US Core Implementation Guide
9.0.0 - CI Build
US Core Implementation Guide
9.0.0 - CI Build
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 9.0.0 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
| Page standards status: Trial-use | Maturity Level: 3 |
{
"resourceType" : "Requirements",
"id" : "us-core-certifying-system",
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n\n<p>These requirements apply to the actor: <i><strong>US Core Certifying System</strong></i></p>\n\n<table class=\"grid\">\n <thead>\n <tr>\n <th>Key</th>\n <th>Conformance</th>\n <th>Requirement</th>\n </tr>\n </thead>\n <tbody>\n \n <tr>\n <td>CONF-0011</td>\n <td style=\"text-align: center;\">SHALL<br/>(conditional)</td>\n <td><div><p>A Server that certifies to the <a href=\"https://www.federalregister.gov/d/2020-07419/p-1177\">21st Century Cures Act for accessing patient data</a> <strong>SHALL</strong> implement all components in the USCDI [<a href=\"https://www.healthit.gov/isp/united-states-core-data-interoperability-uscdi\">USCDI link</a>]</p>\n</div></td>\n </tr>\n \n <tr>\n <td>CONF-0012</td>\n <td style=\"text-align: center;\">SHALL<br/>(conditional)</td>\n <td><div><p>A Server that certifies to the <a href=\"https://www.federalregister.gov/d/2020-07419/p-1177\">21st Century Cures Act for accessing patient data</a> <strong>SHALL</strong> implement all components in the ... the US Core CapabilityStatement [<a href=\"https://hl7.org/fhir/us/core/CapabilityStatement-us-core-Server.html\">Definition</a>] .</p>\n</div></td>\n </tr>\n \n <tr>\n <td>CONF-0873</td>\n <td style=\"text-align: center;\">SHALL</td>\n <td><div><p>If an element is marked as <em>Additional USCDI</em> and defined by a pattern [as described by <a href=\"http://hl7.org/fhir/R4/elementdefinition-definitions.html#ElementDefinition.pattern_x_\">ElementDefinition.pattern</a>], then the pattern defines the elements <em>and</em> element values that the Certifying System <strong>SHALL</strong> be capable of providing.</p>\n</div></td>\n </tr>\n \n <tr>\n <td>CONF-0874</td>\n <td style=\"text-align: center;\">SHALL</td>\n <td><div><p>If [an element is] ... marked as <em>Additional USCDI</em>, then the Certifying System <strong>SHALL</strong> be capable of providing the element value to meet the <em>Additional USCDI</em> requirement.</p>\n</div></td>\n </tr>\n \n <tr>\n <td>CONF-0875</td>\n <td style=\"text-align: center;\">SHALL</td>\n <td><div><p>For any complex element marked as <em>Additional USCDI</em>, the Certifying System <strong>SHALL</strong> be capable of providing at least one of the sub-element values</p>\n</div></td>\n </tr>\n \n <tr>\n <td>CONF-0876</td>\n <td style=\"text-align: center;\">SHALL</td>\n <td><div><p>[For any complex element marked as <em>Additional USCDI</em>]. If any sub-element is marked as <em>Additional USCDI</em>, [the Certifying System <strong>SHALL</strong>] ... meet the <em>Additional USCDI</em> requirements and satisfy the <em>Additional USCDI</em> requirements for the parent element.</p>\n</div></td>\n </tr>\n \n <tr>\n <td>CONF-0878</td>\n <td style=\"text-align: center;\">SHALL</td>\n <td><div><p>When a Reference type element is labeled as <em>Additional USCDI</em> and has a single target profile referenced, the target profile <strong>SHALL</strong> be supported for Certifying Systems.</p>\n</div></td>\n </tr>\n \n <tr>\n <td>CONF-0880</td>\n <td style=\"text-align: center;\">SHALL</td>\n <td><div><p>When a Reference type element labeled as <em>Additional USCDI</em>, has multiple target profiles referenced, and specific targets are labeled as <em>Must Support</em>, the <em>Must Support</em> target profile(s) <strong>SHALL</strong> be supported by Certifying Systems</p>\n</div></td>\n </tr>\n \n <tr>\n <td>CONF-0883</td>\n <td style=\"text-align: center;\">SHALL</td>\n <td><div><p>When a Reference element is labeled as <em>Additional USCDI</em> has multiple target profiles referenced, but none are labeled as <em>Must Support</em>, <em>at least one</em> target profile <strong>SHALL</strong> be supported by Certifying Systems.</p>\n</div></td>\n </tr>\n \n <tr>\n <td>CONF-0884</td>\n <td style=\"text-align: center;\">SHALL</td>\n <td><div><p>If an <em>Additional USCDI</em> element has a choice of datatypes for its content, the datatypes the Certifying System <strong>SHALL</strong> support are labeled as <em>Must Support</em>.</p>\n</div></td>\n </tr>\n \n </tbody>\n</table>\n</div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode" : "cgp"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger" : 3,
"_valueInteger" : {
"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/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/Requirements/us-core-certifying-system",
"identifier" : [
{
"system" : "urn:ietf:rfc:3986",
"value" : "urn:oid:2.16.840.1.113883.4.642.40.2.36.1"
}
],
"version" : "9.0.0",
"name" : "USCoreCertifyingSystemRequirements",
"title" : "US Core Certifying System Requirements",
"status" : "draft",
"date" : "2026-02-27T00:08:25+00:00",
"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" : "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.",
"jurisdiction" : [
{
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "US"
}
]
}
],
"copyright" : "Used by permission of HL7 International, all rights reserved Creative Commons License",
"_actor" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/display",
"valueString" : "US Core Certifying System"
}
]
}
],
"statement" : [
{
"key" : "CONF-0011",
"conformance" : [
"SHALL"
],
"conditionality" : true,
"requirement" : "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)]"
},
{
"key" : "CONF-0012",
"conformance" : [
"SHALL"
],
"conditionality" : true,
"requirement" : "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)] ."
},
{
"key" : "CONF-0873",
"conformance" : [
"SHALL"
],
"requirement" : "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."
},
{
"key" : "CONF-0874",
"conformance" : [
"SHALL"
],
"requirement" : "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."
},
{
"key" : "CONF-0875",
"conformance" : [
"SHALL"
],
"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"
},
{
"key" : "CONF-0876",
"conformance" : [
"SHALL"
],
"requirement" : "[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."
},
{
"key" : "CONF-0878",
"conformance" : [
"SHALL"
],
"requirement" : "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."
},
{
"key" : "CONF-0880",
"conformance" : [
"SHALL"
],
"requirement" : "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"
},
{
"key" : "CONF-0883",
"conformance" : [
"SHALL"
],
"requirement" : "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."
},
{
"key" : "CONF-0884",
"conformance" : [
"SHALL"
],
"requirement" : "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*."
}
]
}
IG © 2026+ HL7 International / Cross-Group Projects. Package hl7.fhir.us.core#9.0.0 based on FHIR 4.0.1. Generated 2026-02-27
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