Physical Activity Implementation Guide
1.0.0-ballot - STU1 ballot-draft United States of America flag

This page is part of the U.S. Physical Activity IG (v1.0.0-ballot: STU 1.0 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

CapabilityStatement: pa-care-manager

Official URL: http://hl7.org/fhir/us/physical-activity/CapabilityStatement/pa-care-manager Version: 1.0.0-ballot
Active as of 2022-06-18 Computable Name: PACareManager

Describes the expected capabilities of a system that is responsible for managing issues related to the physical activity level of a patient.

Raw OpenAPI-Swagger Definition file | Download


General

Supported FHIR Version: 4.0.1
Supported exchange formats: json, xml

Jump to:


REST client behavior

Care managers only act as clients in situation where they are interacting with 'full' service providers which have their own FHIR server interfaces. In this mode, the Care Manager can create and/or retrieve information from the referral recipient. There is no expectation that patient engagement systems will have their own FHIR server interfaces.


Resource summary

Resource Search Read Read Version Instance History Resource History Create Update Delete Operations
CarePlan SHOULD MAY SHOULD
Goal SHOULD MAY SHOULD
Observation SHALL
DiagnosticReport SHALL
Task SHALL SHOULD SHOULD
Subscription SHALL SHALL SHALL


CarePlan

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  update SHOULD

Allows a clinician to make updates to a plan owned by a service provider.

  search-type SHOULD

Allows retrieval of care plans for a given patient.

  history-instance MAY

Allows seeing how a care plan has changed over time. This may be particularly important if multiple stakeholders have the ability to make adjustments to the plan. However, history is not widely supported.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

Allows retrieving known care plan records - and more specifically, retrieving more than one in a single call to check for updates.

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query.

category SHOULD token

Allows retrieving only those plans related to physical activity.

date SHOULD date

Allows filtering plans based on the time frame they apply(ied) to.

lifecycle-status SHALL token

Allows filtering to only active or draft plans.

patient SHALL reference

Allows filtering to only those plans for a specific patient. Most systems will treat this as a mandatory search parameter, though systems MAY support cross-patient search, at least through bulk-data interfaces for payer or research use.



Goal

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  update SHOULD

Allows patients or service providers to modify a goal - for example shifting target values or dates, updating the status, etc. Allowing patients, care-givers, and service providers to help maintain goals is a key aspect of a patient-centered care plan. However, not all care manager systems (or their organizations) yet have the technical mechanisms or policies in place to support this.

  search-type SHOULD

Allows retrieval of goals for a given patient.

  history-instance MAY

Allows seeing how goals have changed over time. This may be particularly important if multiple stakeholders have the ability to make adjustments to goals. However, history is not widely supported.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

Allows retrieving known goal records - and more specifically, retrieving more than one in a single call to poll for updates.

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query.

category SHALL token

Allows retrieving only those goals related to physical activity.

lifecycle-status SHOULD token

Allows filtering to only active, completed or other goal statuses.

patient SHALL reference

Allows filtering to only those goals for a specific patient. Most systems will treat this as a mandatory search parameter, though systems MAY support cross-patient search, at least through bulk-data interfaces for payer or research use.

target-date SHOULD date

Allows filtering goals based on when they're to be achieved.



Observation

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  search-type SHALL

Allows retrieval of observations for a given patient.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

Allows retrieving known observation records - and more specifically, retrieving more than one in a single call to poll for updates.

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query.

category SHALL token

Allows retrieving only those observations related to physical activity. As well, many clinical systems will require searches to specify a category so the server knows which part of the database to search as different types of observations are stored in different areas.

code SHALL token

Allows filtering to only retrieve a specific type of physical activity vital sign or supporting observation.

date SHALL date

Allows filtering to only retrieve a observations from a particular time period.

patient SHALL reference

Allows filtering to only those observations for a specific patient. Most systems will treat this as a mandatory search parameter, though systems MAY support cross-patient search, at least through bulk-data interfaces for payer or research use.

status SHALL token

Allows excluding entered-in-error or non-final observations.

value-quantity SHOULD quantity

Allows retrieval of only those observations that fall in a particular range. Particularly useful for cross-patient queries.



DiagnosticReport

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  search-type SHALL

Allows searching for reports for a particular patient or checking for updates to previously retrieved records.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

Allows retrieving known reports - and more specifically, retrieving more than one in a single call to poll for updates.

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query.

basedOn SHOULD reference

Allows filtering to reports created in fulfillement of a particular order or referral.

code SHOULD token

Allows filtering to specific types of reports.

date SHOULD date

Allows filtering reports based on the period the cover.

category SHALL token

Allows retrieving only those reports related to physical activity.

patient SHALL reference

Allows filtering to only those reports for a specific patient. Most systems will treat this as a mandatory search parameter, though systems MAY support cross-patient search, at least through bulk-data interfaces for payer or research use.

performer SHOULD reference

Allows filtering to only retrieve reports created by a specific performer.

status SHOULD token

Allows filtering to only retrieve active or completed reports.



Task

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  create SHOULD

Allows a creation of Task on a Service Provider system.

  update SHOULD

Allows cancelling or adding notes to an existing Task.

  search-type SHALL

Allows checking for updates on a Task after receiving a subscription notification.

Search

Supported Includes: Task:output

Parameter Conformance Type Definition & Chaining
_id SHALL token

Allows retrieving known task records - and more specifically, retrieving more than one in a single call to poll for updates.

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query.

code SHALL token

Allows filtering for 'fulfill' tasks as opposed to others. Some systems may require code to be included as a filter criteria as different Task codes may correspond to different internal database tables.

owner SHALL reference

Allows filtering only for tasks that are assigned to a particular owner (or alternatively, tasks that have not yet been assigned).

patient SHALL reference

Allows filtering to only those tasks for a specific patient. Most systems will treat this as a mandatory search parameter, though systems MAY support cross-patient search, at least through bulk-data interfaces for payer or research use.

requester SHALL reference

Allows filtering to only retrieve tasks initiated by a specific provider.

status SHALL token

Allows filtering to only retrieve active or completed orders.

focus SHOULD reference

Allows retrieving the task(s) seeking fulfillment of a particular ServiceRequest.

output SHOULD reference

Allows for the 'output' of a Task to be included when retrieving a Task.



Subscription

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  create SHALL

Allows establishing a new subscription.

  update SHALL

Allows revising an existing subscription - to cancel it or change the email address or SMS number.

  search-type SHALL

Allows retrieval of existing subscriptions prior to update.

Search

Parameter Conformance Type Definition & Chaining
topic SHOULD uri

Allows filtering for just subscriptions for Task monitoring.

_id SHALL token

Allows retrieving known subscription records.


REST server behavior

Care Managers act primarily as servers, allowing light and full service providers and patient engagement systems to retrieve information stored on the manager, and in some cases to create and update information present on the manager.


Security:

  • OAuth

See additional guidance on the security page.


Resource summary

Resource Search Read Read Version Instance History Resource History Create Update Delete Operations
CarePlan SHALL MAY SHOULD SHOULD
Condition SHALL MAY
DocumentReference SHALL SHOULD MAY
Goal SHALL MAY SHOULD SHOULD
Observation SHALL SHALL SHOULD
DiagnosticReport SHALL SHALL SHOULD
Questionnaire SHALL
QuestionnaireResponse SHALL SHALL SHOULD
ServiceRequest SHALL
Subscription SHALL SHALL SHALL
Task SHALL SHOULD SHALL


CarePlan

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  update SHOULD

Allows patients or service providers to modify a care plan. Allowing patients, care-givers, and service providers to help maintain care plans is a key aspect of a patient-centered care plan. However, not all care manager systems (or their organizations) yet have the technical mechanisms or policies in place to support this.

  create SHOULD

Allows patients or service providers to add additional physical activity related care plans. As with updates, this is a key part of a patient-centered care plan, but not all systems or organizations will be able to do this.

  search-type SHALL

Allows retrieval of care plans for a given patient.

  history-instance MAY

Allows seeing how a care plan has changed over time. This may be particularly important if multiple stakeholders have the ability to make adjustments to the plan. However, history is not widely supported.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

Allows retrieving known care plan records - and more specifically, retrieving more than one in a single call to check for updates.

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query.

category SHOULD token

Allows retrieving only those plans related to physical activity.

date SHOULD date

Allows filtering plans based on the time frame they apply(ied) to.

lifecycle-status SHALL token

Allows filtering to only active or draft plans.

patient SHALL reference

Allows filtering to only those plans for a specific patient. Most systems will treat this as a mandatory search parameter, though systems MAY support cross-patient search, at least through bulk-data interfaces for payer or research use.



Condition

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  search-type SHALL

Allows retrieval of conditions for a given patient.

  history-instance MAY

Allows seeing how a condition has changed over time.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

Allows retrieving known condition records - and more specifically, retrieving more than one in a single call to check for updates.

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query.

category SHALL token

Allows retrieving only those plans related to physical activity.

clinical-status SHOULD token

Allows filtering to only active conditions.

code SHOULD token

Allows retrieving specific patient conditions - e.g. all 'low physical activity' conditions.

patient SHALL reference

Allows filtering to only those plans for a specific patient. Most systems will treat this as a mandatory search parameter, though systems MAY support cross-patient search, at least through bulk-data interfaces for payer or research use.

verification-status SHOULD token

Allows excluding refuted or erroneous conditions.



DocumentReference

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  create SHOULD

Allows a ServiceProvider to add additional images/documents for later retrieval.

  update MAY

Allows a ServiceProvider to replace an existing image/document with a newer version.

  search-type SHALL

Allows monitoring of previously-retrieved DocumentReferences in the event the image/document is amended, corrected, or updated.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

Allows retrieving known document-reference records - and more specifically, retrieving more than one in a single call to poll for updates.

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query.

contenttype SHOULD token

Allows filtering for only PDFs, images, etc.

category SHOULD token

Allows filtering for only records tied to a particular category (e.g. physical-activity).

description SHOULD string

Allows filtering based on words found in the description - i.e. with a 'contains' search.



Goal

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  update SHOULD

Allows patients or service providers to modify a goal - for example shifting target values or dates, updating the status, etc. Allowing patients, care-givers, and service providers to help maintain goals is a key aspect of a patient-centered care plan. However, not all care manager systems (or their organizations) yet have the technical mechanisms or policies in place to support this.

  create SHOULD

Allows patients or service providers to add additional physical activity related goals. As with updates, this is a key part of a patient-centered care plan, but not all systems or organizations will be able to do this.

  search-type SHALL

Allows retrieval of goals for a given patient.

  history-instance MAY

Allows seeing how goals have changed over time. This may be particularly important if multiple stakeholders have the ability to make adjustments to goals. However, history is not widely supported.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

Allows retrieving known goal records - and more specifically, retrieving more than one in a single call to poll for updates.

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query.

category SHALL token

Allows retrieving only those goals related to physical activity.

lifecycle-status SHOULD token

Allows filtering to only active, completed or other goal statuses.

patient SHALL reference

Allows filtering to only those goals for a specific patient. Most systems will treat this as a mandatory search parameter, though systems MAY support cross-patient search, at least through bulk-data interfaces for payer or research use.

target-date SHOULD date

Allows filtering goals based on when they're to be achieved.



Observation

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  update SHOULD

Allows correction of or adding comments to previously recorded observations.

  create SHALL

Allows other systems to record physical-activity related observations.

  search-type SHALL

Allows retrieval of observations for a given patient.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

Allows retrieving known observation records - and more specifically, retrieving more than one in a single call to poll for updates.

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query.

category SHALL token

Allows retrieving only those observations related to physical activity. As well, many clinical systems will require searches to specify a category so the server knows which part of the database to search as different types of observations are stored in different areas.

code SHALL token

Allows filtering to only retrieve a specific type of physical activity vital sign or supporting observation.

date SHALL date

Allows filtering to only retrieve a observations from a particular time period.

patient SHALL reference

Allows filtering to only those observations for a specific patient. Most systems will treat this as a mandatory search parameter, though systems MAY support cross-patient search, at least through bulk-data interfaces for payer or research use.

status SHALL token

Allows excluding entered-in-error or non-final observations.

value-quantity SHOULD quantity

Allows retrieval of only those observations that fall in a particular range. Particularly useful for cross-patient queries.



DiagnosticReport

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  create SHALL

Allows recording of reports about physical activity interventions.

  update SHOULD

Allows updating or correcting a report on physical activity interventions. E.g. updating to change status, add notes, etc.

  search-type SHALL

Allows searching for reports for a particular patient or checking for updates to previously retrieved records.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

Allows retrieving known reports - and more specifically, retrieving more than one in a single call to poll for updates.

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query.

basedOn SHOULD reference

Allows filtering to reports created in fulfillement of a particular order or referral.

code SHOULD token

Allows filtering to specific types of reports.

date SHOULD date

Allows filtering reports based on the period the cover.

category SHALL token

Allows retrieving only those reports related to physical activity.

patient SHALL reference

Allows filtering to only those reports for a specific patient. Most systems will treat this as a mandatory search parameter, though systems MAY support cross-patient search, at least through bulk-data interfaces for payer or research use.

performer SHOULD reference

Allows filtering to only retrieve reports created by a specific performer.

status SHOULD token

Allows filtering to only retrieve active or completed reports.



Questionnaire

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  search-type SHALL

Allows retrieval of questionnaires to be completed.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

Allows retrieving known questionnaire records - and more specifically, retrieving more than one in a single call to poll for updates.

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query.

url SHALL uri

Allows retrieving a referenced Questionnaire.

version SHOULD token

Allows retrieving a specific version of a referenced questionnaire.

context-type-value SHOULD composite

Allows filtering for Questionnaires that are phyical activity-related.

identifier SHOULD token

Allows retrieving Questionnaires with a known identifier.

publisher SHOULD string

Allows retrieving Questionnaires based on who is responsible for having defined the form.

status SHOULD token

Allows filtering to only retrieve active questionnaires.

subject-type SHOULD token

Allows retrieving Questionnaires that are intended to provide information about patients - as opposed to practitioners, organizations, etc.

title SHOULD string

Allows searching for forms by name.



QuestionnaireResponse

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  update SHOULD

Allows correction of or continued editing of a previously recorded questionnaire response.

  create SHALL

Allows other systems to record questionnaire responses.

  search-type SHALL

Allows retrieval of completed or in-progresss questionnaire responses.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

Allows retrieving known questionnaire response records - and more specifically, retrieving more than one in a single call to poll for updates.

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query.

author SHALL reference

Allows filtering responses previously created by a particular individual.

authored SHOULD date

Allows filtering responses based on when they were completed.

patient SHALL reference

Allows filtering to only those responses for a specific patient. Most systems will treat this as a mandatory search parameter, though systems MAY support cross-patient search, at least through bulk-data interfaces for payer or research use.

questionnaire SHALL reference

Allows retrieving a referenced Questionnaire.

status SHOULD token

Allows filtering to only retrieve completed questionnaire responses.



ServiceRequest

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  search-type SHALL

Allows searching for orders or referrals for a particular patient or for updates to previously retrieved orders.

Search

Supported Includes: ServiceRequest:patient, ServiceRequest:requester

Parameter Conformance Type Definition & Chaining
_id SHALL token

Allows retrieving known service request records - and more specifically, retrieving more than one in a single call to poll for updates.

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query.

authored SHOULD date

Allows filtering orders based on when they were created.

category SHALL token

Allows retrieving only those referrals related to physical activity.

code SHALL token

Allows retrieving only orders for particular types of interventions.

patient SHALL reference

Allows filtering to only those orders for a specific patient. Most systems will treat this as a mandatory search parameter, though systems MAY support cross-patient search, at least through bulk-data interfaces for payer or research use.

performer SHOULD reference

Allows filtering to only retrieve orders targeted to a specific performer.

requester SHOULD reference

Allows filtering to only retrieve orders solicited by a specific provider.

status SHOULD token

Allows filtering to only retrieve active or completed orders.



Subscription

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  create SHALL

Allows establishing a new subscription.

  update SHALL

Allows revising an existing subscription - to cancel it or change the email address or SMS number.

  search-type SHALL

Allows retrieval of existing subscriptions prior to update.

Search

Parameter Conformance Type Definition & Chaining
topic SHOULD uri

Allows filtering for just subscriptions for Task monitoring.

_id SHALL token

Allows retrieving known subscription records.



Task

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  create SHOULD

Allows a service provider to create a patient-assigned Task.

  update SHALL

Allows existing tasks to be updated - to change their status and/or to attach 'outputs' resulting from the Task.

  search-type SHALL

Allows polling multiple tasks simultaneously, as well as retrieving referenced resources as part of a single query.

Search

Supported Includes: Task:focus, Task:output, Task:patient, ServiceRequest:requester

Parameter Conformance Type Definition & Chaining
_id SHALL token

Allows retrieving known task records - and more specifically, retrieving more than one in a single call to poll for updates.

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query.

code SHALL token

Allows filtering for 'fulfill' tasks as opposed to others. Some systems may require code to be included as a filter criteria as different Task codes may correspond to different internal database tables.

owner SHALL reference

Allows filtering only for tasks that are assigned to a particular owner (or alternatively, tasks that have not yet been assigned).

patient SHALL reference

Allows filtering to only those tasks for a specific patient. Most systems will treat this as a mandatory search parameter, though systems MAY support cross-patient search, at least through bulk-data interfaces for payer or research use.

requester SHALL reference

Allows filtering to only retrieve tasks initiated by a specific provider.

status SHALL token

Allows filtering to only retrieve active or completed orders.

focus SHOULD reference

Allows retrieving the task(s) seeking fulfillment of a particular ServiceRequest.

output SHOULD reference

Allows for the 'output' of a Task to be included when retrieving a Task.