Care Coordination Management
0.0.1 - ci-build Estonia (EST)

Care Coordination Management, published by Helex OÜ. This guide is not an authorized publication; it is the continuous build for version 0.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/helexlab/ig-ccm/ and changes regularly. See the Directory of published versions

Resource Profile: CareTeamCcm - Detailed Descriptions

Draft as of 2025-12-05

Definitions for the care-team-ccm resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. CareTeam
Definition

The Care Team includes all the people and organizations who plan to participate in the coordination and delivery of care.

ShortPlanned participants in the coordination and delivery of care
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. CareTeam.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. CareTeam.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

Control0..*
This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
TypeResource
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
6. CareTeam.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Must Supportfalse
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. CareTeam.identifier
Definition

Business identifiers assigned to this care team by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

ShortExternal Ids for this team
Comments

This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..0*
TypeIdentifier
Is Modifierfalse
Must Supportfalse
Summarytrue
Requirements

Allows identification of the care team as it is known by various participating systems and in a way that remains consistent across servers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. CareTeam.status
Definition

Indicates the current state of the care team.

Shortproposed | active | suspended | inactive | entered-in-error
Comments

This element is labeled as a modifier because the status contains the code entered-in-error that marks the care team as not currently valid.

Control10..1
BindingThe codes SHALL be taken from CareTeamStatushttp://hl7.org/fhir/ValueSet/care-team-status|5.0.0
(required to http://hl7.org/fhir/ValueSet/care-team-status|5.0.0)

Indicates the status of the care team.

Typecode
Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. CareTeam.category
Definition

Identifies what kind of team. This is to support differentiation between multiple co-existing teams, such as care plan team, episode of care team, longitudinal care team.

ShortType of team
Comments

There may be multiple axis of categorization and one team may serve multiple purposes.

Control0..0*
BindingFor example codes, see CareTeamCategoryhttp://hl7.org/fhir/ValueSet/care-team-category|5.0.0
(example to http://hl7.org/fhir/ValueSet/care-team-category|5.0.0)

Indicates the type of care team.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summarytrue
Requirements

Used for filtering what teams(s) are retrieved and displayed to different types of users.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. CareTeam.name
Definition

A label for human use intended to distinguish like teams. E.g. the "red" vs. "green" trauma teams.

ShortName of the team, such as crisis assessment team
Comments

The meaning/purpose of the team is conveyed in CareTeam.category. This element may also convey semantics of the team (e.g. "Red trauma team"), but its primary purpose is to distinguish between identical teams in a human-friendly way. ("Team 18735" isn't as friendly.).

Control0..01
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. CareTeam.subject
Definition

Identifies the patient or group whose intended care is handled by the team.

ShortWho care team is for
Comments

Use Group for care provision to all members of the group (e.g. group therapy). Use Patient for care provision to an individual patient.

Control10..1
TypeReference(PatientCcm, Patient, Group)
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

Allows the team to care for a group (e.g. marriage) therapy. Allows for an organization to designate a team such as the PICC line team.

Alternate Namespatient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. CareTeam.period
Definition

Indicates when the team did (or is intended to) come into effect and end.

ShortTime period team covers
Control0..1
TypePeriod
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

Allows tracking what team(s) are in effect at a particular time.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. CareTeam.period.start
Definition

The start of the period. The boundary is inclusive.

ShortStarting time with inclusive boundary
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Control10..1
This element is affected by the following invariants: per-1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. CareTeam.period.end
Definition

The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

ShortEnd time with inclusive boundary, if not ongoing
Comments

The end value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

Control0..1
This element is affected by the following invariants: per-1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. CareTeam.participant
Definition

Identifies all people and organizations who are expected to be involved in the care team.

ShortMembers of the team
Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner (onBehalfOf.exists() implies (member.resolve() is Practitioner))
ctm-2: CareTeam.participant.role or CareTeam.participant.member exists (role.exists() or member.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. CareTeam.participant.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
28. CareTeam.participant.role
Definition

Indicates specific responsibility of an individual within the care team, such as "Primary care physician", "Trained social worker counselor", "Caregiver", etc.

ShortType of involvement
Comments

Roles may sometimes be inferred by type of Practitioner. These are relationships that hold only within the context of the care team. General relationships should be handled as properties of the Patient resource directly. If a participant has multiple roles within the team, then there should be multiple participants.

Control0..1
This element is affected by the following invariants: ctm-2
BindingFor example codes, see ParticipantRoleshttp://hl7.org/fhir/ValueSet/participant-role|5.0.0
(example to http://hl7.org/fhir/ValueSet/participant-role|5.0.0)

Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. CareTeam.participant.member
Definition

The specific person or organization who is participating/expected to participate in the care team.

ShortWho is involved
Comments

Patient only needs to be listed if they have a role other than "subject of care".

Member is optional because some participants may be known only by their role, particularly in draft plans.

Control10..1
This element is affected by the following invariants: ctm-1, ctm-2
TypeReference(PractitionerCcm, Practitioner, PractitionerRole, RelatedPerson, Patient, Organization, CareTeam)
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. CareTeam.participant.onBehalfOf
Definition

The organization of the practitioner.

ShortOrganization of the practitioner
Control0..1
This element is affected by the following invariants: ctm-1
TypeReference(OrganizationCcm, Organization)
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

Practitioners can be associated with multiple organizations. This element indicates which organization they were acting on behalf of.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. CareTeam.participant.coverage[x]
Definition

When the member is generally available within this care team.

ShortWhen the member is generally available within this care team
Comments

This is populated while creating / managing the CareTeam to ensure there is coverage when servicing CarePlan activities from the Schedule.

Control10..1
TypePeriod, Timing
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

To manage members who share the same role, but with different timing. For example, two physical therapists where one is available Monday through Friday whereas the other is available on the weekend.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on CareTeam.participant.coverage[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
  • 36. CareTeam.participant.coverage[x]:coveragePeriod
    Slice NamecoveragePeriod
    Definition

    When the member is generally available within this care team.

    ShortWhen the member is generally available within this care team
    Comments

    This is populated while creating / managing the CareTeam to ensure there is coverage when servicing CarePlan activities from the Schedule.

    Control10..1
    TypePeriod, Timing
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Requirements

    To manage members who share the same role, but with different timing. For example, two physical therapists where one is available Monday through Friday whereas the other is available on the weekend.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    38. CareTeam.reason
    Definition

    Describes why the care team exists.

    ShortWhy the care team exists
    Control0..0*
    BindingFor example codes, see SNOMEDCTClinicalFindingshttp://hl7.org/fhir/ValueSet/clinical-findings|5.0.0
    (example to http://hl7.org/fhir/ValueSet/clinical-findings|5.0.0)

    Indicates the reason for the care team.

    TypeCodeableReference(Condition)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    40. CareTeam.managingOrganization
    Definition

    The organization responsible for the care team.

    ShortOrganization responsible for the care team
    Control0..0*
    TypeReference(Organization)
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Requirements

    Allows for multiple organizations to collaboratively manage cross-organizational, longitudinal care plan.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    42. CareTeam.telecom
    Definition

    A central contact detail for the care team (that applies to all members).

    ShortA contact detail for the care team (that applies to all members)
    Comments

    The ContactPoint.use code of home is not appropriate to use. These contacts are not the contact details of individual care team members.

    Control0..0*
    TypeContactPoint
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. CareTeam.note
    Definition

    Comments made about the CareTeam.

    ShortComments made about the CareTeam
    Control0..0*
    TypeAnnotation
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

    Guidance on how to interpret the contents of this table can be foundhere

    0. CareTeam
    2. CareTeam.identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..0
    4. CareTeam.status
    Control1..?
    Must Supporttrue
    6. CareTeam.category
    Control0..0
    8. CareTeam.name
    Control0..0
    10. CareTeam.subject
    Control1..?
    TypeReference(PatientCcm)
    Must Supporttrue
    12. CareTeam.period
    Must Supporttrue
    14. CareTeam.period.start
    Control1..?
    Must Supporttrue
    16. CareTeam.period.end
    Must Supporttrue
    18. CareTeam.participant
    Must Supporttrue
    20. CareTeam.participant.role
    Must Supporttrue
    22. CareTeam.participant.member
    Control1..?
    TypeReference(PractitionerCcm)
    Must Supporttrue
    24. CareTeam.participant.onBehalfOf
    TypeReference(OrganizationCcm)
    Must Supporttrue
    26. CareTeam.participant.coverage[x]
    Control1..?
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    SlicingThis element introduces a set of slices on CareTeam.participant.coverage[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 28. CareTeam.participant.coverage[x]:coveragePeriod
      Slice NamecoveragePeriod
      Control1..1
      TypePeriod
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Must Supporttrue
      30. CareTeam.reason
      Control0..0
      32. CareTeam.managingOrganization
      Control0..0
      34. CareTeam.telecom
      Control0..0
      36. CareTeam.note
      Control0..0

      Guidance on how to interpret the contents of this table can be foundhere

      0. CareTeam
      Definition

      The Care Team includes all the people and organizations who plan to participate in the coordination and delivery of care.

      ShortPlanned participants in the coordination and delivery of care
      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. CareTeam.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

      Control0..1
      Typeid
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      4. CareTeam.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. CareTeam.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. CareTeam.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

      Control0..1
      BindingThe codes SHALL be taken from AllLanguages
      (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

      IETF language tag for a human language

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. CareTeam.text
      Definition

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Comments

      Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      This element is affected by the following invariants: dom-6
      TypeNarrative
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. CareTeam.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

      ShortContained, inline Resources
      Comments

      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

      Control0..*
      This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
      TypeResource
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. CareTeam.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      16. CareTeam.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Must Supportfalse
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      18. CareTeam.identifier
      Definition

      Business identifiers assigned to this care team by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

      ShortExternal Ids for this team
      Comments

      This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..0
      TypeIdentifier
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Requirements

      Allows identification of the care team as it is known by various participating systems and in a way that remains consistent across servers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. CareTeam.status
      Definition

      Indicates the current state of the care team.

      Shortproposed | active | suspended | inactive | entered-in-error
      Comments

      This element is labeled as a modifier because the status contains the code entered-in-error that marks the care team as not currently valid.

      Control1..1
      BindingThe codes SHALL be taken from CareTeamStatus
      (required to http://hl7.org/fhir/ValueSet/care-team-status|5.0.0)

      Indicates the status of the care team.

      Typecode
      Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. CareTeam.category
      Definition

      Identifies what kind of team. This is to support differentiation between multiple co-existing teams, such as care plan team, episode of care team, longitudinal care team.

      ShortType of team
      Comments

      There may be multiple axis of categorization and one team may serve multiple purposes.

      Control0..0
      BindingFor example codes, see CareTeamCategory
      (example to http://hl7.org/fhir/ValueSet/care-team-category|5.0.0)

      Indicates the type of care team.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Requirements

      Used for filtering what teams(s) are retrieved and displayed to different types of users.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. CareTeam.name
      Definition

      A label for human use intended to distinguish like teams. E.g. the "red" vs. "green" trauma teams.

      ShortName of the team, such as crisis assessment team
      Comments

      The meaning/purpose of the team is conveyed in CareTeam.category. This element may also convey semantics of the team (e.g. "Red trauma team"), but its primary purpose is to distinguish between identical teams in a human-friendly way. ("Team 18735" isn't as friendly.).

      Control0..0
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. CareTeam.subject
      Definition

      Identifies the patient or group whose intended care is handled by the team.

      ShortWho care team is for
      Comments

      Use Group for care provision to all members of the group (e.g. group therapy). Use Patient for care provision to an individual patient.

      Control1..1
      TypeReference(PatientCcm)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Allows the team to care for a group (e.g. marriage) therapy. Allows for an organization to designate a team such as the PICC line team.

      Alternate Namespatient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. CareTeam.period
      Definition

      Indicates when the team did (or is intended to) come into effect and end.

      ShortTime period team covers
      Control0..1
      TypePeriod
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Allows tracking what team(s) are in effect at a particular time.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. CareTeam.period.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..1
      This element is affected by the following invariants: ele-1
      Typeid
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      32. CareTeam.period.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on CareTeam.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 34. CareTeam.period.start
        Definition

        The start of the period. The boundary is inclusive.

        ShortStarting time with inclusive boundary
        Comments

        If the low element is missing, the meaning is that the low boundary is not known.

        Control1..1
        This element is affected by the following invariants: per-1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. CareTeam.period.end
        Definition

        The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

        ShortEnd time with inclusive boundary, if not ongoing
        Comments

        The end value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

        Control0..1
        This element is affected by the following invariants: per-1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. CareTeam.participant
        Definition

        Identifies all people and organizations who are expected to be involved in the care team.

        ShortMembers of the team
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner (onBehalfOf.exists() implies (member.resolve() is Practitioner))
        ctm-2: CareTeam.participant.role or CareTeam.participant.member exists (role.exists() or member.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. CareTeam.participant.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        This element is affected by the following invariants: ele-1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        42. CareTeam.participant.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        44. CareTeam.participant.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        46. CareTeam.participant.role
        Definition

        Indicates specific responsibility of an individual within the care team, such as "Primary care physician", "Trained social worker counselor", "Caregiver", etc.

        ShortType of involvement
        Comments

        Roles may sometimes be inferred by type of Practitioner. These are relationships that hold only within the context of the care team. General relationships should be handled as properties of the Patient resource directly. If a participant has multiple roles within the team, then there should be multiple participants.

        Control0..1
        This element is affected by the following invariants: ctm-2
        BindingFor example codes, see ParticipantRoles
        (example to http://hl7.org/fhir/ValueSet/participant-role|5.0.0)

        Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. CareTeam.participant.member
        Definition

        The specific person or organization who is participating/expected to participate in the care team.

        ShortWho is involved
        Comments

        Patient only needs to be listed if they have a role other than "subject of care".

        Member is optional because some participants may be known only by their role, particularly in draft plans.

        Control1..1
        This element is affected by the following invariants: ctm-1, ctm-2
        TypeReference(PractitionerCcm)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. CareTeam.participant.onBehalfOf
        Definition

        The organization of the practitioner.

        ShortOrganization of the practitioner
        Control0..1
        This element is affected by the following invariants: ctm-1
        TypeReference(OrganizationCcm)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Practitioners can be associated with multiple organizations. This element indicates which organization they were acting on behalf of.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. CareTeam.participant.coverage[x]
        Definition

        When the member is generally available within this care team.

        ShortWhen the member is generally available within this care team
        Comments

        This is populated while creating / managing the CareTeam to ensure there is coverage when servicing CarePlan activities from the Schedule.

        Control1..1
        TypePeriod
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Requirements

        To manage members who share the same role, but with different timing. For example, two physical therapists where one is available Monday through Friday whereas the other is available on the weekend.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on CareTeam.participant.coverage[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
        • type @ $this
        • 54. CareTeam.participant.coverage[x]:coveragePeriod
          Slice NamecoveragePeriod
          Definition

          When the member is generally available within this care team.

          ShortWhen the member is generally available within this care team
          Comments

          This is populated while creating / managing the CareTeam to ensure there is coverage when servicing CarePlan activities from the Schedule.

          Control1..1
          TypePeriod
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          To manage members who share the same role, but with different timing. For example, two physical therapists where one is available Monday through Friday whereas the other is available on the weekend.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. CareTeam.reason
          Definition

          Describes why the care team exists.

          ShortWhy the care team exists
          Control0..0
          BindingFor example codes, see SNOMEDCTClinicalFindings
          (example to http://hl7.org/fhir/ValueSet/clinical-findings|5.0.0)

          Indicates the reason for the care team.

          TypeCodeableReference(Condition)
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          58. CareTeam.managingOrganization
          Definition

          The organization responsible for the care team.

          ShortOrganization responsible for the care team
          Control0..0
          TypeReference(Organization)
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Requirements

          Allows for multiple organizations to collaboratively manage cross-organizational, longitudinal care plan.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. CareTeam.telecom
          Definition

          A central contact detail for the care team (that applies to all members).

          ShortA contact detail for the care team (that applies to all members)
          Comments

          The ContactPoint.use code of home is not appropriate to use. These contacts are not the contact details of individual care team members.

          Control0..0
          TypeContactPoint
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          62. CareTeam.note
          Definition

          Comments made about the CareTeam.

          ShortComments made about the CareTeam
          Control0..0
          TypeAnnotation
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))