Describes the intention of how one or more practitioners intend to deliver care for a particular patient, group or community for a period of time, possibly limited to care for a specific condition or set of conditions.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

An Extension

DSTU2: CarePlan.modified (new:dateTime)

Element CarePlan.modified has a context of CarePlan based on following the parent source element upwards and mapping to CarePlan. Element CarePlan.modified has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

DSTU2: CarePlan.relatedPlan.code (new:code)

Element CarePlan.relatedPlan.code has a context of CarePlan based on following the parent source element upwards and mapping to CarePlan. Element CarePlan.relatedPlan.code has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). Read the relationship as "this plan" [relatedPlan.code] "relatedPlan.plan"; e.g. This plan includes Plan B. Additional relationship types can be proposed for future releases or handled as extensions.

DSTU2: CarePlan.relatedPlan.plan (new:Reference(CarePlan))

Element CarePlan.relatedPlan.plan has a context of CarePlan based on following the parent source element upwards and mapping to CarePlan. Element CarePlan.relatedPlan.plan has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.

The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the care plan.

This element is labeled as a modifier because the status contains the code entered-in-error that marks the plan as not currently valid.

Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.

Allows clinicians to determine whether the plan is actionable or not.

Indicates the level of authority/intentionality associated with the care plan and where the care plan fits into the workflow chain.

This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. This element is expected to be immutable. E.g. A "proposal" instance should never change to be a "plan" instance or "order" instance. Instead, a new instance 'basedOn' the prior instance should be created with the new 'intent' value.

Codes indicating the degree of authority/intentionality associated with a care plan.

Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.

Identifies the patient or group whose intended care is described by the plan.

An Extension

DSTU2: CarePlan.subject additional types from child elements (display, reference)

Element CarePlan.subject is mapped to FHIR R5 element CarePlan.subject as SourceIsBroaderThanTarget. The mappings for CarePlan.subject do not cover the following types based on type expansion: display, reference. The standard extension alternate-reference has been mapped as the representation of FHIR DSTU2 element CarePlan.subject with unmapped reference targets: Group, Patient.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

DSTU2: CarePlan.meta additional types (Meta) additional types from child elements (lastUpdated, profile, security, tag, versionId)

Element CarePlan.meta is mapped to FHIR R5 element CarePlan.meta as SourceIsBroaderThanTarget. The mappings for CarePlan.meta do not cover the following types: Meta. The mappings for CarePlan.meta do not cover the following types based on type expansion: lastUpdated, profile, security, tag, versionId.

DSTU2: CarePlan.text additional types (Narrative) additional types from child elements (div, status)

Element CarePlan.text is mapped to FHIR R5 element CarePlan.text as SourceIsBroaderThanTarget. The mappings for CarePlan.text do not cover the following types: Narrative. The mappings for CarePlan.text do not cover the following types based on type expansion: div, status. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.

DSTU2: CarePlan.modified (new:dateTime)

Element CarePlan.modified has a context of CarePlan based on following the parent source element upwards and mapping to CarePlan. Element CarePlan.modified has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

DSTU2: CarePlan.relatedPlan.code (new:code)

Element CarePlan.relatedPlan.code has a context of CarePlan based on following the parent source element upwards and mapping to CarePlan. Element CarePlan.relatedPlan.code has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). Read the relationship as "this plan" [relatedPlan.code] "relatedPlan.plan"; e.g. This plan includes Plan B. Additional relationship types can be proposed for future releases or handled as extensions.

DSTU2: CarePlan.relatedPlan.plan (new:Reference(CarePlan))

Element CarePlan.relatedPlan.plan has a context of CarePlan based on following the parent source element upwards and mapping to CarePlan. Element CarePlan.relatedPlan.plan has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

DSTU2: CarePlan.identifier additional types (Identifier) additional types from child elements (assigner, period, system, type, use, value)

Element CarePlan.identifier is mapped to FHIR R5 element CarePlan.identifier as SourceIsBroaderThanTarget. The mappings for CarePlan.identifier do not cover the following types: Identifier. The mappings for CarePlan.identifier do not cover the following types based on type expansion: assigner, period, system, type, use, value.

DSTU2: CarePlan.subject additional types from child elements (display, reference)

Element CarePlan.subject is mapped to FHIR R5 element CarePlan.subject as SourceIsBroaderThanTarget. The mappings for CarePlan.subject do not cover the following types based on type expansion: display, reference. The standard extension alternate-reference has been mapped as the representation of FHIR DSTU2 element CarePlan.subject with unmapped reference targets: Group, Patient.

DSTU2: CarePlan.context additional types from child elements (display, reference)

Element CarePlan.context is mapped to FHIR R5 element CarePlan.encounter as SourceIsBroaderThanTarget. The mappings for CarePlan.context do not cover the following types based on type expansion: display, reference. The standard extension alternate-reference has been mapped as the representation of FHIR DSTU2 element CarePlan.context with unmapped reference targets: Encounter, EpisodeOfCare. Activities conducted as a result of the care plan may well occur as part of other encounters/episodes.

DSTU2: CarePlan.period additional types (Period) additional types from child elements (end, start)

Element CarePlan.period is mapped to FHIR R5 element CarePlan.period as SourceIsBroaderThanTarget. The mappings for CarePlan.period do not cover the following types: Period. The mappings for CarePlan.period do not cover the following types based on type expansion: end, start. Any activities scheduled as part of the plan should be constrained to the specified period.

DSTU2: CarePlan.author

Element CarePlan.author is mapped to FHIR R5 element CarePlan.custodian as RelatedTo. The standard extension alternate-reference has been mapped as the representation of FHIR DSTU2 element CarePlan.author with unmapped reference targets: Organization, Patient, Practitioner, RelatedPerson. Collaborative care plans may have multiple authors.

DSTU2: CarePlan.participant.role (new:CodeableConcept)

Element CarePlan.participant.role has a context of CarePlan.careTeam based on following the parent source element upwards and mapping to CarePlan. Element CarePlan.participant.role has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). Roles may sometimes be inferred by type of Practitioner. These are relationships that hold only within the context of the care plan. General relationships should be handled as properties of the Patient resource directly.

DSTU2: CarePlan.participant.member (new:Reference(Practitioner,RelatedPerson,Patient,Organization))

Element CarePlan.participant.member has a context of CarePlan.careTeam based on following the parent source element upwards and mapping to CarePlan. Element CarePlan.participant.member has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). Patient only needs to be listed if they have a role other than "subject of care". Member is optional because some participants may be known only by their role, particularly in draft plans.

DSTU2: CarePlan.addresses additional types (Reference(http://hl7.org/fhir/StructureDefinition/Condition)) additional types from child elements (display, reference)

Element CarePlan.addresses is mapped to FHIR R5 element CarePlan.addresses as RelatedTo. The mappings for CarePlan.addresses do not cover the following types: Reference. The mappings for CarePlan.addresses do not cover the following types based on type expansion: display, reference.

DSTU2: CarePlan.support additional types from child elements (display, reference)

Element CarePlan.support is mapped to FHIR R5 element CarePlan.supportingInfo as SourceIsBroaderThanTarget. The mappings for CarePlan.support do not cover the following types based on type expansion: display, reference. The standard extension alternate-reference has been mapped as the representation of FHIR DSTU2 element CarePlan.support with unmapped reference targets: Resource. Use "concern" to identify specific conditions addressed by the care plan.

DSTU2: CarePlan.goal additional types from child elements (display, reference)

Element CarePlan.goal is mapped to FHIR R5 element CarePlan.goal as SourceIsBroaderThanTarget. The mappings for CarePlan.goal do not cover the following types based on type expansion: display, reference. The standard extension alternate-reference has been mapped as the representation of FHIR DSTU2 element CarePlan.goal with unmapped reference targets: Goal. Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline.

DSTU2: CarePlan.activity.actionResulting (new:Reference(Resource))

Element CarePlan.activity.actionResulting has a context of CarePlan.activity based on following the parent source element upwards and mapping to CarePlan. Element CarePlan.activity.actionResulting has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

DSTU2: CarePlan.activity.detail (new:BackboneElement)

Element CarePlan.activity.detail has a context of CarePlan.activity based on following the parent source element upwards and mapping to CarePlan. Element CarePlan.activity.detail has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

DSTU2: CarePlan.activity.progress additional types (Annotation) additional types from child elements (author[x], text, time)

Element CarePlan.activity.progress is mapped to FHIR R5 element CarePlan.activity.progress as SourceIsBroaderThanTarget. The mappings for CarePlan.activity.progress do not cover the following types: Annotation. The mappings for CarePlan.activity.progress do not cover the following types based on type expansion: author[x], text, time. This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description.

DSTU2: CarePlan.activity.reference

Element CarePlan.activity.reference is mapped to FHIR R5 element CarePlan.activity.plannedActivityReference as RelatedTo. The standard extension alternate-reference has been mapped as the representation of FHIR DSTU2 element CarePlan.activity.reference with unmapped reference targets: Appointment, CommunicationRequest, DeviceUseRequest, DiagnosticOrder, MedicationOrder, NutritionOrder, Order, ProcedureRequest, ProcessRequest, ReferralRequest, SupplyRequest, VisionPrescription.

DSTU2: CarePlan.note additional types (Annotation) additional types from child elements (author[x], text, time)

Element CarePlan.note is mapped to FHIR R5 element CarePlan.note as RelatedTo. The mappings for CarePlan.note do not cover the following types: Annotation. The mappings for CarePlan.note do not cover the following types based on type expansion: author[x], text, time.

Describes the intention of how one or more practitioners intend to deliver care for a particular patient, group or community for a period of time, possibly limited to care for a specific condition or set of conditions.

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

DSTU2: CarePlan.meta additional types (Meta) additional types from child elements (lastUpdated, profile, security, tag, versionId)

Element CarePlan.meta is mapped to FHIR R5 element CarePlan.meta as SourceIsBroaderThanTarget. The mappings for CarePlan.meta do not cover the following types: Meta. The mappings for CarePlan.meta do not cover the following types based on type expansion: lastUpdated, profile, security, tag, versionId.

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

When the resource last changed - e.g. when the version changed.

This element is generally omitted in instances submitted in a PUT or POST. Instead, it is populated in the response instance and when retrieving information using a GET. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

The exact use of the source (and the possible implied Provenance.entity.role and agent.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. The source may correspond to Provenance.entity.what[x] or Provenance.agent.who[x], though it may be a more general or abstract reference.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Unless not suitable, these codes SHALL be taken from AllSecurityLabels
(extensible to http://hl7.org/fhir/ValueSet/security-labels|5.0.0)

Security Labels from the Healthcare Privacy and Security Classification System.

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

The base language in which the resource is written.

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

IETF language tag for a human language

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

DSTU2: CarePlan.text additional types (Narrative) additional types from child elements (div, status)

Element CarePlan.text is mapped to FHIR R5 element CarePlan.text as SourceIsBroaderThanTarget. The mappings for CarePlan.text do not cover the following types: Narrative. The mappings for CarePlan.text do not cover the following types based on type expansion: div, status. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.

The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

The status of a resource narrative.

The actual narrative content, a stripped down version of XHTML.

The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

An Extension

DSTU2: CarePlan.modified (new:dateTime)

Element CarePlan.modified has a context of CarePlan based on following the parent source element upwards and mapping to CarePlan. Element CarePlan.modified has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

DSTU2: CarePlan.relatedPlan.code (new:code)

Element CarePlan.relatedPlan.code has a context of CarePlan based on following the parent source element upwards and mapping to CarePlan. Element CarePlan.relatedPlan.code has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). Read the relationship as "this plan" [relatedPlan.code] "relatedPlan.plan"; e.g. This plan includes Plan B. Additional relationship types can be proposed for future releases or handled as extensions.

DSTU2: CarePlan.relatedPlan.plan (new:Reference(CarePlan))

Element CarePlan.relatedPlan.plan has a context of CarePlan based on following the parent source element upwards and mapping to CarePlan. Element CarePlan.relatedPlan.plan has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Business identifiers assigned to this care plan by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

Allows identification of the care plan as it is known by various participating systems and in a way that remains consistent across servers.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

DSTU2: CarePlan.identifier additional types (Identifier) additional types from child elements (assigner, period, system, type, use, value)

Element CarePlan.identifier is mapped to FHIR R5 element CarePlan.identifier as SourceIsBroaderThanTarget. The mappings for CarePlan.identifier do not cover the following types: Identifier. The mappings for CarePlan.identifier do not cover the following types based on type expansion: assigner, period, system, type, use, value.

The purpose of this identifier.

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Identifies the purpose for this identifier, if known .

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Allows users to make use of identifiers when the identifier system is not known.

Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.

Identifier.system is always case sensitive.

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the http://hl7.org/fhir/StructureDefinition/rendered-value). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Time period during which identifier is/was valid for use.

Organization that issued/manages the identifier.

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

The URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan.

The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan.

This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

A higher-level request resource (i.e. a plan, proposal or order) that is fulfilled in whole or in part by this care plan.

Allows tracing of the care plan and tracking whether proposals/recommendations were acted upon.

Completed or terminated care plan whose function is taken by this new care plan.

The replacement could be because the initial care plan was immediately rejected (due to an issue) or because the previous care plan was completed, but the need for the action described by the care plan remains ongoing.

Allows tracing the continuation of a therapy or administrative process instantiated through multiple care plans.

A larger care plan of which this particular care plan is a component or step.

Each care plan is an independent request, such that having a care plan be part of another care plan can cause issues with cascading statuses. As such, this element is still being discussed.

Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.

The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the care plan.

This element is labeled as a modifier because the status contains the code entered-in-error that marks the plan as not currently valid.

Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.

Allows clinicians to determine whether the plan is actionable or not.

Indicates the level of authority/intentionality associated with the care plan and where the care plan fits into the workflow chain.

This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. This element is expected to be immutable. E.g. A "proposal" instance should never change to be a "plan" instance or "order" instance. Instead, a new instance 'basedOn' the prior instance should be created with the new 'intent' value.

Codes indicating the degree of authority/intentionality associated with a care plan.

Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.

Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc.

There may be multiple axes of categorization and one plan may serve multiple purposes. In some cases, this may be redundant with references to CarePlan.addresses.

Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.

Used for filtering what plan(s) are retrieved and displayed to different types of users.

Human-friendly name for the care plan.

A description of the scope and nature of the plan.

Provides more detail than conveyed by category.

Identifies the patient or group whose intended care is described by the plan.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

DSTU2: CarePlan.subject additional types from child elements (display, reference)

Element CarePlan.subject is mapped to FHIR R5 element CarePlan.subject as SourceIsBroaderThanTarget. The mappings for CarePlan.subject do not cover the following types based on type expansion: display, reference. The standard extension alternate-reference has been mapped as the representation of FHIR DSTU2 element CarePlan.subject with unmapped reference targets: Group, Patient.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.

Unless not suitable, these codes SHALL be taken from ResourceType
(extensible to http://hl7.org/fhir/ValueSet/resource-types|5.0.0)

Aa resource (or, for logical models, the URI of the logical model).

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

The Encounter during which this CarePlan was created or to which the creation of this record is tightly associated.

This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. CarePlan activities conducted as a result of the care plan may well occur as part of other encounters.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

DSTU2: CarePlan.context additional types from child elements (display, reference)

Element CarePlan.context is mapped to FHIR R5 element CarePlan.encounter as SourceIsBroaderThanTarget. The mappings for CarePlan.context do not cover the following types based on type expansion: display, reference. The standard extension alternate-reference has been mapped as the representation of FHIR DSTU2 element CarePlan.context with unmapped reference targets: Encounter, EpisodeOfCare. Activities conducted as a result of the care plan may well occur as part of other encounters/episodes.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.

Unless not suitable, these codes SHALL be taken from ResourceType
(extensible to http://hl7.org/fhir/ValueSet/resource-types|5.0.0)

Aa resource (or, for logical models, the URI of the logical model).

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Indicates when the plan did (or is intended to) come into effect and end.

Any activities scheduled as part of the plan should be constrained to the specified period regardless of whether the activities are planned within a single encounter/episode or across multiple encounters/episodes (e.g. the longitudinal management of a chronic condition).

Allows tracking what plan(s) are in effect at a particular time.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

DSTU2: CarePlan.period additional types (Period) additional types from child elements (end, start)

Element CarePlan.period is mapped to FHIR R5 element CarePlan.period as SourceIsBroaderThanTarget. The mappings for CarePlan.period do not cover the following types: Period. The mappings for CarePlan.period do not cover the following types based on type expansion: end, start. Any activities scheduled as part of the plan should be constrained to the specified period.

The start of the period. The boundary is inclusive.

If the low element is missing, the meaning is that the low boundary is not known.

The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

The end value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

Represents when this particular CarePlan record was created in the system, which is often a system-generated date.

When populated, the custodian is responsible for the care plan. The care plan is attributed to the custodian.

The custodian might or might not be a contributor.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

DSTU2: CarePlan.author

Element CarePlan.author is mapped to FHIR R5 element CarePlan.custodian as RelatedTo. The standard extension alternate-reference has been mapped as the representation of FHIR DSTU2 element CarePlan.author with unmapped reference targets: Organization, Patient, Practitioner, RelatedPerson. Collaborative care plans may have multiple authors.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.

Unless not suitable, these codes SHALL be taken from ResourceType
(extensible to http://hl7.org/fhir/ValueSet/resource-types|5.0.0)

Aa resource (or, for logical models, the URI of the logical model).

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Identifies the individual(s), organization or device who provided the contents of the care plan.

Collaborative care plans may have multiple contributors.

Identifies all people and organizations who are expected to be involved in the care envisioned by this plan.

Allows representation of care teams, helps scope care plan. In some cases may be a determiner of access permissions.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

DSTU2: CarePlan.participant.role (new:CodeableConcept)

Element CarePlan.participant.role has a context of CarePlan.careTeam based on following the parent source element upwards and mapping to CarePlan. Element CarePlan.participant.role has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). Roles may sometimes be inferred by type of Practitioner. These are relationships that hold only within the context of the care plan. General relationships should be handled as properties of the Patient resource directly.

DSTU2: CarePlan.participant.member (new:Reference(Practitioner,RelatedPerson,Patient,Organization))

Element CarePlan.participant.member has a context of CarePlan.careTeam based on following the parent source element upwards and mapping to CarePlan. Element CarePlan.participant.member has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element). Patient only needs to be listed if they have a role other than "subject of care". Member is optional because some participants may be known only by their role, particularly in draft plans.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.

Unless not suitable, these codes SHALL be taken from ResourceType
(extensible to http://hl7.org/fhir/ValueSet/resource-types|5.0.0)

Aa resource (or, for logical models, the URI of the logical model).

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Identifies the conditions/problems/concerns/diagnoses/etc. whose management and/or mitigation are handled by this plan.

Use CarePlan.addresses.concept when a code sufficiently describes the concern (e.g. condition, problem, diagnosis, risk). Use CarePlan.addresses.reference when referencing a resource, which allows more information to be conveyed, such as onset date. CarePlan.addresses.concept and CarePlan.addresses.reference are not meant to be duplicative. For a single concern, either CarePlan.addresses.concept or CarePlan.addresses.reference can be used. CarePlan.addresses.concept may be a summary code, or CarePlan.addresses.reference may be used to reference a very precise definition of the concern using Condition. Both CarePlan.addresses.concept and CarePlan.addresses.reference can be used if they are describing different concerns for the care plan.

Codes that describe the health issues this plan addresses.

The element can identify risks addressed by the plan as well as concerns. Also scopes plans - multiple plans may exist addressing different concerns.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

DSTU2: CarePlan.addresses additional types (Reference(http://hl7.org/fhir/StructureDefinition/Condition)) additional types from child elements (display, reference)

Element CarePlan.addresses is mapped to FHIR R5 element CarePlan.addresses as RelatedTo. The mappings for CarePlan.addresses do not cover the following types: Reference. The mappings for CarePlan.addresses do not cover the following types based on type expansion: display, reference.

A reference to a concept - e.g. the information is identified by its general class to the degree of precision found in the terminology.

A reference to a resource the provides exact details about the information being referenced.

Identifies portions of the patient's record that specifically influenced the formation of the plan. These might include comorbidities, recent procedures, limitations, recent assessments, etc.

Use "concern" to identify specific conditions addressed by the care plan. supportingInfo can be used to convey one or more Advance Directives or Medical Treatment Consent Directives by referencing Consent or any other request resource with intent = directive.

Identifies barriers and other considerations associated with the care plan.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

DSTU2: CarePlan.support additional types from child elements (display, reference)

Element CarePlan.support is mapped to FHIR R5 element CarePlan.supportingInfo as SourceIsBroaderThanTarget. The mappings for CarePlan.support do not cover the following types based on type expansion: display, reference. The standard extension alternate-reference has been mapped as the representation of FHIR DSTU2 element CarePlan.support with unmapped reference targets: Resource. Use "concern" to identify specific conditions addressed by the care plan.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.

Unless not suitable, these codes SHALL be taken from ResourceType
(extensible to http://hl7.org/fhir/ValueSet/resource-types|5.0.0)

Aa resource (or, for logical models, the URI of the logical model).

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Describes the intended objective(s) of carrying out the care plan.

Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline.

Provides context for plan. Allows plan effectiveness to be evaluated by clinicians.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

DSTU2: CarePlan.goal additional types from child elements (display, reference)

Element CarePlan.goal is mapped to FHIR R5 element CarePlan.goal as SourceIsBroaderThanTarget. The mappings for CarePlan.goal do not cover the following types based on type expansion: display, reference. The standard extension alternate-reference has been mapped as the representation of FHIR DSTU2 element CarePlan.goal with unmapped reference targets: Goal. Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.

Unless not suitable, these codes SHALL be taken from ResourceType
(extensible to http://hl7.org/fhir/ValueSet/resource-types|5.0.0)

Aa resource (or, for logical models, the URI of the logical model).

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Identifies an action that has occurred or is a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring that has occurred, education etc.

Allows systems to prompt for performance of planned activities, and validate plans against best practice.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension