9.7.12 JSON Schema for Dictionarynull CareTeam Raw XML Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as Lab reports, etc. Observations are a key aspect of healthcare. This resource is used to capture those that do not require more sophisticated mechanisms. The logical id of the resource, as used in the url for the resoure. Once assigned, this value never changes. 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. 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. A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. 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. 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). 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. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. 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. 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. 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. 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. The information determined as a result of making the observation, if the information has a simple value. Normally, an observation will have either a value or a set of related observations. A few observations (e.g. apgar store) may have both a value and related observations (for apgar, the observations from which the measure is derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For boolean values use valueCodeableConcept and select codes from <http://hl7.org/fhir/v2/vs/0136> (These "yes/no" concepts can be mapped to the display name "true/false" or other mutually exclusive terms that may be needed"). The element, Observation.value[x], has a variable name depending on the type as follows: valueQuantity, valueCodeableConcept, valueRatio, valueChoice, valuePeriod, valueSampleData, or valueString (The name format is "'value' + the type name" with a capital on the first letter of the type). An observation exists to have a value, though it may not if it is in error, or it represents a group of observations. 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. 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. The value of the measured amount. The value includes an implicit precision in the presentation of the value. The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books). How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues. E.g. if the comparator is "<" , then the real value is < stated value. This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value. Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. There are many representations for units and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. Need a computable form of the units that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values. For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result. May include statements about significant, unexpected or unreliable values, or information about the source of the value where this may be relevant to the interpretation of the result. The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself. Knowing when an observation was deemed true is important to its relevance as well as determining trends. OBX-14-date/time of the observation, and/or OBX-19 after v2.4 (depends on who observation made) Need to track the status of individual results - some results are finalised before the whole report is finalised. status Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise" Note that in most contexts, unreliable results are not recorded, deleted, or otherwise excluded, but it's not always possible to exclude them from the record. If the reliability indicator is present, interpreters of a result, whether human or machine, should always either be aware of the status or prevented from using the observation without being unaware that the reliability is not "ok". Codes that provide an estimate of the degree to which quality issues have impacted on the value of an observation Indicates the site on the subject's body where the observation was made ( i.e. the target site). Knowing where the observation is made is important for tracking if multiple sites are possible. In some cases, method can impact results and is thus for determining whether results can be compared or determining significance of results. The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed. Comments: Indirect characteristics may be those of a specimen, fetus, other observer (for example a relative or EMT), or any observation made about the subject. One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated. If the target of the observation is different than the subject, the general extension (http://hl7.org/fhir/StructureDefinition/indirectTarget) can be used. Observations are not made on specimens themselves; they are made on a subject, but usually by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources are often used in contexts that track the specimen explicitly (e.g. Diagnostic Report). May give a degree of confidence in the observation and also indicates where follow-up questions should be directed. OBX.15 / (Practitioner) OBX-16-responsible observer, PRT-5-participation person:PRT-4-participatio n='RO' / (Device) OBX-18-equipment instance identifier , PRT-10-participation device:PRT-4-particip ation='EQUIP' / (Organization) OBX-23-performing organization name, PRT-8-participation organization:PRT-4-participation='PO' May give a degree of confidence in the observation and also indicates where follow-up questions should be directed. OBX.15 / (Practitioner) OBX-16-responsible observer, PRT-5-participation person:PRT-4-participatio n='RO' / (Device) OBX-18-equipment instance identifier , PRT-10-participation device:PRT-4-particip ation='EQUIP' / (Organization) OBX-23-performing organization name, PRT-8-participation organization:PRT-4-participation='PO' documents the name and address of the laboratory that performs the test. This is a CLIA required item to be printed on the report, CLIA requires the name of the laboratory, city and state of the laboratory. May give a degree of confidence in the observation and also indicates where follow-up questions should be directed. OBX.15 / (Practitioner) OBX-16-responsible observer, PRT-5-participation person:PRT-4-participatio n='RO' / (Device) OBX-18-equipment instance identifier , PRT-10-participation device:PRT-4-particip ation='EQUIP' / (Organization) OBX-23-performing organization name, PRT-8-participation organization:PRT-4-participation='PO' An extension should be used if further typing of the device is needed. Devices used to support obtaining an observation can be represented using either extension or through the Observation.related element. The healthcare event ( e.g. a patient and healthcare provider interaction ) during which this observation is made. For some observations it may be important to know the link between an observation and a particular encounter. Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g. specific to the patient's age, gender, weight and other factors), but this may not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties. Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts. 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. 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. 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. 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. The value of the low bound of the reference range. If this element is omitted, the low bound of the reference range is assumed to be meaningless. (e.g. reference range is <2.3) If the low.comparator element is missing, it is assumed to be '>'. not(exists(f:comparator)) or boolean(f:comparator/@value = '<') or boolean(f:comparator/@value = '<=') The value of the high bound of the reference range. If this element is omitted, the high bound of the reference range is assumed to be meaningless. (e.g. reference range is > 5) If the low.comparator element is missing , it is assumed to be '<'. not(exists(f:comparator)) or boolean(f:comparator/@value = '>') or boolean(f:comparator/@value = '>=') Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, or perhaps what state this reference range applies to (i.e. age, hormonal cycles, etc.). The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so. Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative&quot ; or a list or table of 'normals'. Normally, an observation will have either a value or a set of related observations. A few observations (e.g. apgar store) may have both a value and related observations (for apgar, the observations from which the measure is derived). Some observations have important relationships to other observations (e.g Blood Pressure = systolic + diastolic), or are derived from other observations (e.g. calculated apgar score). 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. 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. 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. 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. A relationship type SHOULD be provided. If the relationship type is "COMP" (composed), then the observation should not be displayed/interpreted in the absence of the related observations. May need to indicate whether this observation is composed of others, or merely derived from them.

</StructureDefinition>

Patient Care Work Group

Maturity Level : N/A

Standards Status : Informative

Compartments : Patient , Practitioner , RelatedPerson

Usage note: every effort has been made to ensure that This is a representation of the examples are correct and useful, but they are not json schema for CareTeam, which is just a normative part of the specification. full JSON Schema .

{
  "$schema": "http://json-schema.org/draft-06/schema#",
  "id": "http://hl7.org/fhir/json-schema/CareTeam",
  "$ref": "#/definitions/CareTeam",
  "description": "see http://hl7.org/fhir/json.html#schema for information about the FHIR Json Schemas",
  "definitions": {
    "CareTeam": {
      "description": "The Care Team includes all the people and organizations who plan to participate in the coordination and delivery of care.",
      "properties": {
        "resourceType": {
          "description": "This is a CareTeam resource",
          "const": "CareTeam"
        },
        "id": {
          "description": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
          "$ref": "id.schema.json#/definitions/id"
        },
        "meta": {
          "description": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
          "$ref": "Meta.schema.json#/definitions/Meta"
        },
        "implicitRules": {
          "description": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
          "$ref": "#/definitions/uri"
        },
        "_implicitRules": {
          "description": "Extensions for implicitRules",
          "$ref": "Element.schema.json#/definitions/Element"
        },
        "language": {
          "description": "The base language in which the resource is written.",
          "$ref": "#/definitions/code"
        },
        "_language": {
          "description": "Extensions for language",
          "$ref": "Element.schema.json#/definitions/Element"
        },
        "text": {
          "description": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
          "$ref": "Narrative.schema.json#/definitions/Narrative"
        },
        "contained": {
          "description": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.",
          "items": {
            "$ref": "ResourceList.schema.json#/definitions/ResourceList"
          },
          "type": "array"
        },
        "extension": {
          "description": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
          "items": {
            "$ref": "Extension.schema.json#/definitions/Extension"
          },
          "type": "array"
        },
        "modifierExtension": {
          "description": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element\u0027s descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
          "items": {
            "$ref": "Extension.schema.json#/definitions/Extension"
          },
          "type": "array"
        },
        "identifier": {
          "description": "Business identifiers assigned to this care team by the performer or other systems which remain constant as the resource is updated and propagates from server to server.",
          "items": {
            "$ref": "Identifier.schema.json#/definitions/Identifier"
          },
          "type": "array"
        },
        "status": {
          "description": "Indicates the current state of the care team.",
          "$ref": "#/definitions/code"
        },
        "_status": {
          "description": "Extensions for status",
          "$ref": "Element.schema.json#/definitions/Element"
        },
        "category": {
          "description": "Identifies what kind of team.  This is to support differentiation between multiple co-existing teams, such as care plan team, episode of care team, longitudinal care team.",
          "items": {
            "$ref": "CodeableConcept.schema.json#/definitions/CodeableConcept"
          },
          "type": "array"
        },
        "name": {
          "description": "A label for human use intended to distinguish like teams.  E.g. the \"red\" vs. \"green\" trauma teams.",
          "$ref": "#/definitions/string"
        },
        "_name": {
          "description": "Extensions for name",
          "$ref": "Element.schema.json#/definitions/Element"
        },
        "subject": {
          "description": "Identifies the patient or group whose intended care is handled by the team.",
          "$ref": "Reference.schema.json#/definitions/Reference"
        },
        "period": {
          "description": "Indicates when the team did (or is intended to) come into effect and end.",
          "$ref": "Period.schema.json#/definitions/Period"
        },
        "participant": {
          "description": "Identifies all people and organizations who are expected to be involved in the care team.",
          "items": {
            "$ref": "#/definitions/CareTeam_Participant"
          },
          "type": "array"
        },
        "reason": {
          "description": "Describes why the care team exists.",
          "items": {
            "$ref": "CodeableReference.schema.json#/definitions/CodeableReference"
          },
          "type": "array"
        },
        "managingOrganization": {
          "description": "The organization responsible for the care team.",
          "items": {
            "$ref": "Reference.schema.json#/definitions/Reference"
          },
          "type": "array"
        },
        "telecom": {
          "description": "A central contact detail for the care team (that applies to all members).",
          "items": {
            "$ref": "ContactPoint.schema.json#/definitions/ContactPoint"
          },
          "type": "array"
        },
        "note": {
          "description": "Comments made about the CareTeam.",
          "items": {
            "$ref": "Annotation.schema.json#/definitions/Annotation"
          },
          "type": "array"
        }
      },
      "type": "object",
      "additionalProperties": false,
      "required": [
        "resourceType"
      ]
    },
    "CareTeam_Participant": {
      "description": "The Care Team includes all the people and organizations who plan to participate in the coordination and delivery of care.",
      "properties": {
        "id": {
          "description": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
          "$ref": "string.schema.json#/definitions/string"
        },
        "extension": {
          "description": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
          "items": {
            "$ref": "Extension.schema.json#/definitions/Extension"
          },
          "type": "array"
        },
        "modifierExtension": {
          "description": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element\u0027s descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
          "items": {
            "$ref": "Extension.schema.json#/definitions/Extension"
          },
          "type": "array"
        },
        "role": {
          "description": "Indicates specific responsibility of an individual within the care team, such as \"Primary care physician\", \"Trained social worker counselor\", \"Caregiver\", etc.",
          "$ref": "CodeableConcept.schema.json#/definitions/CodeableConcept"
        },
        "member": {
          "description": "The specific person or organization who is participating/expected to participate in the care team.",
          "$ref": "Reference.schema.json#/definitions/Reference"
        },
        "onBehalfOf": {
          "description": "The organization of the practitioner.",
          "$ref": "Reference.schema.json#/definitions/Reference"
        },
        "coveragePeriod": {
          "description": "When the member is generally available within this care team.",
          "$ref": "Period.schema.json#/definitions/Period"
        },
        "coverageTiming": {
          "description": "When the member is generally available within this care team.",
          "$ref": "Timing.schema.json#/definitions/Timing"
        }
      },
      "type": "object",
      "additionalProperties": false
    }
  }
}