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/fhir-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

ADI CapabilityStatement

  • 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:

  1. Support all profiles defined in this Implementation Guide.
  2. Implement the RESTful behavior according to the FHIR specification.
  3. 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.
  4. Support json source formats for all ADI interactions.
  5. Support the searchParameters on each profile individually and in combination.

The ADI Server SHOULD:

  1. Support xml source formats for all ADI interactions.
Security
  1. See the Guidance section for requirements and recommendations.
  2. 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 TypeProfileRV-RSUCH-ISearches_include_revincludeOperations
Bundle YYYYYY_id, composition, identifier, timestamp, type
CompositionSupported Profiles
  http://hl7.org/fhir/us/pacio-adi/StructureDefinition-ADI-Composition-Header.html
  http://hl7.org/fhir/us/pacio-adi/StructureDefinition-ADI-PACPComposition.html
y?Yy?y?y?Y
ConsentSupported Profiles
  http://hl7.org/fhir/us/pacio-adi/StructureDefinition-ADI-HealthcareAgentAuthority.html
  http://hl7.org/fhir/us/pacio-adi/StructureDefinition-ADI-ConsentForHealthcareAgent.html
y?Yy?y?y?Y
DocumentReferenceSupported Profiles
  http://hl7.org/fhir/us/pacio-adi/StructureDefinition-ADI-DocumentReference.html
YYYYYY_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
GoalSupported Profiles
  http://hl7.org/fhir/us/pacio-adi/StructureDefinition-ADI-PersonalGoal.html
y?Yy?y?y?Y
ListSupported Profiles
  http://hl7.org/fhir/us/pacio-adi/StructureDefinition-ADI-PersonalPrioritiesOrganizer.html
y?Yy?y?y?Y
ObservationSupported Profiles
  http://hl7.org/fhir/us/fhir-pacio-adi/StructureDefinition-ADI-DocumentationObservation.html
  http://hl7.org/fhir/us/fhir-pacio-adi/StructureDefinition-ADI-PersonalInterventionPreference.html
  http://hl7.org/fhir/us/fhir-pacio-adi/StructureDefinition-ADI-OrganDonationObservation.html
  http://hl7.org/fhir/us/fhir-pacio-adi/StructureDefinition-ADI-AutopsyObservation.html
  http://hl7.org/fhir/us/fhir-pacio-adi/StructureDefinition-ADI-CareExperiencePreference.html
y?y?y?y?y?Y
Organization YYYYYY
PatientSupported Profiles
  http://www.hl7.org/fhir/us/core/StructureDefinition-us-core-patient.html
YYYYYY_id, active, address, address-city, address-country, address-postalcode, address-state, address-use, birthdate, death-date, deceased, email, family, gender, general-practitioner, given, identifier, language, link, name, organization, phone, phonetic, telecom, race, ethnicity
ProvenanceSupported Profiles
  http://hl7.org/fhir/us/pacio-adi/StructureDefinition-ADI-Provenance.html
y?Yy?y?y?Y
RelatedPersonSupported Profiles
  http://hl7.org/fhir/us/pacio-adi/StructureDefinition-ADI-HealthcareAgentParticipant.html
y?Yy?y?y?Y

Resource Conformance: SHALL Bundle

Core FHIR Resource
Bundle
Reference Policy
resolves
Interaction summary
  • SHALL support create, read, update.
  • SHOULD support search-type, vread, history-instance.

Search Parameters
ConformanceParameterTypeDocumentation
SHOULD_idtoken
SHOULDcompositionreference
SHOULDidentifiertoken
SHOULDtimestampdate
SHOULDtypetoken
 

Resource Conformance: MAY Composition

Core FHIR Resource
Composition
Reference Policy
resolves
Interaction summary
  • SHOULD support vread, history-instance.
  • MAY support create, search-type, read, update.

Supported Profiles

http://hl7.org/fhir/us/pacio-adi/StructureDefinition-ADI-Composition-Header.html
http://hl7.org/fhir/us/pacio-adi/StructureDefinition-ADI-PACPComposition.html

Resource Conformance: SHOULD Consent

Core FHIR Resource
Consent
Reference Policy
resolves
Interaction summary
  • SHOULD support vread, history-instance.
  • MAY support create, search-type, read, update.

Supported Profiles

http://hl7.org/fhir/us/pacio-adi/StructureDefinition-ADI-HealthcareAgentAuthority.html
http://hl7.org/fhir/us/pacio-adi/StructureDefinition-ADI-ConsentForHealthcareAgent.html

Resource Conformance: SHALL DocumentReference

Core FHIR Resource
DocumentReference
Reference Policy
resolves
Interaction summary
  • SHALL support create, search-type, read, update.
  • SHOULD support vread, history-instance.

Supported Profiles

http://hl7.org/fhir/us/pacio-adi/StructureDefinition-ADI-DocumentReference.html

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken
SHALLcustodianreference
SHALLdatedate
SHALLidentifiertoken
SHALLpatientreference
SHALLperioddate
SHALLstatustoken
SHALLtypetoken
SHOULDcategorytoken
SHOULDcontenttypetoken
SHOULDformattoken
MAYauthenticatorreference
MAYauthorreference
MAYdescriptionstring
MAYencounterreference
MAYeventtoken
MAYfacilitytoken
MAYlanguagetoken
MAYlocationuri
MAYrelatedreference
MAYrelatestoreference
MAYrelationtoken
MAYrelationshipreference
MAYsecurity-labeltoken
MAYsettingtoken
MAYsubjectreference
 

Resource Conformance: MAY Goal

Core FHIR Resource
Goal
Reference Policy
resolves
Interaction summary
  • SHOULD support vread, history-instance.
  • MAY support create, search-type, read, update.

Supported Profiles

http://hl7.org/fhir/us/pacio-adi/StructureDefinition-ADI-PersonalGoal.html

Resource Conformance: MAY List

Core FHIR Resource
List
Reference Policy
resolves
Interaction summary
  • SHOULD support vread, history-instance.
  • MAY support create, search-type, read, update.

Supported Profiles

http://hl7.org/fhir/us/pacio-adi/StructureDefinition-ADI-PersonalPrioritiesOrganizer.html

Resource Conformance: MAY Observation

Core FHIR Resource
Observation
Reference Policy
resolves
Interaction summary
  • SHOULD support history-instance.
  • MAY support create, search-type, read, vread, update.

Supported Profiles

http://hl7.org/fhir/us/fhir-pacio-adi/StructureDefinition-ADI-DocumentationObservation.html
http://hl7.org/fhir/us/fhir-pacio-adi/StructureDefinition-ADI-PersonalInterventionPreference.html
http://hl7.org/fhir/us/fhir-pacio-adi/StructureDefinition-ADI-OrganDonationObservation.html
http://hl7.org/fhir/us/fhir-pacio-adi/StructureDefinition-ADI-AutopsyObservation.html
http://hl7.org/fhir/us/fhir-pacio-adi/StructureDefinition-ADI-CareExperiencePreference.html

Resource Conformance: SHALL Organization

Core FHIR Resource
Organization
Reference Policy
resolves
Interaction summary
  • SHALL support create, search-type, read, update.
  • SHOULD support vread, history-instance.

Resource Conformance: MAY Patient

Core FHIR Resource
Patient
Reference Policy
resolves
Interaction summary
  • SHALL support create, search-type, read, update.
  • SHOULD support vread, history-instance.

Supported Profiles

http://www.hl7.org/fhir/us/core/StructureDefinition-us-core-patient.html

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

http://www.hl7.org/fhir/us/core/SearchParameter-us-core-patient-id.html

SHALLbirthdatedate

http://www.hl7.org/fhir/us/core/SearchParameter-us-core-patient-birthdate.html

SHALLfamilystring

http://www.hl7.org/fhir/us/core/SearchParameter-us-core-patient-family.html

SHALLgendertoken

http://www.hl7.org/fhir/us/core/SearchParameter-us-core-patient-given.html

SHALLgivenstring

http://www.hl7.org/fhir/us/core/SearchParameter-us-core-patient-given.html

SHALLidentifiertoken

http://www.hl7.org/fhir/us/core/SearchParameter-us-core-patient-identifier.html

SHALLnamestring

http://www.hl7.org/fhir/us/core/SearchParameter-us-core-patient-name.html

SHOULDactivetoken
SHOULDemailtoken
SHOULDphonetoken
SHOULDtelecomtoken
MAYaddressstring
MAYaddress-citystring
MAYaddress-countrystring
MAYaddress-postalcodestring
MAYaddress-statestring
MAYaddress-usetoken
MAYdeath-datedate
MAYdeceasedtoken
MAYgeneral-practitionerreference
MAYlanguagetoken
MAYlinkreference
MAYorganizationreference
MAYphoneticstring
MAYracetoken

http://www.hl7.org/fhir/us/core/SearchParameter-us-core-race.html

MAYethnicitytoken

http://www.hl7.org/fhir/us/core/SearchParameter-us-core-ethnicity.html

 

Resource Conformance: MAY Provenance

Core FHIR Resource
Provenance
Reference Policy
resolves
Interaction summary
  • SHOULD support vread, history-instance.
  • MAY support create, search-type, read, update.

Supported Profiles

http://hl7.org/fhir/us/pacio-adi/StructureDefinition-ADI-Provenance.html

Resource Conformance: MAY RelatedPerson

Core FHIR Resource
RelatedPerson
Reference Policy
resolves
Interaction summary
  • SHOULD support vread, history-instance.
  • MAY support create, search-type, read, update.

Supported Profiles

http://hl7.org/fhir/us/pacio-adi/StructureDefinition-ADI-HealthcareAgentParticipant.html