US Core Implementation Guide
8.0.0-ballot - Ballot United States of America flag

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 8.0.0-ballot 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

Resource Profile: USCoreCarePlanProfile - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 3

Definitions for the us-core-careplan resource profile.

Guidance on how to interpret the contents of this table can be found here

0. CarePlan
Must Supportfalse
2. CarePlan.text
ShortText summary of the resource, for human interpretation
Must Supporttrue
4. CarePlan.text.status
Shortgenerated | additional
BindingThe codes SHALL be taken from US Core Narrative Status
(required to http://hl7.org/fhir/us/core/ValueSet/us-core-narrative-status)

Constrained value set of narrative statuses.

Must Supporttrue
6. CarePlan.text.div
ShortLimited xhtml content
Must Supporttrue
8. CarePlan.status
BindingThe codes SHALL be taken from RequestStatus
(required to http://hl7.org/fhir/ValueSet/request-status)

Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.

Must Supporttrue
Requirements

Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.

10. CarePlan.intent
BindingThe codes SHALL be taken from CarePlanIntent
(required to http://hl7.org/fhir/ValueSet/care-plan-intent)

Codes indicating the degree of authority/intentionality associated with a care plan

Must Supporttrue
12. CarePlan.category
Definition

Type of plan.

Control1..?
Must Supporttrue
Requirements

Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g., "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc.

SlicingThis element introduces a set of slices on CarePlan.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ $this
  • 14. CarePlan.category:AssessPlan
    Slice NameAssessPlan
    Definition

    Type of plan.

    Control1..1
    Must Supporttrue
    Requirements

    Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g., "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc.

    Pattern Value{
      "coding" : [{
        "system" : "http://hl7.org/fhir/us/core/CodeSystem/careplan-category",
        "code" : "assess-plan"
      }]
    }
    16. CarePlan.subject
    Definition

    Who care plan is for.

    TypeReference(US Core Patient Profile, Group)
    Must Supporttrue
    Must Support TypesReference(US Core Patient Profile)
    Requirements

    Identifies the patient or group whose intended care is described by the plan.

    Guidance on how to interpret the contents of this table can be found here

    0. CarePlan
    Definition

    Describes the intention of how one or more practitioners intend to deliver care for a particular patient, group or community for a period of time, possibly limited to care for a specific condition or set of conditions.

    ShortHealthcare plan for patient or group
    Control0..*
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Alternate NamesCare Team
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    dom-6: A resource should have narrative for robust management (text.`div`.exists())
    2. CarePlan.implicitRules
    Definition

    A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

    ShortA set of rules under which this content was created
    Comments

    Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

    Control0..1
    Typeuri
    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    4. CarePlan.text
    Definition

    A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

    ShortText summary of the resource, for human interpretation
    Comments

    Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

    Control0..1
    TypeNarrative
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Alternate Namesnarrative, html, xhtml, display
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    6. CarePlan.text.status
    Definition

    The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

    Shortgenerated | additionalgenerated | extensions | additional | empty
    Control1..1
    BindingThe codes SHALL be taken from US Core Narrative Statushttp://hl7.org/fhir/ValueSet/narrative-status|4.0.1
    (required to http://hl7.org/fhir/us/core/ValueSet/us-core-narrative-status)

    Constrained value set of narrative statuses.


    The status of a resource narrative.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    8. CarePlan.text.div
    Definition

    The actual narrative content, a stripped down version of XHTML.

    ShortLimited xhtml content
    Comments

    The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

    Control1..1
    Typexhtml
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (htmlChecks())
    txt-2: The narrative SHALL have some non-whitespace content (htmlChecks())
    txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (htmlChecks())
    txt-2: The narrative SHALL have some non-whitespace content (htmlChecks())
    10. CarePlan.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. CarePlan.status
    Definition

    Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.

    Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
    Comments

    The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the care plan.

    This element is labeled as a modifier because the status contains the code entered-in-error that marks the plan as not currently valid.

    Control1..1
    BindingThe codes SHALL be taken from RequestStatushttp://hl7.org/fhir/ValueSet/request-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/request-status)

    Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.

    Typecode
    Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.


    Allows clinicians to determine whether the plan is actionable or not.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. CarePlan.intent
    Definition

    Indicates the level of authority/intentionality associated with the care plan and where the care plan fits into the workflow chain.

    Shortproposal | plan | order | option
    Comments

    This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

    Control1..1
    BindingThe codes SHALL be taken from CarePlanIntenthttp://hl7.org/fhir/ValueSet/care-plan-intent|4.0.1
    (required to http://hl7.org/fhir/ValueSet/care-plan-intent)

    Codes indicating the degree of authority/intentionality associated with a care plan


    Codes indicating the degree of authority/intentionality associated with a care plan.

    Typecode
    Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request"
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. CarePlan.category
    Definition

    Type of plan.


    Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc.

    ShortType of plan
    Comments

    There may be multiple axes of categorization and one plan may serve multiple purposes. In some cases, this may be redundant with references to CarePlan.concern.

    Control10..*
    BindingFor example codes, see CarePlanCategoryhttp://hl7.org/fhir/ValueSet/care-plan-category
    (example to http://hl7.org/fhir/ValueSet/care-plan-category)

    Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g., "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc.


    Used for filtering what plan(s) are retrieved and displayed to different types of users.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on CarePlan.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ $this
    • 18. CarePlan.category:AssessPlan
      Slice NameAssessPlan
      Definition

      Type of plan.


      Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc.

      ShortType of plan
      Comments

      There may be multiple axes of categorization and one plan may serve multiple purposes. In some cases, this may be redundant with references to CarePlan.concern.

      Control10..1*
      BindingFor example codes, see CarePlanCategoryhttp://hl7.org/fhir/ValueSet/care-plan-category
      (example to http://hl7.org/fhir/ValueSet/care-plan-category)

      Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g., "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc.


      Used for filtering what plan(s) are retrieved and displayed to different types of users.

      Pattern Value{
        "coding" : [{
          "system" : "http://hl7.org/fhir/us/core/CodeSystem/careplan-category",
          "code" : "assess-plan"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. CarePlan.subject
      Definition

      Who care plan is for.


      Identifies the patient or group whose intended care is described by the plan.

      ShortWho the care plan is for
      Control1..1
      TypeReference(US Core Patient Profile, Group, Patient)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesReference(US Core Patient Profile)
      Summarytrue
      Requirements

      Identifies the patient or group whose intended care is described by the plan.

      Alternate Namespatient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Guidance on how to interpret the contents of this table can be found here

      0. CarePlan
      Definition

      Describes the intention of how one or more practitioners intend to deliver care for a particular patient, group or community for a period of time, possibly limited to care for a specific condition or set of conditions.

      ShortHealthcare plan for patient or group
      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate NamesCare Team
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. CarePlan.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. CarePlan.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. CarePlan.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. CarePlan.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

      Control0..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. CarePlan.text
      Definition

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Comments

      Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. CarePlan.text.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      14. CarePlan.text.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on CarePlan.text.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. CarePlan.text.status
        Definition

        The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

        Shortgenerated | additional
        Control1..1
        BindingThe codes SHALL be taken from US Core Narrative Status
        (required to http://hl7.org/fhir/us/core/ValueSet/us-core-narrative-status)

        Constrained value set of narrative statuses.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. CarePlan.text.div
        Definition

        The actual narrative content, a stripped down version of XHTML.

        ShortLimited xhtml content
        Comments

        The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

        Control1..1
        Typexhtml
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (htmlChecks())
        txt-2: The narrative SHALL have some non-whitespace content (htmlChecks())
        20. CarePlan.contained
        Definition

        These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

        ShortContained, inline Resources
        Comments

        This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

        Control0..*
        TypeResource
        Is Modifierfalse
        Summaryfalse
        Alternate Namesinline resources, anonymous resources, contained resources
        22. CarePlan.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        24. CarePlan.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        26. CarePlan.identifier
        Definition

        Business identifiers assigned to this care plan by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

        ShortExternal Ids for this plan
        Comments

        This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Summarytrue
        Requirements

        Allows identification of the care plan as it is known by various participating systems and in a way that remains consistent across servers.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. CarePlan.instantiatesCanonical
        Definition

        The URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan.

        ShortInstantiates FHIR protocol or definition
        Control0..*
        Typecanonical(PlanDefinition, Questionnaire, Measure, ActivityDefinition, OperationDefinition)
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. CarePlan.instantiatesUri
        Definition

        The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan.

        ShortInstantiates external protocol or definition
        Comments

        This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

        Control0..*
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. CarePlan.basedOn
        Definition

        A care plan that is fulfilled in whole or in part by this care plan.

        ShortFulfills CarePlan
        Control0..*
        TypeReference(CarePlan)
        Is Modifierfalse
        Summarytrue
        Requirements

        Allows tracing of the care plan and tracking whether proposals/recommendations were acted upon.

        Alternate Namesfulfills
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. CarePlan.replaces
        Definition

        Completed or terminated care plan whose function is taken by this new care plan.

        ShortCarePlan replaced by this CarePlan
        Comments

        The replacement could be because the initial care plan was immediately rejected (due to an issue) or because the previous care plan was completed, but the need for the action described by the care plan remains ongoing.

        Control0..*
        TypeReference(CarePlan)
        Is Modifierfalse
        Summarytrue
        Requirements

        Allows tracing the continuation of a therapy or administrative process instantiated through multiple care plans.

        Alternate Namessupersedes
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. CarePlan.partOf
        Definition

        A larger care plan of which this particular care plan is a component or step.

        ShortPart of referenced CarePlan
        Comments

        Each care plan is an independent request, such that having a care plan be part of another care plan can cause issues with cascading statuses. As such, this element is still being discussed.

        Control0..*
        TypeReference(CarePlan)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. CarePlan.status
        Definition

        Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.

        Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
        Comments

        The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the care plan.

        This element is labeled as a modifier because the status contains the code entered-in-error that marks the plan as not currently valid.

        Control1..1
        BindingThe codes SHALL be taken from RequestStatus
        (required to http://hl7.org/fhir/ValueSet/request-status)

        Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.

        Typecode
        Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. CarePlan.intent
        Definition

        Indicates the level of authority/intentionality associated with the care plan and where the care plan fits into the workflow chain.

        Shortproposal | plan | order | option
        Comments

        This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

        Control1..1
        BindingThe codes SHALL be taken from CarePlanIntent
        (required to http://hl7.org/fhir/ValueSet/care-plan-intent)

        Codes indicating the degree of authority/intentionality associated with a care plan

        Typecode
        Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request"
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. CarePlan.category
        Definition

        Type of plan.

        ShortType of plan
        Comments

        There may be multiple axes of categorization and one plan may serve multiple purposes. In some cases, this may be redundant with references to CarePlan.concern.

        Control1..*
        BindingFor example codes, see CarePlanCategory
        (example to http://hl7.org/fhir/ValueSet/care-plan-category)

        Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g., "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on CarePlan.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ $this
        • 44. CarePlan.category:AssessPlan
          Slice NameAssessPlan
          Definition

          Type of plan.

          ShortType of plan
          Comments

          There may be multiple axes of categorization and one plan may serve multiple purposes. In some cases, this may be redundant with references to CarePlan.concern.

          Control1..1
          BindingFor example codes, see CarePlanCategory
          (example to http://hl7.org/fhir/ValueSet/care-plan-category)

          Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g., "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc.

          Pattern Value{
            "coding" : [{
              "system" : "http://hl7.org/fhir/us/core/CodeSystem/careplan-category",
              "code" : "assess-plan"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. CarePlan.title
          Definition

          Human-friendly name for the care plan.

          ShortHuman-friendly name for the care plan
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. CarePlan.description
          Definition

          A description of the scope and nature of the plan.

          ShortSummary of nature of plan
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Provides more detail than conveyed by category.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. CarePlan.subject
          Definition

          Who care plan is for.

          ShortWho the care plan is for
          Control1..1
          TypeReference(US Core Patient Profile, Group)
          Is Modifierfalse
          Must Supporttrue
          Must Support TypesReference(US Core Patient Profile)
          Summarytrue
          Requirements

          Identifies the patient or group whose intended care is described by the plan.

          Alternate Namespatient
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. CarePlan.encounter
          Definition

          The Encounter during which this CarePlan was created or to which the creation of this record is tightly associated.

          ShortEncounter created as part of
          Comments

          This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. CarePlan activities conducted as a result of the care plan may well occur as part of other encounters.

          Control0..1
          TypeReference(Encounter)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. CarePlan.period
          Definition

          Indicates when the plan did (or is intended to) come into effect and end.

          ShortTime period plan covers
          Comments

          Any activities scheduled as part of the plan should be constrained to the specified period regardless of whether the activities are planned within a single encounter/episode or across multiple encounters/episodes (e.g. the longitudinal management of a chronic condition).

          Control0..1
          TypePeriod
          Is Modifierfalse
          Summarytrue
          Requirements

          Allows tracking what plan(s) are in effect at a particular time.

          Alternate Namestiming
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. CarePlan.created
          Definition

          Represents when this particular CarePlan record was created in the system, which is often a system-generated date.

          ShortDate record was first recorded
          Control0..1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Alternate NamesauthoredOn
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          58. CarePlan.author
          Definition

          When populated, the author is responsible for the care plan. The care plan is attributed to the author.

          ShortWho is the designated responsible party
          Comments

          The author may also be a contributor. For example, an organization can be an author, but not listed as a contributor.

          Control0..1
          TypeReference(Patient, Practitioner, PractitionerRole, Device, RelatedPerson, Organization, CareTeam)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. CarePlan.contributor
          Definition

          Identifies the individual(s) or organization who provided the contents of the care plan.

          ShortWho provided the content of the care plan
          Comments

          Collaborative care plans may have multiple contributors.

          Control0..*
          TypeReference(Patient, Practitioner, PractitionerRole, Device, RelatedPerson, Organization, CareTeam)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          62. CarePlan.careTeam
          Definition

          Identifies all people and organizations who are expected to be involved in the care envisioned by this plan.

          ShortWho's involved in plan?
          Control0..*
          TypeReference(CareTeam)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows representation of care teams, helps scope care plan. In some cases may be a determiner of access permissions.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. CarePlan.addresses
          Definition

          Identifies the conditions/problems/concerns/diagnoses/etc. whose management and/or mitigation are handled by this plan.

          ShortHealth issues this plan addresses
          Comments

          When the diagnosis is related to an allergy or intolerance, the Condition and AllergyIntolerance resources can both be used. However, to be actionable for decision support, using Condition alone is not sufficient as the allergy or intolerance condition needs to be represented as an AllergyIntolerance.

          Control0..*
          TypeReference(Condition)
          Is Modifierfalse
          Summarytrue
          Requirements

          Links plan to the conditions it manages. The element can identify risks addressed by the plan as well as active conditions. (The Condition resource can include things like "at risk for hypertension" or "fall risk".) Also scopes plans - multiple plans may exist addressing different concerns.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          66. CarePlan.supportingInfo
          Definition

          Identifies portions of the patient's record that specifically influenced the formation of the plan. These might include comorbidities, recent procedures, limitations, recent assessments, etc.

          ShortInformation considered as part of plan
          Comments

          Use "concern" to identify specific conditions addressed by the care plan.

          Control0..*
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies barriers and other considerations associated with the care plan.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          68. CarePlan.goal
          Definition

          Describes the intended objective(s) of carrying out the care plan.

          ShortDesired outcome of plan
          Comments

          Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline.

          Control0..*
          TypeReference(Goal)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides context for plan. Allows plan effectiveness to be evaluated by clinicians.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. CarePlan.activity
          Definition

          Identifies a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring, education, etc.

          ShortAction to occur as part of plan
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows systems to prompt for performance of planned activities, and validate plans against best practice.

          Invariantscpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          72. CarePlan.activity.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          74. CarePlan.activity.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          76. CarePlan.activity.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          78. CarePlan.activity.outcomeCodeableConcept
          Definition

          Identifies the outcome at the point when the status of the activity is assessed. For example, the outcome of an education activity could be patient understands (or not).

          ShortResults of the activity
          Comments

          Note that this should not duplicate the activity status (e.g. completed or in progress).

          Control0..*
          BindingFor example codes, see CarePlanActivityOutcome
          (example to http://hl7.org/fhir/ValueSet/care-plan-activity-outcome)

          Identifies the results of the activity.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          80. CarePlan.activity.outcomeReference
          Definition

          Details of the outcome or action resulting from the activity. The reference to an "event" resource, such as Procedure or Encounter or Observation, is the result/outcome of the activity itself. The activity can be conveyed using CarePlan.activity.detail OR using the CarePlan.activity.reference (a reference to a “request” resource).

          ShortAppointment, Encounter, Procedure, etc.
          Comments

          The activity outcome is independent of the outcome of the related goal(s). For example, if the goal is to achieve a target body weight of 150 lbs and an activity is defined to diet, then the activity outcome could be calories consumed whereas the goal outcome is an observation for the actual body weight measured.

          Control0..*
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Links plan to resulting actions.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          82. CarePlan.activity.progress
          Definition

          Notes about the adherence/status/progress of the activity.

          ShortComments about the activity status/progress
          Comments

          This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description.

          Control0..*
          TypeAnnotation
          Is Modifierfalse
          Summaryfalse
          Requirements

          Can be used to capture information about adherence, progress, concerns, etc.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          84. CarePlan.activity.reference
          Definition

          The details of the proposed activity represented in a specific resource.

          ShortActivity details defined in specific resource
          Comments

          Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
          The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

          Control0..1
          This element is affected by the following invariants: cpl-3
          TypeReference(Appointment, CommunicationRequest, DeviceRequest, MedicationRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Details in a form consistent with other applications and contexts of use.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          86. CarePlan.activity.detail
          Definition

          A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

          ShortIn-line definition of activity
          Control0..1
          This element is affected by the following invariants: cpl-3
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Requirements

          Details in a simple form for generic care plan systems.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          88. CarePlan.activity.detail.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          90. CarePlan.activity.detail.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          92. CarePlan.activity.detail.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          94. CarePlan.activity.detail.kind
          Definition

          A description of the kind of resource the in-line definition of a care plan activity is representing. The CarePlan.activity.detail is an in-line definition when a resource is not referenced using CarePlan.activity.reference. For example, a MedicationRequest, a ServiceRequest, or a CommunicationRequest.

          ShortAppointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription
          Control0..1
          BindingThe codes SHALL be taken from CarePlanActivityKind
          (required to http://hl7.org/fhir/ValueSet/care-plan-activity-kind|4.0.1)

          Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          May determine what types of extensions are permitted.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          96. CarePlan.activity.detail.instantiatesCanonical
          Definition

          The URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity.

          ShortInstantiates FHIR protocol or definition
          Control0..*
          Typecanonical(PlanDefinition, ActivityDefinition, Questionnaire, Measure, OperationDefinition)
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          98. CarePlan.activity.detail.instantiatesUri
          Definition

          The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity.

          ShortInstantiates external protocol or definition
          Comments

          This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

          Control0..*
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          100. CarePlan.activity.detail.code
          Definition

          Detailed description of the type of planned activity; e.g. what lab test, what procedure, what kind of encounter.

          ShortDetail type of activity
          Comments

          Tends to be less relevant for activities involving particular products. Codes should not convey negation - use "prohibited" instead.

          Control0..1
          BindingFor example codes, see ProcedureCodes(SNOMEDCT)
          (example to http://hl7.org/fhir/ValueSet/procedure-code)

          Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows matching performed to planned as well as validation against protocols.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          102. CarePlan.activity.detail.reasonCode
          Definition

          Provides the rationale that drove the inclusion of this particular activity as part of the plan or the reason why the activity was prohibited.

          ShortWhy activity should be done or why activity was prohibited
          Comments

          This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonCondition instead.

          Control0..*
          BindingFor example codes, see SNOMEDCTClinicalFindings
          (example to http://hl7.org/fhir/ValueSet/clinical-findings)

          Identifies why a care plan activity is needed. Can include any health condition codes as well as such concepts as "general wellness", prophylaxis, surgical preparation, etc.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          104. CarePlan.activity.detail.reasonReference
          Definition

          Indicates another resource, such as the health condition(s), whose existence justifies this request and drove the inclusion of this particular activity as part of the plan.

          ShortWhy activity is needed
          Comments

          Conditions can be identified at the activity level that are not identified as reasons for the overall plan.

          Control0..*
          TypeReference(Condition, Observation, DiagnosticReport, DocumentReference)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          106. CarePlan.activity.detail.goal
          Definition

          Internal reference that identifies the goals that this activity is intended to contribute towards meeting.

          ShortGoals this activity relates to
          Control0..*
          TypeReference(Goal)
          Is Modifierfalse
          Summaryfalse
          Requirements

          So that participants know the link explicitly.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          108. CarePlan.activity.detail.status
          Definition

          Identifies what progress is being made for the specific activity.

          Shortnot-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error
          Comments

          Some aspects of status can be inferred based on the resources linked in actionTaken. Note that "status" is only as current as the plan was most recently updated.
          The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the activity.

          Control1..1
          BindingThe codes SHALL be taken from CarePlanActivityStatus
          (required to http://hl7.org/fhir/ValueSet/care-plan-activity-status|4.0.1)

          Codes that reflect the current state of a care plan activity within its overall life cycle.

          Typecode
          Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the activity should not be treated as valid
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          Indicates progress against the plan, whether the activity is still relevant for the plan.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          110. CarePlan.activity.detail.statusReason
          Definition

          Provides reason why the activity isn't yet started, is on hold, was cancelled, etc.

          ShortReason for current status
          Comments

          Will generally not be present if status is "complete". Be sure to prompt to update this (or at least remove the existing value) if the status is changed.

          Control0..1
          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          112. CarePlan.activity.detail.doNotPerform
          Definition

          If true, indicates that the described activity is one that must NOT be engaged in when following the plan. If false, or missing, indicates that the described activity is one that should be engaged in when following the plan.

          ShortIf true, activity is prohibiting action
          Comments

          This element is labeled as a modifier because it marks an activity as an activity that is not to be performed.

          Control0..1
          Typeboolean
          Is Modifiertrue because If true this element negates the specified action. For example, instead of a request for a procedure, it is a request for the procedure to not occur.
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          Captures intention to not do something that may have been previously typical.

          Meaning if MissingIf missing indicates that the described activity is one that should be engaged in when following the plan.
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          114. CarePlan.activity.detail.scheduled[x]
          Definition

          The period, timing or frequency upon which the described activity is to occur.

          ShortWhen activity is to occur
          Control0..1
          TypeChoice of: Timing, Period, string
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          Allows prompting for activities and detection of missed planned activities.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          116. CarePlan.activity.detail.location
          Definition

          Identifies the facility where the activity will occur; e.g. home, hospital, specific clinic, etc.

          ShortWhere it should happen
          Comments

          May reference a specific clinical location or may identify a type of location.

          Control0..1
          TypeReference(Location)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Helps in planning of activity.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          118. CarePlan.activity.detail.performer
          Definition

          Identifies who's expected to be involved in the activity.

          ShortWho will be responsible?
          Comments

          A performer MAY also be a participant in the care plan.

          Control0..*
          TypeReference(Practitioner, PractitionerRole, Organization, RelatedPerson, Patient, CareTeam, HealthcareService, Device)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Helps in planning of activity.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          120. CarePlan.activity.detail.product[x]
          Definition

          Identifies the food, drug or other product to be consumed or supplied in the activity.

          ShortWhat is to be administered/supplied
          Control0..1
          BindingFor example codes, see SNOMEDCTMedicationCodes
          (example to http://hl7.org/fhir/ValueSet/medication-codes)

          A product supplied or administered as part of a care plan activity.

          TypeChoice of: CodeableConcept, Reference(Medication, Substance)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          122. CarePlan.activity.detail.dailyAmount
          Definition

          Identifies the quantity expected to be consumed in a given day.

          ShortHow to consume/day?
          Control0..1
          TypeQuantity(SimpleQuantity)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows rough dose checking.

          Alternate Namesdaily dose
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          124. CarePlan.activity.detail.quantity
          Definition

          Identifies the quantity expected to be supplied, administered or consumed by the subject.

          ShortHow much to administer/supply/consume
          Control0..1
          TypeQuantity(SimpleQuantity)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          126. CarePlan.activity.detail.description
          Definition

          This provides a textual description of constraints on the intended activity occurrence, including relation to other activities. It may also include objectives, pre-conditions and end-conditions. Finally, it may convey specifics about the activity such as body site, method, route, etc.

          ShortExtra info describing activity to perform
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          128. CarePlan.note
          Definition

          General notes about the care plan not covered elsewhere.

          ShortComments about the plan
          Control0..*
          TypeAnnotation
          Is Modifierfalse
          Summaryfalse
          Requirements

          Used to capture information that applies to the plan as a whole that doesn't fit into discrete elements.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))