Narrativa gerada: StructureDefinition br-core-careplan Nome Bandeiras Card. Tipo Descrição e condicionalismos CarePlan CarePlan #xD; id 0..1 id Identificador lógico deste artefato #xD; meta 0..1 Meta Metadados sobre o recurso #xD; implicitRules 0..1 uri Um conjunto de regras sob as quais este conteúdo foi criado #xD; language 0..1 code Idioma do recurso #xD; text 0..1 Narrative Resumo do texto do recurso em linguagem natural #xD; contained 0..* Resource Recursos contidos no recurso #xD; extension 0..* Extension Extensões adicionais que não fazem parte do modelo base #xD; modifierExtension 0..* Extension Extensões adicionais que não podem ser ignoradas, mesmo que não reconhecidas #xD; identifier 0..* Identifier Identificadores externos para este recurso #xD; instantiatesCanonical 0..* canonical(PlanDefinition | Questionnaire | Measure | ActivityDefinition | OperationDefinition) Instância o protocolo ou definição FHIR #xD; instantiatesUri 0..* uri uri da instância do protocolo ou definição FHIR #xD; basedOn 0..* Reference(BRCoreCarePlan) De acordo com o Plano de Cuidado #xD; replaces 0..* Reference(BRCoreCarePlan) Plano de Cuidado substituído por este Plano de Cuidado #xD; partOf 0..* Reference(BRCoreCarePlan) Parte do Plano de Cuidado referenciado #xD; status 1..1 code O status desse Plano de Cuidado: draft | active | on-hold | revoked | completed | entered-in-error | unknown #xD; intent 1..1 code Propósito do Plano de Cuidado definido: proposal | plan | order | option #xD; category 0..* CodeableConcept Tipo de Plano de Cuidado #xD; title 0..1 string Nome do Plano de Cuidado #xD; description 1..1 string Descrição do Plano de Cuidado #xD; subject 1..1 Reference(BRCorePatient) Paciente referenciado pelo Plano de Cuidado #xD; encounter 0..1 Reference(br-core-encounter) Atendimento referenciado pelo Plano de Cuidado #xD; period 0..1 Period O período de tempo que o Plano de Cuidado abrange #xD; created 0..1 dateTime Data de criação do Plano de Cuidado #xD; author 0..1 Reference(BRCorePractitioner | BRCorePractitionerRole | BRCoreOrganization | BRCorePatient | BRCoreRelatedPerson | Device | CareTeam) Autoria do Plano de Cuidado #xD; contributor 0..* Reference(BRCorePractitioner | BRCorePractitionerRole | BRCoreOrganization | BRCorePatient | BRCoreRelatedPerson | Device | CareTeam) Colaboradores na definição do Plano de Cuidado #xD; careTeam 0..* Reference(CareTeam) Equipe assistêncial envolvida no Plano de Cuidado #xD; addresses 0..1 Reference(BRCoreCondition) Problemas de saúde referenciado neste Plano de Cuidado #xD; supportingInfo 0..* Reference(Resource) Informações adicionais do Plano de Cuidado #xD; goal 0..* Reference(Goal) Resultado esperado do Plano de Cuidado #xD; activity 1..1 BackboneElement Atividade parte do Plano de Cuidado #xD; id 0..1 string Identificador único para referência cruzada #xD; extension 0..* Extension Extensões adicionais que não fazem parte do modelo de dados básico #xD; modifierExtension 0..* Extension Extensões adicionais que não podem ser ignoradas, mesmo que não reconhecidas #xD; outcomeCodeableConcept 0..* CodeableConcept Resultados da atividade #xD; outcomeReference 0..* Reference(Resource) Referência à 'Appointment', 'Encounter', 'Procedure', etc #xD; progress 0..* Annotation Comentários sobre o status/progresso da atividade #xD; reference 0..1 Reference(Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription | RequestGroup) Detalhes da atividade definidos em recursos específicos #xD; detail 1..1 BackboneElement Definição da atividade #xD; id 0..1 string Identificador único para referência cruzada #xD; modifierExtension 0..* Extension Extensões que não podem ser ignoradas #xD; kind 0..1 code Tipos de recursos definidos como parte do FHIR que podem ser representados como definições em conformidade de uma atividade do Plano de Cuidados #xD; instantiatesCanonical 0..* canonical(PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition) Instância o protocolo ou definição FHIR #xD; instantiatesUri 0..* uri Instância protocolo externo ou definição #xD; code 0..1 CodeableConcept Código da atividade Vínculo: BR Subgrupo Tabela SUS (required) #xD; reasonCode 0..* CodeableConcept Por quê a atividade deve ser feita ou por quê a atividade foi proibida #xD; reasonReference 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Por quê a atividade é necessária #xD; goal 0..* Reference(Goal) Objetivos da atividade #xD; status 1..1 code Código que reflete o estado atual de uma atividade do Planos de Cuidado #xD; statusReason 0..1 CodeableConcept Motivo do status atual #xD; doNotPerform 0..1 boolean Se for verdade, a atividade não deve ser realizada #xD; scheduled[x] 1..1 Timing, Period, string Quando a atividade deve ocorrer #xD; location 0..1 Reference(Location) Onde a atividade deve ocorrer #xD; performer 0..* Reference(Practitioner | PractitionerRole | Organization | RelatedPerson | Patient | CareTeam | HealthcareService | Device) Responsável pela atividade #xD; product[x] 0..1 CodeableConcept, Reference(Medication | Substance) O que deve ser administrado/fornecido #xD; dailyAmount 0..1 SimpleQuantity Quantidade diária a ser consumida/fornecida/administrada #xD; quantity 0..1 SimpleQuantity Quantidade a ser consumida/fornecida/administrada #xD; description 1..1 string Descrição da atividade a ser realizada #xD; note 0..* Annotation Comentários sobre o Planos de Cuidado #xD; Documentação para este formato
Este perfil restringe o recurso [CarePlan](https://hl7.org/fhir/R4/careplan.html) que descreve a intenção de como um ou mais profissionais pretendem prestar cuidados a um determinado paciente, grupo ou comunidade por um período de tempo, possivelmente limitado ao cuidado de uma condição específica ou conjunto de condições
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.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
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()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
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()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Um conjunto de regras sob as quais este conteúdo foi criado
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.
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
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).
Resumo do texto do recurso em linguagem natural
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.
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.
Extensões adicionais que não fazem parte do modelo base
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
Extensões adicionais que não podem ser ignoradas, mesmo que não reconhecidas
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Identificadores externos para este recurso
This is a business identifier, not a resource identifier (see [discussion](http://hl7.org/fhir/R4/resource.html#identifiers)). 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.
Allows identification of the care plan as it is known by various participating systems and in a way that remains consistent across servers.
uri da instância do protocolo ou definição FHIR
This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
Allows tracing of the care plan and tracking whether proposals/recommendations were acted upon.
Plano de Cuidado substituído por este Plano de Cuidado
The replacement could be because the initial care plan was immediately rejected (due to an issue) or because the previous care plan was completed, but the need for the action described by the care plan remains ongoing.
Allows tracing the continuation of a therapy or administrative process instantiated through multiple care plans.
Each care plan is an independent request, such that having a care plan be part of another care plan can cause issues with cascading statuses. As such, this element is still being discussed.
O status desse Plano de Cuidado: draft | active | on-hold | revoked | completed | entered-in-error | unknown
The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the care plan. This element is labeled as a modifier because the status contains the code entered-in-error that marks the plan as not currently valid.
Allows clinicians to determine whether the plan is actionable or not.
This element is labeled 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
Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
Request.status {uses different ValueSet}
.statusCode planned = new active = active completed = completed
Propósito do Plano de Cuidado definido: proposal | plan | order | option
This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.
Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.
This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request"
Codes indicating the degree of authority/intentionality associated with a care plan.
There may be multiple axes of categorization and one plan may serve multiple purposes. In some cases, this may be redundant with references to CarePlan.concern.
Used for filtering what plan(s) are retrieved and displayed to different types of users.
Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.
Provides more detail than conveyed by category.
Paciente referenciado pelo Plano de Cuidado
Atendimento referenciado pelo Plano de Cuidado
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. CarePlan activities conducted as a result of the care plan may well occur as part of other encounters.
O período de tempo que o Plano de Cuidado abrange
Any activities scheduled as part of the plan should be constrained to the specified period regardless of whether the activities are planned within a single encounter/episode or across multiple encounters/episodes (e.g. the longitudinal management of a chronic condition).
Allows tracking what plan(s) are in effect at a particular time.
The author may also be a contributor. For example, an organization can be an author, but not listed as a contributor.
Colaboradores na definição do Plano de Cuidado
Collaborative care plans may have multiple contributors.
Equipe assistêncial envolvida no Plano de Cuidado
Allows representation of care teams, helps scope care plan. In some cases may be a determiner of access permissions.
Request.performer {similar but does not entail CareTeam}
Problemas de saúde referenciado neste Plano de Cuidado
When the diagnosis is related to an allergy or intolerance, the Condition and AllergyIntolerance resources can both be used. However, to be actionable for decision support, using Condition alone is not sufficient as the allergy or intolerance condition needs to be represented as an AllergyIntolerance.
Links plan to the conditions it manages. The element can identify risks addressed by the plan as well as active conditions. (The Condition resource can include things like "at risk for hypertension" or "fall risk".) Also scopes plans - multiple plans may exist addressing different concerns.
.actRelationship[typeCode=SUBJ].target[classCode=CONC, moodCode=EVN]
Informações adicionais do Plano de Cuidado
Use "concern" to identify specific conditions addressed by the care plan.
Identifies barriers and other considerations associated with the care plan.
Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline.
Provides context for plan. Allows plan effectiveness to be evaluated by clinicians.
Allows systems to prompt for performance of planned activities, and validate plans against best practice.
not(exists(f:detail)) or not(exists(f:reference))
{no mapping NOTE: This is a list of contained Request-Event tuples!}
Identificador único para referência cruzada
Extensões adicionais que não fazem parte do modelo de dados básico
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Note that this should not duplicate the activity status (e.g. completed or in progress).
Referência à 'Appointment', 'Encounter', 'Procedure', etc
The activity outcome is independent of the outcome of the related goal(s). For example, if the goal is to achieve a target body weight of 150 lbs and an activity is defined to diet, then the activity outcome could be calories consumed whereas the goal outcome is an observation for the actual body weight measured.
{Event that is outcome of Request in activity.reference}
Comentários sobre o status/progresso da atividade
This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description.
Can be used to capture information about adherence, progress, concerns, etc.
.inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value
Detalhes da atividade definidos em recursos específicos
Standard extension exists ([resource-pertainsToGoal](http://hl7.org/fhir/R4/extension-resource-pertainstogoal.html)) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference. The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should *not* point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.
Details in a form consistent with other applications and contexts of use.
{Request that resulted in Event in activity.actionResulting}
Details in a simple form for generic care plan systems.
.outboundRelationship[typeCode=COMP, subsetCode=SUMM].target
Additional content defined by implementations
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.
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.
Tipos de recursos definidos como parte do FHIR que podem ser representados como definições em conformidade de uma atividade do Plano de Cuidados
May determine what types of extensions are permitted.
Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity.
Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity.
Instância protocolo externo ou definição
Tends to be less relevant for activities involving particular products. Codes should not convey negation - use "prohibited" instead.
Allows matching performed to planned as well as validation against protocols.
Por quê a atividade deve ser feita ou por quê a atividade foi proibida
This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonCondition instead.
Identifies why a care plan activity is needed. Can include any health condition codes as well as such concepts as "general wellness", prophylaxis, surgical preparation, etc.
Conditions can be identified at the activity level that are not identified as reasons for the overall plan.
So that participants know the link explicitly.
Código que reflete o estado atual de uma atividade do Planos de Cuidado
Some aspects of status can be inferred based on the resources linked in actionTaken. Note that "status" is only as current as the plan was most recently updated. The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the activity.
Indicates progress against the plan, whether the activity is still relevant for the plan.
This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the activity should not be treated as valid
Codes that reflect the current state of a care plan activity within its overall life cycle.
.statusCode not-started = new scheduled = not-started (and fulfillment relationship to appointent) in-progress = active on-hold = suspended completed = completed cancelled = aborted
Will generally not be present if status is "complete". Be sure to prompt to update this (or at least remove the existing value) if the status is changed.
Se for verdade, a atividade não deve ser realizada
This element is labeled as a modifier because it marks an activity as an activity that is not to be performed.
Captures intention to not do something that may have been previously typical.
If missing indicates that the described activity is one that should be engaged in when following the plan.
If true this element negates the specified action. For example, instead of a request for a procedure, it is a request for the procedure to not occur.
Allows prompting for activities and detection of missed planned activities.
May reference a specific clinical location or may identify a type of location.
A performer MAY also be a participant in the care plan.
PRT-5 : ( PRV-4 = (provider participations)); PRT-5 : ( PRV-4 = (non-provider person participations )) ; PRT-5 : ( PRV-4 = (patient non-subject of care) ) ; PRT-8
A product supplied or administered as part of a care plan activity.
Quantidade diária a ser consumida/fornecida/administrada
Quantidade a ser consumida/fornecida/administrada
Used to capture information that applies to the plan as a whole that doesn't fit into discrete elements.