US Core Implementation Guide (Release 1.0.1)

This page is part of the US Core (v1.0.1: STU1) based on FHIR R3. The current version which supercedes this version is 5.0.1. For a full list of available versions, see the Directory of published versions

1.0 - StructureDefinition-us-core-careplan

This profile sets minimum expectations for the CarePlan resource to record search and fetch assessment and plan of treatment data associated with a patient. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile.

Example Usage Scenarios:

The following are example usage scenarios for the US Core-CarePlan profile:

  • Query for a care plan belonging to a Patient
  • Record or update an existing care plan
Mandatory Data Elements and Terminology

The following data-elements are mandatory (i.e data MUST be present). These are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Profile Definition below provides the formal summary, definitions, and terminology requirements.

Each CarePlan must have:

  1. a narrative summary of the patient assessment and plan of treatment
  2. a status
  3. an intent
  4. a category code of “assess-plan”
  5. a patient

Profile specific implementation guidance:

  • none

Examples

1.2 - Formal Views of Profile Content

The official URL for this profile is: 

http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan

This profile builds on CarePlan.

This profile was published on Mon Aug 01 00:00:00 AEST 2016 as a draft by HL7 US Realm Steering Committee.

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

Complete Summary of the Mandatory Requirements

  1. A narrative summary in CarePlan.text
  2. One status in CarePlan.status
  3. One intent in CarePlan.intent
  4. A category in Careplan.category which must have:
    • a fixed Careplan.category.coding.system= “http://hl7.org/fhir/us/core/CodeSystem/careplan-category”
    • a fixed Careplan.category.coding.code=“assess-plan”
  5. One reference to a patient in CarePlan.subject
NameFlagsCard.TypeDescription & Constraintsdoco
.. CarePlan 0..*US Core CarePlan Profile
... text S1..1Narrative
.... status S1..1codeBinding: Narrative Status (required)
... status S1..1codeBinding: CarePlanStatus (required)
... intent S1..1codeBinding: CarePlanIntent (required)
... category SI1..*CodeableConceptus-core-1: Must have a category of 'assess-plan' and a code system 'http://hl7.org/fhir/us/core/CodeSystem/careplan-category'
... subject S1..1Reference(US Core Patient Profile)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. CarePlan I0..*US Core CarePlan Profile
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text SI1..1NarrativeText summary of the resource, for human interpretation
.... id 0..1stringxml:id (or equivalent in JSON)
.... status S1..1codegenerated | extensions | additional | empty
Binding: Narrative Status (required)
.... div I1..1xhtmlLimited xhtml content
txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes
txt-2: The narrative SHALL have some non-whitespace content
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal Ids for this plan
... definition Σ0..*Reference(PlanDefinition), Reference(Questionnaire)Protocol or definition
... basedOn Σ0..*Reference(CarePlan)Fulfills care plan
... replaces Σ0..*Reference(CarePlan)CarePlan replaced by this CarePlan
... partOf Σ0..*Reference(CarePlan)Part of referenced CarePlan
... status ?!SΣ1..1codedraft | active | suspended | completed | entered-in-error | cancelled | unknown
Binding: CarePlanStatus (required)
... intent ?!SΣ1..1codeproposal | plan | order | option
Binding: CarePlanIntent (required)
... category SΣI1..*CodeableConceptType of plan
Binding: Care Plan Category (example)
us-core-1: Must have a category of 'assess-plan' and a code system 'http://hl7.org/fhir/us/core/CodeSystem/careplan-category'
... title Σ0..1stringHuman-friendly name for the CarePlan
... description Σ0..1stringSummary of nature of plan
... subject SΣ1..1Reference(US Core Patient Profile)Who care plan is for
... context Σ0..1Reference(Encounter), Reference(EpisodeOfCare)Created in context of
... period Σ0..1PeriodTime period plan covers
... author Σ0..*Reference(Patient), Reference(Practitioner), Reference(RelatedPerson), Reference(Organization), Reference(CareTeam)Who is responsible for contents of the plan
... careTeam 0..*Reference(CareTeam)Who's involved in plan?
... addresses Σ0..*Reference(Condition)Health issues this plan addresses
... supportingInfo 0..*Reference(Resource)Information considered as part of plan
... goal 0..*Reference(Goal)Desired outcome of plan
... activity I0..*BackboneElementAction to occur as part of plan
cpl-3: Provide a reference or detail, not both
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... outcomeCodeableConcept 0..*CodeableConceptResults of the activity
Binding: Care Plan Activity Outcome (example)
.... outcomeReference 0..*Reference(Resource)Appointment, Encounter, Procedure, etc.
.... progress 0..*AnnotationComments about the activity status/progress
.... reference I0..1Reference(Appointment), Reference(CommunicationRequest), Reference(DeviceRequest), Reference(MedicationRequest), Reference(NutritionOrder), Reference(Task), Reference(ProcedureRequest), Reference(ReferralRequest), Reference(VisionPrescription), Reference(RequestGroup)Activity details defined in specific resource
.... detail I0..1BackboneElementIn-line definition of activity
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
..... category 0..1CodeableConceptdiet | drug | encounter | observation | procedure | supply | other
Binding: CarePlanActivityCategory (example)
..... definition 0..1Reference(PlanDefinition), Reference(ActivityDefinition), Reference(Questionnaire)Protocol or definition
..... code 0..1CodeableConceptDetail type of activity
Binding: Care Plan Activity (example)
..... reasonCode 0..*CodeableConceptWhy activity should be done or why activity was prohibited
Binding: Activity Reason (example)
..... reasonReference 0..*Reference(Condition)Condition triggering need for activity
..... goal 0..*Reference(Goal)Goals this activity relates to
..... status ?!1..1codenot-started | scheduled | in-progress | on-hold | completed | cancelled | unknown
Binding: CarePlanActivityStatus (required)
..... statusReason 0..1stringReason for current status
..... prohibited ?!0..1booleanDo NOT do
..... scheduled[x] 0..1Timing, Period, stringWhen activity is to occur
..... location 0..1Reference(Location)Where it should happen
..... performer 0..*Reference(Practitioner), Reference(Organization), Reference(RelatedPerson), Reference(Patient), Reference(CareTeam)Who will be responsible?
..... product[x] 0..1CodeableConcept, Reference(Medication), Reference(Substance)What is to be administered/supplied
Binding: SNOMED CT Medication Codes (example)
..... dailyAmount 0..1SimpleQuantityHow to consume/day?
..... quantity 0..1SimpleQuantityHow much to administer/supply/consume
..... description 0..1stringExtra info describing activity to perform
... note 0..*AnnotationComments about the plan

doco Documentation for this format

Complete Summary of the Mandatory Requirements

  1. A narrative summary in CarePlan.text
  2. One status in CarePlan.status
  3. One intent in CarePlan.intent
  4. A category in Careplan.category which must have:
    • a fixed Careplan.category.coding.system= “http://hl7.org/fhir/us/core/CodeSystem/careplan-category”
    • a fixed Careplan.category.coding.code=“assess-plan”
  5. One reference to a patient in CarePlan.subject

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. CarePlan 0..*US Core CarePlan Profile
... text S1..1Narrative
.... status S1..1codeBinding: Narrative Status (required)
... status S1..1codeBinding: CarePlanStatus (required)
... intent S1..1codeBinding: CarePlanIntent (required)
... category SI1..*CodeableConceptus-core-1: Must have a category of 'assess-plan' and a code system 'http://hl7.org/fhir/us/core/CodeSystem/careplan-category'
... subject S1..1Reference(US Core Patient Profile)

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. CarePlan I0..*US Core CarePlan Profile
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text SI1..1NarrativeText summary of the resource, for human interpretation
.... id 0..1stringxml:id (or equivalent in JSON)
.... status S1..1codegenerated | extensions | additional | empty
Binding: Narrative Status (required)
.... div I1..1xhtmlLimited xhtml content
txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes
txt-2: The narrative SHALL have some non-whitespace content
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal Ids for this plan
... definition Σ0..*Reference(PlanDefinition), Reference(Questionnaire)Protocol or definition
... basedOn Σ0..*Reference(CarePlan)Fulfills care plan
... replaces Σ0..*Reference(CarePlan)CarePlan replaced by this CarePlan
... partOf Σ0..*Reference(CarePlan)Part of referenced CarePlan
... status ?!SΣ1..1codedraft | active | suspended | completed | entered-in-error | cancelled | unknown
Binding: CarePlanStatus (required)
... intent ?!SΣ1..1codeproposal | plan | order | option
Binding: CarePlanIntent (required)
... category SΣI1..*CodeableConceptType of plan
Binding: Care Plan Category (example)
us-core-1: Must have a category of 'assess-plan' and a code system 'http://hl7.org/fhir/us/core/CodeSystem/careplan-category'
... title Σ0..1stringHuman-friendly name for the CarePlan
... description Σ0..1stringSummary of nature of plan
... subject SΣ1..1Reference(US Core Patient Profile)Who care plan is for
... context Σ0..1Reference(Encounter), Reference(EpisodeOfCare)Created in context of
... period Σ0..1PeriodTime period plan covers
... author Σ0..*Reference(Patient), Reference(Practitioner), Reference(RelatedPerson), Reference(Organization), Reference(CareTeam)Who is responsible for contents of the plan
... careTeam 0..*Reference(CareTeam)Who's involved in plan?
... addresses Σ0..*Reference(Condition)Health issues this plan addresses
... supportingInfo 0..*Reference(Resource)Information considered as part of plan
... goal 0..*Reference(Goal)Desired outcome of plan
... activity I0..*BackboneElementAction to occur as part of plan
cpl-3: Provide a reference or detail, not both
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... outcomeCodeableConcept 0..*CodeableConceptResults of the activity
Binding: Care Plan Activity Outcome (example)
.... outcomeReference 0..*Reference(Resource)Appointment, Encounter, Procedure, etc.
.... progress 0..*AnnotationComments about the activity status/progress
.... reference I0..1Reference(Appointment), Reference(CommunicationRequest), Reference(DeviceRequest), Reference(MedicationRequest), Reference(NutritionOrder), Reference(Task), Reference(ProcedureRequest), Reference(ReferralRequest), Reference(VisionPrescription), Reference(RequestGroup)Activity details defined in specific resource
.... detail I0..1BackboneElementIn-line definition of activity
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
..... category 0..1CodeableConceptdiet | drug | encounter | observation | procedure | supply | other
Binding: CarePlanActivityCategory (example)
..... definition 0..1Reference(PlanDefinition), Reference(ActivityDefinition), Reference(Questionnaire)Protocol or definition
..... code 0..1CodeableConceptDetail type of activity
Binding: Care Plan Activity (example)
..... reasonCode 0..*CodeableConceptWhy activity should be done or why activity was prohibited
Binding: Activity Reason (example)
..... reasonReference 0..*Reference(Condition)Condition triggering need for activity
..... goal 0..*Reference(Goal)Goals this activity relates to
..... status ?!1..1codenot-started | scheduled | in-progress | on-hold | completed | cancelled | unknown
Binding: CarePlanActivityStatus (required)
..... statusReason 0..1stringReason for current status
..... prohibited ?!0..1booleanDo NOT do
..... scheduled[x] 0..1Timing, Period, stringWhen activity is to occur
..... location 0..1Reference(Location)Where it should happen
..... performer 0..*Reference(Practitioner), Reference(Organization), Reference(RelatedPerson), Reference(Patient), Reference(CareTeam)Who will be responsible?
..... product[x] 0..1CodeableConcept, Reference(Medication), Reference(Substance)What is to be administered/supplied
Binding: SNOMED CT Medication Codes (example)
..... dailyAmount 0..1SimpleQuantityHow to consume/day?
..... quantity 0..1SimpleQuantityHow much to administer/supply/consume
..... description 0..1stringExtra info describing activity to perform
... note 0..*AnnotationComments about the plan

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON, CSV), Schema: XML Schematron

 

1.3 - Quick Start

Below is an overview of the required search and read operations for this profile. See the Conformance requirements for the US Core Server for a complete list of supported RESTful operations and search parameters for this IG.

GET /CarePlan?patient=[id]&category=assess-plan

Example: GET [base]/CarePlan?patient=1137192&category=assess-plan

Support: Mandatory to support search by patient.

Implementation Notes: Search for all patient assessments and plans of treatment for a patient. Fetches a bundle of all CarePlan resources for the specified patient (how to search by reference) and (how to search by token).

GET /CarePlan?patient=[id]&category=assess-plan&date=[date]

Example:

  • GET [base]/CarePlan?patient=1137192&category=assess-plan&date=ge2015-01-14
  • GET [base]/CarePlan?patient=1137192&category=assess-plan&date=ge2015-01-14&date=le2016-01-14

Support: Mandatory to support search by date

Implementation Notes: Search for all assessment and plan of treatment for a patient within a time period. Fetches a bundle of all CarePlan resources for the specified patient for a specified time period. (how to search by reference), (how to search by token) and (how to search by date).

GET /CarePlan?patient=[id]&category=assess-plan&status=active

Example: GET [base]/CarePlan?patient=1137192&status=active

Support: SHOULD support search by patient and status = ‘active’.

Implementation Notes: SHOULD support search by reference and status. (how to search by reference), (how to search by token).

GET /CarePlan?patient=[id]&category=assess-plan&status=active&date=[date]

Example: GET [base]/CarePlan?patient=1137192&category=assess-plan&datatus=active&date=ge2015-01-14

Support: SHOULD support search by patient and status = ‘active’ and date.

Implementation Notes: Search for all active assessment and plan of treatment for a patient within a time period. Fetches a bundle of all active (careplan = “active”) CarePlan resources for the specified patient for a specified time period. (how to search by reference), (how to search by token) and (how to search by date).