HL7 FHIR® US Core Implementation Guide STU3 Release 3.1.1

This page is part of the US Core (v3.1.1: STU3) based on FHIR R4. The current version which supercedes this version is 5.0.1. For a full list of available versions, see the Directory of published versions

Implementation Guide HomePage


The US Core Implementation Guide is based on FHIR Version R4 and defines the minimum conformance requirements for accessing patient data. The Argonaut pilot implementations, ONC 2015 Edition Common Clinical Data Set (CCDS), and ONC U.S. Core Data for Interoperability (USCDI) v1 provided the requirements for this guide. The prior Argonaut search and vocabulary requirements, based on FHIR DSTU2, are updated in this guide to support FHIR Version R4. This guide was used as the basis for further testing and guidance by the Argonaut Project Team to provide additional content and guidance specific to Data Query Access for purpose of ONC Certification testing. These profiles are the foundation for future US Realm FHIR implementation guides. In addition to Argonaut, they are used by DAF-Research, QI-Core, and CIMI. Under the guidance of HL7 and the HL7 US Realm Steering Committee, the content will expand in future versions to meet the needs specific to the US Realm.

These requirements were originally developed, balloted, and published in FHIR DSTU2 as part of the Office of the National Coordinator for Health Information Technology (ONC) sponsored Data Access Framework (DAF) project. For more information on how DAF became US Core see the US Core change notes.

How to read this Guide

This Guide is divided into several pages which are listed at the top of each page in the menu bar.

  • Home: The home page provides the introduction and background for HL7 FHIR® US Core Implementation Guide.
  • Guidance: These pages provides overall guidance in using the profiles and transactions defined in this guide.
    • General Guidance provides guidance, definitions and requirements common to all HL7 FHIR® US Core Implementation Guide actors used in this guide.
    • Clinical Notes Guidance gives guidance on the interactions between Consumers and Producers of clinical notes.
    • Medication List Guidance gives guidance on how a patient or provider can access a patient’s medications.
    • Basic Provenance provides implementers with important definitions to create and share the Provenance Resource.
    • DSTU2 to R4 Conversion considers the user and developer experience when transitioning from FHIR DSTU2 to FHIR R4.
    • Future of US Core outlines the approach to adding new content to HL7 FHIR® US Core Implementation Guide.
  • FHIR Artifacts: These pages provides detailed descriptions and formal definitions for all the FHIR objects defined in this guide.
    • Profiles and Extensions: This page lists the set of Profile and Extension that are defined in this guide to exchange quality data. Each Profile page includes a narrative introduction, formal definition and a “Quick Start” guide to the supported search transaction for each HL7 FHIR® US Core Implementation Guide Profile.
    • Search Parameters and Operations: This page lists the HL7 FHIR® US Core Implementation Guide defined Operations and Search Parameters that are used in US Core transactions.
    • Terminology: This page lists the value sets and code system defined for HL7 FHIR® US Core Implementation Guide profiles.
    • Capability Statements: This set of pages describes the expected FHIR capabilities of the various HL7 FHIR® US Core Implementation Guide actors.
  • Security: General security requirements and recommendations for HL7 FHIR® US Core Implementation Guide actors.
  • Examples: List of links to all the examples used in this guide.
  • Downloads: This page provides links to downloadable artifacts.

US Core Actors

The following actors are part of the US Core IG:

  • US Core Requestor: An application that initiates a data access request to retrieve patient data. This can be thought of as the client in a client-server interaction.
  • US Core Responder: A product that responds to the data access request providing patient data. This can be thought of as the server in a client-server interaction.

US Core Profiles

The list of US Core Profiles is shown below. Each profile defines the minimum mandatory elements, extensions and terminology requirements that MUST be present. For each profile, requirements and guidance are given in a simple narrative summary. A formal hierarchical table that presents a logical view of the content in both a differential and snapshot view is also provided along with references to appropriate terminologies and examples. For each US Core Profile, an overview of the required set of RESTful FHIR interactions - for example, search and read operations - is provided in the Quick Start Section of the profile page.

  • US Core AllergyIntolerance Profile
  • US Core CarePlan Profile
  • US Core CareTeam Profile
  • US Core Condition Profile
  • US Core DiagnosticReport Profile for Laboratory Results Reporting
  • US Core DiagnosticReport Profile for Report and Note exchange
  • US Core DocumentReference Profile
  • US Core Encounter Profile
  • US Core Goal Profile
  • US Core Immunization Profile
  • US Core Implantable Device Profile
  • US Core Laboratory Result Observation Profile
  • US Core Location Profile
  • US Core Medication Profile
  • US Core MedicationRequest Profile
  • US Core Organization Profile
  • US Core Patient Profile
  • US Core Pediatric BMI for Age Observation Profile
  • US Core Pediatric Head Occipital-frontal Circumference Percentile Profile
  • US Core Pediatric Weight for Height Observation Profile
  • US Core Practitioner Profile
  • US Core PractitionerRole Profile
  • US Core Procedure Profile
  • US Core Provenance Profile
  • US Core Pulse Oximetry Profile
  • US Core Smoking Status Observation Profile
  • See the General Guidance page for a mapping to the U.S. Core Data for Interoperability (USCDI).

    US Core Conformance Requirements

    The Capability Statements page outlines conformance requirements and expectations for the US Core Servers and Client applications, identifying the specific profiles and RESTful transactions that need to be supported. Note that the individual US Core profiles identify the structural constraints, terminology bindings and invariants. Similarly, the individual US Core SearchParameter and Operation resources specify how they are understood by the server. However, implementers must refer to the CapabilityStatement for details on the RESTful transactions, specific profiles and the search parameters applicable to each of the US Core actors.

    Primary Authors: Brett Marquard, Eric Haas

    Secondary Authors: Grahame Grieve, Nagesh Bashyam