R6 Ballot (2nd Draft)

Publish-box (todo)

9.7 Resource CareTeam - Content

Patient Care icon Work GroupMaturity Level: 2 Trial UseSecurity Category: Patient Compartments: Patient, Practitioner, RelatedPerson

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

9.7.1 Scope and Usage

The CareTeam includes all the people and organizations who plan to participate in the coordination and delivery of care and is assigned to:

  • a single patient, or
  • a group (such as a married couple in therapy or a support group), or
  • an event, prior to a subject being identified (such as a code blue team or emergency response team)

Care Team is not limited to practitioners, but may include other caregivers such as family members, guardians, the patient themself, or others. The Care Team, depending on where used, may include care team members specific to a particular care plan, an episode, an encounter, or may reflect all known team members across these perspectives. An individual's CareTeam can be dynamic over time, such that there can be transience of team members, such as a rehabilitation team.

9.7.2 Boundaries and Relationships

Care Team is distinct from Group. Group identifies an undifferentiated set of individuals who are intended to be the target of one or more clinical activities (e.g. set of clinical trial participants, set of individuals impacted by or at risk of a public health event, a herd or flock, etc.) The participants within a CareTeam are the individual members or organized group of individuals. CareTeam can be referenced by EpisodeOfCare, Encounter, or CarePlan to identify the set of individuals (and their respective roles) who are intended to be involved in providing the care defined by those resources.

9.7.3 References to this Resource

9.7.4 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. CareTeam TU DomainResource Planned participants in the coordination and delivery of care

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ 0..* Identifier External Ids for this team

... status ?!Σ 0..1 code proposed | active | suspended | inactive | entered-in-error
Binding: Care Team Status (Required)
... category Σ 0..* CodeableConcept Type of team
Binding: Care Team category (Example)

... subject Σ 0..1 Reference(Patient | Group) Who care team is for
... period Σ 0..1 Period Time period team covers
... participant C 0..* BackboneElement Members of the team
+ Warning: CareTeam.participant.role or CareTeam.participant.member exists

.... role ΣC 0..1 CodeableConcept Type of involvement
Binding: Participant Roles (Example)
.... member ΣC 0..1 Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Organization | CareTeam) Who is involved
.... onBehalfOf Σ 0..1 Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Organization | CareTeam) Entity that the participant is acting as a proxy of, or an agent of, or in the interest of, or as a representative of
.... effective[x] 0..1 When the member is generally available within this care team
..... effectivePeriod Period
..... effectiveTiming Timing
... reason 0..* CodeableReference(Condition) Why the care team exists
Binding: SNOMED CT Clinical Findings (Example)

... managingOrganization Σ 0..* Reference(Organization) Organization responsible for the care team

... telecom 0..* ContactPoint A contact detail for the care team (that applies to all members)

... note 0..* Annotation Comments made about the CareTeam


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram (Legend)

CareTeam (DomainResource)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 serveridentifier : Identifier [0..*]Indicates the current state of the care team (this element modifies the meaning of other elements)status : code [0..1] « null (Strength=Required)CareTeamStatus! »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 teamcategory : CodeableConcept [0..*] « null (Strength=Example)CareTeamCategory?? »A label for human use intended to distinguish like teams. E.g. the "red" vs. "green" trauma teamsname : string [0..1]Identifies the patient or group whose intended care is handled by the teamsubject : Reference [0..1] « Patient|Group »Indicates when the team did (or is intended to) come into effect and endperiod : Period [0..1]Describes why the care team existsreason : CodeableReference [0..*] « Condition; null (Strength=Example) SNOMEDCTClinicalFindings?? »The organization responsible for the care teammanagingOrganization : Reference [0..*] « Organization »A central contact detail for the care team (that applies to all members)telecom : ContactPoint [0..*]Comments made about the CareTeamnote : Annotation [0..*]ParticipantIndicates specific responsibility of an individual within the care team, such as "Primary care physician", "Trained social worker counselor", "Caregiver", etcrole : CodeableConcept [0..1] « null (Strength=Example)ParticipantRoles?? » « This element has or is affected by some invariantsC »The specific person or organization who is participating/expected to participate in the care teammember : Reference [0..1] « Practitioner|PractitionerRole| RelatedPerson|Patient|Organization|CareTeam » « This element has or is affected by some invariantsC »Entity that the participant is acting as a proxy of, or an agent of, or in the interest of, or as a representative ofonBehalfOf : Reference [0..1] « Practitioner|PractitionerRole| RelatedPerson|Patient|Organization|CareTeam »When the member is generally available within this care teameffective[x] : DataType [0..1] « Period|Timing »Identifies all people and organizations who are expected to be involved in the care teamparticipant[0..*]

XML Template

<CareTeam xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Ids for this team --></identifier>
 <status value="[code]"/><!-- 0..1 proposed | active | suspended | inactive | entered-in-error -->
 <category><!-- 0..* CodeableConcept Type of team --></category>
 <name value="[string]"/><!-- 0..1 Name of the team, such as crisis assessment team -->
 <subject><!-- 0..1 Reference(Group|Patient) Who care team is for --></subject>
 <period><!-- 0..1 Period Time period team covers --></period>
 <participant>  <!-- 0..* Members of the team -->
  <role><!-- I 0..1 CodeableConcept Type of involvement --></role>
  <member><!-- I 0..1 Reference(CareTeam|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) Who is involved --></member>
  <onBehalfOf><!-- 0..1 Reference(CareTeam|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) Entity that the participant is acting as a proxy of, or an agent of, or in the interest of, or as a representative of --></onBehalfOf>
  <effective[x]><!-- 0..1 Period|Timing When the member is generally available within this care team --></effective[x]>
 </participant>
 <reason><!-- 0..* CodeableReference(Condition) Why the care team exists --></reason>
 <managingOrganization><!-- 0..* Reference(Organization) Organization responsible for the care team --></managingOrganization>
 <telecom><!-- 0..* ContactPoint A contact detail for the care team (that applies to all members) --></telecom>
 <note><!-- 0..* Annotation Comments made about the CareTeam --></note>
</CareTeam>

JSON Template

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:CareTeam;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* External Ids for this team
  fhir:status [ code ] ; # 0..1 proposed | active | suspended | inactive | entered-in-error
  fhir:category  ( [ CodeableConcept ] ... ) ; # 0..* Type of team
  fhir:name [ string ] ; # 0..1 Name of the team, such as crisis assessment team
  fhir:subject [ Reference(Group|Patient) ] ; # 0..1 Who care team is for
  fhir:period [ Period ] ; # 0..1 Time period team covers
  fhir:participant ( [ # 0..* Members of the team
    fhir:role [ CodeableConcept ] ; # 0..1 I Type of involvement
    fhir:member [ Reference(CareTeam|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 I Who is involved
    fhir:onBehalfOf [ Reference(CareTeam|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Entity that the participant is acting as a proxy of, or an agent of, or in the interest of, or as a representative of
    # effective[x] : 0..1 When the member is generally available within this care team. One of these 2
      fhir:effective [  a fhir:Period ; Period ]
      fhir:effective [  a fhir:Timing ; Timing ]
  ] ... ) ;
  fhir:reason  ( [ CodeableReference(Condition) ] ... ) ; # 0..* Why the care team exists
  fhir:managingOrganization  ( [ Reference(Organization) ] ... ) ; # 0..* Organization responsible for the care team
  fhir:telecom  ( [ ContactPoint ] ... ) ; # 0..* A contact detail for the care team (that applies to all members)
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Comments made about the CareTeam
]

Changes from both R4 and R4B

CareTeam
CareTeam.participant.role
  • Max Cardinality changed from * to 1
CareTeam.participant.onBehalfOf
  • Type Reference: Added Target Types Practitioner, PractitionerRole, RelatedPerson, Patient, CareTeam
CareTeam.participant.effective[x]
  • Added Element
CareTeam.reason
  • Added Element
CareTeam.encounter
  • Deleted (Avoid circular references since Encounter references CareTeam)
CareTeam.participant.period
  • Deleted
CareTeam.reasonCode
  • Deleted (-> CareTeam.reason)
CareTeam.reasonReference
  • Deleted (-> CareTeam.reason)

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. CareTeam TU DomainResource Planned participants in the coordination and delivery of care

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ 0..* Identifier External Ids for this team

... status ?!Σ 0..1 code proposed | active | suspended | inactive | entered-in-error
Binding: Care Team Status (Required)
... category Σ 0..* CodeableConcept Type of team
Binding: Care Team category (Example)

... subject Σ 0..1 Reference(Patient | Group) Who care team is for
... period Σ 0..1 Period Time period team covers
... participant C 0..* BackboneElement Members of the team
+ Warning: CareTeam.participant.role or CareTeam.participant.member exists

.... role ΣC 0..1 CodeableConcept Type of involvement
Binding: Participant Roles (Example)
.... member ΣC 0..1 Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Organization | CareTeam) Who is involved
.... onBehalfOf Σ 0..1 Reference(Practitioner | PractitionerRole | RelatedPerson | Patient | Organization | CareTeam) Entity that the participant is acting as a proxy of, or an agent of, or in the interest of, or as a representative of
.... effective[x] 0..1 When the member is generally available within this care team
..... effectivePeriod Period
..... effectiveTiming Timing
... reason 0..* CodeableReference(Condition) Why the care team exists
Binding: SNOMED CT Clinical Findings (Example)

... managingOrganization Σ 0..* Reference(Organization) Organization responsible for the care team

... telecom 0..* ContactPoint A contact detail for the care team (that applies to all members)

... note 0..* Annotation Comments made about the CareTeam


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram (Legend)

CareTeam (DomainResource)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 serveridentifier : Identifier [0..*]Indicates the current state of the care team (this element modifies the meaning of other elements)status : code [0..1] « null (Strength=Required)CareTeamStatus! »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 teamcategory : CodeableConcept [0..*] « null (Strength=Example)CareTeamCategory?? »A label for human use intended to distinguish like teams. E.g. the "red" vs. "green" trauma teamsname : string [0..1]Identifies the patient or group whose intended care is handled by the teamsubject : Reference [0..1] « Patient|Group »Indicates when the team did (or is intended to) come into effect and endperiod : Period [0..1]Describes why the care team existsreason : CodeableReference [0..*] « Condition; null (Strength=Example) SNOMEDCTClinicalFindings?? »The organization responsible for the care teammanagingOrganization : Reference [0..*] « Organization »A central contact detail for the care team (that applies to all members)telecom : ContactPoint [0..*]Comments made about the CareTeamnote : Annotation [0..*]ParticipantIndicates specific responsibility of an individual within the care team, such as "Primary care physician", "Trained social worker counselor", "Caregiver", etcrole : CodeableConcept [0..1] « null (Strength=Example)ParticipantRoles?? » « This element has or is affected by some invariantsC »The specific person or organization who is participating/expected to participate in the care teammember : Reference [0..1] « Practitioner|PractitionerRole| RelatedPerson|Patient|Organization|CareTeam » « This element has or is affected by some invariantsC »Entity that the participant is acting as a proxy of, or an agent of, or in the interest of, or as a representative ofonBehalfOf : Reference [0..1] « Practitioner|PractitionerRole| RelatedPerson|Patient|Organization|CareTeam »When the member is generally available within this care teameffective[x] : DataType [0..1] « Period|Timing »Identifies all people and organizations who are expected to be involved in the care teamparticipant[0..*]

XML Template

<CareTeam xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Ids for this team --></identifier>
 <status value="[code]"/><!-- 0..1 proposed | active | suspended | inactive | entered-in-error -->
 <category><!-- 0..* CodeableConcept Type of team --></category>
 <name value="[string]"/><!-- 0..1 Name of the team, such as crisis assessment team -->
 <subject><!-- 0..1 Reference(Group|Patient) Who care team is for --></subject>
 <period><!-- 0..1 Period Time period team covers --></period>
 <participant>  <!-- 0..* Members of the team -->
  <role><!-- I 0..1 CodeableConcept Type of involvement --></role>
  <member><!-- I 0..1 Reference(CareTeam|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) Who is involved --></member>
  <onBehalfOf><!-- 0..1 Reference(CareTeam|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) Entity that the participant is acting as a proxy of, or an agent of, or in the interest of, or as a representative of --></onBehalfOf>
  <effective[x]><!-- 0..1 Period|Timing When the member is generally available within this care team --></effective[x]>
 </participant>
 <reason><!-- 0..* CodeableReference(Condition) Why the care team exists --></reason>
 <managingOrganization><!-- 0..* Reference(Organization) Organization responsible for the care team --></managingOrganization>
 <telecom><!-- 0..* ContactPoint A contact detail for the care team (that applies to all members) --></telecom>
 <note><!-- 0..* Annotation Comments made about the CareTeam --></note>
</CareTeam>

JSON Template

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:CareTeam;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* External Ids for this team
  fhir:status [ code ] ; # 0..1 proposed | active | suspended | inactive | entered-in-error
  fhir:category  ( [ CodeableConcept ] ... ) ; # 0..* Type of team
  fhir:name [ string ] ; # 0..1 Name of the team, such as crisis assessment team
  fhir:subject [ Reference(Group|Patient) ] ; # 0..1 Who care team is for
  fhir:period [ Period ] ; # 0..1 Time period team covers
  fhir:participant ( [ # 0..* Members of the team
    fhir:role [ CodeableConcept ] ; # 0..1 I Type of involvement
    fhir:member [ Reference(CareTeam|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 I Who is involved
    fhir:onBehalfOf [ Reference(CareTeam|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Entity that the participant is acting as a proxy of, or an agent of, or in the interest of, or as a representative of
    # effective[x] : 0..1 When the member is generally available within this care team. One of these 2
      fhir:effective [  a fhir:Period ; Period ]
      fhir:effective [  a fhir:Timing ; Timing ]
  ] ... ) ;
  fhir:reason  ( [ CodeableReference(Condition) ] ... ) ; # 0..* Why the care team exists
  fhir:managingOrganization  ( [ Reference(Organization) ] ... ) ; # 0..* Organization responsible for the care team
  fhir:telecom  ( [ ContactPoint ] ... ) ; # 0..* A contact detail for the care team (that applies to all members)
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Comments made about the CareTeam
]

Changes from both R4 and R4B

CareTeam
CareTeam.participant.role
  • Max Cardinality changed from * to 1
CareTeam.participant.onBehalfOf
  • Type Reference: Added Target Types Practitioner, PractitionerRole, RelatedPerson, Patient, CareTeam
CareTeam.participant.effective[x]
  • Added Element
CareTeam.reason
  • Added Element
CareTeam.encounter
  • Deleted (Avoid circular references since Encounter references CareTeam)
CareTeam.participant.period
  • Deleted
CareTeam.reasonCode
  • Deleted (-> CareTeam.reason)
CareTeam.reasonReference
  • Deleted (-> CareTeam.reason)

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

 

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis

9.7.4.1 Terminology Bindings

Path ValueSet Type Documentation
CareTeam.status CareTeamStatus Required

Indicates the status of the care team.
CareTeam.category CareTeamCategory Example

Indicates the type of care team.
CareTeam.participant.role ParticipantRoles Example

Roles of participants that may be included in a care team. Defined as: Healthcare professional (occupation) or Services (qualifier value).
CareTeam.reason SNOMEDCTClinicalFindings Example

This value set includes all the "Clinical finding" SNOMED CT icon codes - concepts where concept is-a 404684003 (Clinical finding (finding)).

9.7.4.2 Constraints

UniqueKeyLevelLocationDescriptionExpression
img ctm-2Warning CareTeam.participantCareTeam.participant.role or CareTeam.participant.member existsrole.exists() or member.exists()

9.7.4.3 Notes

The Provenance resource can be used for detailed review information, such as when the care team was last reviewed and by whom.

9.7.5 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
category token Type of team CareTeam.category
date date A date within the coverage time period. 26 Resources
identifier token External Ids for this team CareTeam.identifier 65 Resources
name string Name of the team, such as crisis assessment team CareTeam.name | CareTeam.extension('http://hl7.org/fhir/StructureDefinition/careteam-alias').value
participant reference Who is involved CareTeam.participant.member
(Practitioner, Organization, CareTeam, Patient, PractitionerRole, RelatedPerson)
patient reference Who care team is for CareTeam.subject.where(resolve() is Patient)
(Patient)		 65 Resources
status token proposed | active | suspended | inactive | entered-in-error CareTeam.status
subject reference Who care team is for CareTeam.subject
(Group, Patient)