0566">
<td>CONF-0566</td>
<td>
<span style="color: grey;">•</span><a href="security.html#CONF-0566">security.html#patient-privacy-and-security</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>US Federal systems <strong>SHOULD</strong> conform with FIPS PUB 140-2.</p>
</div></td>
</tr>
<tr id="CONF-0568">
<td>CONF-0568</td>
<td>
<span style="color: grey;">•</span><a href="security.html#CONF-0568">security.html#patient-privacy-and-security</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Systems <strong>SHALL</strong> conform to <a href="http://hl7.org/fhir/R4/security.html#http">FHIR Communications Security</a> requirements.</p>
</div></td>
</tr>
<tr id="CONF-0570">
<td>CONF-0570</td>
<td>
<span style="color: grey;">•</span><a href="security.html#CONF-0570">security.html#patient-privacy-and-security</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>For Authentication and Authorization, Systems <strong>SHALL</strong> support any <a href="http://hl7.org/fhir/smart-app-launch/history.html">SMART App Launch Version 2.0.0</a> and later for Client <-> Server interactions.</p>
</div></td>
</tr>
<tr id="CONF-0572">
<td>CONF-0572</td>
<td>
<span style="color: grey;">•</span><a href="security.html#CONF-0572">security.html#patient-privacy-and-security</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Systems <strong>SHALL</strong> implement consent requirements per their state, local, and institutional policies.</p>
</div></td>
</tr>
<tr id="CONF-0574">
<td>CONF-0574</td>
<td>
<span style="color: grey;">•</span><a href="security.html#CONF-0574">security.html#patient-privacy-and-security</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The Business Associate Agreements <strong>SHOULD</strong> document systems’ mutual consent requirements.</p>
</div></td>
</tr>
<tr id="CONF-0576">
<td>CONF-0576</td>
<td>
<span style="color: grey;">•</span><a href="security.html#CONF-0576">security.html#patient-privacy-and-security</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Systems <strong>SHOULD</strong> provide Provenance statements using the <a href="https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-provenance.html">US Core Provenance Profile</a> resource and associated requirements.</p>
</div></td>
</tr>
<tr id="CONF-0578">
<td>CONF-0578</td>
<td>
<span style="color: grey;">•</span><a href="security.html#CONF-0578">security.html#patient-privacy-and-security</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Systems <strong>MAY</strong> implement the <a href="http://hl7.org/fhir/R4/security.html#digital%20signatures">FHIR Digital Signatures</a></p>
</div></td>
</tr>
<tr id="CONF-0580">
<td>CONF-0580</td>
<td>
<span style="color: grey;">•</span><a href="security.html#CONF-0580">security.html#patient-privacy-and-security</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Systems <strong>MAY</strong> protect the confidentiality of data at rest via encryption and associated access controls.</p>
</div></td>
</tr>
<tr id="CONF-0804">
<td>CONF-0804</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0804">must-support.html#must-support---complex-elements</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>If any sub-element is marked as <em>Additional USCDI</em> [for a complex element], it must also meet the <em>Additional USCDI</em> requirements and satisfy the <em>Additional USCDI</em> requirements for the parent element.</p>
</div></td>
</tr>
<tr id="CONF-0808">
<td>CONF-0808</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0808">must-support.html#must-support-targets-for-us-core-profiles</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>When a Reference type element is labeled as Must Support and has a single target profile referenced, the target profile <strong>SHALL</strong> be supported.</p>
</div></td>
</tr>
<tr id="CONF-0810">
<td>CONF-0810</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0810">must-support.html#must-support-targets-for-us-core-profiles</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>When a Reference type element is labeled as Must Support, has multiple target profiles referenced, and specific targets are labeled as Must Support, the Must Support target profile(s) <strong>SHALL</strong> be supported.</p>
</div></td>
</tr>
<tr id="CONF-0813">
<td>CONF-0813</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0813">must-support.html#must-support---slices</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>[If a] slicer's Must Support property only defines the element level Must Support...[, i.e.,] no Must Support... property is defined for the slice, then support for that slice's definition is optional.</p>
</div></td>
</tr>
<tr id="CONF-0818">
<td>CONF-0818</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0818">clinical-notes.html#clinical-notes</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers <strong>SHALL</strong> support, at minimum, these … "Common Clinical Notes":
<a href="https://loinc.org/11504-8.html">Surgical Operation Note (11504-8)</a></p>
</div></td>
</tr>
<tr id="CONF-0819">
<td>CONF-0819</td>
<td>
<span style="color: grey;">•</span><a href="clinical-notes.html#CONF-0819">clinical-notes.html#clinical-notes</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers <strong>SHALL</strong> support, at minimum, these … "Common Clinical Notes":
<a href="https://loinc.org/34111-5.html">Emergency Department Note (34111-5)</a></p>
</div></td>
</tr>
<tr id="CONF-0820">
<td>CONF-0820</td>
<td>
<span style="color: grey;">•</span><a href="screening-and-assessments.html#CONF-0820">screening-and-assessments.html#structured-screening-and-assessments</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers that support the USCDI Health Status/Assessments Data Class <strong>SHALL</strong> support the US Core Observation Screening Assessment Profile</p>
</div></td>
</tr>
<tr id="CONF-0821">
<td>CONF-0821</td>
<td>
<span style="color: grey;">•</span><a href="screening-and-assessments.html#CONF-0821">screening-and-assessments.html#structured-screening-and-assessments</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Servers that support the USCDI Health Status/Assessments Data Class ... <strong>SHOULD</strong> support the SDC Base Questionnaire and the US Core QuestionnaireResponse Profile."</p>
</div></td>
</tr>
<tr id="CONF-0822">
<td>CONF-0822</td>
<td>
<span style="color: grey;">•</span><a href="screening-and-assessments.html#CONF-0822">screening-and-assessments.html#category-codes</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>For the US Core Simple Observation Profile, Servers <strong>SHALL</strong> support all the category codes <a href="https://hl7.org/fhir/us/core/STU8/screening-and-assessments.html#category-codes">listed</a>.</p>
</div></td>
</tr>
<tr id="CONF-0823">
<td>CONF-0823</td>
<td>
<span style="color: grey;">•</span><a href="screening-and-assessments.html#CONF-0823">screening-and-assessments.html#category-codes</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>For the … US Core Observation Screening Assessment Profiles, Servers <strong>SHALL</strong> support all the category codes <a href="https://hl7.org/fhir/us/core/STU8/screening-and-assessments.html#category-codes">listed</a>.</p>
</div></td>
</tr>
<tr id="CONF-0824">
<td>CONF-0824</td>
<td>
<span style="color: grey;">•</span><a href="screening-and-assessments.html#CONF-0824">screening-and-assessments.html#category-codes</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>For the US Core Condition Problems and Health Concerns Profile, Servers <strong>SHALL</strong> support the code ,"sdoh"</p>
</div></td>
</tr>
<tr id="CONF-0825">
<td>CONF-0825</td>
<td>
<span style="color: grey;">•</span><a href="screening-and-assessments.html#CONF-0825">screening-and-assessments.html#category-codes</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>For the US Core Condition Problems and Health Concerns Profile, Servers <strong>SHOULD</strong> support the other category codes <a href="https://hl7.org/fhir/us/core/STU8/screening-and-assessments.html#category-codes">listed</a>.</p>
</div></td>
</tr>
<tr id="CONF-0826">
<td>CONF-0826</td>
<td>
<span style="color: grey;">•</span><a href="screening-and-assessments.html#CONF-0826">screening-and-assessments.html#category-codes</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>For the US Core ServiceRequest Profile, Servers <strong>SHOULD</strong> support all the [<a href="https://hl7.org/fhir/us/core/STU8/screening-and-assessments.html#category-codes">listed</a>] category codes.</p>
</div></td>
</tr>
<tr id="CONF-0831">
<td>CONF-0831</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-condition-problems-health-concerns.html#CONF-0831">StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[The Server <strong>SHALL</strong> support the] category of "problem-list-item"</p>
</div></td>
</tr>
<tr id="CONF-0832">
<td>CONF-0832</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-condition-problems-health-concerns.html#CONF-0832">StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[The Server <strong>SHALL</strong> support the] category of "health-concern"</p>
</div></td>
</tr>
<tr id="CONF-0836">
<td>CONF-0836</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-diagnosticreport-note.html#CONF-0836">StructureDefinition-us-core-diagnosticreport-note.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The <code>DiagnosticRequest.basedOn</code> element connects the DiagnosticReport to the originating order in the EHR. Systems that initiate the order <strong>SHOULD</strong> use this element when reporting the results.</p>
</div></td>
</tr>
<tr id="CONF-0837">
<td>CONF-0837</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-diagnosticreport-note.html#CONF-0837">StructureDefinition-us-core-diagnosticreport-note.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The <code>DiagnosticReport.media.link</code> element <strong>SHOULD</strong> be used to support links to various patient-friendly content, such as jpg images of x-rays (see the DiagnosticReport Chest X-ray Report Example).</p>
</div></td>
</tr>
<tr id="CONF-0838">
<td>CONF-0838</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-diagnosticreport-note.html#CONF-0838">StructureDefinition-us-core-diagnosticreport-note.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The <code>DiagnosticReport.imagingStudy</code> element <strong>SHOULD</strong> be used to support exchange with systems that can view DICOM (Digital Imaging and Communications in Medicine) studies, series, and SOP (Service-Object Pair) instances referenced in the -<a href="http://hl7.org/fhir/R4/imagingstudy.html">ImagingStudy</a> resource.</p>
</div></td>
</tr>
<tr id="CONF-0839">
<td>CONF-0839</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-documentreference.html">StructureDefinition-us-core-documentreference.html</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>If the referenced a document or file [referenced by <code>DocumentReference.content.attachment.url</code>] is hosted on a Server outside the FHIR Server, it should be securely accessible using the same authorization credentials that were used to access the FHIR Server. This reduces complexity for the Client and improves the user experience.</p>
</div></td>
</tr>
<tr id="CONF-0840">
<td>CONF-0840</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-encounter.html#CONF-0840">StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Although the [US Core Interpreter Needed] extension is marked as an Additional USCDI Requirements 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 <strong>SHALL</strong> support the extension on at least one.</p>
</div></td>
</tr>
<tr id="CONF-0841">
<td>CONF-0841</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-immunization.html#CONF-0841">StructureDefinition-us-core-immunization.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>There is no guarantee that vaccine lot numbers are globally unique, and they are not recommended for matching or de-duplication across systems unless used with other data elements such as a vaccine product code, manufacturer code, or date of administration. Implementers <strong>MAY</strong> communicate the <code>Immunization.manufacturer</code> to ensure global uniqueness to lot numbers.</p>
</div></td>
</tr>
<tr id="CONF-0842">
<td>CONF-0842</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-medicationrequest.html#CONF-0842">StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Servers <strong>SHALL</strong> return all active medications following the <a href="https://hl7.org/fhir/us/core/STU8/medication-list.html#get-all-active-medications">Get All Active Medications</a> guidance.</p>
</div></td>
</tr>
<tr id="CONF-0843">
<td>CONF-0843</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-lab.html#CONF-0843">StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[For US Core Laboratory Result Observation Profile, even] when the specimen type is already implied by the LOINC code used in <code>Observation.code</code> (e.g., a LOINC code for Blood Glucose), the <code>Observation.specimen</code> element <strong>SHOULD</strong> also be populated with the referenced Specimen resource to explicitly communicate the collected specimen type.</p>
</div></td>
</tr>
<tr id="CONF-0844">
<td>CONF-0844</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-lab.html#CONF-0844">StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[For US Core Laboratory Result Observation Profile, the] type of specimen [in <code>Observation.specimen</code>] <strong>SHOULD</strong> not conflict with the LOINC code [in <code>Observation.code</code>].</p>
</div></td>
</tr>
<tr id="CONF-0845">
<td>CONF-0845</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0845">StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>[For the US Core Observation Screening Assessment Profile, the] category type "survey" is required.</p>
</div></td>
</tr>
<tr id="CONF-0850">
<td>CONF-0850</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0850">StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[For the US Core Observation Screening Assessment Profile,] when using Observation.derivedFrom to reference an Observation, the referenced Observation <strong>SHOULD</strong> be a US Core Observation.</p>
</div></td>
</tr>
<tr id="CONF-0851">
<td>CONF-0851</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-patient.html#CONF-0851">StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Servers can use the <a href="https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-interpreter-needed.html">US Core Interpreter Needed Extension</a> on [the <a href="https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-patient.html">US Core Patient Profile</a>] or the <a href="https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-encounter.html">US Core Encounter Profile</a> to communicate whether a patient needs an interpreter.</p>
</div></td>
</tr>
<tr id="CONF-0855">
<td>CONF-0855</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-patient.html#CONF-0855">StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-encounter.html#CONF-0855">StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Systems <strong>SHOULD</strong> designate the patient's preferred language in the Patient.communication.preferred element.</p>
</div></td>
</tr>
<tr id="CONF-0857">
<td>CONF-0857</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-servicerequest.html#CONF-0857">StructureDefinition-us-core-servicerequest.html#root</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>For the USCDI <em>Laboratory Order</em>, <em>Imaging Order</em>, <em>Clinical Test Order</em>, and <em>Procedure Order</em> Data Elements, implementers <strong>SHOULD</strong> use the corresponding category codes listed in the table</p>
</div></td>
</tr>
<tr id="CONF-0866">
<td>CONF-0866</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-simple-observation.html#CONF-0866">StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>An <code>Observation.component</code> without a value, <strong>SHALL</strong> include a reason why the data is absent.</p>
</div></td>
</tr>
<tr id="CONF-0867">
<td>CONF-0867</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-simple-observation.html#CONF-0867">StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Systems that never provide a component observation without a component value are not required to support <code>Observation.component.dataAbsentReason</code>.</p>
</div></td>
</tr>
<tr id="CONF-0868">
<td>CONF-0868</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-simple-observation.html#CONF-0868">StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Although 'Observation.performer' target profiles <a href="https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-practitioner.html">US Core Practitioner Profile</a> and <a href="https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-patient.html">US Core Patient Profile</a> are labeled Must Support. Servers are not required to support both, but <strong>SHALL</strong> support at least one.</p>
</div></td>
</tr>
<tr id="CONF-0871">
<td>CONF-0871</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0871">must-support.html#must-support---slices</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>[If a] slicer's Additional USCDI property only defines the element level Additional USCDI...[, i.e.,] no Additional USCDI... property is defined for the slice, then support for that slice's definition is optional.</p>
</div></td>
</tr>
<tr id="CONF-0881">
<td>CONF-0881</td>
<td>
<span style="color: grey;">•</span><a href="must-support.html#CONF-0881">must-support.html#must-support---resource-references</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>When a Reference element is labeled as <em>Must Support</em> has multiple target profiles referenced, but none are labeled as <em>Must Support</em></p>
<p>...</p>
<ul>
<li>US Core Responders <strong>SHALL</strong> be capable of providing [such an element] with a valid reference to <em>at least one</em> target profile.</li>
</ul>
</div></td>
</tr>
<tr id="CONF-0885">
<td>CONF-0885</td>
<td>
<span style="color: grey;">•</span><a href="basic-provenance.html#CONF-0885">basic-provenance.html#individual-level-provenance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The author is communicated by the elements and the author's role by the referenced target resource (for example, Patient, Practitioner/PractitionerRole, RelatedPerson, Device). Details about the author's role are contained in the target resource's contents. Many of these elements are labeled Must Support or Additional USCDI Requirements. However,[even if they are not labeled Must Support or Additional USCDI Requirements] all of these elements and target resources <strong>SHOULD</strong> be supported in the profiles if the system captures the data.</p>
</div></td>
</tr>
<tr id="CONF-0887">
<td>CONF-0887</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0887">StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHALL</td>
<td><div><p>Although 'Observation.performer' target profiles <a href="https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-practitioner.html">US Core Practitioner Profile</a> and <a href="https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-patient.html">US Core Patient Profile</a> are labeled Must Support. Servers are not required to support both, but <strong>SHALL</strong> support at least one.</p>
</div></td>
</tr>
<tr id="CONF-0889">
<td>CONF-0889</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-practitionerrole.html#CONF-0889">StructureDefinition-us-core-practitionerrole.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-organization.html#CONF-0889">StructureDefinition-us-core-organization.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-patient.html#CONF-0889">StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance</a><br/>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-relatedperson.html#CONF-0889">StructureDefinition-us-core-relatedperson.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>… this profile uses USPS Two Letter Alphabetic Codes for US states. When encoding addresses outside the US, systems <strong>SHOULD</strong> use the <a href="https://www.iso.org/iso-3166-country-codes.html">ISO 3166 subdivision codes</a>.</p>
</div></td>
</tr>
<tr id="CONF-0890">
<td>CONF-0890</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-practitionerrole.html#CONF-0890">StructureDefinition-us-core-practitionerrole.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Due to implementer feedback, some US Core Profiles reference the base FHIR PractitionerRole resource instead of the US Core PractitionerRole Profile. However, the US Core PractitionerRole Profile <strong>SHOULD</strong> be used as the default profile if referenced by another US Core profile.</p>
</div></td>
</tr>
<tr id="CONF-0891">
<td>CONF-0891</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-practitionerrole.html#CONF-0891">StructureDefinition-us-core-practitionerrole.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>When selecting role codes...implementers <strong>SHOULD</strong> choose the code that reflects the specific duties performed within that role rather than the specialty unless the individual's professional specialization characterizes the role.</p>
</div></td>
</tr>
<tr id="CONF-0892">
<td>CONF-0892</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-procedure.html#CONF-0892">StructureDefinition-us-core-procedure.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>A procedure including an implantable device <strong>SHOULD</strong> use <code>Procedure.focalDevice</code> referencing the US Core Device Profile</p>
</div></td>
</tr>
<tr id="CONF-0893">
<td>CONF-0893</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-provenance.html#CONF-0893">StructureDefinition-us-core-provenance.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>Other information can be tracked such as what activity has occurred in <code>Provenance.activity</code>, and details about where the entity came from (for example, a document source's identity and role) in <code>Provenance.entity</code>.</p>
</div></td>
</tr>
<tr id="CONF-0894">
<td>CONF-0894</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-practitionerrole.html#CONF-0894">StructureDefinition-us-core-practitionerrole.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Unless exchanging legacy or text-only data, medical specialty codes <strong>SHOULD</strong> be taken from NUCC or SNOMED CT.</p>
</div></td>
</tr>
<tr id="CONF-0895">
<td>CONF-0895</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-procedure.html#CONF-0895">StructureDefinition-us-core-procedure.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Unless exchanging legacy or text-only data, procedure codes <strong>SHOULD</strong> be taken from SNOMED-CT, CPT, HCPCS II, ICD-10-PCS, CDT, or LOINC*.</p>
</div></td>
</tr>
<tr id="CONF-0896">
<td>CONF-0896</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0896">general-requirements.html#extensible-binding-for-coded-elements</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>US Core guidance provides more flexibility for situations where implementers cannot fully comply with the FHIR guidance. This flexibility is sometimes necessary and expected for legacy and text-only data. However, for newly recorded, non-legacy data, a system <strong>SHOULD</strong> adhere to the extensible binding rules.</p>
</div></td>
</tr>
<tr id="CONF-0897">
<td>CONF-0897</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0897">general-requirements.html#extensible-binding-for-coded-elements</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>For data not captured by the system transmitting the information, the coded data <strong>SHOULD</strong> be automatically converted to fine-grained codes from the specified ValueSet.</p>
</div></td>
</tr>
<tr id="CONF-0898">
<td>CONF-0898</td>
<td>
<span style="color: grey;">•</span><a href="general-requirements.html#CONF-0898">general-requirements.html#extensible-binding-for-coded-elements</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>For data not captured by the system transmitting the information, ....the system <strong>MAY</strong> provide the existing code or the free text, and a high-level abstract code, such as the SNOMED CT code "71388002"(Procedure), to remain conformant with the extensible binding.</p>
</div></td>
</tr>
<tr id="CONF-0899">
<td>CONF-0899</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-adi-documentreference.html#CONF-0899">StructureDefinition-us-core-adi-documentreference.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>To represent the patient and provider attestation metadata, the <em>optional</em> DocumentReference Attestor R5 Extension ... <strong>SHOULD</strong> be use</p>
</div></td>
</tr>
<tr id="CONF-0900">
<td>CONF-0900</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-condition-problems-health-concerns.html#CONF-0900">StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Unless exchanging legacy or text-only data, condition codes <strong>SHOULD</strong> be taken from SNOMED CT and ICD-10-CM, USCDI's applicable vocabulary standards for the Problem Data Element.</p>
</div></td>
</tr>
<tr id="CONF-0901">
<td>CONF-0901</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-location.html#CONF-0901">StructureDefinition-us-core-location.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>The Service Delivery Location Role Type value set is inherited from the base resource, and, although its binding strength is <a href="http://hl7.org/fhir/R4/terminologies.html#extensible">extensible</a> in the base resource, US Core implementers <strong>MAY</strong> treat it as <a href="http://hl7.org/fhir/R4/terminologies.html#preferred">preferred</a>.</p>
</div></td>
</tr>
<tr id="CONF-0903">
<td>CONF-0903</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-goal.html#CONF-0903">StructureDefinition-us-core-goal.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>When exchanging Social Determinants of Health (SDOH) data, implementers <strong>SHOULD</strong> use the <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1247.71/expansion">Social Determinants of Health Goals</a> set which is curated by the Gravity Project to represent goals for all SDOH Domains.</p>
</div></td>
</tr>
<tr id="CONF-0904">
<td>CONF-0904</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-servicerequest.html#CONF-0904">StructureDefinition-us-core-servicerequest.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>Implementers <strong>SHOULD</strong> conform to the binding strengths listed for each USCDI Order context...Laboratory Order|[LOINC Common Laboratory Orders Value Set]|extensible, Imaging Order|[LOINC Radiology Codes]|preferred, Clinical Test Order|[LOINC Clinical Test Codes]|preferred</p>
</div></td>
</tr>
<tr id="CONF-0905">
<td>CONF-0905</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-servicerequest.html#CONF-0905">StructureDefinition-us-core-servicerequest.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">MAY</td>
<td><div><p>the US Core ServiceRequest Profile <strong>MAY</strong> be used to represent a derived "actionable" order based on a portable Medical Order(PMO).</p>
</div></td>
</tr>
<tr id="CONF-0906">
<td>CONF-0906</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-servicerequest.html#CONF-0906">StructureDefinition-us-core-servicerequest.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[When] used to represent a derived "actionable" order based on a PMO...The <code>ServiceRequest.category</code> <strong>SHOULD</strong> be bound to <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1267.34/Expansion">Portable Medical Order Categories</a></p>
</div></td>
</tr>
<tr id="CONF-0907">
<td>CONF-0907</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-servicerequest.html#CONF-0907">StructureDefinition-us-core-servicerequest.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>[When] used to represent a derived "actionable" order based on a PMO...ServiceRequest.code` <strong>SHOULD</strong> be aligned with the appropriate Category</p>
</div></td>
</tr>
<tr id="CONF-0908">
<td>CONF-0908</td>
<td>
<span style="color: grey;">•</span><a href="StructureDefinition-us-core-servicerequest.html#CONF-0908">StructureDefinition-us-core-servicerequest.html#profile-specific-implementation-guidance</a><br/>
</td>
<td style="text-align: center;">SHOULD</td>
<td><div><p>The <code>ServiceReqest.reasonReference</code> <strong>SHOULD</strong> be used to reference the US Core ADI DocumentReference Profile that indexes the PMO.</p>
</div></td>
</tr>
</tbody>
</table>
</div>
</text>
<extension
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<valueInteger value="3">
<extension
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<valueCanonical
value="http://hl7.org/fhir/us/core/ImplementationGuide/hl7.fhir.us.core"/>
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<extension
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<name value="USCoreServerRequirements"/>
<title value="US Core Server Requirements"/>
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<description
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<copyright
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<actor>
<extension url="http://hl7.org/fhir/StructureDefinition/display">
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<statement>
<key value="CONF-0001"/>
<conformance value="SHALL"/>
<requirement
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<statement>
<key value="CONF-0002"/>
<conformance value="SHOULD"/>
<requirement
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<reference value="general-requirements.html#profile-only-support">
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<statement>
<key value="CONF-0003"/>
<conformance value="MAY"/>
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<requirement
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<reference
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</reference>
</statement>
<statement>
<key value="CONF-0004"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="Server may deploy and support ... the following US Core interaction: “Quick Start” defined for each Profile"/>
<reference
value="general-requirements.html#profile-support--interaction-support">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0004"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0005"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="Server may deploy and support ... the following US Core interaction: [Clinical Notes](https://hl7.org/fhir/us/core/clinical-notes.html)"/>
<reference
value="general-requirements.html#profile-support--interaction-support">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0005"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0006"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="Server may deploy and support ... the following US Core interaction: [Medication List](https://hl7.org/fhir/us/core/medication-list.html)"/>
<reference
value="general-requirements.html#profile-support--interaction-support">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0006"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0007"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="Server may deploy and support ... the following US Core interaction: [Basic Provenance](https://hl7.org/fhir/us/core/basic-provenance.html)"/>
<reference
value="general-requirements.html#profile-support--interaction-support">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0007"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0008"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="Server may deploy and support ... the following US Core interaction: [Screening and Assessments](https://hl7.org/fhir/us/core/screening-and-assessments.html)"/>
<reference
value="general-requirements.html#profile-support--interaction-support">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0008"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0009"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="Servers implementing ... [clinical information representation] can claim conformance to the US Core Profile content structure ... by implementing all or parts of the US Core CapabilityStatement into their capabilities."/>
<reference
value="general-requirements.html#profile-support--interaction-support">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0009"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0010"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="Servers implementing ... [interactions] can claim conformance to the ... RESTful interactions defined by implementing all or parts of the US Core CapabilityStatement into their capabilities"/>
<reference
value="general-requirements.html#profile-support--interaction-support">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0010"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0013"/>
<conformance value="SHALL"/>
<requirement
value="[To claim conformance to a US Core Profile] a conformant Server:
**SHALL** Be able to populate all profile data elements that are mandatory and/or flagged as Must Support as defined by that profile’s StructureDefinition."/>
<reference
value="general-requirements.html#claiming-conformance-to-a-us-core-profile">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0013"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0014"/>
<conformance value="SHOULD"/>
<requirement
value="[To claim conformance to a US Core Profile] a conformant Server:
**SHOULD** declare conformance with the US [Core Server Capability Statement](https://hl7.org/fhir/us/core/CapabilityStatement-us-core-Server.html) by including its official URL in the Server’s `CapabilityStatement.instantiates` element: `http://hl7.org/fhir/us/core/CapabilityStatement/us-core-Server`"/>
<reference
value="general-requirements.html#claiming-conformance-to-a-us-core-profile">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0014"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0015"/>
<conformance value="SHALL"/>
<requirement
value="[To claim conformance to a US Core Profile] a conformant Server:
**SHALL** specify the full capability details from the US Core CapabilityStatement it claims to implement."/>
<reference
value="general-requirements.html#claiming-conformance-to-a-us-core-profile">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0015"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0016"/>
<conformance value="SHALL"/>
<requirement
value="[To claim conformance to a US Core Profile] a conformant Server:
**SHALL**… Declare support for the US Core Profile by including its official URL in the Server’s CapabilityStatement.rest.resource.supportedProfile element."/>
<reference
value="general-requirements.html#claiming-conformance-to-a-us-core-profile">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0016"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0017"/>
<conformance value="SHALL"/>
<requirement
value="[To claim conformance to a US Core Profile] a conformant Server:
**SHALL**… Declare support for the US Core Profile’s FHIR RESTful transactions."/>
<reference
value="general-requirements.html#claiming-conformance-to-a-us-core-profile">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0017"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0018"/>
<conformance value="SHALL"/>
<requirement
value="[Required binding](http://hl7.org/fhir/R4/terminologies.html#required) to a ValueSet definition means that one of the codes from the specified ValueSet **SHALL** be used."/>
<reference
value="general-requirements.html#required-bindings-for-coded-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0018"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0019"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="For `CodeableConcept`, which permits multiple codings and a text element, this [[Required binding](http://hl7.org/fhir/R4/terminologies.html#required) to a ValueSet definition] rule applies to at least one of the codings"/>
<reference
value="general-requirements.html#required-bindings-for-coded-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0019"/>
</extension>
</reference>
</statement>
<statement>
<extension
url="http://hl7.org/fhir/tools/StructureDefinition/requirements-statementshallnot">
<valueBoolean value="true"/>
</extension>
<key value="CONF-0020"/>
<requirement
value="For a [[required binding](http://hl7.org/fhir/R4/terminologies.html#required) to a ValueSet definition], a `CodeableConcept`which permits multiple codings and a text element … [using] only text is not valid."/>
<reference
value="general-requirements.html#required-bindings-for-coded-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0020"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0021"/>
<conformance value="SHALL"/>
<requirement
value="[When populating a coded element with a [required binding](http://hl7.org/fhir/R4/terminologies.html#required] to a ValueSet definition] US Core Responders **SHALL** provide a code exclusively from [the required binding] ValueSet"/>
<reference
value="general-requirements.html#required-bindings-for-coded-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0021"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0023"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="[Extensible binding] (http://hl7.org/fhir/R4/terminologies.html#extensible) means that one of the codes from the specified value set **SHALL** be used when an appropriate concept exists;…"/>
<reference
value="general-requirements.html#extensible-binding-for-coded-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0023"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0024"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="[When using an [extensible Binding] (http://hl7.org/fhir/R4/terminologies.html#extensible)] If no suitable code exists in the [extensible] ValueSet, alternate code(s) **MAY** be used.."/>
<reference
value="general-requirements.html#extensible-binding-for-coded-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0024"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0026"/>
<conformance value="SHOULD-NOT"/>
<conditionality value="true"/>
<requirement
value="For `CodeableConcept` [with an [extensible binding] (http://hl7.org/fhir/R4/terminologies.html#extensible) … Text-only representation **SHOULD NOT** be used - coded values are expected whenever possible to support interoperability."/>
<reference
value="general-requirements.html#extensible-binding-for-coded-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0026"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0027"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="When claiming conformance to ... [to a US Core profile extensible binding rule, a] US Core Responders Shall provide:
A code from … [the] valueset 'DataElement.code.code' if the concept exists in the valueset [for a DataElement.code that has an extensible binding]
Or an alternative code if the concept does not exist in the valueset [for a DataElement.code that has an extensible binding]
Or text in ... `[DataElement.code.text]’ if only text is available [for a DataElement.code that has an extensible binding]"/>
<reference
value="general-requirements.html#extensible-binding-for-coded-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0027"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0029"/>
<conformance value="MAY"/>
<requirement
value="Alternate codes may be provided in addition to the standard codes defined in required or extensible ValueSets. These alternate codes are called "additional codings"."/>
<reference value="general-requirements.html#translations">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0029"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0030"/>
<conformance value="MAY"/>
<requirement
value="[The additional codings] may be equivalent to or narrower in meaning than the standard concept code."/>
<reference value="general-requirements.html#translations">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0030"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0033"/>
<conformance value="MAY"/>
<requirement
value="Not all modifier elements are Mandatory or Must Support, and there is no requirement for supporting them"/>
<reference value="general-requirements.html#modifier-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0033"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0034"/>
<conformance value="MAY"/>
<requirement
value="Servers **MAY** communicate a system-wide profile in their CapabilityStatement to identify which additional elements, including modifier elements, they support"/>
<reference value="general-requirements.html#modifier-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0034"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0039"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="If the source system does not have data for an element with a minimum cardinality = 0 (including elements labeled Must Support), the data element **SHALL** be omitted from the resource."/>
<reference value="general-requirements.html#missing-data">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0039"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0040"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="If the data element is a Mandatory element (in other words, where the minimum cardinality is > 0), it **SHALL** be present even if the source system does not have data."/>
<reference value="general-requirements.html#missing-data">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0040"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0041"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="For [mandatory] non-coded data elements [where data is not available], use the [DataAbsentReason Extension](http://hl7.org/fhir/R4/extension-data-absent-reason.html) in the data type ... [with] the code `unknown` - The value is expected to exist but is not known."/>
<reference value="general-requirements.html#missing-data">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0041"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0042"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="[In situations where data is not available] for [mandatory] coded data elements … [with] *example*, *preferred*, or *extensible* binding strengths (CodeableConcept or Coding datatypes) If the source system has text but no coded data, only the text element is used."/>
<reference value="general-requirements.html#missing-data">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0042"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0043"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="[In situations where data is not available] for [mandatory] coded data elements… [with] *example*, *preferred*, or *extensible* binding strengths (CodeableConcept or Coding datatypes):
For Coding datatypes, the text-only data is represented as a display element"/>
<reference value="general-requirements.html#missing-data">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0043"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0044"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="[In situations where data is not available] for [mandatory] coded data elements… [with] *example*, *preferred*, or *extensible* binding strengths (CodeableConcept or Coding datatypes): … If there is neither text nor coded data ... [then] use the appropriate “unknown” concept code from the ValueSet if available."/>
<reference value="general-requirements.html#missing-data">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0044"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0045"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="[In situations where data is not available] for [mandatory] coded data elements… [with] *example*, *preferred*, or *extensible* binding strengths (CodeableConcept or Coding datatypes): … If there is neither text nor coded data ... [then] if the ValueSet does not have the appropriate “unknown” concept code, use unknown from the [DataAbsentReason Code System](http://hl7.org/fhir/R4/codesystem-data-absent-reason.html)."/>
<reference value="general-requirements.html#missing-data">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0045"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0046"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="[In situations where data is not available] for [mandatory] coded data elements… [with] *required* binding strength (CodeableConcept or code datatypes): use the appropriate “unknown” concept code from the ValueSet if available"/>
<reference value="general-requirements.html#missing-data">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0046"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0047"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="[In situations where data is not available] for [mandatory] coded data elements… [with] *required* binding strength (CodeableConcept or code datatypes): If the ValueSet does not have the appropriate “unknown” concept code, you must use a concept from the ValueSet. Otherwise, the instance will not be conformant"/>
<reference value="general-requirements.html#missing-data">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0047"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0048"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="[If the source system does not have data for a Mandatory element for a coded data element with *required* binding strength] If any of these status codes is missing [meaning it lacks an "unknown" or otherwise appropriate concept code from the ValueSet, a] 404 HTTP error code and an OperationOutcome **SHALL** be returned in response to a read transaction on the resource."/>
<reference value="general-requirements.html#missing-data">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0048"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0049"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="[If the source system does not have data for a Mandatory element for a coded data element with *required* binding strength, and the ValueSet does not have the appropriate "unknown" concept code, then] if returning a response to a search, the problematic resource **SHALL** be excluded from the search set"/>
<reference value="general-requirements.html#missing-data">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0049"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0050"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[If the source system does not have data for a Mandatory element for a coded data element with *required* binding strength, and the ValueSet does not have the appropriate "unknown" concept code, then] if returning a response to a search, … a *warning* OperationOutcome **SHOULD** be included indicating that other search results were found but could not be compliantly expressed and have been suppressed."/>
<reference value="general-requirements.html#missing-data">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0050"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0051"/>
<conformance value="SHALL"/>
<requirement
value="The [FHIR RESTful Search API](http://hl7.org/fhir/R4/http.html#search) requires that Servers that support search **SHALL** support the HTTP `POST`-based search."/>
<reference
value="general-requirements.html#fhir-restful-search-api-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0051"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0052"/>
<conformance value="SHALL"/>
<requirement
value="For all the supported search interactions in this guide, Servers **SHALL** also support the `GET`-based search."/>
<reference
value="general-requirements.html#fhir-restful-search-api-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0052"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0055"/>
<conformance value="SHALL"/>
<requirement
value="When searching using the `token` type searchparameter [(how to search by token)](http://hl7.org/fhir/R4/search.html#token) The Server **SHALL** support both [system and code values]"/>
<reference
value="general-requirements.html#fhir-restful-search-api-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0055"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0058"/>
<conformance value="SHALL"/>
<requirement
value="When searching using the `reference` type searchparameter [(how to search by reference)](http://hl7.org/fhir/R4/search.html#reference) The Server **SHALL** support both [id and Type values]"/>
<reference
value="general-requirements.html#fhir-restful-search-api-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0058"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0061"/>
<conformance value="SHALL"/>
<requirement
value="When searching using the `date` type searchparameter [(how to search by date)](http://hl7.org/fhir/R4/search.html#date) The Server **SHALL** support values precise to the day for elements of datatype `date`"/>
<reference
value="general-requirements.html#fhir-restful-search-api-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0061"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0062"/>
<conformance value="SHALL"/>
<requirement
value="When searching using the `date` type searchparameter [(how to search by date)](http://hl7.org/fhir/R4/search.html#date) The Server **SHALL** support values precise … to the second + time offset for elements of `datatype` dateTime"/>
<reference
value="general-requirements.html#fhir-restful-search-api-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0062"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0063"/>
<conformance value="SHOULD"/>
<requirement
value="Servers are strongly encouraged to support a query for resources without requiring a status parameter."/>
<reference
value="general-requirements.html#search-for-Servers-requiring-status">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0063"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0064"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="If business requirements prohibit [querying a resource without a status parameter], they **SHALL** follow the guidelines here."/>
<reference
value="general-requirements.html#search-for-Servers-requiring-status">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0064"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0065"/>
<conformance value="MAY"/>
<requirement
value="For searches where the Client does not supply a status parameter, an implementation’s business rules may override the FHIR RESTful search expectations and require a status parameter to be provided"/>
<reference
value="general-requirements.html#search-for-Servers-requiring-status">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0065"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0066"/>
<conformance value="SHALL"/>
<requirement
value="For searches where the Client does not supply a status parameter, … systems [that require a status parameter to be provided] are allowed to reject such requests as follows:
**SHALL** return an HTTP 400 status"/>
<reference
value="general-requirements.html#search-for-Servers-requiring-status">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0066"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0067"/>
<conformance value="SHALL"/>
<requirement
value="For searches where the Client does not supply a status parameter, … systems [that require a status parameter to be provided] are allowed to reject such requests as follows:
**SHALL** return an [OperationOutcome](http://hl7.org/fhir/R4/operationoutcome.html) specifying that status(es) must be present."/>
<reference
value="general-requirements.html#search-for-Servers-requiring-status">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0067"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0068"/>
<conformance value="SHALL"/>
<requirement
value="For searches where the Client does not supply a status parameter, … systems [that require a status parameter to be provided] are allowed to reject such requests as follows:
**SHALL** support search with status if status required"/>
<reference
value="general-requirements.html#search-for-Servers-requiring-status">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0068"/>
</extension>
</reference>
</statement>
<statement>
<extension
url="http://hl7.org/fhir/tools/StructureDefinition/requirements-statementshallnot">
<valueBoolean value="true"/>
</extension>
<key value="CONF-0069"/>
<requirement
value=" **SHALL NOT** restrict search results ( i.e., apply ‘hidden’ filters) when a Client includes status parameters in the query."/>
<reference
value="general-requirements.html#search-for-Servers-requiring-status">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0069"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0070"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[For systems that require a status parameter to be provided,] if a system doesn’t support a specific status code value that is queried, it **SHOULD** return an HTTP 200 status with a search bundle."/>
<reference
value="general-requirements.html#search-for-Servers-requiring-status">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0070"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0071"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[For systems that require a status parameter to be provided,] if a system doesn’t support a specific status code value that is queried [and returns a search bundle],... [t]he search bundle **SHOULD** contain resources matching the search criteria"/>
<reference
value="general-requirements.html#search-for-Servers-requiring-status">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0071"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0072"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[For systems that require a status parameter to be provided,] if a system doesn’t support a specific status code value that is queried [and returns a search bundle],... [t]he search bundle **SHOULD** contain ... an OperationOutcome warning the Client which status code value is not supported."/>
<reference
value="general-requirements.html#search-for-Servers-requiring-status">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0072"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0073"/>
<conformance value="SHALL"/>
<requirement
value="For searches where the Client does not supply a status parameter, … systems [that require a status parameter to be provided] are allowed to reject such requests as follows:...
**SHALL** document this behavior in its CapabilityStatement for the “search-type” interaction in `CapabilityStatement.rest.resource.interaction.documentation.`"/>
<reference
value="general-requirements.html#search-for-Servers-requiring-status">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0073"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0074"/>
<conformance value="SHALL"/>
<requirement
value="When an element is Mandatory, the data is expected always to be present."/>
<reference value="must-support.html#must-support-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0074"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0075"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="For querying and reading US Core Profiles, Must Support on any profile data element **SHALL** be interpreted as follows…:
US Core Responders **SHALL** be capable of populating all data elements as part of the query results specified by the [US Core Server Capability Statement](https://hl7.org/fhir/us/core/STU8/CapabilityStatement-us-core-Server.html)."/>
<reference value="must-support.html#must-support-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0075"/>
</extension>
</reference>
</statement>
<statement>
<extension
url="http://hl7.org/fhir/tools/StructureDefinition/requirements-statementshallnot">
<valueBoolean value="true"/>
</extension>
<key value="CONF-0078"/>
<conditionality value="true"/>
<requirement
value=" **SHALL NOT** include the data elements in the resource instance returned as part of the query results."/>
<reference value="must-support.html#must-support-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0078"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0080"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="For querying and reading US Core Profiles, Must Support on any profile data element **SHALL** be interpreted as follows…:
In cases where information on a specific data element is missing, and the US Core Responder knows the precise reason for the absence of data (other than suppressed data), US Core Responders **SHOULD** send the reason for the missing information."/>
<reference value="must-support.html#must-support-el+D647ements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0080"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0081"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[When sending reason for missing information, follow] the same methdology outlined in the [Missing Data](https://hl7.org/fhir/us/core/STU8/general-requirements.html#missing-data) section but using the appropriate reason code instead of unknown [reason code]."/>
<reference value="must-support.html#must-support-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0081"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0084"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="Implementors [US Core Responders] seeking ONC certification [in the ONC IT Health Certification program] **SHALL** interpret Additional USCDI Requirements as Must Support elements as documented above and below;"/>
<reference value="must-support.html#additional-uscdi-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0084"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0086"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="Implementors [US Core Responders] [not] seeking ONC certification [in the ONC IT Health Certification program] **SHALL** interpret Additional USCDI Requirements as … optional."/>
<reference value="must-support.html#additional-uscdi-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0086"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0087"/>
<conformance value="SHALL"/>
<requirement
value="If an element is marked as Must Support and defined by a pattern [as described by [ElementDefinition.pattern](http://hl7.org/fhir/R4/elementdefinition-definitions.html#ElementDefinition.pattern_x_)], then the pattern defines the elements and element values that the Server **SHALL** be capable of providing."/>
<reference value="must-support.html#defined-pattern-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0087"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0090"/>
<conformance value="SHALL"/>
<requirement
value="Primitive elements are single elements with a primitive value. If they are marked as Must Support, then the Server **SHALL** be capable of providing the element value to meet the Must Support requirement."/>
<reference value="must-support.html#must-support---primitive-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0090"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0091"/>
<conformance value="SHALL"/>
<requirement
value="[W]hen claiming conformance [to a profile with a must support primitive element] … US Core responders **SHALL** be capable of providing the value [of the primitive element]"/>
<reference value="must-support.html#must-support---primitive-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0091"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0093"/>
<conformance value="SHALL"/>
<requirement
value="For any complex element marked as Must Support, the Server **SHALL** be capable of providing at least one of the sub-element values."/>
<reference value="must-support.html#must-support---complex-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0093"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0094"/>
<conformance value="SHALL"/>
<requirement
value="If any sub-element is marked as Must Support [for a complex element], it must also meet the Must Support requirements and satisfy the Must Support requirements for the parent element."/>
<reference value="must-support.html#must-support---complex-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0094"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0095"/>
<conformance value="MAY"/>
<requirement
value="[I]f any sub-element is marked as Must Support or Additional USCDI [for a complex element] and the parent element is not, there is no expectation that you must support the parent."/>
<reference value="must-support.html#must-support---complex-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0095"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0096"/>
<conformance value="SHALL"/>
<requirement
value="[I]f any sub-element is marked as Must Support [for a complex element] and the parent element is not… [and] the parent element is represented in the structure, Servers **SHALL** support the sub-element(s) marked as Must Support."/>
<reference value="must-support.html#must-support---complex-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0096"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0097"/>
<conformance value="SHALL"/>
<requirement
value="When claiming conformance [to a must support complex element with no must support sub-elements] … US Core Responders **SHALL** be capable of providing a value in [the] sub-element"/>
<reference value="must-support.html#must-support---complex-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0097"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0099"/>
<conformance value="SHALL"/>
<requirement
value="When claiming conformance [to a must support complex element with one or more must support sub-elements] … US Core Responders **SHALL** be capable of providing a value in [each must support sub-element]"/>
<reference value="must-support.html#must-support---complex-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0099"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0101"/>
<conformance value="MAY"/>
<requirement
value="Systems [US Core Responders] can support the other elements [of a complex element, not labeled as a Must Support], but this is not a requirement of US Core"/>
<reference value="must-support.html#must-support---complex-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0101"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0103"/>
<conformance value="MAY"/>
<requirement
value="The U.S. Core Data for Interoperability (USCDI) may require additional elements, [which is a requirement for certification in the ONC IT Health Certification program, but not a requirement of US Core conformance for US Core Responders]"/>
<reference value="must-support.html#must-support---complex-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0103"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0105"/>
<conformance value="SHALL"/>
<requirement
value="In certain profiles, only specific resource references are labeled as Must Support.
...
- US Core Responders **SHALL** be capable of providing [such an element] with a valid reference to [all listed Must Support profile(s).]"/>
<reference value="must-support.html#must-support---resource-references">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0105"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0107"/>
<conformance value="MAY"/>
<requirement
value="Systems [US Core Responders] can support other [resource] references [other than those labeled as Must Support], but this is not a requirement of US Core"/>
<reference value="must-support.html#must-support---resource-references">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0107"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0109"/>
<conformance value="SHALL"/>
<requirement
value="In specific profiles, only a single resource reference is present on an element labeled Must Support.
...
- US Core Responders **SHALL** be capable of providing [such an element] with a valid reference to [the Must Support Profile.]"/>
<reference value="must-support.html#must-support---resource-references">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0109"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0111"/>
<conformance value="SHALL"/>
<requirement
value="[If a profile has] a Must Support element [with] a choice of datatypes for its content [and some of] the datatypes … are labeled as Must Support
… When claiming conformance to [such a] profile:
- US Core Responders **SHALL** be capable of populating [the Must Support data type choice]"/>
<reference value="must-support.html#must-support---choice-of-data-types">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0111"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0114"/>
<conformance value="MAY"/>
<requirement
value="[If a profile has] a Must Support element [with] a choice of datatypes for its content [and some of] the datatypes … are labeled as Must Support[, or a profile has] an Additional USCDI element [with] a choice of datatypes for its content [and some of] the datatypes … are labeled as Additional USCDI
…
[US Core Responders] **MAY** support populating ... other [data type] choice elements (such as Observation.effectivePeriod), but this is not a requirement of US Core."/>
<reference value="must-support.html#must-support---choice-of-data-types">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0114"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0115"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="There are several instances in this Guide where there is a choice of supporting one or another profile element to meet the Must Support or Additional USCDI requirement. In such cases, the Server or Certifying System **SHALL** support at least one element."/>
<reference
value="must-support.html#must-support---choice-of-profile-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0115"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0117"/>
<conformance value="MAY"/>
<requirement
value="An individual SMART Server will publish a granular list of its capabilities, and a set of these capabilities is combined to support a specific use, a Capability Set. See SMART App Launch’s [FHIR OAuth authorization Endpoints and Capabilities](http://hl7.org/fhir/smart-app-launch/STU2/conformance.html#smart-on-fhir-oauth-authorization-endpoints-and-capabilities) for more details. Servers **MAY** support ... [any] SMART on FHIR Capability Sets and capabilities [(see [FHIR OAuth authorization Endpoints and Capabilities](http://hl7.org/fhir/smart-app-launch/STU2/conformance.html#smart-on-fhir-oauth-authorization-endpoints-and-capabilities))]"/>
<reference value="scopes.html#capability-sets">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0117"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0118"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="At least one of the following SMART on FHIR Capability Sets **SHOULD** be supported for US Core Servers that support User-Facing Applications ...
[Patient Access Standalone Apps](http://hl7.org/fhir/smart-app-launch/STU2/conformance.html#patient-access-for-standalone-apps)
[Clinician Access for EHR Launch](http://hl7.org/fhir/smart-app-launch/STU2/conformance.html#clinician-access-for-standalone)"/>
<reference
value="scopes.html#capabilities-for-implementations-supporting-user-facing-applications">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0118"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0119"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="For certified systems[, those participating in the ONC IT Health Certification program], both **SHALL** be supported:
[Patient Access Standalone Apps](http://hl7.org/fhir/smart-app-launch/STU2/conformance.html#patient-access-for-standalone-apps)
[Clinician Access for EHR Launch](http://hl7.org/fhir/smart-app-launch/STU2/conformance.html#clinician-access-for-standalone)"/>
<reference
value="scopes.html#capabilities-for-implementations-supporting-user-facing-applications">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0119"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0120"/>
<conformance value="SHALL"/>
<requirement
value="Implementations [US Core Responders] supporting Backend Services ... **SHALL** include support for the Client-confidential-asymmetric capability."/>
<reference
value="scopes.html#capabilities-for-implementations-supporting-backend-services">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0120"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0121"/>
<conformance value="SHALL"/>
<requirement
value="Implementations [US Core Responders] supporting Backend Services ... **SHALL** include support for the ... system/scopes."/>
<reference
value="scopes.html#capabilities-for-implementations-supporting-backend-services">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0121"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0123"/>
<conformance value="SHALL"/>
<requirement
value="US Core Server[s] **SHALL** support token introspection defined by the SMART App Launch Guide. For more details and additional consideration, see SMART App Launch’s [Token Introspection](http://hl7.org/fhir/smart-app-launch/STU2/token-introspection.html#token-introspection)."/>
<reference
value="scopes.html#us-core-Servers-shall-support-token-introspection">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0123"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0125"/>
<conformance value="MAY"/>
<requirement
value="Other systems only need to support scopes for the US Core APIs they support [instead of all US Core's required scopes]"/>
<reference value="scopes.html#smart-scopes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0125"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0126"/>
<conformance value="MAY"/>
<requirement
value="Servers **MAY** support other scopes in addition to those listed below and in the Quick Start sections."/>
<reference value="scopes.html#smart-scopes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0126"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0128"/>
<conformance value="SHALL"/>
<requirement
value="For “User-Facing Applications”, a system’s support for patient-level (patient) or user-level (user) scopes depends on its published list of SMART on FHIR capabilities (see the [capability sets](https://hl7.org/fhir/us/core/STU8/scopes.html#capability-sets) above). For example, if a Server lists permission-patient and permission-user in its capabilities, it **SHALL** support both patient-level and user-level required scopes"/>
<reference value="scopes.html#us-core-scopes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0128"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0129"/>
<conformance value="SHOULD"/>
<requirement
value="For “User-Facing Applications”, a system’s support for patient-level (patient) or user-level (user) scopes depends on its published list of SMART on FHIR capabilities (see the [capability sets](https://hl7.org/fhir/us/core/STU8/scopes.html#capability-sets) above). For example, if a Server lists permission-patient and permission-user in its capabilities, it ... **SHOULD** support both patient-level and user-level recommended best-practice scopes"/>
<reference value="scopes.html#us-core-scopes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0129"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0130"/>
<conformance value="SHALL"/>
<requirement
value="For “Backend-Services”, System-level scopes (system) describe data that a Client system is directly authorized to access. Systems that support system-level (system) scopes **SHALL** support the required US Core scopes"/>
<reference value="scopes.html#us-core-scopes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0130"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0131"/>
<conformance value="SHOULD"/>
<requirement
value="For “Backend-Services”, System-level scopes (system) describe data that a Client system is directly authorized to access. Systems that support system-level (system) scopes **SHOULD** support the recommended US Core scopes"/>
<reference value="scopes.html#us-core-scopes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0131"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0132"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] AllergyIntolerance [the] <patient|user|system>/AllergyIntolerance.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]
"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0132"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-allergyintolerance.html#us-core-scopes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-allergyintolerance.html#CONF-0132"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0133"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] CarePlan [the] <patient|user|system>/CarePlan.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]
"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0133"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0134"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] CareTeam [the] <patient|user|system>/CareTeam.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0134"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0135"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] Condition [the] <patient|user|system>/Condition.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0135"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0136"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] Coverage [the] <patient|user|system>/Coverage.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0136"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0137"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] Device [the] <patient|user|system>/Device.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0137"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0138"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] DiagnosticReport [the] <patient|user|system>/DiagnosticReport.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0138"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0139"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] DocumentReference [the] <patient|user|system>/DocumentReference.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0139"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0140"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] Encounter [the] <patient|user|system>/Encounter.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0140"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0141"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] Goal [the] <patient|user|system>/Goal.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0141"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0142"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] Immunization [the] <patient|user|system>/Immunization.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0142"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0143"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] MedicationDispense [the] <patient|user|system>/MedicationDispense.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0143"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0144"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] MedicationRequest [the] <patient|user|system>/MedicationRequest.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0144"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0145"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] Observation [the] <patient|user|system>/Observation.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0145"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0146"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] Organization [the] <patient|user|system>/Organization.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0146"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0147"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] Patient [the] <patient|user|system>/Patient.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0147"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0148"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] Practitioner [the] <patient|user|system>/Practitioner.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0148"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0149"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] PractitionerRole [the] <patient|user|system>/PractitionerRole.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0149"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0150"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] Procedure [the] <patient|user|system>/Procedure.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0150"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0151"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] Provenance [the] <patient|user|system>/Provenance.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0151"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0152"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] QuestionnaireResponse [the] <patient|user|system>/QuestionnaireResponse.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0152"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0153"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] RelatedPerson [the] <patient|user|system>/RelatedPerson.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0153"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0154"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] ServiceRequest [the] <patient|user|system>/ServiceRequest.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0154"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0155"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **SHALL** be supported
...
[For] Specimen [the] <patient|user|system>/Specimen.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0155"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0156"/>
<conformance value="MAY"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **MAY** be supported
...
[For] Location [the] <patient|user|system>/Location.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0156"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0157"/>
<conformance value="MAY"/>
<requirement
value="The following scopes that correspond directly to FHIR resource types **MAY** be supported
...
[For] Medication [the] <patient|user|system>/Medication.rs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#scopes-for-requesting-fhir-resources-by-type">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0157"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0158"/>
<conformance value="SHALL"/>
<requirement
value="The following granular scopes **SHALL** be supported
...
[For] Condition [the] <patient|user|system>/Condition.rs?category=http://hl7.org/fhir/us/core/CodeSystem/condition-category|health-concern [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#granular-scopes-for-requesting-fhir-resources">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0158"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0159"/>
<conformance value="SHALL"/>
<requirement
value="The following granular scopes **SHALL** be supported
...
[For] Condition [the] <patient|user|system>/Condition.rs?category=http://terminology.hl7.org/CodeSystem/condition-category|encounter-diagnosis [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#granular-scopes-for-requesting-fhir-resources">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0159"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0160"/>
<conformance value="SHALL"/>
<requirement
value="The following granular scopes **SHALL** be supported
...
[For] Condition [the] <patient|user|system>/Condition.rs?category=http://terminology.hl7.org/CodeSystem/condition-category|problem-list-item [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#granular-scopes-for-requesting-fhir-resources">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0160"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0161"/>
<conformance value="SHALL"/>
<requirement
value="The following granular scopes **SHALL** be supported
...
[For] Observation [the] <patient|user|system>/Observation.rs?category=http://hl7.org/fhir/us/core/CodeSystem/us-core-category|sdoh [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#granular-scopes-for-requesting-fhir-resources">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0161"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0162"/>
<conformance value="SHALL"/>
<requirement
value="The following granular scopes **SHALL** be supported
...
[For] Observation [the] <patient|user|system>/Observation.rs?category=http://terminology.hl7.org//CodeSystem-observation-category|social-history [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#granular-scopes-for-requesting-fhir-resources">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0162"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0163"/>
<conformance value="SHALL"/>
<requirement
value="The following granular scopes **SHALL** be supported
...
[For] Observation [the] <patient|user|system>/Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#granular-scopes-for-requesting-fhir-resources">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0163"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0164"/>
<conformance value="SHALL"/>
<requirement
value="The following granular scopes **SHALL** be supported
...
[For] Observation [the] <patient|user|system>/Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|survey [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#granular-scopes-for-requesting-fhir-resources">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0164"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0165"/>
<conformance value="SHALL"/>
<requirement
value="The following granular scopes **SHALL** be supported
...
[For] Observation [the] <patient|user|system>/Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#granular-scopes-for-requesting-fhir-resources">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0165"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0166"/>
<conformance value="SHOULD"/>
<requirement
value="The following granular scopes **SHOULD** be supported
...
[For] DocumentReference [the] <patient|user|system>/DocumentReference.rs?category=http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category|clinical-note [see [SMART Clinical Scope Syntax](https://hl7.org/fhir/smart-app-launch/STU2/scopes-and-launch-context.html#clinical-scope-syntax) for details on clinical data scopes]"/>
<reference
value="scopes.html#granular-scopes-for-requesting-fhir-resources">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0166"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0167"/>
<conformance value="SHALL"/>
<requirement
value="In addition to the capabilities defined in the Server’s CapabilityStatement, Servers **SHALL** document their SMART capabilities in their [Well-Known Uniform Resource Identifiers (URIs)](https://hl7.org/fhir/smart-app-launch/STU2/conformance.html#using-well-known) JSON file."/>
<reference
value="scopes.html#Servers-shall-support-the-following-metadata-in-their-well-knownsmart-configuration">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0167"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0168"/>
<conformance value="SHALL"/>
<requirement
value="US Core requires ... additional metadata [to be available through the Server's [Well-Known Uniform Resource Identifier (URI)](https://hl7.org/fhir/smart-app-launch/STU2/conformance.html#using-well-known)]: ... [in] `scopes_supported` [the] array of scopes a Client may request.... The Server **SHALL** list all the required US Core Scopes for the US Core Profiles they support in the scopes_supported array"/>
<reference value="scopes.html#additional-us-core-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0168"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0169"/>
<conformance value="MAY"/>
<requirement
value="US Core requires ... additional metadata [to be available through the Server's [Well-Known Uniform Resource Identifier (URI)](https://hl7.org/fhir/smart-app-launch/STU2/conformance.html#using-well-known)]: ... [in] `scopes_supported` [the] array of scopes a Client may request. The Server [MAY support] additional scopes (so Clients should not consider … [the required scopes] an exhaustive list)."/>
<reference value="scopes.html#additional-us-core-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0169"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0170"/>
<conformance value="MAY"/>
<requirement
value="US Core requires ... additional metadata [to be available through the Server's [Well-Known Uniform Resource Identifier (URI)](https://hl7.org/fhir/smart-app-launch/STU2/conformance.html#using-well-known)]: ... [in] `scopes_supported` [the] array of scopes a Client may request. Servers **MAY** limit Clients’ scopes to those configured at registration time."/>
<reference value="scopes.html#additional-us-core-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0170"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0171"/>
<conformance value="SHALL"/>
<requirement
value="US Core requires ... additional metadata [to be available through the Server's [Well-Known Uniform Resource Identifier (URI)](https://hl7.org/fhir/smart-app-launch/STU2/conformance.html#using-well-known)]: ... [in] `scopes_supported` [the] array of scopes a Client may request. … Servers **SHALL** allow users to select a subset of the requested scopes at the approval time."/>
<reference value="scopes.html#additional-us-core-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0171"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0173"/>
<conformance value="SHALL"/>
<requirement
value="US Core requires ... additional metadata [to be available through the Server's [Well-Known Uniform Resource Identifier (URI)](https://hl7.org/fhir/smart-app-launch/STU2/conformance.html#using-well-known)]: ... [in] `introspection_endpoint` the URL to a Server’s introspection endpoint. ... Servers **SHALL** document this endpoint in the file"/>
<reference value="scopes.html#additional-us-core-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="scopes.html#CONF-0173"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0174"/>
<conformance value="SHOULD"/>
<requirement
value="Therefore, a [reference](http://hl7.org/fhir/R4/references.html) to a US Core resource **SHOULD** include a logical id (Reference.reference), not an identifier (Reference.identifier)."/>
<reference value="general-guidance.html#referencing-us-core-profiles">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0174"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0175"/>
<conformance value="SHOULD"/>
<requirement
value="For all references, US Core Responders **SHOULD** return resources that conform to a US Core profile if a US Core profile exists for the resource type."/>
<reference value="general-guidance.html#referencing-us-core-profiles">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0175"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0176"/>
<conformance value="SHOULD-NOT"/>
<requirement
value="When responding to a query, Servers **SHOULD** not use inline [contained](http://hl7.org/fhir/R4/references.html#contained) resources to represent the returned data."/>
<reference value="general-guidance.html#contained-resources">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0176"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0177"/>
<conformance value="SHOULD"/>
<requirement
value="[I]f referencing a contained resource in a US Core Profile, the contained resource **SHOULD** be a US Core Profile if a US Core Profile exists for the resource type."/>
<reference value="general-guidance.html#contained-resources">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0177"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0178"/>
<conformance value="SHOULD"/>
<requirement
value="[M]asking data [where a specific piece of data is hidden for security and privacy reasons] **SHOULD** be handled based on implemented policies."/>
<reference value="general-guidance.html#contained-resources">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0178"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0179"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[When masking data] elements with a minimum cardinality = 0 (including elements labeled Must Support) [for security and privacy reasons], the element **SHOULD** be omitted from the resource."/>
<reference value="general-guidance.html#contained-resources">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0179"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0180"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[When masking] Mandatory elements (in other words, where the minimum cardinality is > 0) [for security and privacy reasons, use the code “unknown” following the guidance on Missing Data in the Conformance Sections."/>
<reference value="general-guidance.html#contained-resources">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0180"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0181"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="[When using SNOMED codes in US Core Profiles I]mplementers **MAY** use the default system URI [of [SNOMED CT](http://snomed.info/sct)], which refers to an unspecified edition/version [of SNOMED]"/>
<reference value="general-guidance.html#snomed-ct-united-states-edition">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0181"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0182"/>
<conformance value="SHOULD"/>
<requirement
value="[To enable] terminology Servers to be able to validate US Edition-only codes [of [SNOMED CT](http://snomed.info/sct)], implementers **SHOULD** provide the accompanying system URI to describe the edition [see example 2 on [US Core general guidance](https://hl7.org/fhir/us/core/STU8/general-guidance.html#snomed-ct-united-states-edition)]"/>
<reference value="general-guidance.html#snomed-ct-united-states-edition">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0182"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0183"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[If a] US Core Profiles binds the Quantity.code element in the Quantity datatype to the [UCUM](http://unitsofmeasure.org/) code system, [then] systems should also use UCUM for the optional valueRange and valueRatio datatypes (which are complex datatypes with Quantity elements)"/>
<reference
value="general-guidance.html#using-ucum-codes-in-the-quantity-datatype">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0183"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0184"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[If a] US Core Profiles binds the Quantity.code element in the Quantity datatype to the [UCUM](http://unitsofmeasure.org/) code system, [when] UCUM code [is] provided [it **SHOULD** be indicated in the Quantity.unit and Quantity.code elements with Quantity.system = "http://unitsofmeasure.org"]"/>
<reference
value="general-guidance.html#using-ucum-codes-in-the-quantity-datatype">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0184"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0185"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[If a] US Core Profiles binds the Quantity.code element in the Quantity datatype to the [UCUM](http://unitsofmeasure.org/) code system, [then] if UCUM units are unavailable, represent units in the unit element"/>
<reference
value="general-guidance.html#using-ucum-codes-in-the-quantity-datatype">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0185"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0186"/>
<conformance value="SHOULD-NOT"/>
<conditionality value="true"/>
<requirement value=" **SHOULD NOT** supply the unit field]"/>
<reference
value="general-guidance.html#using-ucum-codes-in-the-quantity-datatype">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0186"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0187"/>
<conformance value="SHOULD-NOT"/>
<requirement value="A FHIR Server **SHOULD** not delete records."/>
<reference
value="general-guidance.html#representing-deleted-and-entered-in-error-information">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0187"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0188"/>
<conformance value="SHOULD"/>
<requirement
value="A FHIR Server **SHOULD** update the appropriate resource status to entered-in-error or inactive [when requested to delete records]"/>
<reference
value="general-guidance.html#representing-deleted-and-entered-in-error-information">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0188"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0189"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="If a system supports the deletion of records, they **SHOULD** refer to the [Deletion Safety Checks](http://hl7.org/fhir/R4/safety.html#conformance) in the FHIR specification."/>
<reference
value="general-guidance.html#representing-deleted-and-entered-in-error-information">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0189"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0190"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="A FHIR Server **SHOULD** allow these resources [those entered in error] to be searchable by Client applications."/>
<reference
value="general-guidance.html#representing-deleted-and-entered-in-error-information">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0190"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0191"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="If the FHIR Server has updated the resource status to entered-in-error:
For patient facing applications, A FHIR Server **SHOULD** remove the resource’s contents, leaving only an id and status. Note that this typically will not conform to the US Core or FHIR StructureDefinitions."/>
<reference
value="general-guidance.html#representing-deleted-and-entered-in-error-information">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0191"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0192"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="If the FHIR Server has updated the resource status to entered-in-error:
...
For provider-facing applications, the content may be supplied with content and additional detail (such as the reason for the status change) that the patient viewing system would typically not have access to."/>
<reference
value="general-guidance.html#representing-deleted-and-entered-in-error-information">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0192"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0193"/>
<conformance value="SHOULD"/>
<requirement
value="the data provider **SHOULD** do their best to translate (safely) to the requested language [when accessing records in a native or requested language]"/>
<reference value="general-guidance.html#language-support">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0193"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0195"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[When Clients request a resource in a specific language] Servers **SHOULD** make reasonable efforts to translate what can be safely translated."/>
<reference value="general-guidance.html#language-support">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0195"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0196"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[When Clients request a resource in a specific language] Servers **SHOULD** populate the Resource’s language element with a code based on the underlying language of record, not the requested language.
"/>
<reference value="general-guidance.html#language-support">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0196"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0197"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[When Clients request a resource in a specific language] Servers **SHOULD** … [use] the [Human Language](http://hl7.org/fhir/R4/extension-language.html) Extension when the language of a display, etc, is known to differ from the stated (or inferred) language."/>
<reference value="general-guidance.html#language-support">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0197"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0198"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[When Clients request a resource in a specific language] [Servers **SHOULD** use] the [Translation](http://hl7.org/fhir/R4/extension-translation.html) Extension when the Server provides additional translations by its own choice or in response to a different Accept-Language than what the resource is stored in."/>
<reference value="general-guidance.html#language-support">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0198"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0199"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[When Clients request a resource in a specific language] Servers **SHOULD** make it known what languages are supported in their CapabilityStatement(s) using this extension:
http://hl7.org/fhir/5.0/StructureDefinition/extension-CapablilityStatement.acceptLanguage [[definition](https://hl7.org/fhir/R5/capabilitystatement-definitions.html#CapabilityStatement.acceptLanguage)]"/>
<reference value="general-guidance.html#language-support">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0199"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0200"/>
<conformance value="SHOULD"/>
<requirement
value="Servers **SHOULD** support the [_lastUpdated](http://hl7.org/fhir/R4/search.html#lastUpdated) search parameter for US Core Profiles"/>
<reference value="general-guidance.html#searching-using-lastupdated">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0200"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0201"/>
<conformance value="SHOULD"/>
<requirement
value="Servers ... **SHOULD** populate [Resource.meta.lastUpdated](http://hl7.org/fhir/R4/resource.html#Meta) for US Core Profiles as accurately as possible."/>
<reference value="general-guidance.html#searching-using-lastupdated">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0201"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0202"/>
<conformance value="SHALL"/>
<requirement
value="Servers **SHALL** document in CapabilityStatement.rest.resource.searchParam.documentation the types of changes that can be detected using the _lastUpdated search parameter"/>
<reference value="general-guidance.html#searching-using-lastupdated">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0202"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0203"/>
<conformance value="MAY"/>
<requirement
value="US Core Servers [MAY support compartment based searchs, but] are not required to support patient [compartment](http://hl7.org/fhir/R4/compartmentdefinition.html) based searches."/>
<reference value="general-guidance.html#compartment-based-search">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0203"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0204"/>
<conformance value="MAY"/>
<requirement
value="US Core Servers [MAY resolve absolute URLs, but] are not required to resolve absolute URLs external to their environment."/>
<reference value="general-guidance.html#across-platform-searches">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0204"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0205"/>
<conformance value="MAY"/>
<requirement
value="Servers can [MAY] choose to return the results in a series of pages to manage the number of search results returned."/>
<reference
value="general-guidance.html#limiting-the-number-of-search-results">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-guidance.html#CONF-0205"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0206"/>
<conformance value="SHALL"/>
<requirement
value="Servers **SHALL** support, at minimum, these … "Common Clinical Notes":
[Consultation Note (11488-4)](https://loinc.org/11488-4.html)"/>
<reference value="clinical-notes.html#clinical-notes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0206"/>
</extension>
</reference>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0206"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0207"/>
<conformance value="SHALL"/>
<requirement
value="Servers **SHALL** support, at minimum, these … "Common Clinical Notes":
[Discharge Summary (18842-5)](https://loinc.org/18842-5.html)"/>
<reference value="clinical-notes.html#clinical-notes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0207"/>
</extension>
</reference>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0207"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0208"/>
<conformance value="SHALL"/>
<requirement
value="Servers **SHALL** support, at minimum, these … "Common Clinical Notes":
[History & Physical Note (34117-2)](https://loinc.org/34117-2.html)"/>
<reference value="clinical-notes.html#clinical-notes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0208"/>
</extension>
</reference>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0208"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0209"/>
<conformance value="SHALL"/>
<requirement
value="Servers **SHALL** support, at minimum, these … "Common Clinical Notes":
[Procedures Note (28570-0)](https://loinc.org/28570-0.html)"/>
<reference value="clinical-notes.html#clinical-notes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0209"/>
</extension>
</reference>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0209"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0210"/>
<conformance value="SHALL"/>
<requirement
value="Servers **SHALL** support, at minimum, these … "Common Clinical Notes":
[Progress Note (11506-3)](https://loinc.org/11506-3.html)"/>
<reference value="clinical-notes.html#clinical-notes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0210"/>
</extension>
</reference>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0210"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0211"/>
<conformance value="SHALL"/>
<requirement
value="Servers **SHALL** support, at minimum, these … "Common Clinical Notes":
[Imaging Narrative (18748-4)](https://loinc.org/18748-4.html)"/>
<reference value="clinical-notes.html#clinical-notes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0211"/>
</extension>
</reference>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0211"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0212"/>
<conformance value="SHALL"/>
<requirement
value="Servers **SHALL** support, at minimum, these … "Common Clinical Notes":
[Laboratory Report Narrative (11502-2)](https://loinc.org/11502-2.html)"/>
<reference value="clinical-notes.html#clinical-notes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0212"/>
</extension>
</reference>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0212"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0213"/>
<conformance value="SHALL"/>
<requirement
value="Servers **SHALL** support, at minimum, these … "Common Clinical Notes":
[Pathology Report Narrative (11526-1)](https://loinc.org/11526-1.html)"/>
<reference value="clinical-notes.html#clinical-notes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0213"/>
</extension>
</reference>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0213"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0214"/>
<conformance value="SHALL"/>
<requirement
value="Servers **SHALL** support, at minimum, these … DiagnosticReport categories:
[Cardiology (LP29708-2)](https://loinc.org/LP29708-2)"/>
<reference value="clinical-notes.html#clinical-notes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0214"/>
</extension>
</reference>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0214"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0215"/>
<conformance value="SHALL"/>
<requirement
value="Servers **SHALL** support, at minimum, these … DiagnosticReport categories:
[Pathology (LP7839-6)](https://loinc.org/LP7839-6)"/>
<reference value="clinical-notes.html#clinical-notes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0215"/>
</extension>
</reference>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0215"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0216"/>
<conformance value="SHALL"/>
<requirement
value="Servers **SHALL** support, at minimum, these … DiagnosticReport categories:
[Radiology (LP29684-5)](https://loinc.org/LP29684-5)"/>
<reference value="clinical-notes.html#clinical-notes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0216"/>
</extension>
</reference>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0216"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0217"/>
<conformance value="SHOULD"/>
<requirement
value="systems are encouraged to support other common notes types, such as:
[Referral Note (57133-1)](https://loinc.org/57133-1.html)"/>
<reference value="clinical-notes.html#clinical-notes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0217"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0219"/>
<conformance value="SHOULD"/>
<requirement
value="systems are encouraged to support other common notes types, such as:
[Nurse Note (34746-8)](https://loinc.org/34746-8.html)"/>
<reference value="clinical-notes.html#clinical-notes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0219"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0220"/>
<conformance value="SHALL"/>
<requirement
value="To enable consistent access to scanned DiagnosticReport clinical reports, the FHIR Server **SHALL** expose these overlapping scanned or narrative-only reports through both DiagnosticReport and DocumentReference by representing the same attachment URL [as] DocumentReference.content.attachment.url [and]
DiagnosticReport.presentedForm.url"/>
<reference
value="clinical-notes.html#fhir-resources-to-exchange-clinical-notes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0220"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0221"/>
<conformance value="SHALL"/>
<requirement
value="when DiagnosticReport.presentedForm.url references a Scan (PDF), that Attachment **SHALL** also be accessible through DocumentReference.content.attachment.url"/>
<reference
value="clinical-notes.html#fhir-resources-to-exchange-clinical-notes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0221"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0222"/>
<conformance value="MAY"/>
<requirement
value="Systems [Servers] may extend their capabilities [around types of clinical notes] to the complete US Core DocumentReference Type Value Set."/>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0222"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0223"/>
<conformance value="SHALL"/>
<requirement
value="This guide requires [Server] systems to implement the [US Core DocumentReference Profile](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-documentreference.html)"/>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0223"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0224"/>
<conformance value="SHALL"/>
<requirement
value="This guide requires [Server] systems to implement the [US Core DiagnosticReport Profile for Report and Note exchange](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-diagnosticreport-note.html)"/>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0224"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0225"/>
<conformance value="MAY"/>
<requirement
value="Systems [Servers] may support other [DiagnosticReport] categories as well."/>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0225"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0227"/>
<conformance value="SHOULD"/>
<requirement
value="The following **SHOULD** be exposed via DiagnosticReport: Imaging Narrative
"/>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0227"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0228"/>
<conformance value="SHOULD"/>
<requirement
value="The following **SHOULD** be exposed via DiagnosticReport: Laboratory Report Narrative
"/>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0228"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0229"/>
<conformance value="SHOULD"/>
<requirement
value="The following **SHOULD** be exposed via DiagnosticReport: Pathology Report Narrative
"/>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0229"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0230"/>
<conformance value="SHOULD"/>
<requirement
value="The following **SHOULD** be exposed via DiagnosticReport: Procedure Note"/>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0230"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0231"/>
<conformance value="SHALL"/>
<requirement
value="Servers that support DiagnosticReport will include the clinical note narrative content in `DiagnosticReport.presentedForm`"/>
<reference value="clinical-notes.html#support-requirements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0231"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0233"/>
<conformance value="SHOULD"/>
<requirement
value="FHIR Server claiming support to this guide **SHOULD** support the $expand operation [[operation link](http://hl7.org/fhir/R4/valueset-operation-expand.html) to provide information to Clients requesting information on the note and report types the Server supports]"/>
<reference value="clinical-notes.html#using-expand">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0233"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0234"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[If Servers support the [$expand](http://hl7.org/fhir/R4/valueset-operation-expand.html) operation for discovering note and report types, then Servers **SHALL** support] the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note#DiagnosticReport.category&contextDirection=outgoing for DiagnosticReport report category discovery [for read operations]"/>
<reference value="clinical-notes.html#using-expand">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0234"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0235"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[If Servers support the [$expand](http://hl7.org/fhir/R4/valueset-operation-expand.html) operation for discovering note and report types, then Servers **SHALL** support] the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note#DiagnosticReport.category&contextDirection=incoming for DiagnosticReport report category discovery [for write operations]"/>
<reference value="clinical-notes.html#using-expand">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0235"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0236"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[If Servers support the [$expand](http://hl7.org/fhir/R4/valueset-operation-expand.html) operation for discovering note and report types, then Servers **SHALL** support] the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note#DiagnosticReport.code&contextDirection=outgoing for DiagnosticReport report type discovery [for read operations]"/>
<reference value="clinical-notes.html#using-expand">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0236"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0237"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[If Servers support the [$expand](http://hl7.org/fhir/R4/valueset-operation-expand.html) operation for discovering note and report types, then Servers **SHALL** support] the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note#DiagnosticReport.code&contextDirection=incoming for DiagnosticReport report type discovery [for write operations]"/>
<reference value="clinical-notes.html#using-expand">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0237"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0238"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[If Servers support the [$expand](http://hl7.org/fhir/R4/valueset-operation-expand.html) operation for discovering note and report types, then Servers **SHALL** support] the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference#DocumentReference.category&contextDirection=outgoing for DocumentReference note category discovery [for read operations]"/>
<reference value="clinical-notes.html#using-expand">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0238"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0239"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[If Servers support the [$expand](http://hl7.org/fhir/R4/valueset-operation-expand.html) operation for discovering note and report types, then Servers **SHALL** support] the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference#DocumentReference.category&contextDirection=incoming for DocumentReference note category discovery [for write operations]"/>
<reference value="clinical-notes.html#using-expand">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0239"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0240"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[If Servers support the [$expand](http://hl7.org/fhir/R4/valueset-operation-expand.html) operation for discovering note and report types, then Servers **SHALL** support] the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference#DocumentReference.type&contextDirection=outgoing for DocumentReference note type discovery [for read operations]"/>
<reference value="clinical-notes.html#using-expand">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0240"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0241"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[If Servers support the [$expand](http://hl7.org/fhir/R4/valueset-operation-expand.html) operation for discovering note and report types, then Servers **SHALL** support] the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference#DocumentReference.type&contextDirection=incoming for DocumentReference note type discovery [for write operations]"/>
<reference value="clinical-notes.html#using-expand">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0241"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0242"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[If Servers support the [$expand](http://hl7.org/fhir/R4/valueset-operation-expand.html) operation then] the note and report types for a particular Server [SHOULD be] discovered by invoking the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note#DiagnosticReport.presentedForm.contentType&contextDirection=outgoing for DiagnosticReport report content type discovery [for read operations]"/>
<reference
value="clinical-notes.html#discovering-Server-read-and-write-formats">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0242"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0243"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[If Servers support the [$expand](http://hl7.org/fhir/R4/valueset-operation-expand.html) operation then] the note and report types for a particular Server [SHOULD be] discovered by invoking the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note#DiagnosticReport.presentedForm.contentType&contextDirection=incoming for DiagnosticReport report content type discovery [for write operations]"/>
<reference
value="clinical-notes.html#discovering-Server-read-and-write-formats">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0243"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0244"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[If Servers support the [$expand](http://hl7.org/fhir/R4/valueset-operation-expand.html) operation then] the note and report types for a particular Server [SHOULD be] discovered by invoking the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference#DocumentReference.content.attachment.contentType&contextDirection=outgoing for DocumentReference note content type discovery [for read operations]"/>
<reference
value="clinical-notes.html#discovering-Server-read-and-write-formats">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0244"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0245"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[If Servers support the [$expand](http://hl7.org/fhir/R4/valueset-operation-expand.html) operation then] the note and report types for a particular Server [SHOULD be] discovered by invoking the #expand operation as follows:
GET [base]/ValueSet/$expand?context=http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference#DocumentReference.content.attachment.contentType&contextDirection=incoming for DocumentReference note content type discovery [for write operations]"/>
<reference
value="clinical-notes.html#discovering-Server-read-and-write-formats">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0245"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0246"/>
<conformance value="MAY"/>
<requirement
value="[The [MedicationAdministration](http://hl7.org/fhir/R4/medicationadministration.html) and [MedicationStatement](http://hl7.org/fhir/R4/medicationstatement.html)] medication resources are not profiled by US Core, and systems that support US Core are permitted to use them"/>
<reference
value="medication-list.html#background-on-the-fhir-medications-resources">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="medication-list.html#CONF-0246"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0247"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="When using a code [to represent a medication][, the code **SHALL** follow the [extensible](http://hl7.org/fhir/R4/terminologies.html#extensible) binding rules to [Medication Clinical Drug (RxNorm)](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1010.4/expansion) - i.e., unless RxNorm does not cover the concept, the RxNorm code **SHALL** be used."/>
<reference
value="medication-list.html#options-for-representing-medication">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="medication-list.html#CONF-0247"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0248"/>
<conformance value="MAY"/>
<requirement
value="USCDI recommends the [National Drug Codes (NDC)](https://www.fda.gov/drugs/drug-approvals-and-databases/national-drug-code-directory) as an optional medication terminology. They can be supplied as an additional coding element [when representing a medication]"/>
<reference
value="medication-list.html#options-for-representing-medication">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="medication-list.html#CONF-0248"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0249"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="When referencing the Medication resource, the resource may be included in the returned bundle, as an external resource, or as a [contained](http://hl7.org/fhir/R4/references.html#contained) resource if it can’t stand alone. … The Server application **MAY** choose any combination of these methods"/>
<reference
value="medication-list.html#options-for-representing-medication">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="medication-list.html#CONF-0249"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0250"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="if an external reference to Medication is used, the Server **SHALL** support the [_include](http://hl7.org/fhir/R4/search.html#include) parameter for searching this element"/>
<reference
value="medication-list.html#options-for-representing-medication">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="medication-list.html#CONF-0250"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0252"/>
<conformance value="SHALL"/>
<requirement
value="Requirements to access “all medications” [all historical, active, and future prescribed medications and medications entered in error and whose status is unknown.] and “all active medications” [all medications with an active status. Active medications do not include past, future, unknown status, and entered-in-error medications.] for a patient:
A MedicationRequest resource query **SHALL** be all that is required to access "all medications" or "all active medications" for a patient. (In other words, no other medication resource type needs to be fetched)"/>
<reference
value="medication-list.html#fetching-all-medications-active-medications-and-all-medications-for-an-encounter">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="medication-list.html#CONF-0252"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0253"/>
<conformance value="SHALL"/>
<requirement
value="Requirements to access “all medications” [all historical, active, and future prescribed medications and medications entered in error and whose status is unknown.] and “all active medications” [all medications with an active status. Active medications do not include past, future, unknown status, and entered-in-error medications.] for a patient:
The [MedicationRequest resource] query result **SHALL** include all MedicationRequest resources with a `MedicationRequest.intent` = "order" representing authorized medication orders directly derived from the system's orders."/>
<reference
value="medication-list.html#fetching-all-medications-active-medications-and-all-medications-for-an-encounter">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="medication-list.html#CONF-0253"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0254"/>
<conformance value="SHALL"/>
<requirement
value="Requirements to access “all medications” [all historical, active, and future prescribed medications and medications entered in error and whose status is unknown.] and “all active medications” [all medications with an active status. Active medications do not include past, future, unknown status, and entered-in-error medications.] for a patient:
The [MedicationRequest resource] query result **SHALL** include all prescribed and "self-prescribed" MedicationRequest resources with a `MedicationRequest.intent` = "plan" representing reported medications."/>
<reference
value="medication-list.html#fetching-all-medications-active-medications-and-all-medications-for-an-encounter">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="medication-list.html#CONF-0254"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0256"/>
<conformance value="SHALL"/>
<requirement
value="Requirements to access “all medications” [all historical, active, and future prescribed medications and medications entered in error and whose status is unknown.] and “all active medications” [all medications with an active status. Active medications do not include past, future, unknown status, and entered-in-error medications.] for a patient:
Servers **SHALL** use the `MedicationRequest.reported[x]` element to indicate that the MedicationRequest record was captured as a secondary "reported" record rather than an original primary source-of-truth record."/>
<reference
value="medication-list.html#fetching-all-medications-active-medications-and-all-medications-for-an-encounter">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="medication-list.html#CONF-0256"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0257"/>
<conformance value="MAY"/>
<requirement
value="Requirements to access “all medications” [all historical, active, and future prescribed medications and medications entered in error and whose status is unknown.] and “all active medications” [all medications with an active status. Active medications do not include past, future, unknown status, and entered-in-error medications.] for a patient:
Servers [MAY] use the `MedicationRequest.reported[x]` element to indicate ... the source of the report."/>
<reference
value="medication-list.html#fetching-all-medications-active-medications-and-all-medications-for-an-encounter">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="medication-list.html#CONF-0257"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0258"/>
<conformance value="SHOULD"/>
<requirement
value="Requirements to access “all medications” [all historical, active, and future prescribed medications and medications entered in error and whose status is unknown.] and “all active medications” [all medications with an active status. Active medications do not include past, future, unknown status, and entered-in-error medications.] for a patient:
When recording "self-prescribed" medication, Servers **SHOULD** use the `MedicationRequest.requester` element to indicate the Patient or RelatedPerson is the prescriber."/>
<reference
value="medication-list.html#fetching-all-medications-active-medications-and-all-medications-for-an-encounter">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="medication-list.html#CONF-0258"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0259"/>
<conformance value="SHOULD"/>
<requirement
value="Requirements to access “all medications” [all historical, active, and future prescribed medications and medications entered in error and whose status is unknown.] and “all active medications” [all medications with an active status. Active medications do not include past, future, unknown status, and entered-in-error medications.] for a patient:
Servers **SHOULD** support the encounter search parameter. "/>
<reference
value="medication-list.html#fetching-all-medications-active-medications-and-all-medications-for-an-encounter">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="medication-list.html#CONF-0259"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0260"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="Requirements to access “all medications” [all historical, active, and future prescribed medications and medications entered in error and whose status is unknown.] and “all active medications” [all medications with an active status. Active medications do not include past, future, unknown status, and entered-in-error medications.] for a patient:
[If Servers support the encounter search parameter, s]earching by encounter will return all medications ordered during that encounter, including medications administered in the hospital and prescribed or discharge medications intended to be taken at home."/>
<reference
value="medication-list.html#fetching-all-medications-active-medications-and-all-medications-for-an-encounter">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="medication-list.html#CONF-0260"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0262"/>
<conformance value="MAY"/>
<requirement
value="Requirements to access “all medications” [all historical, active, and future prescribed medications and medications entered in error and whose status is unknown.] and “all active medications” [all medications with an active status. Active medications do not include past, future, unknown status, and entered-in-error medications.] for a patient:
Servers **MAY** support the search parameters `category`and `encounter`. This search will return all medications ordered during an encounter for a given MedicationRequest.category such as "inpatient"."/>
<reference
value="medication-list.html#fetching-all-medications-active-medications-and-all-medications-for-an-encounter">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="medication-list.html#CONF-0262"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0263"/>
<conformance value="MAY"/>
<requirement
value="To provide a list of a patient’s medications, it may be necessary to “de-duplicate” them. The de-duplication activity **MAY** be supplied by the Server"/>
<reference value="medication-list.html#de-duplication-of-data">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="medication-list.html#CONF-0263"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0267"/>
<conformance value="MAY"/>
<requirement
value="An agent.type=”assembler”, agent.type=”transmitter”, or other agents from [Provenance Agent Type](https://hl7.org/fhir/us/core/STU8/ValueSet-us-core-provenance-participant-type.html) value set **MAY** also be included."/>
<reference value="basic-provenance.html#hie-transformation">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="basic-provenance.html#CONF-0267"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0268"/>
<conformance value="SHOULD"/>
<requirement
value="implementers [of US Core's framework of Screening and Assessments] **SHOULD** consider more constrained, domain-specific profiles derived from the US Core Profiles to meet the needs of their respective use cases."/>
<reference value="screening-and-assessments.html#introduction">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="screening-and-assessments.html#CONF-0268"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0269"/>
<conformance value="SHALL"/>
<requirement
value="Every Server that supports the USDCI Data Class “Health Status/Assessments”:
**SHALL** support representing clinical judgments using [US Core Condition Problems and Health Concerns Profile](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-condition-problems-health-concerns.html) or [US Core Simple Observation Profile](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-simple-observation.html)."/>
<reference value="screening-and-assessments.html#clinical-judgments">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="screening-and-assessments.html#CONF-0269"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0270"/>
<conformance value="SHOULD"/>
<requirement
value="Every Server that supports the USDCI Data Class “Health Status/Assessments”:
...
The US Core Simple Observation Profile's Observation.derivedFrom element **SHOULD** reference the [Structured Screening and Assessment](https://hl7.org/fhir/us/core/STU8/screening-and-assessments.html#structured-screening-and-assessments) upon which clinical judgment observations are made"/>
<reference value="screening-and-assessments.html#clinical-judgments">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="screening-and-assessments.html#CONF-0270"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0271"/>
<conformance value="SHOULD"/>
<requirement
value="Every Server that supports the USDCI Data Class “Health Status/Assessments”:
...
the US Core Condition Profile's Condition.evidence.detail element **SHOULD** reference the [Structured Screening and Assessment](https://hl7.org/fhir/us/core/STU8/screening-and-assessments.html#structured-screening-and-assessments) which assist in diagnosing problems or health concerns."/>
<reference value="screening-and-assessments.html#clinical-judgments">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="screening-and-assessments.html#CONF-0271"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0272"/>
<conformance value="SHOULD"/>
<requirement
value="For API developers using US Core, it’s important to understand when to use the QuestionnaireResponse versus Observation to represent structured assessments and surveys. Here are some guidelines to help choose the appropriate profile:
Observations represent specific point-in-time facts that need to be searched, trended, the subject of statistical analysis, and directly referenced in support of other actions ... anything that meets one of the preceding criteria must be surfaced as an Observation."/>
<reference
value="screening-and-assessments.html#choosing-between-questionnaireresponse-and-observation">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="screening-and-assessments.html#CONF-0272"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0280"/>
<conformance value="SHOULD"/>
<requirement
value="Implementers **SHOULD** treat these [USCDI Health Status Assessments Data Element] value sets as having an [extensible](http://hl7.org/fhir/R4/terminologies.html#extensible) binding."/>
<reference
value="screening-and-assessments.html#uscdi-health-assessments-data-element-value-sets">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="screening-and-assessments.html#CONF-0280"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0281"/>
<conformance value="SHOULD"/>
<requirement
value="when recording SDOH data [with] US Core Profiles, Servers **SHOULD** use … [Social Determinants of Health Conditions Value Set](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1196.788/expansion), [Social Determinants of Health Procedures Value Set](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1196.789/expansion), [Social Determinants of Health Goals Value Set](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1247.71/expansion), [and] [Social Determinants of Health Service Requests Value Set](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1196.790/expansion)"/>
<reference
value="screening-and-assessments.html#uscdi-health-assessments-data-element-value-sets">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="screening-and-assessments.html#CONF-0281"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0287"/>
<conformance value="SHOULD"/>
<requirement
value="Servers **SHOULD** maintain a stable common identifier for a resource across [FHIR] versions."/>
<reference
value="changes-between-versions.html#no-guarantee-that-resource-ids-are-preserved">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="changes-between-versions.html#CONF-0287"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0288"/>
<conformance value="SHOULD"/>
<requirement
value="In an upgraded R4 endpoint, any data in FHIR DSTU2 **SHOULD** be in FHIR R4."/>
<reference
value="changes-between-versions.html#expectation-that-data-is-preserved-between-versions">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="changes-between-versions.html#CONF-0288"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0289"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="The FHIR RESTful resource types supported in a DSTU2 implementation **SHOULD** be supported in a R4 implementation"/>
<reference
value="changes-between-versions.html#expectation-that-data-is-preserved-between-versions">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="changes-between-versions.html#CONF-0289"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0290"/>
<conformance value="SHOULD"/>
<requirement
value="The FHIR RESTful resource types supported in a DSTU2 implementation **SHOULD** be supported in a R4 implementation [with the] exception [of]
MedicationStatement may be deprecated, and the data **SHOULD** be mapped to MedicationRequest."/>
<reference
value="changes-between-versions.html#expectation-that-data-is-preserved-between-versions">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="changes-between-versions.html#CONF-0290"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0291"/>
<conformance value="SHOULD"/>
<requirement
value="The FHIR RESTful resource types supported in a DSTU2 implementation **SHOULD** be supported in a R4 implementation [with the] exception [of]
Care teams as represented by CarePlan in DSTU2 **SHOULD** be replaced by and the data mapped to CareTeam in R4"/>
<reference
value="changes-between-versions.html#expectation-that-data-is-preserved-between-versions">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="changes-between-versions.html#CONF-0291"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0295"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="Servers **SHOULD** make available the same information in DSTU2 and R4 where the more recent standard allows."/>
<reference
value="changes-between-versions.html#expectation-that-data-is-preserved-between-versions">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="changes-between-versions.html#CONF-0295"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0296"/>
<conformance value="SHOULD"/>
<requirement
value="Servers **SHOULD** make available the same information in DSTU2 and R4 where the more recent standard allows … [with the] exception [of]
MedicationStatement data [should be] mapped to MedicationRequest"/>
<reference
value="changes-between-versions.html#expectation-that-data-is-preserved-between-versions">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="changes-between-versions.html#CONF-0296"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0297"/>
<conformance value="SHOULD"/>
<requirement
value="Servers **SHOULD** make available the same information in DSTU2 and R4 where the more recent standard allows … [with the] exception [of]
care teams, as represented by CarePlan, **SHOULD** be mapped to CareTeam in R4"/>
<reference
value="changes-between-versions.html#expectation-that-data-is-preserved-between-versions">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="changes-between-versions.html#CONF-0297"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0298"/>
<conformance value="SHOULD"/>
<requirement
value="Data **SHOULD** be maintained between [FHIR] versions (i.e., not be degraded)."/>
<reference
value="changes-between-versions.html#expectation-that-data-is-preserved-between-versions">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="changes-between-versions.html#CONF-0298"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0300"/>
<conformance value="SHOULD"/>
<requirement
value="To allow Clients to use a single authorization token when accessing resources from multiple version-specific endpoints, Servers **SHOULD** use the same base authorization endpoint across versions."/>
<reference
value="changes-between-versions.html#authorization-across-versions">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="changes-between-versions.html#CONF-0300"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0302"/>
<conformance value="SHALL"/>
<requirement
value="[The clinical status of the allergy] **SHALL** be present if verification status is not “entered-in-error”"/>
<reference
value="StructureDefinition-us-core-allergyintolerance.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-allergyintolerance.html#CONF-0302"/>
</extension>
</reference>
</statement>
<statement>
<extension
url="http://hl7.org/fhir/tools/StructureDefinition/requirements-statementshallnot">
<valueBoolean value="true"/>
</extension>
<key value="CONF-0303"/>
<requirement
value="[The clinical status of the allergy] **SHALL NOT** be present if verification Status is “entered-in-error”"/>
<reference
value="StructureDefinition-us-core-allergyintolerance.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-allergyintolerance.html#CONF-0303"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0305"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="Profile Specific Implementation Guidance:
No Known Allergies may be represented using the US Core-AllergyIntolerance profile"/>
<reference
value="StructureDefinition-us-core-allergyintolerance.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-allergyintolerance.html#CONF-0305"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0306"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="[When used No Known Allergies is documented the system Shall use an] appropriate negation code in AllergyIntolerence.code"/>
<reference
value="StructureDefinition-us-core-allergyintolerance.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-allergyintolerance.html#CONF-0306"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0307"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="[When used No Known Allergies is documented the system Shall use an] verification status in AllergyIntolerance.verificationStatus"/>
<reference
value="StructureDefinition-us-core-allergyintolerance.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-allergyintolerance.html#CONF-0307"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0308"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="If a patient has not been asked about their allergies, this would be represented as:
AllergyIntolerance.code = “1631000175102” (Patient not asked (contextual qualifier) (qualifier value))
AllergyIntolerance.verificationStatus = “unconfirmed” or empty (in other words, then element omitted)"/>
<reference
value="StructureDefinition-us-core-allergyintolerance.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-allergyintolerance.html#CONF-0308"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0309"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="If a patient has been asked, but has indicated they have no known allergies, this would be represented as:
AllergyIntolerance.code = “716186003” (No known allergy (situation))
AllergyIntolerance.verificationStatus = “confirmed”"/>
<reference
value="StructureDefinition-us-core-allergyintolerance.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-allergyintolerance.html#CONF-0309"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0310"/>
<conformance value="SHOULD"/>
<requirement
value="Considerations for systems aligning with [HL7 Consolidated (C-CDA)](http://www.hl7.org/implement/standards/product_brief.cfm?product_id=492) Care Plan requirements: US Core Goal **SHOULD** be present in CarePlan.goal"/>
<reference
value="StructureDefinition-us-core-careplan.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-careplan.html#CONF-0310"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0311"/>
<conformance value="SHOULD"/>
<requirement
value="Considerations for systems aligning with [HL7 Consolidated (C-CDA)] (http://www.hl7.org/implement/standards/product_brief.cfm?product_id=492) Care Plan requirements: ... US Core Condition **SHOULD** be present in CarePlan.addresses"/>
<reference
value="StructureDefinition-us-core-careplan.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-careplan.html#CONF-0311"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0312"/>
<conformance value="MAY"/>
<requirement
value="Considerations for systems aligning with [HL7 Consolidated (C-CDA)] (http://www.hl7.org/implement/standards/product_brief.cfm?product_id=492) Care Plan requirements: Assessment and Plan **MAY** be included as narrative in CarePlan.text"/>
<reference
value="StructureDefinition-us-core-careplan.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-careplan.html#CONF-0312"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0313"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="Although both US Core Practitioner Profile and US Core PractitionerRole are Must Support, ... Server system[s conforming to the US Core CareTeam profile are] ... not required to support references to both, but **SHALL** support at least one of them"/>
<reference
value="StructureDefinition-us-core-careteam.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-careteam.html#CONF-0313"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0317"/>
<conformance value="SHOULD"/>
<requirement
value="[When conforming to the US Core CareTeam profile] Because the US Core PractitionerRole Profile supplies the provider’s location and contact information and a reference to the Practitioner, Server systems [conforming to the US Core CareTeam profile] **SHOULD** reference it instead of the US Core Practitioner Profile [when conforming to the US Core CareTeam profile] ."/>
<reference
value="StructureDefinition-us-core-careteam.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-careteam.html#CONF-0317"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0318"/>
<conformance value="SHALL"/>
<requirement
value="Servers [conforming to the US Core CareTeam profile] that support only US Core Practitioner Profile and do not support the US Core PractitionerRole Profile **SHALL** provide implementation-specific guidance on how to access a provider’s location ... information using only the Practitioner resource."/>
<reference
value="StructureDefinition-us-core-careteam.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-careteam.html#CONF-0318"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0319"/>
<conformance value="SHALL"/>
<requirement
value="Servers [conforming to the US Core CareTeam profile] that support only US Core Practitioner Profile and do not support the US Core PractitionerRole Profile **SHALL** provide implementation-specific guidance on how to access a provider’s ... contact information using only the Practitioner resource."/>
<reference
value="StructureDefinition-us-core-careteam.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-careteam.html#CONF-0319"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0320"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="For Problems and Health Concerns [records, systems **SHOULD**] use the [US Core Condition Problems and Health Concerns Profile](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-condition-problems-health-concerns.html)."/>
<reference
value="StructureDefinition-us-core-condition-encounter-diagnosis.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-condition-encounter-diagnosis.html#CONF-0320"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0323"/>
<conformance value="SHOULD"/>
<requirement
value="USCDI’s applicable vocabulary standards for Encounter Diagnosis are SNOMED CT and ICD-10-CM. The US Core Condition Codes only supports ICD-9-CM for historical purposes. When using ICD codes, only non-header ICD-10-CM codes **SHOULD** be used as the primary code for current encounter diagnoses."/>
<reference
value="StructureDefinition-us-core-condition-encounter-diagnosis.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-condition-encounter-diagnosis.html#CONF-0323"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-condition-problems-health-concerns.html#CONF-0323"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0324"/>
<conformance value="SHOULD"/>
<requirement
value="[A US Core Condition Encounter Diagnosis] encounter **SHOULD** always be referenced in Condition.encounter."/>
<reference
value="StructureDefinition-us-core-condition-encounter-diagnosis.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-condition-encounter-diagnosis.html#CONF-0324"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0330"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="For Encounter Diagnosis [records, systems **SHOULD**] use the [US Core Condition Encounter Diagnosis Profile](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-condition-encounter-diagnosis.html)."/>
<reference
value="StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-condition-problems-health-concerns.html#CONF-0330"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0331"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="If the category is "problem-list-item", Condition.clinicalStatus **SHOULD** be present."/>
<reference
value="StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-condition-problems-health-concerns.html#CONF-0331"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0332"/>
<conformance value="SHOULD"/>
<requirement
value="Updates to .meta.lastUpdated **SHOULD** reflect: New problems and health concerns "/>
<reference
value="StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-condition-problems-health-concerns.html#CONF-0332"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0333"/>
<conformance value="SHOULD"/>
<requirement
value="Updates to .meta.lastUpdated **SHOULD** reflect:
Changes in the clinical status or verifications status of problems or health concerns."/>
<reference
value="StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-condition-problems-health-concerns.html#CONF-0333"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0334"/>
<conformance value="MAY"/>
<requirement
value="A coverage.type of “81” (Self-pay) **MAY** be used to imply that the patient has no coverage or that an individual or organization other than an insurer is taking responsibility for payment for a portion of the health care costs."/>
<reference
value="StructureDefinition-us-core-coverage.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-coverage.html#CONF-0334"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0335"/>
<conformance value="SHOULD"/>
<requirement
value="Implementers should refer to the [PHDSC Payer Type Committee User’s Guide](https://www.nahdo.org/sites/default/files/2020-12/SourceofPaymentTypologyUsersGuideVersion9.2December2020.pdf) for the Source of Payment Typology when selecting codes."/>
<reference
value="StructureDefinition-us-core-coverage.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-coverage.html#CONF-0335"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0336"/>
<conformance value="SHOULD"/>
<requirement
value="To differentiate Medicare Parts A, B, C, and D systems can use the following codes [when sending Coverage.type]: [For] Part A and B [use] 121 (Medicare Fee For Service)"/>
<reference
value="StructureDefinition-us-core-coverage.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-coverage.html#CONF-0336"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0337"/>
<conformance value="SHOULD"/>
<requirement
value="To differentiate Medicare Parts A, B, C, and D systems can use the following codes: [For] Part C (Medicare Advantage Plan) [use] 111 (Medicare HMO), 112 (Medicare PPO), 113 (Medicare POS)"/>
<reference
value="StructureDefinition-us-core-coverage.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-coverage.html#CONF-0337"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0338"/>
<conformance value="SHOULD"/>
<requirement
value="To differentiate Medicare Parts A, B, C, and D systems can use the following codes: [For] Part D [use] 122 (Medicare Drug Benefit)"/>
<reference
value="StructureDefinition-us-core-coverage.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-coverage.html#CONF-0338"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0339"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="If Insurers issue unique member IDs for dependents, then the memberId Coverage.identifier should be used [with the unique dependent ID] instead of Coverage.dependent to uniquely refer to the dependent with respect to their insurance."/>
<reference
value="StructureDefinition-us-core-coverage.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-coverage.html#CONF-0339"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0341"/>
<conformance value="SHOULD"/>
<requirement
value="Implementers are encouraged to use the FDA Global UDI Database (GUDID) and associated APIs to parse and validate the [unique device ID] UDI"/>
<reference
value="StructureDefinition-us-core-device.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-device.html#CONF-0341"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0342"/>
<conformance value="SHALL"/>
<requirement
value="Medical devices with UDI information **SHALL** represent the UDI code in Device.udiCarrier.carrierHRF"/>
<reference
value="StructureDefinition-us-core-device.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-device.html#CONF-0342"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0343"/>
<conformance value="SHALL"/>
<requirement
value="UDI-PI elements present [in Device.udiCarrier.carrierHRF] **SHALL** be represented in the corresponding US Core Device Profile elements"/>
<reference
value="StructureDefinition-us-core-device.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-device.html#CONF-0343"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0344"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="If UDI is not present and the manufacturer … is available, … [it] **SHOULD** be included to support historical reports of implantable medical devices [where] manufacturer [is sent in] Device.manufacturer"/>
<reference
value="StructureDefinition-us-core-device.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-device.html#CONF-0344"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0345"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="If UDI is not present and the ... model number information is available, … [it] **SHOULD** be included to support historical reports of implantable medical devices [where] model [is sent in] Device.model"/>
<reference
value="StructureDefinition-us-core-device.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-device.html#CONF-0345"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0347"/>
<conformance value="MAY"/>
<requirement
value="Records of implanted devices **MAY** be queried against UDI data, including: UDI HRF string (udi-carrier)"/>
<reference
value="StructureDefinition-us-core-device.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-device.html#CONF-0347"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0348"/>
<conformance value="MAY"/>
<requirement
value="Records of implanted devices **MAY** be queried against UDI data, including:UDI Device Identifier (udi-di)"/>
<reference
value="StructureDefinition-us-core-device.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-device.html#CONF-0348"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0349"/>
<conformance value="MAY"/>
<requirement
value="Records of implanted devices **MAY** be queried against UDI data, including: Manufacturer (manufacturer)"/>
<reference
value="StructureDefinition-us-core-device.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-device.html#CONF-0349"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0350"/>
<conformance value="MAY"/>
<requirement
value="Records of implanted devices **MAY** be queried against UDI data, including: Model number (model)"/>
<reference
value="StructureDefinition-us-core-device.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-device.html#CONF-0350"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0351"/>
<conformance value="MAY"/>
<requirement
value="Implementers **MAY** also adopt custom SearchParameters for searching by lot numbers"/>
<reference
value="StructureDefinition-us-core-device.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-device.html#CONF-0351"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0352"/>
<conformance value="MAY"/>
<requirement
value="Implementers **MAY** also adopt custom SearchParameters for searching by serial number"/>
<reference
value="StructureDefinition-us-core-device.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-device.html#CONF-0352"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0353"/>
<conformance value="MAY"/>
<requirement
value="Implementers **MAY** also adopt custom SearchParameters for searching by expiration date"/>
<reference
value="StructureDefinition-us-core-device.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-device.html#CONF-0353"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0354"/>
<conformance value="MAY"/>
<requirement
value="Implementers **MAY** also adopt custom SearchParameters for searching by manufacture date"/>
<reference
value="StructureDefinition-us-core-device.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-device.html#CONF-0354"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0355"/>
<conformance value="MAY"/>
<requirement
value="Implementers **MAY** also adopt custom SearchParameters for searching by distinct identifier"/>
<reference
value="StructureDefinition-us-core-device.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-device.html#CONF-0355"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0356"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The diagnostically relevant time (known as the “effective time” and typically the time of specimen collection) … **SHALL** be present if status [of the diagnostic report] is ‘partial’, ‘preliminary’, ‘final’, ‘amended’, ‘corrected’, or ‘appended’."/>
<reference
value="StructureDefinition-us-core-diagnosticreport-lab.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-diagnosticreport-lab.html#CONF-0356"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-diagnosticreport-note.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-diagnosticreport-note.html#CONF-0356"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0357"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="When the report was released … **SHALL** be present if status [of the diagnostic report] is ‘partial’, ‘preliminary’, ‘final’, ‘amended’, ‘corrected’, or ‘appended’."/>
<reference
value="StructureDefinition-us-core-diagnosticreport-lab.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-diagnosticreport-lab.html#CONF-0357"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0358"/>
<conformance value="SHOULD"/>
<requirement
value="Updates to .meta.lastUpdated **SHOULD** reflect New laboratory reports. "/>
<reference
value="StructureDefinition-us-core-diagnosticreport-lab.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-diagnosticreport-lab.html#CONF-0358"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0359"/>
<conformance value="SHOULD"/>
<requirement
value="Updates to .meta.lastUpdated **SHOULD** reflect changes in the status of laboratory reports, including events that trigger the same status (e.g., amended → amended)."/>
<reference
value="StructureDefinition-us-core-diagnosticreport-lab.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-diagnosticreport-lab.html#CONF-0359"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0360"/>
<conformance value="SHALL"/>
<requirement
value="The DiagnosticReport.category binding Must Support, at a minimum, the US Core DiagnosticReport Category Codes of Cardiology, Radiology, and Pathology"/>
<reference
value="StructureDefinition-us-core-diagnosticreport-note.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-diagnosticreport-note.html#CONF-0360"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0361"/>
<conformance value="MAY"/>
<requirement
value="Other [diagnostic report] categories may be supported [when using US Core DiagnosticReport Profile for Report and Note Exchange]"/>
<reference
value="StructureDefinition-us-core-diagnosticreport-note.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-diagnosticreport-note.html#CONF-0361"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0362"/>
<conformance value="MAY"/>
<requirement
value="[L]inkages between specific LOINC codes and the LP-type codes may be used as guidance [for a Server's categorization of diagnostic reports]"/>
<reference
value="StructureDefinition-us-core-diagnosticreport-note.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-diagnosticreport-note.html#CONF-0362"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0364"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="For Diagnostic Imaging Reports systems **SHOULD** support using the subset of LOINC codes listed Table 4: LOINC® Document Type Codes in *HL7 Standard for CDA® Release 2: Imaging Integration; Basic Imaging Reports in CDA and DICOM, Release 1*"/>
<reference
value="StructureDefinition-us-core-diagnosticreport-note.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-diagnosticreport-note.html#CONF-0364"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0365"/>
<conformance value="SHALL"/>
<requirement
value="The DocumentReference.type binding Must Support, at a minimum, the 10 [Common Clinical Notes](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-documentreference.html#mandatory-and-must-support-data-elements)"/>
<reference
value="StructureDefinition-us-core-documentreference.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-documentreference.html#CONF-0365"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0366"/>
<conformance value="MAY"/>
<requirement
value="The DocumentReference.type binding may extend to the whole [US Core DocumentReference Type Value Set](https://hl7.org/fhir/us/core/STU8/ValueSet-us-core-documentreference-type.html)"/>
<reference
value="StructureDefinition-us-core-documentreference.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-documentreference.html#CONF-0366"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0367"/>
<conformance value="MAY"/>
<requirement
value="[DocumentReference.type may also use] other category schemes such as the LOINC-based [Document Class Value Set](http://hl7.org/fhir/R4/valueset-document-classcodes.html) and [IHE XDSclassCode](https://wiki.ihe.net/index.php/XDS_classCode_Metadata_Coding_System)"/>
<reference
value="StructureDefinition-us-core-documentreference.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-documentreference.html#CONF-0367"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0368"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="Although both [DocumentReference.attachment.url and DocumentReference.attachment.data] are marked as Must Support, the Server system is not required to support an address and inline base64 encoded data, but **SHALL** support at least one of these elements."/>
<reference
value="StructureDefinition-us-core-documentreference.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-documentreference.html#CONF-0368"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0372"/>
<conformance value="SHALL"/>
<requirement
value="If there are multiple DocumentReference.content element repetitions, these **SHALL** all represent the same document in different formats or attachment metadata"/>
<reference
value="StructureDefinition-us-core-documentreference.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-documentreference.html#CONF-0372"/>
</extension>
</reference>
</statement>
<statement>
<extension
url="http://hl7.org/fhir/tools/StructureDefinition/requirements-statementshallnot">
<valueBoolean value="true"/>
</extension>
<key value="CONF-0373"/>
<requirement
value="The [documentReference.content] element **SHALL NOT** contain different versions of the same content."/>
<reference
value="StructureDefinition-us-core-documentreference.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-documentreference.html#CONF-0373"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0374"/>
<conformance value="SHALL"/>
<requirement
value="The organization responsible for the DocumentReference **SHALL** be present either in DocumentReference.custodian or accessible in the Provenance resource targeting the DocumentReference using Provenance.agent.who or Provenance.agent.onBehalfOf"/>
<reference
value="StructureDefinition-us-core-documentreference.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-documentreference.html#CONF-0374"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0375"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="Although ... marked as Must Support, Servers are not required to support both [an Encounter.reasonCode or a reference with Encounter.reasonReference], but they **SHALL** support at least one of these elements."/>
<reference
value="StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-encounter.html#CONF-0375"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0378"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="If Encounter.reasonReference references an Observation, it **SHOULD** conform to a US Core Observation [profile applicable to the observation being made]"/>
<reference
value="StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-encounter.html#CONF-0378"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0379"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="Although … marked as Must Support, Servers are not required to support both Encounter.location.location and Encounter.serviceProvider, but they **SHALL** support at least one of these elements."/>
<reference
value="StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-encounter.html#CONF-0379"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0382"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="If the event facility/location differs from the Encounter.location, systems **SHOULD** reference it directly"/>
<reference
value="StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-encounter.html#CONF-0382"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-location.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-location.html#CONF-0382"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0383"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="If the event facility/location differs from the Encounter.location, … systems **SHALL** use the location element for all resources where the element is available."/>
<reference
value="StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-encounter.html#CONF-0383"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-location.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-location.html#CONF-0383"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0384"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="If the event facility/location differs from the Encounter.location … systems **MAY** use the standard [Event Location Extension](http://hl7.org/fhir/StructureDefinition/event-location) for US Core DiagnosticReport Profile for Laboratory Results Reporting and US Core Observation Clinical Result Profile."/>
<reference
value="StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-encounter.html#CONF-0384"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-location.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-location.html#CONF-0384"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0385"/>
<conformance value="SHOULD"/>
<requirement
value="Updates to .meta.lastUpdated **SHOULD** reflect New encounters/visits"/>
<reference
value="StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-encounter.html#CONF-0385"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0386"/>
<conformance value="SHOULD"/>
<requirement
value="Updates to .meta.lastUpdated **SHOULD** reflect changes in the status of encounters, including events that trigger the same status (e.g., in-progress → in-progress)."/>
<reference
value="StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-encounter.html#CONF-0386"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0387"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="Although both Goal.startDate and Goal.target.dueDate are marked as Must Support, the Server system is not required to support both, but **SHALL** support at least one of these elements."/>
<reference
value="StructureDefinition-us-core-goal.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-goal.html#CONF-0387"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0390"/>
<conformance value="SHALL"/>
<requirement
value="[Servers shall] use the status code: not-done to represent that an immunization was not given."/>
<reference
value="StructureDefinition-us-core-immunization.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-immunization.html#CONF-0390"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0393"/>
<conformance value="SHOULD"/>
<requirement
value="The preferred code system identifier … is [http://hl7.org/fhir/sid/cvx](http://hl7.org/fhir/sid/cvx) for CVX [vaccine codes]"/>
<reference
value="StructureDefinition-us-core-immunization.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-immunization.html#CONF-0393"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0394"/>
<conformance value="SHOULD"/>
<requirement
value="The preferred code system identifier … is [http://hl7.org/fhir/sid/ndc](http://hl7.org/fhir/sid/ndc) for NDC vaccine codes]"/>
<reference
value="StructureDefinition-us-core-immunization.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-immunization.html#CONF-0394"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0397"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="When using a code [to represent a medication for a medication dispense], RXNorm concepts are used."/>
<reference
value="StructureDefinition-us-core-medicationdispense.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-medicationdispense.html#CONF-0397"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-medicationrequest.html#CONF-0397"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0398"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="When using a code [to represent a medication for a medication dispense], USCDI recommends the [National Drug Codes (NDC)](https://www.fda.gov/drugs/drug-approvals-and-databases/national-drug-code-directory) as an *optional* terminology. They can be supplied as an additional coding element."/>
<reference
value="StructureDefinition-us-core-medicationdispense.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-medicationdispense.html#CONF-0398"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-medicationrequest.html#CONF-0398"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0399"/>
<conformance value="MAY"/>
<requirement
value="When referencing a Medication resource in .medicationReference, the resource may be [contained](http://hl7.org/fhir/R4/references.html#contained)"/>
<reference
value="StructureDefinition-us-core-medicationdispense.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-medicationdispense.html#CONF-0399"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-medicationrequest.html#CONF-0399"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0400"/>
<conformance value="MAY"/>
<requirement
value="When referencing a Medication resource in .medicationReference, the resource may be an external resource"/>
<reference
value="StructureDefinition-us-core-medicationdispense.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-medicationdispense.html#CONF-0400"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-medicationrequest.html#CONF-0400"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0401"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The Server systems are not required to support both a [medication] code and a reference [when sending medicationDispense], but **SHALL** support at least one of these methods"/>
<reference
value="StructureDefinition-us-core-medicationdispense.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-medicationdispense.html#CONF-0401"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-medicationrequest.html#CONF-0401"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0402"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="If an external reference to a Medication resource is used, the Server **SHALL** support the [_include](http://hl7.org/fhir/R4/search.html#include) parameter for searching this element."/>
<reference
value="StructureDefinition-us-core-medicationdispense.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-medicationdispense.html#CONF-0402"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-medicationrequest.html#CONF-0402"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0407"/>
<conformance value="SHOULD"/>
<requirement
value="When recording “self-prescribed” medication, requester **SHOULD** be used to indicate the Patient or RelatedPerson as the prescriber"/>
<reference
value="StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-medicationrequest.html#CONF-0407"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0408"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="Although [medicationRequest.reportedBoolean and MedicationRequest.reportedReference] are both marked as Must Support, the Server system is not required to support both, but **SHALL** support at least one of these elements"/>
<reference
value="StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-medicationrequest.html#CONF-0408"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0416"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[For organizations participating in the ONC Health IT Certification program,] the referenced resources **SHOULD** be a US Core Profile as documented in [Referencing US Core Profiles](https://hl7.org/fhir/us/core/STU8/general-guidance.html#referencing-us-core-profiles)."/>
<reference
value="StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-medicationrequest.html#CONF-0416"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0417"/>
<conformance value="SHOULD"/>
<requirement
value="Source EHR identifiers **SHOULD** be included to support deduplication across MedicationRequest resources."/>
<reference
value="StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-medicationrequest.html#CONF-0417"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0419"/>
<conformance value="MAY"/>
<requirement
value="The observations **MAY** have additional codes that translate or map to the Observation code or category codes [such as] … local system-specific codes [and] …more specific codes"/>
<reference
value="StructureDefinition-us-core-average-blood-pressure.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-average-blood-pressure.html#CONF-0419"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-vital-signs.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-vital-signs.html#CONF-0419"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-treatment-intervention-preference.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-treatment-intervention-preference.html#CONF-0419"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0420"/>
<conformance value="SHOULD"/>
<requirement
value="[For an Observation a] code system value **SHOULD** be supplied for each additional code"/>
<reference
value="StructureDefinition-us-core-average-blood-pressure.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-average-blood-pressure.html#CONF-0420"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-vital-signs.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-vital-signs.html#CONF-0420"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-treatment-intervention-preference.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-treatment-intervention-preference.html#CONF-0420"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0421"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="Because the blood pressure values are communicated in the mandatory systolic and diastolic components [when using the US Core Average Blood Pressure Profile,] the Observation.value[x] element **SHALL** be omitted"/>
<reference
value="StructureDefinition-us-core-average-blood-pressure.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-average-blood-pressure.html#CONF-0421"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0422"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="The context or precondition of a patient’s [care experience] preference **SHOULD** be supplied in the Observation.valueString or in an extension"/>
<reference
value="StructureDefinition-us-core-care-experience-preference.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-care-experience-preference.html#CONF-0422"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0423"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="Servers **SHOULD** use the base FHIR [Observation Category Codes] (http://hl7.org/fhir/R4/valueset-observation-category.html) [in Observation.category]"/>
<reference
value="StructureDefinition-us-core-observation-clinical-result.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-clinical-result.html#CONF-0423"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0424"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="Systems **SHOULD** support Observation.effectivePeriod to accurately represent measurements over time"/>
<reference
value="StructureDefinition-us-core-observation-clinical-result.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-clinical-result.html#CONF-0424"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-lab.html#CONF-0424"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0425"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="An Observation.component without a value, **SHALL** include a reason why the data is absent"/>
<reference
value="StructureDefinition-us-core-observation-clinical-result.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-clinical-result.html#CONF-0425"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-lab.html#CONF-0425"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0425"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-lab.html#CONF-0425"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0426"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="Systems that never provide a component observation without a component value … [MAY choose not] to support Observation.component.dataAbsentReason"/>
<reference
value="StructureDefinition-us-core-observation-clinical-result.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-clinical-result.html#CONF-0426"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-lab.html#CONF-0426"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0426"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-vital-signs.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-vital-signs.html#CONF-0426"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0427"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="An Observation without a value, **SHALL** include a reason why the data is absent"/>
<reference
value="StructureDefinition-us-core-observation-clinical-result.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-clinical-result.html#CONF-0427"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-lab.html#CONF-0427"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0427"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-vital-signs.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-vital-signs.html#CONF-0427"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-simple-observation.html#CONF-0427"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0428"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="[For] an Observation without a value … [Systems **MAY** choose not to] include a reason why the data is absent … [if] there are component observations or … reporting panel observations using Observation.hasMember"/>
<reference
value="StructureDefinition-us-core-observation-clinical-result.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-clinical-result.html#CONF-0428"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-lab.html#CONF-0428"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0428"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-vital-signs.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-vital-signs.html#CONF-0428"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-simple-observation.html#CONF-0428"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0429"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="Systems that never provide an observation without a value ... [MAY choose not] to support Observation.dataAbsentReason"/>
<reference
value="StructureDefinition-us-core-observation-clinical-result.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-clinical-result.html#CONF-0429"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-lab.html#CONF-0429"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0429"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-vital-signs.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-vital-signs.html#CONF-0429"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-simple-observation.html#CONF-0429"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0430"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[When sending US Core Laboratory Results Observation Profile] updates to .meta.lastUpdated **SHOULD** reflect new laboratory observations"/>
<reference
value="StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-lab.html#CONF-0430"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0431"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[When sending US Core Laboratory Results Observation Profile] updates to .meta.lastUpdated **SHOULD** reflect changes in the status of laboratory observations, including events that trigger the same status (e.g., amended → amended)"/>
<reference
value="StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-lab.html#CONF-0431"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0432"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="[When sending US Core Observation Occupation Profile] for … [a] current job, [Servers SHALL] omit observation.effectivePeriod.end to indicate it is ongoing."/>
<reference
value="StructureDefinition-us-core-observation-occupation.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-occupation.html#CONF-0432"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0433"/>
<conformance value="SHALL"/>
<requirement
value="When the industry is known, but the occupation is not, [Servers SHALL] use the value “unknown” from the [DataAbsentReason Code System](http://hl7.org/fhir/R4/codesystem-data-absent-reason.html)"/>
<reference
value="StructureDefinition-us-core-observation-occupation.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-occupation.html#CONF-0433"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0434"/>
<conformance value="SHALL"/>
<requirement
value="when the occupation is known but the industry is not, [Servers SHALL] omit the industry Observation.component"/>
<reference
value="StructureDefinition-us-core-observation-occupation.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-occupation.html#CONF-0434"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0435"/>
<conformance value="SHALL"/>
<requirement
value="To represent the patient’s pregnancy status, [Servers SHALL] use the [US Core Observation Pregnancy Status Profile](https://hl7.org/fhir/us/core/StructureDefinition-us-core-observation-pregnancystatus.html)."/>
<reference
value="StructureDefinition-us-core-observation-pregnancyintent.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-pregnancyintent.html#CONF-0435"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0436"/>
<conformance value="SHALL"/>
<requirement
value="To represent the patient’s intent to become pregnant, [Servers SHALL] use the [US Core Observation Pregnancy Intent Profile](https://hl7.org/fhir/us/core/StructureDefinition-us-core-observation-pregnancyintent.html)."/>
<reference
value="StructureDefinition-us-core-observation-pregnancystatus.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-pregnancystatus.html#CONF-0436"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0437"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[For] multi-question surveys or assessments Observation.code is an overarching assessment or screening code, and the Observation.value element **SHOULD** be empty"/>
<reference
value="StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0437"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0438"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="A practitioner’s clinical observation or assertion about a patient’s health status, which is not a response to a screening or assessment question, **SHOULD** use the [US Core Simple Observation Profile](https://hl7.org/fhir/us/core/StructureDefinition-us-core-simple-observation.html) instead [of the US Core Observation Screening Assessment Profile]"/>
<reference
value="StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0438"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0439"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="the Server system ... **SHALL** support [either] Reference(US Core Observation Screening Assessment Profile) or Reference(US Core QuestionnaireResponse Profile) for Observation.derivedFrom"/>
<reference
value="StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0439"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0441"/>
<conformance value="SHOULD"/>
<requirement
value="Observations formally part of an assessment tool or survey **SHOULD** use the [US Core Observation Screening Assessment Profile](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-observation-screening-assessment.html)."/>
<reference
value="StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-simple-observation.html#CONF-0441"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0442"/>
<conformance value="SHOULD"/>
<requirement
value="An assertion or determination derived from screening and assessment tools **SHOULD** reference them using Observation.derivedFrom"/>
<reference
value="StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-simple-observation.html#CONF-0442"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0443"/>
<conformance value="SHOULD"/>
<requirement
value="When using `Observation.derivedFrom’ to reference an Observation, the referenced Observation **SHOULD** be a US Core Observation"/>
<reference
value="StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-simple-observation.html#CONF-0443"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0445"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="[US Core] treatment intervention preferences expressed by a patient may be documented in narrative (text) form or the result of selecting from a list of options provided by the content creator/implementer."/>
<reference
value="StructureDefinition-us-core-treatment-intervention-preference.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-treatment-intervention-preference.html#CONF-0445"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0446"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[When using US Core Treatment Intervention Preference Profile] the context or precondition of a patient’s preference **SHOULD** be supplied in the Observation.valueString ... or an extension"/>
<reference
value="StructureDefinition-us-core-treatment-intervention-preference.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-treatment-intervention-preference.html#CONF-0446"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0447"/>
<conformance value="MAY"/>
<requirement
value="[US Core Vital Signs] observations **MAY** have [component](http://hl7.org/fhir/R4/observation.html#gr-comp) observations … [see] FHIR core specification [vital signs table](http://hl7.org/fhir/R4/observation-vitalsigns.html#vitals-table) for examples"/>
<reference
value="StructureDefinition-us-core-vital-signs.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-vital-signs.html#CONF-0447"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0448"/>
<conformance value="SHOULD"/>
<requirement
value="Information about the growth chart tables used to determine percentiles **SHOULD** be supplied in Observation.note.text"/>
<reference
value="StructureDefinition-pediatric-bmi-for-age.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-pediatric-bmi-for-age.html#CONF-0448"/>
</extension>
</reference>
<reference
value="StructureDefinition-pediatric-weight-for-height.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-pediatric-weight-for-height.html#CONF-0448"/>
</extension>
</reference>
<reference
value="StructureDefinition-head-occipital-frontal-circumference-percentile.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-head-occipital-frontal-circumference-percentile.html#CONF-0448"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0449"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[In the US Core Blood Pressure Profile] because the blood pressure values are communicated in the mandatory systolic and diastolic components[,] the Observation.value[x] element **SHOULD** be omitted"/>
<reference
value="StructureDefinition-us-core-blood-pressure.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-blood-pressure.html#CONF-0449"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0450"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="[In the US Core Blood Pressure Profile] because the blood pressure values are communicated in the mandatory systolic and diastolic components[,] an Observation without a systolic or diastolic result value, **SHALL** include a reason why the data is absent in Observation.component.dataAbsentReason"/>
<reference
value="StructureDefinition-us-core-blood-pressure.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-blood-pressure.html#CONF-0450"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0451"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="[In the US Core Blood Pressure Profile] because the blood pressure values are communicated in the mandatory systolic and diastolic components[,] All Server systems - including those that never provide a component observation without a value - **SHALL** support Observation.component.dataAbsentReason for the components."/>
<reference
value="StructureDefinition-us-core-blood-pressure.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-blood-pressure.html#CONF-0451"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0452"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="Inspired oxygen therapy may be represented with [component](http://hl7.org/fhir/R4/observation.html#gr-comp) observations when measured at the same time as the pulse oximetry measurements [in the US Core Pulse Oximetry profile]"/>
<reference
value="StructureDefinition-us-core-pulse-oximetry.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-pulse-oximetry.html#CONF-0452"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0453"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="Many pulse oximetry readings are taken while the patient is breathing room air. The concept of “room air” (unmodified, ambient air) **SHOULD** be represented as an inhaled oxygen flow rate of 0 liters/min"/>
<reference
value="StructureDefinition-us-core-pulse-oximetry.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-pulse-oximetry.html#CONF-0453"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0454"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="A pulse oximetry reading without inspired oxygen component observations may imply that the measurement was performed while the patient was breathing room air or that the inspired oxygen reading was omitted. To remove this uncertainty, the inspired oxygen [component](http://hl7.org/fhir/R4/observation.html#gr-comp) observations **SHOULD** be used [when using the US Core Pulse Oximetry profile.]"/>
<reference
value="StructureDefinition-us-core-pulse-oximetry.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-pulse-oximetry.html#CONF-0454"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0455"/>
<conformance value="SHALL"/>
<requirement
value="Systems **SHALL** support National Provider Identifier (NPI) for organizations"/>
<reference
value="StructureDefinition-us-core-organization.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-organization.html#CONF-0455"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0456"/>
<conformance value="SHOULD"/>
<requirement
value="Systems … **SHOULD** the National Association of Insurance Commissioners NAIC Company code (sometimes called “NAIC Number” or “cocode”) for payers."/>
<reference
value="StructureDefinition-us-core-organization.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-organization.html#CONF-0456"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0457"/>
<conformance value="SHOULD"/>
<requirement
value="Systems … **SHOULD** support Clinical Laboratory Improvement Amendments (CLIA) for laboratories"/>
<reference
value="StructureDefinition-us-core-organization.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-organization.html#CONF-0457"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0461"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="The Complex [Extension] for Race ... allow[s] for one or more codes of which **MAY** include additional codes from the detailed ethnicity ... value sets drawn from the [Race & Ethnicity - CDC (CDCREC)](https://phinvads.cdc.gov/vads/ViewCodeSystem.action?id=2.16.840.1.113883.6.238) code system [when using the [US Core Race Extension] (https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-race.html)]"/>
<reference
value="StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-patient.html#CONF-0461"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-race.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-race.html#CONF-0461"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0462"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The Complex [Extension] for Race ... allow[s] for one or more codes of which **SHALL** include a text description [of category codes when using the [US Core Race Extension] (https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-race.html)]"/>
<reference
value="StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-patient.html#CONF-0462"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-ethnicity.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-ethnicity.html#CONF-0462"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0463"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="The Complex [Extension] for ... Ethnicity allow[s] for one or more codes of which **MAY** include additional codes from the detailed ... race value sets drawn from the [Race & Ethnicity - CDC (CDCREC)](https://phinvads.cdc.gov/vads/ViewCodeSystem.action?id=2.16.840.1.113883.6.238) code system [when using the [US Core Race Extension] (https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-race.html)]"/>
<reference
value="StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-patient.html#CONF-0463"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-race.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-race.html#CONF-0463"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0464"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="The Complex [Extension] for ... Ethnicity allow[s] for one or more codes of which **SHALL** include a text description [of category codes when using the [US Core Ethnicity Extension] (https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-ethnicity.html)]"/>
<reference
value="StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-patient.html#CONF-0464"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-ethnicity.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-ethnicity.html#CONF-0464"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0466"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="Previous name is represented by setting Patient.name.use to “old” or providing an end date in Patient.name.period or doing both"/>
<reference
value="StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-patient.html#CONF-0466"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0467"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="Previous address is represented by setting Patient.address.use to “old” or providing an end date in Patient.address.period or doing both."/>
<reference
value="StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-patient.html#CONF-0467"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0470"/>
<conformance value="SHOULD"/>
<requirement
value="Non-certifying systems[, systems that are not participating in the ONC Health IT certification program,] **SHOULD** follow the [Project US@ Technical Specification for Patient Addresses Final Version 1.0](https://asapnet.org/wp-content/uploads/2022/03/Project_US_FINAL_Technical_Specification_Version_1.0.pdf) as the standard style guide for Patient.address.line and Patient.address.city for new and updated records."/>
<reference
value="StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-patient.html#CONF-0470"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0471"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="[For systems participating in the ONC Health IT certification program,] this requirement [to follow the [Project US@ Technical Specification for Patient Addresses Final Version 1.0](https://asapnet.org/wp-content/uploads/2022/03/Project_US_FINAL_Technical_Specification_Version_1.0.pdf) for Patient.address.line and Patient.address.city] does not apply to historical records or documents that are exposed through FHIR-based APIs. [Organizations **MAY** choose not to use use Project US@ Technical Specification for Patient Addresses Final Version 1.0 when sending historical records]"/>
<reference
value="StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-patient.html#CONF-0471"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0472"/>
<conformance value="SHOULD-NOT"/>
<requirement
value=" **SHOULD NOT** be used as a patient identifier in Patient.identifier.value"/>
<reference
value="StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-patient.html#CONF-0472"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0473"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="Servers that support only the US Core Practitioner Profile and do not support the [US Core PractitionerRole Profile](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-practitionerrole.html) **SHALL** provide implementation-specific guidance on how to access a provider’s location and contact information using only the Practitioner resource."/>
<reference
value="StructureDefinition-us-core-practitioner.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-practitioner.html#CONF-0473"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0474"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="Although Practitioner.address is marked as Must Support, the Server system … [**MAY** choose not to] support it if they support the US Core PractitionerRole Profile"/>
<reference
value="StructureDefinition-us-core-practitioner.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-practitioner.html#CONF-0474"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0475"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="[When using the US Core Practioner Profile] Practitioner.address … **SHALL**[be supported] if … [the Server does] not support the US Core PractitionerRole Profile"/>
<reference
value="StructureDefinition-us-core-practitioner.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-practitioner.html#CONF-0475"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0477"/>
<conformance value="SHOULD"/>
<requirement
value="Only professional/work contact information about the practitioner **SHOULD** be available to the patient"/>
<reference
value="StructureDefinition-us-core-practitioner.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-practitioner.html#CONF-0477"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0480"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[If using LOINC codes in procedure.code] only LOINC concepts that reflect actual procedures **SHOULD** be used"/>
<reference
value="StructureDefinition-us-core-procedure.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-procedure.html#CONF-0480"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0486"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="[For organizations participating in the ONC Health IT Certification program,] when using Procedure.reasonReference Servers **SHALL** support at least one target resource in Procedure.reasonReference"/>
<reference
value="StructureDefinition-us-core-procedure.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-procedure.html#CONF-0486"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0488"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[For organizations participating in the ONC Health IT Certification program,] when using Procedure.reasonReference …The referenced resources **SHOULD** be a US Core Profile as documented in [Referencing US Core Profiles](https://hl7.org/fhir/us/core/STU8/general-guidance.html#referencing-us-core-profiles)"/>
<reference
value="StructureDefinition-us-core-procedure.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-procedure.html#CONF-0488"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0489"/>
<conformance value="SHALL"/>
<requirement
value="The US Core Provenance resource **SHALL** be supported for these US Core resource types:
AllergyIntolerance, CarePlan, CareTeam, Condition, Coverage, Device, DiagnosticReport, DocumentReference, Encounter, Goal, Immunization, MedicationDispense, MedicationRequest, Observation, Patient, Procedure, QuestionnaireResponse, RelatedPerson, ServiceRequest"/>
<reference
value="StructureDefinition-us-core-provenance.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-provenance.html#CONF-0489"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0508"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="If a system receives a provider in Provenance.agent.who as free text, they must capture [the organization] who sent them the information [and upon] request ... **SHALL** provide this organization as the source"/>
<reference
value="StructureDefinition-us-core-provenance.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-provenance.html#CONF-0508"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0509"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="If a system receives a provider in Provenance.agent.who as free text, … [upon request they] **MAY** include the free text provider."/>
<reference
value="StructureDefinition-us-core-provenance.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-provenance.html#CONF-0509"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0514"/>
<conformance value="MAY"/>
<requirement
value="The Must Support `ServiceRequest.category` is bound, at a minimum, to the [US Core ServiceRequest Category Codes](https://hl7.org/fhir/us/core/STU8/ValueSet-us-core-servicerequest-category.html), and other category codes can be used."/>
<reference
value="StructureDefinition-us-core-servicerequest.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-servicerequest.html#CONF-0514"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0515"/>
<conformance value="SHOULD"/>
<requirement
value="The ServiceRequest.code value ... **SHOULD** be constrained to a subset for a particular use case or domain"/>
<reference
value="StructureDefinition-us-core-servicerequest.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-servicerequest.html#CONF-0515"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0523"/>
<conformance value="MAY"/>
<requirement
value="Since the binding [for Specimen.type and additional USCDI elements] is [extensible](http://hl7.org/fhir/R4/terminologies.html#extensible) when a code is unavailable, just text is allowed [and conformant]."/>
<reference
value="StructureDefinition-us-core-specimen.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-specimen.html#CONF-0523"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0524"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="Although both Specimen.identifier and Specimen.accessionIdentifier are marked as Must Support, the Server system is not required to support both, but **SHALL** support at least one of these elements."/>
<reference
value="StructureDefinition-us-core-specimen.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-specimen.html#CONF-0524"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0550"/>
<conformance value="SHALL"/>
<requirement
value="Systems **SHALL** establish a risk analysis and management regime that conforms with HIPAA security regulatory requirements"/>
<reference value="security.html#patient-privacy-and-security">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="security.html#CONF-0550"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0552"/>
<conformance value="SHOULD"/>
<requirement
value="US Federal systems **SHOULD** conform with the risk management and mitigation requirements defined in NIST 800 series documents."/>
<reference value="security.html#patient-privacy-and-security">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="security.html#CONF-0552"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0554"/>
<conformance value="SHOULD"/>
<requirement
value="US Federal systems … **SHOULD** include security category assignment following NIST 800-60 vol. 2 Appendix D.14."/>
<reference value="security.html#patient-privacy-and-security">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="security.html#CONF-0554"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0556"/>
<conformance value="SHOULD"/>
<requirement
value="The coordination of risk management and the related security and privacy controls … **SHOULD** be defined in the Business Associate Agreement when available."/>
<reference value="security.html#patient-privacy-and-security">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="security.html#CONF-0556"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0558"/>
<conformance value="SHALL"/>
<requirement
value="Systems **SHALL** reference a single time source to establish a common time base for security auditing and clinical data records among computing systems."/>
<reference value="security.html#patient-privacy-and-security">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="security.html#CONF-0558"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0560"/>
<conformance value="SHOULD"/>
<requirement
value="The selected time service **SHOULD** be documented in the Business Associate Agreement when available."/>
<reference value="security.html#patient-privacy-and-security">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="security.html#CONF-0560"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0562"/>
<conformance value="SHALL"/>
<requirement
value="Systems **SHALL** keep audit logs of the various transactions."/>
<reference value="security.html#patient-privacy-and-security">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="security.html#CONF-0562"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0564"/>
<conformance value="SHALL"/>
<requirement
value="Systems **SHALL** use TLS version 1.2 or higher for all transmissions not taking place over a secure network connection."/>
<reference value="security.html#patient-privacy-and-security">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="security.html#CONF-0564"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0566"/>
<conformance value="SHOULD"/>
<requirement
value="US Federal systems **SHOULD** conform with FIPS PUB 140-2."/>
<reference value="security.html#patient-privacy-and-security">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="security.html#CONF-0566"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0568"/>
<conformance value="SHALL"/>
<requirement
value="Systems **SHALL** conform to [FHIR Communications Security](http://hl7.org/fhir/R4/security.html#http) requirements."/>
<reference value="security.html#patient-privacy-and-security">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="security.html#CONF-0568"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0570"/>
<conformance value="SHALL"/>
<requirement
value="For Authentication and Authorization, Systems **SHALL** support any [SMART App Launch Version 2.0.0](http://hl7.org/fhir/smart-app-launch/history.html) and later for Client <-> Server interactions."/>
<reference value="security.html#patient-privacy-and-security">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="security.html#CONF-0570"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0572"/>
<conformance value="SHALL"/>
<requirement
value="Systems **SHALL** implement consent requirements per their state, local, and institutional policies."/>
<reference value="security.html#patient-privacy-and-security">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="security.html#CONF-0572"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0574"/>
<conformance value="SHOULD"/>
<requirement
value="The Business Associate Agreements **SHOULD** document systems’ mutual consent requirements."/>
<reference value="security.html#patient-privacy-and-security">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="security.html#CONF-0574"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0576"/>
<conformance value="SHOULD"/>
<requirement
value="Systems **SHOULD** provide Provenance statements using the [US Core Provenance Profile](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-provenance.html) resource and associated requirements."/>
<reference value="security.html#patient-privacy-and-security">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="security.html#CONF-0576"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0578"/>
<conformance value="MAY"/>
<requirement
value="Systems **MAY** implement the [FHIR Digital Signatures](http://hl7.org/fhir/R4/security.html#digital%20signatures)"/>
<reference value="security.html#patient-privacy-and-security">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="security.html#CONF-0578"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0580"/>
<conformance value="MAY"/>
<requirement
value="Systems **MAY** protect the confidentiality of data at rest via encryption and associated access controls."/>
<reference value="security.html#patient-privacy-and-security">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="security.html#CONF-0580"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0804"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="If any sub-element is marked as *Additional USCDI* [for a complex element], it must also meet the *Additional USCDI* requirements and satisfy the *Additional USCDI* requirements for the parent element."/>
<reference value="must-support.html#must-support---complex-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0804"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0808"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="When a Reference type element is labeled as Must Support and has a single target profile referenced, the target profile **SHALL** be supported."/>
<reference
value="must-support.html#must-support-targets-for-us-core-profiles">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0808"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0810"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="When a Reference type element is labeled as Must Support, has multiple target profiles referenced, and specific targets are labeled as Must Support, the Must Support target profile(s) **SHALL** be supported."/>
<reference
value="must-support.html#must-support-targets-for-us-core-profiles">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0810"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0813"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="[If a] slicer's Must Support property only defines the element level Must Support...[, i.e.,] no Must Support... property is defined for the slice, then support for that slice's definition is optional."/>
<reference value="must-support.html#must-support---slices">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0813"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0818"/>
<conformance value="SHALL"/>
<requirement
value="Servers **SHALL** support, at minimum, these … "Common Clinical Notes":
[Surgical Operation Note (11504-8)](https://loinc.org/11504-8.html)"/>
<reference value="clinical-notes.html#clinical-notes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0818"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0819"/>
<conformance value="SHALL"/>
<requirement
value="Servers **SHALL** support, at minimum, these … "Common Clinical Notes":
[Emergency Department Note (34111-5)](https://loinc.org/34111-5.html)"/>
<reference value="clinical-notes.html#clinical-notes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="clinical-notes.html#CONF-0819"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0820"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="Servers that support the USCDI Health Status/Assessments Data Class **SHALL** support the US Core Observation Screening Assessment Profile"/>
<reference
value="screening-and-assessments.html#structured-screening-and-assessments">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="screening-and-assessments.html#CONF-0820"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0821"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="Servers that support the USCDI Health Status/Assessments Data Class ... **SHOULD** support the SDC Base Questionnaire and the US Core QuestionnaireResponse Profile.""/>
<reference
value="screening-and-assessments.html#structured-screening-and-assessments">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="screening-and-assessments.html#CONF-0821"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0822"/>
<conformance value="SHALL"/>
<requirement
value="For the US Core Simple Observation Profile, Servers **SHALL** support all the category codes [listed](https://hl7.org/fhir/us/core/STU8/screening-and-assessments.html#category-codes)."/>
<reference value="screening-and-assessments.html#category-codes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="screening-and-assessments.html#CONF-0822"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0823"/>
<conformance value="SHALL"/>
<requirement
value="For the … US Core Observation Screening Assessment Profiles, Servers **SHALL** support all the category codes [listed](https://hl7.org/fhir/us/core/STU8/screening-and-assessments.html#category-codes)."/>
<reference value="screening-and-assessments.html#category-codes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="screening-and-assessments.html#CONF-0823"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0824"/>
<conformance value="SHALL"/>
<requirement
value="For the US Core Condition Problems and Health Concerns Profile, Servers **SHALL** support the code ,"sdoh""/>
<reference value="screening-and-assessments.html#category-codes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="screening-and-assessments.html#CONF-0824"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0825"/>
<conformance value="SHOULD"/>
<requirement
value="For the US Core Condition Problems and Health Concerns Profile, Servers **SHOULD** support the other category codes [listed](https://hl7.org/fhir/us/core/STU8/screening-and-assessments.html#category-codes)."/>
<reference value="screening-and-assessments.html#category-codes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="screening-and-assessments.html#CONF-0825"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0826"/>
<conformance value="SHOULD"/>
<requirement
value="For the US Core ServiceRequest Profile, Servers **SHOULD** support all the [[listed](https://hl7.org/fhir/us/core/STU8/screening-and-assessments.html#category-codes)] category codes."/>
<reference value="screening-and-assessments.html#category-codes">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="screening-and-assessments.html#CONF-0826"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0831"/>
<conformance value="SHALL"/>
<requirement
value="[The Server **SHALL** support the] category of "problem-list-item""/>
<reference
value="StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-condition-problems-health-concerns.html#CONF-0831"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0832"/>
<conformance value="SHALL"/>
<requirement
value="[The Server **SHALL** support the] category of "health-concern""/>
<reference
value="StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-condition-problems-health-concerns.html#CONF-0832"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0836"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="The `DiagnosticRequest.basedOn` element connects the DiagnosticReport to the originating order in the EHR. Systems that initiate the order **SHOULD** use this element when reporting the results."/>
<reference
value="StructureDefinition-us-core-diagnosticreport-note.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-diagnosticreport-note.html#CONF-0836"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0837"/>
<conformance value="SHOULD"/>
<requirement
value="The `DiagnosticReport.media.link` element **SHOULD** be used to support links to various patient-friendly content, such as jpg images of x-rays (see the DiagnosticReport Chest X-ray Report Example)."/>
<reference
value="StructureDefinition-us-core-diagnosticreport-note.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-diagnosticreport-note.html#CONF-0837"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0838"/>
<conformance value="SHOULD"/>
<requirement
value="The `DiagnosticReport.imagingStudy` element **SHOULD** be used to support exchange with systems that can view DICOM (Digital Imaging and Communications in Medicine) studies, series, and SOP (Service-Object Pair) instances referenced in the -[ImagingStudy](http://hl7.org/fhir/R4/imagingstudy.html) resource."/>
<reference
value="StructureDefinition-us-core-diagnosticreport-note.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-diagnosticreport-note.html#CONF-0838"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0839"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value=" If the referenced a document or file [referenced by `DocumentReference.content.attachment.url`] is hosted on a Server outside the FHIR Server, it should be securely accessible using the same authorization credentials that were used to access the FHIR Server. This reduces complexity for the Client and improves the user experience."/>
<reference value="StructureDefinition-us-core-documentreference.html">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-documentreference.html"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0840"/>
<conformance value="SHALL"/>
<conditionality value="true"/>
<requirement
value="Although the [US Core Interpreter Needed] extension is marked as an Additional USCDI Requirements 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."/>
<reference
value="StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-encounter.html#CONF-0840"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0841"/>
<conformance value="MAY"/>
<requirement
value="There is no guarantee that vaccine lot numbers are globally unique, and they are not recommended for matching or de-duplication across systems unless used with other data elements such as a vaccine product code, manufacturer code, or date of administration. Implementers **MAY** communicate the `Immunization.manufacturer` to ensure global uniqueness to lot numbers."/>
<reference
value="StructureDefinition-us-core-immunization.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-immunization.html#CONF-0841"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0842"/>
<conformance value="SHALL"/>
<requirement
value="Servers **SHALL** return all active medications following the [Get All Active Medications](https://hl7.org/fhir/us/core/STU8/medication-list.html#get-all-active-medications) guidance."/>
<reference
value="StructureDefinition-us-core-medicationrequest.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-medicationrequest.html#CONF-0842"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0843"/>
<conformance value="SHOULD"/>
<conditionality value="true"/>
<requirement
value="[For US Core Laboratory Result Observation Profile, even] when the specimen type is already implied by the LOINC code used in `Observation.code` (e.g., a LOINC code for Blood Glucose), the `Observation.specimen` element **SHOULD** also be populated with the referenced Specimen resource to explicitly communicate the collected specimen type."/>
<reference
value="StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-lab.html#CONF-0843"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0844"/>
<conformance value="SHOULD"/>
<requirement
value="[For US Core Laboratory Result Observation Profile, the] type of specimen [in `Observation.specimen`] **SHOULD** not conflict with the LOINC code [in `Observation.code`]."/>
<reference
value="StructureDefinition-us-core-observation-lab.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-lab.html#CONF-0844"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0845"/>
<conformance value="SHALL"/>
<requirement
value="[For the US Core Observation Screening Assessment Profile, the] category type "survey" is required."/>
<reference
value="StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0845"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0850"/>
<conformance value="SHOULD"/>
<requirement
value="[For the US Core Observation Screening Assessment Profile,] when using Observation.derivedFrom to reference an Observation, the referenced Observation **SHOULD** be a US Core Observation."/>
<reference
value="StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0850"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0851"/>
<conformance value="MAY"/>
<requirement
value="Servers can use the [US Core Interpreter Needed Extension](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-interpreter-needed.html) on [the [US Core Patient Profile](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-patient.html)] or the [US Core Encounter Profile](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-encounter.html) to communicate whether a patient needs an interpreter."/>
<reference
value="StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-patient.html#CONF-0851"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0855"/>
<conformance value="SHOULD"/>
<requirement
value="Systems **SHOULD** designate the patient's preferred language in the Patient.communication.preferred element."/>
<reference
value="StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-patient.html#CONF-0855"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-encounter.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-encounter.html#CONF-0855"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0857"/>
<conformance value="SHOULD"/>
<requirement
value="For the USCDI *Laboratory Order*, *Imaging Order*, *Clinical Test Order*, and *Procedure Order* Data Elements, implementers **SHOULD** use the corresponding category codes listed in the table"/>
<reference value="StructureDefinition-us-core-servicerequest.html#root">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-servicerequest.html#CONF-0857"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0866"/>
<conformance value="SHALL"/>
<requirement
value="An `Observation.component` without a value, **SHALL** include a reason why the data is absent. "/>
<reference
value="StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-simple-observation.html#CONF-0866"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0867"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="Systems that never provide a component observation without a component value are not required to support `Observation.component.dataAbsentReason`."/>
<reference
value="StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-simple-observation.html#CONF-0867"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0868"/>
<conformance value="SHALL"/>
<requirement
value="Although 'Observation.performer' target profiles [US Core Practitioner Profile](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-practitioner.html) and [US Core Patient Profile](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-patient.html) are labeled Must Support. Servers are not required to support both, but **SHALL** support at least one."/>
<reference
value="StructureDefinition-us-core-simple-observation.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-simple-observation.html#CONF-0868"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0871"/>
<conformance value="MAY"/>
<conditionality value="true"/>
<requirement
value="[If a] slicer's Additional USCDI property only defines the element level Additional USCDI...[, i.e.,] no Additional USCDI... property is defined for the slice, then support for that slice's definition is optional."/>
<reference value="must-support.html#must-support---slices">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0871"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0881"/>
<conformance value="SHALL"/>
<requirement
value="When a Reference element is labeled as *Must Support* has multiple target profiles referenced, but none are labeled as *Must Support*
...
- US Core Responders **SHALL** be capable of providing [such an element] with a valid reference to *at least one* target profile."/>
<reference value="must-support.html#must-support---resource-references">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="must-support.html#CONF-0881"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0885"/>
<conformance value="SHOULD"/>
<requirement
value="The author is communicated by the elements and the author's role by the referenced target resource (for example, Patient, Practitioner/PractitionerRole, RelatedPerson, Device). Details about the author's role are contained in the target resource's contents. Many of these elements are labeled Must Support or Additional USCDI Requirements. However,[even if they are not labeled Must Support or Additional USCDI Requirements] all of these elements and target resources **SHOULD** be supported in the profiles if the system captures the data."/>
<reference value="basic-provenance.html#individual-level-provenance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="basic-provenance.html#CONF-0885"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0887"/>
<conformance value="SHALL"/>
<requirement
value="Although 'Observation.performer' target profiles [US Core Practitioner Profile](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-practitioner.html) and [US Core Patient Profile](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-patient.html) are labeled Must Support. Servers are not required to support both, but **SHALL** support at least one."/>
<reference
value="StructureDefinition-us-core-observation-screening-assessment.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-observation-screening-assessment.html#CONF-0887"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0889"/>
<conformance value="SHOULD"/>
<requirement
value=" … this profile uses USPS Two Letter Alphabetic Codes for US states. When encoding addresses outside the US, systems **SHOULD** use the [ISO 3166 subdivision codes](https://www.iso.org/iso-3166-country-codes.html)."/>
<reference
value="StructureDefinition-us-core-practitionerrole.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-practitionerrole.html#CONF-0889"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-organization.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-organization.html#CONF-0889"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-patient.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-patient.html#CONF-0889"/>
</extension>
</reference>
<reference
value="StructureDefinition-us-core-relatedperson.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-relatedperson.html#CONF-0889"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0890"/>
<conformance value="SHOULD"/>
<requirement
value="Due to implementer feedback, some US Core Profiles reference the base FHIR PractitionerRole resource instead of the US Core PractitionerRole Profile. However, the US Core PractitionerRole Profile **SHOULD** be used as the default profile if referenced by another US Core profile."/>
<reference
value="StructureDefinition-us-core-practitionerrole.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-practitionerrole.html#CONF-0890"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0891"/>
<conformance value="SHOULD"/>
<requirement
value="When selecting role codes...implementers **SHOULD** choose the code that reflects the specific duties performed within that role rather than the specialty unless the individual's professional specialization characterizes the role."/>
<reference
value="StructureDefinition-us-core-practitionerrole.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-practitionerrole.html#CONF-0891"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0892"/>
<conformance value="SHOULD"/>
<requirement
value="A procedure including an implantable device **SHOULD** use `Procedure.focalDevice` referencing the US Core Device Profile"/>
<reference
value="StructureDefinition-us-core-procedure.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-procedure.html#CONF-0892"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0893"/>
<conformance value="MAY"/>
<requirement
value="Other information can be tracked such as what activity has occurred in `Provenance.activity`, and details about where the entity came from (for example, a document source's identity and role) in `Provenance.entity`."/>
<reference
value="StructureDefinition-us-core-provenance.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-provenance.html#CONF-0893"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0894"/>
<conformance value="SHOULD"/>
<requirement
value="Unless exchanging legacy or text-only data, medical specialty codes **SHOULD** be taken from NUCC or SNOMED CT."/>
<reference
value="StructureDefinition-us-core-practitionerrole.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-practitionerrole.html#CONF-0894"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0895"/>
<conformance value="SHOULD"/>
<requirement
value="Unless exchanging legacy or text-only data, procedure codes **SHOULD** be taken from SNOMED-CT, CPT, HCPCS II, ICD-10-PCS, CDT, or LOINC*."/>
<reference
value="StructureDefinition-us-core-procedure.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-procedure.html#CONF-0895"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0896"/>
<conformance value="SHOULD"/>
<requirement
value="US Core guidance provides more flexibility for situations where implementers cannot fully comply with the FHIR guidance. This flexibility is sometimes necessary and expected for legacy and text-only data. However, for newly recorded, non-legacy data, a system **SHOULD** adhere to the extensible binding rules."/>
<reference
value="general-requirements.html#extensible-binding-for-coded-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0896"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0897"/>
<conformance value="SHOULD"/>
<requirement
value="For data not captured by the system transmitting the information, the coded data **SHOULD** be automatically converted to fine-grained codes from the specified ValueSet."/>
<reference
value="general-requirements.html#extensible-binding-for-coded-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0897"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0898"/>
<conformance value="MAY"/>
<requirement
value="For data not captured by the system transmitting the information, ....the system **MAY** provide the existing code or the free text, and a high-level abstract code, such as the SNOMED CT code "71388002"(Procedure), to remain conformant with the extensible binding."/>
<reference
value="general-requirements.html#extensible-binding-for-coded-elements">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="general-requirements.html#CONF-0898"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0899"/>
<conformance value="SHOULD"/>
<requirement
value="To represent the patient and provider attestation metadata, the *optional* DocumentReference Attestor R5 Extension ... **SHOULD** be use"/>
<reference
value="StructureDefinition-us-core-adi-documentreference.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-adi-documentreference.html#CONF-0899"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0900"/>
<conformance value="SHOULD"/>
<requirement
value="Unless exchanging legacy or text-only data, condition codes **SHOULD** be taken from SNOMED CT and ICD-10-CM, USCDI's applicable vocabulary standards for the Problem Data Element."/>
<reference
value="StructureDefinition-us-core-condition-problems-health-concerns.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-condition-problems-health-concerns.html#CONF-0900"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0901"/>
<conformance value="MAY"/>
<requirement
value="The Service Delivery Location Role Type value set is inherited from the base resource, and, although its binding strength is [extensible](http://hl7.org/fhir/R4/terminologies.html#extensible) in the base resource, US Core implementers **MAY** treat it as [preferred](http://hl7.org/fhir/R4/terminologies.html#preferred)."/>
<reference
value="StructureDefinition-us-core-location.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-location.html#CONF-0901"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0903"/>
<conformance value="SHOULD"/>
<requirement
value="When exchanging Social Determinants of Health (SDOH) data, implementers **SHOULD** use the [Social Determinants of Health Goals](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1247.71/expansion) set which is curated by the Gravity Project to represent goals for all SDOH Domains."/>
<reference
value="StructureDefinition-us-core-goal.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl value="StructureDefinition-us-core-goal.html#CONF-0903"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0904"/>
<conformance value="SHOULD"/>
<requirement
value="Implementers **SHOULD** conform to the binding strengths listed for each USCDI Order context...Laboratory Order|[LOINC Common Laboratory Orders Value Set]|extensible, Imaging Order|[LOINC Radiology Codes]|preferred, Clinical Test Order|[LOINC Clinical Test Codes]|preferred"/>
<reference
value="StructureDefinition-us-core-servicerequest.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-servicerequest.html#CONF-0904"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0905"/>
<conformance value="MAY"/>
<requirement
value="the US Core ServiceRequest Profile **MAY** be used to represent a derived "actionable" order based on a portable Medical Order(PMO)."/>
<reference
value="StructureDefinition-us-core-servicerequest.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-servicerequest.html#CONF-0905"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0906"/>
<conformance value="SHOULD"/>
<requirement
value="[When] used to represent a derived "actionable" order based on a PMO...The `ServiceRequest.category` **SHOULD** be bound to [Portable Medical Order Categories](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1267.34/Expansion)"/>
<reference
value="StructureDefinition-us-core-servicerequest.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-servicerequest.html#CONF-0906"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0907"/>
<conformance value="SHOULD"/>
<requirement
value="[When] used to represent a derived "actionable" order based on a PMO...ServiceRequest.code` **SHOULD** be aligned with the appropriate Category"/>
<reference
value="StructureDefinition-us-core-servicerequest.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-servicerequest.html#CONF-0907"/>
</extension>
</reference>
</statement>
<statement>
<key value="CONF-0908"/>
<conformance value="SHOULD"/>
<requirement
value="The `ServiceReqest.reasonReference` **SHOULD** be used to reference the US Core ADI DocumentReference Profile that indexes the PMO."/>
<reference
value="StructureDefinition-us-core-servicerequest.html#profile-specific-implementation-guidance">
<extension url="http://hl7.org/fhir/StructureDefinition/narrativeLink">
<valueUrl
value="StructureDefinition-us-core-servicerequest.html#CONF-0908"/>
</extension>
</reference>
</statement>
</Requirements>
IG © 2026+ HL7 International / Cross-Group Projects. Package hl7.fhir.us.core#9.0.0 based on FHIR 4.0.1. Generated 2026-03-20
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