Release 4 R6 Ballot (1st Full Ballot)

This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU v6.0.0-ballot4: Release 6 Ballot (1st Full Ballot) (see Ballot Notes ) in it's permanent home (it will always be available at this URL). ). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions for published versions icon . Page versions: R5 R4B R4 R3 R2

9.5 Resource CarePlan - Content

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

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 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's sake, CarePlan allows the inline 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" resources. These references could be to resources with a status of "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 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 itself,

9.5.3 References to this Resource

9.5.3 9.5.4 Resource Content

Structure

Instantiates FHIR protocol basedOn Σ 0..* Reference ( CarePlan ) Fulfills CarePlan I Results of the activity I Activity details defined in specific resource detail I 0..1 BackboneElement In-line definition of activity kind 0..1 code Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription Care Plan
Name Flags Card. Type Description & Constraints      Filter: Filters doco
. . CarePlan TU 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

. . . instantiatesCanonical basedOn Σ 0..* canonical Reference ( PlanDefinition | Questionnaire CarePlan | Measure ServiceRequest | ActivityDefinition RequestOrchestration | OperationDefinition NutritionOrder ) Fulfills plan, proposal or definition order
instantiatesUri Σ 0..* uri Instantiates external protocol or definition
. . . replaces Σ 0..* Reference ( CarePlan ) CarePlan replaced by this CarePlan

. . . status ?! Σ 1..1 code draft | active | on-hold | revoked entered-in-error | ended | completed | entered-in-error revoked | unknown
Binding: RequestStatus ( Required )
. . . intent ?! Σ 1..1 code proposal | plan | order | option | directive
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 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
. . . encounter Σ 0..1 Reference ( Encounter ) The Encounter during which this CarePlan was created as part of
. . . period Σ 0..1 Period Time period plan covers
. . . created Σ 0..1 dateTime Date record was first recorded
. . . author custodian Σ 0..1 Reference ( Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam ) Who is the designated responsible 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
+ Rule: 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 | ServiceRequest | VisionPrescription | RequestGroup RequestOrchestration ) Activity Kind ( Required ) instantiatesCanonical 0..* canonical ( PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition ) Instantiates FHIR protocol or definition instantiatesUri 0..* uri Instantiates external protocol or definition code 0..1 CodeableConcept Detail type of activity Procedure Codes (SNOMED CT) ( Example ) reasonCode 0..* CodeableConcept Why activity should be done or why activity was prohibited SNOMED CT Clinical Findings ( Example ) reasonReference 0..* Reference ( Condition | Observation | DiagnosticReport | DocumentReference ) Why activity is needed goal 0..* Reference ( Goal ) Goals this activity relates to status ?! 1..1 code not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error CarePlanActivityStatus ( Required ) statusReason 0..1 CodeableConcept Reason for current status doNotPerform ?! 0..1 boolean If true, activity is prohibiting action 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 | PractitionerRole | Organization | RelatedPerson | Patient | CareTeam | HealthcareService | Device ) 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 ) Business identifiers assigned to this care plan by the performer or other systems which remain constant as the resource is updated and propagates from server to server identifier : Identifier [0..*] The URL pointing to A higher-level request resource (i.e. a FHIR-defined protocol, guideline, questionnaire plan, proposal or other definition order) that is adhered to fulfilled in whole or in part by this CarePlan care plan instantiatesCanonical basedOn : canonical Reference [0..*] « PlanDefinition | Questionnaire | Measure CarePlan | ActivityDefinition ServiceRequest | OperationDefinition » The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan instantiatesUri : uri [0..*] A care plan that is fulfilled in whole or in part by this care plan basedOn : Reference RequestOrchestration [0..*] « CarePlan | 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) 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" of plan this is to support differentiation between multiple co-existing plans; e.g. "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) CarePlanCategory ?? » Human-friendly name for the 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 » The Encounter during which this CarePlan was created or to which the creation of this record is tightly associated encounter : Reference [0..1] « Encounter » Indicates when the plan did (or is intended to) come into effect and end period : Period [0..1] Represents when this particular CarePlan record was created in the system, which is often a system-generated date created : dateTime [0..1] When populated, the author custodian is responsible for the care plan. The care plan is attributed to the author custodian author custodian : Reference [0..1] « Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam » Identifies the individual(s) or individual(s), organization or device who provided the contents of the care plan 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 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) CarePlanActivityOutcome ?? » Details of the outcome education, exercise, or action resulting from the activity. a medication administration. The reference to an "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” 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 | ServiceRequest | VisionPrescription | RequestGroup » Detail A description of the kind of resource the in-line definition of a care plan activity is representing. The CarePlan.activity.detail is an in-line definition when a resource is not referenced using CarePlan.activity.reference. For example, a MedicationRequest, a ServiceRequest, or a CommunicationRequest kind : code [0..1] « Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity. (Strength=Required) CarePlanActivityKind ! » The URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity instantiatesCanonical : canonical [0..*] « PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition » The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity instantiatesUri : uri [0..*] 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) ProcedureCodes(SNOMEDCT) ?? » 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) SNOMEDCTClinicalFindings ?? » Indicates another resource, such as the health condition(s), whose existence justifies this request and drove the inclusion of this particular activity as part of the plan reasonReference : Reference [0..*] « Condition | Observation | DiagnosticReport | DocumentReference » 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] « Codes that reflect the current state of a care plan activity within its overall life cycle. (Strength=Required) CarePlanActivityStatus ! » Provides reason why the activity isn't yet started, is on hold, was cancelled, etc statusReason : CodeableConcept [0..1] If true, indicates that the described activity is one that must NOT be engaged in when following the plan. If false, or missing, indicates that the described activity is one that should be engaged in when following the plan (this element modifies the meaning of other elements) doNotPerform : boolean [0..1] The period, timing 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 | PractitionerRole | Organization | RelatedPerson | Patient | CareTeam | HealthcareService | Device » 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) SNOMEDCTMedicationCodes RequestOrchestration ?? » 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 an action that has occurred or is 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><!-- 0..* Identifier External Ids for this plan --></identifier>
 <|
   </instantiatesCanonical>
 <
 <</basedOn>

 <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>
 <title value="[string]"/><!-- 0..1 Human-friendly name for the care plan -->
 <description value="[string]"/><!-- 0..1 Summary of nature of plan -->
 <</subject>
 <</encounter>

 <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>
 <created value="[dateTime]"/><!-- 0..1 Date record was first recorded -->
 <|
   </author>
 <|
   </contributor>

 <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>

 <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>
  <
   <
   <|
     </instantiatesCanonical>
   <
   <</code>
   <</reasonCode>
   <|
     </reasonReference>
   <</goal>
   <
   <</statusReason>
   <
   <</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" : "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:
      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 R3 from R5 to R6

CarePlan
CarePlan.instantiatesCanonical CarePlan.status
  • Added Element Remove codes revoked , completed
    • CarePlan.instantiatesUri
  • Added Element Add code ended
CarePlan.status CarePlan.activity.plannedActivityReference
  • Change value set from http://hl7.org/fhir/ValueSet/care-plan-status to http://hl7.org/fhir/ValueSet/request-status|4.0.1 Type Reference: Removed Target Types ImmunizationRecommendation, SupplyRequest
CarePlan.intent CarePlan.instantiatesCanonical
  • Change value set from http://hl7.org/fhir/ValueSet/care-plan-intent to http://hl7.org/fhir/ValueSet/care-plan-intent|4.0.1 Deleted
CarePlan.encounter CarePlan.instantiatesUri
  • Added Element Deleted

Changes from R4 and R4B to R6

CarePlan.created CarePlan Added Element
CarePlan.author CarePlan.basedOn
    Max Cardinality changed from * to 1
  • Type Reference: Added Target Types PractitionerRole, Device ServiceRequest, RequestOrchestration, NutritionOrder
CarePlan.contributor CarePlan.status
  • Added Element Remove codes revoked , completed
  • Add code ended
CarePlan.activity.reference CarePlan.intent
  • Type Reference: Added Target Type ServiceRequest Type Reference: Removed Target Types ProcedureRequest, ReferralRequest Add code directive
CarePlan.activity.detail.kind CarePlan.custodian
  • Renamed from category to kind Type changed from CodeableConcept author to code Add Binding http://hl7.org/fhir/ValueSet/care-plan-activity-kind|4.0.1 (required) custodian
CarePlan.activity.detail.instantiatesCanonical CarePlan.addresses
  • Added Element Type changed from Reference(Condition) to CodeableReference
CarePlan.activity.detail.instantiatesUri CarePlan.activity.performedActivity
  • Added Element
CarePlan.activity.detail.reasonReference CarePlan.activity.plannedActivityReference
  • Renamed from reference to plannedActivityReference
  • Type Reference: Added Target Types Observation, DiagnosticReport, DocumentReference CarePlan.activity.detail.status Change value set from http://hl7.org/fhir/ValueSet/care-plan-activity-status to http://hl7.org/fhir/ValueSet/care-plan-activity-status|4.0.1 Type RequestOrchestration
    • CarePlan.activity.detail.statusReason
  • Type changed from string to CodeableConcept Reference: Removed Target Type RequestGroup
CarePlan.activity.detail.doNotPerform CarePlan.instantiatesCanonical
  • Renamed from prohibited to doNotPerform Default Value "false" removed Deleted
CarePlan.activity.detail.performer CarePlan.instantiatesUri
  • Type Reference: Added Target Types PractitionerRole, HealthcareService, Device Deleted
CarePlan.definition CarePlan.activity.outcomeCodeableConcept
  • deleted Deleted (-> CarePlan.activity.performedActivity)
CarePlan.context CarePlan.activity.outcomeReference
  • deleted Deleted (-> CarePlan.activity.performedActivity)
CarePlan.activity.detail.definition 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 R3 <--> R4 Conversion Maps (status = 11 tests that all execute ok. All tests pass round-trip testing and 10 r3 resources are invalid (0 errors). ) for R4B as XML or JSON .

Structure

Instantiates FHIR protocol or definition instantiatesUri Σ 0..* uri Instantiates external protocol I Results of the activity I Activity details defined in specific resource detail I 0..1 BackboneElement In-line definition of activity kind 0..1 code Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription Care Plan 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 TU 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

. . . instantiatesCanonical basedOn Σ 0..* canonical Reference ( PlanDefinition | Questionnaire CarePlan | Measure ServiceRequest | ActivityDefinition RequestOrchestration | OperationDefinition NutritionOrder ) Fulfills plan, proposal or definition order
basedOn Σ 0..* Reference ( CarePlan ) Fulfills CarePlan
. . . replaces Σ 0..* Reference ( CarePlan ) CarePlan replaced by this CarePlan

. . . status ?! Σ 1..1 code draft | active | on-hold | revoked entered-in-error | ended | completed | entered-in-error revoked | unknown
Binding: RequestStatus ( Required )
. . . intent ?! Σ 1..1 code proposal | plan | order | option | directive
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 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
. . . encounter Σ 0..1 Reference ( Encounter ) The Encounter during which this CarePlan was created as part of
. . . period Σ 0..1 Period Time period plan covers
. . . created Σ 0..1 dateTime Date record was first recorded
. . . author custodian Σ 0..1 Reference ( Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam ) Who is the designated responsible 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
+ Rule: 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 | ServiceRequest | VisionPrescription | RequestGroup RequestOrchestration ) Activity Kind ( Required ) instantiatesCanonical 0..* canonical ( PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition ) Instantiates FHIR protocol or definition instantiatesUri 0..* uri Instantiates external protocol or definition code 0..1 CodeableConcept Detail type of activity Procedure Codes (SNOMED CT) ( Example ) reasonCode 0..* CodeableConcept Why activity should be done or why activity was prohibited SNOMED CT Clinical Findings ( Example ) reasonReference 0..* Reference ( Condition | Observation | DiagnosticReport | DocumentReference ) Why activity is needed goal 0..* Reference ( Goal ) Goals this activity relates to status ?! 1..1 code not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error CarePlanActivityStatus ( Required ) statusReason 0..1 CodeableConcept Reason for current status doNotPerform ?! 0..1 boolean If true, activity is prohibiting action 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 | PractitionerRole | Organization | RelatedPerson | Patient | CareTeam | HealthcareService | Device ) 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?
. . . note 0..* Annotation Comments about the plan


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

CarePlan ( DomainResource ) Business identifiers assigned to this care plan by the performer or other systems which remain constant as the resource is updated and propagates from server to server identifier : Identifier [0..*] The URL pointing to A higher-level request resource (i.e. a FHIR-defined protocol, guideline, questionnaire plan, proposal or other definition order) that is adhered to fulfilled in whole or in part by this CarePlan care plan instantiatesCanonical basedOn : canonical Reference [0..*] « PlanDefinition | Questionnaire | Measure CarePlan | ActivityDefinition ServiceRequest | OperationDefinition » The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan instantiatesUri : uri [0..*] A care plan that is fulfilled in whole or in part by this care plan basedOn : Reference RequestOrchestration [0..*] « CarePlan | 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) 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" of plan this is to support differentiation between multiple co-existing plans; e.g. "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) CarePlanCategory ?? » Human-friendly name for the 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 » The Encounter during which this CarePlan was created or to which the creation of this record is tightly associated encounter : Reference [0..1] « Encounter » Indicates when the plan did (or is intended to) come into effect and end period : Period [0..1] Represents when this particular CarePlan record was created in the system, which is often a system-generated date created : dateTime [0..1] When populated, the author custodian is responsible for the care plan. The care plan is attributed to the author custodian author custodian : Reference [0..1] « Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam » Identifies the individual(s) or individual(s), organization or device who provided the contents of the care plan 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 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) CarePlanActivityOutcome ?? » Details of the outcome education, exercise, or action resulting from the activity. a medication administration. The reference to an "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” 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 | ServiceRequest | VisionPrescription | RequestGroup » Detail A description of the kind of resource the in-line definition of a care plan activity is representing. The CarePlan.activity.detail is an in-line definition when a resource is not referenced using CarePlan.activity.reference. For example, a MedicationRequest, a ServiceRequest, or a CommunicationRequest kind : code [0..1] « Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity. (Strength=Required) CarePlanActivityKind ! » The URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity instantiatesCanonical : canonical [0..*] « PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition » The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity instantiatesUri : uri [0..*] 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) ProcedureCodes(SNOMEDCT) ?? » 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) SNOMEDCTClinicalFindings ?? » Indicates another resource, such as the health condition(s), whose existence justifies this request and drove the inclusion of this particular activity as part of the plan reasonReference : Reference [0..*] « Condition | Observation | DiagnosticReport | DocumentReference » 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] « Codes that reflect the current state of a care plan activity within its overall life cycle. (Strength=Required) CarePlanActivityStatus ! » Provides reason why the activity isn't yet started, is on hold, was cancelled, etc statusReason : CodeableConcept [0..1] If true, indicates that the described activity is one that must NOT be engaged in when following the plan. If false, or missing, indicates that the described activity is one that should be engaged in when following the plan (this element modifies the meaning of other elements) doNotPerform : boolean [0..1] The period, timing 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 | PractitionerRole | Organization | RelatedPerson | Patient | CareTeam | HealthcareService | Device » 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) SNOMEDCTMedicationCodes RequestOrchestration ?? » 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 an action that has occurred or is 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><!-- 0..* Identifier External Ids for this plan --></identifier>
 <|
   </instantiatesCanonical>
 <
 <</basedOn>

 <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>
 <title value="[string]"/><!-- 0..1 Human-friendly name for the care plan -->
 <description value="[string]"/><!-- 0..1 Summary of nature of plan -->
 <</subject>
 <</encounter>

 <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>
 <created value="[dateTime]"/><!-- 0..1 Date record was first recorded -->
 <|
   </author>
 <|
   </contributor>

 <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>

 <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>
  <
   <
   <|
     </instantiatesCanonical>
   <
   <</code>
   <</reasonCode>
   <|
     </reasonReference>
   <</goal>
   <
   <</statusReason>
   <
   <</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" : "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:
      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 Release 3 from R5 to R6

CarePlan
CarePlan.instantiatesCanonical CarePlan.status
  • Added Element Remove codes revoked , completed
    • CarePlan.instantiatesUri
  • Added Element Add code ended
CarePlan.status CarePlan.activity.plannedActivityReference
  • Change value set from http://hl7.org/fhir/ValueSet/care-plan-status to http://hl7.org/fhir/ValueSet/request-status|4.0.1 Type Reference: Removed Target Types ImmunizationRecommendation, SupplyRequest
CarePlan.intent CarePlan.instantiatesCanonical
  • Change value set from http://hl7.org/fhir/ValueSet/care-plan-intent to http://hl7.org/fhir/ValueSet/care-plan-intent|4.0.1 Deleted
CarePlan.encounter CarePlan.instantiatesUri
  • Added Element Deleted

Changes from R4 and R4B to R6

CarePlan.created CarePlan Added Element
CarePlan.author CarePlan.basedOn
    Max Cardinality changed from * to 1
  • Type Reference: Added Target Types PractitionerRole, Device ServiceRequest, RequestOrchestration, NutritionOrder
CarePlan.contributor CarePlan.status
  • Added Element Remove codes revoked , completed
  • Add code ended
CarePlan.activity.reference CarePlan.intent
  • Type Reference: Added Target Type ServiceRequest Type Reference: Removed Target Types ProcedureRequest, ReferralRequest Add code directive
CarePlan.activity.detail.kind CarePlan.custodian
  • Renamed from category to kind Type changed from CodeableConcept author to code Add Binding http://hl7.org/fhir/ValueSet/care-plan-activity-kind|4.0.1 (required) custodian
CarePlan.activity.detail.instantiatesCanonical CarePlan.addresses
  • Added Element Type changed from Reference(Condition) to CodeableReference
CarePlan.activity.detail.instantiatesUri CarePlan.activity.performedActivity
  • Added Element
CarePlan.activity.detail.reasonReference CarePlan.activity.plannedActivityReference
  • Renamed from reference to plannedActivityReference
  • Type Reference: Added Target Types Observation, DiagnosticReport, DocumentReference CarePlan.activity.detail.status Change value set from http://hl7.org/fhir/ValueSet/care-plan-activity-status to http://hl7.org/fhir/ValueSet/care-plan-activity-status|4.0.1 Type RequestOrchestration
    • CarePlan.activity.detail.statusReason
  • Type changed from string to CodeableConcept Reference: Removed Target Type RequestGroup
CarePlan.activity.detail.doNotPerform CarePlan.instantiatesCanonical
  • Renamed from prohibited to doNotPerform Default Value "false" removed Deleted
CarePlan.activity.detail.performer CarePlan.instantiatesUri
  • Type Reference: Added Target Types PractitionerRole, HealthcareService, Device Deleted
CarePlan.definition CarePlan.activity.outcomeCodeableConcept
  • deleted Deleted (-> CarePlan.activity.performedActivity)
CarePlan.context CarePlan.activity.outcomeReference
  • deleted Deleted (-> CarePlan.activity.performedActivity)
CarePlan.activity.detail.definition 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 R3 <--> R4 Conversion Maps (status = 11 tests that all execute ok. All tests pass round-trip testing and 10 r3 resources are invalid (0 errors). ) for R4B as XML or JSON .

 

See the Profiles & Extensions and the alternate Additional definitions: Master Definition XML + JSON , XML Schema / Schematron + 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 RequestStatus

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

CarePlan.category CarePlanCategory Example CarePlanActivityOutcome CarePlan.activity.detail.kind Resource types defined as part of FHIR that can be represented as in-line definitions of

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

CarePlan.addresses ProcedureCodes(SNOMEDCT) SNOMEDCTClinicalFindings Example SNOMEDCTClinicalFindings CarePlan.activity.detail.status Codes that reflect

This value set includes all the current state of a care plan activity within 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 SNOMEDCTMedicationCodes

9.5.3.2 Constraints id Level Location Description Expression cpl-3 Rule CarePlan.activity Provide a reference or detail, Example codes indicating the care plan activity that was performed. Note that these are in no way complete and might not both detail.empty() or reference.empty() even be appropriate for some uses.

9.5.3.3 9.5.4.2 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.

Detail type of activity CarePlan.activity.detail.code activity-date date Specified date occurs within period specified by CarePlan.activity.detail.scheduled[x] CarePlan.activity.detail.scheduled activity-reference instantiates-canonical reference Instantiates FHIR protocol or definition CarePlan.instantiatesCanonical ( Questionnaire , Measure , PlanDefinition , OperationDefinition , ActivityDefinition ) Instantiates external protocol or definition CarePlan.instantiatesUri intent 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 , Device , Patient , HealthcareService , PractitionerRole , RelatedPerson ) replaces
Name Type Description Expression In Common
activity-code token 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 , MedicationRequest , Task , NutritionOrder , RequestGroup RequestOrchestration , VisionPrescription , DeviceRequest , ServiceRequest , CommunicationRequest )
based-on reference Fulfills 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.reference
custodian CarePlan.addresses reference Who is the designated responsible party CarePlan.custodian
( Condition Practitioner , Organization , CareTeam , Device , Patient , PractitionerRole , RelatedPerson )
date date Time period plan covers CarePlan.period 17 22 Resources
encounter reference The Encounter during which this CarePlan was created as part of CarePlan.encounter
( Encounter ) 		26 Resources
goal reference Desired outcome of plan CarePlan.goal
( Goal )
identifier token External Ids for this plan CarePlan.identifier 30 58 Resources
instantiates-uri uri 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.where(resolve() is Patient)
( Patient ) 		33 60 Resources
performer reference replaces reference CarePlan replaced by this CarePlan CarePlan.replaces
( CarePlan )
status token draft | active | on-hold | revoked | completed | entered-in-error | unknown CarePlan.status
subject reference Who the care plan is for CarePlan.subject
( Group , Patient )