QI-Core Implementation Guide: STU Ballot (v3.3.0 for FHIR 4.0.0)

Quality Improvement Core Framework (v3.3.0: STU 4 Ballot 1). The current version is 3.2.0 based on FHIR R4. See the Directory of published versions

D.4.1 StructureDefinition-qicore-careplan

Introduction:

See the patterns page for implementation and usage patterns.

Examples:

D.4.1.1 Formal Views of Profile Content

The official URL for this profile is: 

http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-careplan

Defines constraints and extensions on the CarePlan resource for the minimal set of data to query and retrieve a patient's Care Plan.

This profile builds on USCoreCarePlanProfile.

This profile was published on Sun Jul 28 00:00:00 EDT 2019 as a draft by Health Level Seven, Inc. - CQI WG.

Description of Profiles, Differentials, and Snapshots.

Summary

Mandatory: 1 element
Must-Support: 1 element

Structures

This structure refers to these other structures:

NameFlagsCard.TypeDescription & Constraintsdoco
.. CarePlan I0..*Healthcare plan for patient or group
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text S1..1NarrativeText summary of the resource, for human interpretation
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... status S1..1codegenerated | extensions | additional | empty
Binding: US Core Narrative Status (required)
.... div I1..1xhtmlLimited xhtml content
txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes
txt-2: The narrative SHALL have some non-whitespace content
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal Ids for this plan
... instantiatesCanonical Σ0..*canonical(PlanDefinition | Questionnaire | Measure | ActivityDefinition | OperationDefinition)Instantiates FHIR protocol or definition
... instantiatesUri Σ0..*uriInstantiates external protocol or definition
... basedOn Σ0..*Reference(CarePlan)Fulfills CarePlan
... replaces Σ0..*Reference(CarePlan)CarePlan replaced by this CarePlan
... partOf Σ0..*Reference(CarePlan)Part of referenced CarePlan
... status ?!SΣ1..1codedraft | active | suspended | completed | entered-in-error | cancelled | unknown
Binding: RequestStatus (required)
... intent ?!SΣ1..1codeproposal | plan | order | option
Binding: CarePlanIntent (required)
... category SΣ(Slice Definition)Type of plan
Slice: Unordered, Open by pattern:$this
Binding: CarePlanCategory (example)
.... assessplan SΣ1..1CodeableConceptType of plan
Binding: CarePlanCategory (example)

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/careplan-category
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: assess-plan
...... display0..1stringRepresentation defined by the system
...... userSelected0..1booleanIf this coding was chosen directly by the user
..... text0..1stringPlain text representation of the concept
... title Σ0..1stringHuman-friendly name for the care plan
... description Σ0..1stringSummary of nature of plan
... subject SΣ1..1Reference(QICorePatient)Who the care plan is for
... encounter Σ0..1Reference(Encounter)Encounter created as part of
... period Σ0..1PeriodTime period plan covers
... created Σ0..1dateTimeDate record was first recorded
... author Σ0..1Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam)Who is the designated responsible party
... contributor 0..*Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam)Who provided the content of the care plan
... careTeam 0..*Reference(CareTeam)Who's involved in plan?
... addresses Σ0..*Reference(Condition)Health issues this plan addresses
... supportingInfo 0..*Reference(Resource)Information considered as part of plan
... goal 0..*Reference(Goal)Desired outcome of plan
... activity I0..*BackboneElementAction to occur as part of plan
cpl-3: Provide a reference or detail, not both
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... outcomeCodeableConcept 0..*CodeableConceptResults of the activity
Binding: CarePlanActivityOutcome (example)
.... outcomeReference 0..*Reference(Resource)Appointment, Encounter, Procedure, etc.
.... progress 0..*AnnotationComments about the activity status/progress
.... reference I0..1Reference(Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription | RequestGroup)Activity details defined in specific resource
.... detail I0..1BackboneElementIn-line definition of activity
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... kind 0..1codeKind of resource
Binding: CarePlanActivityKind (required)
..... instantiatesCanonical 0..*canonical(PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition)Instantiates FHIR protocol or definition
..... instantiatesUri 0..*uriInstantiates external protocol or definition
..... code 0..1CodeableConceptDetail type of activity
Binding: ProcedureCodes(SNOMEDCT) (example)
..... reasonCode 0..*CodeableConceptWhy activity should be done or why activity was prohibited
Binding: SNOMEDCTClinicalFindings (example)
..... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)Why activity is needed
..... goal 0..*Reference(Goal)Goals this activity relates to
..... status ?!1..1codenot-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error
Binding: CarePlanActivityStatus (required)
..... statusReason 0..1CodeableConceptReason for current status
..... doNotPerform ?!0..1booleanIf true, activity is prohibiting action
..... scheduled[x] 0..1When activity is to occur
...... scheduledTimingTiming
...... scheduledPeriodPeriod
...... scheduledStringstring
..... location 0..1Reference(Location)Where it should happen
..... performer 0..*Reference(Practitioner | PractitionerRole | Organization | RelatedPerson | Patient | CareTeam | HealthcareService | Device)Who will be responsible?
..... product[x] 0..1What is to be administered/supplied
Binding: SNOMEDCTMedicationCodes (example)
...... productCodeableConceptCodeableConcept
...... productReferenceReference(http://hl7.org/fhir/R4/medication.html | http://hl7.org/fhir/R4/substance.html)
..... dailyAmount 0..1SimpleQuantityHow to consume/day?
..... quantity 0..1SimpleQuantityHow much to administer/supply/consume
..... description 0..1stringExtra info describing activity to perform
... note 0..*AnnotationComments about the plan

doco Documentation for this format

Summary

Mandatory: 1 element
Must-Support: 1 element

Structures

This structure refers to these other structures:

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. CarePlan I0..*Healthcare plan for patient or group
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text S1..1NarrativeText summary of the resource, for human interpretation
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... status S1..1codegenerated | extensions | additional | empty
Binding: US Core Narrative Status (required)
.... div I1..1xhtmlLimited xhtml content
txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes
txt-2: The narrative SHALL have some non-whitespace content
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal Ids for this plan
... instantiatesCanonical Σ0..*canonical(PlanDefinition | Questionnaire | Measure | ActivityDefinition | OperationDefinition)Instantiates FHIR protocol or definition
... instantiatesUri Σ0..*uriInstantiates external protocol or definition
... basedOn Σ0..*Reference(CarePlan)Fulfills CarePlan
... replaces Σ0..*Reference(CarePlan)CarePlan replaced by this CarePlan
... partOf Σ0..*Reference(CarePlan)Part of referenced CarePlan
... status ?!SΣ1..1codedraft | active | suspended | completed | entered-in-error | cancelled | unknown
Binding: RequestStatus (required)
... intent ?!SΣ1..1codeproposal | plan | order | option
Binding: CarePlanIntent (required)
... category SΣ(Slice Definition)Type of plan
Slice: Unordered, Open by pattern:$this
Binding: CarePlanCategory (example)
.... assessplan SΣ1..1CodeableConceptType of plan
Binding: CarePlanCategory (example)

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/core/CodeSystem/careplan-category
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: assess-plan
...... display0..1stringRepresentation defined by the system
...... userSelected0..1booleanIf this coding was chosen directly by the user
..... text0..1stringPlain text representation of the concept
... title Σ0..1stringHuman-friendly name for the care plan
... description Σ0..1stringSummary of nature of plan
... subject SΣ1..1Reference(QICorePatient)Who the care plan is for
... encounter Σ0..1Reference(Encounter)Encounter created as part of
... period Σ0..1PeriodTime period plan covers
... created Σ0..1dateTimeDate record was first recorded
... author Σ0..1Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam)Who is the designated responsible party
... contributor 0..*Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam)Who provided the content of the care plan
... careTeam 0..*Reference(CareTeam)Who's involved in plan?
... addresses Σ0..*Reference(Condition)Health issues this plan addresses
... supportingInfo 0..*Reference(Resource)Information considered as part of plan
... goal 0..*Reference(Goal)Desired outcome of plan
... activity I0..*BackboneElementAction to occur as part of plan
cpl-3: Provide a reference or detail, not both
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... outcomeCodeableConcept 0..*CodeableConceptResults of the activity
Binding: CarePlanActivityOutcome (example)
.... outcomeReference 0..*Reference(Resource)Appointment, Encounter, Procedure, etc.
.... progress 0..*AnnotationComments about the activity status/progress
.... reference I0..1Reference(Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription | RequestGroup)Activity details defined in specific resource
.... detail I0..1BackboneElementIn-line definition of activity
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... kind 0..1codeKind of resource
Binding: CarePlanActivityKind (required)
..... instantiatesCanonical 0..*canonical(PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition)Instantiates FHIR protocol or definition
..... instantiatesUri 0..*uriInstantiates external protocol or definition
..... code 0..1CodeableConceptDetail type of activity
Binding: ProcedureCodes(SNOMEDCT) (example)
..... reasonCode 0..*CodeableConceptWhy activity should be done or why activity was prohibited
Binding: SNOMEDCTClinicalFindings (example)
..... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)Why activity is needed
..... goal 0..*Reference(Goal)Goals this activity relates to
..... status ?!1..1codenot-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error
Binding: CarePlanActivityStatus (required)
..... statusReason 0..1CodeableConceptReason for current status
..... doNotPerform ?!0..1booleanIf true, activity is prohibiting action
..... scheduled[x] 0..1When activity is to occur
...... scheduledTimingTiming
...... scheduledPeriodPeriod
...... scheduledStringstring
..... location 0..1Reference(Location)Where it should happen
..... performer 0..*Reference(Practitioner | PractitionerRole | Organization | RelatedPerson | Patient | CareTeam | HealthcareService | Device)Who will be responsible?
..... product[x] 0..1What is to be administered/supplied
Binding: SNOMEDCTMedicationCodes (example)
...... productCodeableConceptCodeableConcept
...... productReferenceReference(http://hl7.org/fhir/R4/medication.html | http://hl7.org/fhir/R4/substance.html)
..... dailyAmount 0..1SimpleQuantityHow to consume/day?
..... quantity 0..1SimpleQuantityHow much to administer/supply/consume
..... description 0..1stringExtra info describing activity to perform
... note 0..*AnnotationComments about the plan

doco Documentation for this format

 

D.4.1.2 Terminology Bindings

Terminology Bindings

PathConformanceValueSet / Code
CarePlan.languagepreferredCommonLanguages
Max Binding: AllLanguages
CarePlan.text.statusrequiredNarrativeStatus
CarePlan.statusrequiredRequestStatus
CarePlan.intentrequiredCarePlanIntent
CarePlan.categoryexampleCarePlanCategory
CarePlan.category:assessplanexamplePattern: assess-plan
CarePlan.activity.outcomeCodeableConceptexampleCarePlanActivityOutcome
CarePlan.activity.detail.kindrequiredCarePlanActivityKind
CarePlan.activity.detail.codeexampleProcedureCodes(SNOMEDCT)
CarePlan.activity.detail.reasonCodeexampleSNOMEDCTClinicalFindings
CarePlan.activity.detail.statusrequiredCarePlanActivityStatus
CarePlan.activity.detail.product[x]exampleSNOMEDCTMedicationCodes

D.4.1.3 Constraints

Constraints

IdPathDetailsRequirements
dom-2CarePlanIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-4CarePlanIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3CarePlanIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6CarePlanA resource should have narrative for robust management
: text.div.exists()
dom-5CarePlanIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
txt-1CarePlan.text.divThe narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes
: htmlChecks()
txt-2CarePlan.text.divThe narrative SHALL have some non-whitespace content
: htmlChecks()
ele-1CarePlan.activityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
cpl-3CarePlan.activityProvide a reference or detail, not both
: detail.empty() or reference.empty()
ele-1CarePlan.activity.detailAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())