US Core Implementation Guide
8.0.1 - STU 8 US

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 8.0.1 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

## Extension: US Core Race Extension

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race | Version: 8.0.1
Standards status: Trial-use | Maturity Level: 3 | Computable Name: USCoreRaceExtension
Other Identifiers: OID:2.16.840.1.113883.4.642.40.2.42.55
Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the Race & Ethnicity - CDC (CDCREC) which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:

- American Indian or Alaska Native
- Asian
- Black or African American
- Native Hawaiian or Other Pacific Islander
- White.

Complies with 2015 Edition Common Clinical Data Set for patient race.

Context of Use

This extension may be used on the following element(s)

- Element ID: `Patient`
- Element ID: `RelatedPerson`
- Element ID: `Person`
- Element ID: `Practitioner`
- Element ID: `FamilyMemberHistory`

### Profile specific implementation guidance

- This Complex Extension for race allows one or more race codes of which:
  - Must Support at least one code from OMB Race Categories
  - May include additional race codes from CDC Race Codes
  - Must include a text description of race
- A `race` search parameter has been defined for this extension. However, there are no race search requirements for the Client or Server.

Usage info

Usages:

- Use this Extension: US Core Patient Profile
- Examples for this Extension: Patient/child-example, Patient/deceased-example, Patient/example and Patient/infant-example

You can also check for usages in the FHIR IG Statistics

Changes since version 7.0.0:

- The resource metadata has changed (description)
- The data elements list has changed
- One or more text definitions, invariants or bindings have changed

### Formal Views of Extension Content

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

- Differential Table
- Snapshot Table
- Statistics/References
- All

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension | C | 0..1 | Extension | US Core Race Extension Constraints: us-core-23
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ombCategory | S | 0..6 | Extension | American Indian or Alaska Native|Asian|Black or African American|Native Hawaiian or Other Pacific Islander|White
url |  | 1..1 | uri | "ombCategory"
value[x] |  | 1..1 | Coding | Value of extension Binding: Race Categories (required): The 5 race category codes according to the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997.
extension:detailed |  | 0..* | Extension | Extended race codes
url |  | 1..1 | uri | "detailed"
value[x] |  | 1..1 | Coding | Value of extension Binding: Detailed race including absence reasons. (required)
extension:text | S | 1..1 | Extension | Race Text
url |  | 1..1 | uri | "text"
value[x] |  | 1..1 | string | Value of extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension | C | 0..1 | Extension | US Core Race Extension Constraints: us-core-23
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ombCategory | S | 0..6 | Extension | American Indian or Alaska Native|Asian|Black or African American|Native Hawaiian or Other Pacific Islander|White
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "ombCategory"
value[x] |  | 1..1 | Coding | Value of extension Binding: Race Categories (required): The 5 race category codes according to the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997.
extension:detailed |  | 0..* | Extension | Extended race codes
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "detailed"
value[x] |  | 1..1 | Coding | Value of extension Binding: Detailed race including absence reasons. (required)
extension:text | S | 1..1 | Extension | Race Text
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "text"
value[x] |  | 1..1 | string | Value of extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the Race & Ethnicity - CDC (CDCREC) which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:

- American Indian or Alaska Native
- Asian
- Black or African American
- Native Hawaiian or Other Pacific Islander
- White.

- ombCategory: Coding: The 5 race category codes according to the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997.
- detailed: Coding: The 900+ CDC race codes that are grouped under one of the 5 OMB race category codes:.
- text: string: Plain text representation of the race concept(s).

Maturity: 3

Differential View

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension | C | 0..1 | Extension | US Core Race Extension Constraints: us-core-23
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ombCategory | S | 0..6 | Extension | American Indian or Alaska Native|Asian|Black or African American|Native Hawaiian or Other Pacific Islander|White
url |  | 1..1 | uri | "ombCategory"
value[x] |  | 1..1 | Coding | Value of extension Binding: Race Categories (required): The 5 race category codes according to the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997.
extension:detailed |  | 0..* | Extension | Extended race codes
url |  | 1..1 | uri | "detailed"
value[x] |  | 1..1 | Coding | Value of extension Binding: Detailed race including absence reasons. (required)
extension:text | S | 1..1 | Extension | Race Text
url |  | 1..1 | uri | "text"
value[x] |  | 1..1 | string | Value of extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension | C | 0..1 | Extension | US Core Race Extension Constraints: us-core-23
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ombCategory | S | 0..6 | Extension | American Indian or Alaska Native|Asian|Black or African American|Native Hawaiian or Other Pacific Islander|White
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "ombCategory"
value[x] |  | 1..1 | Coding | Value of extension Binding: Race Categories (required): The 5 race category codes according to the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997.
extension:detailed |  | 0..* | Extension | Extended race codes
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "detailed"
value[x] |  | 1..1 | Coding | Value of extension Binding: Detailed race including absence reasons. (required)
extension:text | S | 1..1 | Extension | Race Text
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "text"
value[x] |  | 1..1 | string | Value of extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the Race & Ethnicity - CDC (CDCREC) which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:

- American Indian or Alaska Native
- Asian
- Black or African American
- Native Hawaiian or Other Pacific Islander
- White.

- ombCategory: Coding: The 5 race category codes according to the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997.
- detailed: Coding: The 900+ CDC race codes that are grouped under one of the 5 OMB race category codes:.
- text: string: Plain text representation of the race concept(s).

Maturity: 3

Other representations of profile: CSV, Excel, Schematron

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Extension.extension:ombCategory.​value[x] | Base | required | Race Categories | 📦20250419 | VSAC v0.24
Extension.extension:detailed.​value[x] | Base | required | Detailed race including absence reasons. | 📦20250419 | VSAC v0.24

#### Constraints

Id | Grade | Path(s) | Description | Expression
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
us-core-23 | error | Extension | If "ASKU" or "UNK" are present, then no other OMB race categories can be present. | `extension.where(url = 'ombCategory').value.where(code in 'ASKU'|'UNK').exists() implies extension.where(url = 'ombCategory').count() = 1`