SDOH Clinical Care
1.1.0 - STU 2 ballot

This page is part of the SDOH Clinical Care for Multiple Domains (v1.1.0: STU 2 Ballot 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

CapabilityStatement: SDOHCC Referral Source Capability Statement

Raw OpenAPI-Swagger Definition file | Download

SDOHCC Referral Source

(Requirements Definition Capability Statement)

Canonical URL: http://hl7.org/fhir/us/sdoh-clinicalcare/CapabilityStatement/SDOHCC-ReferralSource Published: 2021-06 (draft)

This resource describes the required and desired behavior of systems acting as SDOH clinical care 'referral sources'. These are typically EHR or Payer systems that initiate the process of identifying patients with SDOH needs and requesting appropriate services.

General

FHIR Version: 4.0.1
Supported formats: xml, json

REST client behavior

The referral source needs to receive information about procedures done in response to referrals. They SHOULD also be able to receive information from upstream systems in cases where they are referred to themselves.

Security:

SMART-on-FHIR

Implementations must meet the general privacy & security requirements documented in this implementation guide.

Resource summary

Resource Search Read Read Version Instance History Resource History Create Update Delete Operations
CareTeam MAY MAY
Condition SHOULD SHOULD
Consent SHOULD SHOULD
Device SHOULD SHOULD
DocumentReference SHOULD SHOULD
Goal SHOULD SHOULD
HealthcareService SHOULD SHOULD
Location MAY SHOULD
Observation SHOULD SHOULD
Organization SHOULD SHOULD
Patient SHOULD SHOULD
Practitioner SHOULD SHOULD
PractitionerRole SHOULD SHOULD
Procedure SHOULD SHALL SHALL SHALL
Questionnaire SHOULD $populate: MAY
QuestionnaireResponse SHOULD SHOULD
RelatedPerson MAY MAY
ServiceRequest SHOULD SHOULD
Subscription SHOULD MAY $status: SHOULD
$topic-list: MAY
Task SHOULD SHALL
(conditional read:
modified-since)
SHALL SHALL

General interactions

Name Capability Statement Description
  batch SHOULD

Allows polling for changes to multiple resource types simultaneously



CareTeam

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read MAY

Allows the system to retrieve a CareTeam that is the intended performer of a ServiceRequest.

  search-type MAY

Allows the monitoring of previously-retrieved CareTeams that are the intended performer of ServiceRequests.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query



Condition

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHOULD

Allows the system to retrieve a Condition that is the reason for a ServiceRequest.

  search-type SHOULD

Allows the monitoring of previously-retrieved Conditions that are referenced by ServiceRequests.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

category SHALL token

Allows filtering to only SDOH-related conditions

clinical-status SHOULD token

Allows filtering to only active conditions

code SHOULD token

Allows filtering to only specific SDOH conditions or sets of conditions

patient SHALL reference

Allows filtering to only conditions associated with a specific patient. Some systems will require that searches be patient-specific

verification-status SHOULD token

Allows filtering to exclude refuted or entered-in-error conditions



Consent

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHOULD

Allows the system to retrieve a Consent referenced as a 'supportingInformation' item of a ServiceRequest.

  search-type SHOULD

Allows the monitoring of previously-retrieved Consents related to ServiceRequests of interest.

Search

Supported Includes: Consent:source-reference:DocumentReference

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

source-reference SHOULD reference

Allows including the document that contains the PDF or similar representation of a paper consent



Device

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHOULD

Allows the system to retrieve a Device that is the requester or intended performer of a ServiceRequest.

  search-type SHOULD

Allows the monitoring of previously-retrieved Devices that are the requester or intended performer of ServiceRequests.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query



DocumentReference

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHOULD

Allows the system to retrieve a PDF or similar content referenced by a Consent or Task.

  search-type SHOULD

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

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query



Goal

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHOULD

Allows the system to retrieve a goal referenced by a ServiceRequest.

  search-type SHOULD

Allows the monitoring of previously-retrieved Goals in the event they are updated.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

achievement-status SHOULD token

Allows filtering to only include unmet goals

category SHALL token

Allows filtering to only include SDOH-related goals

lifecycle-status SHOULD token

Allows filtering to only include active goals

patient SHALL reference

Allows filtering to only include goals for a particular patient. Some systems will require searches to be patient-specific

target-date SHOULD date

Allows filtering based on when a particular goal is desired to be achieved



HealthcareService

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHOULD

Allows the system to retrieve a HealthcareService that is the intended performer of a ServiceRequest.

  search-type SHOULD

Allows the monitoring of previously-retrieved HealthcareServices that are the intended performer of ServiceRequests.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

location SHALL reference

Allows retrieval of the phyical site(s) associated with a HealthService



Location

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHOULD

Allows the system to retrieve a Location that is an available location for a service.

  search-type MAY

Allows the monitoring of previously-retrieved Locations that are the intended locations for services.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query



Observation

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHOULD

Allows the system to retrieve an Observation referenced by a ServiceRequest.

  search-type SHOULD

Allows the monitoring of previously-retrieved Observations for updates/corrections.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

category SHALL token

Allows filtering for only SDOH-related observations

code SHOULD token

Allows filtering for specific types of observations

code-value-concept MAY composite

Allows filtering for observations that have a specific coded value answer for a specified observation type

date SHOULD date

Allows filtering for observations that held in a particular time period

derived-from SHOULD reference

Allows filtering for observations derived from a particular QuestionnaireResponse

patient SHALL reference

Allows filtering for observations specific to a particular patient. Some systems will require that all queries be patient-specific

status SHOULD token

Allows filtering for observations that are completed or revised (i.e. not in-progress or entered-in-error)



Organization

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHOULD

Allows the system to retrieve an Organization that is the requester or intended performer of a ServiceRequest.

  search-type SHOULD

Allows the monitoring of previously-retrieved Organizations that are the requester or intended performer of ServiceRequests.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query



Patient

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHOULD

Allows the system to retrieve the Patient that is the subject of a ServiceRequest.

  search-type SHOULD

Allows the monitoring of previously-retrieved Patients.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query



Practitioner

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHOULD

Allows the system to retrieve a Practitioner that is the requester or intended performer of a ServiceRequest.

  search-type SHOULD

Allows the monitoring of previously-retrieved Practitioners that are the requester or intended performer of ServiceRequests.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query



PractitionerRole

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHOULD

Allows the system to retrieve a PractitionerRole that is the requester or intended performer of a ServiceRequest.

  search-type SHOULD

Allows the monitoring of previously-retrieved PractitionerRoles that are the requester or intended performer of ServiceRequests.

Search

Supported Includes: PractitionerRole:organization PractitionerRole:practitioner

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

organization SHOULD reference

Allows doing an _include on Organization when retrieving the PractitionerRole

practitioner SHOULD reference

Allows doing an _include on Practitioner when retrieving the PractitionerRole



Procedure

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  create SHALL

Allows the system to write records of procedures done in response to a referral on the system that asked for the referral.

  update SHALL

Allows the system to update records of procedures done in response to a referral on the system that asked for the referral.

  read SHALL

Allows the referral source to retrieve procedures referenced by Tasks from more sophisticated 'delivery' systems that store their data on their own system rather than using the referral source as a persistence layer.

  search-type SHOULD

Allows the referral source to check for updates on Procedures after they've already been received or to look for procedures that haven't yet been linked as outputs to the Tasks that initiated the work.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

based-on SHALL reference

Allows filtering for procedures resulting from a particular service request

category SHALL token

Allows filtering for procedures that are SDOH-related

code SHOULD token

Allows filtering for procedures based on the specific service delivered

date SHOULD date

Allows filtering for procedures based on when they were delivered

patient SHALL reference

Allows filtering for procedures based on who they were delivered to. Some systems may require that all searches be patient-specific.

performer SHALL reference

Allows filtering for procedures based on who delivered the procedure.

status SHALL token

Allows filtering for procedures that are complete or in progress



Questionnaire

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  search-type SHOULD

Allows the referral source to search for questionnaires relevant to a patient context.

  $populate MAY

Allows SMART on FHIR or other systems to pre-populate a questionnaire response with existing information either available locally or queried from elsewhere

Search

Parameter Conformance Type Definition & Chaining
code SHOULD token

Allows filtering for questionnaires associated with particular LOINC or similar codes

context-type-value SHOULD composite

Allows filtering for procedures that are SDOH-related

identifier SHOULD token

Allows retrieving Questionnaires with a known identifier

publisher SHOULD string

Allows retrieving Questionnaires based on who is responsible for them

status SHOULD token

Allows retrieving Questionnaires that are active (and not draft or required)

subject-type SHOULD token

Allows retrieving Questionnaires that are intended to be completed about patients - as opposed to practitioner, organizations, etc.

title SHOULD string

Allows retrieving Questionnaires based on the name of the form

url SHALL uri

Allows retrieving Questionnaires based on its canonical URL

version SHALL token

Allows retrieving a specific version of a Questionnaire



QuestionnaireResponse

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHOULD

Allows the retrieval of QuestionnaireResponses pointed to as supporting information by a ServiceRequest or as output of a Task.

  search-type SHOULD

Allows checking for updates in previously retrieved QuestionnaireResponses.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

author SHALL reference

Allows filtering QuestionnaireResponses previously created/edited by a particular individual

authored SHOULD date

Allows filtering for QuestionnaireResponses by when they were created/last edited

patient SHALL reference

Allows retrieving QuestionnaireResponses associated with a particular patient. Some systems may only permit searches that are patient-specific

questionnaire SHALL reference

Allows retrieving QuestionnaireResponses that have been completed against a specified form

status SHALL token

Allows retrieving QuestionnaireResponses that are complete (or incomplete)



RelatedPerson

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read MAY

Allows the system to retrieve a RelatedPerson that is the requester or intended performer of a ServiceRequest.

  search-type MAY

Allows the monitoring of previously-retrieved RelatedPersons that are the requester or intended performer of ServiceRequests.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query



ServiceRequest

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHOULD

Allows client systems to retrieve the ServiceRequest pointed to by a Task.

  search-type SHOULD

Allows client systems to monitor multiple ServiceRequests for change simultaneously via polling.

Search

Supported Includes: HealthCareService:location ServiceRequest:supporting-info ServiceRequest:pertains-to-goal ServiceRequest:patient ServiceRequest:requester ServiceRequest:performer PractitionerRole:practitioner PractitionerRole:organization

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

category SHALL token

Allows filtering to only retrieve ServiceRequests that are SDOH-related

code SHOULD token

Allows filtering to retrieve ServiceRequests for specific types of services

intent SHALL token

Allows filtering to retrieve only 'order' ServiceRequests and not plans, proposals, etc.

occurrence SHOULD date

Allows filtering to retrieve ServiceRequests based on the timeframe in which the service needs to be provided

patient SHALL reference

Allows filtering to retrieve only ServiceRequests associated with a particular patient. Note that some systems may mandate that searches are always patient-specific

performer SHOULD reference

Allows filtering to retrieve only ServiceRequests that designate a specific performer

requester SHOULD reference

Allows filtering to retrieve only ServiceRequests created by a specific practitioner

status SHALL token

Allows filtering to retrieve only active ServiceRequests

supporting-info SHOULD reference

Allows _include to retrieve supporting information for a ServiceRequest - particularly Consent



Subscription

Supported Profile(s):

Interactions

Name Conformance Description
  create SHOULD

Necessary if using subscriptions to monitor updates to the Task

  update MAY

Needed to allow the requester to update a subscription - to adjust delivery target, to add additional tasks to monitor (if subscribing by id) typically to cancel a request for fulfillment

  $status SHOULD

Necessary for systems supporting subscriptions to ensure that the subscription is functioning properly and to check for errors

  $topic-list MAY

Allows discovery of what subscription topics the systems supports - needed for systems that aren't pre-configured to be aware of what topics are available for use.



Task

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  create SHALL

Allows the referral source to create tasks on a delivery system (or downstream coordination system).

  update SHALL

Allows the referral source to modify the status of previously created tasks - e.g. to cancel them.

  read SHALL

Allows the referral source to poll a single Task for changes.

  search-type SHOULD

Allows the referral source to poll multiple tasks simultaneously, as well as to retrieve referenced resources as part of a single query.

Search

Supported Includes: Task:focus Task:output HealthCareService:location ServiceRequest:supporting-info ServiceRequest:pertains-to-goal ServiceRequest:patient ServiceRequest:requester ServiceRequest:performer PractitionerRole:practitioner PractitionerRole:organization

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

code SHALL token

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

owner SHOULD reference

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

patient SHALL reference

Allows monitoring of tasks associated with a particular patient. (Some systems may require that all queries be done in the context of a single patient.)

requester SHALL reference

Allows retrieving all tasks that have been requested by a particular organization or individual. This will commonly be used to monitor the tasks initiated by a particular system

status SHALL token

Allows filtering to only active or completed tasks

focus SHALL reference

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

output SHOULD reference

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

REST server behavior

Referral sources must make both the referral and all information referenced by it available to downstream coordination platforms and referral recipient systems and - depending on the capabilities of the receivers - may also need to make the Tasks themselves available for query and support writing of procedures in situations where the recipient is a 'light' referral recipient that doesn't have local persistence or FHIR server capabilities.

Security:

SMART-on-FHIR

Implementations must meet the general privacy & security requirements documented in this implementation guide.

Resource summary

Resource Search Read Read Version Instance History Resource History Create Update Delete Operations
CareTeam MAY MAY
Condition SHALL SHALL MAY MAY
Consent SHALL SHALL MAY MAY
Device SHOULD SHOULD
DocumentReference SHALL SHALL SHALL SHOULD
Goal SHALL SHALL MAY MAY
Group SHALL SHALL
HealthcareService SHOULD SHOULD
Location MAY SHOULD
Observation SHALL SHALL MAY MAY
Organization SHALL SHALL
Patient SHALL SHALL
Practitioner SHALL SHALL
PractitionerRole SHALL SHALL
Procedure SHALL SHALL SHALL SHALL
Questionnaire MAY $populate: MAY
QuestionnaireResponse SHOULD SHOULD SHOULD SHOULD
RelatedPerson MAY MAY
ServiceRequest SHALL SHALL MAY MAY
Subscription SHOULD MAY $status: SHOULD
$topic-list: MAY
Task SHALL SHALL
(conditional read:
modified-since)
SHALL SHALL

General interactions

Name Capability Statement Description
  batch SHOULD

Allows other systems to poll for changes to multiple resource types simultaneously



CareTeam

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read MAY

Allows downstream coordination platforms or referral recipients to retrieve a CareTeam that is the intended performer of a ServiceRequest.

  search-type MAY

Allows downstream coordination platforms or referral recipients to monitor previously-retrieved CareTeams that are the intended performer of ServiceRequests.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query



Condition

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  create MAY

Allows records to be authored by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.

  update MAY

Allows records to be edited by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.

  read SHALL

Allows downstream coordination platforms or referral recipients to retrieve a Condition that is the requester or performer of a ServiceRequest.

  search-type SHALL

Allows downstream coordination platforms or referral recipients to monitor previously-retrieved Conditions that are referenced by ServiceRequests.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

category SHALL token

Allows filtering to only SDOH-related conditions

clinical-status SHOULD token

Allows filtering to only active conditions

code SHOULD token

Allows filtering to only specific SDOH conditions or sets of conditions

patient SHALL reference

Allows filtering to only conditions associated with a specific patient. Some systems will require that searches be patient-specific

verification-status SHOULD token

Allows filtering to exclude refuted or entered-in-error conditions



Consent

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  create MAY

Allows records to be authored by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.

  update MAY

Allows records to be edited by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.

  read SHALL

Allows downstream coordination platforms or referral recipients to retrieve a Consent referenced as a 'supportingInformation' item of a ServiceRequest.

  search-type SHALL

Allows downstream coordination platforms or referral recipients to monitor previously-retrieved Consents related to ServiceRequests of interest.

Search

Supported Includes: Consent:source-reference:DocumentReference

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

source-reference SHALL reference

Allows including the document that contains the PDF or similar representation of a paper consent



Device

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHOULD

Allows downstream coordination platforms or referral recipients to retrieve a Device that is the requester or intended performer of a ServiceRequest.

  search-type SHOULD

Allows downstream coordination platforms or referral recipients to monitor previously-retrieved Devices that are the requester or intended performer of ServiceRequests.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query



DocumentReference

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  create SHALL

Allows the app to record a new PDF (e.g. a completed form)

  update SHOULD

Allows the system to revise a previously stored PDF

  read SHALL

Allows downstream coordination platforms or referral recipients to retrieve a PDF or similar content referenced by a Consent or Task.

  search-type SHALL

Allows downstream coordination platforms or referral recipients to monitor previously-retrieved DocumentReferences in the event the image/document is amended/corrected/updated.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query



Goal

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  create MAY

Allows records to be authored by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.

  update MAY

Allows records to be edited by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.

  read SHALL

Allows downstream coordination platforms or referral recipients to retrieve a goal referenced by a ServiceRequest.

  search-type SHALL

Allows downstream coordination platforms or referral recipients to monitor previously-retrieved Goals in the event they are updated.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

achievement-status SHOULD token

Allows filtering to only include unmet goals

category SHALL token

Allows filtering to only include SDOH-related goals

lifecycle-status SHOULD token

Allows filtering to only include active goals

patient SHALL reference

Allows filtering to only include goals for a particular patient. Some systems will require searches to be patient-specific

target-date SHOULD date

Allows filtering based on when a particular goal is desired to be achieved



Group

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHALL

Allows a payer or other oversight agency to a Group whose identity is already known (e.g. for polling).

  search-type SHALL

Allows a payer or oversight agency to search for groups of interest to allow monitoring of what patients are under care/management for SDOH issues.

Search

Supported Includes: Group:member

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

characteristic-value SHOULD composite

Allows filtering based on the insurer or plan associated with the group

code SHALL token

Allows filtering based on the type of group

managing-entity SHOULD reference

Allows filtering based on who is maintaining the group

member SHALL reference

Allows performing an _include to retrieve the members of the group



HealthcareService

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHOULD

Allows downstream coordination platforms or referral recipients to retrieve a HealthcareService that is the intended performer of a ServiceRequest.

  search-type SHOULD

Allows downstream coordination platforms or referral recipients to monitor previously-retrieved HealthcareServices that are the intended performer of ServiceRequests.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

location SHALL reference

Allows retrieval of the phyical site(s) associated with a HealthService



Location

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHOULD

Allows other systems to retrieve a Location that is an available location for a service.

  search-type MAY

Allows the monitoring of previously-retrieved Locations that are the intended locations for services.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query



Observation

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  create MAY

Allows records to be authored by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.

  update MAY

Allows records to be edited by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.

  read SHALL

Allows downstream coordination platforms or referral recipients to retrieve an Observation referenced by a ServiceRequest.

  search-type SHALL

Allows downstream coordination platforms or referral recipients to monitor previously-retrieved Observations for updates/corrections.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

category SHALL token

Allows filtering for only SDOH-related observations

code SHOULD token

Allows filtering for specific types of observations

code-value-concept MAY composite

Allows filtering for observations that have a specific coded value answer for a specified observation type

date SHOULD date

Allows filtering for observations that held in a particular time period

derived-from SHOULD reference

Allows filtering for observations derived from a particular QuestionnaireResponse

patient SHALL reference

Allows filtering for observations specific to a particular patient. Some systems will require that all queries be patient-specific

status SHALL token

Allows filtering for observations that are completed or revised (i.e. not in-progress or entered-in-error)



Organization

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHALL

Allows downstream coordination platforms or referral recipients to retrieve an Organization that is the requester or intended performer of a ServiceRequest.

  search-type SHALL

Allows downstream coordination platforms or referral recipients to monitor previously-retrieved Organizations that are the requester or intended performer of ServiceRequests.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query



Patient

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHALL

Allows downstream coordination platforms or referral recipients to retrieve the Patient that is the subject of a ServiceRequest.

  search-type SHALL

Allows downstream coordination platforms or referral recipients to monitor previously-retrieved Patients.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query



Practitioner

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHALL

Allows downstream coordination platforms or referral recipients to retrieve a Practitioner that is the requester or intended performer of a ServiceRequest.

  search-type SHALL

Allows downstream coordination platforms or referral recipients to monitor previously-retrieved Practitioners that are the requester or intended performer of ServiceRequests.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query



PractitionerRole

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read SHALL

Allows downstream coordination platforms or referral recipients to retrieve a PractitionerRole that is the requester or intended performer of a ServiceRequest.

  search-type SHALL

Allows downstream coordination platforms or referral recipients to monitor previously-retrieved PractitionerRoles that are the requester or intended performer of ServiceRequests.

Search

Supported Includes: PractitionerRole:organization PractitionerRole:practitioner

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

organization SHOULD reference

Allows doing an _include on Organization when retrieving the PractitionerRole

practitioner SHOULD reference

Allows doing an _include on Practitioner when retrieving the PractitionerRole



Procedure

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  create SHALL

Allows downstream coordination platforms and referral recipients to write records of procedures done in response to a referral in situations where they can't store the procedure on their own local system.

  update SHALL

Allows downstream coordination platforms and referral recipients to update records of procedures done - e.g. changing status, adding notes.

  read SHALL

Allows upstream systems to retrieve procedures referenced by Tasks.

  search-type SHALL

Allows upstream systems to check for updates on Procedures after they've already been received or to look for procedures that haven't yet been linked as outputs to the Tasks that initiated the work.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

based-on SHALL reference

Allows filtering for procedures resulting from a particular service request

category SHALL token

Allows filtering for procedures that are SDOH-related

code SHOULD token

Allows filtering for procedures based on the specific service delivered

date SHOULD date

Allows filtering for procedures based on when they were delivered

patient SHALL reference

Allows filtering for procedures based on who they were delivered to. Some systems may require that all searches be patient-specific.

performer SHALL reference

Allows filtering for procedures based on who delivered the procedure.

status SHALL token

Allows filtering for procedures that are complete or in progress



Questionnaire

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  search-type MAY

Allows SMART apps or downstream systems to search for questionnaires relevant to a patient context.

  $populate MAY

Allows SMART on FHIR or other systems to pre-populate a questionnaire response with existing information either available locally or queried from elsewhere

Search

Parameter Conformance Type Definition & Chaining
code SHOULD token

Allows filtering for questionnaires associated with particular LOINC or similar codes

context-type-value SHOULD composite

Allows filtering for procedures that are SDOH-related

identifier SHOULD token

Allows retrieving Questionnaires with a known identifier

publisher SHOULD string

Allows retrieving Questionnaires based on who is responsible for them

status SHOULD token

Allows retrieving Questionnaires that are active (and not draft or required)

subject-type SHOULD token

Allows retrieving Questionnaires that are intended to be completed about patients - as opposed to practitioner, organizations, etc.

title SHOULD string

Allows retrieving Questionnaires based on the name of the form

url SHALL uri

Allows retrieving Questionnaires based on its canonical URL

version SHALL token

Allows retrieving a specific version of a Questionnaire



QuestionnaireResponse

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  create SHOULD

Allows questionnaire responses to be authored by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.

  update SHOULD

Allows questionnaire responses to be edited by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.

  read SHOULD

Allows the retrieval of QuestionnaireResponses to use as a starting point for new responses or to continue editing.

  search-type SHOULD

Allows checking for updates in previously retrieved QuestionnaireResponses.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

author SHALL reference

Allows filtering QuestionnaireResponses previously created/edited by a particular individual

authored SHOULD date

Allows filtering for QuestionnaireResponses by when they were created/last edited

patient SHALL reference

Allows retrieving QuestionnaireResponses associated with a particular patient. Some systems may only permit searches that are patient-specific

questionnaire SHALL reference

Allows retrieving QuestionnaireResponses that have been completed against a specified form

status SHALL token

Allows retrieving QuestionnaireResponses that are complete (or incomplete)



RelatedPerson

Supported Profile(s):

Behavior

Reference policy: literal

Interactions

Name Conformance Description
  read MAY

Allows downstream coordination platforms or referral recipients to retrieve a RelatedPerson that is the requester or intended performer of a ServiceRequest.

  search-type MAY

Allows downstream coordination platforms or referral recipients to monitor previously-retrieved RelatedPersons that are the requester or intended performer of ServiceRequests.

Search

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query



ServiceRequest

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  create MAY

Allows records to be authored by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.

  update MAY

Allows records to be edited by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.

  read SHALL

Allows client systems to retrieve the ServiceRequest pointed to by a Task.

  search-type SHALL

Allows client systems to monitor multiple ServiceRequests for change simultaneously via polling.

Search

Supported Includes: HealthCareService:location ServiceRequest:supporting-info ServiceRequest:pertains-to-goal ServiceRequest:patient ServiceRequest:requester ServiceRequest:performer PractitionerRole:practitioner PractitionerRole:organization

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

category SHALL token

Allows filtering to only retrieve ServiceRequests that are SDOH-related

code SHOULD token

Allows filtering to retrieve ServiceRequests for specific types of services

intent SHALL token

Allows filtering to retrieve only 'order' ServiceRequests and not plans, proposals, etc.

occurrence SHOULD date

Allows filtering to retrieve ServiceRequests based on the timeframe in which the service needs to be provided

patient SHALL reference

Allows filtering to retrieve only ServiceRequests associated with a particular patient. Note that some systems may mandate that searches are always patient-specific

performer SHOULD reference

Allows filtering to retrieve only ServiceRequests that designate a specific performer

requester SHOULD reference

Allows filtering to retrieve only ServiceRequests created by a specific practitioner

status SHALL token

Allows filtering to retrieve only active ServiceRequests

supporting-info SHOULD reference

Allows _include to retrieve supporting information for a ServiceRequest - particularly Consent



Subscription

Supported Profile(s):

Interactions

Name Conformance Description
  create SHOULD

Allows upstream systems to initiate a subscription to monitor updates to Tasks (and theoretically other things)

  update MAY

Allows upstream systems to revise existing subscriptions - to adjust delivery target, to add additional tasks to monitor (if subscribing by id), etc.

  $status SHOULD

Allows upstream systems to verify their subscription is functioning properly and to check for errors

  $topic-list MAY

Allows upstream systems to discover of what subscription topics this system supports - needed for systems that aren't pre-configured to be aware of what topics are available for use.



Task

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal

Interactions

Name Conformance Description
  create SHALL

Allows upstream coordination platforms and referral sources system to create tasks on this system seeking fulfillment of a ServiceRequest or an action to be performed by a patient or caregiver.

  update SHALL

Allows modification of an existing Task by upstream systems (e.g. to cancel it) or by downstream systems (to accept or reject it or add output links to performed procedures).

  read SHALL

Allows retrieval of a Task that was referenced in a subscription notification or per-Task polling for change.

  search-type SHALL

Allows the other systems to poll multiple tasks simultaneously, as well as to retrieve referenced resources as part of a single query.

Search

Supported Includes: Task:focus Task:output HealthCareService:location ServiceRequest:supporting-info ServiceRequest:pertains-to-goal ServiceRequest:patient ServiceRequest:requester ServiceRequest:performer PractitionerRole:practitioner PractitionerRole:organization

Parameter Conformance Type Definition & Chaining
_id SHALL token

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

_lastUpdated SHOULD date

Allows filtering for only records that have changed since last query

code SHALL token

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

owner SHOULD reference

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

patient SHALL reference

Allows monitoring of tasks associated with a particular patient. (Some systems may require that all queries be done in the context of a single patient.)

requester SHALL reference

Allows retrieving all tasks that have been requested by a particular organization or individual. This will commonly be used to monitor the tasks initiated by a particular system

status SHALL token

Allows filtering to only active or completed tasks

focus SHALL reference

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

output SHOULD reference

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