US Core Implementation Guide
5.0.0 - STU5 Release United States of America flag

US Core Implementation Guide, published by HL7 International - Cross-Group Projects. This is not an authorized publication; it is the continuous build for version 5.0.0). 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 Practitioner Profile

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner Version: 5.0.0
Active as of 2022-04-20 Computable Name: USCorePractitionerProfile

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

This profile sets minimum expectations for the Practitioner resource to record, search, and fetch basic demographics and other administrative information about an individual practitioner to promote interoperability and adoption through common implementation. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile. It provides the floor for standards development for specific uses cases.

Example Usage Scenarios:

The following are example usage scenarios for the this profile:

  • Query for an practitioner by name or NPI
  • Reference from other Resources

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 Profile Definition below provides the formal summary, definitions, and terminology requirements.

Each Practitioner must have:

  1. An identifier which must support an NPI if available.
  2. A name

Each PractitionerRole must support:

  1. Contact information
  2. An address

Profile specific implementation guidance:

Usage:

Formal Views of Profile Content

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

This structure is derived from Practitioner

Summary

Mandatory: 5 elements
Must-Support: 15 elements

Slices

This structure defines the following Slices:

  • The element Practitioner.identifier is sliced based on the value of pattern:$this

This structure is derived from Practitioner

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..*PractitionerA person with a formal responsibility in the provisioning of healthcare or related services
... Slices for identifier S1..*IdentifierAn identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:All Slices Content/Rules for all slices
..... system S1..1uriThe namespace for the identifier value
..... value S1..1stringThe value that is unique
.... identifier:NPI S0..1IdentifierAn identifier for the person as this agent
Required Pattern: At least the following
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
... name S1..*HumanNameThe name(s) associated with the practitioner
.... family S1..1stringFamily name (often called 'Surname')
... telecom S0..*ContactPointA contact detail for the practitioner (that apply to all roles)
.... system S0..1codephone | fax | email | pager | url | sms | other
.... value S0..1stringThe actual contact point details
... address S0..*AddressAddress(es) of the practitioner that are not role specific (typically home address)
.... line S0..4stringStreet name, number, direction & P.O. Box etc.
.... city S0..1stringName of city, town etc.
.... state S0..1stringSub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.

.... postalCode S0..1stringUS Zip Codes
.... country S0..1stringCountry (e.g. can be ISO 3166 2 or 3 letter code)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..*PractitionerA person with a formal responsibility in the provisioning of healthcare or related services
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier SΣ1..*IdentifierAn identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system SΣ1..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ1..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:NPI SΣ0..1IdentifierAn identifier for the person as this agent

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... use0..1codeusual | official | temp | secondary | old (If known)
..... type0..1CodeableConceptDescription of identifier
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... value0..1stringThe value that is unique
..... period0..1PeriodTime period when id is/was valid for use
..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
... active Σ0..1booleanWhether this practitioner's record is in active use
... name SΣ1..*HumanNameThe name(s) associated with the practitioner
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ0..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... text Σ0..1stringText representation of the full name
.... family SΣ1..1stringFamily name (often called 'Surname')
.... given Σ0..*stringGiven names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
.... prefix Σ0..*stringParts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
.... suffix Σ0..*stringParts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
.... period Σ0..1PeriodTime period when name was/is in use
... telecom SΣ0..*ContactPointA contact detail for the practitioner (that apply to all roles)
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... system SΣI0..1codephone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.

.... value SΣ0..1stringThe actual contact point details
.... use ?!Σ0..1codehome | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.

.... rank Σ0..1positiveIntSpecify preferred order of use (1 = highest)
.... period Σ0..1PeriodTime period when the contact point was/is in use
... address SΣ0..*AddressAddress(es) of the practitioner that are not role specific (typically home address)
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ0..1codehome | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.


Example General: home
.... type Σ0..1codepostal | physical | both
Binding: AddressType (required): The type of an address (physical / postal).


Example General: both
.... text Σ0..1stringText representation of the address
Example General: 137 Nowhere Street, Erewhon 9132
.... line SΣ0..4stringStreet name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
.... city SΣ0..1stringName of city, town etc.
Example General: Erewhon
.... district Σ0..1stringDistrict name (aka county)
Example General: Madison
.... state SΣ0..1stringSub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.

.... postalCode SΣ0..1stringUS Zip Codes
Example General: 9132
.... country SΣ0..1stringCountry (e.g. can be ISO 3166 2 or 3 letter code)
.... period Σ0..1PeriodTime period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}
... gender Σ0..1codemale | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.

... birthDate Σ0..1dateThe date on which the practitioner was born
... photo 0..*AttachmentImage of the person
... qualification 0..*BackboneElementCertification, licenses, or training pertaining to the provision of care
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... identifier 0..*IdentifierAn identifier for this qualification for the practitioner
.... code 1..1CodeableConceptCoded representation of the qualification
Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.

.... period 0..1PeriodPeriod during which the qualification is valid
.... issuer 0..1Reference(Organization)Organization that regulates and issues the qualification
... communication 0..*CodeableConceptA language the practitioner can use in patient communication
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding


doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..*PractitionerA person with a formal responsibility in the provisioning of healthcare or related services
... Slices for identifier Σ1..*IdentifierAn identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:All Slices Content/Rules for all slices
..... system Σ1..1uriThe namespace for the identifier value
..... value Σ1..1stringThe value that is unique
.... identifier:NPI Σ0..1IdentifierAn identifier for the person as this agent

Required Pattern: At least the following
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
... name Σ1..*HumanNameThe name(s) associated with the practitioner
.... family Σ1..1stringFamily name (often called 'Surname')
... telecom Σ0..*ContactPointA contact detail for the practitioner (that apply to all roles)
.... system ΣI0..1codephone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.

.... value Σ0..1stringThe actual contact point details
... address Σ0..*AddressAddress(es) of the practitioner that are not role specific (typically home address)
.... line Σ0..4stringStreet name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
.... city Σ0..1stringName of city, town etc.
.... state Σ0..1stringSub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.

.... postalCode Σ0..1stringUS Zip Codes
.... country Σ0..1stringCountry (e.g. can be ISO 3166 2 or 3 letter code)

doco Documentation for this format

This structure is derived from Practitioner

Summary

Mandatory: 5 elements
Must-Support: 15 elements

Slices

This structure defines the following Slices:

  • The element Practitioner.identifier is sliced based on the value of pattern:$this

Differential View

This structure is derived from Practitioner

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..*PractitionerA person with a formal responsibility in the provisioning of healthcare or related services
... Slices for identifier S1..*IdentifierAn identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:All Slices Content/Rules for all slices
..... system S1..1uriThe namespace for the identifier value
..... value S1..1stringThe value that is unique
.... identifier:NPI S0..1IdentifierAn identifier for the person as this agent
Required Pattern: At least the following
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
... name S1..*HumanNameThe name(s) associated with the practitioner
.... family S1..1stringFamily name (often called 'Surname')
... telecom S0..*ContactPointA contact detail for the practitioner (that apply to all roles)
.... system S0..1codephone | fax | email | pager | url | sms | other
.... value S0..1stringThe actual contact point details
... address S0..*AddressAddress(es) of the practitioner that are not role specific (typically home address)
.... line S0..4stringStreet name, number, direction & P.O. Box etc.
.... city S0..1stringName of city, town etc.
.... state S0..1stringSub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.

.... postalCode S0..1stringUS Zip Codes
.... country S0..1stringCountry (e.g. can be ISO 3166 2 or 3 letter code)

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..*PractitionerA person with a formal responsibility in the provisioning of healthcare or related services
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier SΣ1..*IdentifierAn identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system SΣ1..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ1..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:NPI SΣ0..1IdentifierAn identifier for the person as this agent

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... use0..1codeusual | official | temp | secondary | old (If known)
..... type0..1CodeableConceptDescription of identifier
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... value0..1stringThe value that is unique
..... period0..1PeriodTime period when id is/was valid for use
..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
... active Σ0..1booleanWhether this practitioner's record is in active use
... name SΣ1..*HumanNameThe name(s) associated with the practitioner
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ0..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... text Σ0..1stringText representation of the full name
.... family SΣ1..1stringFamily name (often called 'Surname')
.... given Σ0..*stringGiven names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
.... prefix Σ0..*stringParts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
.... suffix Σ0..*stringParts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
.... period Σ0..1PeriodTime period when name was/is in use
... telecom SΣ0..*ContactPointA contact detail for the practitioner (that apply to all roles)
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... system SΣI0..1codephone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.

.... value SΣ0..1stringThe actual contact point details
.... use ?!Σ0..1codehome | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.

.... rank Σ0..1positiveIntSpecify preferred order of use (1 = highest)
.... period Σ0..1PeriodTime period when the contact point was/is in use
... address SΣ0..*AddressAddress(es) of the practitioner that are not role specific (typically home address)
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ0..1codehome | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.


Example General: home
.... type Σ0..1codepostal | physical | both
Binding: AddressType (required): The type of an address (physical / postal).


Example General: both
.... text Σ0..1stringText representation of the address
Example General: 137 Nowhere Street, Erewhon 9132
.... line SΣ0..4stringStreet name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
.... city SΣ0..1stringName of city, town etc.
Example General: Erewhon
.... district Σ0..1stringDistrict name (aka county)
Example General: Madison
.... state SΣ0..1stringSub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.

.... postalCode SΣ0..1stringUS Zip Codes
Example General: 9132
.... country SΣ0..1stringCountry (e.g. can be ISO 3166 2 or 3 letter code)
.... period Σ0..1PeriodTime period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}
... gender Σ0..1codemale | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.

... birthDate Σ0..1dateThe date on which the practitioner was born
... photo 0..*AttachmentImage of the person
... qualification 0..*BackboneElementCertification, licenses, or training pertaining to the provision of care
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... identifier 0..*IdentifierAn identifier for this qualification for the practitioner
.... code 1..1CodeableConceptCoded representation of the qualification
Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.

.... period 0..1PeriodPeriod during which the qualification is valid
.... issuer 0..1Reference(Organization)Organization that regulates and issues the qualification
... communication 0..*CodeableConceptA language the practitioner can use in patient communication
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding


doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSet
Practitioner.languagepreferredCommonLanguages
Max Binding: AllLanguages
Practitioner.identifier.userequiredIdentifierUse
Practitioner.identifier.typeextensibleIdentifier Type Codes
Practitioner.name.userequiredNameUse
Practitioner.telecom.systemrequiredContactPointSystem
Practitioner.telecom.userequiredContactPointUse
Practitioner.address.userequiredAddressUse
Practitioner.address.typerequiredAddressType
Practitioner.address.stateextensibleUspsTwoLetterAlphabeticCodes
Practitioner.genderrequiredAdministrativeGender
Practitioner.qualification.codeexamplev2.0360.2.7
Practitioner.communicationpreferredCommonLanguages
Max Binding: AllLanguages

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.

  • The syntax used to describe the interactions is described here.
  • 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.

Mandatory Search Parameters:

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

  1. SHALL support searching for a practitioner by a string match of any part of name using the name search parameter:

    GET [base]/Practitioner?name=[string]

    Example:

    1. GET [base]/Practitioner?name=Smith

    Implementation Notes: Fetches a bundle of all Practitioner resources matching the name (how to search by string)

  2. SHALL support searching a practitioner by an identifier such as an NPI using the identifier search parameter:

    GET [base]/Practitioner?identifier={system|}[code]

    Example:

    1. GET [base]/Practitioner?dentifier=http://hl7.org/fhir/sid/us-npi|97860456

    Implementation Notes: Fetches a bundle containing any Practitioner resources matching the identifier (how to search by token)

Optional Search Parameters:

The following search parameter combinations SHOULD be supported:

  1. SHOULD support searching using the _id search parameter:

    GET [base]/Practitioner?_id={system|}[code]

    Example:

    1. GET [base]/Practitioner/practitioner-1
    2. GET [base]/Practitioner?_id=practitioner-1

    Implementation Notes: DOES THIS DO ANYTHING? (how to search by token)