ADI CapabilityStatement

PACIO Advance Healthcare Directive Interoperability Implementation Guide
2.0.0-ballot - STU 2 – Ballot United States of America flag

PACIO Advance Healthcare Directive Interoperability Implementation Guide, published by HL7 International / Patient Empowerment. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-pacio-adi/ and changes regularly. See the Directory of published versions

CapabilityStatement: ADI CapabilityStatement

Official URL: http://hl7.org/fhir/us/pacio-adi/CapabilityStatement/adi				Version: 2.0.0-ballot
Standards status: Trial-use			Maturity Level: 2	Computable Name: PacioAdiCapabilityStatement

This section describes the expected capabilities of the PACIO Advance Directive Interoperability (ADI) Server actor which is responsible for providing responses to the queries submitted by the ADI Requestors.

There are two primary vehicles in which Advance Directive Information can be conveyed: DocumentReference and Bundle. Through a DocumentReference, the ADI may be encoded inside directly as content data or referred to through a content reference (pointing to the ADI included in a resource like Binary) or reference a Bundle with the type=document for FHIR encoded data. The resources referred to by the Composition in the document bundle include Patient, Observation,Goal, ServiceRequest, Organization, RelatedPerson, Consent, List, and Provenance.

Raw OpenAPI-Swagger Definition file | Download

Implementation Guide Version: 2.0.0-ballot
FHIR Version: 4.0.1
Supported Formats: xml, json
Supported Patch Formats: application/json-patch+json
Published on: 2025-08-24
Published by: HL7 International / Patient Empowerment

Note to Implementers: FHIR Capabilities
Any FHIR capability may be 'allowed' by the system unless explicitly marked as 'SHALL NOT'. A few items are marked as MAY in the Implementation Guide to highlight their potential relevance to the use case.

SHALL Support the Following Implementation Guides

http://hl7.org/fhir/us/pacio-adi/ImplementationGuide-hl7.fhir.us.fhir-pacio-adi

FHIR RESTful Capabilities

Mode: `server`

The ADI Server SHALL:

Support all profiles defined in this Implementation Guide.
Implement the RESTful behavior according to the FHIR specification.
Return the following response classes:
- (Status 400): invalid parameter
- (Status 401/4xx): unauthorized request
- (Status 403): insufficient scope
- (Status 404): unknown resource
- (Status 410): deleted resource.
Support json source formats for all ADI interactions.
Support the searchParameters on each profile individually and in combination.

The ADI Server SHOULD:

Support xml source formats for all ADI interactions.

Security

See the Guidance section for requirements and recommendations.

A server SHALL reject any unauthorized requests by returning an HTTP 401 "Unauthorized", HTTP 403 "Forbidden", or HTTP 404 "Not Found" response code.

Capabilities by Resource/Profile

Summary

The summary table lists the resources that are part of this configuration, and for each resource it lists:

The relevant profiles (if any)
The interactions supported by each resource (Read, Search, Update, and Create, are always shown, while VRead, Patch, Delete, History on Instance, or History on Type are only present if at least one of the resources has support for them.
The required, recommended, and some optional search parameters (if any).
The linked resources enabled for _include
The other resources enabled for _revinclude
The operations on the resource (if any)

Resource Type	Profile	R	V-R	S	U	C	H-I	Searches
Bundle		Y	Y	Y	Y	Y	Y	_id, composition, identifier, timestamp, type
Composition	Supported Profiles ADI Composition Header ADI Person-Authored Composition ADI PMO Composition	y?	Y	y?	y?	y?	Y
Consent	Supported Profiles ADI Healthcare Agent Consent	y?	Y	y?	y?	y?	Y
DocumentReference	Supported Profiles ADI Document Reference	Y	Y	Y	Y	Y	Y	_id, authenticator, author, category, contenttype, custodian, date, description, encounter, event, facility, format, identifier, language, location, patient, period, related, relatesto, relation, relationship, security-label, setting, status, subject, type
Goal	Supported Profiles ADI Personal Goal	y?	Y	y?	y?	y?	Y
List	Supported Profiles ADI Personal Priorities Organizer	y?	Y	y?	y?	y?	Y
Observation	Supported Profiles ADI Documentation Observation ADI Person Authored Personal Intervention Preference ADI Organ Donation Observation ADI Autopsy Observation ADI Person-Authored Care Experience Preference	y?	y?	y?	y?	y?	Y
Organization		Y	Y	Y	Y	Y	Y
Patient	Supported Profiles US Core Patient Profile	Y	Y	Y	Y	Y	Y	_id, active, address, address-city, address-country, address-postalcode, address-state, address-use, birthdate, death-date, deceased, email, family, general-practitioner, given, identifier, language, link, name, organization, phone, phonetic, telecom, race, ethnicity
Provenance	Supported Profiles ADI Provenance	y?	Y	y?	y?	y?	Y
RelatedPerson	Supported Profiles ADI Healthcare Agent Participant	y?	Y	y?	y?	y?	Y

Resource Conformance: SHALLBundle

Core FHIR Resource
Bundle

Reference Policy
resolves

Interaction summary

SHALL support create, read, update.
SHOULD support search-type, vread, history-instance.

Search Parameters

Conformance	Parameter	Type
SHOULD	_id	`token`
SHOULD	composition	`reference`
SHOULD	identifier	`token`
SHOULD	timestamp	`date`
SHOULD	type	`token`

Resource Conformance: MAYComposition

Core FHIR Resource
Composition

Reference Policy
resolves

Interaction summary

SHOULD support vread, history-instance.
MAY support create, search-type, read, update.

Supported Profiles

ADI Composition Header
ADI Person-Authored Composition
ADI PMO Composition

Resource Conformance: SHOULDConsent

Core FHIR Resource
Consent

Reference Policy
resolves

Interaction summary

SHOULD support vread, history-instance.
MAY support create, search-type, read, update.

Supported Profiles

ADI Healthcare Agent Consent

Resource Conformance: SHALLDocumentReference

Core FHIR Resource
DocumentReference

Reference Policy
resolves

Interaction summary

SHALL support create, search-type, read, update.
SHOULD support vread, history-instance.

Supported Profiles

ADI Document Reference

Search Parameters

Conformance	Parameter	Type
SHALL	_id	`token`
SHALL	custodian	`reference`
SHALL	date	`date`
SHALL	identifier	`token`
SHALL	patient	`reference`
SHALL	period	`date`
SHALL	status	`token`
SHALL	type	`token`
SHOULD	category	`token`
SHOULD	contenttype	`token`
SHOULD	format	`token`
MAY	authenticator	`reference`
MAY	author	`reference`
MAY	description	`string`
MAY	encounter	`reference`
MAY	event	`token`
MAY	facility	`token`
MAY	language	`token`
MAY	location	`uri`
MAY	related	`reference`
MAY	relatesto	`reference`
MAY	relation	`token`
MAY	relationship	`reference`
MAY	security-label	`token`
MAY	setting	`token`
MAY	subject	`reference`

Resource Conformance: MAYGoal

Core FHIR Resource
Goal

Reference Policy
resolves

Interaction summary

SHOULD support vread, history-instance.
MAY support create, search-type, read, update.

Supported Profiles

ADI Personal Goal

Resource Conformance: MAYList

Core FHIR Resource
List

Reference Policy
resolves

Interaction summary

SHOULD support vread, history-instance.
MAY support create, search-type, read, update.

Supported Profiles

ADI Personal Priorities Organizer

Resource Conformance: MAYObservation

Core FHIR Resource
Observation

Reference Policy
resolves

Interaction summary

SHOULD support history-instance.
MAY support create, search-type, read, vread, update.

Supported Profiles

ADI Documentation Observation
ADI Person Authored Personal Intervention Preference
ADI Organ Donation Observation
ADI Autopsy Observation
ADI Person-Authored Care Experience Preference

Resource Conformance: SHALLOrganization

Core FHIR Resource
Organization

Reference Policy
resolves

Interaction summary

SHALL support create, search-type, read, update.
SHOULD support vread, history-instance.

Resource Conformance: MAYPatient

Core FHIR Resource
Patient

Reference Policy
resolves

Interaction summary

SHALL support create, search-type, read, update.
SHOULD support vread, history-instance.

Supported Profiles

US Core Patient Profile

Search Parameters

Conformance	Parameter	Type	Documentation
SHALL	_id	`token`	http://www.hl7.org/fhir/us/core/SearchParameter-us-core-patient-id.html
SHALL	birthdate	`date`	http://hl7.org/fhir/us/core/SearchParameter-us-core-patient-birthdate.html.html
SHALL	family	`string`	http://www.hl7.org/fhir/us/core/SearchParameter-us-core-patient-family.html
SHALL	given	`string`	http://www.hl7.org/fhir/us/core/SearchParameter-us-core-patient-given.html
SHALL	identifier	`token`	http://www.hl7.org/fhir/us/core/SearchParameter-us-core-patient-identifier.html
SHALL	name	`string`	http://www.hl7.org/fhir/us/core/SearchParameter-us-core-patient-name.html
SHOULD	active	`token`
SHOULD	email	`token`
SHOULD	phone	`token`
SHOULD	telecom	`token`
MAY	address	`string`
MAY	address-city	`string`
MAY	address-country	`string`
MAY	address-postalcode	`string`
MAY	address-state	`string`
MAY	address-use	`token`
MAY	death-date	`date`
MAY	deceased	`token`
MAY	general-practitioner	`reference`
MAY	language	`token`
MAY	link	`reference`
MAY	organization	`reference`
MAY	phonetic	`string`
MAY	race	`token`	http://www.hl7.org/fhir/us/core/SearchParameter-us-core-race.html
MAY	ethnicity	`token`	http://www.hl7.org/fhir/us/core/SearchParameter-us-core-ethnicity.html