• FHIR Version: 3.0.1
• Supported formats: xml, json
• Published: 2017-12-22
• Published by: Health Level Seven International US Realm Steering Committee

The Section describes the expected capabilities of the US Core Server actor which is responsible for providing responses to the queries submitted by the US Core Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by US Core Servers are defined. Systems implementing this capability statement should meet the ONC 2015 Common Clinical Data Set (CCDS) access requirement for Patient Selection 170.315(g)(7) and Application Access - Data Category Request 170.315(g)(8). US Core Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

Behavior

Description:

The US Core Server SHALL:

1. Support the US Core Patient resource profile.
2. Support at least one additional resource profile from the list of US Core Profiles.
3. Implement the RESTful behavior according to the FHIR specification.
4. Return the following response classes:
   • (Status 200): successful operation
   • (Status 400): invalid parameter
   • (Status 401/4xx): unauthorized request
   • (Status 403): insufficient scope
   • (Status 404): unknown resource
   • (Status 410): deleted resource.
5. Support jsonesource formats for all US Core interactions.
6. Declare a CapabilityStatement identifying the list of profiles, operations, search parameter supported.

The US Core Server SHOULD:

1. Support xmlesource formats for all US Core interactions.
2. Identify the US Core profiles supported as part of the FHIR meta.profilettribute for each instance.

Security:

US Core Servers SHALL:

1. Implement the security requirementsocumented in the this IG.
2. A server has ensured that every API request includes a valid Authorization token, supplied via: Authorization: Bearer {server-specific-token-here}
3. A server has rejected any unauthorized requests by returning an HTTP 401nauthorized response code.

Profile Interaction Summary:

1. All servers SHALLake available the readnd searchnteractions for the Profiles the server chooses to support.
2. All servers SHOULDake available the vreadnd history-instancenteractions for the Profiles the server chooses to support.

Summary of US Core search criteria

Specific server search capabilities are described in detail in each of the resource sections below.

Resource Type	Supported Profiles	Supported Searches	Supported Includes
Patient	US Core Patient Profile	name , family , given , identifier , gender , birthdate , name + gender , name + birthdate , family + gender , given + gender
AllergyIntolerance	US Core AllergyIntolerance Profile	patient
CarePlan	US Core CarePlan Profile	patient , category , status , date, patient + category , patient + category + date , patient + category + status , patient + category + status + date
CareTeam	US Core CareTeam Profile	patient , status, patient + status
Condition	US Core Condition Profile	patient , category , clinicalstatus, patient + clinicalstatus , patient + category
Device	US Core Device Profile	patient
DiagnosticReport	US Core DiagnosticReport Profile	patient , category , code , date, patient + category , patient + category + date , patient + category + code, patient + category + code + date
DocumentReference	US Core DocumentReference Profile	patient , patient + period + type , patient + date + $docref
Encounter	US Core Encounter Profile	patient , patient + date
Goal	US Core Goal Profile	patient , date, patient + date
Immunization	US Core Immunization Profile	patient
Location	US Core Location Profile	name , address
Medication	US Core Medication Profile
MedicationStatement	US Core MedicationStatement Profile	patient	MedicationStatement.medication
MedicationRequest	US Core MedicationRequest Profile	patient	MedicationRequest.medication
Observation	US Core Result Observation Profile, Vital Signs Profile, US Core Smoking Status Observation Profile	patient , category , code , date, patient + category , patient + category + date , patient + category + code, patient + category + code + date
Organization	US Core Organization Profile	identifier , name , address
Practitioner	US Core Practitioner Profile	identifier , name
PractitionerRole	US Core PractitionerRole Profile	identifier , family + given, specialty
Procedure	US Core Procedure Profile	patient , date , patient + date

Resource Details:

---

Patient

Supported Profiles: US Core Patient Profile

Search Criteria:

1. A server SHALLe capable of returning a patient using:

   GET [base]/Patient/[id].

2. A server SHALLe capable of returning a patient by identifier using

   GET [base]/Patient?identifier=[system]|[code]

3. A server SHALLe capbable of returning a patient by supporting at a minimum the following search parameters when at least 2 are present:

   • name
   • gender

   • birthdate

     • for example:

       GET [base]/Patient?name=[name]&gender=[gender]

Search Parameters:

Conformance	Parameter	Type
SHALL	name	string
SHALL	identifier	token
SHALL	family +gender	string + token
SHALL	given +gender	string + token
SHALL	name+gender	string + token
SHALL	name+birthdate	string + date

---

AllergyIntolerance

Supported Profiles: US Core AllergyIntolerance Profile

Search Criteria:

1. A server SHALLe capable of returning all patient’s allergies using:

   GET [base]/AllergyIntolerance?patient=[id]

Search Parameters:

Conformance	Parameter	Type
SHALL	patient	reference

---

CarePlan

Supported Profiles: US Core CarePlan Profile

Search Criteria:

1. A server SHALLe capable of returning all of a patient’s Assessment and Plan of Treatment information using:

   GET [base]/CarePlan?patient=[id]&category=assess-plan

2. A server SHALLe capable of returning a patient’s Assessment and Plan of Treatment information over a specified time period using:

   GET [base]/CarePlan?patient=[id]&category=assess-plan&date=[date]

3. A server SHOULDe capable returning all of a patient’s active Assessment and Plan of Treatment information using

   GET [base]/CarePlan?patient=[id]&category=assess-plan&status=active

4. A server SHOULDe capable returning a patient’s active Assessment and Plan of Treatment information over a specified time period using

   GET [base]/CarePlan?patient=[id]&category=assess-plan&status=active&date=[date]

Search Parameters:

Conformance	Parameter	Type	Modifiers
SHALL	patient + category	reference + token
SHALL	patient + category + date	reference + token + date	date modifiers‘ge’,‘le’,’gt’,’lt’
SHOULD	patient + category + status	reference + token
SHOULD	patient + category + date + status	reference + token + date	date modifiers‘ge’,‘le’,’gt’,’lt’

---

CareTeam

Supported Profiles: US Core CareTeam Profile

Search Criteria:

1. A server SHALLe capable of returning a patient’s current care team members using:

   GET [base]/CareTeam?patient=[id]&status=active

Search Parameters:

Conformance	Parameter	Type
SHALL	patient + status	reference + token

---

Condition

Supported Profiles: US Core Condition Profile

Search Criteria:

1. A server SHALLe capable of returning all problems and health concerns for a patient, including current as well as historical problems and health concerns using:

   GET [base]/Condition?patient=[id]

2. A server SHOULDe capable returning all of a patient’s activeroblems and health concerns using:

   GET [base]/Condition?patient=[id]&clinicalstatus=active,recurrance,remission

3. A server SHOULDe capable returning all of a patient’s problems or all of patient’s health concerns using:

   GET [base]/Condition?patient=[id]&category=[problem|health-concern]

Search Parameters:

Conformance	Parameter	Type
SHALL	patient	reference
SHOULD	patient + category	reference + token
SHOULD	patient + clinicalstatus	reference + token

---

Device

Supported Profiles: US Core Device Profile

Search Criteria:

1. A server SHALLe capable of returning all Unique device identifier(s)(UDI) for a patient’s implanted device(s):

   GET [base]/Device?patient=[id]

Search Parameters:

Conformance	Parameter	Type
SHALL	patient	reference

---

DiagnosticReport

Supported Profiles: US Core DiagnosticReport Profile

Search Criteria:

1. A server SHALLe capable of returning all of a patient’s laboratory diagnostic reports queried by category using:

   GET [base]/DiagnosticReport?patient=[id]&category=LAB

2. A server SHALLe capable of returning all of a patient’s laboratory diagnostic reports queried by category code and date range using:

   GET [base]/DiagnosticReport?patient=[id]&category=LAB&date=[date]{&date=[date]}

3. A server SHALLe capable of returning all of a patient’s laboratory diagnostic reports queried by category and code using:

   GET [base]/DiagnosticReport?patient=[id]&category=LAB&code=[LOINC]

4. A server SHOULDe capable of returning all of a patient’s laboratory diagnostic reports queried by category and one or more codes and date range using:

   GET [base]/DiagnosticReport?patient=[id]&category=LAB&code=[LOINC1{,LOINC2,LOINC3,…}]&date=[date]{&date=[date]}

Search Parameters:

Conformance	Parameter	Type	Modifiers
SHALL	patient + category	reference + token
SHALL	patient + category + code	reference + token
SHALL	patient + category + date	reference + token + date	date modifiers‘ge’,‘le’,’gt’,’lt’
SHOULD	patient + category + code + date	reference + token + date	date modifiers‘ge’,‘le’,’gt’,’lt’

---

DocumentReference

Supported Profiles: US Core DocumentReference Profile

Search Criteria:

1. A server SHALLe capable of returning all of a patient’s DocumentReferences using:

   GET [base]/DocumentReference?patient=[id]

2. A server SHALLe capable of responding to a $docrefperation. At minimum, it must return a reference to a CCD document.

   GET [base]/DocumentReference/$docref?patient=[id]

3. A server SHOULDe capable of returning all of all of a patient’s DocumentReferences for a given time period and document type:

   GET [base]/DocumentReference?patient=[id]&type=[type]&period=[date]{&date=[date]}

Search Parameters:

Conformance	Parameter	Type	Modifiers
SHALL	patient	reference
SHALL	patient + $docref	reference + oepration
SHOULD	patient + type + period	reference + token + date	date modifiers‘ge’,‘le’,’gt’,’lt’

---

Encounter

Supported Profiles: US Core Encounter Profile

Search Criteria:

1. A server SHALLe capable of returning all of a patient’s encounters using:

   GET [base]/Encounter?patient=[id]

2. A server SHALLe capable of returning all of all of a patient’s encounters over a specified time period using:

   GET [base]/Encounter?patient=[id]&date=[date]{&date=[date]}

Search Parameters:

Conformance	Parameter	Type	Modifiers
SHALL	patient	reference
SHALL	patient + date	reference + date	date modifiers‘ge’,‘le’,’gt’,’lt’

---

Goal

Supported Profiles: US Core Goal Profile

Search Criteria:

1. A server SHALLe capable of returning all of a patient’s goals using:

   GET [base]/Goal?patient=[id]

2. A server SHALLe capable of returning all of all of a patient’s goals over a specified time period using:

   GET [base]/Goal?patient=[id]&date=[date]{&date=[date]}

Search Parameters:

Conformance	Parameter	Type	Modifiers
SHALL	patient	reference
SHALL	patient + date	reference + date	date modifiers‘ge’,‘le’,’gt’,’lt’

---

Immunization

Supported Profiles: US Core Immunization Profile

Search Criteria:

1. A server SHALLe capable of returning all immunizations for a patient using:

   GET [base]/Immunization?patient=[id]

Search Parameters:

Conformance	Parameter	Type
SHALL	patient	reference

---

Location

Supported Profiles: US Core Location Profile

Search Criteria:

1. A server SHALLe capable of returning a location by name using:

   GET [base]/Location?name=[string]

2. A server SHALLe capable of returning a location by address using:

   GET [base]/Location?address=[string]

Search Parameters:

Conformance	Parameter	Type
SHALL	name	string
SHALL	address	string

---

Medication

Supported Profiles: US Core Medication Profile

The MedicationStatement and MedicationRequest resources can represent a medication, using an external reference to a Medication resource. If an external Medication Resource is used in a MedicationStatement or a MedicationRequest, then the READ and SEARCH Criteria SHALL be supported.

---

MedicationStatement

Supported Profiles: US Core MedicationStatement Profile

Search Criteria:

The MedicationStatement resources can represent a medication using either a code or refer to the Medication resource. When referencing a Medication resource, the resource may be containedr an external resource. The server application MAYhoose any one way or more than one method, but ifn external reference to Medication is used, the server SHALLupport the _include arameter for searching this element. The client application must support all methods.

A server SHALLe capable of returning all medications for a patient using one of or both:

GET /MedicationStatement?patient=[id]

GET /MedicationStatement?patient=[id]&_include=MedicationStatement:medication

Search Parameters:

Conformance	Parameter	Type	_include(see documentation)
SHALL	patient	reference	MedicationStatement:medication

---

MedicationRequest

Supported Profiles: US Core MedicationRequest Profile

Search Criteria:

The MedicationRequest resources can represent a medication using either a code or refer to the Medication resource. When referencing a Medication resource, the resource may be containedr an external resource. The server application MAYhoose any one way or more than one method, but ifn external reference to Medication is used, the server SHALLupport the _include arameter for searching this element. The client application must support all methods.

A server SHALLe capable of returning all medications for a patient using one of or both:

GET /MedicationRequest?patient=[id]

GET /MedicationRequest?patient=[id]&_include=MedicationRequest:medication

Search Parameters:

Conformance	Parameter	Type	_include(see documentation)
SHALL	patient	reference	MedicationRequest:medication

---

Observation

Supported Profiles:

1. US Core Result Observation Profile

   Search Criteria:

   1. A server SHALLe capable of returning all of a patient’s laboratory results queried by category using:

      GET [base]/Observation?patient=[id]&category=laboratory

   2. A server SHALLe capable of returning all of a patient’s laboratory results queried by category code and date range using:

      GET [base]/Observation?patient=[id]&category=laboratory&date=[date]{&date=[date]}

   3. A server SHALLe capable of returning all of a patient’s laboratory results queried by category and code using:

      GET [base]/Observation?patient=[id]&category=laboratory&code=[LOINC]

   4. A server SHOULDe capable of returning all of a patient’s laboratory results queried by category and one or more codes and date range using:

      GET [base]/Observation?patient=[id]&category=laboratory&code=[LOINC1{,LOINC2,LOINC3,...}]&date=[date]{&date=[date]}

2. Vital Signs Profile

   Search Criteria:

   1. A server SHALLe capable of returning all of a patient’s vital signs that it supports using:

      GET [base]/Observation?patient=[id]&category=vital-signs

   2. A server SHALLe capable of returning all of a patient’s vital signs queried by date range using:

      GET [base]/Observation?patient=[id]&category=vital-signs&date=[date]{&date=[date]}

   3. A server SHALLe capable of returning any of a patient’s vital signs queried by one or more of the codes listed below using:

      GET [base]/Observation?patient=[id]&code[vital sign LOINC{,LOINC2,LOINC3,…}]

   4. A server SHOULDe capable of returning any of a patient’s vital signs queried by one or more of the codes listed below and date range using:

      GET [base]/Observation?patient=[id]&code=[LOINC{,LOINC2…}]vital-signs&date=[date]{&date=[date]}

3. US Core Smoking Status Observation Profile

   Search Criteria:

   1. A server SHALLe capable of returning a patient’s smoking status using:

      GET [base]/Observation?patient=[id]&code=72166-2

Search Parameters:

Conformance	Parameter	Type	Modifiers
SHALL	patient + category	reference + token
SHALL	patient + category + code	reference + token
SHALL	patient + category + date	reference + token + date	date modifiers‘ge’,‘le’,’gt’,’lt’
SHOULD	patient + category + code + date	reference + token + date	date modifiers‘ge’,‘le’,’gt’,’lt’

---

Organization

Supported Profiles: US Core Organization Profile

Search Criteria:

1. A server SHALLe capable of returning an organization by identifier using:

   `GET [base]/Organization?identifier=[system]

   [code]’

2. A server SHALLe capable of returning an organization by name using:

   GET [base]/Organization?name=[string]

3. A server SHALLe capable of returning an organization by address using:

   GET [base]/Organization?address=[string]

Search Parameters:

Conformance	Parameter	Type
SHALL	identifier	token
SHALL	name	string
SHALL	address	string

---

Practitioner

Supported Profiles: US Core Practitioner Profile

Search Criteria:

1. A server SHALLe capable of returning a practitioner by identifier using:

   GET [base]/Practitioner?identifier=[system]|[code]

2. A server SHALLe capable of returning a practitioner by name using:

   GET [base]/Practitioner?family=[string]&given=[string]

Search Parameters:

Conformance	Parameter	Type
SHALL	identifier	token
SHALL	name	string

---

PractitionerRole

Supported Profiles: US Core PractitionerRole Profile

Search Criteria:

1. A server SHALLe capable of returning PractitionerRoles by Practitioner.identifier using:

   GET [base]/PractitionerRole?practitioner.identifier=[system]|[code]

2. A server SHALLe capable of returning PractitionerRoles by Practitioner.family and Practitioner.given using:

   GET [base]/PractitionerRole?practitioner.family=[string]&given=[string]

3. A server SHALLe capable of returning PractitionerRoles by specialty using:

GET [base]/PractitionerRole?specialty=[system]|[code]]

Search Parameters:

Conformance	Parameter	Type
SHALL	practitioner.identifier	reference + token
SHALL	practitioner.family + practitioner.given	reference + string + string
SHALL	specialty	token

---

Procedure

Supported Profiles: US Core Procedure Profile

Search Criteria:

1. A server SHALLe capable of returning a patient’s procedures using: GET/Procedure?patient=[id]

2. A server SHALLe capable of returning all of a patient’s procedures over a specified time period using: GET /Procedure?patient=[id]&date=[date]{&date=[date]}

Search Parameters:

Conformance	Parameter	Type	Modifiers
SHALL	patient	reference
SHALL	patient + date	reference + date	date modifiers‘ge’,‘le’,’gt’,’lt’