StructureDefinition-UKCore-CarePlan

Canonical_URLStatusCurrent_VersionLast_UpdatedDescription
https://fhir.hl7.org.uk/StructureDefinition/UKCore-CarePlandraft2.2.02023-12-16

This profile defines the UK constraints and extensions on the International FHIR resource CarePlan.


Profile_Purpose

This profile allows recording of care plans which are used in many areas of healthcare with a variety of scopes. They can be as simple as a general practitioner keeping track of when an individual is next due for a tetanus immunisation through to a detailed plan for an oncology patient covering diet, chemotherapy, radiation, lab work and counselling with detailed timing relationships, pre-conditions and goals.

identifierΣ0..*Identifier
instantiatesCanonicalΣ0..*canonical(PlanDefinition | Questionnaire | Measure | ActivityDefinition | OperationDefinition)
instantiatesUriΣ0..*uri
basedOnΣ I0..*Reference(CarePlan)
replacesΣ I0..*Reference(CarePlan)
partOfΣ I0..*Reference(CarePlan)
statusS Σ ?!1..1codeBinding
intentS Σ ?!1..1codeBinding
categoryS Σ0..*CodeableConcept
titleΣ0..1string
descriptionΣ0..1string
subjectS Σ I1..1Reference(Patient | Group)
encounterΣ I0..1Reference(Encounter)
periodΣ I0..1Period
createdΣ0..1dateTime
authorΣ I0..1Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam)
contributorI0..*Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam)
careTeamI0..*Reference(CareTeam)
addressesΣ I0..*Reference(Condition)
supportingInfoI0..*Reference(Resource)
goalI0..*Reference(Goal)
outcomeCodeableConcept0..*CodeableConcept
outcomeReferenceI0..*Reference(Resource)
progress0..*Annotation
referenceI0..1Reference(Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription | RequestGroup)
kind0..1codeBinding
instantiatesCanonical0..*canonical(PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition)
instantiatesUri0..*uri
code0..1CodeableConcept
reasonCode0..*CodeableConcept
reasonReferenceI0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)
goalI0..*Reference(Goal)
status?!1..1codeBinding
statusReason0..1CodeableConcept
doNotPerform?!0..1boolean
scheduledTimingTiming
scheduledPeriodPeriod
scheduledStringstring
locationI0..1Reference(Location)
performerI0..*Reference(Practitioner | PractitionerRole | Organization | RelatedPerson | Patient | CareTeam | HealthcareService | Device)
productCodeableConceptCodeableConcept
productReferenceReference(Medication | Substance)
dailyAmountI0..1SimpleQuantity
quantityI0..1SimpleQuantity
description0..1string
note0..*Annotation

Detailed Descriptions

CarePlan
DefinitionDescribes 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
Invariants
  • 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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-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:Entity. Role, or Act
  • workflow:Request
  • rim:Act[classCode=PCPR, moodCode=INT]
CarePlan.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
TypeSystem.String
SummaryTrue
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

CarePlan.meta
DefinitionThe 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
Invariants
  • 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
DefinitionA 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 it's narrative along with other profiles, value sets, etc.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim:n/a
CarePlan.language
DefinitionThe base language in which the resource is written.
Cardinality0...1
Typecode
Binding

A human language.

CommonLanguages (preferred)
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).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim:n/a
CarePlan.text
DefinitionA 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 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.

Invariants
  • 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
DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality0...*
TypeResource
Aliasinline resources, anonymous resources, contained resources
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.

Mappings
  • rim:Entity. Role, or Act
  • rim:N/A
CarePlan.extension
DefinitionMay 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 manageable, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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
DefinitionMay 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 manageable, 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
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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
DefinitionBusiness identifiers assigned to this care plan by the performer or other systems which remain constant as the resource is updated and propagates from server to server.
Cardinality0...*
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

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
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
DefinitionThe 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...*
Typecanonical(PlanDefinition | Questionnaire | Measure | ActivityDefinition | OperationDefinition)
SummaryTrue
Comments

see Canonical References

Invariants
  • 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
DefinitionThe 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...*
Typeuri
SummaryTrue
Comments

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

Invariants
  • 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
DefinitionA care plan that is fulfilled in whole or in part by this care plan.
Cardinality0...*
TypeReference(CarePlan)
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 resolveable (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.

Invariants
  • 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
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
DefinitionCompleted or terminated care plan whose function is taken by this new care plan.
Cardinality0...*
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.

Invariants
  • 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
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
DefinitionA larger care plan of which this particular care plan is a component or step.
Cardinality0...*
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.

Invariants
  • 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
CarePlan.status
DefinitionIndicates 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)
Must SupportTrue
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.

Invariants
  • 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
DefinitionIndicates 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)
Must SupportTrue
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.

Invariants
  • 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
DefinitionIdentifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc.
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)
Must SupportTrue
SummaryTrue
Requirements

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

Comments

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

Invariants
  • 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
DefinitionHuman-friendly name for the care plan.
Cardinality0...1
Typestring
SummaryTrue
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim:n/a
CarePlan.description
DefinitionA description of the scope and nature of the plan.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Provides more detail than conveyed by category.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • 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
DefinitionIdentifies the patient or group whose intended care is described by the plan.
Cardinality1...1
TypeReference(Patient | Group)
Must SupportTrue
SummaryTrue
Aliaspatient
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (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.

Invariants
  • 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
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]
  • w5:FiveWs.subject
CarePlan.encounter
DefinitionThe Encounter during which this CarePlan was created or to which the creation of this record is tightly associated.
Cardinality0...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.

Invariants
  • 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow:Request.context
  • w5:FiveWs.context
  • v2:Associated PV1
  • rim:.
CarePlan.period
DefinitionIndicates 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).

Invariants
  • 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 value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
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
DefinitionRepresents when this particular CarePlan record was created in the system, which is often a system-generated date.
Cardinality0...1
TypedateTime
SummaryTrue
AliasauthoredOn
Invariants
  • 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.author
DefinitionWhen populated, the author is responsible for the care plan. The care plan is attributed to the author.
Cardinality0...1
TypeReference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam)
SummaryTrue
Comments

The author may also be a contributor. For example, an organization can be an author, but not listed as a contributor.

Invariants
  • 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
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
DefinitionIdentifies the individual(s) or organization who provided the contents of the care plan.
Cardinality0...*
TypeReference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam)
Comments

Collaborative care plans may have multiple contributors.

Invariants
  • 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
CarePlan.careTeam
DefinitionIdentifies all people and organizations who are expected to be involved in the care envisioned by this plan.
Cardinality0...*
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 resolveable (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.

Invariants
  • 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
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.addresses
DefinitionIdentifies the conditions/problems/concerns/diagnoses/etc. whose management and/or mitigation are handled by this plan.
Cardinality0...*
TypeReference(Condition)
SummaryTrue
Requirements

Links plan to the conditions it manages. The element can identify risks addressed by the plan as well as active conditions. (The Condition resource can include things like "at risk for hypertension" or "fall risk".) Also scopes plans - multiple plans may exist addressing different concerns.

Comments

When the diagnosis is related to an allergy or intolerance, the Condition and AllergyIntolerance resources can both be used. However, to be actionable for decision support, using Condition alone is not sufficient as the allergy or intolerance condition needs to be represented as an AllergyIntolerance.

Invariants
  • 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow:Request.reasonReference
  • w5:FiveWs.why[x]
  • v2:PRB-4
  • rim:.actRelationship[typeCode=SUBJ].target[classCode=CONC, moodCode=EVN]
CarePlan.supportingInfo
DefinitionIdentifies 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...*
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.

Invariants
  • 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
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
DefinitionDescribes 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.

Invariants
  • 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
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.activity
DefinitionIdentifies a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring, education, etc.
Cardinality0...*
TypeBackboneElement
Requirements

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

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • cpl-3:Provide a reference or detail, not both
    detail.empty() or reference.empty()
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
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
TypeSystem.String
Mappings
  • rim:n/a
CarePlan.activity.extension
DefinitionMay 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 manageable, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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
DefinitionMay 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 manageable, 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...*
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.

Invariants
  • 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.outcomeCodeableConcept
DefinitionIdentifies the outcome at the point when the status of the activity is assessed. For example, the outcome of an education activity could be patient understands (or not).
Cardinality0...*
TypeCodeableConcept
Binding

Identifies the results of the activity.

CarePlanActivityOutcome (example)
Comments

Note that this should not duplicate the activity status (e.g. completed or in progress).

Invariants
  • 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
CarePlan.activity.outcomeReference
DefinitionDetails of the outcome or action resulting from the activity. The reference to an "event" resource, such as Procedure or Encounter or Observation, is the result/outcome of the activity itself. The activity can be conveyed using CarePlan.activity.detail OR using the CarePlan.activity.reference (a reference to a “request” resource).
Cardinality0...*
TypeReference(Resource)
Requirements

Links plan to resulting actions.

Comments

The activity outcome 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 diet, then the activity outcome could be calories consumed whereas the goal outcome is an observation for the actual body weight measured.

Invariants
  • 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow:{Event that is outcome of Request in activity.reference}
  • rim:.inboundRelationship[typeCode=FLFS].source
CarePlan.activity.progress
DefinitionNotes about the adherence/status/progress of the activity.
Cardinality0...*
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.

Invariants
  • 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.reference
DefinitionThe details of the proposed activity represented in a specific resource.
Cardinality0...1
TypeReference(Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription | RequestGroup)
Requirements

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

Comments

Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
The goal should be visible when the resource referenced by CarePlan.activity.reference 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.

Invariants
  • 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
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.actionResulting}
  • rim:.outboundRelationship[typeCode=COMP].target
CarePlan.activity.detail
DefinitionA simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.
Cardinality0...1
TypeBackboneElement
Requirements

Details in a simple form for generic care plan systems.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.outboundRelationship[typeCode=COMP, subsetCode=SUMM].target
CarePlan.activity.detail.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
TypeSystem.String
Mappings
  • rim:n/a
CarePlan.activity.detail.extension
DefinitionMay 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 manageable, 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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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.detail.modifierExtension
DefinitionMay 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 manageable, 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...*
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.

Invariants
  • 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.detail.kind
DefinitionA description of the kind of resource the in-line definition of a care plan activity is representing. The CarePlan.activity.detail is an in-line definition when a resource is not referenced using CarePlan.activity.reference. For example, a MedicationRequest, a ServiceRequest, or a CommunicationRequest.
Cardinality0...1
Typecode
Binding

Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity.

CarePlanActivityKind (required)
Requirements

May determine what types of extensions are permitted.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:.inboundRelationship[typeCode=COMP].source[classCode=LIST].code
CarePlan.activity.detail.instantiatesCanonical
DefinitionThe URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity.
Cardinality0...*
Typecanonical(PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition)
Requirements

Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity.

Comments

see Canonical References

Invariants
  • 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.activity.detail.instantiatesUri
DefinitionThe URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity.
Cardinality0...*
Typeuri
Requirements

Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity.

Comments

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

Invariants
  • 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.activity.detail.code
DefinitionDetailed description of the type of planned activity; e.g. what lab test, what procedure, what kind of encounter.
Cardinality0...1
TypeCodeableConcept
Binding

Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.

ProcedureCodes(SNOMEDCT) (example)
Requirements

Allows matching performed to planned as well as validation against protocols.

Comments

Tends to be less relevant for activities involving particular products. Codes should not convey negation - use "prohibited" instead.

Invariants
  • 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
  • workflow:Request.code
  • v2:OBR-4 / RXE-2 / RXO-1 / RXD-2
  • rim:.code
CarePlan.activity.detail.reasonCode
DefinitionProvides the rationale that drove the inclusion of this particular activity as part of the plan or the reason why the activity was prohibited.
Cardinality0...*
TypeCodeableConcept
Binding

Identifies why a care plan activity is needed. Can include any health condition codes as well as such concepts as "general wellness", prophylaxis, surgical preparation, etc.

SNOMEDCTClinicalFindings (example)
Comments

This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonCondition instead.

Invariants
  • 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
  • workflow:Request.reasonCode
CarePlan.activity.detail.reasonReference
DefinitionIndicates another resource, such as the health condition(s), whose existence justifies this request and drove the inclusion of this particular activity as part of the plan.
Cardinality0...*
TypeReference(Condition | Observation | DiagnosticReport | DocumentReference)
Comments

Conditions can be identified at the activity level that are not identified as reasons for the overall plan.

Invariants
  • 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow:Request.reasonReference
CarePlan.activity.detail.goal
DefinitionInternal reference that identifies the goals that this activity is intended to contribute towards meeting.
Cardinality0...*
TypeReference(Goal)
Requirements

So that participants know the link explicitly.

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (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.

Invariants
  • 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim:.outboundRelationship[typeCode<=OBJ].
CarePlan.activity.detail.status
DefinitionIdentifies what progress is being made for the specific activity.
Cardinality1...1
Typecode
Binding

Codes that reflect the current state of a care plan activity within its overall life cycle.

CarePlanActivityStatus (required)
ModifierTrue
Requirements

Indicates progress against the plan, whether the activity is still relevant for the plan.

Comments

Some aspects of status can be inferred based on the resources linked in actionTaken. Note that "status" is only as current as the plan was most recently updated.
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 activity.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim:n/a
  • workflow:Request.status
  • v2:ORC-5?
  • rim:.statusCode not-started = new scheduled = not-started (and fulfillment relationship to appointent) in-progress = active on-hold = suspended completed = completed cancelled = aborted
CarePlan.activity.detail.statusReason
DefinitionProvides reason why the activity isn't yet started, is on hold, was cancelled, etc.
Cardinality0...1
TypeCodeableConcept
Comments

Will generally not be present if status is "complete". Be sure to prompt to update this (or at least remove the existing value) if the status is changed.

Invariants
  • 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
  • workflow:Request.statusReason
CarePlan.activity.detail.doNotPerform
DefinitionIf true, indicates that the described activity is one that must NOT be engaged in when following the plan. If false, or missing, indicates that the described activity is one that should be engaged in when following the plan.
Cardinality0...1
Typeboolean
ModifierTrue
Requirements

Captures intention to not do something that may have been previously typical.

Comments

This element is labeled as a modifier because it marks an activity as an activity that is not to be performed.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim:n/a
  • workflow:Request.doNotPerform
  • rim:actionNegationInd
CarePlan.activity.detail.scheduled[x]
DefinitionThe period, timing or frequency upon which the described activity is to occur.
Cardinality0...1
TypeTiming
Requirements

Allows prompting for activities and detection of missed planned activities.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim:n/a
  • workflow:Request.occurrence[x]
  • v2:TQ1
  • rim:.effectiveTime
CarePlan.activity.detail.location
DefinitionIdentifies the facility where the activity will occur; e.g. home, hospital, specific clinic, etc.
Cardinality0...1
TypeReference(Location)
Requirements

Helps in planning of activity.

Comments

May reference a specific clinical location or may identify a type of location.

Invariants
  • 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2:OBR-24(???!!)
  • rim:.participation[typeCode=LOC].role
CarePlan.activity.detail.performer
DefinitionIdentifies who's expected to be involved in the activity.
Cardinality0...*
TypeReference(Practitioner | PractitionerRole | Organization | RelatedPerson | Patient | CareTeam | HealthcareService | Device)
Requirements

Helps in planning of activity.

Comments

A performer MAY also be a participant in the care plan.

Invariants
  • 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.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
  • rim:n/a
  • rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • workflow:Request.performer
  • v2:PRT-5 : ( PRV-4 = (provider participations)); PRT-5 : ( PRV-4 = (non-provider person participations )) ; PRT-5 : ( PRV-4 = (patient non-subject of care) ) ; PRT-8
  • rim:.participation[typeCode=PFM]
CarePlan.activity.detail.product[x]
DefinitionIdentifies the food, drug or other product to be consumed or supplied in the activity.
Cardinality0...1
TypeCodeableConcept
Binding

A product supplied or administered as part of a care plan activity.

SNOMEDCTMedicationCodes (example)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:RXE-2 / RXO-1 / RXD-2
  • rim:.participation[typeCode=PRD].role
CarePlan.activity.detail.dailyAmount
DefinitionIdentifies the quantity expected to be consumed in a given day.
Cardinality0...1
TypeSimpleQuantity
Aliasdaily dose
Requirements

Allows rough dose checking.

Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3:If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1:The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim:n/a
  • v2:SN (see also Range) or CQ
  • rim:PQ, IVL<PQ>, MO, CO, depending on the values
  • v2:RXO-23 / RXE-19 / RXD-12
  • rim:.outboundRelationship[typeCode=COMP][classCode=SBADM].doseQuantity
CarePlan.activity.detail.quantity
DefinitionIdentifies the quantity expected to be supplied, administered or consumed by the subject.
Cardinality0...1
TypeSimpleQuantity
Comments

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • qty-3:If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • sqty-1:The comparator is not used on a SimpleQuantity
    comparator.empty()
Mappings
  • rim:n/a
  • v2:SN (see also Range) or CQ
  • rim:PQ, IVL<PQ>, MO, CO, depending on the values
  • v2:RXO-11 / RXE-10 / RXD-4 / RXG-5 / RXA-6 / TQ1-2.1 *and* RXO-12 / RXE-11 / RXD-5 / RXG-7 / RXA-7 / TQ1-2.2
  • rim:.outboundRelationship[typeCode=COMP][classCode=SPLY].quantity
CarePlan.activity.detail.description
DefinitionThis provides a textual description of constraints on the intended activity occurrence, including relation to other activities. It may also include objectives, pre-conditions and end-conditions. Finally, it may convey specifics about the activity such as body site, method, route, etc.
Cardinality0...1
Typestring
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:NTE?
  • rim:.text
CarePlan.note
DefinitionGeneral notes about the care plan not covered elsewhere.
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).

Invariants
  • 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

Table View

CarePlan..
CarePlan.status..
CarePlan.intent..
CarePlan.category..
CarePlan.subject..


XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="UKCore-CarePlan" />
    <url value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-CarePlan" />
    <version value="2.2.0" />
    <name value="UKCoreCarePlan" />
    <title value="UK Core CarePlan" />
    <status value="draft" />
    <date value="2023-12-16" />
    <publisher value="HL7 UK" />
    <contact>
        <name value="HL7 UK" />
        <telecom>
            <system value="email" />
            <value value="ukcore@hl7.org.uk" />
            <use value="work" />
            <rank value="1" />
        </telecom>
    </contact>
    <description value="This profile defines the UK constraints and extensions on the International FHIR resource [CarePlan](https://hl7.org/fhir/R4/CarePlan.html)." />
    <purpose value="This profile allows recording of care plans which are used in many areas of healthcare with a variety of scopes. They can be as simple as a general practitioner keeping track of when an individual is next due for a tetanus immunisation through to a detailed plan for an oncology patient covering diet, chemotherapy, radiation, lab work and counselling with detailed timing relationships, pre-conditions and goals." />
    <copyright value="Copyright &#169; 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the &quot;License&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html." />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="workflow" />
        <uri value="http://hl7.org/fhir/workflow" />
        <name value="Workflow Pattern" />
    </mapping>
    <mapping>
        <identity value="rim" />
        <uri value="http://hl7.org/v3" />
        <name value="RIM Mapping" />
    </mapping>
    <mapping>
        <identity value="w5" />
        <uri value="http://hl7.org/fhir/fivews" />
        <name value="FiveWs Pattern Mapping" />
    </mapping>
    <mapping>
        <identity value="v2" />
        <uri value="http://hl7.org/v2" />
        <name value="HL7 v2 Mapping" />
    </mapping>
    <kind value="resource" />
    <abstract value="false" />
    <type value="CarePlan" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/CarePlan" />
    <derivation value="constraint" />
    <differential>
        <element id="CarePlan.status">
            <path value="CarePlan.status" />
            <mustSupport value="true" />
        </element>
        <element id="CarePlan.intent">
            <path value="CarePlan.intent" />
            <mustSupport value="true" />
        </element>
        <element id="CarePlan.category">
            <path value="CarePlan.category" />
            <mustSupport value="true" />
        </element>
        <element id="CarePlan.subject">
            <path value="CarePlan.subject" />
            <mustSupport value="true" />
        </element>
    </differential>
</StructureDefinition>

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "UKCore-CarePlan",
    "url": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-CarePlan",
    "version": "2.2.0",
    "name": "UKCoreCarePlan",
    "title": "UK Core CarePlan",
    "status": "draft",
    "date": "2023-12-16",
    "publisher": "HL7 UK",
    "contact":  [
        {
            "name": "HL7 UK",
            "telecom":  [
                {
                    "system": "email",
                    "value": "ukcore@hl7.org.uk",
                    "use": "work",
                    "rank": 1
                }
            ]
        }
    ],
    "description": "This profile defines the UK constraints and extensions on the International FHIR resource [CarePlan](https://hl7.org/fhir/R4/CarePlan.html).",
    "purpose": "This profile allows recording of care plans which are used in many areas of healthcare with a variety of scopes. They can be as simple as a general practitioner keeping track of when an individual is next due for a tetanus immunisation through to a detailed plan for an oncology patient covering diet, chemotherapy, radiation, lab work and counselling with detailed timing relationships, pre-conditions and goals.",
    "copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "workflow",
            "uri": "http://hl7.org/fhir/workflow",
            "name": "Workflow Pattern"
        },
        {
            "identity": "rim",
            "uri": "http://hl7.org/v3",
            "name": "RIM Mapping"
        },
        {
            "identity": "w5",
            "uri": "http://hl7.org/fhir/fivews",
            "name": "FiveWs Pattern Mapping"
        },
        {
            "identity": "v2",
            "uri": "http://hl7.org/v2",
            "name": "HL7 v2 Mapping"
        }
    ],
    "kind": "resource",
    "abstract": false,
    "type": "CarePlan",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/CarePlan",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "CarePlan.status",
                "path": "CarePlan.status",
                "mustSupport": true
            },
            {
                "id": "CarePlan.intent",
                "path": "CarePlan.intent",
                "mustSupport": true
            },
            {
                "id": "CarePlan.category",
                "path": "CarePlan.category",
                "mustSupport": true
            },
            {
                "id": "CarePlan.subject",
                "path": "CarePlan.subject",
                "mustSupport": true
            }
        ]
    }
}

Usage

This Profile has the following derived profiles:


This Profile is referenced in the following Extensions:


This Profile is referenced in the following Profiles:

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Examples

Wellness Plan - An example to illustrate a...
Example UKCore-CarePlan-WellnessPlan

Example Usage Scenarios

The following are example usage scenarios for the UK Core CarePlan profile:

  • Query for a...
  • Record or update a...

Profile Specific Implementation Guidance: