Multiple Chronic Condition Care Plan Procedure - MCC eCare Plan Implementation Guide v1.0.0

MCC eCare Plan Implementation Guide
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This page is part of the MCC eCare Plan Implementation Guide (v1.0.0: STU 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: Multiple Chronic Condition Care Plan Procedure

Official URL: http://hl7.org/fhir/us/mcc/StructureDefinition/MCCProcedure				Version: 1.0.0
Draft as of 2020-07-22				Computable Name: MCCProcedure

This profile constrains US Core Procedure for use in the MCC FHIR Care Plan or other FHIR Care Plans.

The US Core Procedure profile sets minimum expectations for the Procedure resource to record, search, and fetch procedures associated with a patient, including information about a Social Determinants of Health-related procedures. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile.

In addition to the requirements set forth in US Core Procedure, this derived profile is designed to add requirements to the following elements:

Procedure.extension:resource-pertainsToGoal (Must Support) to encourage linking to the goal the procedure hopes to facilitate and/or to encourage systems to be able to receive and understand a goal linkage if present. Procedue.reasonReference (Must Support) to encourage linking back to the health concern, problem or observation associated with the procedure, and/or to encourage systems to be able to receive and understand a reason for a procedure, if present.

See the MCC Care Plan SDOH Guidance page for more information when exchanging Social Determinants of Health (SDOH) procedures.

No additional value sets were defined for use in this profile beyond the the value set bindings in the US Core Procedure profile, but please see the MCC Procedure and Service Request Value Set library page for guidance on use of procedure terminology in this guide.

Usage:

Formal Views of Profile Content

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

Differential Table
Key Elements Table
Snapshot Table
Statistics/References
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This structure is derived from USCoreProcedureProfile

Name	Flags	Card.	Type	Description & Constraints
Procedure		0..*	USCoreProcedureProfile	An action that is being or was performed on a patient
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
code		1..1	CodeableConcept	Please see the Procedure and Service Request Value Set Library for value sets that are subsets of US Core Procedure Codes that can be used at the Procedure.code element element
reasonReference	S	0..*	Reference(Condition \| Observation \| Procedure \| DiagnosticReport \| DocumentReference)	The procedure.reason.reference should be populated with the health concern or problem for which it is or was performed.
report		0..*	Reference(DiagnosticReport \| DocumentReference \| Composition)	Any report resulting from the procedure
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Procedure	C	0..*	USCoreProcedureProfile	An action that is being or was performed on a patient us-core-7: Performed SHALL be present if the status is 'completed' or 'in-progress'
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣC	1..1	code	(USCDI) preparation \| in-progress \| not-done \| on-hold \| stopped \| completed \| entered-in-error \| unknown Binding: EventStatus (required)
code	SΣ	1..1	CodeableConcept	Please see the Procedure and Service Request Value Set Library for value sets that are subsets of US Core Procedure Codes that can be used at the Procedure.code element element Binding: US Core Procedure Codes (extensible): Codes describing the type of Procedure
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who the procedure was performed on
performed[x]	SΣC	0..1		(USCDI) When the procedure was performed
performedDateTime			dateTime
reasonReference	SΣ	0..*	Reference(Condition \| Observation \| Procedure \| DiagnosticReport \| DocumentReference)	The procedure.reason.reference should be populated with the health concern or problem for which it is or was performed.
report		0..*	Reference(DiagnosticReport \| DocumentReference \| Composition)	Any report resulting from the procedure
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Procedure.status	required	EventStatus `http://hl7.org/fhir/ValueSet/event-status` from the FHIR Standard
Procedure.code	extensible	USCoreProcedureCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code`

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Procedure	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().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Procedure	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	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Procedure	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
us-core-7	error	Procedure	Performed SHALL be present if the status is 'completed' or 'in-progress' : (status='completed' or status='in-progress') implies performed.exists()