US Quality Core Implementation Guide
1.0.0-ballot - STU 1 - ballot United States of America flag

US Quality Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-quality-core/ and changes regularly. See the Directory of published versions

Resource Profile: US Quality Core CareTeam

Official URL: http://hl7.org/fhir/us/quality-core/StructureDefinition/us-quality-core-careteam Version: 1.0.0-ballot
Standards status: Trial-use Maturity Level: 4 Computable Name: USQualityCoreCareTeam
Other Identifiers: OID:2.16.840.1.113883.4.642.40.78.42.4

Profile of CareTeam for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

USCDI+ Quality Element Support Expectations

Systems are expected to support this profile as part of implementing USCDI+ Quality V2 in FHIR and meeting the conformance requirements of this guide.

The following elements are specifically relevant to USCDI+ Quality V2 data classes and elements. Systems are expected to support these elements as applicable to their role in US Quality Core data exchange. See the Must Support section of this guide for more information. These elements are flagged as (USCDI+ Quality) in the formal profile views.

USCDI+ Quality Elements:

Profile element Description USCDI+ Quality Data Element(s)
participant Members of the team Care Team Members: Care Team Member Identifier
participant.member Who is involved Care Team Members: Care Team Member Identifier
participant.role Type of involvement Care Team Members: Care Team Member Role

Because this profile is derived directly or indirectly from US Core, systems are also expected to support the Must Support and Additional USCDI requirements specified by the US Core profile this profile inherits from. For more information about those requirements, refer to the US Core CareTeam Profile. The Formal Views section also provides the formal summary, definitions, terminology requirements, and mandatory element requirements.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CareTeam 0..* USCoreCareTeam(9.0.0) Planned participants in the coordination and delivery of care for a patient or group
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 0..1 code proposed | active | suspended | inactive | entered-in-error
Binding: CareTeamStatus (required): Indicates whether the team is current, represents future intentions or is now a historical record.
... participant SC 1..* BackboneElement (USCDI+ Quality) Members of the team
Constraints: ctm-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... role SΣ 1..1 CodeableConcept (USCDI+ Quality) Type of involvement
Binding: Care Team Member Function . (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
.... member SΣ 1..1 Reference(US Quality Core Patient | US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core CareTeam | US Quality Core RelatedPerson) (USCDI+ Quality) Who is involved

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CareTeam.status Base required CareTeamStatus 📦4.0.1 FHIR Std.
CareTeam.participant.​role Base extensible Care Team Member Function . ⏿20240605 tx.fhir.org

Constraints

Id Grade Path(s) Description Expression
ctm-1 error CareTeam.participant CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner onBehalfOf.exists() implies (member.resolve().iif(empty(), true, ofType(Practitioner).exists()))
dom-2 error CareTeam If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CareTeam If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error CareTeam If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error CareTeam If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CareTeam A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CareTeam 0..* USCoreCareTeam(9.0.0) Planned participants in the coordination and delivery of care for a patient or group
... subject 1..1 Reference(US Quality Core Patient) Who the care team is for.
... participant 1..* BackboneElement (USCDI+ Quality) Members of the team
.... role 1..1 CodeableConcept (USCDI+ Quality) Type of involvement
.... member 1..1 Reference(US Quality Core Patient | US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core CareTeam | US Quality Core RelatedPerson) (USCDI+ Quality) Who is involved

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CareTeam 0..* USCoreCareTeam(9.0.0) Planned participants in the coordination and delivery of care for a patient or group
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External Ids for this team
... status ?!SΣ 0..1 code proposed | active | suspended | inactive | entered-in-error
Binding: CareTeamStatus (required): Indicates whether the team is current, represents future intentions or is now a historical record.
... category Σ 0..* CodeableConcept Type of team
Binding: CareTeamCategory (example): Indicates the type of care team.
... name Σ 0..1 string Name of the team, such as crisis assessment team
... subject SΣ 1..1 Reference(US Quality Core Patient) Who the care team is for.
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... period Σ 0..1 Period Time period team covers
... participant SC 1..* BackboneElement (USCDI+ Quality) Members of the team
Constraints: ctm-1
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... role SΣ 1..1 CodeableConcept (USCDI+ Quality) Type of involvement
Binding: Care Team Member Function . (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
.... member SΣ 1..1 Reference(US Quality Core Patient | US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core CareTeam | US Quality Core RelatedPerson) (USCDI+ Quality) Who is involved
.... onBehalfOf Σ 0..1 Reference(Organization) Organization of the practitioner
.... period 0..1 Period Time period of participant
... reasonCode 0..* CodeableConcept Why the care team exists
Binding: SNOMEDCTClinicalFindings (example): Indicates the reason for the care team.
... reasonReference 0..* Reference(Condition) Why the care team exists
... managingOrganization Σ 0..* Reference(Organization) Organization responsible for the care team
... telecom 0..* ContactPoint A contact detail for the care team (that applies to all members)
... note 0..* Annotation Comments made about the CareTeam

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CareTeam.language Base preferred Common Languages 📍4.0.1 FHIR Std.
CareTeam.status Base required CareTeamStatus 📦4.0.1 FHIR Std.
CareTeam.category Base example Care Team category 📍4.0.1 FHIR Std.
CareTeam.participant.​role Base extensible Care Team Member Function . ⏿20240605 tx.fhir.org
CareTeam.reasonCode Base example SNOMED CT Clinical Findings 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
ctm-1 error CareTeam.participant CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner onBehalfOf.exists() implies (member.resolve().iif(empty(), true, ofType(Practitioner).exists()))
dom-2 error CareTeam If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CareTeam If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error CareTeam If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error CareTeam If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CareTeam A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CareTeam 0..* USCoreCareTeam(9.0.0) Planned participants in the coordination and delivery of care for a patient or group
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 0..1 code proposed | active | suspended | inactive | entered-in-error
Binding: CareTeamStatus (required): Indicates whether the team is current, represents future intentions or is now a historical record.
... participant SC 1..* BackboneElement (USCDI+ Quality) Members of the team
Constraints: ctm-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... role SΣ 1..1 CodeableConcept (USCDI+ Quality) Type of involvement
Binding: Care Team Member Function . (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
.... member SΣ 1..1 Reference(US Quality Core Patient | US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core CareTeam | US Quality Core RelatedPerson) (USCDI+ Quality) Who is involved

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CareTeam.status Base required CareTeamStatus 📦4.0.1 FHIR Std.
CareTeam.participant.​role Base extensible Care Team Member Function . ⏿20240605 tx.fhir.org

Constraints

Id Grade Path(s) Description Expression
ctm-1 error CareTeam.participant CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner onBehalfOf.exists() implies (member.resolve().iif(empty(), true, ofType(Practitioner).exists()))
dom-2 error CareTeam If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CareTeam If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error CareTeam If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error CareTeam If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CareTeam A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CareTeam 0..* USCoreCareTeam(9.0.0) Planned participants in the coordination and delivery of care for a patient or group
... subject 1..1 Reference(US Quality Core Patient) Who the care team is for.
... participant 1..* BackboneElement (USCDI+ Quality) Members of the team
.... role 1..1 CodeableConcept (USCDI+ Quality) Type of involvement
.... member 1..1 Reference(US Quality Core Patient | US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core CareTeam | US Quality Core RelatedPerson) (USCDI+ Quality) Who is involved

doco Documentation for this format

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CareTeam 0..* USCoreCareTeam(9.0.0) Planned participants in the coordination and delivery of care for a patient or group
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External Ids for this team
... status ?!SΣ 0..1 code proposed | active | suspended | inactive | entered-in-error
Binding: CareTeamStatus (required): Indicates whether the team is current, represents future intentions or is now a historical record.
... category Σ 0..* CodeableConcept Type of team
Binding: CareTeamCategory (example): Indicates the type of care team.
... name Σ 0..1 string Name of the team, such as crisis assessment team
... subject SΣ 1..1 Reference(US Quality Core Patient) Who the care team is for.
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... period Σ 0..1 Period Time period team covers
... participant SC 1..* BackboneElement (USCDI+ Quality) Members of the team
Constraints: ctm-1
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... role SΣ 1..1 CodeableConcept (USCDI+ Quality) Type of involvement
Binding: Care Team Member Function . (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
.... member SΣ 1..1 Reference(US Quality Core Patient | US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core CareTeam | US Quality Core RelatedPerson) (USCDI+ Quality) Who is involved
.... onBehalfOf Σ 0..1 Reference(Organization) Organization of the practitioner
.... period 0..1 Period Time period of participant
... reasonCode 0..* CodeableConcept Why the care team exists
Binding: SNOMEDCTClinicalFindings (example): Indicates the reason for the care team.
... reasonReference 0..* Reference(Condition) Why the care team exists
... managingOrganization Σ 0..* Reference(Organization) Organization responsible for the care team
... telecom 0..* ContactPoint A contact detail for the care team (that applies to all members)
... note 0..* Annotation Comments made about the CareTeam

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CareTeam.language Base preferred Common Languages 📍4.0.1 FHIR Std.
CareTeam.status Base required CareTeamStatus 📦4.0.1 FHIR Std.
CareTeam.category Base example Care Team category 📍4.0.1 FHIR Std.
CareTeam.participant.​role Base extensible Care Team Member Function . ⏿20240605 tx.fhir.org
CareTeam.reasonCode Base example SNOMED CT Clinical Findings 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
ctm-1 error CareTeam.participant CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner onBehalfOf.exists() implies (member.resolve().iif(empty(), true, ofType(Practitioner).exists()))
dom-2 error CareTeam If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CareTeam If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error CareTeam If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error CareTeam If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CareTeam A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Element Conformance Indicators by Profile Layer

Badges identify the profile layer where each conformance indicator is first introduced. Indicators introduced in an earlier layer remain applicable in later derived profiles.

Element conformance indicators organized by the profile layer where they are first introduced
Profile element FHIR US Core US Quality Core
status Must Support
subject Mandatory Must Support
participant Mandatory Must Support USCDI+ Quality
participant.role Mandatory Must Support USCDI+ Quality
participant.member Mandatory Must Support USCDI+ Quality

Cardinality note: “Mandatory” means the element has a minimum cardinality greater than zero. For nested elements, the cardinality indicator applies when the containing element is present.

Mandatory US Quality Core Server Search Parameters

The searches below are the focused set identified by US Quality Core as needed to retrieve USCDI+ Quality data for quality measurement and reporting. See the US Core FHIR RESTful Search API Requirements for detailed information on requirements by search parameter type.

Because this profile derives directly or indirectly from US Core, servers SHALL also support all mandatory searches described in the US Core Server CapabilityStatement requirements for CareTeam. When possible, this guide reuses mandatory searches from US Core and notes them with the EXISTING US CORE REQUIREMENT flag. While US Quality Core may restate US Core requirements to highlight searches directly relevant to USCDI+ Quality data access, US Core requirements not restated here remain applicable.

See the US Quality Core Server CapabilityStatement for complete requirements for the underlying CareTeam resource and Search Requirement Selection for how this focused set was selected.

Servers supporting this profile SHALL support the following search parameters and search parameter combinations:

  1. SHALL support searching for all CareTeam resources for a patient using the combination of the patient and status search parameters. EXISTING US CORE REQUIREMENT

    • Including optional support for OR search on status (e.g.status=[status],[status],...).

    GET [base]/CareTeam?patient={Patient/}[id]&status=[status]

    Example:

    GET [base]/CareTeam?patient=Patient/example&status=active

    Implementation Notes: Fetches a bundle of US Quality Core CareTeam resources matching the specified search criteria. See how to search by reference and how to search by token.

    Rationale for inclusion: Supports patient-scoped retrieval of CareTeam resources filtered by status for status-sensitive quality workflows.