Bundle Resource profile for exchanging public health messages, knowledge artifacts or content.

Bundle Resource profile for exchanging one of public health messages, knowledge artifacts or content.

This Composition profile represents a public health composition.

This is the Endpoint Resource profile for the IG used to specify receivers addresses

Defines the library containing the US Public Health supplemental value sets.

Defines the library containing the US Public Health triggering value sets.

Defines an executable value set as one that SHALL have an expansion included, as well as a usage warning indicating the expansion is a point-in-time snapshot and must be maintained over time for production usage.

Defines a computable value set as one that SHALL have an expression-based definition (i.e. a value set defined intensionally using expressions of the code systems involved) and MAY have an expansion included. The expression-based definition SHALL be represented in only one of three ways; using the compose element, using the expression extension, or using the rules-text extension to provide a step-by-step process for expanding the value set definition

This profile describes the US Public Health Triggering value set.

This profile describes the US Public Health Supplemental value set.

This profile describes US Public Health value sets.

This profile sets the minimum expectations for an executable CQL library. Specifically, the profile requires that the library contain one of ELM XML or JSON content, the compiled representation of the CQL logic.

The computable library profile sets the minimum expectations for a computable CQL library.

Defines the library containing US Public Health value sets.

This Bundle profile represents a US Public Health Specification Bundle.

This Bundle profile represents a US Public Health Supplemental Bundle.

This profile describes the US Public Health CodeSystem.

A reference to a CodeSystem or ValueSet that establishes the allowable values for a code system property

This is the MessageHeader Resource profile for the IG.

This Bundle profile represents a Public Health Document Bundle. It contains a US Public Health Composition.

This Patient profile represents a US Public Health Patient.

It is based on the US Core Patient profile with further restrictions to allow masking of some data elements and the addition of the patient-genderIdentity extension.

For ONC’s USCDI requirements, it adds Must Support constraints to the following:

• contact detail (e.g. a telephone number or an email address)
• a communication language
• a race
• an ethnicity
• a birth sex

Group Resource profile for specifying survey participant groups, research groups.

This Organization profile represents an organization involved in public health. It is based on the US Core Organization profile and establishes the core elements, extensions, vocabularies and value sets for representing organizations for public health.

This Location profile represents the location/facility in which care was provided.

This PractitionerRole profile represents the roles and organizations of the practitioner.

It is based on the US Core PractitionerRole profile with a further restriction of a mandatory identifier data element.

This profile represents information that is required during a public health emergency/outbreak. This information can be highly variable, so a generic structure has been chosen to represent it.

This information will be recorded using a question/answer pattern with questions specific to the public health emergency/outbreak.

This Condition profile represents the signs, symptoms, and diagnoses related to a public health event.

It is based on the US Core Condition profile with further restriction of a Must Support constraint on the onset[x] and verificationStatus data elements.

In the case of a condition being mistakenly entered into the system and later corrected:

• verificationStatus of ‘entered-in-error’ must be set

This Observation profile represents characteristics of the patient’s home environment.

Such characteristics include, but are not limited to, type of residence (trailer, single family home, assisted living), living arrangement (e.g., alone, with parents), and housing status (e.g., evicted, homeless, home owner). Congregate living situations would be represented in this profile - such shared housing includes a broad range of settings, such as apartments, condominiums, student or faculty housing, national and state park staff housing, transitional housing, and domestic violence and abuse shelters.

This profile represents the Disability Element defined here: https://aspe.hhs.gov/basic-report/hhs-implementation-guidance-data-collection-standards-race-ethnicity-sex-primary-language-and-disability-status.

The six item set of questions used on ACS and other major surveys to gauge disability is the data standard for survey questions on disability. Note the age thresholds for survey participants for the different disability questions.

Data Standard for Disability Status

1. Are you deaf or do you have serious difficulty hearing?
2. Are you blind or do you have serious difficulty seeing, even when wearing glasses?
3. Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions? (5 years old or older)
4. Do you have serious difficulty walking or climbing stairs? (5 years old or older)
5. Do you have difficulty dressing or bathing? (5 years old or older)
6. Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor’s office or shopping? (15 years old or older)

This profile represents the postpartum status of a patient.

If the profile is present, the patient is in the postpartum period and further information about the postpartum status is communicated by the code chosen.

The postpartum period, also known as the puerperium, refers to the time after delivery when maternal physiological changes related to pregnancy return to the nonpregnant state. There is consensus that the postpartum period begins upon delivery of the infant. The end is less well defined but is often considered the six to eight weeks after delivery because the effects of pregnancy on many systems have largely returned to the pre-pregnancy state.

This profile represents a result of the pregnancy such as live birth, still birth, miscarriage, etc.

The subject of this profile is the mother. The focus of this profile is the related Pregnancy Status Observation.

The order born in the delivery, live born or fetal death (1st, 2nd, 3rd, 4th, 5th, 6th, 7th, etc.) is contained in Observation.component. All live births and fetal losses are included. If the pregnancy plurality is 1 then this value will also be 1.

There will be one Pregnancy Outcome Observation for each fetus delivered live or dead at any time in the pregnancy, regardless of gestational age or if the fetuses were delivered at different dates in the pregnancy. All live births and fetal losses are included. The order born in the delivery, live born or fetal death is contained in Observation.component.

This profile represents current and/or prior pregnancy statuses and their date ranges, enabling investigators to determine if a patient was pregnant, possibly pregnant, not pregnant or whether the pregnancy status was unknown during a particular date range.

The subject of this profile is the mother.

This profile includes the determination method, determination date, and recorded date of the pregnancy status.

Use the effectivePeriod to indicate the date range over which the patient was pregnant/possibly pregnant/not pregnant/unknown. To record the date that the pregnancy status was recorded, use the date-recorded-extension and to record the date on which the pregnancy status determination was made, use the date-determined-extension. If the effectivePeriod.end is not present it is assumed that the date range over which the pregnancy status is asserted is from effectivePeriod.start to the date in the date-recorded-extension. For example, if the effectivePeriod.start has been recorded as two months prior to the date contained in the date-recorded-extension, and there is no effectivePeriod.end recorded, no assumptions can be made about the pregnancy status after the date contained in the date-recorded-extension.

This Observation profile represents potential patient exposure and contact information.

The type of exposure/contact is contained in Observation.code (environmental, activity, event, location, person, animal, etc.). If the exposure/contact is an entity (person, animal, location) then it is represented in Observation.focus which is a reference to a Patient, RelatedPerson, Location, Group, etc.. (An animal would be represented by a RelatedPerson that contains the Extension Practitioner Animal Species. Free text information about the exposure/contact can be recorded in Observation.valueString and the date or period of exposure is held in Observation.effective[x]. If an address where the exposure/contact took place is known then it can be contained in the address-extension.

The following are some exposures that might be captured in this profile:

• Environmental exposures
  • Living facilities
  • Work facilities
  • School facilities
• Contact exposures
  • Person
  • Animal
• Event Exposures
  • Sporting event
  • Rally
  • Wedding
  • Activity

This Observation profile represents transportation details such as the type of transport (plane, train, ship, etc.) along with any associated information (e.g. name of cruise ship, flight number, airport, seat number, cabin number, etc.).

This profile describes the US Public Health PlanDefinition.

This Observation profile represents a patient’s travel history.

The following data for a patient can be recorded:

• travel history as a string, an address, or a coded location
• the date or period of time spent in the location (Observation.effectiveTime)
  • it is important to accurately capture the most accurate dates possible
  • the focus should be on date of arrival and date of departure
  • the concepts of dates as related to travel are especially useful for determining need for Federal Public Health Notifications (FPHNs) and these dates are used to alert foreign ministries of health about their residents who may have been contacts of cases, or if a flight that was outbound from the USA had an infectious traveler on it
• most uses will involve a single location (Observation.component), however, it is possible to specify multiple locations (but there is only a single effectiveTime)
  • this allows for cases where a patient cannot remember exact dates of travel (e.g. I traveled to London, Paris, and Berlin in July and August 2016)
• free text describing the travel history details and location (Observation.component.valueCodeableConcept.text element)
• use Observation.component.codeableConcept to record a coded location
• use Observationcomponent.extension to record a specific address
• where a more granular address than state is known (e.g. city, street) it is appropriate to use the extension to record an address rather than using the coded location

This profile constrains the base MedicationAdministration resource. The constraints are based on the requirements laid out in USCDI Level 2 for Medication Administration.

This Extension profile represents an affiliated tribe name and whether or not the patient is an enrolled member

The date a status or observation was determined (date of determination).

The date a status or observation was recorded (recorded date).

This Extension profile represents a rule that led to the determination of reportability.

This Extension profile represents where the patient traveled to or visited as an address e.g.: country, state, city, street address (if applicable).

At the least, address must contain the country. State is required if the country is US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies.

Supports communicating the FHIR query for a given data requirement. The query is server-specific, and will need to be created as informed by a CapabilityStatement. The $data-requirements operation should be extended to be able to provide an Endpoint or CapabilityStatement to provide this information. If no endpoint or capability statement is provided, the capability statement of the server performing the operation is used. This is not a resolveable URL, and that it will contain 1) No base canonical (so it’s a relative query), and 2) Parameters using tokens that are denoted using double-braces and the context parameters are dependent solely on the subjectType, according to the following: Patient: context.patientId, Practitioner: context.practitionerId, Organization: context.organizationId, Location: context.locationId, Device: context.deviceId

This Extension profile represents the determination of reportability.

Reportability is “the quality or state of being reportable or not”. Reportability does not equate to the patient having a condition or meeting a case definition (definitively being a case).

For each condition included in the report and the relevant public health agency(s), this element indicates the determination of whether the condition is reportable to public health.

The values that can be used for the Determination of Reportability are described below.

A possible condition is:

• Reportable - The information provided meets reporting criteria for an associated PHA.

A possible condition:

• May be Reportable - The information provided may meet reporting criteria if additional information is provided. The Reportability Response will also be able to share the information needed to definitively determine reportability.

A possible condition is:

• Not Reportable - The information provided conclusively does not meet reporting criteria.

Some decision support systems may not be able to fully differentiate between possible conditions that are Not Reportable and those that May be Reportable if additional information is provided. In these circumstances there may only be a reportability determination of:

• No Reporting Rule Met - The information provided does not meet reporting criteria or may meet reporting criteria if additional information is provided.

The determination of No Reporting Rule Met may be provided for a possible condition or for all conditions in the report.

This Extension profile represents the reason for the determination of reportability.

This extension represents an US Public Health Alternative Expression

Indicates the types of named events to subscribe to from the EHR.

An extra warning about the correct use of the value set.

This extension contains an explanation for the manual or alternate initiation of the public health report.

If there are multiple distinct reasons for manual or alternate initiation then each reason should be contained in a separate US Public Health Initiation Reason Extension.

The reason may be entered either as:

• free text (string)
• coded value (valueCodeableConcept) (not necessarily initiated by a provider of care but might be “programmed-in” by the EHR implementer for some purpose)

Indicates whether the data in the content bundle is encrypted or not.

Indicates how systems have to deal with messages in terms of duplicates, lack of responses.

Supports the definition of expansion parameters for the ValueSet.

This extension represents a US Public Health Information Recipient

Indicates the endpoint address where the report has to be sent.

This Encounter profile represents the encounter related to the event. It is based on the US Core Encounter.

Defines the asset-collection library containing the US Public Health supplemental assets.

Defines the asset-collection library containing the US Public Health specification assets.

The US Public Health TriggerDefinition NamedEvent Value Set is a ‘starter set’ of codes for identifying named events uniquely in TriggerDefinition instances contained within a PlanDefinition.

This value set contains codes representing pregnancy statuses.

The impact of the content of a message.

The US Public Health Message Types Value Set is a ‘starter set’ of codes for uniquely identifying messages in MessageHeader instances contained within a reporting bundle.

The US Public Health PlanDefinition Action Value Set is a ‘starter set’ of codes for uniquely identifying actions in PlanDefinition instances.

This code system contains codes that identify the use context type of a valueset.

This code system contains codes that identify the use context of a valueset.

The US Public Health TriggerDefinition NamedEvents CodeSystem is a ‘starter set’ of codes supported for identifying named events to subscribe to in clinical workflows.

The US Public Health Message Types CodeSystem is a ‘starter set’ of codes supported for identifying types of messages being exchanged.

The US Public Health PlanDefinition Actions CodeSystem is a ‘starter set’ of codes supported for identifying actions in PlanDefinition.