US Core Implementation Guide
9.0.0 - STU 9 US

US Core Implementation Guide - Downloaded Version 9.0.0 See the Directory of published versions

## Resource Profile: USCoreCareTeam - Detailed Descriptions

Page standards status: Trial-use | Maturity Level: 5

Definitions for the us-core-careteam resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

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

0. CareTeam
Definition | The Care Team includes all the people and organizations who plan to participate in the coordination and delivery of care for a patient.
Short | Planned participants in the coordination and delivery of care for a patient or group
Control | 0..*
Is Modifier | false
Must Support | false
Summary | false
Invariants | dom-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. CareTeam.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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. CareTeam.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
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 Names | extensions, user content
Invariants | ele-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())
6. CareTeam.status
Definition | Indicates the current state of the care team.
Short | proposed | active | suspended | inactive | entered-in-error
Comments | This element is labeled as a modifier because the status contains the code entered-in-error that marks the care team as not currently valid.
Control | 0..1
Binding | The codes SHALL be taken from CareTeamStatus http://hl7.org/fhir/ValueSet/care-team-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/care-team-status` ) Indicates whether the team is current, represents future intentions or is now a historical record. Indicates the status of the care team.
Type | code
Is Modifier | true because This element is labelled 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 Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. CareTeam.subject
Definition | Identifies the patient or group whose intended care is handled by the team.
Short | Who care team is for
Control | 10..1
Type | Reference(US Core Patient Profile, Group, Patient, Group)
Is Modifier | false
Must Support | true
Must Support Types | Reference(US Core Patient Profile)
Summary | true
Requirements | Allows the team to care for a group (e.g. marriage) therapy. Allows for an organization to designate a team such as the PICC line team.
Alternate Names | patient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. CareTeam.participant
Definition | Identifies all people and organizations who are expected to be involved in the care team.
Short | Members of the team
Control | 10..* This element is affected by the following invariants: ctm-1
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner (`onBehalfOf.exists() implies (member.resolve().iif(empty(), true, ofType(Practitioner).exists()))`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner (onBehalfOf.exists() implies (member.resolve().iif(empty(), true, ofType(Practitioner).exists())))
12. CareTeam.participant.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-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())
14. CareTeam.participant.role
Definition | Indicates specific responsibility of an individual within the care team, such as "Primary care physician", "Trained social worker counselor", "Caregiver", etc.
Short | Type of involvement
Comments | Roles may sometimes be inferred by type of Practitioner. These are relationships that hold only within the context of the care team. General relationships should be handled as properties of the Patient resource directly.
Control | 10..1*
Binding | Unless not suitable, these codes SHALL be taken from For example codes, see Care Team Member Function http://hl7.org/fhir/ValueSet/participant-role|4.0.1 (extensible to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30` ) Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc. Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. CareTeam.participant.member
Definition | The specific person or organization who is participating/expected to participate in the care team.
Short | Who is involved
Comments | Patient only needs to be listed if they have a role other than "subject of care". Member is optional because some participants may be known only by their role, particularly in draft plans.
Control | 10..1
Type | Reference(US Core Practitioner Profile, US Core Organization Profile, US Core Patient Profile, US Core PractitionerRole Profile, US Core CareTeam Profile, US Core RelatedPerson Profile, Practitioner, PractitionerRole, RelatedPerson, Patient, Organization, CareTeam)
Is Modifier | false
Must Support | true
Must Support Types | Reference(US Core Practitioner Profile, US Core PractitionerRole Profile, US Core RelatedPerson Profile)
Summary | true
Invariants | ele-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 foundhere

0. CareTeam
Must Support | false
2. CareTeam.status
Binding | The codes SHALL be taken from CareTeamStatus (required to `http://hl7.org/fhir/ValueSet/care-team-status` ) Changed: Indicates whether the team is current, represents future intentions or is now a historical record.
Must Support | true
4. CareTeam.subject
Control | 1..?
Type | Reference(US Core Patient Profile, Group)
Must Support | true
Must Support Types | Reference(US Core Patient Profile)
6. CareTeam.participant
Control | 1..?
Must Support | true
8. CareTeam.participant.role
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from Care Team Member Function (extensible to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30` ) Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
Must Support | true
10. CareTeam.participant.member
Control | 1..?
Type | Reference(US Core Practitioner Profile, US Core Organization Profile, US Core Patient Profile, US Core PractitionerRole Profile, US Core CareTeam Profile, US Core RelatedPerson Profile)
Must Support | true
Must Support Types | Reference(US Core Practitioner Profile, US Core PractitionerRole Profile, US Core RelatedPerson Profile)

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

0. CareTeam
Definition | The Care Team includes all the people and organizations who plan to participate in the coordination and delivery of care for a patient.
Short | Planned participants in the coordination and delivery of care for a patient or group
Control | 0..*
Is Modifier | false
Must Support | false
Summary | false
Invariants | dom-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. CareTeam.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical 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.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. CareTeam.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.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. CareTeam.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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. CareTeam.language
Definition | The base language in which the resource is written.
Short | 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).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. CareTeam.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.
Short | Text 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.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. CareTeam.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.
Short | Contained, 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.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. CareTeam.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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-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()`)
16. CareTeam.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
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 Names | extensions, user content
Invariants | ele-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()`)
18. CareTeam.identifier
Definition | Business identifiers assigned to this care team by the performer or other systems which remain constant as the resource is updated and propagates from server to server.
Short | External Ids for this team
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.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Summary | true
Requirements | Allows identification of the care team as it is known by various participating systems and in a way that remains consistent across servers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. CareTeam.status
Definition | Indicates the current state of the care team.
Short | proposed | active | suspended | inactive | entered-in-error
Comments | This element is labeled as a modifier because the status contains the code entered-in-error that marks the care team as not currently valid.
Control | 0..1
Binding | The codes SHALL be taken from CareTeamStatus (required to `http://hl7.org/fhir/ValueSet/care-team-status` ) Indicates whether the team is current, represents future intentions or is now a historical record.
Type | code
Is Modifier | true because This element is labelled 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 Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
22. CareTeam.category
Definition | Identifies what kind of team. This is to support differentiation between multiple co-existing teams, such as care plan team, episode of care team, longitudinal care team.
Short | Type of team
Comments | There may be multiple axis of categorization and one team may serve multiple purposes.
Control | 0..*
Binding | For example codes, see CareTeamCategory (example to `http://hl7.org/fhir/ValueSet/care-team-category|4.0.1` ) Indicates the type of care team.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Used for filtering what teams(s) are retrieved and displayed to different types of users.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. CareTeam.name
Definition | A label for human use intended to distinguish like teams. E.g. the "red" vs. "green" trauma teams.
Short | Name of the team, such as crisis assessment team
Comments | The meaning/purpose of the team is conveyed in CareTeam.category. This element may also convey semantics of the team (e.g. "Red trauma team"), but its primary purpose is to distinguish between identical teams in a human-friendly way. ("Team 18735" isn't as friendly.).
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. CareTeam.subject
Definition | Identifies the patient or group whose intended care is handled by the team.
Short | Who care team is for
Control | 1..1
Type | Reference(US Core Patient Profile, Group)
Is Modifier | false
Must Support | true
Must Support Types | Reference(US Core Patient Profile)
Summary | true
Requirements | Allows the team to care for a group (e.g. marriage) therapy. Allows for an organization to designate a team such as the PICC line team.
Alternate Names | patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. CareTeam.encounter
Definition | The Encounter during which this CareTeam was created or to which the creation of this record is tightly associated.
Short | Encounter 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.
Control | 0..1
Type | Reference(Encounter)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
30. CareTeam.period
Definition | Indicates when the team did (or is intended to) come into effect and end.
Short | Time period team covers
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Requirements | Allows tracking what team(s) are in effect at a particular time.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
32. CareTeam.participant
Definition | Identifies all people and organizations who are expected to be involved in the care team.
Short | Members of the team
Control | 1..* This element is affected by the following invariants: ctm-1
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner (`onBehalfOf.exists() implies (member.resolve().iif(empty(), true, ofType(Practitioner).exists()))`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
34. CareTeam.participant.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
36. CareTeam.participant.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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-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()`)
38. CareTeam.participant.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-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()`)
40. CareTeam.participant.role
Definition | Indicates specific responsibility of an individual within the care team, such as "Primary care physician", "Trained social worker counselor", "Caregiver", etc.
Short | Type of involvement
Comments | Roles may sometimes be inferred by type of Practitioner. These are relationships that hold only within the context of the care team. General relationships should be handled as properties of the Patient resource directly.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from Care Team Member Function (extensible to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30` ) Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. CareTeam.participant.member
Definition | The specific person or organization who is participating/expected to participate in the care team.
Short | Who is involved
Comments | Patient only needs to be listed if they have a role other than "subject of care". Member is optional because some participants may be known only by their role, particularly in draft plans.
Control | 1..1
Type | Reference(US Core Practitioner Profile, US Core Organization Profile, US Core Patient Profile, US Core PractitionerRole Profile, US Core CareTeam Profile, US Core RelatedPerson Profile)
Is Modifier | false
Must Support | true
Must Support Types | Reference(US Core Practitioner Profile, US Core PractitionerRole Profile, US Core RelatedPerson Profile)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. CareTeam.participant.onBehalfOf
Definition | The organization of the practitioner.
Short | Organization of the practitioner
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Requirements | Practitioners can be associated with multiple organizations. This element indicates which organization they were acting on behalf of.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. CareTeam.participant.period
Definition | Indicates when the specific member or organization did (or is intended to) come into effect and end.
Short | Time period of participant
Control | 0..1
Type | Period
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. CareTeam.reasonCode
Definition | Describes why the care team exists.
Short | Why the care team exists
Control | 0..*
Binding | For example codes, see SNOMEDCTClinicalFindings (example to `http://hl7.org/fhir/ValueSet/clinical-findings|4.0.1` ) Indicates the reason for the care team.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. CareTeam.reasonReference
Definition | Condition(s) that this care team addresses.
Short | Why the care team exists
Control | 0..*
Type | Reference(Condition)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. CareTeam.managingOrganization
Definition | The organization responsible for the care team.
Short | Organization responsible for the care team
Control | 0..*
Type | Reference(Organization)
Is Modifier | false
Summary | true
Requirements | Allows for multiple organizations to collaboratively manage cross-organizational, longitudinal care plan.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. CareTeam.telecom
Definition | A central contact detail for the care team (that applies to all members).
Short | A contact detail for the care team (that applies to all members)
Comments | The ContactPoint.use code of home is not appropriate to use. These contacts are not the contact details of individual care team members.
Control | 0..*
Type | ContactPoint
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. CareTeam.note
Definition | Comments made about the CareTeam.
Short | Comments made about the CareTeam
Control | 0..*
Type | Annotation
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)