Argonaut Data Query Implementation Guide Version 1.0.0

This page is part of the Argonaut Data Query Implementation Guide (v1.0.0: Release) based on FHIR R2. This is the current published version. For a full list of available versions, see the Directory of published versions

D.4.1.4 StructureDefinition:Argonaut CareTeam Profile - Detailed Descriptions

Definitions for the StructureDefinition-argo-careteam Profile.

CarePlan(argoprofile)
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.

Control0..*
Alternate NamesCare Team
CarePlan.id
Definition

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

Control0..1
Typeid
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. Bundles always have an id, though it is usually a generated UUID.

CarePlan.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

Control0..1
TypeMeta
CarePlan.implicitRules
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.

Control0..1
Typeuri
Is Modifiertrue
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 as much as possible.

CarePlan.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHALL be taken from http://tools.ietf.org/html/bcp47
Typecode
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).

CarePlan.text
Definition

A human-readable narrative that contains a summary of the resource, and may 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.

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.

CarePlan.contained
Definition

These 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.

Control0..*
TypeResource
Alternate Namesinline 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.

CarePlan.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, 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.

CarePlan.modifierExtension
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. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, 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.

CarePlan.identifier
Definition

This records identifiers associated with this care plan that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Requirements

Need to allow connection to a wider workflow.

CarePlan.subject
Definition

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

Control1..1
TypeReference(Argonaut Patient Profile)
Must Supporttrue
CarePlan.status
Definition

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

Control1..1
Bindingnull
The codes SHALL be taken from CarePlanStatus
Typecode
Is Modifiertrue
Must Supporttrue
Requirements

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

CarePlan.context
Definition

Identifies the context in which this particular CarePlan is defined.

Control0..1
TypeChoice of: Reference(Encounter), Reference(EpisodeOfCare)
Comments

Activities conducted as a result of the care plan may well occur as part of other encounters/episodes.

CarePlan.period
Definition

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

Control0..1
TypePeriod
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.

CarePlan.author
Definition

Identifies the individual(s) or ogranization who is responsible for the content of the care plan.

Control0..*
TypeChoice of: Reference(Patient), Reference(Practitioner), Reference(RelatedPerson), Reference(Organization)
Comments

Collaborative care plans may have multiple authors.

CarePlan.modified
Definition

Identifies the most recent date on which the plan has been revised.

Control0..1
TypedateTime
Requirements

Indicates how current the plan is.

CarePlan.category
Definition

Identifies 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.

Control1..*
BindingIdentifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.
For example codes, see Care Plan Category
TypeCodeableConcept
Must Supporttrue
Requirements

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

Comments

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

InvariantsDefined on this element
arg-1: Must have a category of 'careteam' and a code system 'http://argonaut.hl7.org' (: where(coding.system='http://argonaut.hl7.org' and coding.code='careteam').exists())
CarePlan.description
Definition

A description of the scope and nature of the plan.

Control0..1
Typestring
Requirements

Provides more detail than conveyed by category.

CarePlan.addresses
Definition

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

Control0..*
TypeReference(Condition)
Requirements

Links plan to the conditions it manages. Also scopes plans - multiple plans may exist addressing different concerns.

CarePlan.support
Definition

Identifies portions of the patient's record that specifically influenced the formation of the plan. These might include co-morbidities, recent procedures, limitations, recent assessments, etc.

Control0..*
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.

CarePlan.relatedPlan
Definition

Identifies CarePlans with some sort of formal relationship to the current plan.

Control0..*
TypeBackboneElement
Comments

Relationships are uni-directional with the "newer" plan pointing to the older one.

CarePlan.relatedPlan.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
CarePlan.relatedPlan.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, 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.

CarePlan.relatedPlan.modifierExtension
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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

CarePlan.relatedPlan.code
Definition

Identifies the type of relationship this plan has to the target plan.

Control0..1
BindingCodes identifying the types of relationships between two plans.
The codes SHALL be taken from CarePlanRelationship
Typecode
Comments

Read the relationship as "this plan" [relatedPlan.code] "relatedPlan.plan"; e.g. This plan includes Plan B. Additional relationship types can be proposed for future releases or handled as extensions.

CarePlan.relatedPlan.plan
Definition

A reference to the plan to which a relationship is asserted.

Control1..1
TypeReference(CarePlan)
CarePlan.participant
Definition

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

Control1..*
TypeBackboneElement
Must Supporttrue
Requirements

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

Alternate NamesCare Team
CarePlan.participant.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
CarePlan.participant.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, 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.

CarePlan.participant.modifierExtension
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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

CarePlan.participant.role
Definition

Indicates specific responsibility of an individual within the care plan; e.g. "Primary physician", "Team coordinator", "Caregiver", etc.

Control1..1
Bindingnull
The codes SHALL be taken from Care Team Provider Roles; other codes may be used where these codes are not suitable
TypeCodeableConcept
Must Supporttrue
Comments

Roles may sometimes be inferred by type of Practitioner. These are relationships that hold only within the context of the care plan. General relationships should be handled as properties of the Patient resource directly.

CarePlan.participant.member
Definition

The specific person or organization who is participating/expected to participate in the care plan.

Control1..1
TypeChoice of: Reference(Argonaut Patient Profile), Reference(Practitioner), Reference(RelatedPerson), Reference(Organization)
Must Supporttrue
Comments

Patient only needs to be listed if they have a role other than "subject of care". Member is optional because some participants may be known only by their role, particularly in draft plans.

CarePlan.goal
Definition

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

Control0..*
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.

CarePlan.activity
Definition

Identifies 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.

Control0..*
TypeBackboneElement
Requirements

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

InvariantsDefined on this element
cpl-3: Provide a reference or detail, not both (: )
CarePlan.activity.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
CarePlan.activity.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, 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.

CarePlan.activity.modifierExtension
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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

CarePlan.activity.actionResulting
Definition

Resources that describe follow-on actions resulting from the plan, such as drug prescriptions, encounter records, appointments, etc.

Control0..*
TypeReference(Resource)
Requirements

Links plan to resulting actions.

CarePlan.activity.progress
Definition

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

Control0..*
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.

CarePlan.activity.reference
Definition

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

Control0..1 This element is affected by the following invariants: cpl-3
TypeChoice of: Reference(Appointment), Reference(CommunicationRequest), Reference(DeviceUseRequest), Reference(DiagnosticOrder), Reference(MedicationOrder), Reference(NutritionOrder), Reference(Order), Reference(ProcedureRequest), Reference(ProcessRequest), Reference(ReferralRequest), Reference(SupplyRequest), Reference(VisionPrescription)
Requirements

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

CarePlan.activity.detail
Definition

A 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.

Control0..1 This element is affected by the following invariants: cpl-3
TypeBackboneElement
Requirements

Details in a simple form for generic care plan systems.

CarePlan.activity.detail.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
CarePlan.activity.detail.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, 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.

CarePlan.activity.detail.modifierExtension
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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

CarePlan.activity.detail.category
Definition

High-level categorization of the type of activity in a care plan.

Control0..1
BindingHigh-level categorization of the type of activity in a care plan.
For example codes, see CarePlanActivityCategory
TypeCodeableConcept
Requirements

May determine what types of extensions are permitted.

CarePlan.activity.detail.code
Definition

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

Control0..1
BindingDetailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.
For example codes, see Care Plan Activity
TypeCodeableConcept
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.

CarePlan.activity.detail.reasonCode
Definition

Provides the rationale that drove the inclusion of this particular activity as part of the plan.

Control0..*
BindingIdentifies 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.
For example codes, see Activity Reason
TypeCodeableConcept
Comments

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

CarePlan.activity.detail.reasonReference
Definition

Provides the health condition(s) that drove the inclusion of this particular activity as part of the plan.

Control0..*
TypeReference(Condition)
Comments

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

CarePlan.activity.detail.goal
Definition

Internal reference that identifies the goals that this activity is intended to contribute towards meeting.

Control0..*
TypeReference(Goal)
Requirements

So that participants know the link explicitly.

CarePlan.activity.detail.status
Definition

Identifies what progress is being made for the specific activity.

Control0..1
BindingIndicates where the activity is at in its overall life cycle.
The codes SHALL be taken from CarePlanActivityStatus
Typecode
Is 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.

CarePlan.activity.detail.statusReason
Definition

Provides reason why the activity isn't yet started, is on hold, was cancelled, etc.

Control0..1
BindingDescribes why the current activity has the status it does; e.g. "Recovering from injury" as a reason for non-started or on-hold, "Patient does not enjoy activity" as a reason for cancelling a planned activity.
For example codes, see GoalStatusReason
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.

CarePlan.activity.detail.prohibited
Definition

If true, indicates that the described activity is one that must NOT be engaged in when following the plan.

Control1..1
Typeboolean
Is Modifiertrue
Requirements

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

CarePlan.activity.detail.scheduled[x]
Definition

The period, timing or frequency upon which the described activity is to occur.

Control0..1
TypeChoice of: Timing, Period, string
[x] NoteSee Choice of Data Types for further information about how to use [x]
Requirements

Allows prompting for activities and detection of missed planned activities.

CarePlan.activity.detail.location
Definition

Identifies the facility where the activity will occur; e.g. home, hospital, specific clinic, etc.

Control0..1
TypeReference(Location)
Requirements

Helps in planning of activity.

Comments

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

CarePlan.activity.detail.performer
Definition

Identifies who's expected to be involved in the activity.

Control0..*
TypeChoice of: Reference(Practitioner), Reference(Organization), Reference(RelatedPerson), Reference(Patient)
Requirements

Helps in planning of activity.

Comments

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

CarePlan.activity.detail.product[x]
Definition

Identifies the food, drug or other product to be consumed or supplied in the activity.

Control0..1
BindingA product supplied or administered as part of a care plan activity.
For example codes, see SNOMED CT Medication Codes
TypeChoice of: CodeableConcept, Reference(Medication), Reference(Substance)
[x] NoteSee Choice of Data Types for further information about how to use [x]
CarePlan.activity.detail.dailyAmount
Definition

Identifies the quantity expected to be consumed in a given day.

Control0..1
TypeQuantity(SimpleQuantity)
Requirements

Allows rough dose checking.

Alternate Namesdaily dose
CarePlan.activity.detail.quantity
Definition

Identifies the quantity expected to be supplied, administered or consumed by the subject.

Control0..1
TypeQuantity(SimpleQuantity)
CarePlan.activity.detail.description
Definition

This 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.

Control0..1
Typestring
CarePlan.note
Definition

General notes about the care plan not covered elsewhere.

Control0..1
TypeAnnotation
Requirements

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