Example Usage Scenarios:

The following are example usage scenarios for this profile:

• Query for a care plan belonging to a Patient
• Record or update an existing care plan

Mandatory and Must Support Data Elements

The following data elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each CarePlan Must Have:

1. a status
2. an intent
3. a category code of "assess-plan"
4. a patient

Each CarePlan Must Support:

1. a narrative summary of the patient assessment and plan of treatment*

*see guidance below

Profile Specific Implementation Guidance:

• *The original Assessment and Plan design in the CarePlan was to support the "Assessment and Plan" from a narrative Progress Note. Systems have advanced significantly since the introduction of this requirement in 2015. Relaxing this to 0..1 allows more sophisticated systems to discretely encode a CarePlan instead of providing the narrative portion.
• Additional considerations for systems aligning with HL7 Consolidated (C-CDA) Care Plan requirements:
  • US Core Goal SHOULD be present in CarePlan.goal
  • US Core Condition SHOULD be present in CarePlan.addresses
  • Assessment and Plan MAY be included as narrative in CarePlan.text
• As an alternative to the US Core CarePlan, Assessment and Plan of Treatment may be included in various types of Clinical Notes, such as Progress Notes, History & Physical (H&P), Discharge Summaries, etc.

Changes since version 7.0.0:

Quick Start

Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile's information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

• See the Scopes Format section for a description of the SMART scopes syntax.
• See the Search Syntax section for a description of the US Core search syntax.
• See the General Requirements section for additional rules and expectations when a Server requires status parameters.
• See the General Guidance section for additional guidance on searching for multiple patients.

US Core Scopes

Servers providing access to care plan data SHALL support these US Core SMART Scopes:

• resource level scopes: <patient|user|system>/CarePlan.rs

Mandatory Search Parameters:

The following search parameters and search parameter combinations SHALL be supported:

1. SHALL support searching using the combination of the patient and category search parameters:

   GET [base]/CarePlan?patient={Type/}[id]&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan

   Example:

   1. GET [base]/CarePlan?patient=1137192&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan

   Implementation Notes: Fetches a bundle of all CarePlan resources for the specified patient and category=assess-plan (how to search by reference and how to search by token)

Optional Search Parameters:

The following search parameter combinations SHOULD be supported:

1. SHOULD support searching using the combination of the patient and category and date search parameters:
   • including support for these date comparators: gt,lt,ge,le
   • including optional support for AND search on date (e.g.date=[date]&date=[date]]&...)

   GET [base]/CarePlan?patient={Type/}[id]&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

   Example:

   1. GET [base]/CarePlan?patient=1137192&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan&date=ge2019-01-01T00:00:00Z
   2. GET [base]/CarePlan?patient=1137192&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan&date=ge2018-01-01T00:00:00Z&date=le2019-01-01T00:00:00Z

   Implementation Notes: Fetches a bundle of all CarePlan resources for the specified patient and category=assess-plan and date (how to search by reference and how to search by token and how to search by date)

2. SHOULD support searching using the combination of the patient and category and status search parameters:
   • including support for OR search on status (e.g.status={system|}[code],{system|}[code],...)

   GET [base]/CarePlan?patient={Type/}[id]&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan&status={system|}[code]{,{system|}[code],...}

   Example:

   1. GET [base]/CarePlan?patient=1137192&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan&status=active

   Implementation Notes: Fetches a bundle of all CarePlan resources for the specified patient and category=assess-plan and status=active (how to search by reference and how to search by token)

3. SHOULD support searching using the combination of the patient and category and status and date search parameters:
   • including support for OR search on status (e.g.status={system|}[code],{system|}[code],...)
   • including support for these date comparators: gt,lt,ge,le
   • including optional support for AND search on date (e.g.date=[date]&date=[date]]&...)

   GET [base]/CarePlan?patient={Type/}[id]&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan&status={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

   Example:

   1. GET [base]/CarePlan?patient=1137192&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan&status=active&date=ge2019-01-01T00:00:00Z
   2. GET [base]/CarePlan?patient=1137192&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan&status=active&date=ge2018-01-01T00:00:00Z&date=le2019-01-01T00:00:00Z

   Implementation Notes: Fetches a bundle of all CarePlan resources for the specified patient and category=assess-plan and status=active and date (how to search by reference and how to search by token and how to search by date)