This page is part of the C-CDA on FHIR Implementation Guide (v1.6.0: STU 1 Ballot 1) based on FHIR v1.6.0. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions

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D.4.1 StructureDefinition: ccda-care-plan-composition

D.4.1.1 Formal Views of Profile Content

The official URL for this profile is:

http://hl7.org/fhir/ccda/StructureDefinition/ccda-care-plan-composition

CARE PLAN FRAMEWORK: Care Plan (including Home Health Plan of Care (HHPoC)) is a consensus-driven dynamic plan that represents a patient’s and Care Team Members’ prioritized concerns, goals, and planned interventions. It serves as a blueprint shared by all Care Team Members (including the patient, their caregivers and providers), to guide the patient’s care. A Care Plan integrates multiple interventions proposed by multiple providers and disciplines for multiple conditions.

A Care Plan represents one or more Plan(s) of Care and serves to reconcile and resolve conflicts between the various Plans of Care developed for a specific patient by different providers. While both a plan of care and a care plan include the patient’s life goals and require Care Team Members (including patients) to prioritize goals and interventions, the reconciliation process becomes more complex as the number of plans of care increases. The Care Plan also serves to enable longitudinal coordination of care.

The Care Plan represents an instance of this dynamic Care Plan at a point in time. The composition itself is NOT dynamic.

Key differentiators between a Care Plan profile and CCD profile (another “snapshot in time” document):

• Requires relationships between various acts:

    o  Health Concerns

    o  Problems

    o  Interventions

    o  Goals

    o  Outcomes

• Provides the ability to identify patient and provider priorities with each act

• Provides a header participant to indicate occurrences of Care Plan review

This profile was published on Thu Aug 11 21:16:47 AEST 2016 as a draft by Lantana Consulting Group.

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

Example for: C-CDA on FHIR Care Plan.

 

D.4.1.2 Terminology Bindings

Terminology Bindings

Path	Name	Conformance	ValueSet
Composition.language	Common Languages	extensible	Common Languages
Composition.type	FHIR Document Type Codes	preferred	FHIR Document Type Codes
Composition.class	FHIR Document Class Codes	example	FHIR Document Class Codes
Composition.status	CompositionStatus	required	CompositionStatus
Composition.confidentiality	HL7 BasicConfidentialityKind	required	HL7 BasicConfidentialityKind
Composition.attester.mode	CompositionAttestationMode	required	CompositionAttestationMode
Composition.attester.mode	CompositionAttestationMode	required	CompositionAttestationMode
Composition.event.code	v3 Code System ActCode	example	v3 Code System ActCode
Composition.section.code	Document Section Codes	example	Document Section Codes
Composition.section.mode	ListMode	required	ListMode
Composition.section.orderedBy	List Order Codes	preferred	List Order Codes
Composition.section.emptyReason	List Empty Reasons	preferred	List Empty Reasons
Composition.section.code	Document Section Codes	example	Document Section Codes
Composition.section.mode	ListMode	required	ListMode
Composition.section.orderedBy	List Order Codes	preferred	List Order Codes
Composition.section.emptyReason	List Empty Reasons	preferred	List Empty Reasons
Composition.section.code	Document Section Codes	example	Document Section Codes
Composition.section.mode	ListMode	required	ListMode
Composition.section.orderedBy	List Order Codes	preferred	List Order Codes
Composition.section.emptyReason	List Empty Reasons	preferred	List Empty Reasons
Composition.section.code	Document Section Codes	example	Document Section Codes
Composition.section.mode	ListMode	required	ListMode
Composition.section.orderedBy	List Order Codes	preferred	List Order Codes
Composition.section.emptyReason	List Empty Reasons	preferred	List Empty Reasons

D.4.1.3 Constraints

Constraints

Id	Path	Details	Requirements
dom-2	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources XPath: not(parent::f:contained and f:contained)
dom-1	Composition	If the resource is contained in another resource, it SHALL NOT contain any narrative XPath: not(parent::f:contained and f:text)
dom-4	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated XPath: not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
dom-3	Composition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource XPath: not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))
ele-1	Composition.extension	All FHIR elements must have a @value or children XPath: @value|f:*|h:div
ext-1	Composition.extension	Must have either extensions or value[x], not both XPath: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
ele-1	Composition.extension	All FHIR elements must have a @value or children XPath: @value|f:*|h:div
ext-1	Composition.extension	Must have either extensions or value[x], not both XPath: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
ele-1	Composition.extension	All FHIR elements must have a @value or children XPath: @value|f:*|h:div
ext-1	Composition.extension	Must have either extensions or value[x], not both XPath: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
ele-1	Composition.extension	All FHIR elements must have a @value or children XPath: @value|f:*|h:div
ext-1	Composition.extension	Must have either extensions or value[x], not both XPath: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
ele-1	Composition.extension	All FHIR elements must have a @value or children XPath: @value|f:*|h:div
ext-1	Composition.extension	Must have either extensions or value[x], not both XPath: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
ele-1	Composition.extension	All FHIR elements must have a @value or children XPath: @value|f:*|h:div
ext-1	Composition.extension	Must have either extensions or value[x], not both XPath: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
ele-1	Composition.extension	All FHIR elements must have a @value or children XPath: @value|f:*|h:div
ext-1	Composition.extension	Must have either extensions or value[x], not both XPath: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
cmp-1	Composition.section	A section must at least one of text, entries, or sub-sections XPath: exists(f:text) or exists(f:entry) or exists(f:section)
cmp-2	Composition.section	A section can only have an emptyReason if it is empty XPath: not(exists(f:emptyReason) and exists(f:entry))
cmp-1	Composition.section	A section must at least one of text, entries, or sub-sections XPath: exists(f:text) or exists(f:entry) or exists(f:section)
cmp-2	Composition.section	A section can only have an emptyReason if it is empty XPath: not(exists(f:emptyReason) and exists(f:entry))
cmp-1	Composition.section	A section must at least one of text, entries, or sub-sections XPath: exists(f:text) or exists(f:entry) or exists(f:section)
cmp-2	Composition.section	A section can only have an emptyReason if it is empty XPath: not(exists(f:emptyReason) and exists(f:entry))
cmp-1	Composition.section	A section must at least one of text, entries, or sub-sections XPath: exists(f:text) or exists(f:entry) or exists(f:section)
cmp-2	Composition.section	A section can only have an emptyReason if it is empty XPath: not(exists(f:emptyReason) and exists(f:entry))
cmp-1	Composition.section	A section must at least one of text, entries, or sub-sections XPath: exists(f:text) or exists(f:entry) or exists(f:section)
cmp-2	Composition.section	A section can only have an emptyReason if it is empty XPath: not(exists(f:emptyReason) and exists(f:entry))

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