FHIR Release 3 (STU) CI-Build

This page is part of the FHIR Specification (v3.0.2: STU 3). The current version which supercedes this version is 5.0.0 . For a full list Continuous Integration Build of available versions, see FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions icon . Page versions: R5 R4B R4 R3 R2

9.5 Resource CarePlan - Content

Responsible Owner: Patient Care icon Work Group   Normative Maturity Level : 2   Trial Use Security Category : Patient Compartments : Patient Encounter , Practitioner Group , RelatedPerson Patient

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.

9.5.1 Scope and Usage

CarePlan is one of the request resources in the FHIR workflow specification.

Care Plans 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 their patient is next due for a tetanus immunization through to a detailed plan for an oncology patient covering diet, chemotherapy, radiation, lab work and counseling with detailed timing relationships, pre-conditions and goals. They may be used in veterinary care or clinical research to describe the care of a herd or other collection of animals. In public health, they may describe education or immunization campaigns.

This resource takes an intermediate approach to complexity. It captures basic details about who is involved and what actions are intended without dealing in discrete data about dependencies and timing relationships. These can be supported where necessary using the extension mechanism.

The scope of care plans may vary widely. Examples include:

  • Multi-disciplinary cross-organizational care plans; e.g. An oncology plan including the oncologist, home nursing staff, pharmacy and others
  • Plans to manage specific disease/condition(s) (e.g. nutritional plan for a patient post bowel resection, neurological plan post head injury, pre-natal prenatal plan, post-partum postpartum plan, grief management plan, etc.)
  • Decision support-generated support generated plans following specific practice guidelines (e.g. stroke care plan, diabetes plan, falls prevention, etc.)
  • Self-maintained patient or care-giver authored plans identifying their goals and an integrated understanding of actions to be taken taken. This does not include the legal Advance Directives, which should be represented with either the Consent resource with Consent.category = Advance Directive or with a specific request resource with intent = directive. Informal advance directives could be represented as a Goal, such as "I want to die at home."

This resource can be used to represent both proposed plans (for example, recommendations from a decision support engine or returned as part of a consult report) as well as active plans. The nature of the plan is communicated by the status. Some systems may need to filter CarePlans to ensure that only appropriate plans are exposed via a given user interface.

9.5.2 Boundaries and Relationships

For simplicity sake, CarePlan allows the in-line definition of activities as part of a plan using the activity.detail element. However, activities can also be defined using references to the various "request" "request" resources. These references could be to resources with a status of "planned" "planned" or to an active order. It is possible for planned activities to exist (e.g. appointments) without needing a CarePlan at all. CarePlans are used when there's a need to group activities, goals and/or participants together to provide some degree of context.

The CarePlan resource represents an authorization as well as fulfillment on the service provided, while not necessarily providing all the details of such fulfillment. Further details about the fulfillment are handled by the Task resource. For further information about this separation of responsibilities, refer to the Fulfillment/Execution section of the Request pattern.

CarePlans can be tied to specific Conditions , however they can also be condition-independent and instead focused on a particular type of care (e.g. psychological, nutritional) or the care delivered by a particular practitioner or group of practitioners.

An ImmunizationRecommendation icon can be interpreted as a narrow type of Care Plan CarePlan dealing only with immunization events. Where such information could appear in either resource, the immunization-specific resource is preferred.

CarePlans represent a specific plan instance for a particular patient or group. It is not intended to be used to define generic plans or protocols that are independent of a specific individual or group. CarePlan represents a specific intent, not a general definition. Protocols and order sets are supported through PlanDefinition .

This resource is referenced by

9.5.3 References to this Resource

9.5.3 9.5.4 Resource Content

Structure

I Results of the activity I reasonCode 0..* CodeableConcept Why activity should be done or why activity was prohibited
Name Flags Card. Type Description & Constraints      Filter: Filters doco
. . CarePlan N DomainResource Healthcare plan for patient or group

Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier External Ids for this plan
definition Σ 0..* Reference ( PlanDefinition | Questionnaire ) Protocol or definition
. . . basedOn Σ 0..* Reference ( CarePlan | ServiceRequest | RequestOrchestration | NutritionOrder ) Fulfills care plan plan, proposal or order

. . . replaces Σ 0..* Reference ( CarePlan ) CarePlan replaced by this CarePlan

. . . status ?! Σ 1..1 code draft | active | suspended | completed on-hold | entered-in-error | cancelled ended | completed | revoked | unknown
CarePlanStatus Binding: RequestStatus ( Required )
. . . intent ?! Σ 1..1 code proposal | plan | order | option | directive
CarePlanIntent Binding: Care Plan Intent ( Required )
. . . category Σ 0..* CodeableConcept Type of plan
Binding: Care Plan Category ( Example )

. . . title Σ 0..1 string Human-friendly name for the CarePlan care plan
. . . description Σ 0..1 string Summary of nature of plan
. . . subject Σ 1..1 Reference ( Patient | Group ) Who the care plan is for
. . context . encounter Σ 0..1 Reference ( Encounter | EpisodeOfCare ) The Encounter during which this CarePlan was created
Created in context of
. . . period Σ 0..1 Period Time period plan covers
. . author . created Σ 0..1 dateTime 0..* Date record was first recorded
. . . custodian Σ 0..1 Reference ( Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam ) Who is the designated responsible for contents party
... contributor 0..* Reference ( Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam ) Who provided the content of the care plan

. . . careTeam 0..* Reference ( CareTeam ) Who's involved in plan?

. . . addresses Σ 0..* Reference CodeableReference ( Condition | Procedure | MedicationAdministration ) Health issues this plan addresses
Binding: SNOMED CT Clinical Findings ( Example )

. . . supportingInfo 0..* Reference ( Any ) Information considered as part of plan

. . . goal 0..* Reference ( Goal ) Desired outcome of plan

. . . activity 0..* BackboneElement Action to occur or has occurred as part of plan
+ Provide a reference or detail, not both
. . . outcomeCodeableConcept . performedActivity 0..* CodeableConcept CodeableReference ( Any ) Activities that are completed or in progress (concept, or Appointment, Encounter, Procedure, etc.)
Binding: Care Plan Activity Outcome Performed ( Example )
outcomeReference 0..* Reference ( Any ) Appointment, Encounter, Procedure, etc.
. . . . progress 0..* Annotation Comments about the activity status/progress

. . . reference . plannedActivityReference 0..1 Reference ( Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ProcedureRequest | ReferralRequest ServiceRequest | VisionPrescription | RequestGroup ) Activity details defined in specific resource detail I 0..1 BackboneElement In-line definition of activity category 0..1 CodeableConcept diet | drug | encounter | observation | procedure | supply | other CarePlanActivityCategory ( Example ) definition 0..1 Reference ( PlanDefinition | ActivityDefinition | Questionnaire ) Protocol or definition code 0..1 CodeableConcept Detail type of activity Care Plan Activity ( Example RequestOrchestration ) Activity Reason ( Example ) reasonReference 0..* Reference ( Condition ) Condition triggering need for activity goal 0..* Reference ( Goal ) Goals this activity relates to status ?! 1..1 code not-started | scheduled | in-progress | on-hold | completed | cancelled | unknown CarePlanActivityStatus ( Required ) statusReason 0..1 string Reason for current status prohibited ?! 0..1 boolean Do NOT do scheduled[x] 0..1 When activity is to occur scheduledTiming Timing scheduledPeriod Period scheduledString string location 0..1 Reference ( Location ) Where it should happen performer 0..* Reference ( Practitioner | Organization | RelatedPerson | Patient | CareTeam ) Who will be responsible? product[x] 0..1 What that is intended to be administered/supplied part of the care plan
SNOMED CT Medication Codes ( Example ) productCodeableConcept CodeableConcept productReference Reference ( Medication | Substance ) dailyAmount 0..1 SimpleQuantity How to consume/day? quantity 0..1 SimpleQuantity How much to administer/supply/consume description 0..1 string Extra info describing activity to perform
. . . note 0..* Annotation Comments about the plan


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

CarePlan ( DomainResource ) This records Business identifiers associated with assigned to this care plan that are defined by business processes and/or used to refer to it when a direct URL reference to the performer or other systems which remain constant as the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation) updated and propagates from server to server identifier : Identifier [0..*] Identifies the protocol, questionnaire, guideline or other specification the care plan should be conducted in accordance with definition : Reference [0..*] PlanDefinition | Questionnaire A care plan higher-level request resource (i.e. a plan, proposal or order) that is fulfilled in whole or in part by this care plan basedOn : Reference [0..*] « CarePlan | ServiceRequest | RequestOrchestration | NutritionOrder » Completed or terminated care plan whose function is taken by this new care plan replaces : Reference [0..*] « CarePlan » A larger care plan of which this particular care plan is a component or step partOf : Reference [0..*] « CarePlan » Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record (this element modifies the meaning of other elements) status : code [1..1] « Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record. null (Strength=Required) CarePlanStatus RequestStatus ! » Indicates the level of authority/intentionality associated with the care plan and where the care plan fits into the workflow chain (this element modifies the meaning of other elements) intent : code [1..1] « Codes indicating the degree of authority/intentionality associated with a care plan null (Strength=Required) CarePlanIntent ! » Identifies what "kind" "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", "wellness plan", "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc category : CodeableConcept [0..*] « Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc. null (Strength=Example) Care Plan Category CarePlanCategory ?? » Human-friendly name for the CarePlan care plan title : string [0..1] A description of the scope and nature of the plan description : string [0..1] Identifies the patient or group whose intended care is described by the plan subject : Reference [1..1] « Patient | Group » Identifies the original context in The Encounter during which this particular CarePlan was created or to which the creation of this record is tightly associated context encounter : Reference [0..1] « Encounter | EpisodeOfCare » Indicates when the plan did (or is intended to) come into effect and end period : Period [0..1] Identifies Represents when this particular CarePlan record was created in the individual(s) or ogranization who system, which is often a system-generated date created : dateTime [0..1] When populated, the custodian is responsible for the content care plan. The care plan is attributed to the custodian custodian : Reference [0..1] « Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam » Identifies the individual(s), organization or device who provided the contents of the care plan author contributor : Reference [0..*] « Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam » Identifies all people and organizations who are expected to be involved in the care envisioned by this plan careTeam : Reference [0..*] « CareTeam » Identifies the conditions/problems/concerns/diagnoses/etc. whose management and/or mitigation are handled by this plan addresses : Reference CodeableReference [0..*] « Condition | Procedure | MedicationAdministration ; null (Strength=Example) SNOMEDCTClinicalFindings ?? » Identifies portions of the patient's record that specifically influenced the formation of the plan. These might include co-morbidities, comorbidities, recent procedures, limitations, recent assessments, etc supportingInfo : Reference [0..*] « Any » Describes the intended objective(s) of carrying out the care plan goal : Reference [0..*] « Goal » General notes about the care plan not covered elsewhere note : Annotation [0..*] Activity Identifies the outcome at the point when the status of the activity is assessed. that was performed. For example, the outcome of an education activity could be patient understands (or not) outcomeCodeableConcept : CodeableConcept [0..*] Identifies the results of the activity (Strength=Example) Care Plan Activity Outcome ?? Details of the outcome education, exercise, or action resulting from the activity. a medication administration. The reference to an "event" "event" resource, such as Procedure or Encounter or Observation, is the result/outcome of represents the activity itself. that was performed. The requested activity can be conveyed using CarePlan.activity.detail OR using the CarePlan.activity.reference CarePlan.activity.plannedActivityReference (a reference to a request “request” resource) outcomeReference performedActivity : Reference CodeableReference [0..*] « Any ; null (Strength=Example) CarePlanActivityPerformed ?? » Notes about the adherence/status/progress of the activity progress : Annotation [0..*] The details of the proposed activity represented in a specific resource reference plannedActivityReference : Reference [0..1] « Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ProcedureRequest | ReferralRequest ServiceRequest | VisionPrescription | RequestGroup Detail High-level categorization of the type of activity in a care plan category : CodeableConcept [0..1] High-level categorization of the type of activity in a care plan. (Strength=Example) CarePlanActivityCategory ?? Identifies the protocol, questionnaire, guideline or other specification the planned activity should be conducted in accordance with definition : Reference [0..1] PlanDefinition | ActivityDefinition | Questionnaire Detailed description of the type of planned activity; e.g. What lab test, what procedure, what kind of encounter code : CodeableConcept [0..1] Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter. (Strength=Example) Care Plan Activity RequestOrchestration ?? » Provides the rationale that drove the inclusion of this particular activity as part of the plan or the reason why the activity was prohibited reasonCode : CodeableConcept [0..*] 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. (Strength=Example) Activity Reason ?? Provides the health condition(s) that drove the inclusion of this particular activity as part of the plan reasonReference : Reference [0..*] Condition Internal reference that identifies the goals that this activity is intended to contribute towards meeting goal : Reference [0..*] Goal Identifies what progress is being made for the specific activity (this element modifies the meaning of other elements) status : code [1..1] Indicates where the activity is at in its overall life cycle. (Strength=Required) CarePlanActivityStatus ! Provides reason why the activity isn't yet started, is on hold, was cancelled, etc statusReason : string [0..1] If true, indicates that the described activity is one that must NOT be engaged in when following the plan. If false, indicates that the described activity is one an action that should be engaged in when following the plan (this element modifies the meaning of other elements) prohibited : boolean [0..1] The period, timing has occurred or frequency upon which the described activity is to occur scheduled[x] : Type [0..1] Timing | Period | string Identifies the facility where the activity will occur; e.g. home, hospital, specific clinic, etc location : Reference [0..1] Location Identifies who's expected to be involved in the activity performer : Reference [0..*] Practitioner | Organization | RelatedPerson | Patient | CareTeam Identifies the food, drug or other product to be consumed or supplied in the activity product[x] : Type [0..1] CodeableConcept | Reference ( Medication | Substance ); A product supplied or administered as part of a care plan activity. (Strength=Example) SNOMED CT Medication ?? Identifies the quantity expected to be consumed in a given day dailyAmount : Quantity ( SimpleQuantity ) [0..1] Identifies the quantity expected to be supplied, administered or consumed by the subject quantity : Quantity ( SimpleQuantity ) [0..1] 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 description : string [0..1] 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 detail [0..1] 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, self-monitoring that has occurred, education etc activity [0..*]

XML Template 

<

<CarePlan xmlns="http://hl7.org/fhir"> doco

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <</identifier>
 <</definition>
 <</basedOn>

 <identifier><!-- 0..* Identifier External Ids for this plan --></identifier>
 <basedOn><!-- 0..* Reference(CarePlan|NutritionOrder|RequestOrchestration|
   ServiceRequest) Fulfills plan, proposal or order --></basedOn>
 <replaces><!-- 0..* Reference(CarePlan) CarePlan replaced by this CarePlan --></replaces>
 <partOf><!-- 0..* Reference(CarePlan) Part of referenced CarePlan --></partOf>
 <
 <

 <status value="[code]"/><!-- 1..1 draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown -->
 <intent value="[code]"/><!-- 1..1 proposal | plan | order | option | directive -->

 <category><!-- 0..* CodeableConcept Type of plan --></category>
 <
 <
 <</subject>
 <</context>

 <title value="[string]"/><!-- 0..1 Human-friendly name for the care plan -->
 <description value="[string]"/><!-- 0..1 Summary of nature of plan -->
 <subject><!-- 1..1 Reference(Group|Patient) Who the care plan is for --></subject>
 <encounter><!-- 0..1 Reference(Encounter) The Encounter during which this CarePlan was created --></encounter>

 <period><!-- 0..1 Period Time period plan covers --></period>
 <|
   </author>

 <created value="[dateTime]"/><!-- 0..1 Date record was first recorded -->
 <custodian><!-- 0..1 Reference(CareTeam|Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Who is the designated responsible party --></custodian>

 <contributor><!-- 0..* Reference(CareTeam|Device|Organization|Patient|
   Practitioner|PractitionerRole|RelatedPerson) Who provided the content of the care plan --></contributor>
 <careTeam><!-- 0..* Reference(CareTeam) Who's involved in plan? --></careTeam>
 <</addresses>
 <</supportingInfo>

 <addresses><!-- 0..* CodeableReference(Condition|MedicationAdministration|
   Procedure) Health issues this plan addresses --></addresses>

 <supportingInfo><!-- 0..* Reference(Any) Information considered as part of plan --></supportingInfo>

 <goal><!-- 0..* Reference(Goal) Desired outcome of plan --></goal>
 <
  <</outcomeCodeableConcept>
  <</outcomeReference>

 <activity>  <!-- 0..* Action to occur or has occurred as part of plan -->
  <performedActivity><!-- 0..* CodeableReference(Any) Activities that are completed or in progress (concept, or Appointment, Encounter, Procedure, etc.) --></performedActivity>

  <progress><!-- 0..* Annotation Comments about the activity status/progress --></progress>
  <|
    |
    </reference>
  <
   <</category>
   <|
     </definition>
   <</code>
   <</reasonCode>
   <</reasonReference>
   <</goal>
   <
   <
   <
   <</scheduled[x]>
   <</location>
   <|
     </performer>
   <</product[x]>
   <</dailyAmount>
   <</quantity>
   <
  </detail>

  <plannedActivityReference><!-- 0..1 Reference(Appointment|CommunicationRequest|
    DeviceRequest|MedicationRequest|NutritionOrder|RequestOrchestration|
    ServiceRequest|Task|VisionPrescription) Activity that is intended to be part of the care plan --></plannedActivityReference>
 </activity>
 <note><!-- 0..* Annotation Comments about the plan --></note>
</CarePlan>

JSON Template 

{doco
  "resourceType" : "",

  "resourceType" : "CarePlan",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "
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      ">",
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    }

  "identifier" : [{ Identifier }], // External Ids for this plan
  "basedOn" : [{ Reference(CarePlan|NutritionOrder|RequestOrchestration|
   ServiceRequest) }], // Fulfills plan, proposal or order

  "replaces" : [{ Reference(CarePlan) }], // CarePlan replaced by this CarePlan
  "partOf" : [{ Reference(CarePlan) }], // Part of referenced CarePlan
  "status" : "<code>", // R!  draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown
  "intent" : "<code>", // R!  proposal | plan | order | option | directive
  "category" : [{ CodeableConcept }], // Type of plan
  "title" : "<string>", // Human-friendly name for the care plan
  "description" : "<string>", // Summary of nature of plan
  "subject" : { Reference(Group|Patient) }, // R!  Who the care plan is for
  "encounter" : { Reference(Encounter) }, // The Encounter during which this CarePlan was created
  "period" : { Period }, // Time period plan covers
  "created" : "<dateTime>", // Date record was first recorded
  "custodian" : { Reference(CareTeam|Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Who is the designated responsible party

  "contributor" : [{ Reference(CareTeam|Device|Organization|Patient|
   Practitioner|PractitionerRole|RelatedPerson) }], // Who provided the content of the care plan

  "careTeam" : [{ Reference(CareTeam) }], // Who's involved in plan?
  "addresses" : [{ CodeableReference(Condition|MedicationAdministration|
   Procedure) }], // Health issues this plan addresses

  "supportingInfo" : [{ Reference(Any) }], // Information considered as part of plan
  "goal" : [{ Reference(Goal) }], // Desired outcome of plan
  "activity" : [{ // Action to occur or has occurred as part of plan
    "performedActivity" : [{ CodeableReference(Any) }], // Activities that are completed or in progress (concept, or Appointment, Encounter, Procedure, etc.)
    "progress" : [{ Annotation }], // Comments about the activity status/progress
    "plannedActivityReference" : { Reference(Appointment|CommunicationRequest|
    DeviceRequest|MedicationRequest|NutritionOrder|RequestOrchestration|
    ServiceRequest|Task|VisionPrescription) } // Activity that is intended to be part of the care plan
  }],
  "

  "note" : [{ Annotation }] // Comments about the plan

}

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:CarePlan;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from 
  # from 
  fhir:
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    fhir:
      fhir:
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      fhir:
      # . One of these 3
        fhir: ]
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      fhir:
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      # . One of these 2
        fhir: ]
        fhir:) ]
      fhir:
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    ];
  ], ...;
  fhir:

  # from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language
  # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* External Ids for this plan
  fhir:basedOn  ( [ Reference(CarePlan|NutritionOrder|RequestOrchestration|ServiceRequest) ] ... ) ; # 0..* Fulfills plan, proposal or order
  fhir:replaces  ( [ Reference(CarePlan) ] ... ) ; # 0..* CarePlan replaced by this CarePlan
  fhir:partOf  ( [ Reference(CarePlan) ] ... ) ; # 0..* Part of referenced CarePlan
  fhir:status [ code ] ; # 1..1 draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown
  fhir:intent [ code ] ; # 1..1 proposal | plan | order | option | directive
  fhir:category  ( [ CodeableConcept ] ... ) ; # 0..* Type of plan
  fhir:title [ string ] ; # 0..1 Human-friendly name for the care plan
  fhir:description [ string ] ; # 0..1 Summary of nature of plan
  fhir:subject [ Reference(Group|Patient) ] ; # 1..1 Who the care plan is for
  fhir:encounter [ Reference(Encounter) ] ; # 0..1 The Encounter during which this CarePlan was created
  fhir:period [ Period ] ; # 0..1 Time period plan covers
  fhir:created [ dateTime ] ; # 0..1 Date record was first recorded
  fhir:custodian [ Reference(CareTeam|Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Who is the designated responsible party
  fhir:contributor  ( [ Reference(CareTeam|Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ... ) ; # 0..* Who provided the content of the care plan
  fhir:careTeam  ( [ Reference(CareTeam) ] ... ) ; # 0..* Who's involved in plan?
  fhir:addresses  ( [ CodeableReference(Condition|MedicationAdministration|Procedure) ] ... ) ; # 0..* Health issues this plan addresses
  fhir:supportingInfo  ( [ Reference(Any) ] ... ) ; # 0..* Information considered as part of plan
  fhir:goal  ( [ Reference(Goal) ] ... ) ; # 0..* Desired outcome of plan
  fhir:activity ( [ # 0..* Action to occur or has occurred as part of plan
    fhir:performedActivity  ( [ CodeableReference(Any) ] ... ) ; # 0..* Activities that are completed or in progress (concept, or Appointment, Encounter, Procedure, etc.)
    fhir:progress  ( [ Annotation ] ... ) ; # 0..* Comments about the activity status/progress
    fhir:plannedActivityReference [ Reference(Appointment|CommunicationRequest|DeviceRequest|MedicationRequest|NutritionOrder|
  RequestOrchestration|ServiceRequest|Task|VisionPrescription) ] ; # 0..1 Activity that is intended to be part of the care plan

  ] ... ) ;
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Comments about the plan

]

Changes since DSTU2 from both R4 and R4B

CarePlan.definition
CarePlan Added Element
CarePlan.basedOn
  • Type Reference: Added Element CarePlan.replaces Added Element CarePlan.partOf Added Element CarePlan.intent Added Element CarePlan.title Added Element Target Types ServiceRequest, RequestOrchestration, NutritionOrder
CarePlan.subject CarePlan.status
  • Min Cardinality changed from 0 to 1 Remove codes revoked , completed
    • CarePlan.author
  • Add Reference(CareTeam) code ended
CarePlan.careTeam CarePlan.intent
  • Added Element Add code directive
CarePlan.supportingInfo CarePlan.custodian
  • Renamed from support author to supportingInfo CarePlan.activity.outcomeCodeableConcept Added Element custodian
CarePlan.activity.outcomeReference CarePlan.addresses
  • Renamed Type changed from actionResulting Reference(Condition) to outcomeReference CarePlan.activity.reference Remove Reference(DiagnosticOrder), Remove Reference(MedicationOrder), Remove Reference(Order), Remove Reference(ProcessRequest), Remove Reference(SupplyRequest), Add Reference(MedicationRequest), Add Reference(Task), Add Reference(RequestGroup) CodeableReference
CarePlan.activity.detail.definition CarePlan.activity.performedActivity
  • Added Element
CarePlan.activity.detail.status CarePlan.activity.plannedActivityReference
  • Min Cardinality changed Renamed from 0 reference to 1 plannedActivityReference
    • CarePlan.activity.detail.statusReason
  • Type changed from CodeableConcept to string CarePlan.activity.detail.prohibited Min Cardinality changed from 1 to 0 Reference: Added Target Type RequestOrchestration
  • Default Value "false" added Type Reference: Removed Target Type RequestGroup
CarePlan.activity.detail.performer CarePlan.instantiatesCanonical
  • Add Reference(CareTeam) Deleted
CarePlan.note CarePlan.instantiatesUri
  • Max Cardinality changed from 1 to * Deleted
CarePlan.modified CarePlan.activity.outcomeCodeableConcept
  • deleted Deleted (-> CarePlan.activity.performedActivity)
CarePlan.relatedPlan CarePlan.activity.outcomeReference
  • deleted Deleted (-> CarePlan.activity.performedActivity)
CarePlan.participant CarePlan.activity.detail
  • deleted Deleted (-> CarePlan.activity.plannedActivityReference)

See the Full Difference for further information

This analysis is available for R4 as XML or JSON . See R2 <--> R3 Conversion Maps (status = 10 tests that all execute ok. 8 fail round-trip testing and 10 r3 resources are invalid (33 errors). ). for R4B as XML or JSON .

Structure

I Results of the activity I reasonCode 0..* CodeableConcept Why activity should be done or why activity was prohibited productCodeableConcept CodeableConcept productReference Reference ( Medication | Substance ) dailyAmount 0..1 SimpleQuantity How to consume/day? quantity 0..1 SimpleQuantity How much to administer/supply/consume description 0..1 string Extra info describing activity to perform
Name Flags Card. Type Description & Constraints      Filter: Filters doco
. . CarePlan N DomainResource Healthcare plan for patient or group

Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier External Ids for this plan
definition Σ 0..* Reference ( PlanDefinition | Questionnaire ) Protocol or definition
. . . basedOn Σ 0..* Reference ( CarePlan | ServiceRequest | RequestOrchestration | NutritionOrder ) Fulfills care plan plan, proposal or order

. . . replaces Σ 0..* Reference ( CarePlan ) CarePlan replaced by this CarePlan

. . . status ?! Σ 1..1 code draft | active | suspended | completed on-hold | entered-in-error | cancelled ended | completed | revoked | unknown
CarePlanStatus Binding: RequestStatus ( Required )
. . . intent ?! Σ 1..1 code proposal | plan | order | option | directive
CarePlanIntent Binding: Care Plan Intent ( Required )
. . . category Σ 0..* CodeableConcept Type of plan
Binding: Care Plan Category ( Example )

. . . title Σ 0..1 string Human-friendly name for the CarePlan care plan
. . . description Σ 0..1 string Summary of nature of plan
. . . subject Σ 1..1 Reference ( Patient | Group ) Who the care plan is for
. . context . encounter Σ 0..1 Reference ( Encounter | EpisodeOfCare ) The Encounter during which this CarePlan was created
Created in context of
. . . period Σ 0..1 Period Time period plan covers
. . author . created Σ 0..1 dateTime 0..* Date record was first recorded
. . . custodian Σ 0..1 Reference ( Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam ) Who is the designated responsible for contents party
... contributor 0..* Reference ( Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam ) Who provided the content of the care plan

. . . careTeam 0..* Reference ( CareTeam ) Who's involved in plan?

. . . addresses Σ 0..* Reference CodeableReference ( Condition | Procedure | MedicationAdministration ) Health issues this plan addresses
Binding: SNOMED CT Clinical Findings ( Example )

. . . supportingInfo 0..* Reference ( Any ) Information considered as part of plan

. . . goal 0..* Reference ( Goal ) Desired outcome of plan

. . . activity 0..* BackboneElement Action to occur or has occurred as part of plan
+ Provide a reference or detail, not both
. . . outcomeCodeableConcept . performedActivity 0..* CodeableConcept CodeableReference ( Any ) Activities that are completed or in progress (concept, or Appointment, Encounter, Procedure, etc.)
Binding: Care Plan Activity Outcome Performed ( Example )
outcomeReference 0..* Reference ( Any ) Appointment, Encounter, Procedure, etc.
. . . . progress 0..* Annotation Comments about the activity status/progress

. . . reference . plannedActivityReference 0..1 Reference ( Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ProcedureRequest | ReferralRequest ServiceRequest | VisionPrescription | RequestGroup ) Activity details defined in specific resource detail I 0..1 BackboneElement In-line definition of activity category 0..1 CodeableConcept diet | drug | encounter | observation | procedure | supply | other CarePlanActivityCategory ( Example ) definition 0..1 Reference ( PlanDefinition | ActivityDefinition | Questionnaire ) Protocol or definition code 0..1 CodeableConcept Detail type of activity Care Plan Activity ( Example RequestOrchestration ) Activity Reason ( Example ) reasonReference 0..* Reference ( Condition ) Condition triggering need for activity goal 0..* Reference ( Goal ) Goals this activity relates to status ?! 1..1 code not-started | scheduled | in-progress | on-hold | completed | cancelled | unknown CarePlanActivityStatus ( Required ) statusReason 0..1 string Reason for current status prohibited ?! 0..1 boolean Do NOT do scheduled[x] 0..1 When activity is to occur scheduledTiming Timing scheduledPeriod Period scheduledString string location 0..1 Reference ( Location ) Where it should happen performer 0..* Reference ( Practitioner | Organization | RelatedPerson | Patient | CareTeam ) Who will be responsible? product[x] 0..1 What that is intended to be administered/supplied part of the care plan
SNOMED CT Medication Codes ( Example )
. . . note 0..* Annotation Comments about the plan


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

CarePlan ( DomainResource ) This records Business identifiers associated with assigned to this care plan that are defined by business processes and/or used to refer to it when a direct URL reference to the performer or other systems which remain constant as the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation) updated and propagates from server to server identifier : Identifier [0..*] Identifies the protocol, questionnaire, guideline or other specification the care plan should be conducted in accordance with definition : Reference [0..*] PlanDefinition | Questionnaire A care plan higher-level request resource (i.e. a plan, proposal or order) that is fulfilled in whole or in part by this care plan basedOn : Reference [0..*] « CarePlan | ServiceRequest | RequestOrchestration | NutritionOrder » Completed or terminated care plan whose function is taken by this new care plan replaces : Reference [0..*] « CarePlan » A larger care plan of which this particular care plan is a component or step partOf : Reference [0..*] « CarePlan » Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record (this element modifies the meaning of other elements) status : code [1..1] « Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record. null (Strength=Required) CarePlanStatus RequestStatus ! » Indicates the level of authority/intentionality associated with the care plan and where the care plan fits into the workflow chain (this element modifies the meaning of other elements) intent : code [1..1] « Codes indicating the degree of authority/intentionality associated with a care plan null (Strength=Required) CarePlanIntent ! » Identifies what "kind" "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", "wellness plan", "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc category : CodeableConcept [0..*] « Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc. null (Strength=Example) Care Plan Category CarePlanCategory ?? » Human-friendly name for the CarePlan care plan title : string [0..1] A description of the scope and nature of the plan description : string [0..1] Identifies the patient or group whose intended care is described by the plan subject : Reference [1..1] « Patient | Group » Identifies the original context in The Encounter during which this particular CarePlan was created or to which the creation of this record is tightly associated context encounter : Reference [0..1] « Encounter | EpisodeOfCare » Indicates when the plan did (or is intended to) come into effect and end period : Period [0..1] Identifies Represents when this particular CarePlan record was created in the individual(s) or ogranization who system, which is often a system-generated date created : dateTime [0..1] When populated, the custodian is responsible for the content care plan. The care plan is attributed to the custodian custodian : Reference [0..1] « Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam » Identifies the individual(s), organization or device who provided the contents of the care plan author contributor : Reference [0..*] « Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam » Identifies all people and organizations who are expected to be involved in the care envisioned by this plan careTeam : Reference [0..*] « CareTeam » Identifies the conditions/problems/concerns/diagnoses/etc. whose management and/or mitigation are handled by this plan addresses : Reference CodeableReference [0..*] « Condition | Procedure | MedicationAdministration ; null (Strength=Example) SNOMEDCTClinicalFindings ?? » Identifies portions of the patient's record that specifically influenced the formation of the plan. These might include co-morbidities, comorbidities, recent procedures, limitations, recent assessments, etc supportingInfo : Reference [0..*] « Any » Describes the intended objective(s) of carrying out the care plan goal : Reference [0..*] « Goal » General notes about the care plan not covered elsewhere note : Annotation [0..*] Activity Identifies the outcome at the point when the status of the activity is assessed. that was performed. For example, the outcome of an education activity could be patient understands (or not) outcomeCodeableConcept : CodeableConcept [0..*] Identifies the results of the activity (Strength=Example) Care Plan Activity Outcome ?? Details of the outcome education, exercise, or action resulting from the activity. a medication administration. The reference to an "event" "event" resource, such as Procedure or Encounter or Observation, is the result/outcome of represents the activity itself. that was performed. The requested activity can be conveyed using CarePlan.activity.detail OR using the CarePlan.activity.reference CarePlan.activity.plannedActivityReference (a reference to a request “request” resource) outcomeReference performedActivity : Reference CodeableReference [0..*] « Any ; null (Strength=Example) CarePlanActivityPerformed ?? » Notes about the adherence/status/progress of the activity progress : Annotation [0..*] The details of the proposed activity represented in a specific resource reference plannedActivityReference : Reference [0..1] « Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ProcedureRequest | ReferralRequest ServiceRequest | VisionPrescription | RequestGroup Detail High-level categorization of the type of activity in a care plan category : CodeableConcept [0..1] High-level categorization of the type of activity in a care plan. (Strength=Example) CarePlanActivityCategory ?? Identifies the protocol, questionnaire, guideline or other specification the planned activity should be conducted in accordance with definition : Reference [0..1] PlanDefinition | ActivityDefinition | Questionnaire Detailed description of the type of planned activity; e.g. What lab test, what procedure, what kind of encounter code : CodeableConcept [0..1] Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter. (Strength=Example) Care Plan Activity RequestOrchestration ?? » Provides the rationale that drove the inclusion of this particular activity as part of the plan or the reason why the activity was prohibited reasonCode : CodeableConcept [0..*] 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. (Strength=Example) Activity Reason ?? Provides the health condition(s) that drove the inclusion of this particular activity as part of the plan reasonReference : Reference [0..*] Condition Internal reference that identifies the goals that this activity is intended to contribute towards meeting goal : Reference [0..*] Goal Identifies what progress is being made for the specific activity (this element modifies the meaning of other elements) status : code [1..1] Indicates where the activity is at in its overall life cycle. (Strength=Required) CarePlanActivityStatus ! Provides reason why the activity isn't yet started, is on hold, was cancelled, etc statusReason : string [0..1] If true, indicates that the described activity is one that must NOT be engaged in when following the plan. If false, indicates that the described activity is one an action that should be engaged in when following the plan (this element modifies the meaning of other elements) prohibited : boolean [0..1] The period, timing has occurred or frequency upon which the described activity is to occur scheduled[x] : Type [0..1] Timing | Period | string Identifies the facility where the activity will occur; e.g. home, hospital, specific clinic, etc location : Reference [0..1] Location Identifies who's expected to be involved in the activity performer : Reference [0..*] Practitioner | Organization | RelatedPerson | Patient | CareTeam Identifies the food, drug or other product to be consumed or supplied in the activity product[x] : Type [0..1] CodeableConcept | Reference ( Medication | Substance ); A product supplied or administered as part of a care plan activity. (Strength=Example) SNOMED CT Medication ?? Identifies the quantity expected to be consumed in a given day dailyAmount : Quantity ( SimpleQuantity ) [0..1] Identifies the quantity expected to be supplied, administered or consumed by the subject quantity : Quantity ( SimpleQuantity ) [0..1] 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 description : string [0..1] 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 detail [0..1] 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, self-monitoring that has occurred, education etc activity [0..*]

XML Template 

<

<CarePlan xmlns="http://hl7.org/fhir"> doco

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <</identifier>
 <</definition>
 <</basedOn>

 <identifier><!-- 0..* Identifier External Ids for this plan --></identifier>
 <basedOn><!-- 0..* Reference(CarePlan|NutritionOrder|RequestOrchestration|
   ServiceRequest) Fulfills plan, proposal or order --></basedOn>
 <replaces><!-- 0..* Reference(CarePlan) CarePlan replaced by this CarePlan --></replaces>
 <partOf><!-- 0..* Reference(CarePlan) Part of referenced CarePlan --></partOf>
 <
 <

 <status value="[code]"/><!-- 1..1 draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown -->
 <intent value="[code]"/><!-- 1..1 proposal | plan | order | option | directive -->

 <category><!-- 0..* CodeableConcept Type of plan --></category>
 <
 <
 <</subject>
 <</context>

 <title value="[string]"/><!-- 0..1 Human-friendly name for the care plan -->
 <description value="[string]"/><!-- 0..1 Summary of nature of plan -->
 <subject><!-- 1..1 Reference(Group|Patient) Who the care plan is for --></subject>
 <encounter><!-- 0..1 Reference(Encounter) The Encounter during which this CarePlan was created --></encounter>

 <period><!-- 0..1 Period Time period plan covers --></period>
 <|
   </author>

 <created value="[dateTime]"/><!-- 0..1 Date record was first recorded -->
 <custodian><!-- 0..1 Reference(CareTeam|Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Who is the designated responsible party --></custodian>

 <contributor><!-- 0..* Reference(CareTeam|Device|Organization|Patient|
   Practitioner|PractitionerRole|RelatedPerson) Who provided the content of the care plan --></contributor>
 <careTeam><!-- 0..* Reference(CareTeam) Who's involved in plan? --></careTeam>
 <</addresses>
 <</supportingInfo>

 <addresses><!-- 0..* CodeableReference(Condition|MedicationAdministration|
   Procedure) Health issues this plan addresses --></addresses>

 <supportingInfo><!-- 0..* Reference(Any) Information considered as part of plan --></supportingInfo>

 <goal><!-- 0..* Reference(Goal) Desired outcome of plan --></goal>
 <
  <</outcomeCodeableConcept>
  <</outcomeReference>

 <activity>  <!-- 0..* Action to occur or has occurred as part of plan -->
  <performedActivity><!-- 0..* CodeableReference(Any) Activities that are completed or in progress (concept, or Appointment, Encounter, Procedure, etc.) --></performedActivity>

  <progress><!-- 0..* Annotation Comments about the activity status/progress --></progress>
  <|
    |
    </reference>
  <
   <</category>
   <|
     </definition>
   <</code>
   <</reasonCode>
   <</reasonReference>
   <</goal>
   <
   <
   <
   <</scheduled[x]>
   <</location>
   <|
     </performer>
   <</product[x]>
   <</dailyAmount>
   <</quantity>
   <
  </detail>

  <plannedActivityReference><!-- 0..1 Reference(Appointment|CommunicationRequest|
    DeviceRequest|MedicationRequest|NutritionOrder|RequestOrchestration|
    ServiceRequest|Task|VisionPrescription) Activity that is intended to be part of the care plan --></plannedActivityReference>
 </activity>
 <note><!-- 0..* Annotation Comments about the plan --></note>
</CarePlan>

JSON Template 

{doco
  "resourceType" : "",

  "resourceType" : "CarePlan",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "|
   
  "
  "
  "
  "
  "
    "
    "
    "
    "|
    |
    
    "
      "
      "|
     
      "
      "
      "
      "
      "
      "
      "
      
      " },
      " },
      ">",
      "
      "|
     
      
      " },
      " },
      "
      "
      "
    }

  "identifier" : [{ Identifier }], // External Ids for this plan
  "basedOn" : [{ Reference(CarePlan|NutritionOrder|RequestOrchestration|
   ServiceRequest) }], // Fulfills plan, proposal or order

  "replaces" : [{ Reference(CarePlan) }], // CarePlan replaced by this CarePlan
  "partOf" : [{ Reference(CarePlan) }], // Part of referenced CarePlan
  "status" : "<code>", // R!  draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown
  "intent" : "<code>", // R!  proposal | plan | order | option | directive
  "category" : [{ CodeableConcept }], // Type of plan
  "title" : "<string>", // Human-friendly name for the care plan
  "description" : "<string>", // Summary of nature of plan
  "subject" : { Reference(Group|Patient) }, // R!  Who the care plan is for
  "encounter" : { Reference(Encounter) }, // The Encounter during which this CarePlan was created
  "period" : { Period }, // Time period plan covers
  "created" : "<dateTime>", // Date record was first recorded
  "custodian" : { Reference(CareTeam|Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Who is the designated responsible party

  "contributor" : [{ Reference(CareTeam|Device|Organization|Patient|
   Practitioner|PractitionerRole|RelatedPerson) }], // Who provided the content of the care plan

  "careTeam" : [{ Reference(CareTeam) }], // Who's involved in plan?
  "addresses" : [{ CodeableReference(Condition|MedicationAdministration|
   Procedure) }], // Health issues this plan addresses

  "supportingInfo" : [{ Reference(Any) }], // Information considered as part of plan
  "goal" : [{ Reference(Goal) }], // Desired outcome of plan
  "activity" : [{ // Action to occur or has occurred as part of plan
    "performedActivity" : [{ CodeableReference(Any) }], // Activities that are completed or in progress (concept, or Appointment, Encounter, Procedure, etc.)
    "progress" : [{ Annotation }], // Comments about the activity status/progress
    "plannedActivityReference" : { Reference(Appointment|CommunicationRequest|
    DeviceRequest|MedicationRequest|NutritionOrder|RequestOrchestration|
    ServiceRequest|Task|VisionPrescription) } // Activity that is intended to be part of the care plan
  }],
  "

  "note" : [{ Annotation }] // Comments about the plan

}

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:CarePlan;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from 
  # from 
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
    fhir:
    fhir:
    fhir:
    fhir:|
  
    fhir:
      fhir:
      fhir:
      fhir:
      fhir:
      fhir:
      fhir:
      fhir:
      fhir:
      fhir:
      # . One of these 3
        fhir: ]
        fhir: ]
        fhir: ]
      fhir:
      fhir:
      # . One of these 2
        fhir: ]
        fhir:) ]
      fhir:
      fhir:
      fhir:
    ];
  ], ...;
  fhir:

  # from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language
  # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* External Ids for this plan
  fhir:basedOn  ( [ Reference(CarePlan|NutritionOrder|RequestOrchestration|ServiceRequest) ] ... ) ; # 0..* Fulfills plan, proposal or order
  fhir:replaces  ( [ Reference(CarePlan) ] ... ) ; # 0..* CarePlan replaced by this CarePlan
  fhir:partOf  ( [ Reference(CarePlan) ] ... ) ; # 0..* Part of referenced CarePlan
  fhir:status [ code ] ; # 1..1 draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown
  fhir:intent [ code ] ; # 1..1 proposal | plan | order | option | directive
  fhir:category  ( [ CodeableConcept ] ... ) ; # 0..* Type of plan
  fhir:title [ string ] ; # 0..1 Human-friendly name for the care plan
  fhir:description [ string ] ; # 0..1 Summary of nature of plan
  fhir:subject [ Reference(Group|Patient) ] ; # 1..1 Who the care plan is for
  fhir:encounter [ Reference(Encounter) ] ; # 0..1 The Encounter during which this CarePlan was created
  fhir:period [ Period ] ; # 0..1 Time period plan covers
  fhir:created [ dateTime ] ; # 0..1 Date record was first recorded
  fhir:custodian [ Reference(CareTeam|Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Who is the designated responsible party
  fhir:contributor  ( [ Reference(CareTeam|Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ... ) ; # 0..* Who provided the content of the care plan
  fhir:careTeam  ( [ Reference(CareTeam) ] ... ) ; # 0..* Who's involved in plan?
  fhir:addresses  ( [ CodeableReference(Condition|MedicationAdministration|Procedure) ] ... ) ; # 0..* Health issues this plan addresses
  fhir:supportingInfo  ( [ Reference(Any) ] ... ) ; # 0..* Information considered as part of plan
  fhir:goal  ( [ Reference(Goal) ] ... ) ; # 0..* Desired outcome of plan
  fhir:activity ( [ # 0..* Action to occur or has occurred as part of plan
    fhir:performedActivity  ( [ CodeableReference(Any) ] ... ) ; # 0..* Activities that are completed or in progress (concept, or Appointment, Encounter, Procedure, etc.)
    fhir:progress  ( [ Annotation ] ... ) ; # 0..* Comments about the activity status/progress
    fhir:plannedActivityReference [ Reference(Appointment|CommunicationRequest|DeviceRequest|MedicationRequest|NutritionOrder|
  RequestOrchestration|ServiceRequest|Task|VisionPrescription) ] ; # 0..1 Activity that is intended to be part of the care plan

  ] ... ) ;
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Comments about the plan

]

Changes since DSTU2 from both R4 and R4B

CarePlan.definition
CarePlan Added Element
CarePlan.basedOn
  • Type Reference: Added Element CarePlan.replaces Added Element CarePlan.partOf Added Element CarePlan.intent Added Element CarePlan.title Added Element Target Types ServiceRequest, RequestOrchestration, NutritionOrder
CarePlan.subject CarePlan.status
  • Min Cardinality changed from 0 to 1 Remove codes revoked , completed
    • CarePlan.author
  • Add Reference(CareTeam) code ended
CarePlan.careTeam CarePlan.intent
  • Added Element Add code directive
CarePlan.supportingInfo CarePlan.custodian
  • Renamed from support author to supportingInfo CarePlan.activity.outcomeCodeableConcept Added Element custodian
CarePlan.activity.outcomeReference CarePlan.addresses
  • Renamed Type changed from actionResulting Reference(Condition) to outcomeReference CarePlan.activity.reference Remove Reference(DiagnosticOrder), Remove Reference(MedicationOrder), Remove Reference(Order), Remove Reference(ProcessRequest), Remove Reference(SupplyRequest), Add Reference(MedicationRequest), Add Reference(Task), Add Reference(RequestGroup) CodeableReference
CarePlan.activity.detail.definition CarePlan.activity.performedActivity
  • Added Element
CarePlan.activity.detail.status CarePlan.activity.plannedActivityReference
  • Min Cardinality changed Renamed from 0 reference to 1 plannedActivityReference
    • CarePlan.activity.detail.statusReason
  • Type changed from CodeableConcept to string CarePlan.activity.detail.prohibited Min Cardinality changed from 1 to 0 Reference: Added Target Type RequestOrchestration
  • Default Value "false" added Type Reference: Removed Target Type RequestGroup
CarePlan.activity.detail.performer CarePlan.instantiatesCanonical
  • Add Reference(CareTeam) Deleted
CarePlan.note CarePlan.instantiatesUri
  • Max Cardinality changed from 1 to * Deleted
CarePlan.modified CarePlan.activity.outcomeCodeableConcept
  • deleted Deleted (-> CarePlan.activity.performedActivity)
CarePlan.relatedPlan CarePlan.activity.outcomeReference
  • deleted Deleted (-> CarePlan.activity.performedActivity)
CarePlan.participant CarePlan.activity.detail
  • deleted Deleted (-> CarePlan.activity.plannedActivityReference)

See the Full Difference for further information

This analysis is available for R4 as XML or JSON . See R2 <--> R3 Conversion Maps (status = 10 tests that all execute ok. 8 fail round-trip testing and 10 r3 resources are invalid (33 errors). ). for R4B as XML or JSON .

 

Alternate Additional definitions: Master Definition ( XML , + JSON ), , XML Schema / Schematron (for ) + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis

9.5.3.1 9.5.4.1 Terminology Bindings

Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc. Example CarePlan.activity.outcomeCodeableConcept Identifies the results of the activity CarePlan.activity.detail.code Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter. Example CarePlan.activity.detail.reasonCode 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. CarePlan.activity.detail.product[x]
Path Definition ValueSet Type Reference Documentation
CarePlan.status Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record. RequestStatus Required CarePlanStatus

Codes identifying the lifecycle stage of a request.

CarePlan.intent CarePlanIntent Required

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

CarePlan.category Care Plan Category CarePlanCategory Example Care Plan Activity Outcome CarePlan.activity.detail.category High-level categorization of

Example codes indicating the type of activity in category a care plan. Example CarePlanActivityCategory plan falls within. Note that these are in no way complete and might not even be appropriate for some uses.

CarePlan.addresses Care Plan Activity SNOMEDCTClinicalFindings Example Activity Reason CarePlan.activity.detail.status Indicates where

This value set includes all the activity is at in its overall life cycle. Required "Clinical finding" SNOMED CT icon CarePlanActivityStatus codes - concepts where concept is-a 404684003 (Clinical finding (finding)).

CarePlan.activity.performedActivity A product supplied or administered as part of a care plan activity. CarePlanActivityPerformed Example SNOMED CT Medication Codes

Example codes indicating the care plan activity that was performed. Note that these are in no way complete and might not even be appropriate for some uses.

9.5.3.2 Constraints 9.5.4.2 cpl-3 : On CarePlan.activity: Provide a reference or detail, not both ( expression on CarePlan.activity: detail.empty() or reference.empty() ) Notes 9.5.3.3 Notes

The Provenance resource can be used for detailed review information, such as when the care plan was last reviewed and by whom.

9.5.4 9.5.5 Open Issues

9.5.5 9.5.6 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource , and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

activity-code token Detail type of activity CarePlan.activity.detail.code Specified date occurs within period specified by CarePlan.activity.timingSchedule CarePlan.activity.detail.scheduled activity-reference definition performer
Name Type Description Expression In Common
activity-date date activity-reference reference Activity details defined in specific resource that is intended to be part of the care plan CarePlan.activity.reference CarePlan.activity.plannedActivityReference
( Appointment , ReferralRequest , MedicationRequest , Task , NutritionOrder , RequestGroup RequestOrchestration , VisionPrescription , ProcedureRequest , DeviceRequest , ServiceRequest , CommunicationRequest )
based-on reference Fulfills care plan CarePlan CarePlan.basedOn
( CarePlan , RequestOrchestration , NutritionOrder , ServiceRequest )
care-team reference Who's involved in plan? CarePlan.careTeam
( CareTeam )
category token Type of plan CarePlan.category
condition reference Health issues this plan addresses Reference to a resource (by instance) CarePlan.addresses ( Condition ) CarePlan.addresses.reference
custodian context reference Created in context of Who is the designated responsible party CarePlan.context CarePlan.custodian
( EpisodeOfCare Practitioner , Encounter Organization , CareTeam , Device , Patient , PractitionerRole , RelatedPerson )
date date Time period plan covers CarePlan.period 18 22 Resources
reference Protocol or definition CarePlan.definition ( Questionnaire , PlanDefinition encounter ) encounter reference Created in context of The Encounter during which this CarePlan was created CarePlan.context CarePlan.encounter
( Encounter ) 		26 Resources
goal reference Desired outcome of plan CarePlan.goal
( Goal )
identifier token External Ids for this plan CarePlan.identifier 26 58 Resources
intent token proposal | plan | order | option | directive CarePlan.intent
part-of reference Part of referenced CarePlan CarePlan.partOf
( CarePlan )
patient reference Who the care plan is for CarePlan.subject CarePlan.subject.where(resolve() is Patient)
( Patient ) 		31 60 Resources
reference Matches if the practitioner is listed as a performer in any of the "simple" activities. (For performers of the detailed activities, chain through the activitydetail search parameter.) CarePlan.activity.detail.performer ( Practitioner , Organization , CareTeam , Patient , RelatedPerson replaces ) replaces reference CarePlan replaced by this CarePlan CarePlan.replaces
( CarePlan )
status token draft | active | suspended on-hold | revoked | completed | entered-in-error | cancelled | unknown CarePlan.status
subject reference Who the care plan is for CarePlan.subject
( Group , Patient )