# US Core PractitionerRole Profile - US Core Implementation Guide v9.0.0

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **US Core PractitionerRole Profile**

## Resource Profile: US Core PractitionerRole Profile 

| | | |
| :--- | :--- | :--- |
| *Official URL*:http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole | *Version*:9.0.0 | |
| * Standards status: *[Trial-use](http://hl7.org/fhir/R4/versions.html#std-process) | [Maturity Level](changes-between-versions.md#us-core-maturity-levels): 5 | *Computable Name*:USCorePractitionerRoleProfile |
| *Other Identifiers:*OID:2.16.840.1.113883.4.642.40.2.42.52 | | |

 
The US Core PractitionerRole Profile inherits from the FHIR [PractitionerRole](https://hl7.org/fhir/R4/practitionerrole.html) resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the PractitionerRole Resource to record, search, and fetch the practitioner role information. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption. The requirements for the US Core Practitioner were drawn from the [Argonaut Provider Directory](http://www.fhir.org/guides/argonaut/pd//release1/index.html), [IHE Healthcare Provider Directory](http://ihe.net/uploadedFiles/Documents/ITI/IHE_ITI_Suppl_HPD.pdf) and the [ONC Provider Directory Workshop](https://confluence.oncprojectracking.org/display/PDW/Workshop+Documents). 

### Mandatory and Must Support Data Elements

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

**Each PractitionerRole Must Support:**

1. An associated organization1
1. An associated practitioner1
1. A role2
1. A specialty3
1. An associated location1
1. Contact information4
1. A communication endpoint4

1,2,3,4 see guidance below

### Profile Specific Implementation Guidance

This section provides detailed implementation guidance for the US Core Profile to support implementation and certification.

* 1At least one of the following elements must be present: 
* `PractitionerRole.practitioner`
* `PractitionerRole.organization`
* `PractitionerRole.healthcareService`
* `PractitionerRole.location`
 
* Due to implementer feedback, some US Core Profiles reference the [PractitionerRole](http://hl7.org/fhir/R4/practitionerrole.html) resource instead of the US Core PractitionerRole Profile. However, the US Core PractitionerRole Profile **SHOULD** be used as the default profile if referenced by another US Core profile.[§](requirements.md#CONF-0890) See this guidance on [Referencing US Core Profiles](general-guidance.md#referencing-us-core-profiles).
* 4A [Direct address](https://www.healthit.gov/sites/default/files/directbasicsforprovidersqa_05092014.pdf) can be represented in the `telecom` element using the [US Core Direct email Extension](StructureDefinition-us-core-direct.md) or in a referenced [Endpoint](http://hl7.org/fhir/R4/endpoint.html) as a "direct-project" endpoint connection type.
* 2When selecting role codes 
* implementers **SHOULD** choose the code that reflects the specific duties performed within that role rather than the specialty unless the individual's professional specialization characterizes the role.[§](requirements.md#CONF-0891)
* Systems that primarily rely on NUCC codes instead of SNOMED CT to represent role codes can use the Da Vinci HRex [NUCC to SNOMED CT Mappings](https://build.fhir.org/ig/HL7/davinci-ehrx/ConceptMap-NUCC-CareTeamMemberFunction.html) to aid in translations.
 
* 3Unless exchanging legacy or text-only data, medical specialty codes **SHOULD** be taken from NUCC or SNOMED CT.[§](requirements.md#CONF-0894)
* Clients can request Servers return the Practitioner and Endpoint resources using `_include`. See the [Quick Start](#search) section below for further guidance.

**Usages:**

* Refer to this Profile: [US Core ADI DocumentReference Profile](StructureDefinition-us-core-adi-documentreference.md), [US Core CareTeam Profile](StructureDefinition-us-core-careteam.md), [US Core DiagnosticReport Profile for Laboratory Results Reporting](StructureDefinition-us-core-diagnosticreport-lab.md), [US Core DiagnosticReport Profile for Report and Note Exchange](StructureDefinition-us-core-diagnosticreport-note.md)... Show 8 more, [US Core DocumentReference Profile](StructureDefinition-us-core-documentreference.md), [US Core Encounter Profile](StructureDefinition-us-core-encounter.md), [US Core FamilyMemberHistory Recorder Extension](StructureDefinition-us-core-familymemberhistory-recorder.md), [US Core Immunization Profile](StructureDefinition-us-core-immunization.md), [US Core MedicationDispense Profile](StructureDefinition-us-core-medicationdispense.md), [US Core MedicationRequest Profile](StructureDefinition-us-core-medicationrequest.md), [US Core Procedure Profile](StructureDefinition-us-core-procedure.md) and [US Core Provenance Profile](StructureDefinition-us-core-provenance.md)
* CapabilityStatements using this Profile: [US Core Client CapabilityStatement](CapabilityStatement-us-core-client.md) and [US Core Server CapabilityStatement](CapabilityStatement-us-core-server.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/hl7.fhir.us.core|current/StructureDefinition/us-core-practitionerrole)

**Changes since version 8.0.1:**

* The resource metadata has changed (copyright)

* The data elements list has changed

### Formal Views of Profile Content

 [Description of Profiles, Differentials, Snapshots and how the different presentations work](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](StructureDefinition-us-core-practitionerrole.csv), [Excel](StructureDefinition-us-core-practitionerrole.xlsx), [Schematron](StructureDefinition-us-core-practitionerrole.sch) 

### 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](CapabilityStatement-us-core-server.md) for a complete list of supported RESTful interactions for this IG.

* See the [Scopes Format](scopes.md#scopes-format) section for a description of the SMART scopes syntax.
* See the [Search Syntax](general-guidance.md#search-syntax) section for a description of the US Core search syntax.
* See the [General Requirements](general-requirements.md) section for additional rules and expectations when a Server requires status parameters.
* See the [General Guidance](general-guidance.md) section for additional guidance on searching for multiple patients.

#### US Core Scopes

Servers providing access to practitioner role data **SHALL** support these [US Core SMART Scopes](scopes.md#smart-scopes):

* [resource level scopes](http://hl7.org/fhir/smart-app-launch/STU2.2/scopes-and-launch-context.html#scopes-for-requesting-clinical-data): `<patient|user|system>/PractitionerRole.rs` [§](requirements.md#CONF-0149)

-------

#### Mandatory Search Parameters:

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

1. **SHALL** support searching practitioner role by practitioner name and identifier using chained parameters using the [practitioner](SearchParameter-us-core-practitionerrole-practitioner.md) search parameter
* Including support for these chained parameters: `practitioner.identifier,name`
* Including optional support for these `_include` parameters: `PractitionerRole:endpoint`, `PractitionerRole:practitioner`
`GET [base]/PractitionerRole?practitioner={Type/}[id]`Examples:
> 
1. GET [base]/PractitionerRole?practitioner.identifier=http://hl7.org/fhir/sid/us-npi|97860456&_include=PractitionerRole:practitioner&_include=PractitionerRole:endpoint
1. GET [base]/PractitionerRole?practitioner.name=Henry&_include=PractitionerRole:practitioner&_include=PractitionerRole:endpoint

**Implementation Notes**: Fetches a bundle containing US Core PractitionerRole Profile resources matching the chained parameter practitioner.name or practitioner.identifier. SHOULD support the _include parameters ( see [how to search by reference](http://hl7.org/fhir/R4/search.html#reference)).
1. **SHALL** support searching practitioner role by specialty using the [specialty](SearchParameter-us-core-practitionerrole-specialty.md) search parameter
* Including optional support for these `_include` parameters: `PractitionerRole:endpoint`, `PractitionerRole:practitioner`
`GET [base]/PractitionerRole?specialty={system|}[search_code]`Example:
> 
1. GET [base]/PractitionerRole?specialty=http://nucc.org/provider-taxonomy|208D0000X

**Implementation Notes**: Fetches a bundle containing US Core PractitionerRole Profile resources matching the specialty ( see [how to search by token](http://hl7.org/fhir/R4/search.html#token)).



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "us-core-practitionerrole",
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 5
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "cgp"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode" : "trial-use",
    "_valueCode" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical" : "http://hl7.org/fhir/us/core/ImplementationGuide/hl7.fhir.us.core"
      }]
    }
  }],
  "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole",
  "identifier" : [{
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.4.642.40.2.42.52"
  }],
  "version" : "9.0.0",
  "name" : "USCorePractitionerRoleProfile",
  "title" : "US Core PractitionerRole Profile",
  "status" : "active",
  "experimental" : false,
  "date" : "2022-04-20",
  "publisher" : "HL7 International / Cross-Group Projects",
  "contact" : [{
    "name" : "HL7 International / Cross-Group Projects",
    "telecom" : [{
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/cgp"
    },
    {
      "system" : "email",
      "value" : "cgp@lists.HL7.org"
    }]
  }],
  "description" : "The US Core PractitionerRole Profile inherits from the FHIR [PractitionerRole](https://hl7.org/fhir/R4/practitionerrole.html) resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the PractitionerRole Resource to record, search, and fetch the practitioner role information. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption. The requirements for the US Core Practitioner were drawn from the [Argonaut Provider Directory](http://www.fhir.org/guides/argonaut/pd//release1/index.html),  [IHE Healthcare Provider Directory](http://ihe.net/uploadedFiles/Documents/ITI/IHE_ITI_Suppl_HPD.pdf)  and the [ONC Provider Directory Workshop](https://confluence.oncprojectracking.org/display/PDW/Workshop+Documents).",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "US"
    }]
  }],
  "fhirVersion" : "4.0.1",
  "mapping" : [{
    "identity" : "v2",
    "uri" : "http://hl7.org/v2",
    "name" : "HL7 v2 Mapping"
  },
  {
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  },
  {
    "identity" : "servd",
    "uri" : "http://www.omg.org/spec/ServD/1.0/",
    "name" : "ServD"
  },
  {
    "identity" : "w5",
    "uri" : "http://hl7.org/fhir/fivews",
    "name" : "FiveWs Pattern Mapping"
  }],
  "kind" : "resource",
  "abstract" : false,
  "type" : "PractitionerRole",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
  "derivation" : "constraint",
  "differential" : {
    "element" : [{
      "id" : "PractitionerRole",
      "path" : "PractitionerRole",
      "constraint" : [{
        "key" : "pd-1",
        "severity" : "error",
        "human" : "SHALL have contact information or a reference to an Endpoint",
        "expression" : "telecom.exists() or endpoint.exists()",
        "xpath" : "exists(f:telecom) or exists(f:endpoint)"
      },
      {
        "key" : "us-core-13",
        "severity" : "error",
        "human" : "SHALL have a practitioner, an organization, a healthcare service, or a location.",
        "expression" : "practitioner.exists() or organization.exists() or healthcareService.exists() or location.exists()",
        "xpath" : "exists(f:practitioner) or exists(f:organization) or exists(f:healthcareService) or exists(f:location)"
      }],
      "mustSupport" : false
    },
    {
      "id" : "PractitionerRole.practitioner",
      "path" : "PractitionerRole.practitioner",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"]
      }],
      "condition" : ["us-core-13"],
      "mustSupport" : true
    },
    {
      "id" : "PractitionerRole.organization",
      "path" : "PractitionerRole.organization",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"]
      }],
      "condition" : ["us-core-13"],
      "mustSupport" : true
    },
    {
      "id" : "PractitionerRole.code",
      "path" : "PractitionerRole.code",
      "mustSupport" : true,
      "binding" : {
        "strength" : "extensible",
        "description" : "Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30"
      }
    },
    {
      "id" : "PractitionerRole.specialty",
      "path" : "PractitionerRole.specialty",
      "mustSupport" : true,
      "binding" : {
        "strength" : "extensible",
        "valueSet" : "http://hl7.org/fhir/us/core/ValueSet/us-core-practitionerrole-specialty"
      }
    },
    {
      "id" : "PractitionerRole.location",
      "path" : "PractitionerRole.location",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-location"]
      }],
      "condition" : ["us-core-13"],
      "mustSupport" : true
    },
    {
      "id" : "PractitionerRole.healthcareService",
      "path" : "PractitionerRole.healthcareService",
      "condition" : ["us-core-13"]
    },
    {
      "id" : "PractitionerRole.telecom",
      "path" : "PractitionerRole.telecom",
      "condition" : ["pd-1"],
      "mustSupport" : true
    },
    {
      "id" : "PractitionerRole.telecom.system",
      "path" : "PractitionerRole.telecom.system",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "code"
      }],
      "mustSupport" : true
    },
    {
      "id" : "PractitionerRole.telecom.value",
      "path" : "PractitionerRole.telecom.value",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "string"
      }],
      "mustSupport" : true
    },
    {
      "id" : "PractitionerRole.endpoint",
      "path" : "PractitionerRole.endpoint",
      "condition" : ["pd-1"],
      "mustSupport" : true
    }]
  }
}

```
