Version 3.1.0 Draft Change Log

In order meet the proposed ONC [U.S. Core Data for Interoperability (USCDI)] regulatory requirements for access to patient data, this STU Update of the US Core Implementation Guide has added new content. Structured Documents and the Argonaut Project Team have spent the last several months reviewing, testing and providing invaluable feedback on these and other topics including most notably:

• A [US Core Provenance Profile] and [Basic Provenance] guidance on fetching Provenance for patient data.
• [Medication List Guidance] for fetching a patient's medications
• Recasting the US Core Device profile into a [US Core Implantable Device Profile]
• A US Core spO2 by [US Core Pulse Oximetry Profile]
• Updated search to support requiring search by multiple statuses
• Guidance when the source has no data
• General guidelines and considerations for DSTU2 to R4 Conversion
• Guidance for language support
• Considerations for fetching data for multiple patients
• Future considerations for times offset and timezone guidelines
• Future Considerations for writing and updating data
• Update security page to reflect current testing.
• Clarify definition of MustSupport to reflect the intent that the server must be able to populate a MustSupport element in order to claim conformance to the profile.
• Expanding bindings for Procedure and Condition codes for quality measures and other purposes.

These sections as well as several other clarifications, corrections and technical changes that are listed in the sections below have been reviewed and voted on by the members of the HL7 International Structured Documents WorkGroup who is sponsoring this STU Update comment period and reconciliation of the comments.

The following pages, page sections and artifacts have been changed for this version US Core Implementation Guide:

• 2.1.1.5 Missing Data (GF#22276 update guidance on when source has no data)
• 2.1.1.8 Language Support (GF#22753 Add language support guidance )
• 2.1.1.12 Search for Servers Requiring Status (GF#22754 Provide guidance on Search filters and hidden default values by EHRs)
• 2.1.1.13 Searching multiple patients(GF#23734 add guidance on multiple patients)
• 2.3 - Medication List Guidance (GF#22751 Add med list guidance and update MedRequest profile to support med list)
• 2.4 - Basic Provenance
• 2.5 - DSTU2 to R4 Conversion (GF#22755 Add R2 to R4 conversion and guidance)
• 2.6.1.1.3 Candidates under consideration (GF#20571 Add a Coverage Profile to US Core to Support Interactions with Payers, GF#23734 add guidance on multiple patients,GF#23778 add timezone and time offset guidance)
• 3.2.1.2 - Structure Definition US Core PractitionerRole See changes highlighted in ‘Text Summary’ tab (GF#23041 us-core-practitionerrole change cardinality of code role from 0..1 to 1..*)
• 3.8 - StructureDefinition US Core Provenance
• 3.11.1.3 - StructureDefinition US Core Patient See changes highlighted in ‘Text Summary’ tab (GF#23735 add telecom.use and address.period to Patient) Note
• 3.12 - StructureDefinition US Core Pulse Oximetry (GF#20616 Add FIO2 to vitals as isted in USCDI)
• 3.16.1.2 - StructureDefinition US Core DocumentReference See changes highlighted in ‘Text Summary’ tab (GF#22806 Update US Core DocumentReference.identifier to 0..*)
• 3.23.1.1 - StructureDefinition US Core Organization See changes highlighted in ‘Text Summary’ tab (GF#22771 Update Organization requirements to support more than just provider directory)
• 3.28.1.1 - Structure Definition US Core MedicationRequest See changes highlighted in ‘Text Summary’ tab (GF#22751 Add med list guidance and update MedRequest profile to support med list)
• 3.28.1.4 - MedicationRequest Quick Start (GF#22751 Add med list guidance and update MedRequest profile to support med list)
• 3.29 - StructureDefinition US Core Implantable Device (GF#22851 Rename US Core Device Profile, GF#19796 Clarify that this US Core Device profile is actually US Core Implanted Device Profile rather than a generic US Core Device, GF#20971 Add UDI Elements including Parsed UDI-DI and applicable UDI-PIs, GF#22901 Update Device Intro and Examples per FDA)
• 5.1.1 - US Core Encounter Type (GF#22853 Add SNOMED back to Encounter Type Value Set)
• 5.1.1 - US Core Procedure Code (GF#23053 US Core Procedure Code Value Set Description and Content Don't Match)

The following pages and sections have be removed (Links to US Core Implementation Guide (v3.0.0: STU3)):

• US Core MedicationStatement Profile and SearchParameters (GF#22751 Add med list guidance and update MedRequest profile to support med list)
• Extensible + Max-ValueSet binding for CodeableConcept Datatype (GF#23773 remove MaxValue Extension from 4 extensible valuesets)
• Syntax for searches limited by patient (GF#22750 Remove extra patient search syntax from US Core)

Other technical Corrections that cannot be highlighted since they are embeded in the JSON and XML Representations (Comments on these structures will be considered during this STU Update period).

• Added conformance expectation of SHALL for the multipleOR SearchParameter element for all status parameters. An example of this can be seen here. (GF#22756 Add SHALL support multipleOR on Statuses)
• Converted fixed values to patterns for US Core CarePlan Profile, US Core Pediatric Weight for Height Observation Profile, US Core Pediatric BMI for Age Observation Profile, US Core Practitioner Profile and US Core Organization Profile, and US Core Pulse Oximetry Profile (GF#22772 change careplan slice discriminator from pattern to slice for easier reading in diff)
• Converted fixed values to patterns for US Core CarePlan Profile, US Core Pediatric Weight for Height Observation Profile, US Core Pediatric BMI for Age Observation Profile, US Core Practitioner Profile and US Core Organization Profile, and US Core Pulse Oximetry Profile (GF#22772 change careplan slice discriminator from pattern to slice for easier reading in diff)
• Remove CapabilityStatement.rest.resource.profile elements from CapabilityStatements. (GF#23779 remove base profile element from CapabilityStatements)