CarePlan

idΣ0..1id
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
textC0..1Narrative
containedC0..*Resource
extensionC0..*Extension
modifierExtensionΣ ?! C0..*Extension
identifierΣ C1..1Identifier
instantiatesCanonicalΣ0..0canonical(ActivityDefinition | Measure | OperationDefinition | PlanDefinition | Questionnaire)
instantiatesUriΣ0..0uri
basedOnΣ C0..0Reference(CarePlan | NutritionOrder | RequestOrchestration | ServiceRequest)
replacesΣ C0..0Reference(CarePlan)
partOfΣ C0..0Reference(CarePlan)
statusΣ ?!1..1codeBinding
intentΣ ?!1..1codeBinding
categoryΣ0..*CodeableConcept
titleΣ0..0string
descriptionΣ0..0string
id0..0string
extensionC0..0Extension
referenceΣ C0..0string
typeΣ1..1uriBindingFixed Value
id0..0string
extensionC0..0Extension
useΣ ?!0..0codeBinding
typeΣ0..0CodeableConceptBinding
systemΣ1..1uriFixed Value
valueΣ C1..1string
periodΣ C0..0Period
assignerΣ C0..0Reference(Organization)
displayΣ C0..1string
id0..0string
extensionC0..0Extension
referenceΣ C0..0string
typeΣ1..1uriBinding
id0..0string
extensionC0..0Extension
useΣ ?!0..0codeBinding
typeΣ0..0CodeableConceptBinding
systemΣ1..1uriFixed Value
valueΣ C1..1string
periodΣ C0..0Period
assignerΣ C0..0Reference(Organization)
displayΣ C0..0string
periodΣ C0..1Period
createdΣ0..0dateTime
custodianΣ C0..0Reference(CareTeam | Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
id0..0string
extensionC0..0Extension
referenceΣ C0..0string
typeΣ1..1uriBinding
id0..0string
extensionC0..0Extension
useΣ ?!0..0codeBinding
typeΣ0..0CodeableConceptBinding
systemΣ1..1uriFixed Value
valueΣ C1..1string
periodΣ C0..0Period
assignerΣ C0..0Reference(Organization)
displayΣ C0..1string
id0..0string
extensionC0..0Extension
referenceΣ C1..1string
typeΣ0..0uriBinding
identifierΣ C0..0Identifier
displayΣ C0..0string
id0..0string
extensionC0..0Extension
conceptΣ0..0CodeableConcept
referenceΣ C1..1Reference
supportingInfoC0..0Reference(Resource)
id0..0string
extensionC0..0Extension
referenceΣ C1..1string
typeΣ0..0uriBinding
identifierΣ C0..0Identifier
displayΣ C0..0string
id0..0string
extensionC0..0Extension
modifierExtensionΣ ?! C0..0Extension
id0..0string
extensionC0..0Extension
conceptΣ1..1CodeableConcept
referenceΣ C0..0Reference
id0..0string
extensionC0..0Extension
id0..0string
extensionC0..0Extension
referenceΣ C0..0string
typeΣ1..1uriBinding
identifierΣ C1..1Identifier
displayΣ C0..1string
timeΣ1..1dateTime
textΣ1..1markdown
plannedActivityReferenceC0..1Reference(Appointment | CommunicationRequest | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | SupplyRequest | Task | VisionPrescription)
note0..*Annotation
{
"resourceType": "StructureDefinition",
"url": "https://fhir.synapxe.sg/StructureDefinition/profile-careplan",
"version": "1.2.0",
"name": "CarePlan",
"status": "active",
"description": "This resource represents the treatment plan used to describe 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.",
"fhirVersion": "5.0.0",
"kind": "resource",
"abstract": false,
"type": "CarePlan",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/CarePlan",
"derivation": "constraint",
"element": [
{
"id": "CarePlan.contained",
"path": "CarePlan.contained",
"short": "Information about an individual or animal receiving health care services",
"definition": "Demographics and other administrative information about an individual or animal receiving care or other health-related services.",
"alias": [
"SubjectOfCare Client Resident"
],
"mapping": [
{
"identity": "w5",
"map": "administrative.individual"
},
{
"identity": "rim",
"map": "Patient[classCode=PAT]"
},
{
"identity": "interface",
"map": "ParticipantLiving"
},
{
"identity": "cda",
"map": "ClinicalDocument.recordTarget.patientRole"
}
]
},
{
"id": "CarePlan.identifier",
"path": "CarePlan.identifier",
"short": "An identifier intended for computation",
"definition": "An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.",
"comment": "The rules of the identifier.type determine if a check digit is part of the ID value or sent separately, such as through the checkDigit extension.",
"min": 1,
"max": "1",
"type": [
{
"code": "Identifier",
"profile": [
"https://fhir.synapxe.sg/StructureDefinition/profile-identifier"
]
}
]
},
{
"id": "CarePlan.instantiatesCanonical",
"path": "CarePlan.instantiatesCanonical",
"max": "0"
},
{
"id": "CarePlan.instantiatesUri",
"path": "CarePlan.instantiatesUri",
"max": "0"
},
{
"id": "CarePlan.basedOn",
"path": "CarePlan.basedOn",
"max": "0"
},
{
"id": "CarePlan.replaces",
"path": "CarePlan.replaces",
"max": "0"
},
{
"id": "CarePlan.partOf",
"path": "CarePlan.partOf",
"max": "0"
},
{
"id": "CarePlan.category",
"path": "CarePlan.category",
"short": "Concept - reference to a terminology or just text",
"definition": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"type": [
{
"code": "CodeableConcept",
"profile": [
"https://fhir.synapxe.sg/StructureDefinition/profile-codeableconcept"
]
}
]
},
{
"id": "CarePlan.title",
"path": "CarePlan.title",
"max": "0"
},
{
"id": "CarePlan.description",
"path": "CarePlan.description",
"max": "0"
},
{
"id": "CarePlan.subject",
"path": "CarePlan.subject",
"type": [
{
"code": "Reference",
"https://fhir.synapxe.sg/StructureDefinition/profile-patient"
]
}
]
},
{
"id": "CarePlan.subject.id",
"path": "CarePlan.subject.id",
"max": "0"
},
{
"id": "CarePlan.subject.extension",
"path": "CarePlan.subject.extension",
"max": "0"
},
{
"id": "CarePlan.subject.reference",
"path": "CarePlan.subject.reference",
"max": "0"
},
{
"id": "CarePlan.subject.type",
"path": "CarePlan.subject.type",
"min": 1,
"fixedUri": "Patient"
},
{
"id": "CarePlan.subject.identifier",
"path": "CarePlan.subject.identifier",
"short": "An identifier intended for computation",
"definition": "An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.",
"comment": "The rules of the identifier.type determine if a check digit is part of the ID value or sent separately, such as through the checkDigit extension.",
"min": 1,
"type": [
{
"code": "Identifier",
"profile": [
"https://fhir.synapxe.sg/StructureDefinition/profile-identifier"
]
}
]
},
{
"id": "CarePlan.subject.identifier.system",
"path": "CarePlan.subject.identifier.system",
"fixedUri": "https://fhir.synapxe.sg/NamingSystem/nric"
},
{
"id": "CarePlan.encounter",
"path": "CarePlan.encounter",
"min": 1,
"type": [
{
"code": "Reference",
"https://fhir.synapxe.sg/StructureDefinition/profile-encounter"
]
}
]
},
{
"id": "CarePlan.encounter.id",
"path": "CarePlan.encounter.id",
"max": "0"
},
{
"id": "CarePlan.encounter.extension",
"path": "CarePlan.encounter.extension",
"max": "0"
},
{
"id": "CarePlan.encounter.reference",
"path": "CarePlan.encounter.reference",
"max": "0"
},
{
"id": "CarePlan.encounter.type",
"path": "CarePlan.encounter.type",
"min": 1
},
{
"id": "CarePlan.encounter.identifier",
"path": "CarePlan.encounter.identifier",
"short": "An identifier intended for computation",
"definition": "An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.",
"comment": "The rules of the identifier.type determine if a check digit is part of the ID value or sent separately, such as through the checkDigit extension.",
"min": 1,
"type": [
{
"code": "Identifier",
"profile": [
"https://fhir.synapxe.sg/StructureDefinition/profile-identifier"
]
}
]
},
{
"id": "CarePlan.encounter.identifier.system",
"path": "CarePlan.encounter.identifier.system",
"fixedUri": "https://fhir.synapxe.sg/NamingSystem/eventID"
},
{
"id": "CarePlan.encounter.display",
"path": "CarePlan.encounter.display",
"max": "0"
},
{
"id": "CarePlan.created",
"path": "CarePlan.created",
"max": "0"
},
{
"id": "CarePlan.custodian",
"path": "CarePlan.custodian",
"max": "0"
},
{
"id": "CarePlan.contributor",
"path": "CarePlan.contributor",
"max": "1",
"type": [
{
"code": "Reference",
"https://fhir.synapxe.sg/StructureDefinition/profile-practitioner"
]
}
]
},
{
"id": "CarePlan.contributor.id",
"path": "CarePlan.contributor.id",
"max": "0"
},
{
"id": "CarePlan.contributor.extension",
"path": "CarePlan.contributor.extension",
"max": "0"
},
{
"id": "CarePlan.contributor.reference",
"path": "CarePlan.contributor.reference",
"max": "0"
},
{
"id": "CarePlan.contributor.type",
"path": "CarePlan.contributor.type",
"min": 1
},
{
"id": "CarePlan.contributor.identifier",
"path": "CarePlan.contributor.identifier",
"short": "An identifier intended for computation",
"definition": "An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.",
"comment": "The rules of the identifier.type determine if a check digit is part of the ID value or sent separately, such as through the checkDigit extension.",
"min": 1,
"type": [
{
"code": "Identifier",
"profile": [
"https://fhir.synapxe.sg/StructureDefinition/profile-identifier"
]
}
]
},
{
"id": "CarePlan.contributor.identifier.system",
"path": "CarePlan.contributor.identifier.system",
"fixedUri": "https://fhir.synapxe.sg/NamingSystem/mcr"
},
{
"id": "CarePlan.careTeam",
"path": "CarePlan.careTeam",
"min": 1,
"max": "1"
},
{
"id": "CarePlan.careTeam.id",
"path": "CarePlan.careTeam.id",
"max": "0"
},
{
"id": "CarePlan.careTeam.extension",
"path": "CarePlan.careTeam.extension",
"max": "0"
},
{
"id": "CarePlan.careTeam.reference",
"path": "CarePlan.careTeam.reference",
"min": 1
},
{
"id": "CarePlan.careTeam.type",
"path": "CarePlan.careTeam.type",
"max": "0"
},
{
"id": "CarePlan.careTeam.identifier",
"path": "CarePlan.careTeam.identifier",
"max": "0"
},
{
"id": "CarePlan.careTeam.display",
"path": "CarePlan.careTeam.display",
"max": "0"
},
{
"id": "CarePlan.addresses",
"path": "CarePlan.addresses",
"type": [
{
"code": "CodeableReference",
"https://fhir.synapxe.sg/StructureDefinition/profile-condition"
]
}
]
},
{
"id": "CarePlan.addresses.id",
"path": "CarePlan.addresses.id",
"max": "0"
},
{
"id": "CarePlan.addresses.extension",
"path": "CarePlan.addresses.extension",
"max": "0"
},
{
"id": "CarePlan.addresses.concept",
"path": "CarePlan.addresses.concept",
"max": "0"
},
{
"id": "CarePlan.addresses.reference",
"path": "CarePlan.addresses.reference",
"min": 1
},
{
"id": "CarePlan.supportingInfo",
"path": "CarePlan.supportingInfo",
"max": "0"
},
{
"id": "CarePlan.goal",
"path": "CarePlan.goal",
"type": [
{
"code": "Reference",
"https://fhir.synapxe.sg/StructureDefinition/profile-goal"
],
"contained"
]
}
]
},
{
"id": "CarePlan.goal.id",
"path": "CarePlan.goal.id",
"max": "0"
},
{
"id": "CarePlan.goal.extension",
"path": "CarePlan.goal.extension",
"max": "0"
},
{
"id": "CarePlan.goal.reference",
"path": "CarePlan.goal.reference",
"min": 1
},
{
"id": "CarePlan.goal.type",
"path": "CarePlan.goal.type",
"max": "0"
},
{
"id": "CarePlan.goal.identifier",
"path": "CarePlan.goal.identifier",
"max": "0"
},
{
"id": "CarePlan.goal.display",
"path": "CarePlan.goal.display",
"max": "0"
},
{
"id": "CarePlan.activity.id",
"path": "CarePlan.activity.id",
"max": "0"
},
{
"id": "CarePlan.activity.extension",
"path": "CarePlan.activity.extension",
"max": "0"
},
{
"id": "CarePlan.activity.modifierExtension",
"path": "CarePlan.activity.modifierExtension",
"max": "0"
},
{
"id": "CarePlan.activity.performedActivity",
"path": "CarePlan.activity.performedActivity",
"type": [
{
"code": "CodeableReference",
"https://fhir.synapxe.sg/StructureDefinition/profile-location",
"https://fhir.synapxe.sg/StructureDefinition/profile-organization"
]
}
]
},
{
"id": "CarePlan.activity.performedActivity.id",
"path": "CarePlan.activity.performedActivity.id",
"max": "0"
},
{
"id": "CarePlan.activity.performedActivity.extension",
"path": "CarePlan.activity.performedActivity.extension",
"max": "0"
},
{
"id": "CarePlan.activity.performedActivity.concept",
"path": "CarePlan.activity.performedActivity.concept",
"short": "Concept - reference to a terminology or just text",
"definition": "A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.",
"min": 1,
"type": [
{
"code": "CodeableConcept",
"profile": [
"https://fhir.synapxe.sg/StructureDefinition/profile-codeableconcept"
]
}
]
},
{
"id": "CarePlan.activity.performedActivity.reference",
"path": "CarePlan.activity.performedActivity.reference",
"max": "0"
},
{
"id": "CarePlan.activity.progress",
"path": "CarePlan.activity.progress",
"min": 1,
"max": "1"
},
{
"id": "CarePlan.activity.progress.id",
"path": "CarePlan.activity.progress.id",
"max": "0"
},
{
"id": "CarePlan.activity.progress.extension",
"path": "CarePlan.activity.progress.extension",
"max": "0"
},
{
"id": "CarePlan.activity.progress.author[x]",
"path": "CarePlan.activity.progress.author[x]",
"min": 1,
"type": [
{
"code": "Reference",
"https://fhir.synapxe.sg/StructureDefinition/profile-patient",
"https://fhir.synapxe.sg/StructureDefinition/profile-practitioner",
"https://fhir.synapxe.sg/StructureDefinition/profile-organization"
]
}
]
},
{
"id": "CarePlan.activity.progress.author[x].id",
"path": "CarePlan.activity.progress.author[x].id",
"max": "0"
},
{
"id": "CarePlan.activity.progress.author[x].extension",
"path": "CarePlan.activity.progress.author[x].extension",
"max": "0"
},
{
"id": "CarePlan.activity.progress.author[x].reference",
"path": "CarePlan.activity.progress.author[x].reference",
"max": "0"
},
{
"id": "CarePlan.activity.progress.author[x].type",
"path": "CarePlan.activity.progress.author[x].type",
"min": 1
},
{
"id": "CarePlan.activity.progress.author[x].identifier",
"path": "CarePlan.activity.progress.author[x].identifier",
"short": "An identifier intended for computation",
"definition": "An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.",
"comment": "The rules of the identifier.type determine if a check digit is part of the ID value or sent separately, such as through the checkDigit extension.",
"min": 1,
"type": [
{
"code": "Identifier",
"profile": [
"https://fhir.synapxe.sg/StructureDefinition/profile-identifier"
]
}
]
},
{
"id": "CarePlan.activity.progress.time",
"path": "CarePlan.activity.progress.time",
"min": 1
},
{
"id": "CarePlan.note",
"path": "CarePlan.note",
"short": "Text node with attribution",
"definition": "A text note which also contains information about who made the statement and when.",
"type": [
{
"code": "Annotation",
"profile": [
"https://fhir.synapxe.sg/StructureDefinition/profile-annotation"
]
}
]
}
]
}
}
CarePlan
ShortHealthcare plan for patient or group
Definition

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.

Cardinality0..*
AliasCare Team
Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-4: If 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-3: If 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
Mappings
  • rim: n/a
  • rim: Entity. Role, or Act
  • rim: Entity, Role, or Act
  • workflow: Request
  • w5: clinical.careprovision
  • rim: Act[classCode=PCPR, moodCode=INT]
CarePlan.id
ShortLogical id of this artifact
Definition

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

Cardinality0..1
Typeid
SummaryTrue
Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
CarePlan.meta
ShortMetadata about the resource
Definition

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.

Cardinality0..1
TypeMeta
SummaryTrue
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.implicitRules
ShortA set of rules under which this content was created
Definition

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.

Cardinality0..1
Typeuri
ModifierTrue
SummaryTrue
Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
CarePlan.language
ShortLanguage of the resource content
Definition

The base language in which the resource is written.

Cardinality0..1
Typecode
Binding

IETF language tag for a human language

AllLanguages (required)

Additional bindings
Comments

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).

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
CarePlan.text
ShortText summary of the resource, for human interpretation
Definition

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.

Cardinality0..1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: dom-6
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
CarePlan.contained
ShortInformation about an individual or animal receiving health care services
Definition

Demographics and other administrative information about an individual or animal receiving care or other health-related services.

Cardinality0..*
TypeResource
Aliasinline resources, anonymous resources, contained resources, SubjectOfCare Client Resident
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: dom-2, dom-4, dom-3, dom-5
Mappings
  • rim: n/a
  • rim: Entity. Role, or Act
  • rim: N/A
  • w5: administrative.individual
  • rim: Patient[classCode=PAT]
  • interface: ParticipantLiving
  • cda: ClinicalDocument.recordTarget.patientRole
CarePlan.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.modifierExtension
ShortExtensions that cannot be ignored
Definition

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).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content
Requirements

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.

Comments

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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.identifier
ShortAn identifier intended for computation
Definition

An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

Cardinality1..1
TypeIdentifier
SummaryTrue
Requirements

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

Comments

The rules of the identifier.type determine if a check digit is part of the ID value or sent separately, such as through the checkDigit extension.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ident-1: Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason
    value.exists()
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • workflow: Request.identifier
  • w5: FiveWs.identifier
  • v2: PTH-3
  • rim: .id
CarePlan.instantiatesCanonical
ShortInstantiates FHIR protocol or definition
Definition

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.

Cardinality0..0
Typecanonical(ActivityDefinition | Measure | OperationDefinition | PlanDefinition | Questionnaire)
SummaryTrue
Comments
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.instantiatesCanonical
  • rim: .outboundRelationship[typeCode=DEFN].target
CarePlan.instantiatesUri
ShortInstantiates external protocol or definition
Definition

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.

Cardinality0..0
Typeuri
SummaryTrue
Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.instantiatesUri
  • rim: .outboundRelationship[typeCode=DEFN].target
CarePlan.basedOn
ShortFulfills plan, proposal or order
Definition

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

Cardinality0..0
TypeReference(CarePlan | NutritionOrder | RequestOrchestration | ServiceRequest)
SummaryTrue
Aliasfulfills
Requirements

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

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.basedOn
CarePlan.replaces
ShortCarePlan replaced by this CarePlan
Definition

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

Cardinality0..0
TypeReference(CarePlan)
SummaryTrue
Aliassupersedes
Requirements

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

Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.replaces
CarePlan.partOf
ShortPart of referenced CarePlan
Definition

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

Cardinality0..0
TypeReference(CarePlan)
SummaryTrue
Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
CarePlan.status
Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
Definition

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

Cardinality1..1
Typecode
Binding

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

RequestStatus (required)

ModifierTrue
SummaryTrue
Requirements

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

Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.status {uses different ValueSet}
  • w5: FiveWs.status
  • v2: PTH-5
  • rim: .statusCode planned = new active = active completed = completed
CarePlan.intent
Shortproposal | plan | order | option | directive
Definition

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

Cardinality1..1
Typecode
Binding

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

CarePlanIntent (required)

ModifierTrue
SummaryTrue
Requirements

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

Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.intent
CarePlan.category
ShortConcept - reference to a terminology or just text
Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Cardinality0..*
TypeCodeableConcept
Binding

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

CarePlanCategory (example)

SummaryTrue
Requirements

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

Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.class
CarePlan.title
ShortHuman-friendly name for the care plan
Definition

Human-friendly name for the care plan.

Cardinality0..0
Typestring
SummaryTrue
Comments

Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
CarePlan.description
ShortSummary of nature of plan
Definition

A description of the scope and nature of the plan.

Cardinality0..0
Typestring
SummaryTrue
Requirements

Provides more detail than conveyed by category.

Comments

Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • w5: FiveWs.what[x]
CarePlan.subject
ShortWho the care plan is for
Definition

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

Cardinality1..1
TypeReference(Patient)
SummaryTrue
Aliaspatient
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.subject
  • w5: FiveWs.subject[x]
  • v2: PID-3
  • rim: .participation[typeCode=PAT].role[classCode=PAT]
CarePlan.subject.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
CarePlan.subject.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.subject.reference
ShortLiteral reference, Relative, internal or absolute URL
Definition

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.

Cardinality0..0
Typestring
SummaryTrue
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2, ref-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.subject.type
ShortType the reference refers to (e.g. "Patient") - must be a resource in resources
Definition

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).

Cardinality1..1
Typeuri
Binding

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

ResourceType (extensible)

SummaryTrue
Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
Patient
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.subject.identifier
ShortAn identifier intended for computation
Definition

An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

Cardinality1..1
TypeIdentifier
SummaryTrue
Comments

The rules of the identifier.type determine if a check digit is part of the ID value or sent separately, such as through the checkDigit extension.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ident-1: Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason
    value.exists()
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • rim: .identifier
CarePlan.subject.identifier.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
CarePlan.subject.identifier.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.subject.identifier.use
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..0
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
Requirements

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

Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Role.code or implied by context
CarePlan.subject.identifier.type
ShortDescription of identifier
Definition

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

Cardinality0..0
TypeCodeableConcept
Binding

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

IdentifierTypeCodes (extensible)

SummaryTrue
Requirements

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

Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
CarePlan.subject.identifier.system
ShortThe namespace for the identifier value
Definition

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

Cardinality1..1
Typeuri
SummaryTrue
Requirements

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.

Comments

Identifier.system is always case sensitive.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
https://fhir.synapxe.sg/NamingSystem/nric
ExamplesGeneral
http://www.acme.com/identifiers/patient
Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
CarePlan.subject.identifier.value
ShortThe value that is unique
Definition

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

Cardinality1..1
Typestring
SummaryTrue
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ident-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
123456
Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
CarePlan.subject.identifier.period
ShortTime period when id is/was valid for use
Definition

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

Cardinality0..0
TypePeriod
SummaryTrue
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower or equal value than end
    start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() <= end.highBoundary())
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
CarePlan.subject.identifier.assigner
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality0..0
TypeReference(Organization)
SummaryTrue
Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
CarePlan.subject.display
ShortText alternative for the resource
Definition

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

Cardinality0..1
Typestring
SummaryTrue
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.encounter
ShortThe Encounter during which this CarePlan was created
Definition

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

Cardinality1..1
TypeReference(Encounter)
SummaryTrue
Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.encounter
  • w5: FiveWs.context
  • v2: Associated PV1
  • rim: .
CarePlan.encounter.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
CarePlan.encounter.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.encounter.reference
ShortLiteral reference, Relative, internal or absolute URL
Definition

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.

Cardinality0..0
Typestring
SummaryTrue
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2, ref-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.encounter.type
ShortType the reference refers to (e.g. "Patient") - must be a resource in resources
Definition

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).

Cardinality1..1
Typeuri
Binding

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

ResourceType (extensible)

SummaryTrue
Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.encounter.identifier
ShortAn identifier intended for computation
Definition

An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

Cardinality1..1
TypeIdentifier
SummaryTrue
Comments

The rules of the identifier.type determine if a check digit is part of the ID value or sent separately, such as through the checkDigit extension.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ident-1: Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason
    value.exists()
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • rim: .identifier
CarePlan.encounter.identifier.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
CarePlan.encounter.identifier.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.encounter.identifier.use
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..0
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
Requirements

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

Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Role.code or implied by context
CarePlan.encounter.identifier.type
ShortDescription of identifier
Definition

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

Cardinality0..0
TypeCodeableConcept
Binding

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

IdentifierTypeCodes (extensible)

SummaryTrue
Requirements

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

Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
CarePlan.encounter.identifier.system
ShortThe namespace for the identifier value
Definition

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

Cardinality1..1
Typeuri
SummaryTrue
Requirements

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.

Comments

Identifier.system is always case sensitive.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
https://fhir.synapxe.sg/NamingSystem/eventID
ExamplesGeneral
http://www.acme.com/identifiers/patient
Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
CarePlan.encounter.identifier.value
ShortThe value that is unique
Definition

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

Cardinality1..1
Typestring
SummaryTrue
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ident-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
123456
Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
CarePlan.encounter.identifier.period
ShortTime period when id is/was valid for use
Definition

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

Cardinality0..0
TypePeriod
SummaryTrue
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower or equal value than end
    start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() <= end.highBoundary())
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
CarePlan.encounter.identifier.assigner
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality0..0
TypeReference(Organization)
SummaryTrue
Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
CarePlan.encounter.display
ShortText alternative for the resource
Definition

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

Cardinality0..0
Typestring
SummaryTrue
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.period
ShortTime period plan covers
Definition

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

Cardinality0..1
TypePeriod
SummaryTrue
Aliastiming
Requirements

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

Comments

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).

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower or equal value than end
    start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() <= end.highBoundary())
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • workflow: Request.occurrence[x]
  • w5: FiveWs.planned
  • v2: GOL-7 / GOL-8
  • rim: .effectiveTime
CarePlan.created
ShortDate record was first recorded
Definition

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

Cardinality0..0
TypedateTime
SummaryTrue
AliasauthoredOn
Comments

UTC offset is allowed for dates and partial dates

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.authoredOn
  • w5: FiveWs.recorded
  • rim: .participation[typeCode=AUT].time
CarePlan.custodian
ShortWho is the designated responsible party
Definition

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

Cardinality0..0
TypeReference(CareTeam | Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
SummaryTrue
Comments

The custodian might or might not be a contributor.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.requester
  • w5: FiveWs.author
CarePlan.contributor
ShortWho provided the content of the care plan
Definition

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

Cardinality0..1
TypeReference(Practitioner)
Comments

Collaborative care plans may have multiple contributors.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
CarePlan.contributor.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
CarePlan.contributor.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.contributor.reference
ShortLiteral reference, Relative, internal or absolute URL
Definition

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.

Cardinality0..0
Typestring
SummaryTrue
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2, ref-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.contributor.type
ShortType the reference refers to (e.g. "Patient") - must be a resource in resources
Definition

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).

Cardinality1..1
Typeuri
Binding

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

ResourceType (extensible)

SummaryTrue
Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.contributor.identifier
ShortAn identifier intended for computation
Definition

An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

Cardinality1..1
TypeIdentifier
SummaryTrue
Comments

The rules of the identifier.type determine if a check digit is part of the ID value or sent separately, such as through the checkDigit extension.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ident-1: Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason
    value.exists()
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • rim: .identifier
CarePlan.contributor.identifier.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
CarePlan.contributor.identifier.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.contributor.identifier.use
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..0
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
Requirements

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

Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Role.code or implied by context
CarePlan.contributor.identifier.type
ShortDescription of identifier
Definition

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

Cardinality0..0
TypeCodeableConcept
Binding

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

IdentifierTypeCodes (extensible)

SummaryTrue
Requirements

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

Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
CarePlan.contributor.identifier.system
ShortThe namespace for the identifier value
Definition

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

Cardinality1..1
Typeuri
SummaryTrue
Requirements

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.

Comments

Identifier.system is always case sensitive.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
https://fhir.synapxe.sg/NamingSystem/mcr
ExamplesGeneral
http://www.acme.com/identifiers/patient
Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
CarePlan.contributor.identifier.value
ShortThe value that is unique
Definition

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

Cardinality1..1
Typestring
SummaryTrue
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ident-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
123456
Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
CarePlan.contributor.identifier.period
ShortTime period when id is/was valid for use
Definition

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

Cardinality0..0
TypePeriod
SummaryTrue
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower or equal value than end
    start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() <= end.highBoundary())
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
CarePlan.contributor.identifier.assigner
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality0..0
TypeReference(Organization)
SummaryTrue
Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
CarePlan.contributor.display
ShortText alternative for the resource
Definition

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

Cardinality0..1
Typestring
SummaryTrue
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.careTeam
ShortWho's involved in plan?
Definition

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

Cardinality1..1
TypeReference(CareTeam)
Requirements

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

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.performer {similar but does not entail CareTeam}
  • w5: FiveWs.actor
CarePlan.careTeam.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
CarePlan.careTeam.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.careTeam.reference
ShortLiteral reference, Relative, internal or absolute URL
Definition

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.

Cardinality1..1
Typestring
SummaryTrue
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2, ref-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.careTeam.type
ShortType the reference refers to (e.g. "Patient") - must be a resource in resources
Definition

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).

Cardinality0..0
Typeuri
Binding

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

ResourceType (extensible)

SummaryTrue
Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.careTeam.identifier
ShortLogical reference, when literal reference is not known
Definition

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.

Cardinality0..0
TypeIdentifier
SummaryTrue
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ident-1: Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason
    value.exists()
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • rim: .identifier
CarePlan.careTeam.display
ShortText alternative for the resource
Definition

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

Cardinality0..0
Typestring
SummaryTrue
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.addresses
ShortHealth issues this plan addresses
Definition

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

Cardinality0..*
TypeCodeableReference(Condition)
Binding

Codes that describe the health issues this plan addresses.

SNOMEDCTClinicalFindings (example)

SummaryTrue
Requirements

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

Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: Request.reason
  • w5: FiveWs.why[x]
  • v2: PRB-4
  • rim: .actRelationship[typeCode=SUBJ].target[classCode=CONC, moodCode=EVN]
CarePlan.addresses.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
CarePlan.addresses.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.addresses.concept
ShortReference to a concept (by class)
Definition

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

Cardinality0..0
TypeCodeableConcept
SummaryTrue
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim: N/A
CarePlan.addresses.reference
ShortReference to a resource (by instance)
Definition

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

Cardinality1..1
TypeReference
SummaryTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: N/A
CarePlan.supportingInfo
ShortInformation considered as part of plan
Definition

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.

Cardinality0..0
TypeReference(Resource)
Requirements

Identifies barriers and other considerations associated with the care plan.

Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: Request.supportingInfo
CarePlan.goal
ShortDesired outcome of plan
Definition

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

Cardinality0..*
TypeReference(Goal)
Requirements

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

Comments

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: GOL-1
  • rim: .outboundRelationship[typeCode<=OBJ].
CarePlan.goal.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
CarePlan.goal.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.goal.reference
ShortLiteral reference, Relative, internal or absolute URL
Definition

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.

Cardinality1..1
Typestring
SummaryTrue
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2, ref-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.goal.type
ShortType the reference refers to (e.g. "Patient") - must be a resource in resources
Definition

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).

Cardinality0..0
Typeuri
Binding

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

ResourceType (extensible)

SummaryTrue
Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.goal.identifier
ShortLogical reference, when literal reference is not known
Definition

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.

Cardinality0..0
TypeIdentifier
SummaryTrue
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ident-1: Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason
    value.exists()
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • rim: .identifier
CarePlan.goal.display
ShortText alternative for the resource
Definition

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

Cardinality0..0
Typestring
SummaryTrue
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.activity
ShortAction to occur or has occurred as part of plan
Definition

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.

Cardinality0..*
TypeBackboneElement
Requirements

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

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: {no mapping NOTE: This is a list of contained Request-Event tuples!}
  • rim: .outboundRelationship[typeCode=COMP].target
CarePlan.activity.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
CarePlan.activity.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.activity.modifierExtension
ShortExtensions that cannot be ignored even if unrecognized
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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).

Cardinality0..0
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

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.

Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.activity.performedActivity
ShortResults of the activity (concept, or Appointment, Encounter, Procedure, etc.)
Definition

Identifies the activity that was performed. For example, an activity could be patient education, exercise, or a medication administration. The reference to an "event" resource, such as Procedure or Encounter or Observation, represents the activity that was performed. The requested activity can be conveyed using the CarePlan.activity.plannedActivityReference (a reference to a “request” resource).

Cardinality0..*
TypeCodeableReference(Location | Organization)
Binding

Identifies the results of the activity.

CarePlanActivityPerformed (example)

Requirements

Links plan to resulting actions.

Comments

Note that this should not duplicate the activity status (e.g. completed or in progress). The activity performed is independent of the outcome of the related goal(s). For example, if the goal is to achieve a target body weight of 150 lbs and an activity is defined to exercise, then the activity performed could be amount and intensity of exercise performed whereas the goal outcome is an observation for the actual body weight measured.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • workflow: {Event that is outcome of Request in activity.plannedActivityReference}
  • rim: .inboundRelationship[typeCode=FLFS].source
CarePlan.activity.performedActivity.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
CarePlan.activity.performedActivity.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.activity.performedActivity.concept
ShortConcept - reference to a terminology or just text
Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Cardinality1..1
TypeCodeableConcept
SummaryTrue
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim: N/A
CarePlan.activity.performedActivity.reference
ShortReference to a resource (by instance)
Definition

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

Cardinality0..0
TypeReference
SummaryTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: N/A
CarePlan.activity.progress
ShortComments about the activity status/progress
Definition

Notes about the adherence/status/progress of the activity.

Cardinality1..1
TypeAnnotation
Requirements

Can be used to capture information about adherence, progress, concerns, etc.

Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act
  • v2: NTE?
  • rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value
CarePlan.activity.progress.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
CarePlan.activity.progress.extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.activity.progress.author[x]
ShortIndividual responsible for the annotation
Definition

The individual responsible for making the annotation.

Cardinality1..1
TypeReference(Organization | Patient | Practitioner)
SummaryTrue
Comments

Organization is used when there's no need for specific attribution as to who made the comment.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.participant[typeCode=AUT].role
CarePlan.activity.progress.author[x].id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..0
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Mappings
  • rim: n/a
CarePlan.activity.progress.author[x].extension
ShortAdditional content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.activity.progress.author[x].reference
ShortLiteral reference, Relative, internal or absolute URL
Definition

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.

Cardinality0..0
Typestring
SummaryTrue
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2, ref-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.activity.progress.author[x].type
ShortType the reference refers to (e.g. "Patient") - must be a resource in resources
Definition

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).

Cardinality1..1
Typeuri
Binding

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

ResourceType (extensible)

SummaryTrue
Comments

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.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.activity.progress.author[x].identifier
ShortAn identifier intended for computation
Definition

An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

Cardinality1..1
TypeIdentifier
SummaryTrue
Comments

The rules of the identifier.type determine if a check digit is part of the ID value or sent separately, such as through the checkDigit extension.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ident-1: Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason
    value.exists()
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • rim: .identifier
CarePlan.activity.progress.author[x].display
ShortText alternative for the resource
Definition

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

Cardinality0..1
Typestring
SummaryTrue
Comments

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ref-2
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
CarePlan.activity.progress.time
ShortWhen the annotation was made
Definition

Indicates when this particular annotation was made.

Cardinality1..1
TypedateTime
SummaryTrue
Comments

UTC offset is allowed for dates and partial dates

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.effectiveTime
CarePlan.activity.progress.text
ShortThe annotation - text content (as markdown)
Definition

The text of the annotation in markdown format.

Cardinality1..1
Typemarkdown
SummaryTrue
Comments

Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.text
CarePlan.activity.plannedActivityReference
ShortActivity that is intended to be part of the care plan
Definition

The details of the proposed activity represented in a specific resource.

Cardinality0..1
TypeReference(Appointment | CommunicationRequest | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | SupplyRequest | Task | VisionPrescription)
Requirements

Details in a form consistent with other applications and contexts of use.

Comments

Standard extension exists (http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.plannedActivityReference.
The goal should be visible when the resource referenced by CarePlan.activity.plannedActivityReference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
  • ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
    reference.exists() or identifier.exists() or display.exists() or extension.exists()
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow: {Request that resulted in Event in activity.performedActivity}
  • rim: .outboundRelationship[typeCode=COMP].target
CarePlan.note
ShortText node with attribution
Definition

A text note which also contains information about who made the statement and when.

Cardinality0..*
TypeAnnotation
Requirements

Used to capture information that applies to the plan as a whole that doesn't fit into discrete elements.

Comments

For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act
  • workflow: Request.note
  • v2: NTE?
  • rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value

Example

Example-CarePlan

API Specification

See CarePlan.Create and CarePlan.Read for the API specification to create and retrieve careplan records.

Terminology Bindings

PathBinding StrengthValue Set (Code System)Description
CarePlan.languagerequiredhttp://hl7.org/fhir/ValueSet/all-languages|5.0.0

IETF language tag for a human language

CarePlan.statusrequiredhttp://hl7.org/fhir/ValueSet/request-status|5.0.0

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

CarePlan.intentrequiredhttp://hl7.org/fhir/ValueSet/care-plan-intent|5.0.0

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

CarePlan.categoryexamplehttp://hl7.org/fhir/ValueSet/care-plan-category

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

CarePlan.subject.typeextensiblehttp://hl7.org/fhir/ValueSet/resource-types

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

CarePlan.encounter.typeextensiblehttp://hl7.org/fhir/ValueSet/resource-types

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

CarePlan.contributor.typeextensiblehttp://hl7.org/fhir/ValueSet/resource-types

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

CarePlan.addressesexamplehttp://hl7.org/fhir/ValueSet/clinical-findings

Codes that describe the health issues this plan addresses.

CarePlan.activity.performedActivityexamplehttp://hl7.org/fhir/ValueSet/care-plan-activity-performed

Identifies the results of the activity.

CarePlan.activity.progress.author[x].typeextensiblehttp://hl7.org/fhir/ValueSet/resource-types

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

Constraints