SGHI FHIR Profile Implementation Guide
0.1.0 - ci-build

SGHI FHIR Profile Implementation Guide, published by Kathurima Kimathi. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/savannahghi/sil_fhir_profile_ig/ and changes regularly. See the Directory of published versions

## Resource Profile: SGHICarePlan - Detailed Descriptions

Draft as of 2026-04-27

Definitions for the careplan resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

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

0. CarePlan
Definition | Describes the intention of how one or more practitioners intend to deliver care for a particular patient, group or community for a period of time, possibly limited to care for a specific condition or set of conditions.
Short | Healthcare plan for patient or group
Control | 0..*
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | Care Team
Invariants | dom-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. CarePlan.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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. CarePlan.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.
Short | Contained, 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.
Control | 0..* This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
Type | Resource
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
6. CarePlan.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Must Support | false
Summary | true
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 Names | extensions, user content
Invariants | ele-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. CarePlan.identifier
Definition | Business identifiers assigned to this care plan by the performer or other systems which remain constant as the resource is updated and propagates from server to server.
Short | External Ids for this plan
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.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 10..*
Type | Identifier
Is Modifier | false
Must Support | false
Summary | true
Requirements | Allows identification of the care plan as it is known by various participating systems and in a way that remains consistent across servers.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. CarePlan.identifier.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..1
Binding | The codes SHALL be taken from IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|5.0.0 (required to `http://hl7.org/fhir/ValueSet/identifier-use` )
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. CarePlan.identifier.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 0..1
Binding | The codes SHALL be taken from Unless not suitable, these codes SHALL be taken from SGHI Default Identifier Types http://hl7.org/fhir/ValueSet/identifier-type|5.0.0 (required to `https://fhir.slade360.co.ke/fhir/ValueSet/default-identifier-types` )
Type | CodeableConcept(SGHI CodeableConcept)
Is Modifier | false
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. CarePlan.identifier.system
Definition | Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. CarePlan.identifier.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the http://hl7.org/fhir/StructureDefinition/rendered-value). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 10..1 This element is affected by the following invariants: ident-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. CarePlan.identifier.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 10..1
Type | Reference(SGHI Reference)(SGHI Organization, Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. CarePlan.instantiatesCanonical
Definition | The URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan.
Short | Instantiates FHIR protocol or definition
Control | 10..*
Type | canonical(PlanDefinition, Questionnaire, Measure, ActivityDefinition, OperationDefinition)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. CarePlan.status
Definition | Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
Short | draft | active | on-hold | revoked | completed | entered-in-error | unknown
Comments | The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the care plan. This element is labeled as a modifier because the status contains the code entered-in-error that marks the plan as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from RequestStatus http://hl7.org/fhir/ValueSet/request-status|5.0.0 (required to `http://hl7.org/fhir/ValueSet/request-status|5.0.0` ) Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
Type | code
Is Modifier | true because This element is labeled 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 Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | Allows clinicians to determine whether the plan is actionable or not.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. CarePlan.intent
Definition | Indicates the level of authority/intentionality associated with the care plan and where the care plan fits into the workflow chain.
Short | proposal | plan | order | option | directive
Comments | This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. This element is expected to be immutable. E.g. A "proposal" instance should never change to be a "plan" instance or "order" instance. Instead, a new instance 'basedOn' the prior instance should be created with the new 'intent' value.
Control | 1..1
Binding | The codes SHALL be taken from CarePlanIntent http://hl7.org/fhir/ValueSet/care-plan-intent|5.0.0 (required to `http://hl7.org/fhir/ValueSet/care-plan-intent|5.0.0` ) Codes indicating the degree of authority/intentionality associated with a care plan.
Type | code
Is Modifier | true because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request"
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. CarePlan.title
Definition | Human-friendly name for the care plan.
Short | Human-friendly name for the care plan
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. CarePlan.description
Definition | A description of the scope and nature of the plan.
Short | Summary of nature of plan
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | Provides more detail than conveyed by category.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. CarePlan.subject
Definition | Identifies the patient or group whose intended care is described by the plan.
Short | Who the care plan is for
Control | 1..1
Type | Reference(SGHI Patient, Patient, Group)
Is Modifier | false
Must Support | false
Summary | true
Alternate Names | patient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. CarePlan.created
Definition | Represents when this particular CarePlan record was created in the system, which is often a system-generated date.
Short | Date record was first recorded
Control | 10..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Alternate Names | authoredOn
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. CarePlan.custodian
Definition | When populated, the custodian is responsible for the care plan. The care plan is attributed to the custodian.
Short | Who is the designated responsible party
Comments | The custodian might or might not be a contributor.
Control | 10..1
Type | Reference(SGHI Organization, Patient, Practitioner, PractitionerRole, Device, RelatedPerson, Organization, CareTeam)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. CarePlan.activity
Definition | Identifies an action that has occurred or is a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring that has occurred, education etc.
Short | Action to occur or has occurred as part of plan
Control | 10..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Requirements | Allows systems to prompt for performance of planned activities, and validate plans against best practice.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. CarePlan.activity.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-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())
40. CarePlan.activity.performedActivity
Definition | Identifies the activity that was performed. For example, an activity could be patient education, exercise, or a medication administration. The reference to an "event" resource, such as Procedure or Encounter or Observation, represents the activity that was performed. The requested activity can be conveyed using the CarePlan.activity.plannedActivityReference (a reference to a “request” resource).
Short | Results of the activity (concept, or Appointment, Encounter, Procedure, etc.)
Comments | Note that this should not duplicate the activity status (e.g. completed or in progress). The activity performed is independent of the outcome of the related goal(s). For example, if the goal is to achieve a target body weight of 150 lbs and an activity is defined to exercise, then the activity performed could be amount and intensity of exercise performed whereas the goal outcome is an observation for the actual body weight measured.
Control | 10..*
Binding | For example codes, see CarePlanActivityPerformed http://hl7.org/fhir/ValueSet/care-plan-activity-performed|5.0.0 (example to `http://hl7.org/fhir/ValueSet/care-plan-activity-performed|5.0.0` ) Identifies the results of the activity.
Type | CodeableReference(SGHI CodeableReference)(SGHI Task, Resource)
Is Modifier | false
Must Support | true
Summary | false
Requirements | Links plan to resulting actions.
Invariants | ele-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. CarePlan
2. CarePlan.identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..?
4. CarePlan.identifier.use
Binding | The codes SHALL be taken from IdentifierUse (required to `http://hl7.org/fhir/ValueSet/identifier-use` )
6. CarePlan.identifier.type
Binding | The codes SHALL be taken from SGHI Default Identifier Types (required to `https://fhir.slade360.co.ke/fhir/ValueSet/default-identifier-types` )
Type | CodeableConcept(SGHI CodeableConcept)
8. CarePlan.identifier.system
Control | 1..?
10. CarePlan.identifier.value
Control | 1..?
12. CarePlan.identifier.assigner
Control | 1..?
Type | Reference(SGHI Reference)(SGHI Organization)
14. CarePlan.instantiatesCanonical
Control | 1..?
Must Support | true
16. CarePlan.title
Control | 1..?
Must Support | true
18. CarePlan.description
Control | 1..?
20. CarePlan.subject
Type | Reference(SGHI Patient)
22. CarePlan.created
Control | 1..?
24. CarePlan.custodian
Control | 1..?
Type | Reference(SGHI Organization)
Must Support | true
26. CarePlan.activity
Control | 1..?
Must Support | true
28. CarePlan.activity.performedActivity
Control | 1..?
Type | CodeableReference(SGHI CodeableReference)(SGHI Task)
Must Support | true
30. CarePlan.note
32. CarePlan.note.author[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Slicing | This element introduces a set of slices on `CarePlan.note.author[x]`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ $this
34. CarePlan.note.author[x]:authorReference
Slice Name | authorReference
Control | 0..1
Type | Reference(SGHI Organization, SGHI Practitioner)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]

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

0. CarePlan
Definition | Describes the intention of how one or more practitioners intend to deliver care for a particular patient, group or community for a period of time, possibly limited to care for a specific condition or set of conditions.
Short | Healthcare plan for patient or group
Control | 0..*
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | Care Team
Invariants | dom-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. CarePlan.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical 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.
Control | 0..1
Type | id
Is Modifier | false
Must Support | false
Summary | true
4. CarePlan.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.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. CarePlan.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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. CarePlan.language
Definition | The base language in which the resource is written.
Short | Language 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).
Control | 0..1
Binding | The 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
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. CarePlan.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.
Short | Text 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.
Control | 0..1 This element is affected by the following invariants: dom-6
Type | Narrative
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. CarePlan.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.
Short | Contained, 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.
Control | 0..* This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
Type | Resource
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. CarePlan.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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Must Support | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-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. CarePlan.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Must Support | false
Summary | true
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 Names | extensions, user content
Invariants | ele-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. CarePlan.identifier
Definition | Business identifiers assigned to this care plan by the performer or other systems which remain constant as the resource is updated and propagates from server to server.
Short | External Ids for this plan
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.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..*
Type | Identifier
Is Modifier | false
Must Support | false
Summary | true
Requirements | Allows identification of the care plan as it is known by various participating systems and in a way that remains consistent across servers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. CarePlan.identifier.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1 This element is affected by the following invariants: ele-1
Type | id
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
22. CarePlan.identifier.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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-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()`)
Slicing | This element introduces a set of slices on `CarePlan.identifier.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
24. CarePlan.identifier.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..1
Binding | The codes SHALL be taken from IdentifierUse (required to `http://hl7.org/fhir/ValueSet/identifier-use` )
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. CarePlan.identifier.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 0..1
Binding | The codes SHALL be taken from SGHI Default Identifier Types (required to `https://fhir.slade360.co.ke/fhir/ValueSet/default-identifier-types` )
Type | CodeableConcept(SGHI CodeableConcept)
Is Modifier | false
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. CarePlan.identifier.system
Definition | Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Example | General: http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
30. CarePlan.identifier.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the http://hl7.org/fhir/StructureDefinition/rendered-value). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 1..1 This element is affected by the following invariants: ident-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Example | General: 123456
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
32. CarePlan.identifier.period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
34. CarePlan.identifier.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 1..1
Type | Reference(SGHI Reference)(SGHI Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. CarePlan.instantiatesCanonical
Definition | The URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan.
Short | Instantiates FHIR protocol or definition
Control | 1..*
Type | canonical(PlanDefinition, Questionnaire, Measure, ActivityDefinition, OperationDefinition)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
38. CarePlan.instantiatesUri
Definition | The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan.
Short | Instantiates external protocol or definition
Comments | This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
Control | 0..*
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. CarePlan.basedOn
Definition | A higher-level request resource (i.e. a plan, proposal or order) that is fulfilled in whole or in part by this care plan.
Short | Fulfills plan, proposal or order
Control | 0..*
Type | Reference(CarePlan, ServiceRequest, RequestOrchestration, NutritionOrder)
Is Modifier | false
Must Support | false
Summary | true
Requirements | Allows tracing of the care plan and tracking whether proposals/recommendations were acted upon.
Alternate Names | fulfills
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. CarePlan.replaces
Definition | Completed or terminated care plan whose function is taken by this new care plan.
Short | CarePlan replaced by this CarePlan
Comments | The replacement could be because the initial care plan was immediately rejected (due to an issue) or because the previous care plan was completed, but the need for the action described by the care plan remains ongoing.
Control | 0..*
Type | Reference(CarePlan)
Is Modifier | false
Must Support | false
Summary | true
Requirements | Allows tracing the continuation of a therapy or administrative process instantiated through multiple care plans.
Alternate Names | supersedes
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. CarePlan.partOf
Definition | A larger care plan of which this particular care plan is a component or step.
Short | Part of referenced CarePlan
Comments | Each care plan is an independent request, such that having a care plan be part of another care plan can cause issues with cascading statuses. As such, this element is still being discussed.
Control | 0..*
Type | Reference(CarePlan)
Is Modifier | false
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. CarePlan.status
Definition | Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
Short | draft | active | on-hold | revoked | completed | entered-in-error | unknown
Comments | The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the care plan. This element is labeled as a modifier because the status contains the code entered-in-error that marks the plan as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from RequestStatus (required to `http://hl7.org/fhir/ValueSet/request-status|5.0.0` ) Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
Type | code
Is Modifier | true because This element is labeled 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 Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | Allows clinicians to determine whether the plan is actionable or not.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. CarePlan.intent
Definition | Indicates the level of authority/intentionality associated with the care plan and where the care plan fits into the workflow chain.
Short | proposal | plan | order | option | directive
Comments | This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. This element is expected to be immutable. E.g. A "proposal" instance should never change to be a "plan" instance or "order" instance. Instead, a new instance 'basedOn' the prior instance should be created with the new 'intent' value.
Control | 1..1
Binding | The codes SHALL be taken from CarePlanIntent (required to `http://hl7.org/fhir/ValueSet/care-plan-intent|5.0.0` ) Codes indicating the degree of authority/intentionality associated with a care plan.
Type | code
Is Modifier | true because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request"
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. CarePlan.category
Definition | Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc.
Short | Type of plan
Comments | There may be multiple axes of categorization and one plan may serve multiple purposes. In some cases, this may be redundant with references to CarePlan.addresses.
Control | 0..*
Binding | For example codes, see CarePlanCategory (example to `http://hl7.org/fhir/ValueSet/care-plan-category|5.0.0` ) Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.
Type | CodeableConcept
Is Modifier | false
Must Support | false
Summary | true
Requirements | Used for filtering what plan(s) are retrieved and displayed to different types of users.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. CarePlan.title
Definition | Human-friendly name for the care plan.
Short | Human-friendly name for the care plan
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. CarePlan.description
Definition | A description of the scope and nature of the plan.
Short | Summary of nature of plan
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Requirements | Provides more detail than conveyed by category.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. CarePlan.subject
Definition | Identifies the patient or group whose intended care is described by the plan.
Short | Who the care plan is for
Control | 1..1
Type | Reference(SGHI Patient)
Is Modifier | false
Must Support | false
Summary | true
Alternate Names | patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. CarePlan.encounter
Definition | The Encounter during which this CarePlan was created or to which the creation of this record is tightly associated.
Short | The Encounter during which this CarePlan was created
Comments | This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. CarePlan activities conducted as a result of the care plan may well occur as part of other encounters.
Control | 0..1
Type | Reference(Encounter)
Is Modifier | false
Must Support | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. CarePlan.period
Definition | Indicates when the plan did (or is intended to) come into effect and end.
Short | Time period plan covers
Comments | Any activities scheduled as part of the plan should be constrained to the specified period regardless of whether the activities are planned within a single encounter/episode or across multiple encounters/episodes (e.g. the longitudinal management of a chronic condition).
Control | 0..1
Type | Period
Is Modifier | false
Must Support | false
Summary | true
Requirements | Allows tracking what plan(s) are in effect at a particular time.
Alternate Names | timing
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. CarePlan.created
Definition | Represents when this particular CarePlan record was created in the system, which is often a system-generated date.
Short | Date record was first recorded
Control | 1..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | false
Summary | true
Alternate Names | authoredOn
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
64. CarePlan.custodian
Definition | When populated, the custodian is responsible for the care plan. The care plan is attributed to the custodian.
Short | Who is the designated responsible party
Comments | The custodian might or might not be a contributor.
Control | 1..1
Type | Reference(SGHI Organization)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. CarePlan.contributor
Definition | Identifies the individual(s), organization or device who provided the contents of the care plan.
Short | Who provided the content of the care plan
Comments | Collaborative care plans may have multiple contributors.
Control | 0..*
Type | Reference(Patient, Practitioner, PractitionerRole, Device, RelatedPerson, Organization, CareTeam)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. CarePlan.careTeam
Definition | Identifies all people and organizations who are expected to be involved in the care envisioned by this plan.
Short | Who's involved in plan?
Control | 0..*
Type | Reference(CareTeam)
Is Modifier | false
Must Support | false
Summary | false
Requirements | Allows representation of care teams, helps scope care plan. In some cases may be a determiner of access permissions.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. CarePlan.addresses
Definition | Identifies the conditions/problems/concerns/diagnoses/etc. whose management and/or mitigation are handled by this plan.
Short | Health issues this plan addresses
Comments | Use CarePlan.addresses.concept when a code sufficiently describes the concern (e.g. condition, problem, diagnosis, risk). Use CarePlan.addresses.reference when referencing a resource, which allows more information to be conveyed, such as onset date. CarePlan.addresses.concept and CarePlan.addresses.reference are not meant to be duplicative. For a single concern, either CarePlan.addresses.concept or CarePlan.addresses.reference can be used. CarePlan.addresses.concept may be a summary code, or CarePlan.addresses.reference may be used to reference a very precise definition of the concern using Condition. Both CarePlan.addresses.concept and CarePlan.addresses.reference can be used if they are describing different concerns for the care plan.
Control | 0..*
Binding | For example codes, see SNOMEDCTClinicalFindings (example to `http://hl7.org/fhir/ValueSet/clinical-findings|5.0.0` ) Codes that describe the health issues this plan addresses.
Type | CodeableReference(Condition)
Is Modifier | false
Must Support | false
Summary | true
Requirements | The element can identify risks addressed by the plan as well as concerns. Also scopes plans - multiple plans may exist addressing different concerns.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. CarePlan.supportingInfo
Definition | Identifies portions of the patient's record that specifically influenced the formation of the plan. These might include comorbidities, recent procedures, limitations, recent assessments, etc.
Short | Information considered as part of plan
Comments | Use "concern" to identify specific conditions addressed by the care plan. supportingInfo can be used to convey one or more Advance Directives or Medical Treatment Consent Directives by referencing Consent or any other request resource with intent = directive.
Control | 0..*
Type | Reference(Resource)
Is Modifier | false
Must Support | false
Summary | false
Requirements | Identifies barriers and other considerations associated with the care plan.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. CarePlan.goal
Definition | Describes the intended objective(s) of carrying out the care plan.
Short | Desired outcome of plan
Comments | Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline.
Control | 0..*
Type | Reference(Goal)
Is Modifier | false
Must Support | false
Summary | false
Requirements | Provides context for plan. Allows plan effectiveness to be evaluated by clinicians.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. CarePlan.activity
Definition | Identifies an action that has occurred or is a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring that has occurred, education etc.
Short | Action to occur or has occurred as part of plan
Control | 1..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Requirements | Allows systems to prompt for performance of planned activities, and validate plans against best practice.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. CarePlan.activity.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1 This element is affected by the following invariants: ele-1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
80. CarePlan.activity.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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-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()`)
82. CarePlan.activity.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-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()`)
84. CarePlan.activity.performedActivity
Definition | Identifies the activity that was performed. For example, an activity could be patient education, exercise, or a medication administration. The reference to an "event" resource, such as Procedure or Encounter or Observation, represents the activity that was performed. The requested activity can be conveyed using the CarePlan.activity.plannedActivityReference (a reference to a “request” resource).
Short | Results of the activity (concept, or Appointment, Encounter, Procedure, etc.)
Comments | Note that this should not duplicate the activity status (e.g. completed or in progress). The activity performed is independent of the outcome of the related goal(s). For example, if the goal is to achieve a target body weight of 150 lbs and an activity is defined to exercise, then the activity performed could be amount and intensity of exercise performed whereas the goal outcome is an observation for the actual body weight measured.
Control | 1..*
Binding | For example codes, see CarePlanActivityPerformed (example to `http://hl7.org/fhir/ValueSet/care-plan-activity-performed|5.0.0` ) Identifies the results of the activity.
Type | CodeableReference(SGHI CodeableReference)(SGHI Task)
Is Modifier | false
Must Support | true
Summary | false
Requirements | Links plan to resulting actions.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. CarePlan.activity.progress
Definition | Notes about the adherence/status/progress of the activity.
Short | Comments about the activity status/progress
Comments | This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description.
Control | 0..*
Type | Annotation
Is Modifier | false
Must Support | false
Summary | false
Requirements | Can be used to capture information about adherence, progress, concerns, etc.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
88. CarePlan.activity.plannedActivityReference
Definition | The details of the proposed activity represented in a specific resource.
Short | Activity that is intended to be part of the care plan
Comments | Standard extension exists (http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.plannedActivityReference. The goal should be visible when the resource referenced by CarePlan.activity.plannedActivityReference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.
Control | 0..1
Type | Reference(Appointment, CommunicationRequest, DeviceRequest, MedicationRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestOrchestration, ImmunizationRecommendation, SupplyRequest)
Is Modifier | false
Must Support | false
Summary | false
Requirements | Details in a form consistent with other applications and contexts of use.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
90. CarePlan.note
Definition | General notes about the care plan not covered elsewhere.
Short | Comments about the plan
Control | 0..*
Type | Annotation
Is Modifier | false
Must Support | false
Summary | false
Requirements | Used to capture information that applies to the plan as a whole that doesn't fit into discrete elements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
92. CarePlan.note.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1 This element is affected by the following invariants: ele-1
Type | id
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
94. CarePlan.note.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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-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()`)
Slicing | This element introduces a set of slices on `CarePlan.note.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
96. CarePlan.note.author[x]
Definition | The individual responsible for making the annotation.
Short | Individual responsible for the annotation
Comments | Organization is used when there's no need for specific attribution as to who made the comment.
Control | 0..1
Type | Choice of: Reference(Practitioner, PractitionerRole, Patient, RelatedPerson, Organization), string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `CarePlan.note.author[x]`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ $this
98. CarePlan.note.author[x]:authorReference
Slice Name | authorReference
Definition | The individual responsible for making the annotation.
Short | Individual responsible for the annotation
Comments | Organization is used when there's no need for specific attribution as to who made the comment.
Control | 0..1
Type | Reference(SGHI Organization, SGHI Practitioner)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. CarePlan.note.time
Definition | Indicates when this particular annotation was made.
Short | When the annotation was made
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
102. CarePlan.note.text
Definition | The text of the annotation in markdown format.
Short | The annotation - text content (as markdown)
Control | 1..1
Type | markdown
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)