These requirements apply to the actor: US Core Certifying System Key Conformance Requirement CONF-0011 SHALL A Server that certifies to the 21st Century Cures Act for accessing patient data SHALL implement all components in the USCDI [USCDI link] CONF-0012 SHALL A Server that certifies to the 21st Century Cures Act for accessing patient data SHALL implement all components in the ... the US Core CapabilityStatement [Definition] . CONF-0124 SHALL Implementations meeting US EHR certification [of the ONC IT Health Certification program] requirements must support all US Core’s required scopes. CONF-0465 SHALL Although Patient.deceased[x] is marked as additional USCDI, certifying systems are not required to support both [boolean and dateTime data types], but SHALL support [at] least Patient.deceasedDateTime CONF-0469 SHALL Certifying systems [, those that are participating in the ONC Health IT certification program,] SHALL... follow the Project US@ Technical Specification for Patient Addresses Final Version 1.0 as the standard style guide for Patient.address.line and Patient.address.city for new and updated records. CONF-0801 SHALL If an element is marked as Additional USCDI and defined by a pattern [as described by ElementDefinition.pattern], then the pattern defines the elements and element values that the Certifying System SHALL be capable of providing. CONF-0802 SHALL Primitive elements are single elements with a primitive value…. If they are marked as Additional USCDI, then the Certifying System SHALL be capable of providing the element value to meet the Additional USCDI requirement. CONF-0803 SHALL For any complex element marked as Additional USCDI, the Certifying System SHALL be capable of providing at least one of the sub-element values. CONF-0805 SHALL [I]f any sub-element is marked as Additional USCDI [for a complex element] and the parent element is not… [and] the parent element is represented in the structure, Certifying System SHALL support the sub-elements labeled as Additional USCDI. CONF-0809 SHALL When a Reference type element is labeled as Additional USCDI and has a single target profile referenced, the target profile SHALL be supported for Certifying Systems. CONF-0811 SHALL When a Reference type element labeled as Additional USCDI, has multiple target profiles referenced, and specific targets are labeled as Must Support, the Must Support target profile(s) SHALL be supported by Certifying Systems. CONF-0812 SHALL [I]f a slice is labeled as ... Additional USCDI and the slicer element is not labeled as ... Additional USCDI, then if the ... certifying system supports the element, it must support the slice's definition. There are no examples of this structure in US Core. CONF-0814 SHALL [I]f a slice is labeled as … Additional USCDI and the slicer element is ... labeled as … Additional USCDI, then … certifying system [SHALL support] the element[ and] the slice's definition. CONF-0833 SHALL Certifying Systems SHALL support, a category of "sdoh" CONF-0834 SHOULD Certifying Systems ... SHOULD support the ... US Core Simple Observation Category codes CONF-0835 MAY Certifying Systems ... MAY support other categories CONF-0846 SHALL [For the US Core Observation Screening Assessment Profile,] Certifying Systems SHALL support, the US Core Screening Assessment Observation Category codes CONF-0847 SHOULD [For the US Core Observation Screening Assessment Profile,] Certifying Systems SHOULD support, the US Core Screening Assessment Observation Maximum Category codes CONF-0848 MAY [For the US Core Observation Screening Assessment Profile,] Certifying Systems MAY support other codes. CONF-0861 SHOULD [For US Core Simple Observation Profile, ]Certifying Systems ... SHOULD support the other US Core Simple Observation Category codes [in addition to the US Core Screening Assessment Observation Category codes] CONF-0862 SHALL [For US Core Simple Observation Profile, ]Certifying Systems SHALL support, the US Core Screening Assessment Observation Category codes CONF-0863 MAY [For US Core Simple Observation Profile, ]Certifying Systems ... MAY support other categories [in addition to US Core Screening Assessment Observation Category codes and US Core Simple Observation Category codes]. CONF-0873 SHALL If an element is marked as Additional USCDI and defined by a pattern [as described by ElementDefinition.pattern], then the pattern defines the elements and element values that the Certifying System SHALL be capable of providing. CONF-0874 SHALL If [an element is] ... marked as Additional USCDI, then the Certifying System SHALL be capable of providing the element value to meet the Additional USCDI requirement. CONF-0875 SHALL For any complex element marked as Additional USCDI, the Certifying System SHALL be capable of providing at least one of the sub-element values CONF-0876 SHALL [For any complex element marked as Additional USCDI]. If any sub-element is marked as Additional USCDI, [the Certifying System SHALL] ... meet the Additional USCDI requirements and satisfy the Additional USCDI requirements for the parent element. CONF-0878 SHALL When a Reference type element is labeled as Additional USCDI and has a single target profile referenced, the target profile SHALL be supported for Certifying Systems. CONF-0880 SHALL When a Reference type element labeled as Additional USCDI, has multiple target profiles referenced, and specific targets are labeled as Must Support, the Must Support target profile(s) SHALL be supported by Certifying Systems CONF-0883 SHALL When a Reference element is labeled as Additional USCDI has multiple target profiles referenced, but none are labeled as Must Support, at least one target profile SHALL be supported by Certifying Systems. CONF-0884 SHALL If an Additional USCDI element has a choice of datatypes for its content, the datatypes the Certifying System SHALL support are labeled as Must Support.
HL7 International / Cross-Group Projects
This [Requirements](https://hl7.org/fhir/R5/requirements.html) resource lists the *additional requirements* for systems certifying for ASTP Health IT Certification (g(10) certification. These requirements represent the regulatory and technical specifications that design artifacts must meet to ensure interoperability. See the [US Core Server Requirements](Requirements-us-core-server.html) for the US Core Responder (Server) requirements defined in the US Core Implementation Guide narrative sections.
Used by permission of HL7 International, all rights reserved Creative Commons License
A Server that certifies to the [21st Century Cures Act for accessing patient data](https://www.federalregister.gov/d/2020-07419/p-1177) **SHALL** implement all components in the USCDI [[USCDI link](https://www.healthit.gov/isp/united-states-core-data-interoperability-uscdi)]
A Server that certifies to the [21st Century Cures Act for accessing patient data](https://www.federalregister.gov/d/2020-07419/p-1177) **SHALL** implement all components in the ... the US Core CapabilityStatement [[Definition](https://hl7.org/fhir/us/core/CapabilityStatement-us-core-Server.html)] .
Implementations meeting US EHR certification [of the ONC IT Health Certification program] requirements must support all US Core’s required scopes.
Although Patient.deceased[x] is marked as additional USCDI, certifying systems are not required to support both [boolean and dateTime data types], but **SHALL** support [at] least Patient.deceasedDateTime
[Certifying systems](https://www.healthit.gov/topic/certification-ehrs/about-onc-health-it-certification-program) [, those that are participating in the ONC Health IT certification program,] **SHALL**... follow the [Project US@ Technical Specification for Patient Addresses Final Version 1.0](https://asapnet.org/wp-content/uploads/2022/03/Project_US_FINAL_Technical_Specification_Version_1.0.pdf) as the standard style guide for Patient.address.line and Patient.address.city for new and updated records.
If an element is marked as *Additional USCDI* and defined by a pattern [as described by [ElementDefinition.pattern](http://hl7.org/fhir/R4/elementdefinition-definitions.html#ElementDefinition.pattern_x_)], then the pattern defines the elements *and* element values that the Certifying System **SHALL** be capable of providing.
Primitive elements are single elements with a primitive value…. If they are marked as *Additional USCDI*, then the Certifying System **SHALL** be capable of providing the element value to meet the *Additional USCDI* requirement.
For any complex element marked as *Additional USCDI*, the Certifying System **SHALL** be capable of providing at least one of the sub-element values.
[I]f any sub-element is marked as *Additional USCDI* [for a complex element] and the parent element is not… [and] the parent element is represented in the structure, Certifying System **SHALL** support the sub-elements labeled as *Additional USCDI*.
When a Reference type element is labeled as Additional USCDI and has a single target profile referenced, the target profile **SHALL** be supported for Certifying Systems.
When a Reference type element labeled as Additional USCDI, has multiple target profiles referenced, and specific targets are labeled as Must Support, the Must Support target profile(s) **SHALL** be supported by Certifying Systems.
[I]f a slice is labeled as ... Additional USCDI and the slicer element is not labeled as ... Additional USCDI, then if the ... certifying system supports the element, it must support the slice's definition. There are no examples of this structure in US Core.
[I]f a slice is labeled as … Additional USCDI and the slicer element is ... labeled as … Additional USCDI, then … certifying system [**SHALL** support] the element[ and] the slice's definition.
Certifying Systems **SHALL** support, a category of "sdoh"
Certifying Systems ... **SHOULD** support the ... [US Core Simple Observation Category](https://hl7.org/fhir/us/core/STU8/ValueSet-us-core-simple-observation-category.html) codes
Certifying Systems ... **MAY** support other categories
[For the US Core Observation Screening Assessment Profile,] Certifying Systems **SHALL** support, the [US Core Screening Assessment Observation Category](https://hl7.org/fhir/us/core/STU8/ValueSet-us-core-screening-assessment-observation-category.html) codes
[For the US Core Observation Screening Assessment Profile,] Certifying Systems **SHOULD** support, the [US Core Screening Assessment Observation Maximum Category](https://hl7.org/fhir/us/core/STU8/ValueSet-us-core-screening-assessment-observation-maximum-category.html) codes
[For the US Core Observation Screening Assessment Profile,] Certifying Systems **MAY** support other codes.
[For [US Core Simple Observation Profile](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-simple-observation.html), ]Certifying Systems ... **SHOULD** support the other [US Core Simple Observation Category codes](https://hl7.org/fhir/us/core/STU8/ValueSet-us-core-simple-observation-category.html) [in addition to the [US Core Screening Assessment Observation Category codes](https://hl7.org/fhir/us/core/STU8/ValueSet-us-core-screening-assessment-observation-category.html)]
[For [US Core Simple Observation Profile](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-simple-observation.html), ]Certifying Systems **SHALL** support, the [US Core Screening Assessment Observation Category codes](https://hl7.org/fhir/us/core/STU8/ValueSet-us-core-screening-assessment-observation-category.html)
[For [US Core Simple Observation Profile](https://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-simple-observation.html), ]Certifying Systems ... **MAY** support other categories [in addition to [US Core Screening Assessment Observation Category codes](https://hl7.org/fhir/us/core/STU8/ValueSet-us-core-screening-assessment-observation-category.html) and [US Core Simple Observation Category codes](https://hl7.org/fhir/us/core/STU8/ValueSet-us-core-simple-observation-category.html)].
If [an element is] ... marked as *Additional USCDI*, then the Certifying System **SHALL** be capable of providing the element value to meet the *Additional USCDI* requirement.
For any complex element marked as *Additional USCDI*, the Certifying System **SHALL** be capable of providing at least one of the sub-element values
[For any complex element marked as *Additional USCDI*]. If any sub-element is marked as *Additional USCDI*, [the Certifying System **SHALL**] ... meet the *Additional USCDI* requirements and satisfy the *Additional USCDI* requirements for the parent element.
When a Reference type element is labeled as *Additional USCDI* and has a single target profile referenced, the target profile **SHALL** be supported for Certifying Systems.
When a Reference type element labeled as *Additional USCDI*, has multiple target profiles referenced, and specific targets are labeled as *Must Support*, the *Must Support* target profile(s) **SHALL** be supported by Certifying Systems
When a Reference element is labeled as *Additional USCDI* has multiple target profiles referenced, but none are labeled as *Must Support*, *at least one* target profile **SHALL** be supported by Certifying Systems.
If an *Additional USCDI* element has a choice of datatypes for its content, the datatypes the Certifying System **SHALL** support are labeled as *Must Support*.