This page is part of the C-CDA on FHIR Implementation Guide (v1.0.0: STU 1) based on FHIR R3. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions

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D.4.1 StructureDefinition: CCDA-on-FHIR-Care-Plan

D.4.1.1 Formal Views of Profile Content

The official URL for this profile is:

http://hl7.org/fhir/us/ccda/StructureDefinition/CCDA-on-FHIR-Care-Plan

CARE PLAN FRAMEWORK: A Care Plan (including Home Health Plan of Care (HHPoC)) is a consensus-driven dynamic plan that represents a patient and Care Team Members prioritized concerns, goals, and planned interventions. It serves as a blueprint shared by all Care Team Members (including the patient, their caregivers and providers), to guide the patients care. A Care Plan integrates multiple interventions proposed by multiple providers and disciplines for multiple conditions.

A Care Plan represents one or more Plan(s) of Care and serves to reconcile and resolve conflicts between the various Plans of Care developed for a specific patient by different providers. While both a plan of care and a care plan include the patient's life goals and require Care Team Members (including patients) to prioritize goals and interventions, the reconciliation process becomes more complex as the number of plans of care increases. The Care Plan also serves to enable longitudinal coordination of care.

The Care Plan represents an instance of this dynamic Care Plan at a point in time. The composition itself is NOT dynamic.

Key differentiators between a Care Plan profile and CCD profile (another snapshot in time document):

• Requires relationships between various concepts:

  *  Health Concerns
  
  *  Interventions
  
  *  Goals
  
  *  Outcomes
  

• Provides the ability to identify patient and provider priorities with each act

• Provides a header participant to indicate occurrences of Care Plan review

This profile builds on C-CDA on FHIR US Realm Header.

This profile was published on Sat Apr 07 06:53:01 AEST 2018 as a draft by Lantana Consulting Group.

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

 

D.4.1.2 Terminology Bindings

Terminology Bindings

Path	Name	Conformance	ValueSet
Composition.language	Common Languages	extensible	Common Languages
Composition.status	CompositionStatus	required	CompositionStatus
Composition.type	Care Plan Document Codes	preferred	Care Plan Document Codes
Composition.class	FHIR Document Class Codes	example	FHIR Document Class Codes
Composition.confidentiality	ConfidentialityClassification	required	ConfidentialityClassification
Composition.attester.mode	CompositionAttestationMode	required	CompositionAttestationMode
Composition.attester.mode	CompositionAttestationMode	required	CompositionAttestationMode
Composition.attester.mode	CompositionAttestationMode	required	CompositionAttestationMode
Composition.attester.mode	CompositionAttestationMode	required	CompositionAttestationMode
Composition.relatesTo.code	DocumentRelationshipType	required	DocumentRelationshipType
Composition.event.code	v3 Code System ActCode	example	v3 Code System ActCode
Composition.section.code	Document Section Codes	example	Document Section Codes
Composition.section.mode	ListMode	required	ListMode
Composition.section.orderedBy	List Order Codes	preferred	List Order Codes
Composition.section.emptyReason	List Empty Reasons	preferred	List Empty Reasons
Composition.section.code	Document Section Codes	example	Document Section Codes
Composition.section.mode	ListMode	required	ListMode
Composition.section.orderedBy	List Order Codes	preferred	List Order Codes
Composition.section.emptyReason	List Empty Reasons	preferred	List Empty Reasons
Composition.section.code	Document Section Codes	example	Document Section Codes
Composition.section.mode	ListMode	required	ListMode
Composition.section.orderedBy	List Order Codes	preferred	List Order Codes
Composition.section.emptyReason	List Empty Reasons	preferred	List Empty Reasons
Composition.section.code	Document Section Codes	example	Document Section Codes
Composition.section.mode	ListMode	required	ListMode
Composition.section.orderedBy	List Order Codes	preferred	List Order Codes
Composition.section.emptyReason	List Empty Reasons	preferred	List Empty Reasons
Composition.section.code	Document Section Codes	example	Document Section Codes
Composition.section.mode	ListMode	required	ListMode
Composition.section.orderedBy	List Order Codes	preferred	List Order Codes
Composition.section.emptyReason	List Empty Reasons	preferred	List Empty Reasons

D.4.1.3 Constraints

Constraints

Id	Path	Details	Requirements
dom-2	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-1	Composition	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-4	Composition	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-3	Composition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
ele-1	Composition.extension	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Composition.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Composition.extension	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Composition.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Composition.extension	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Composition.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Composition.extension	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Composition.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Composition.extension	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Composition.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Composition.extension	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Composition.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Composition.extension	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Composition.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Composition.extension	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	Composition.extension	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ele-1	Composition.attester	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ele-1	Composition.attester	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ele-1	Composition.attester	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ele-1	Composition.attester	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ele-1	Composition.relatesTo	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ele-1	Composition.event	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ele-1	Composition.section	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
cmp-1	Composition.section	A section must at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	Composition.section	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
ele-1	Composition.section	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
cmp-1	Composition.section	A section must at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	Composition.section	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
ele-1	Composition.section	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
cmp-1	Composition.section	A section must at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	Composition.section	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
ele-1	Composition.section	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
cmp-1	Composition.section	A section must at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	Composition.section	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
ele-1	Composition.section	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
cmp-1	Composition.section	A section must at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	Composition.section	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()

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