Content Examples
Formal Definitions Mappings
* Profiles
# 4.3 Resource CarePlan - Content
Describes the intention of how one or more practitioners intend to deliver care for a particular patient for a period of time, possibly limited to care for a specific condition or set of conditions.
## 4.3.1 Scope and Usage
Care Plans are used in many of 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.
This resource takes an intermediate approach. 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 mechanisms.
Comments are welcome about the appropriateness of the proposed level of
granularity, whether it’s too much detail for what most systems need, or not
sufficient for common essential use cases.
This resource is referenced by [Procedure]
4.3.2
Resource Content
Structure
Name | Card. | Type | Description & Constraints |
---|---|---|---|
CarePlan | Resource | Healthcare plan for patient | |
identifier | 0.. | Identifier | External Ids for this plan |
patient | 0..1 | Patient | Who care plan is for |
status | 1..1 | code | planned | active | completed CarePlanStatus (Required) |
period | 0..1 | Period | Time period plan covers |
modified | 0..1 | dateTime | When last updated |
concern | 0.. | Condition | Health issues this plan addresses |
participant | Element | Who’s involved in plan? | |
role | 0..1 | CodeableConcept | Type of involvement |
member | 1..1 | Practitioner | RelatedPerson | Patient | Organization | Who is involved |
goal | Element | Desired outcome of plan | |
description | 1..1 | string | What’s the desired outcome? |
status | 0..1 | code | in progress | achieved | sustaining | cancelled CarePlanGoalStatus (Required) |
notes | 0..1 | string | Comments about the goal |
concern | 0.. | Condition | Health issues this goal addresses |
activity | Element | Action to occur as part of plan | |
goal | 0.. | idref | Goals this activity relates to |
status | 0..1 | code | not started | scheduled | in progress | on hold | completed | cancelled CarePlanActivityStatus (Required) |
prohibited | 1..1 | boolean | Do NOT do |
actionResulting | 0.. | Any | Appointments, orders, etc. |
notes | 0..1 | string | Comments about the activity |
detail | 0..1 | Procedure | MedicationPrescription | DiagnosticOrder | Encounter | Supply | Activity details defined in specific resource |
simple | Element | Activity details summarised here Only provide a detail reference, or a simple detail summaryQuantity can only be specified if activity category is supplyDailyDose can only be specified if activity category is drug or food | |
category | 1..1 | code | diet | drug | encounter | observation | procedure | supply | other CarePlanActivityCategory (Required) |
code | 0..1 | CodeableConcept | Detail type of activity |
timing[x] | When activity is to occur | ||
timingSchedule | 0..1 | Schedule | |
timingPeriod | 0..1 | Period | |
timingString | 0..1 | string | |
location | 0..1 | Location | Where it should happen |
performer | 0.. | Practitioner | Organization | RelatedPerson | Patient | Who’s responsible? |
product | 0..1 | Medication | Substance | What’s administered/supplied |
dailyAmount | 0..1 | Quantity | How much consumed/day? |
quantity | 0..1 | Quantity | How much is administered/supplied/consumed |
details | 0..1 | string | Extra info on activity occurrence |
notes | 0..1 | string | Comments about the plan |
XML Template
<CarePlan xmlns="http://hl7.org/fhir">
<!– from Resource: extension, modifierExtension, language, text, and contained –>
<identifier><!– 0..* Identifier External Ids for this plan –></identifier>
<patient><!– 0..1 Resource(Patient) Who care plan is for –></patient>
<status value="[code]"/><!– 1..1 planned | active | completed –>
<period><!– 0..1 Period Time period plan covers –></period>
<modified value="[dateTime]"/><!– 0..1 When last updated –>
<concern><!– 0..* Resource(Condition) Health issues this plan addresses –></concern>
<participant> <!– 0..* Who’s involved in plan? –>
<role><!– 0..1 CodeableConcept Type of involvement –></role>
<member><!– 1..1 Resource(Practitioner|RelatedPerson|Patient|Organization) Who is involved –></member>
</participant>
<goal> <!– 0..* Desired outcome of plan –>
<description value="[string]"/><!– 1..1 What’s the desired outcome? –>
<status value="[code]"/><!– 0..1 in progress | achieved | sustaining | cancelled –>
<notes value="[string]"/><!– 0..1 Comments about the goal –>
<concern><!– 0..* Resource(Condition) Health issues this goal addresses –></concern>
</goal>
<activity> <!– 0..* Action to occur as part of plan –>
<goal value="[idref]"/><!– 0..* Goals this activity relates to –>
<status value="[code]"/><!– 0..1 not started | scheduled | in progress | on hold | completed | cancelled –>
<prohibited value="[boolean]"/><!– 1..1 Do NOT do –>
<actionResulting><!– 0..* Resource(Any) Appointments, orders, etc. –></actionResulting>
<notes value="[string]"/><!– 0..1 Comments about the activity –>
<detail><!– 0..1 Resource(Procedure|MedicationPrescription|DiagnosticOrder|
Encounter|Supply) Activity details defined in specific resource –></detail>
<simple> <!– 0..1 Activity details summarised here –>
<category value="[code]"/><!– 1..1 diet | drug | encounter | observation | procedure | supply | other –>
<code><!– 0..1 CodeableConcept Detail type of activity –></code>
<timing[x]><!– 0..1 Schedule|Period|string When activity is to occur –></timing[x]>
<location><!– 0..1 Resource(Location) Where it should happen –></location>
<performer><!– 0..* Resource(Practitioner|Organization|RelatedPerson|Patient)
Who’s responsible? –></performer>
<product><!– 0..1 Resource(Medication|Substance) What’s administered/supplied –></product>
<dailyAmount><!– 0..1 Quantity How much consumed/day? –></dailyAmount>
<quantity><!– 0..1 Quantity How much is administered/supplied/consumed –></quantity>
<details value="[string]"/><!– 0..1 Extra info on activity occurrence –>
</simple>
</activity>
<notes value="[string]"/><!– 0..1 Comments about the plan –>
</CarePlan>
Alternate definitions: Schema/Schematron,
Resource Profile (XML, JSON)
4.3.2.1
Terminology Bindings
Path | Definition | Type | Reference |
---|---|---|---|
CarePlan.status | Indicates whether the plan is currently being acted upon, represents future intentions or is now just historical record. | Fixed | http://hl7.org/fhir/care-plan-status |
CarePlan.participant.role | Indicates specific responsibility of an individual within the care plan. E.g. "Primary physician", "Team coordinator", "Caregiver", etc. | Unknown | No details provided yet |
CarePlan.goal.status | Indicates whether the goal has been met and is still being targeted | Fixed | http://hl7.org/fhir/care-plan-goal-status |
CarePlan.activity.status | Indicates where the activity is at in its overall life cycle | Fixed | http://hl7.org/fhir/care-plan-activity-status |
CarePlan.activity.simple.category | High-level categorization of the type of activity in a care plan. | Fixed | http://hl7.org/fhir/care-plan-activity-category |
CarePlan.activity.simple.code | Detailed description of the type of activity. E.g. What lab test, what procedure, what kind of encounter. | Unknown | No details provided yet |
4.3.2.2 Constraints
- Inv-1: On CarePlan.activity.simple: DailyDose can only be specified if activity category is drug or food (xpath on f:CarePlan/f:activity/f:simple: (f:category/@value=(‘drug’,’diet’)) = exists(f:dailyAmount))
- Inv-2: On CarePlan.activity.simple: Quantity can only be specified if activity category is supply (xpath on f:CarePlan/f:activity/f:simple: (f:category/@value=(‘supply’)) = exists(f:quantity))
- Inv-3: On CarePlan.activity.simple: Only provide a detail reference, or a simple detail summary (xpath on f:CarePlan/f:activity/f:simple: not(exists(f:detail)) or not(exists(f:simple)))
4.3.3 Open Issues
- This resource combines the concepts of "Care Plan" and "Care Team" into a single resource. Is this appropriate?
- DSTU: At present, the patient element is optional to allow experimentation with care plan templates, though the resource was not designed for this use. Feedback on this subject is requested during the trial use period.
4.3.4 Search Parameters
Search parameters for this resource. The standard parameters also apply. See Searching for more information about searching in REST, messaging, and services.
Name | Type | Description | Paths |
_id | token | The logical resource id associated with the resource (must be supported by all servers) | |
_language | token | The stated language of the resource | |
activitycode | token | Detail type of activity | CarePlan.activity.simple.code |
activitydate | date | Specified date occurs within period specified by CarePlan.activity.timingSchedule | CarePlan.activity.simple.timing[x] |
activitydetail | reference | Activity details defined in specific resource | CarePlan.activity.detail (Supply, MedicationPrescription, Encounter, Procedure, DiagnosticOrder) |
condition | reference | Health issues this plan addresses | CarePlan.concern (Condition) |
date | date | Time period plan covers | CarePlan.period |
participant | reference | Who is involved | CarePlan.participant.member (Organization, Patient, Practitioner, RelatedPerson) |
patient | reference | Who care plan is for | CarePlan.patient (Patient) |
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