US Core Implementation Guide
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US Core Implementation Guide, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 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: US Core CareTeam Profile

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam Version: 8.0.0-ballot
Standards status: Trial-use Maturity Level: 3 Computable Name: USCoreCareTeam
Other Identifiers: OID:2.16.840.1.113883.4.642.40.2.42.16

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

The US Core CareTeam Profile inherits from the FHIR CareTeam resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the CareTeam resource for identifying the Care Team members associated with a patient to promote interoperability and adoption through common implementation. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present in the resource and how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.

Example Usage Scenarios:

The following are example usage scenarios for this profile:

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 CareTeam Must Have:

  1. a patient
  2. a participant role for each careteam member
  3. a reference to each careteam member, which can be:
    • a practitioner or practitioner type (doctor, nurse, therapist)*
    • a relative, friend, or guardian

*See below for how practitioner members are represented in this Profile.

Each CareTeam Must Support:

  1. a status code

Profile Specific Implementation Guidance:

In order to access care team member's names, identifiers, locations, and contact information, the CareTeam profile supports several types of care team participants. They are represented as references to other profiles and include the following three profiles, which are marked as Must Support:

  1. US Core Practitioner Profile
  2. US Core PractitionerRole Profile
  3. US Core RelatedPerson Profile
  • Although both US Core Practitioner Profile and US Core PractitionerRole are Must Support, the Server system is not required to support references to both, but SHALL support at least one of them.
  • The Client application SHALL support all three profile references.
  • Because the US Core PractitionerRole Profile supplies the provider's location and contact information and a reference to the Practitioner, Server systems SHOULD reference it instead of the US Core Practitioner Profile. The quick start section below shows an example of how to access the practitioner name and identifier.
  • Servers 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 and contact information using only the Practitioner resource.

Usage:

Changes since version 7.0.0:

  • No changes

    • Formal Views of Profile Content

    Description of Profiles, Differentials, Snapshots and how the different presentations work.

    This structure is derived from CareTeam

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. CareTeam 0..* CareTeam Planned participants in the coordination and delivery of care for a patient or group
    ... status S 0..1 code proposed | active | suspended | inactive | entered-in-error
    Binding: CareTeamStatus (required): Indicates whether the team is current , represents future intentions or is now a historical record.

    ... subject S 1..1 Reference(US Core Patient Profile S | Group) Who care team is for
    ... participant S 1..* BackboneElement Members of the team
    .... role S 1..1 CodeableConcept Type of involvement
    Binding: Care Team Member Function . (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.

    .... member S 1..1 Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile S | US Core CareTeam Profile | US Core RelatedPerson Profile S) Who is involved

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    CareTeam.statusrequiredCareTeamStatus
    http://hl7.org/fhir/ValueSet/care-team-status
    from the FHIR Standard
    CareTeam.participant.roleextensibleCareTeamMemberFunction .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. CareTeam 0..* CareTeam Planned participants in the coordination and delivery of care for a patient or group
    dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    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
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    dom-6: A resource should have narrative for robust management
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ele-1: All FHIR elements must have a @value or children
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ... status ?!SΣ 0..1 code proposed | active | suspended | inactive | entered-in-error
    Binding: CareTeamStatus (required): Indicates whether the team is current , represents future intentions or is now a historical record.


    ele-1: All FHIR elements must have a @value or children
    ... subject SΣ 1..1 Reference(US Core Patient Profile) Who care team is for
    ele-1: All FHIR elements must have a @value or children
    ... participant SC 1..* BackboneElement Members of the team
    ctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner
    ele-1: All FHIR elements must have a @value or children
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... role SΣ 1..1 CodeableConcept Type of involvement
    Binding: Care Team Member Function . (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.


    ele-1: All FHIR elements must have a @value or children
    .... member SΣ 1..1 Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile) Who is involved
    ele-1: All FHIR elements must have a @value or children

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    CareTeam.statusrequiredCareTeamStatus
    http://hl7.org/fhir/ValueSet/care-team-status
    from the FHIR Standard
    CareTeam.participant.roleextensibleCareTeamMemberFunction .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. CareTeam 0..* CareTeam Planned participants in the coordination and delivery of care for a patient or group
    ... id Σ 0..1 id Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.

    Additional BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    ... contained 0..* Resource Contained, inline Resources
    ... extension 0..* Extension Additional content defined by implementations
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier Σ 0..* Identifier External Ids for this team
    ... status ?!SΣ 0..1 code proposed | active | suspended | inactive | entered-in-error
    Binding: CareTeamStatus (required): Indicates whether the team is current , represents future intentions or is now a historical record.

    ... category Σ 0..* CodeableConcept Type of team
    Binding: CareTeamCategory (example): Indicates the type of care team.


    ... name Σ 0..1 string Name of the team, such as crisis assessment team
    ... subject SΣ 1..1 Reference(US Core Patient Profile S | Group) Who care team is for
    ... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
    ... period Σ 0..1 Period Time period team covers
    ... participant SC 1..* BackboneElement Members of the team
    ctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... role SΣ 1..1 CodeableConcept Type of involvement
    Binding: Care Team Member Function . (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.


    .... member SΣ 1..1 Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile S | US Core CareTeam Profile | US Core RelatedPerson Profile S) Who is involved
    .... onBehalfOf Σ 0..1 Reference(Organization) Organization of the practitioner
    .... period 0..1 Period Time period of participant
    ... reasonCode 0..* CodeableConcept Why the care team exists
    Binding: SNOMEDCTClinicalFindings (example): Indicates the reason for the care team.


    ... reasonReference 0..* Reference(Condition) Why the care team exists
    ... managingOrganization Σ 0..* Reference(Organization) Organization responsible for the care team
    ... telecom 0..* ContactPoint A contact detail for the care team (that applies to all members)
    ... note 0..* Annotation Comments made about the CareTeam

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    CareTeam.languagepreferredCommonLanguages
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Additional Bindings Purpose
    AllLanguages Max Binding
    CareTeam.statusrequiredCareTeamStatus
    http://hl7.org/fhir/ValueSet/care-team-status
    from the FHIR Standard
    CareTeam.categoryexampleCareTeamCategory
    http://hl7.org/fhir/ValueSet/care-team-category
    from the FHIR Standard
    CareTeam.participant.roleextensibleCareTeamMemberFunction .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30
    CareTeam.reasonCodeexampleSNOMEDCTClinicalFindings
    http://hl7.org/fhir/ValueSet/clinical-findings
    from the FHIR Standard

    Differential View

    This structure is derived from CareTeam

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. CareTeam 0..* CareTeam Planned participants in the coordination and delivery of care for a patient or group
    ... status S 0..1 code proposed | active | suspended | inactive | entered-in-error
    Binding: CareTeamStatus (required): Indicates whether the team is current , represents future intentions or is now a historical record.

    ... subject S 1..1 Reference(US Core Patient Profile S | Group) Who care team is for
    ... participant S 1..* BackboneElement Members of the team
    .... role S 1..1 CodeableConcept Type of involvement
    Binding: Care Team Member Function . (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.

    .... member S 1..1 Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile S | US Core CareTeam Profile | US Core RelatedPerson Profile S) Who is involved

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    CareTeam.statusrequiredCareTeamStatus
    http://hl7.org/fhir/ValueSet/care-team-status
    from the FHIR Standard
    CareTeam.participant.roleextensibleCareTeamMemberFunction .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30

    Key Elements View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. CareTeam 0..* CareTeam Planned participants in the coordination and delivery of care for a patient or group
    dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    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
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    dom-6: A resource should have narrative for robust management
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ele-1: All FHIR elements must have a @value or children
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ... status ?!SΣ 0..1 code proposed | active | suspended | inactive | entered-in-error
    Binding: CareTeamStatus (required): Indicates whether the team is current , represents future intentions or is now a historical record.


    ele-1: All FHIR elements must have a @value or children
    ... subject SΣ 1..1 Reference(US Core Patient Profile) Who care team is for
    ele-1: All FHIR elements must have a @value or children
    ... participant SC 1..* BackboneElement Members of the team
    ctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner
    ele-1: All FHIR elements must have a @value or children
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... role SΣ 1..1 CodeableConcept Type of involvement
    Binding: Care Team Member Function . (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.


    ele-1: All FHIR elements must have a @value or children
    .... member SΣ 1..1 Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile) Who is involved
    ele-1: All FHIR elements must have a @value or children

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    CareTeam.statusrequiredCareTeamStatus
    http://hl7.org/fhir/ValueSet/care-team-status
    from the FHIR Standard
    CareTeam.participant.roleextensibleCareTeamMemberFunction .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30

    Snapshot View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. CareTeam 0..* CareTeam Planned participants in the coordination and delivery of care for a patient or group
    ... id Σ 0..1 id Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.

    Additional BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    ... contained 0..* Resource Contained, inline Resources
    ... extension 0..* Extension Additional content defined by implementations
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier Σ 0..* Identifier External Ids for this team
    ... status ?!SΣ 0..1 code proposed | active | suspended | inactive | entered-in-error
    Binding: CareTeamStatus (required): Indicates whether the team is current , represents future intentions or is now a historical record.

    ... category Σ 0..* CodeableConcept Type of team
    Binding: CareTeamCategory (example): Indicates the type of care team.


    ... name Σ 0..1 string Name of the team, such as crisis assessment team
    ... subject SΣ 1..1 Reference(US Core Patient Profile S | Group) Who care team is for
    ... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
    ... period Σ 0..1 Period Time period team covers
    ... participant SC 1..* BackboneElement Members of the team
    ctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... role SΣ 1..1 CodeableConcept Type of involvement
    Binding: Care Team Member Function . (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.


    .... member SΣ 1..1 Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile S | US Core CareTeam Profile | US Core RelatedPerson Profile S) Who is involved
    .... onBehalfOf Σ 0..1 Reference(Organization) Organization of the practitioner
    .... period 0..1 Period Time period of participant
    ... reasonCode 0..* CodeableConcept Why the care team exists
    Binding: SNOMEDCTClinicalFindings (example): Indicates the reason for the care team.


    ... reasonReference 0..* Reference(Condition) Why the care team exists
    ... managingOrganization Σ 0..* Reference(Organization) Organization responsible for the care team
    ... telecom 0..* ContactPoint A contact detail for the care team (that applies to all members)
    ... note 0..* Annotation Comments made about the CareTeam

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    CareTeam.languagepreferredCommonLanguages
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Additional Bindings Purpose
    AllLanguages Max Binding
    CareTeam.statusrequiredCareTeamStatus
    http://hl7.org/fhir/ValueSet/care-team-status
    from the FHIR Standard
    CareTeam.categoryexampleCareTeamCategory
    http://hl7.org/fhir/ValueSet/care-team-category
    from the FHIR Standard
    CareTeam.participant.roleextensibleCareTeamMemberFunction .
    http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30
    CareTeam.reasonCodeexampleSNOMEDCTClinicalFindings
    http://hl7.org/fhir/ValueSet/clinical-findings
    from the FHIR Standard

     

    Other representations of profile: CSV, Excel, Schematron

    Notes:

    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 careteam data SHALL support these US Core SMART Scopes:

    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 status search parameters:
      • including optional support for these _include parameters: CareTeam:participant:PractitionerRole,CareTeam:participant:Practitioner,CareTeam:participant:Patient,CareTeam:participant:RelatedPerson
      • including optional support for OR search on status (e.g.status={system|}[code],{system|}[code],...)

      GET [base]/CareTeam?patient={Type/}[id]&status=active

      Example:

      1. GET [base]/CareTeam?patient=1137192&status=active
      2. GET [base]/CareTeam?patient=1137192&status=active&_include=CareTeam:participant:RelatedPerson&_include=CareTeam:participant:Patient&_include=CareTeam:participant:Practitioner&_include=CareTeam:participant:PractitionerRole

      Implementation Notes: Fetches a bundle of all CareTeam resources for the specified patient and status =active and may include CareTeam Patient, RelatedPerson and Practitioner and PractitionerRole participants.
      To get Practitioner name and identifier using PractitionerRole:
      1) Search for the careteam PractitionerRole: GET [base]/CareTeam?patient=[id]&status=active&_include=CareTeam:participant:PractitionerRole 2) Use the FHIR _id from the PractitionerRole.practitioner element, to fetch the Practitioner resources using GET [base]/Practitioner?_id=[id] (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 role search parameters:
      • including optional support for these _include parameters: CareTeam:participant:PractitionerRole,CareTeam:participant:Practitioner,CareTeam:participant:Patient,CareTeam:participant:RelatedPerson
      • including optional support for OR search on role (e.g.role={system|}[code],{system|}[code],...)

      GET [base]/CareTeam?patient={Type/}[id]&role={system|}[code]{,{system|}[code],...}

      Example:

      1. GET [base]/CareTeam?patient=1137192&role=http://snomed.info/sct|17561000

      Implementation Notes: Fetches a bundle of all CareTeam resources for the specified patient and participant role (how to search by reference and how to search by token)