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 CarePlan

Official URL: http://hl7.org/fhir/us/quality-core/StructureDefinition/us-quality-core-careplan Version: 1.0.0-ballot
Standards status: Trial-use Maturity Level: 4 Computable Name: USQualityCoreCarePlan
Other Identifiers: OID:2.16.840.1.113883.4.642.40.78.42.3

Defines constraints and extensions on the CarePlan resource for the minimal set of data to query and retrieve a patient's Care Plan.

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)
addresses Health issues this plan addresses Care Plans: Care Plan
category Type of plan Care Plans: Care Plan
contributor Who provided the content of the care plan Care Plans: Care Plan, Provenance: Author
intent proposal | plan | order | option Care Plans: Care Plan
status draft | active | on-hold | revoked | completed | entered-in-error | unknown Care Plans: Care Plan
subject Who the care plan is for. Care Plans: Care Plan
text Text summary of the resource, for human interpretation Care Plans: Assessment and Plan of Treatment

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 CarePlan 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
.. CarePlan 0..* USCoreCarePlanProfile(9.0.0) Healthcare plan for patient or group
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text S 0..1 Narrative (USCDI+ Quality) Text summary of the resource, for human interpretation
This profile constrains the narrative content by fixing the status codes to generated and additional
This profile does not constrain the narrative in regard to language specific sections
This profile does not constrain the narrative in regard to traceability to data elements
.... status S 1..1 code generated | additional
Binding: US Core Narrative Status (required): Constrained value set of narrative statuses.
.... div SC 1..1 xhtml Limited xhtml content
Constraints: txt-1, txt-2
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... intent ?!SΣ 1..1 code (USCDI+ Quality) proposal | plan | order | option
Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan
... category SΣ 0..1 CodeableConcept (USCDI+ Quality) Type of plan
Binding: CarePlanCategory (preferred)
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI+ Quality) Who the care plan is for.
... contributor 0..* Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile | US Core Device Profile) (USCDI+ Quality) Who provided the content of the care plan
... addresses Σ 0..* Reference(US Core Condition Problems and Health Concerns Profile) (USCDI+ Quality) Health issues this plan addresses

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CarePlan.text.status Base required US Core Narrative Status 📦9.0.0 US Core v9.0
CarePlan.status Base required RequestStatus 📦4.0.1 FHIR Std.
CarePlan.intent Base required Care Plan Intent 📦4.0.1 FHIR Std.
CarePlan.category Base preferred Care Plan Category 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error CarePlan If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CarePlan 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 CarePlan 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 CarePlan If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CarePlan 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()
txt-1 error CarePlan.text.div The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes htmlChecks()
txt-2 error CarePlan.text.div The narrative SHALL have some non-whitespace content htmlChecks()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CarePlan 0..* USCoreCarePlanProfile(9.0.0) Healthcare plan for patient or group
... text 0..1 Narrative (USCDI+ Quality) Text summary of the resource, for human interpretation
... status 1..1 code (USCDI+ Quality) draft | active | on-hold | revoked | completed | entered-in-error | unknown
... intent 1..1 code (USCDI+ Quality) proposal | plan | order | option
... subject 1..1 Reference(US Quality Core Patient) (USCDI+ Quality) Who the care plan is for.
... contributor 0..* Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile | US Core Device Profile) (USCDI+ Quality) Who provided the content of the care plan
... addresses 0..* Reference(US Core Condition Problems and Health Concerns Profile) (USCDI+ Quality) Health issues this plan addresses

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CarePlan 0..* USCoreCarePlanProfile(9.0.0) Healthcare plan for 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
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text S 0..1 Narrative (USCDI+ Quality) Text summary of the resource, for human interpretation
This profile constrains the narrative content by fixing the status codes to generated and additional
This profile does not constrain the narrative in regard to language specific sections
This profile does not constrain the narrative in regard to traceability to data elements
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... status S 1..1 code generated | additional
Binding: US Core Narrative Status (required): Constrained value set of narrative statuses.
.... div SC 1..1 xhtml Limited xhtml content
Constraints: txt-1, txt-2
... 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 plan
... instantiatesCanonical Σ 0..* canonical(PlanDefinition | Questionnaire | Measure | ActivityDefinition | OperationDefinition) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan) Fulfills CarePlan
... replaces Σ 0..* Reference(CarePlan) CarePlan replaced by this CarePlan
... partOf Σ 0..* Reference(CarePlan) Part of referenced CarePlan
... status ?!SΣ 1..1 code (USCDI+ Quality) draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
... intent ?!SΣ 1..1 code (USCDI+ Quality) proposal | plan | order | option
Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan
... category SΣ 0..1 CodeableConcept (USCDI+ Quality) Type of plan
Binding: CarePlanCategory (preferred)
... title Σ 0..1 string Human-friendly name for the care plan
... description Σ 0..1 string Summary of nature of plan
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI+ Quality) Who the care plan is for.
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... period Σ 0..1 Period Time period plan covers
... created Σ 0..1 dateTime Date record was first recorded
... author Σ 0..1 Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam) Who is the designated responsible party
... contributor 0..* Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile | US Core Device Profile) (USCDI+ Quality) Who provided the content of the care plan
... careTeam 0..* Reference(CareTeam) Who's involved in plan?
... addresses Σ 0..* Reference(US Core Condition Problems and Health Concerns Profile) (USCDI+ Quality) Health issues this plan addresses
... supportingInfo 0..* Reference(Resource) Information considered as part of plan
... goal 0..* Reference(Goal) Desired outcome of plan
... activity C 0..* BackboneElement Action to occur as part of plan
Constraints: cpl-3
.... 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
.... outcomeCodeableConcept 0..* CodeableConcept Results of the activity
Binding: CarePlanActivityOutcome (example): Identifies the results of the activity.
.... outcomeReference 0..* Reference(Resource) Appointment, Encounter, Procedure, etc.
.... progress 0..* Annotation Comments about the activity status/progress
.... reference C 0..1 Reference(Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription | RequestGroup) Activity details defined in specific resource
.... detail C 0..1 BackboneElement In-line definition of activity
..... 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
..... kind 0..1 code Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription
Binding: CarePlanActivityKind (required): Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity.
..... instantiatesCanonical 0..* canonical(PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition) Instantiates FHIR protocol or definition
..... instantiatesUri 0..* uri Instantiates external protocol or definition
..... code 0..1 CodeableConcept Detail type of activity
Binding: ProcedureCodes(SNOMEDCT) (example): Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.
..... reasonCode 0..* CodeableConcept Why activity should be done or why activity was prohibited
Binding: SNOMEDCTClinicalFindings (example): Identifies why a care plan activity is needed. Can include any health condition codes as well as such concepts as "general wellness", prophylaxis, surgical preparation, etc.
..... reasonReference 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Why activity is needed
..... goal 0..* Reference(Goal) Goals this activity relates to
..... status ?! 1..1 code not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error
Binding: CarePlanActivityStatus (required): Codes that reflect the current state of a care plan activity within its overall life cycle.
..... statusReason 0..1 CodeableConcept Reason for current status
..... doNotPerform ?! 0..1 boolean If true, activity is prohibiting action
..... scheduled[x] 0..1 When activity is to occur
...... scheduledTiming Timing
...... scheduledPeriod Period
...... scheduledString string
..... location 0..1 Reference(Location) Where it should happen
..... performer 0..* Reference(Practitioner | PractitionerRole | Organization | RelatedPerson | Patient | CareTeam | HealthcareService | Device) Who will be responsible?
..... product[x] 0..1 What is to be administered/supplied
Binding: SNOMEDCTMedicationCodes (example): A product supplied or administered as part of a care plan activity.
...... productCodeableConcept CodeableConcept
...... productReference Reference(Medication | Substance)
..... dailyAmount 0..1 SimpleQuantity(4.0.1) How to consume/day?
..... quantity 0..1 SimpleQuantity(4.0.1) How much to administer/supply/consume
..... description 0..1 string Extra info describing activity to perform
... note 0..* Annotation Comments about the plan

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CarePlan.language Base preferred Common Languages 📍4.0.1 FHIR Std.
CarePlan.text.status Base required US Core Narrative Status 📦9.0.0 US Core v9.0
CarePlan.status Base required RequestStatus 📦4.0.1 FHIR Std.
CarePlan.intent Base required Care Plan Intent 📦4.0.1 FHIR Std.
CarePlan.category Base preferred Care Plan Category 📦4.0.1 FHIR Std.
CarePlan.activity.outcomeCodeableConcept Base example Care Plan Activity Outcome 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​kind Base required Care Plan Activity Kind 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​code Base example Procedure Codes (SNOMED CT) 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​reasonCode Base example SNOMED CT Clinical Findings 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​status Base required CarePlanActivityStatus 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​product[x] Base example SNOMED CT Medication Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
cpl-3 error CarePlan.activity Provide a reference or detail, not both detail.empty() or reference.empty()
dom-2 error CarePlan If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CarePlan 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 CarePlan 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 CarePlan If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CarePlan 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()
txt-1 error CarePlan.text.div The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes htmlChecks()
txt-2 error CarePlan.text.div The narrative SHALL have some non-whitespace content htmlChecks()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CarePlan 0..* USCoreCarePlanProfile(9.0.0) Healthcare plan for patient or group
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text S 0..1 Narrative (USCDI+ Quality) Text summary of the resource, for human interpretation
This profile constrains the narrative content by fixing the status codes to generated and additional
This profile does not constrain the narrative in regard to language specific sections
This profile does not constrain the narrative in regard to traceability to data elements
.... status S 1..1 code generated | additional
Binding: US Core Narrative Status (required): Constrained value set of narrative statuses.
.... div SC 1..1 xhtml Limited xhtml content
Constraints: txt-1, txt-2
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... intent ?!SΣ 1..1 code (USCDI+ Quality) proposal | plan | order | option
Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan
... category SΣ 0..1 CodeableConcept (USCDI+ Quality) Type of plan
Binding: CarePlanCategory (preferred)
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI+ Quality) Who the care plan is for.
... contributor 0..* Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile | US Core Device Profile) (USCDI+ Quality) Who provided the content of the care plan
... addresses Σ 0..* Reference(US Core Condition Problems and Health Concerns Profile) (USCDI+ Quality) Health issues this plan addresses

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CarePlan.text.status Base required US Core Narrative Status 📦9.0.0 US Core v9.0
CarePlan.status Base required RequestStatus 📦4.0.1 FHIR Std.
CarePlan.intent Base required Care Plan Intent 📦4.0.1 FHIR Std.
CarePlan.category Base preferred Care Plan Category 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error CarePlan If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CarePlan 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 CarePlan 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 CarePlan If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CarePlan 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()
txt-1 error CarePlan.text.div The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes htmlChecks()
txt-2 error CarePlan.text.div The narrative SHALL have some non-whitespace content htmlChecks()

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CarePlan 0..* USCoreCarePlanProfile(9.0.0) Healthcare plan for patient or group
... text 0..1 Narrative (USCDI+ Quality) Text summary of the resource, for human interpretation
... status 1..1 code (USCDI+ Quality) draft | active | on-hold | revoked | completed | entered-in-error | unknown
... intent 1..1 code (USCDI+ Quality) proposal | plan | order | option
... subject 1..1 Reference(US Quality Core Patient) (USCDI+ Quality) Who the care plan is for.
... contributor 0..* Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile | US Core Device Profile) (USCDI+ Quality) Who provided the content of the care plan
... addresses 0..* Reference(US Core Condition Problems and Health Concerns Profile) (USCDI+ Quality) Health issues this plan addresses

doco Documentation for this format

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CarePlan 0..* USCoreCarePlanProfile(9.0.0) Healthcare plan for 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
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text S 0..1 Narrative (USCDI+ Quality) Text summary of the resource, for human interpretation
This profile constrains the narrative content by fixing the status codes to generated and additional
This profile does not constrain the narrative in regard to language specific sections
This profile does not constrain the narrative in regard to traceability to data elements
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... status S 1..1 code generated | additional
Binding: US Core Narrative Status (required): Constrained value set of narrative statuses.
.... div SC 1..1 xhtml Limited xhtml content
Constraints: txt-1, txt-2
... 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 plan
... instantiatesCanonical Σ 0..* canonical(PlanDefinition | Questionnaire | Measure | ActivityDefinition | OperationDefinition) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan) Fulfills CarePlan
... replaces Σ 0..* Reference(CarePlan) CarePlan replaced by this CarePlan
... partOf Σ 0..* Reference(CarePlan) Part of referenced CarePlan
... status ?!SΣ 1..1 code (USCDI+ Quality) draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
... intent ?!SΣ 1..1 code (USCDI+ Quality) proposal | plan | order | option
Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan
... category SΣ 0..1 CodeableConcept (USCDI+ Quality) Type of plan
Binding: CarePlanCategory (preferred)
... title Σ 0..1 string Human-friendly name for the care plan
... description Σ 0..1 string Summary of nature of plan
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI+ Quality) Who the care plan is for.
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... period Σ 0..1 Period Time period plan covers
... created Σ 0..1 dateTime Date record was first recorded
... author Σ 0..1 Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam) Who is the designated responsible party
... contributor 0..* Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile | US Core Device Profile) (USCDI+ Quality) Who provided the content of the care plan
... careTeam 0..* Reference(CareTeam) Who's involved in plan?
... addresses Σ 0..* Reference(US Core Condition Problems and Health Concerns Profile) (USCDI+ Quality) Health issues this plan addresses
... supportingInfo 0..* Reference(Resource) Information considered as part of plan
... goal 0..* Reference(Goal) Desired outcome of plan
... activity C 0..* BackboneElement Action to occur as part of plan
Constraints: cpl-3
.... 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
.... outcomeCodeableConcept 0..* CodeableConcept Results of the activity
Binding: CarePlanActivityOutcome (example): Identifies the results of the activity.
.... outcomeReference 0..* Reference(Resource) Appointment, Encounter, Procedure, etc.
.... progress 0..* Annotation Comments about the activity status/progress
.... reference C 0..1 Reference(Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription | RequestGroup) Activity details defined in specific resource
.... detail C 0..1 BackboneElement In-line definition of activity
..... 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
..... kind 0..1 code Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription
Binding: CarePlanActivityKind (required): Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity.
..... instantiatesCanonical 0..* canonical(PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition) Instantiates FHIR protocol or definition
..... instantiatesUri 0..* uri Instantiates external protocol or definition
..... code 0..1 CodeableConcept Detail type of activity
Binding: ProcedureCodes(SNOMEDCT) (example): Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.
..... reasonCode 0..* CodeableConcept Why activity should be done or why activity was prohibited
Binding: SNOMEDCTClinicalFindings (example): Identifies why a care plan activity is needed. Can include any health condition codes as well as such concepts as "general wellness", prophylaxis, surgical preparation, etc.
..... reasonReference 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Why activity is needed
..... goal 0..* Reference(Goal) Goals this activity relates to
..... status ?! 1..1 code not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error
Binding: CarePlanActivityStatus (required): Codes that reflect the current state of a care plan activity within its overall life cycle.
..... statusReason 0..1 CodeableConcept Reason for current status
..... doNotPerform ?! 0..1 boolean If true, activity is prohibiting action
..... scheduled[x] 0..1 When activity is to occur
...... scheduledTiming Timing
...... scheduledPeriod Period
...... scheduledString string
..... location 0..1 Reference(Location) Where it should happen
..... performer 0..* Reference(Practitioner | PractitionerRole | Organization | RelatedPerson | Patient | CareTeam | HealthcareService | Device) Who will be responsible?
..... product[x] 0..1 What is to be administered/supplied
Binding: SNOMEDCTMedicationCodes (example): A product supplied or administered as part of a care plan activity.
...... productCodeableConcept CodeableConcept
...... productReference Reference(Medication | Substance)
..... dailyAmount 0..1 SimpleQuantity(4.0.1) How to consume/day?
..... quantity 0..1 SimpleQuantity(4.0.1) How much to administer/supply/consume
..... description 0..1 string Extra info describing activity to perform
... note 0..* Annotation Comments about the plan

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CarePlan.language Base preferred Common Languages 📍4.0.1 FHIR Std.
CarePlan.text.status Base required US Core Narrative Status 📦9.0.0 US Core v9.0
CarePlan.status Base required RequestStatus 📦4.0.1 FHIR Std.
CarePlan.intent Base required Care Plan Intent 📦4.0.1 FHIR Std.
CarePlan.category Base preferred Care Plan Category 📦4.0.1 FHIR Std.
CarePlan.activity.outcomeCodeableConcept Base example Care Plan Activity Outcome 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​kind Base required Care Plan Activity Kind 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​code Base example Procedure Codes (SNOMED CT) 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​reasonCode Base example SNOMED CT Clinical Findings 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​status Base required CarePlanActivityStatus 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​product[x] Base example SNOMED CT Medication Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
cpl-3 error CarePlan.activity Provide a reference or detail, not both detail.empty() or reference.empty()
dom-2 error CarePlan If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CarePlan 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 CarePlan 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 CarePlan If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CarePlan 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()
txt-1 error CarePlan.text.div The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes htmlChecks()
txt-2 error CarePlan.text.div The narrative SHALL have some non-whitespace content htmlChecks()

 

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
text Must Support USCDI+ Quality
text.status Mandatory Must Support
text.div Mandatory Must Support
status Mandatory Must Support USCDI+ Quality
intent Mandatory Must Support USCDI+ Quality
category Must Support USCDI+ Quality
subject Mandatory Must Support USCDI+ Quality
contributor Additional USCDI USCDI+ Quality
addresses Additional USCDI USCDI+ Quality
activity.detail.status Mandatory

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 CarePlan. 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 CarePlan 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 CarePlan resources for a patient using the combination of the patient and category search parameters. EXISTING US CORE REQUIREMENT

    • Including optional support for OR search on category (e.g.category={system|}[search_code],{system|}[search_code],...).

    GET [base]/CarePlan?patient={Patient/}[id]&category={system|}[search_code]

    Example:

    GET [base]/CarePlan?patient=Patient/example&category=http://hl7.org/fhir/us/core/CodeSystem/careplan-category|assess-plan

    Implementation Notes: Fetches a bundle of US Quality Core CarePlan 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 CarePlan resources filtered by category for USCDI+ Quality workflows.