The Care Plan Act represents a snapshot in time of a dynamic, consensus-driven plan that has captured a patient's and care team members' prioritized concerns, goals, and planned interventions. It reflects the state of the care plan as managed within a source system and may be exchanged to support care coordination across systems and settings.

The Care Plan Act identifies the authoring individual or organization (act.author), which aligns with the FHIR CarePlan.contributor, and records the set of health concerns or conditions being addressed.

To meet USCDI requirements, at least one entryRelationship:addresses element referencing an Indication, Problem Observation, or Observation is required.

The Care Plan Act may integrate multiple condition- or discipline-specific plans of care and serves to align activities and responsibilities among participants. Supporting entryRelationship templates such as Goal, Intervention Act, Planned Intervention Act, and Act are available for systems capable of representing structured care plans, but their use is optional and not required for USCDI compliance.

This entry conveys an instance of the evolving Care Plan at a specific point in time and does not represent a dynamically updated plan.

Templates Used

Although open templates may contain any valid CDA content, the following templates are specifically called out by this template:

Optional EntryRelationships: Act, EntryReference, GoalObservation, Indication, InterventionAct, Observation, PlannedInterventionAct, ProblemObservation