US Core Implementation Guide
7.0.0-ballot - Ballot
US Core Implementation Guide
7.0.0-ballot - Ballot
This page is part of the US Core (v7.0.0-ballot: STU7 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 6.1.0. For a full list of available versions, see the Directory of published versions
| Page standards status: Informative |
This page is new content for US Core Version 7.0.0
To meet the ONC’s granular scope requirement in HTI-1 proposed rule, the US Core API requires servers to support both resource level scopes and granular scopes as defined in Version 2.0.0 of SMART App Launch. US Core clients should follow the principle of least privilege and access only the necessary resources. In other words, if a client needs only vital sign observations, it should request access only to Observations with a category of “vital-signs”. US Core requires scopes for:
In addition to the read and search capabilities defined in the server’s CapabilityStatement,
servers SHALL document supported scopes in the scopes_supported section of a .well-known/smart-configuration capabilities array.
Version 2.0.0 of SMART App Launch introduced a scope syntax of: <patient|user|system> / <fhir-resource>. <c | r | u | d |s> [?param=value]
For example, to limit read and search access to a specific patient’s laboratory observations but not other observations, the server grants the following scope:
patient/Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory.
The example scopes below use a single FHIR search parameter of category applied to Condition and Observation. They use a patient/ prefix, but implementers can also support system/ and user/.
patient/Condition.rs?category=http://terminology.hl7.org/CodeSystem/condition-category|encounter-diagnosispatient/Condition.rs?category=http://terminology.hl7.org/CodeSystem/condition-category|problem-list-itempatient/Condition.rs?category=http://hl7.org/fhir/us/core/CodeSystem/condition-category|health-concernpatient/Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|clinical-testpatient/Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratoryThe table below summarizes the US Core scope requirements. The same information can be found in each US Core Profile page’s “Quick Start” section.
| US Core Profile | Scopes |
|---|---|
| US Core AllergyIntolerance Profile |
resource level scope: patient/AllergyIntolerance.rs
|
| US Core CarePlan Profile |
resource level scope: patient/CarePlan.rs
|
| US Core CareTeam Profile |
resource level scope: patient/CareTeam.rs
|
| US Core Condition Encounter Diagnosis Profile |
resource level scope: patient/Condition.rs
granular scope: patient.Condition.rs?category=http://terminology.hl7.org/CodeSystem/condition-category|encounter-diagnosis
|
| US Core Condition Problems and Health Concerns Profile |
resource level scope: patient/Condition.rs
granular scope: patient.Condition.rs?category=http://terminology.hl7.org/CodeSystem/condition-category|problem-list-item
granular scope: patient.Condition.rs?category=http://hl7.org/fhir/us/core/CodeSystem/condition-category|health-concern`
|
| US Core Coverage Profile |
resource level scope: patient/Coverage.rs
|
| US Core Implantable Device Profile |
resource level scope: patient/Device.rs
|
| US Core DiagnosticReport Profile for Report and Note Exchange |
resource level scope: patient/DiagnosticReport.rs
granular scope: patient.DiagnosticReport.rs?category=http://loinc.org|LP29684-5
granular scope: patient.DiagnosticReport.rs?category=http://loinc.org|LP29708-2
granular scope: patient.DiagnosticReport.rs?category=http://loinc.org|LP7839-6
|
| US Core DiagnosticReport Profile for Laboratory Results Reporting |
resource level scope: patient/DiagnosticReport.rs
granular scope: patient.DiagnosticReport.rs?category=http://terminology.hl7.org/CodeSystem/v2-0074|LAB
|
| US Core DocumentReference Profile |
resource level scope: patient/DocumentReference.rs
granular scope: patient.DocumentReference.rs?category=http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category|clinical-note
|
| US Core Encounter Profile |
resource level scope: patient/Encounter.rs
|
| US Core Goal Profile |
resource level scope: patient/Goal.rs
|
| US Core Immunization Profile |
resource level scope: patient/Immunization.rs
|
| US Core MedicationRequest Profile |
resource level scope: patient/MedicationRequest.rs
|
| US Core MedicationDispense Profile |
resource level scope: patient/MedicationDispense.rs
|
| US Core Laboratory Result Observation Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory
|
| US Core Observation Pregnancy Status Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org//CodeSystem-observation-category.html|social-history
|
| US Core Observation Pregnancy Intent Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org//CodeSystem-observation-category.html|social-history
|
| US Core Observation Occupation Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org//CodeSystem-observation-category.html|social-history
|
| US Core Respiratory Rate Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs
|
| US Core Simple Observation Profile |
resource level scope: patient/Observation.rs
|
| US Core Heart Rate Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs
|
| US Core Body Temperature Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs
|
| US Core Pediatric Weight for Height Observation Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs
|
| US Core Pulse Oximetry Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs
|
| US Core Smoking Status Observation Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org//CodeSystem-observation-category.html|social-history
|
| US Core Observation Sexual Orientation Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org//CodeSystem-observation-category.html|social-history
|
| US Core Head Circumference Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs
|
| US Core Body Height Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs
|
| US Core BMI Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs
|
| US Core Observation Screening Assessment Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|survey
|
| US Core Average Blood Pressure Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs
|
| US Core Blood Pressure Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs
|
| US Core Observation Clinical Result Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|imaging
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|procedure
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory
|
| US Core Pediatric BMI for Age Observation Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs
|
| US Core Pediatric Head Occipital Frontal Circumference Percentile Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs
|
| US Core Body Weight Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs
|
| US Core Vital Signs Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs
|
| US Core Organization Profile |
resource level scope: patient/Organization.rs
|
| US Core Patient Profile |
resource level scope: patient/Patient.rs
|
| US Core Practitioner Profile |
resource level scope: patient/Practitioner.rs
|
| US Core PractitionerRole Profile |
resource level scope: patient/PractitionerRole.rs
|
| US Core Procedure Profile |
resource level scope: patient/Procedure.rs
|
| US Core Provenance Profile |
resource level scope: patient/Provenance.rs
|
| US Core QuestionnaireResponse Profile |
resource level scope: patient/QuestionnaireResponse.rs
|
| US Core RelatedPerson Profile |
resource level scope: patient/RelatedPerson.rs
|
| US Core ServiceRequest Profile |
resource level scope: patient/ServiceRequest.rs
granular scope: patient.ServiceRequest.rs?category=http://hl7.org/fhir/us/core/CodeSystem/us-core-category|sdoh
granular scope: patient.ServiceRequest.rs?category=http://hl7.org/fhir/us/core/CodeSystem/us-core-category|functional-status
granular scope: patient.ServiceRequest.rs?category=http://snomed.info/sct|surgical-procedure
|
| US Core Specimen Profile |
resource level scope: patient/Specimen.rs
|
| US Core Treatment Intervention Preference Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://hl7.org/fhir/us/core/CodeSystem/us-core-category|treatment-intervention-preference
|
| US Core Care Experience Preference Profile |
resource level scope: patient/Observation.rs
granular scope: patient.Observation.rs?category=http://hl7.org/fhir/us/core/CodeSystem/us-core-category|care-experience-preference
|
The scopes are formally defined in a server hosts a smart-configuration file at [url]/.well-known/smart-configuration that is available to both authenticated and unauthenticated clients.
The server SHALL support all scopes listed in the table above for the US Core Profiles they support; additional scopes MAY be supported (so clients should not consider this an exhaustive list).
Servers MAY limit clients’ scopes to those configured at registration time. Servers SHALL allow users to select a subset of the requested scopes at the approval time. The app SHOULD inspect the returned scopes and accommodate the differences from the scopes it requested and registered.
.well-known/smart-configuration FileThis example .well-known/smart-configuration file contains all the US Core scopes listed in the capabilities array. See the SMART App Launch Implementation Guide for more example and details.
HTTP/1.1 200 OK
Content-Type: application/json
{
"issuer": "https://ehr.example.com",
"jwks_uri": "https://ehr.example.com/.well-known/jwks.json",
"authorization_endpoint": "https://ehr.example.com/auth/authorize",
"token_endpoint": "https://ehr.example.com/auth/token",
"token_endpoint_auth_methods_supported": [
"client_secret_basic",
"private_key_jwt"
],
"grant_types_supported": [
"authorization_code",
"client_credentials"
],
"registration_endpoint": "https://ehr.example.com/auth/register",
"scopes_supported": [
"openid",
"profile",
"launch",
"launch/patient",
"offline_access",
"patient/AllergyIntolerance.rs",
"patient/CarePlan.rs",
"patient/CareTeam.rs",
"patient/Condition.rs",
"patient/Condition.rs?category=http://hl7.org/fhir/us/core/CodeSystem/condition-category|health-concern`",
"patient/Condition.rs?category=http://terminology.hl7.org/CodeSystem/condition-category|encounter-diagnosis",
"patient/Condition.rs?category=http://terminology.hl7.org/CodeSystem/condition-category|problem-list-item",
"patient/Coverage.rs",
"patient/Device.rs",
"patient/DiagnosticReport.rs",
"patient/DiagnosticReport.rs?category=http://loinc.org|LP29684-5",
"patient/DiagnosticReport.rs?category=http://loinc.org|LP29708-2",
"patient/DiagnosticReport.rs?category=http://loinc.org|LP7839-6",
"patient/DiagnosticReport.rs?category=http://terminology.hl7.org/CodeSystem/v2-0074|LAB",
"patient/DocumentReference.rs",
"patient/DocumentReference.rs?category=http://hl7.org/fhir/us/core/CodeSystem/us-core-documentreference-category|clinical-note",
"patient/Encounter.rs",
"patient/Goal.rs",
"patient/Immunization.rs",
"patient/MedicationDispense.rs",
"patient/MedicationRequest.rs",
"patient/Observation.rs",
"patient/Observation.rs?category=http://hl7.org/fhir/us/core/CodeSystem/us-core-category|care-experience-preference",
"patient/Observation.rs?category=http://hl7.org/fhir/us/core/CodeSystem/us-core-category|treatment-intervention-preference",
"patient/Observation.rs?category=http://terminology.hl7.org//CodeSystem-observation-category.html|social-history",
"patient/Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|imaging",
"patient/Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|laboratory",
"patient/Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|procedure",
"patient/Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|survey",
"patient/Observation.rs?category=http://terminology.hl7.org/CodeSystem/observation-category|vital-signs",
"patient/Organization.rs",
"patient/Patient.rs",
"patient/Practitioner.rs",
"patient/PractitionerRole.rs",
"patient/Procedure.rs",
"patient/Provenance.rs",
"patient/QuestionnaireResponse.rs",
"patient/RelatedPerson.rs",
"patient/ServiceRequest.rs",
"patient/ServiceRequest.rs?category=http://hl7.org/fhir/us/core/CodeSystem/us-core-category|functional-status",
"patient/ServiceRequest.rs?category=http://hl7.org/fhir/us/core/CodeSystem/us-core-category|sdoh",
"patient/ServiceRequest.rs?category=http://snomed.info/sct|surgical-procedure",
"patient/Specimen.rs"
],
"response_types_supported": ["code"],
"management_endpoint": "https://ehr.example.com/user/manage",
"introspection_endpoint": "https://ehr.example.com/user/introspect",
"revocation_endpoint": "https://ehr.example.com/user/revoke",
"code_challenge_methods_supported": ["S256"],
"capabilities": [
"launch-ehr",
"permission-patient",
"permission-v2",
"client-public",
"client-confidential-symmetric",
"context-ehr-patient",
"sso-openid-connect"
]
}
IG © 2023+ HL7 International / Cross-Group Projects. Package hl7.fhir.us.core#7.0.0-ballot based on FHIR 4.0.1. Generated 2023-12-19
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