eHealth Infrastructure (v2019.5.2)

StructureDefinition: ehealth-careteam

Introduction

The CareTeam includes all the people and organizations who plan to participate in the coordination and delivery of care for a patient. A CareTeam can be constructed for a single patient but typically handles more patients.

Scope and Usage

In the eHealth Infrastructure, a CareTeam has a lifecycle independent of Patients. A CareTeam represents an organizational unit; either a “real-world” unit such as a hospital department/care unit or a “virtual” unit spanning sectors or several real-world organizational units.

Although a CareTeam has subject and context which can reference a Patient and EpisodeOfCare, respectively, this tying of a CareTeam to a Patient context is not currently used in the eHealth Infrastructure. The subject and context have been retained for possible future use.

Instead CareTeam is intended to be referenced from CarePlan. It can be used to group practitioners from different organizations into a single CareTeam. It can also be used to assign practitioners from the same organization to more specific teams. A CareTeam can be referenced from a single CarePlan but the typical scenario is that it is referenced by multiple CarePlan instances crossing multiple Patient instances.

The intended usage is depicted here:

                    +---------------+
                    | EpisodeOfCare |           ---> :  "References"
                    +-------------+-+
                       ^          |
                       |          v
              +--------+-+      +---------+     
              | CarePlan |----->| Patient |
              +--------+-+      +---------+
                       |        
                       v         
                   +---------------+                              
                   |    CareTeam   |                              
                   +---------------+
                      |    |    |  
                      |    |    |  
                      |    |    |                                                   
       +--------------+    |    +----------------+                   
       |                   |                     |                   
       |                   |                     |                   
       v                   v                     v                   
+----------+       +--------------+       +--------------+  
| CareTeam |       | Practitioner |       | Organization |  
+----------+       +--------------+       +--------------+

Composition of CareTeams

Each CareTeam can comprise a number of other CareTeam, Practitioner, and Organization. The ability for a CareTeam to be comprised of a number of Patient and RelatedPerson as well is not currently used in the eHealth Infrastructure, but has been retained for possible future use.

There are currently no restrictions on the composition of CareTeams. The intended usage is to establish a few layers of CareTeams, but it is important to make sure that the CareTem member graph contains no cycles.

Formal Views of Profile Content

The official URL for this profile is: 

http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-careteam

This profile builds on CareTeam.

This profile was published on Wed May 29 18:05:58 UTC 2019 as a draft by ehealth.sundhed.dk.

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

This structure is derived from CareTeam

NameFlagsCard.TypeDescription & Constraintsdoco
.. CareTeam 0..*People and organizations who plan to participate in the coordination and delivery of care for a patient.
... name 1..1string
... subject 0..1Reference(eHealth Patient | Group) {r}
... context 0..1Reference(Encounter | eHealth EpisodeOfCare) {r}
... reasonReference 0..*Reference(eHealth Condition) {r}
... managingOrganization 0..*Reference(eHealth Organization) {r}

doco Documentation for this format

This structure is derived from CareTeam

NameFlagsCard.TypeDescription & Constraintsdoco
.. CareTeam I0..*People and organizations who plan to participate in the coordination and delivery of care for a patient.
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal Ids for this team
... status ?!Σ0..1codeproposed | active | suspended | inactive | entered-in-error
Binding: CareTeamStatus (required)
... category Σ0..*CodeableConceptType of team
Binding: CareTeamCategory (example)
... name Σ1..1stringName of the team, such as crisis assessment team
... subject Σ0..1Reference(eHealth Patient | Group) {r}Who care team is for
... context Σ0..1Reference(Encounter | eHealth EpisodeOfCare) {r}Encounter or episode associated with CareTeam
... period Σ0..1PeriodTime period team covers
... participant I0..*BackboneElementMembers of the team
ctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... role Σ1..1CodeableConceptType of involvement
Binding: CareTeamParticipantRole (example)
.... member Σ1..1Reference(eHealth Practitioner | eHealth RelatedPerson | eHealth Patient | eHealth Organization | eHealth CareTeam) {r}Who is involved
.... onBehalfOf Σ0..1Reference(eHealth Organization) {r}Organization of the practitioner
.... period 0..1PeriodTime period of participant
... reasonCode 0..*CodeableConceptWhy the care team exists
Binding: SNOMED CT Clinical Findings (example)
... reasonReference 0..*Reference(eHealth Condition) {r}Why the care team exists
... managingOrganization Σ0..*Reference(eHealth Organization) {r}Organization responsible for the care team
... note 0..*AnnotationComments made about the CareTeam
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... author[x] Σ0..1Reference(eHealth Practitioner | eHealth Patient | eHealth RelatedPerson), stringIndividual responsible for the annotation
.... time Σ0..1dateTimeWhen the annotation was made
.... text 1..1stringThe annotation - text content

doco Documentation for this format

Differential View

This structure is derived from CareTeam

NameFlagsCard.TypeDescription & Constraintsdoco
.. CareTeam 0..*People and organizations who plan to participate in the coordination and delivery of care for a patient.
... name 1..1string
... subject 0..1Reference(eHealth Patient | Group) {r}
... context 0..1Reference(Encounter | eHealth EpisodeOfCare) {r}
... reasonReference 0..*Reference(eHealth Condition) {r}
... managingOrganization 0..*Reference(eHealth Organization) {r}

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. CareTeam I0..*People and organizations who plan to participate in the coordination and delivery of care for a patient.
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal Ids for this team
... status ?!Σ0..1codeproposed | active | suspended | inactive | entered-in-error
Binding: CareTeamStatus (required)
... category Σ0..*CodeableConceptType of team
Binding: CareTeamCategory (example)
... name Σ1..1stringName of the team, such as crisis assessment team
... subject Σ0..1Reference(eHealth Patient | Group) {r}Who care team is for
... context Σ0..1Reference(Encounter | eHealth EpisodeOfCare) {r}Encounter or episode associated with CareTeam
... period Σ0..1PeriodTime period team covers
... participant I0..*BackboneElementMembers of the team
ctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... role Σ1..1CodeableConceptType of involvement
Binding: CareTeamParticipantRole (example)
.... member Σ1..1Reference(eHealth Practitioner | eHealth RelatedPerson | eHealth Patient | eHealth Organization | eHealth CareTeam) {r}Who is involved
.... onBehalfOf Σ0..1Reference(eHealth Organization) {r}Organization of the practitioner
.... period 0..1PeriodTime period of participant
... reasonCode 0..*CodeableConceptWhy the care team exists
Binding: SNOMED CT Clinical Findings (example)
... reasonReference 0..*Reference(eHealth Condition) {r}Why the care team exists
... managingOrganization Σ0..*Reference(eHealth Organization) {r}Organization responsible for the care team
... note 0..*AnnotationComments made about the CareTeam
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... author[x] Σ0..1Reference(eHealth Practitioner | eHealth Patient | eHealth RelatedPerson), stringIndividual responsible for the annotation
.... time Σ0..1dateTimeWhen the annotation was made
.... text 1..1stringThe annotation - text content

doco Documentation for this format

 

Terminology Bindings

PathNameConformanceValueSet
CareTeam.languageCommon LanguagesextensibleCommon Languages
CareTeam.statusCareTeamStatusrequiredCareTeamStatus
CareTeam.categoryCareTeamCategoryexampleCareTeamCategory
CareTeam.participant.roleCareTeamParticipantRoleexampleCareTeamParticipantRole
CareTeam.reasonCodeSNOMED CT Clinical FindingsexampleSNOMED CT Clinical Findings

Constraints

IdPathDetailsRequirements
dom-2CareTeamIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-1CareTeamIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-4CareTeamIf 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-3CareTeamIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
ele-1CareTeam.participantAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ctm-1CareTeam.participantCareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner
: onBehalfOf.exists() implies (member.resolve() is Practitioner)
.