PackagesCanonicalsLogsProblems
    Packages
    hl7.cda.us.ccda@5.0.0-ballot
    http://hl7.org/cda/us/ccda/StructureDefinition/CarePlanAct
description: 'The Care Plan Act represents a snapshot in time of a dynamic, consensus-driven plan that has captured a patient''s and care team members'' prioritized concerns, goals, and planned interventions. It reflects the state of the care plan as managed within a source system and may be exchanged to support care coordination across systems and settings.\n\nThe Care Plan Act identifies the authoring individual or organization (act.author), which aligns with the FHIR CarePlan.contributor, and records the set of health concerns or conditions being addressed.\n\n**To meet USCDI requirements, at least one entryRelationship:addresses element referencing an Indication, Problem Observation, or Observation is required.**\n\nThe Care Plan Act may integrate multiple condition- or discipline-specific plans of care and serves to align activities and responsibilities among participants. *Supporting entryRelationship templates such as Goal, Intervention Act, Planned Intervention Act, and Act are available for systems capable of representing structured care plans, but their use is optional and not required for USCDI compliance.*\n\nThis entry conveys an instance of the evolving Care Plan at a specific point in time and does not represent a dynamically updated plan.\n\n#### Templates Used\nAlthough open templates may contain any valid CDA content, the following templates are specifically called out by this template:\n\n**Optional EntryRelationships**: [Act](https://hl7.org/cda/stds/core/StructureDefinition-Act.html), [EntryReference](StructureDefinition-EntryReference.html), [GoalObservation](StructureDefinition-GoalObservation.html), [Indication](StructureDefinition-Indication.html), [InterventionAct](StructureDefinition-InterventionAct.html), [Observation](https://hl7.org/cda/stds/core/StructureDefinition-Observation.html), [PlannedInterventionAct](StructureDefinition-PlannedInterventionAct.html), [ProblemObservation](StructureDefinition-ProblemObservation.html)'
package_name: hl7.cda.us.ccda
derivation: constraint
name: CarePlanAct
type: http://hl7.org/cda/stds/core/StructureDefinition/Act
elements:
  templateId:
    index: 0
    slicing:
      rules: open
      discriminator:
      - {path: root, type: value}
      - {path: extension, type: value}
      min: 1
      slices:
        care-plan-act:
          match: {root: 2.16.840.1.113883.10.20.22.4.518, extension: '2026-05-01'}
          schema:
            _required: true
            index: 1
            elements:
              root:
                pattern: {type: String, value: 2.16.840.1.113883.10.20.22.4.518}
                index: 2
              extension:
                pattern: {type: String, value: '2026-05-01'}
                index: 3
            required: [root, extension]
            extensions: {}
  moodCode:
    short: CarePlan.intent
    binding: {strength: required, valueSet: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.37'}
    index: 4
  code:
    short: Plan of care note
    index: 5
    elements:
      code:
        pattern: {type: Code, value: 18776-5}
        index: 6
      codeSystem:
        short: LOINC
        pattern: {type: String, value: 2.16.840.1.113883.6.1}
        index: 7
      translation:
        binding: {strength: preferred, valueSet: 'http://hl7.org/fhir/ValueSet/care-plan-category'}
        index: 8
    required: [codeSystem, code]
  text:
    short: SHOULD reference the portion of section narrative text corresponding to this entry
    index: 9
    elements:
      reference:
        constraint:
          value-starts-octothorpe: {human: 'If reference/@value is present, it SHALL begin with a ''#'' and SHALL point to its corresponding narrative', source: 'http://hl7.org/cda/us/ccda/StructureDefinition/CarePlanAct', severity: error, expression: value.exists() implies value.startsWith('#')}
        index: 10
  statusCode: {short: CarePlan.status, index: 11}
  author: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Author', short: CarePlan.contributor, index: 12}
  entryRelationship:
    short: Entries can be embedded directly or referenced via EntryReference. Use the @typeCode attribute to distinguish the type of relationship.
    index: 13
    slicing:
      rules: open
      discriminator:
      - {path: typeCode, type: value}
      min: null
      slices:
        addresses:
          match: {typeCode: RSON}
          schema:
            constraint:
              act-or-observation: {human: Either act or observation SHALL be present but not both., source: 'http://hl7.org/cda/us/ccda/StructureDefinition/CarePlanAct', severity: error, expression: act.exists() or observation.exists()}
            short: '𝗨𝗦𝗖𝗗𝗜: CarePlan.addresses'
            array: true
            index: 14
            elements:
              typeCode:
                pattern: {type: Code, value: RSON}
                index: 15
              act: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Act', short: 'References an Indication, Problem Observation, or other Problem described elsewhere in the document.', index: 16}
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', short: Directly-embedded Problem or Indication observation. Use EntryReference to reference an existing problem observation or indication described elsewhere in the document., index: 17}
        goal:
          match: {typeCode: GEVL}
          schema:
            short: Desired outcome of the plan (CarePlan.goal). Can embed a Goal Observation directly or use the EntryReference template to reference a Goal Observation described elsewhere in the document.
            constraint:
              act-or-observation: {human: Either act or observation SHALL be present but not both., source: 'http://hl7.org/cda/us/ccda/StructureDefinition/CarePlanAct', severity: error, expression: act.exists() or observation.exists()}
            array: true
            index: 18
            elements:
              typeCode:
                pattern: {type: Code, value: GEVL}
                index: 19
              act:
                type: http://hl7.org/cda/stds/core/StructureDefinition/Act
                short: Use to reference a Goal Observation elsewhere
                constraint:
                  entry-ref-goal: {human: This entryReference template **SHALL** reference an instance of a Goal Observation template., source: 'http://hl7.org/cda/us/ccda/StructureDefinition/CarePlanAct', severity: error, expression: '%resource.descendants().ofType(CDA.Observation).where(templateId.exists($this.root = ''2.16.840.1.113883.10.20.22.4.121'' and $this.extension = ''2022-06-01'') and id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension))'}
                index: 20
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', short: Use to embed a Goal Observation directly, index: 21}
        supportingInfo:
          match: {typeCode: SPRT}
          schema:
            short: Information considered as part of the plan (CarePlan.supportingInfo)
            array: true
            index: 22
            elements:
              typeCode:
                pattern: {type: Code, value: SPRT}
                index: 23
        activity:
          match: {typeCode: COMP}
          schema:
            short: Activity to occur as part of plan (CarePlan.activity). Common examples include the Intervention Act and Planned Intervention Act, but any entry may be considered an activity of the care plan.
            array: true
            index: 24
            elements:
              typeCode:
                pattern: {type: Code, value: COMP}
                index: 25
              act: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Act', short: 'A care plan may have multiple COMP entryRelationships, but each entryRelationship may only have a single act/encounter/observation/supply or other clinical statement.', index: 26}
              encounter: {short: 'A care plan may have multiple COMP entryRelationships, but each entryRelationship may only have a single act/encounter/observation/supply or other clinical statement.', index: 27}
              observation: {short: 'A care plan may have multiple COMP entryRelationships, but each entryRelationship may only have a single act/encounter/observation/supply or other clinical statement.', index: 28}
              supply: {short: 'A care plan may have multiple COMP entryRelationships, but each entryRelationship may only have a single act/encounter/observation/supply or other clinical statement.', index: 29}
package_version: 5.0.0-ballot
class: logical
kind: logical
url: http://hl7.org/cda/us/ccda/StructureDefinition/CarePlanAct
base: http://hl7.org/cda/stds/core/StructureDefinition/Act
version: 5.0.0-ballot
required: [statusCode, templateId]