CarePlan

Maturity Level	Security Category	Resource Category
2	Patient	Clinical

Describes the intention of how one or more practitioners intend to deliver care for a particular patient, group or community for a period of time, possibly limited to care for a specific condition or set of conditions.

Resource Content

Name	Card.	Type	Description
TU		DomainResource	Healthcare plan for patient or group
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	0..*	Identifier	External Ids for this plan
instantiatesCanonical	0..*	canonical(PlanDefinition \| Questionnaire \| Measure \| ActivityDefinition \| OperationDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	0..*	uri	Instantiates external protocol or definition
basedOn	0..*	Reference(CarePlan)	Fulfills CarePlan
replaces	0..*	Reference(CarePlan)	CarePlan replaced by this CarePlan
partOf	0..*	Reference(CarePlan)	Part of referenced CarePlan
status	1..1	code	draft \| active \| on-hold \| revoked \| completed \| entered-in-error \| unknown
intent	1..1	code	proposal \| plan \| order \| option
category	0..*	CodeableConcept	Type of plan
title	0..1	string	Human-friendly name for the care plan
description	0..1	string	Summary of nature of plan
subject	1..1	Reference(Patient \| Group)	Who the care plan is for
encounter	0..1	Reference(Encounter)	Encounter created as part of
period	0..1	Period	Time period plan covers
created	0..1	dateTime	Date record was first recorded
author	0..1	Reference(Patient \| Practitioner \| PractitionerRole \| Device \| RelatedPerson \| Organization \| CareTeam)	Who is the designated responsible party
contributor	0..*	Reference(Patient \| Practitioner \| PractitionerRole \| Device \| RelatedPerson \| Organization \| CareTeam)	Who provided the content of the care plan
careTeam	0..*	Reference(CareTeam)	Who's involved in plan?
addresses	0..*	Reference(Condition)	Health issues this plan addresses
supportingInfo	0..*	Reference(Any)	Information considered as part of plan
goal	0..*	Reference(Goal)	Desired outcome of plan
activity	0..*	BackboneElement	Action to occur as part of plan
└─ outcomeCodeableConcept	0..*	CodeableConcept	Results of the activity
└─ outcomeReference	0..*	Reference(Any)	Appointment, Encounter, Procedure, etc.
└─ progress	0..*	Annotation	Comments about the activity status/progress
└─ reference	0..1	Reference(Appointment \| CommunicationRequest \| DeviceRequest \| MedicationRequest \| NutritionOrder \| Task \| ServiceRequest \| VisionPrescription)	Activity details defined in specific resource
└─ detail	0..1	BackboneElement	In-line definition of activity
└───kind	0..1	code	Appointment \| CommunicationRequest \| DeviceRequest \| MedicationRequest \| NutritionOrder \| Task \| ServiceRequest \| VisionPrescription
└───instantiatesCanonical	0..*	canonical(PlanDefinition \| ActivityDefinition \| Questionnaire \| Measure \| OperationDefinition)	Instantiates FHIR protocol or definition
└───instantiatesUri	0..*	uri	Instantiates external protocol or definition
└───code	0..1	CodeableConcept	Detail type of activity
└───reasonCode	0..*	CodeableConcept	Why activity should be done or why activity was prohibited
└───reasonReference	0..*	Reference(Condition \| Observation \| DiagnosticReport \| DocumentReference)	Why activity is needed
└───goal	0..*	Reference(Goal)	Goals this activity relates to
└───status	1..1	code	not-started \| scheduled \| in-progress \| on-hold \| completed \| cancelled \| stopped \| unknown \| entered-in-error
└───statusReason	0..1	CodeableConcept	Reason for current status
└───doNotPerform	0..1	boolean	If true, activity is prohibiting action
└───scheduled[x]	0..1	Timing \| Period \| string	When activity is to occur
└───location	0..1	Reference(Location)	Where it should happen
└───performer	0..*	Reference(Practitioner \| PractitionerRole \| Organization \| RelatedPerson \| Patient \| CareTeam \| HealthcareService \| Device)	Who will be responsible?
└───product[x]	0..1	CodeableConcept \| Reference(Medication \| Substance)	What is to be administered/supplied
└───dailyAmount	0..1	SimpleQuantity	How to consume/day?
└───quantity	0..1	SimpleQuantity	How much to administer/supply/consume
└───description	0..1	string	Extra info describing activity to perform
note	0..*	Annotation	Comments about the plan

Search Parameters

Name	Type	Description	Expression
date	date	Time period plan covers	`CarePlan.period`
identifier	token	External Ids for this plan	`CarePlan.identifier`
patient	reference	Who the care plan is for	`CarePlan.subject.where(resolve() is Patient)`
activity-code	token	Detail type of activity	`CarePlan.activity.detail.code`
activity-date	date	Specified date occurs within period specified by CarePlan.activity.detail.scheduled[x]	`CarePlan.activity.detail.scheduled`
activity-reference	reference	Activity details defined in specific resource	`CarePlan.activity.reference`
based-on	reference	Fulfills CarePlan	`CarePlan.basedOn`
care-team	reference	Who's involved in plan?	`CarePlan.careTeam`
category	token	Type of plan	`CarePlan.category`
condition	reference	Health issues this plan addresses	`CarePlan.addresses`
encounter	reference	Encounter created as part of	`CarePlan.encounter`
goal	reference	Desired outcome of plan	`CarePlan.goal`
instantiates-canonical	reference	Instantiates FHIR protocol or definition	`CarePlan.instantiatesCanonical`
instantiates-uri	uri	Instantiates external protocol or definition	`CarePlan.instantiatesUri`
intent	token	proposal \| plan \| order \| option	`CarePlan.intent`
part-of	reference	Part of referenced CarePlan	`CarePlan.partOf`
performer	reference	Matches if the practitioner is listed as a performer in any of the "simple" activities	`CarePlan.activity.detail.performer`
replaces	reference	CarePlan replaced by this CarePlan	`CarePlan.replaces`
status	token	draft \| active \| on-hold \| revoked \| completed \| entered-in-error \| unknown	`CarePlan.status`
subject	reference	Who the care plan is for	`CarePlan.subject`

Scope and Usage

CarePlan is one of the request resources in the FHIR workflow specification.

Overview

Care Plans are used across healthcare with varying levels of complexity:

Simple Plans: Basic tracking (e.g., tetanus immunization schedules)
Complex Plans: Detailed treatment protocols (e.g., oncology plans including diet, chemotherapy, radiation, lab work, and counseling)
Special Uses:
- Veterinary care for herds/groups of animals
- Public health campaigns (education, immunization)

Implementation Approach

This resource uses an intermediate complexity approach:

Captures basic details about participants and intended actions
Does not handle complex dependencies or timing relationships
Supports additional complexity through extensions when needed

Common Use Cases

Multi-disciplinary Care
- Cross-organizational coordination
- Example: Oncology plans involving multiple specialists
Condition Management
- Nutritional plans post surgery
- Neurological plans post injury
- Pre-natal and post-partum care
- Grief management
Protocol-Based Care
- Decision support generated plans
- Clinical practice guidelines
- Examples: Stroke care, diabetes management, falls prevention
Patient-Centered Plans
- Self-maintained by patients/caregivers
- Focus on personal goals and actions

Boundaries and Relationships

Implementation Details

Activity Definition
- Can be defined inline using activity.detail
- Can reference external "request" resources
- Activities can exist independently without a CarePlan
Relationship to Conditions
- May be condition-specific
- Can be condition-independent (focused on care type or provider)

Important Distinctions

Scope Limitations
- Represents specific patient/group instances
- Not for defining generic protocols
- Protocols and order sets use PlanDefinition resource
Related Resources
- ImmunizationRecommendation preferred for immunization-specific plans
- PlanDefinition used for generic protocols

Referenced Elements

This resource is referenced by:

CarePlan

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