Interweave Implementation Guide
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Interweave Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the STU3 profiles here.

Resource Profile: InterweaveCarePlan - Detailed Descriptions

Draft as of 2024-07-15

Definitions for the Interweave-CarePlan resource profile.

Guidance on how to interpret the contents of this table can be found here

0. CarePlan
2. CarePlan.id
Must Supporttrue
4. CarePlan.meta
6. CarePlan.meta.id
Control0..0
8. CarePlan.meta.versionId
Must Supporttrue
10. CarePlan.meta.lastUpdated
ShortMANDATORY except in Contained Resources. When the resource version last changed.
Must Supporttrue
12. CarePlan.meta.profile
ShortProfiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
Must Supporttrue
14. CarePlan.meta.security
ShortDISCOURAGED - may not be honoured by Data Consumers
16. CarePlan.meta.tag
SlicingThis element introduces a set of slices on CarePlan.meta.tag. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ system
  • 18. CarePlan.meta.tag:Source
    Slice NameSource
    ShortMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
    Control0..1
    Must Supporttrue
    20. CarePlan.meta.tag:Source.id
    Control0..0
    22. CarePlan.meta.tag:Source.system
    Control1..?
    Fixed Valuehttps://fhir.interweavedigital.nhs.uk/Source
    24. CarePlan.meta.tag:Source.version
    NoteThis is a business version Id, not a resource version Id (see discussion)
    Control0..0
    26. CarePlan.meta.tag:Source.code
    ShortThe Data Provider Id of the system supplying the data
    Control1..?
    Must Supporttrue
    28. CarePlan.meta.tag:Source.display
    ShortName of the system supplying the data
    Control1..?
    Must Supporttrue
    30. CarePlan.meta.tag:Provenance
    Slice NameProvenance
    ShortMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
    Control0..1
    Must Supporttrue
    32. CarePlan.meta.tag:Provenance.id
    Control0..0
    34. CarePlan.meta.tag:Provenance.system
    Control1..?
    Fixed Valuehttps://fhir.interweavedigital.nhs.uk/Provenance
    36. CarePlan.meta.tag:Provenance.version
    NoteThis is a business version Id, not a resource version Id (see discussion)
    Control0..0
    38. CarePlan.meta.tag:Provenance.code
    ShortThe ODS Code of the organisation responsible for the data
    Control1..?
    Must Supporttrue
    40. CarePlan.meta.tag:Provenance.display
    ShortName of the organisation supplying the data
    Control1..?
    Must Supporttrue
    42. CarePlan.implicitRules
    ShortDISCOURAGED - may not be honoured by Data Consumers
    44. CarePlan.language
    ShortEnglish is assumed (not currently a multi-lingual implementation)
    46. CarePlan.text
    ShortDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
    48. CarePlan.identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    SlicingThis element introduces a set of slices on CarePlan.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ system
    • 50. CarePlan.identifier.assigner
      TypeReference(InterweaveOrganization)
      52. CarePlan.identifier:localIdentifier
      Slice NamelocalIdentifier
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1
      Must Supporttrue
      54. CarePlan.identifier:localIdentifier.system
      Control1..?
      Must Supporttrue
      Fixed Valuehttps://fhir.interweavedigital.nhs.uk/Id/local-carePlan-identifier
      56. CarePlan.identifier:localIdentifier.value
      ShortThe Local carePlan Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
      Control1..?
      Must Supporttrue
      58. CarePlan.identifier:localIdentifier.period
      Control0..0
      60. CarePlan.instantiatesCanonical
      Control0..0
      62. CarePlan.instantiatesUri
      Control0..0
      64. CarePlan.category
      BindingThe codes SHOULD be taken from CarePlanCategory
      (preferred to http://hl7.org/fhir/ValueSet/care-plan-category)
      Must Supporttrue
      66. CarePlan.subject
      ShortThe patient whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.
      TypeReference(InterweavePatient)
      Must Supporttrue
      68. CarePlan.subject.reference
      ShortReference to a resource (could be Contained)
      Control1..?
      70. CarePlan.subject.identifier
      ShortIf relevant could include an id
      NoteThis is a business identifier, not a resource identifier (see discussion)
      72. CarePlan.subject.display
      ShortDescription of the referenced resource
      Control1..?
      74. CarePlan.encounter
      TypeReference(InterweaveEncounter)
      Must Supporttrue
      76. CarePlan.encounter.reference
      ShortReference to a resource (could be Contained)
      Control1..?
      78. CarePlan.encounter.identifier
      ShortIf relevant could include an id
      NoteThis is a business identifier, not a resource identifier (see discussion)
      80. CarePlan.encounter.display
      ShortIf relevant, description of the referenced resource
      82. CarePlan.period
      84. CarePlan.period.start
      Must Supporttrue
      86. CarePlan.created
      Must Supporttrue
      88. CarePlan.contributor
      Control0..0
      90. CarePlan.supportingInfo
      Control0..0
      92. CarePlan.activity
      94. CarePlan.activity.detail
      Must Supporttrue
      96. CarePlan.activity.detail.instantiatesCanonical
      Control0..0
      98. CarePlan.activity.detail.instantiatesUri
      Control0..0
      100. CarePlan.activity.detail.reasonCode
      BindingThe codes SHOULD be taken from SNOMEDCTClinicalFindings
      (preferred to http://hl7.org/fhir/ValueSet/clinical-findings)

      Guidance on how to interpret the contents of this table can be found here

      0. CarePlan
      Definition

      Describes the intention of how one or more practitioners intend to deliver care for a particular patient, group or community for a period of time, possibly limited to care for a specific condition or set of conditions.

      ShortHealthcare plan for patient or group
      Control0..*
      Is Modifierfalse
      Summaryfalse
      Alternate NamesCare Team
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. CarePlan.id
      Definition

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

      ShortLogical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control0..1
      Typeidstring
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      4. CarePlan.meta
      Definition

      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.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. CarePlan.meta.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..01
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      8. CarePlan.meta.versionId
      Definition

      The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

      ShortVersion specific identifier
      Comments

      The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

      Control0..1
      Typeid
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. CarePlan.meta.lastUpdated
      Definition

      When the resource last changed - e.g. when the version changed.

      ShortMANDATORY except in Contained Resources. When the resource version last changed.When the resource version last changed
      Comments

      This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

      Control0..1
      Typeinstant
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. CarePlan.meta.profile
      Definition

      A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

      ShortProfiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
      Comments

      It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

      Control0..*
      Typecanonical(StructureDefinition)
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. CarePlan.meta.security
      Definition

      Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

      ShortDISCOURAGED - may not be honoured by Data ConsumersSecurity Labels applied to this resource
      Comments

      The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

      Control0..*
      BindingUnless not suitable, these codes SHALL be taken from All Security Labelshttp://hl7.org/fhir/ValueSet/security-labels
      (extensible to http://hl7.org/fhir/ValueSet/security-labels)

      Security Labels from the Healthcare Privacy and Security Classification System.

      TypeCoding
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. CarePlan.meta.tag
      Definition

      Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

      ShortTags applied to this resource
      Comments

      The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

      Control0..*
      BindingFor example codes, see CommonTagshttp://hl7.org/fhir/ValueSet/common-tags
      (example to http://hl7.org/fhir/ValueSet/common-tags)

      Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

      TypeCoding
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on CarePlan.meta.tag. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ system
      • 18. CarePlan.meta.tag:Source
        Slice NameSource
        Definition

        Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

        ShortMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the dataTags applied to this resource
        Comments

        The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

        Control0..1*
        BindingFor example codes, see CommonTagshttp://hl7.org/fhir/ValueSet/common-tags
        (example to http://hl7.org/fhir/ValueSet/common-tags)

        Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

        TypeCoding
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        20. CarePlan.meta.tag:Source.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..01
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        22. CarePlan.meta.tag:Source.system
        Definition

        The identification of the code system that defines the meaning of the symbol in the code.

        ShortIdentity of the terminology system
        Comments

        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

        Control10..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to be unambiguous about the source of the definition of the symbol.

        Fixed Valuehttps://fhir.interweavedigital.nhs.uk/Source
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. CarePlan.meta.tag:Source.version
        Definition

        The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

        ShortVersion of the system - if relevant
        Comments

        Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

        NoteThis is a business version Id, not a resource version Id (see discussion)
        Control0..01
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. CarePlan.meta.tag:Source.code
        Definition

        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

        ShortThe Data Provider Id of the system supplying the dataSymbol in syntax defined by the system
        Control10..1
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to refer to a particular code in the system.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. CarePlan.meta.tag:Source.display
        Definition

        A representation of the meaning of the code in the system, following the rules of the system.

        ShortName of the system supplying the dataRepresentation defined by the system
        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. CarePlan.meta.tag:Provenance
        Slice NameProvenance
        Definition

        Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

        ShortMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the dataTags applied to this resource
        Comments

        The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

        Control0..1*
        BindingFor example codes, see CommonTagshttp://hl7.org/fhir/ValueSet/common-tags
        (example to http://hl7.org/fhir/ValueSet/common-tags)

        Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

        TypeCoding
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. CarePlan.meta.tag:Provenance.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..01
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        34. CarePlan.meta.tag:Provenance.system
        Definition

        The identification of the code system that defines the meaning of the symbol in the code.

        ShortIdentity of the terminology system
        Comments

        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

        Control10..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to be unambiguous about the source of the definition of the symbol.

        Fixed Valuehttps://fhir.interweavedigital.nhs.uk/Provenance
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. CarePlan.meta.tag:Provenance.version
        Definition

        The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

        ShortVersion of the system - if relevant
        Comments

        Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

        NoteThis is a business version Id, not a resource version Id (see discussion)
        Control0..01
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. CarePlan.meta.tag:Provenance.code
        Definition

        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

        ShortThe ODS Code of the organisation responsible for the dataSymbol in syntax defined by the system
        Control10..1
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to refer to a particular code in the system.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. CarePlan.meta.tag:Provenance.display
        Definition

        A representation of the meaning of the code in the system, following the rules of the system.

        ShortName of the organisation supplying the dataRepresentation defined by the system
        Control10..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. CarePlan.implicitRules
        Definition

        A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

        ShortDISCOURAGED - may not be honoured by Data ConsumersA set of rules under which this content was created
        Comments

        Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

        Control0..1
        Typeuri
        Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. CarePlan.language
        Definition

        The base language in which the resource is written.

        ShortEnglish is assumed (not currently a multi-lingual implementation)Language of the resource content
        Comments

        Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

        Control0..1
        BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages
        (preferred to http://hl7.org/fhir/ValueSet/languages)

        A human language.

        Additional BindingsPurpose
        AllLanguagesMax Binding
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. CarePlan.text
        Definition

        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.

        ShortDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its usersText summary of the resource, for human interpretation
        Comments

        Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

        Control0..1
        TypeNarrative
        Is Modifierfalse
        Summaryfalse
        Alternate Namesnarrative, html, xhtml, display
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. CarePlan.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's 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.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        50. CarePlan.identifier
        Definition

        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.

        ShortExternal Ids for this plan
        Comments

        This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

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

        Allows identification of the care plan as it is known by various participating systems and in a way that remains consistent across servers.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on CarePlan.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ system
        • 52. CarePlan.identifier.use
          Definition

          The purpose of this identifier.

          Shortusual | official | temp | secondary | old (If known)
          Comments

          Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

          Control0..1
          BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
          (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

          Identifies the purpose for this identifier, if known .

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. CarePlan.identifier.assigner
          Definition

          Organization that issued/manages the identifier.

          ShortOrganization that issued id (may be just text)
          Comments

          The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

          Control0..1
          TypeReference(InterweaveOrganization, Organization)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. CarePlan.identifier:localIdentifier
          Slice NamelocalIdentifier
          Definition

          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.

          ShortExternal Ids for this plan
          Comments

          This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..1*
          TypeIdentifier
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          Allows identification of the care plan as it is known by various participating systems and in a way that remains consistent across servers.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          58. CarePlan.identifier:localIdentifier.use
          Definition

          The purpose of this identifier.

          Shortusual | official | temp | secondary | old (If known)
          Comments

          Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

          Control0..1
          BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
          (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

          Identifies the purpose for this identifier, if known .

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. CarePlan.identifier:localIdentifier.system
          Definition

          Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

          ShortThe namespace for the identifier value
          Comments

          Identifier.system is always case sensitive.

          Control10..1
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

          Fixed Valuehttps://fhir.interweavedigital.nhs.uk/Id/local-carePlan-identifier
          Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          62. CarePlan.identifier:localIdentifier.value
          Definition

          The portion of the identifier typically relevant to the user and which is unique within the context of the system.

          ShortThe Local carePlan Identifier. Please prefix with ODS code plus period (XXX.) to ensure uniqueThe value that is unique
          Comments

          If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

          Control10..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Example<br/><b>General</b>:123456
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. CarePlan.identifier:localIdentifier.period
          Definition

          Time period during which identifier is/was valid for use.

          ShortTime period when id is/was valid for use
          Control0..01
          TypePeriod
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          66. CarePlan.instantiatesCanonical
          Definition

          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.

          ShortInstantiates FHIR protocol or definition
          Control0..0*
          Typecanonical(PlanDefinition, Questionnaire, Measure, ActivityDefinition, OperationDefinition)
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          68. CarePlan.instantiatesUri
          Definition

          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.

          ShortInstantiates external protocol or definition
          Comments

          This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

          Control0..0*
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. CarePlan.status
          Definition

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

          Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
          Comments

          The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the care plan.

          This element is labeled as a modifier because the status contains the code entered-in-error that marks the plan as not currently valid.

          Control1..1
          BindingThe codes SHALL be taken from RequestStatushttp://hl7.org/fhir/ValueSet/request-status|4.0.1
          (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

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

          Typecode
          Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          72. CarePlan.intent
          Definition

          Indicates the level of authority/intentionality associated with the care plan and where the care plan fits into the workflow chain.

          Shortproposal | plan | order | option
          Comments

          This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

          Control1..1
          BindingThe codes SHALL be taken from CarePlanIntenthttp://hl7.org/fhir/ValueSet/care-plan-intent|4.0.1
          (required to http://hl7.org/fhir/ValueSet/care-plan-intent|4.0.1)

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

          Typecode
          Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request"
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          74. CarePlan.category
          Definition

          Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc.

          ShortType of plan
          Comments

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

          Control0..*
          BindingThe codes SHOULD be taken from For example codes, see CarePlanCategoryhttp://hl7.org/fhir/ValueSet/care-plan-category
          (preferred to http://hl7.org/fhir/ValueSet/care-plan-category)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          76. CarePlan.subject
          Definition

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

          ShortThe patient whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.Who the care plan is for
          Control1..1
          TypeReference(InterweavePatient, Patient, Group)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Alternate Namespatient
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          78. CarePlan.subject.reference
          Definition

          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

          ShortReference to a resource (could be Contained)Literal reference, Relative, internal or absolute URL
          Comments

          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

          Control10..1
          This element is affected by the following invariants: ref-1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          80. CarePlan.subject.identifier
          Definition

          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

          ShortIf relevant could include an idLogical reference, when literal reference is not known
          Comments

          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..1
          TypeIdentifier
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          82. CarePlan.subject.display
          Definition

          Plain text narrative that identifies the resource in addition to the resource reference.

          ShortDescription of the referenced resourceText alternative for the resource
          Comments

          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

          Control10..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          84. CarePlan.encounter
          Definition

          The Encounter during which this CarePlan was created or to which the creation of this record is tightly associated.

          ShortEncounter created as part of
          Comments

          This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. CarePlan activities conducted as a result of the care plan may well occur as part of other encounters.

          Control0..1
          TypeReference(InterweaveEncounter, Encounter)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          86. CarePlan.encounter.reference
          Definition

          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

          ShortReference to a resource (could be Contained)Literal reference, Relative, internal or absolute URL
          Comments

          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

          Control10..1
          This element is affected by the following invariants: ref-1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          88. CarePlan.encounter.identifier
          Definition

          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

          ShortIf relevant could include an idLogical reference, when literal reference is not known
          Comments

          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..1
          TypeIdentifier
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          90. CarePlan.encounter.display
          Definition

          Plain text narrative that identifies the resource in addition to the resource reference.

          ShortIf relevant, description of the referenced resourceText alternative for the resource
          Comments

          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          92. CarePlan.period
          Definition

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

          ShortTime period plan covers
          Comments

          Any activities scheduled as part of the plan should be constrained to the specified period regardless of whether the activities are planned within a single encounter/episode or across multiple encounters/episodes (e.g. the longitudinal management of a chronic condition).

          Control0..1
          TypePeriod
          Is Modifierfalse
          Summarytrue
          Requirements

          Allows tracking what plan(s) are in effect at a particular time.

          Alternate Namestiming
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          94. CarePlan.period.start
          Definition

          The start of the period. The boundary is inclusive.

          ShortStarting time with inclusive boundary
          Comments

          If the low element is missing, the meaning is that the low boundary is not known.

          Control0..1
          This element is affected by the following invariants: per-1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          96. CarePlan.created
          Definition

          Represents when this particular CarePlan record was created in the system, which is often a system-generated date.

          ShortDate record was first recorded
          Control0..1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Alternate NamesauthoredOn
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          98. CarePlan.contributor
          Definition

          Identifies the individual(s) or organization who provided the contents of the care plan.

          ShortWho provided the content of the care plan
          Comments

          Collaborative care plans may have multiple contributors.

          Control0..0*
          TypeReference(Patient, Practitioner, PractitionerRole, Device, RelatedPerson, Organization, CareTeam)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          100. CarePlan.supportingInfo
          Definition

          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.

          ShortInformation considered as part of plan
          Comments

          Use "concern" to identify specific conditions addressed by the care plan.

          Control0..0*
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies barriers and other considerations associated with the care plan.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          102. CarePlan.activity
          Definition

          Identifies a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring, education, etc.

          ShortAction to occur as part of plan
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Requirements

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

          Invariantscpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
          104. CarePlan.activity.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's 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.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          106. CarePlan.activity.detail
          Definition

          A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

          ShortIn-line definition of activity
          Control0..1
          This element is affected by the following invariants: cpl-3
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          Details in a simple form for generic care plan systems.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          108. CarePlan.activity.detail.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's 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.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          110. CarePlan.activity.detail.instantiatesCanonical
          Definition

          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.

          ShortInstantiates FHIR protocol or definition
          Control0..0*
          Typecanonical(PlanDefinition, ActivityDefinition, Questionnaire, Measure, OperationDefinition)
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          112. CarePlan.activity.detail.instantiatesUri
          Definition

          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.

          ShortInstantiates external protocol or definition
          Comments

          This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

          Control0..0*
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          114. CarePlan.activity.detail.reasonCode
          Definition

          Provides the rationale that drove the inclusion of this particular activity as part of the plan or the reason why the activity was prohibited.

          ShortWhy activity should be done or why activity was prohibited
          Comments

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

          Control0..*
          BindingThe codes SHOULD be taken from For example codes, see SNOMEDCTClinicalFindingshttp://hl7.org/fhir/ValueSet/clinical-findings
          (preferred to http://hl7.org/fhir/ValueSet/clinical-findings)
          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          116. CarePlan.activity.detail.status
          Definition

          Identifies what progress is being made for the specific activity.

          Shortnot-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error
          Comments

          Some aspects of status can be inferred based on the resources linked in actionTaken. Note that "status" is only as current as the plan was most recently updated.
          The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the activity.

          Control1..1
          BindingThe codes SHALL be taken from CarePlanActivityStatushttp://hl7.org/fhir/ValueSet/care-plan-activity-status|4.0.1
          (required to http://hl7.org/fhir/ValueSet/care-plan-activity-status|4.0.1)

          Codes that reflect the current state of a care plan activity within its overall life cycle.

          Typecode
          Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the activity should not be treated as valid
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          Indicates progress against the plan, whether the activity is still relevant for the plan.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          118. CarePlan.activity.detail.doNotPerform
          Definition

          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.

          ShortIf true, activity is prohibiting action
          Comments

          This element is labeled as a modifier because it marks an activity as an activity that is not to be performed.

          Control0..1
          Typeboolean
          Is Modifiertrue because If true this element negates the specified action. For example, instead of a request for a procedure, it is a request for the procedure to not occur.
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

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

          Meaning if MissingIf missing indicates that the described activity is one that should be engaged in when following the plan.
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

          Guidance on how to interpret the contents of this table can be found here

          0. CarePlan
          Definition

          Describes the intention of how one or more practitioners intend to deliver care for a particular patient, group or community for a period of time, possibly limited to care for a specific condition or set of conditions.

          ShortHealthcare plan for patient or group
          Control0..*
          Is Modifierfalse
          Summaryfalse
          Alternate NamesCare Team
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
          dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          2. CarePlan.id
          Definition

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

          ShortLogical id of this artifact
          Comments

          The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

          Control0..1
          Typeid
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          4. CarePlan.meta
          Definition

          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.

          ShortMetadata about the resource
          Control0..1
          TypeMeta
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. CarePlan.meta.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..0
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          8. CarePlan.meta.extension
          Definition

          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.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on CarePlan.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 10. CarePlan.meta.versionId
            Definition

            The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

            ShortVersion specific identifier
            Comments

            The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

            Control0..1
            Typeid
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            12. CarePlan.meta.lastUpdated
            Definition

            When the resource last changed - e.g. when the version changed.

            ShortMANDATORY except in Contained Resources. When the resource version last changed.
            Comments

            This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

            Control0..1
            Typeinstant
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            14. CarePlan.meta.source
            Definition

            A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

            ShortIdentifies where the resource comes from
            Comments

            In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

            This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

            Control0..1
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            16. CarePlan.meta.profile
            Definition

            A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

            ShortProfiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
            Comments

            It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

            Control0..*
            Typecanonical(StructureDefinition)
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            18. CarePlan.meta.security
            Definition

            Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

            ShortDISCOURAGED - may not be honoured by Data Consumers
            Comments

            The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

            Control0..*
            BindingUnless not suitable, these codes SHALL be taken from All Security Labels
            (extensible to http://hl7.org/fhir/ValueSet/security-labels)

            Security Labels from the Healthcare Privacy and Security Classification System.

            TypeCoding
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            20. CarePlan.meta.tag
            Definition

            Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

            ShortTags applied to this resource
            Comments

            The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

            Control0..*
            BindingFor example codes, see CommonTags
            (example to http://hl7.org/fhir/ValueSet/common-tags)

            Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

            TypeCoding
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on CarePlan.meta.tag. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ system
            • 22. CarePlan.meta.tag:Source
              Slice NameSource
              Definition

              Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

              ShortMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
              Comments

              The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

              Control0..1
              BindingFor example codes, see CommonTags
              (example to http://hl7.org/fhir/ValueSet/common-tags)

              Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

              TypeCoding
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              24. CarePlan.meta.tag:Source.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..0
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              26. CarePlan.meta.tag:Source.extension
              Definition

              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.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on CarePlan.meta.tag.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 28. CarePlan.meta.tag:Source.system
                Definition

                The identification of the code system that defines the meaning of the symbol in the code.

                ShortIdentity of the terminology system
                Comments

                The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                Control1..1
                Typeuri
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Need to be unambiguous about the source of the definition of the symbol.

                Fixed Valuehttps://fhir.interweavedigital.nhs.uk/Source
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                30. CarePlan.meta.tag:Source.version
                Definition

                The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                ShortVersion of the system - if relevant
                Comments

                Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                NoteThis is a business version Id, not a resource version Id (see discussion)
                Control0..0
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                32. CarePlan.meta.tag:Source.code
                Definition

                A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                ShortThe Data Provider Id of the system supplying the data
                Control1..1
                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Requirements

                Need to refer to a particular code in the system.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                34. CarePlan.meta.tag:Source.display
                Definition

                A representation of the meaning of the code in the system, following the rules of the system.

                ShortName of the system supplying the data
                Control1..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Requirements

                Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                36. CarePlan.meta.tag:Source.userSelected
                Definition

                Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                ShortIf this coding was chosen directly by the user
                Comments

                Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                Control0..1
                Typeboolean
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                38. CarePlan.meta.tag:Provenance
                Slice NameProvenance
                Definition

                Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

                ShortMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
                Comments

                The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

                Control0..1
                BindingFor example codes, see CommonTags
                (example to http://hl7.org/fhir/ValueSet/common-tags)

                Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

                TypeCoding
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                40. CarePlan.meta.tag:Provenance.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..0
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                42. CarePlan.meta.tag:Provenance.extension
                Definition

                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.

                ShortAdditional content defined by implementations
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on CarePlan.meta.tag.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 44. CarePlan.meta.tag:Provenance.system
                  Definition

                  The identification of the code system that defines the meaning of the symbol in the code.

                  ShortIdentity of the terminology system
                  Comments

                  The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                  Control1..1
                  Typeuri
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  Need to be unambiguous about the source of the definition of the symbol.

                  Fixed Valuehttps://fhir.interweavedigital.nhs.uk/Provenance
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  46. CarePlan.meta.tag:Provenance.version
                  Definition

                  The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                  ShortVersion of the system - if relevant
                  Comments

                  Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                  NoteThis is a business version Id, not a resource version Id (see discussion)
                  Control0..0
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  48. CarePlan.meta.tag:Provenance.code
                  Definition

                  A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                  ShortThe ODS Code of the organisation responsible for the data
                  Control1..1
                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Need to refer to a particular code in the system.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  50. CarePlan.meta.tag:Provenance.display
                  Definition

                  A representation of the meaning of the code in the system, following the rules of the system.

                  ShortName of the organisation supplying the data
                  Control1..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  52. CarePlan.meta.tag:Provenance.userSelected
                  Definition

                  Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                  ShortIf this coding was chosen directly by the user
                  Comments

                  Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                  Control0..1
                  Typeboolean
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  54. CarePlan.implicitRules
                  Definition

                  A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                  ShortDISCOURAGED - may not be honoured by Data Consumers
                  Comments

                  Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                  Control0..1
                  Typeuri
                  Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  56. CarePlan.language
                  Definition

                  The base language in which the resource is written.

                  ShortEnglish is assumed (not currently a multi-lingual implementation)
                  Comments

                  Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                  Control0..1
                  BindingThe codes SHOULD be taken from CommonLanguages
                  (preferred to http://hl7.org/fhir/ValueSet/languages)

                  A human language.

                  Additional BindingsPurpose
                  AllLanguagesMax Binding
                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  58. CarePlan.text
                  Definition

                  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.

                  ShortDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
                  Comments

                  Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                  Control0..1
                  TypeNarrative
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesnarrative, html, xhtml, display
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  60. CarePlan.contained
                  Definition

                  These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                  ShortContained, inline Resources
                  Comments

                  This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                  Control0..*
                  TypeResource
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesinline resources, anonymous resources, contained resources
                  62. CarePlan.extension
                  Definition

                  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.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  64. CarePlan.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's 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.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                  Summaryfalse
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  66. CarePlan.identifier
                  Definition

                  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.

                  ShortExternal Ids for this plan
                  Comments

                  This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

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

                  Allows identification of the care plan as it is known by various participating systems and in a way that remains consistent across servers.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on CarePlan.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ system
                  • 68. CarePlan.identifier.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    70. CarePlan.identifier.extension
                    Definition

                    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.

                    ShortAdditional content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on CarePlan.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 72. CarePlan.identifier.use
                      Definition

                      The purpose of this identifier.

                      Shortusual | official | temp | secondary | old (If known)
                      Comments

                      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                      Control0..1
                      BindingThe codes SHALL be taken from IdentifierUse
                      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                      Identifies the purpose for this identifier, if known .

                      Typecode
                      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      74. CarePlan.identifier.type
                      Definition

                      A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                      ShortDescription of identifier
                      Comments

                      This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                      Control0..1
                      BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                      (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                      A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      Allows users to make use of identifiers when the identifier system is not known.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      76. CarePlan.identifier.system
                      Definition

                      Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                      ShortThe namespace for the identifier value
                      Comments

                      Identifier.system is always case sensitive.

                      Control0..1
                      Typeuri
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                      Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      78. CarePlan.identifier.value
                      Definition

                      The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                      ShortThe value that is unique
                      Comments

                      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Example<br/><b>General</b>:123456
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      80. CarePlan.identifier.period
                      Definition

                      Time period during which identifier is/was valid for use.

                      ShortTime period when id is/was valid for use
                      Control0..1
                      TypePeriod
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      82. CarePlan.identifier.assigner
                      Definition

                      Organization that issued/manages the identifier.

                      ShortOrganization that issued id (may be just text)
                      Comments

                      The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                      Control0..1
                      TypeReference(InterweaveOrganization)
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      84. CarePlan.identifier:localIdentifier
                      Slice NamelocalIdentifier
                      Definition

                      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.

                      ShortExternal Ids for this plan
                      Comments

                      This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control0..1
                      TypeIdentifier
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      Allows identification of the care plan as it is known by various participating systems and in a way that remains consistent across servers.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      86. CarePlan.identifier:localIdentifier.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      88. CarePlan.identifier:localIdentifier.extension
                      Definition

                      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.

                      ShortAdditional content defined by implementations
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on CarePlan.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 90. CarePlan.identifier:localIdentifier.use
                        Definition

                        The purpose of this identifier.

                        Shortusual | official | temp | secondary | old (If known)
                        Comments

                        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                        Control0..1
                        BindingThe codes SHALL be taken from IdentifierUse
                        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                        Identifies the purpose for this identifier, if known .

                        Typecode
                        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        92. CarePlan.identifier:localIdentifier.type
                        Definition

                        A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                        ShortDescription of identifier
                        Comments

                        This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                        Control0..1
                        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                        (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                        A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summarytrue
                        Requirements

                        Allows users to make use of identifiers when the identifier system is not known.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        94. CarePlan.identifier:localIdentifier.system
                        Definition

                        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                        ShortThe namespace for the identifier value
                        Comments

                        Identifier.system is always case sensitive.

                        Control1..1
                        Typeuri
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                        Fixed Valuehttps://fhir.interweavedigital.nhs.uk/Id/local-carePlan-identifier
                        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        96. CarePlan.identifier:localIdentifier.value
                        Definition

                        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                        ShortThe Local carePlan Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
                        Comments

                        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                        Control1..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Example<br/><b>General</b>:123456
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        98. CarePlan.identifier:localIdentifier.period
                        Definition

                        Time period during which identifier is/was valid for use.

                        ShortTime period when id is/was valid for use
                        Control0..0
                        TypePeriod
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        100. CarePlan.identifier:localIdentifier.assigner
                        Definition

                        Organization that issued/manages the identifier.

                        ShortOrganization that issued id (may be just text)
                        Comments

                        The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                        Control0..1
                        TypeReference(Organization)
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        102. CarePlan.instantiatesCanonical
                        Definition

                        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.

                        ShortInstantiates FHIR protocol or definition
                        Control0..0
                        Typecanonical(PlanDefinition, Questionnaire, Measure, ActivityDefinition, OperationDefinition)
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        104. CarePlan.instantiatesUri
                        Definition

                        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.

                        ShortInstantiates external protocol or definition
                        Comments

                        This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

                        Control0..0
                        Typeuri
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        106. CarePlan.basedOn
                        Definition

                        A care plan that is fulfilled in whole or in part by this care plan.

                        ShortFulfills CarePlan
                        Control0..*
                        TypeReference(CarePlan)
                        Is Modifierfalse
                        Summarytrue
                        Requirements

                        Allows tracing of the care plan and tracking whether proposals/recommendations were acted upon.

                        Alternate Namesfulfills
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        108. CarePlan.replaces
                        Definition

                        Completed or terminated care plan whose function is taken by this new care plan.

                        ShortCarePlan replaced by this CarePlan
                        Comments

                        The replacement could be because the initial care plan was immediately rejected (due to an issue) or because the previous care plan was completed, but the need for the action described by the care plan remains ongoing.

                        Control0..*
                        TypeReference(CarePlan)
                        Is Modifierfalse
                        Summarytrue
                        Requirements

                        Allows tracing the continuation of a therapy or administrative process instantiated through multiple care plans.

                        Alternate Namessupersedes
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        110. CarePlan.partOf
                        Definition

                        A larger care plan of which this particular care plan is a component or step.

                        ShortPart of referenced CarePlan
                        Comments

                        Each care plan is an independent request, such that having a care plan be part of another care plan can cause issues with cascading statuses. As such, this element is still being discussed.

                        Control0..*
                        TypeReference(CarePlan)
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        112. CarePlan.status
                        Definition

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

                        Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
                        Comments

                        The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the care plan.

                        This element is labeled as a modifier because the status contains the code entered-in-error that marks the plan as not currently valid.

                        Control1..1
                        BindingThe codes SHALL be taken from RequestStatus
                        (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

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

                        Typecode
                        Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

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

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        114. CarePlan.intent
                        Definition

                        Indicates the level of authority/intentionality associated with the care plan and where the care plan fits into the workflow chain.

                        Shortproposal | plan | order | option
                        Comments

                        This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

                        Control1..1
                        BindingThe codes SHALL be taken from CarePlanIntent
                        (required to http://hl7.org/fhir/ValueSet/care-plan-intent|4.0.1)

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

                        Typecode
                        Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request"
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        116. CarePlan.category
                        Definition

                        Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc.

                        ShortType of plan
                        Comments

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

                        Control0..*
                        BindingThe codes SHOULD be taken from CarePlanCategory
                        (preferred to http://hl7.org/fhir/ValueSet/care-plan-category)
                        TypeCodeableConcept
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Requirements

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

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        118. CarePlan.title
                        Definition

                        Human-friendly name for the care plan.

                        ShortHuman-friendly name for the care plan
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        120. CarePlan.description
                        Definition

                        A description of the scope and nature of the plan.

                        ShortSummary of nature of plan
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Provides more detail than conveyed by category.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        122. CarePlan.subject
                        Definition

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

                        ShortThe patient whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.
                        Control1..1
                        TypeReference(InterweavePatient)
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Alternate Namespatient
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        124. CarePlan.subject.id
                        Definition

                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        ShortUnique id for inter-element referencing
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        126. CarePlan.subject.extension
                        Definition

                        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.

                        ShortAdditional content defined by implementations
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingThis element introduces a set of slices on CarePlan.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 128. CarePlan.subject.reference
                          Definition

                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                          ShortReference to a resource (could be Contained)
                          Comments

                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                          Control1..1
                          This element is affected by the following invariants: ref-1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          130. CarePlan.subject.type
                          Definition

                          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                          ShortType the reference refers to (e.g. "Patient")
                          Comments

                          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                          Control0..1
                          BindingUnless not suitable, these codes SHALL be taken from ResourceType
                          (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                          Aa resource (or, for logical models, the URI of the logical model).

                          Typeuri
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          132. CarePlan.subject.identifier
                          Definition

                          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                          ShortIf relevant could include an id
                          Comments

                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..1
                          TypeIdentifier
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          134. CarePlan.subject.display
                          Definition

                          Plain text narrative that identifies the resource in addition to the resource reference.

                          ShortDescription of the referenced resource
                          Comments

                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                          Control1..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          136. CarePlan.encounter
                          Definition

                          The Encounter during which this CarePlan was created or to which the creation of this record is tightly associated.

                          ShortEncounter created as part of
                          Comments

                          This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. CarePlan activities conducted as a result of the care plan may well occur as part of other encounters.

                          Control0..1
                          TypeReference(InterweaveEncounter)
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          138. CarePlan.encounter.id
                          Definition

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          140. CarePlan.encounter.extension
                          Definition

                          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.

                          ShortAdditional content defined by implementations
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on CarePlan.encounter.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 142. CarePlan.encounter.reference
                            Definition

                            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                            ShortReference to a resource (could be Contained)
                            Comments

                            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                            Control1..1
                            This element is affected by the following invariants: ref-1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            144. CarePlan.encounter.type
                            Definition

                            The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                            The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                            ShortType the reference refers to (e.g. "Patient")
                            Comments

                            This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                            Control0..1
                            BindingUnless not suitable, these codes SHALL be taken from ResourceType
                            (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                            Aa resource (or, for logical models, the URI of the logical model).

                            Typeuri
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            146. CarePlan.encounter.identifier
                            Definition

                            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                            ShortIf relevant could include an id
                            Comments

                            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                            NoteThis is a business identifier, not a resource identifier (see discussion)
                            Control0..1
                            TypeIdentifier
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            148. CarePlan.encounter.display
                            Definition

                            Plain text narrative that identifies the resource in addition to the resource reference.

                            ShortIf relevant, description of the referenced resource
                            Comments

                            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            150. CarePlan.period
                            Definition

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

                            ShortTime period plan covers
                            Comments

                            Any activities scheduled as part of the plan should be constrained to the specified period regardless of whether the activities are planned within a single encounter/episode or across multiple encounters/episodes (e.g. the longitudinal management of a chronic condition).

                            Control0..1
                            TypePeriod
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Allows tracking what plan(s) are in effect at a particular time.

                            Alternate Namestiming
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            152. CarePlan.period.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            154. CarePlan.period.extension
                            Definition

                            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.

                            ShortAdditional content defined by implementations
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on CarePlan.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 156. CarePlan.period.start
                              Definition

                              The start of the period. The boundary is inclusive.

                              ShortStarting time with inclusive boundary
                              Comments

                              If the low element is missing, the meaning is that the low boundary is not known.

                              Control0..1
                              This element is affected by the following invariants: per-1
                              TypedateTime
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              158. CarePlan.period.end
                              Definition

                              The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                              ShortEnd time with inclusive boundary, if not ongoing
                              Comments

                              The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                              Control0..1
                              This element is affected by the following invariants: per-1
                              TypedateTime
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              160. CarePlan.created
                              Definition

                              Represents when this particular CarePlan record was created in the system, which is often a system-generated date.

                              ShortDate record was first recorded
                              Control0..1
                              TypedateTime
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summarytrue
                              Alternate NamesauthoredOn
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              162. CarePlan.author
                              Definition

                              When populated, the author is responsible for the care plan. The care plan is attributed to the author.

                              ShortWho is the designated responsible party
                              Comments

                              The author may also be a contributor. For example, an organization can be an author, but not listed as a contributor.

                              Control0..1
                              TypeReference(Patient, Practitioner, PractitionerRole, Device, RelatedPerson, Organization, CareTeam)
                              Is Modifierfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              164. CarePlan.contributor
                              Definition

                              Identifies the individual(s) or organization who provided the contents of the care plan.

                              ShortWho provided the content of the care plan
                              Comments

                              Collaborative care plans may have multiple contributors.

                              Control0..0
                              TypeReference(Patient, Practitioner, PractitionerRole, Device, RelatedPerson, Organization, CareTeam)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              166. CarePlan.careTeam
                              Definition

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

                              ShortWho's involved in plan?
                              Control0..*
                              TypeReference(CareTeam)
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

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

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              168. CarePlan.addresses
                              Definition

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

                              ShortHealth issues this plan addresses
                              Comments

                              When the diagnosis is related to an allergy or intolerance, the Condition and AllergyIntolerance resources can both be used. However, to be actionable for decision support, using Condition alone is not sufficient as the allergy or intolerance condition needs to be represented as an AllergyIntolerance.

                              Control0..*
                              TypeReference(Condition)
                              Is Modifierfalse
                              Summarytrue
                              Requirements

                              Links plan to the conditions it manages. The element can identify risks addressed by the plan as well as active conditions. (The Condition resource can include things like "at risk for hypertension" or "fall risk".) Also scopes plans - multiple plans may exist addressing different concerns.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              170. CarePlan.supportingInfo
                              Definition

                              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.

                              ShortInformation considered as part of plan
                              Comments

                              Use "concern" to identify specific conditions addressed by the care plan.

                              Control0..0
                              TypeReference(Resource)
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

                              Identifies barriers and other considerations associated with the care plan.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              172. CarePlan.goal
                              Definition

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

                              ShortDesired outcome of plan
                              Comments

                              Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline.

                              Control0..*
                              TypeReference(Goal)
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

                              Provides context for plan. Allows plan effectiveness to be evaluated by clinicians.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              174. CarePlan.activity
                              Definition

                              Identifies a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring, education, etc.

                              ShortAction to occur as part of plan
                              Control0..*
                              TypeBackboneElement
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

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

                              Invariantscpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              176. CarePlan.activity.id
                              Definition

                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              178. CarePlan.activity.extension
                              Definition

                              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.

                              ShortAdditional content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              180. CarePlan.activity.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's 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.

                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                              Summarytrue
                              Requirements

                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                              Alternate Namesextensions, user content, modifiers
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              182. CarePlan.activity.outcomeCodeableConcept
                              Definition

                              Identifies the outcome at the point when the status of the activity is assessed. For example, the outcome of an education activity could be patient understands (or not).

                              ShortResults of the activity
                              Comments

                              Note that this should not duplicate the activity status (e.g. completed or in progress).

                              Control0..*
                              BindingFor example codes, see CarePlanActivityOutcome
                              (example to http://hl7.org/fhir/ValueSet/care-plan-activity-outcome)

                              Identifies the results of the activity.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              184. CarePlan.activity.outcomeReference
                              Definition

                              Details of the outcome or action resulting from the activity. The reference to an "event" resource, such as Procedure or Encounter or Observation, is the result/outcome of the activity itself. The activity can be conveyed using CarePlan.activity.detail OR using the CarePlan.activity.reference (a reference to a “request” resource).

                              ShortAppointment, Encounter, Procedure, etc.
                              Comments

                              The activity outcome is independent of the outcome of the related goal(s). For example, if the goal is to achieve a target body weight of 150 lbs and an activity is defined to diet, then the activity outcome could be calories consumed whereas the goal outcome is an observation for the actual body weight measured.

                              Control0..*
                              TypeReference(Resource)
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

                              Links plan to resulting actions.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              186. CarePlan.activity.progress
                              Definition

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

                              ShortComments about the activity status/progress
                              Comments

                              This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description.

                              Control0..*
                              TypeAnnotation
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

                              Can be used to capture information about adherence, progress, concerns, etc.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              188. CarePlan.activity.reference
                              Definition

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

                              ShortActivity details defined in specific resource
                              Comments

                              Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
                              The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

                              Control0..1
                              This element is affected by the following invariants: cpl-3
                              TypeReference(Appointment, CommunicationRequest, DeviceRequest, MedicationRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup)
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

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

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              190. CarePlan.activity.detail
                              Definition

                              A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

                              ShortIn-line definition of activity
                              Control0..1
                              This element is affected by the following invariants: cpl-3
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Details in a simple form for generic care plan systems.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              192. CarePlan.activity.detail.id
                              Definition

                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              194. CarePlan.activity.detail.extension
                              Definition

                              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.

                              ShortAdditional content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              196. CarePlan.activity.detail.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's 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.

                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                              Summarytrue
                              Requirements

                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                              Alternate Namesextensions, user content, modifiers
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              198. CarePlan.activity.detail.kind
                              Definition

                              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.

                              ShortAppointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription
                              Control0..1
                              BindingThe codes SHALL be taken from CarePlanActivityKind
                              (required to http://hl7.org/fhir/ValueSet/care-plan-activity-kind|4.0.1)

                              Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity.

                              Typecode
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summaryfalse
                              Requirements

                              May determine what types of extensions are permitted.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              200. CarePlan.activity.detail.instantiatesCanonical
                              Definition

                              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.

                              ShortInstantiates FHIR protocol or definition
                              Control0..0
                              Typecanonical(PlanDefinition, ActivityDefinition, Questionnaire, Measure, OperationDefinition)
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summaryfalse
                              Requirements

                              Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              202. CarePlan.activity.detail.instantiatesUri
                              Definition

                              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.

                              ShortInstantiates external protocol or definition
                              Comments

                              This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

                              Control0..0
                              Typeuri
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summaryfalse
                              Requirements

                              Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              204. CarePlan.activity.detail.code
                              Definition

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

                              ShortDetail type of activity
                              Comments

                              Tends to be less relevant for activities involving particular products. Codes should not convey negation - use "prohibited" instead.

                              Control0..1
                              BindingFor example codes, see ProcedureCodes(SNOMEDCT)
                              (example to http://hl7.org/fhir/ValueSet/procedure-code)

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

                              TypeCodeableConcept
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

                              Allows matching performed to planned as well as validation against protocols.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              206. CarePlan.activity.detail.reasonCode
                              Definition

                              Provides the rationale that drove the inclusion of this particular activity as part of the plan or the reason why the activity was prohibited.

                              ShortWhy activity should be done or why activity was prohibited
                              Comments

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

                              Control0..*
                              BindingThe codes SHOULD be taken from SNOMEDCTClinicalFindings
                              (preferred to http://hl7.org/fhir/ValueSet/clinical-findings)
                              TypeCodeableConcept
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              208. CarePlan.activity.detail.reasonReference
                              Definition

                              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.

                              ShortWhy activity is needed
                              Comments

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

                              Control0..*
                              TypeReference(Condition, Observation, DiagnosticReport, DocumentReference)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              210. CarePlan.activity.detail.goal
                              Definition

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

                              ShortGoals this activity relates to
                              Control0..*
                              TypeReference(Goal)
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

                              So that participants know the link explicitly.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              212. CarePlan.activity.detail.status
                              Definition

                              Identifies what progress is being made for the specific activity.

                              Shortnot-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error
                              Comments

                              Some aspects of status can be inferred based on the resources linked in actionTaken. Note that "status" is only as current as the plan was most recently updated.
                              The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the activity.

                              Control1..1
                              BindingThe codes SHALL be taken from CarePlanActivityStatus
                              (required to http://hl7.org/fhir/ValueSet/care-plan-activity-status|4.0.1)

                              Codes that reflect the current state of a care plan activity within its overall life cycle.

                              Typecode
                              Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the activity should not be treated as valid
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summaryfalse
                              Requirements

                              Indicates progress against the plan, whether the activity is still relevant for the plan.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              214. CarePlan.activity.detail.statusReason
                              Definition

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

                              ShortReason for current status
                              Comments

                              Will generally not be present if status is "complete". Be sure to prompt to update this (or at least remove the existing value) if the status is changed.

                              Control0..1
                              TypeCodeableConcept
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              216. CarePlan.activity.detail.doNotPerform
                              Definition

                              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.

                              ShortIf true, activity is prohibiting action
                              Comments

                              This element is labeled as a modifier because it marks an activity as an activity that is not to be performed.

                              Control0..1
                              Typeboolean
                              Is Modifiertrue because If true this element negates the specified action. For example, instead of a request for a procedure, it is a request for the procedure to not occur.
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summaryfalse
                              Requirements

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

                              Meaning if MissingIf missing indicates that the described activity is one that should be engaged in when following the plan.
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              218. CarePlan.activity.detail.scheduled[x]
                              Definition

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

                              ShortWhen activity is to occur
                              Control0..1
                              TypeChoice of: Timing, Period, string
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summaryfalse
                              Requirements

                              Allows prompting for activities and detection of missed planned activities.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              220. CarePlan.activity.detail.location
                              Definition

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

                              ShortWhere it should happen
                              Comments

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

                              Control0..1
                              TypeReference(Location)
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

                              Helps in planning of activity.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              222. CarePlan.activity.detail.performer
                              Definition

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

                              ShortWho will be responsible?
                              Comments

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

                              Control0..*
                              TypeReference(Practitioner, PractitionerRole, Organization, RelatedPerson, Patient, CareTeam, HealthcareService, Device)
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

                              Helps in planning of activity.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              224. CarePlan.activity.detail.product[x]
                              Definition

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

                              ShortWhat is to be administered/supplied
                              Control0..1
                              BindingFor example codes, see SNOMEDCTMedicationCodes
                              (example to http://hl7.org/fhir/ValueSet/medication-codes)

                              A product supplied or administered as part of a care plan activity.

                              TypeChoice of: CodeableConcept, Reference(Medication, Substance)
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              226. CarePlan.activity.detail.dailyAmount
                              Definition

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

                              ShortHow to consume/day?
                              Control0..1
                              TypeQuantity(SimpleQuantity)
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

                              Allows rough dose checking.

                              Alternate Namesdaily dose
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              228. CarePlan.activity.detail.quantity
                              Definition

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

                              ShortHow much to administer/supply/consume
                              Control0..1
                              TypeQuantity(SimpleQuantity)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              230. CarePlan.activity.detail.description
                              Definition

                              This provides a textual description of constraints on the intended activity occurrence, including relation to other activities. It may also include objectives, pre-conditions and end-conditions. Finally, it may convey specifics about the activity such as body site, method, route, etc.

                              ShortExtra info describing activity to perform
                              Control0..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              232. CarePlan.note
                              Definition

                              General notes about the care plan not covered elsewhere.

                              ShortComments about the plan
                              Control0..*
                              TypeAnnotation
                              Is Modifierfalse
                              Summaryfalse
                              Requirements

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

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))