HL7 FHIR® US Core Implementation Guide Edition 9.0.0 - US Realm

DESCRIPTION

This guide and the US Core profiles have become the foundation for US Realm FHIR implementation guides. This annual release reflects changes to U.S. Core Data for Interoperability (USCDI) v3 and comments and requests from the US Realm FHIR community. (The Future of US Core page outlines this approach to yearly updates.) US Core has benefitted from testing and guidance by the Argonaut Project Team. Their feedback continues to lay the groundwork for documenting the US Core Profile design, interactions, requirements, and guidelines for patient data access and ONC Certification testing. Under the guidance of HL7 and the HL7 US Realm Steering Committee, the content will expand in future versions to meet the needs specific to the US Realm.

The US Core Implementation Guide is based on FHIR Version R4. It defines the minimum constraints on the FHIR resources to create the US Core Profiles. The elements, extensions, vocabularies, and value sets that SHALL be present are identified, and how they are used is defined. It also documents the minimum FHIR RESTful interactions for each US Core Profiles to access patient data. Establishing the “floor” of standards to promote interoperability and adoption through common implementation allows for further standards development evolution for specific use cases.

ALTERNATIVE NAMES

HL7 FHIR® US Core Implementation Guide Edition 9.0.0 - US Realm may also go by the following names or acronyms:

TARGETS

• Clinical and Public Health Laboratories
• Immunization Registries
• Regulatory Agency
• Pharmaceutical Vendors
• EHR, PHR Vendors
• Equipment Vendors
• Health Care IT Vendors
• Clinical Decision Support Systems Vendors
• Emergency Services Providers
• Local and State Departments of Health
• Medical Imaging Service Providers
• Healthcare Institutions (hospitals, long term care, home care, mental health)

BENEFITS

• Encourages consistency around how data access is accomplished between healthcare systems within and across organizations between healthcare systems
• Encourages consistency around what data is accessed including vocabularies and value sets
• Encourages consistency around security standards used to allow authentication, authorization and auditing of data access

 

IMPLEMENTATIONS/CASE STUDIES

• Argonaut
• Cerner
• Epic
• Meditech

 

DEVELOPMENT BACKGROUND

The US Core Implementation Guide (available at http://hl7.org/fhir/us/core/STU9) is based on FHIR Version R4  and defines the minimum conformance requirements for accessing patient data. The Argonaut pilot implementations, ONC 2015 Edition Common Clinical Data Set (CCDS), and the ONC U.S. Core Data for Interoperability (USCDI) v2 provided the requirements for this guide. The prior Argonaut search and vocabulary requirements, based on FHIR DSTU2, are updated in this guide to support FHIR Version R4. This guide was used as the basis for further testing and guidance by the Argonaut Project Team to provide additional content and guidance specific to Data Query Access for purpose of ONC Certification testing. These profiles are the foundation for future US Realm FHIR implementation guides. In addition to Argonaut, they are used by many other US Realm implementation guides. Under the guidance of HL7 and the HL7 US Realm Steering Committee, the content will expand in future versions to meet the needs specific to the US Realm. Prior versions and detailed changes are available: http://hl7.org/fhir/us/core/history.html.

RELATED DOCUMENTS

	HL7 FHIR® US Core Implementation Guide Edition 9.0.0 - US Realm
	HL7 FHIR® R4 Implementation Guide: Electronic Long-Term Services and Supports (eLTSS) Edition 1 STU2 - US Realm	(View Brief)
	HL7 FHIR® R4 Implementation Guide: QI-Core, Edition 7.0.2 - US Realm	(View Brief)

STU DOCUMENTS

	HL7 FHIR® Implementation Guide: US-Core, Edition 9.0.0 - US Realm See the standard at '>http://hl7.org/fhir/us/core/STU9'>.	(Submit Feedback on STU)
	HL7 FHIR® Implementation Guide: US-Core, Edition 8.0.0 - US Realm See the standard at http://hl7.org/fhir/us/core/STU8.	(Submit Feedback on STU)
	HL7 FHIR® Implementation Guide: US-Core, STU7 Release 7.0.0 - US Realm See the standard at http://hl7.org/fhir/us/core/STU7.	Expiration May 2026
	HL7 FHIR® Implementation Guide: US-Core, STU4 Release 6.0.0 - US Realm See the standard at http://hl7.org/fhir/us/core/STU6.	Expiration May 2025
	HL7 FHIR® Implementation Guide: US-Core, STU4 Release 6.1.0 - US Realm See the standard at http://hl7.org/fhir/us/core/STU6.1.	Expiration May 2025
	HL7 FHIR® Implementation Guide: US-Core, STU4 Release 5.0.1 - US Realm See the standard at http://hl7.org/fhir/us/core/STU5.0.1.	Expiration May 2024
	HL7 FHIR® Implementation Guide: US-Core, STU4 Release 4.0.0 - US Realm See the standard at http://hl7.org/fhir/us/core/STU4. Submit comments here.	Expiration Jun 2023
	HL7 FHIR® US Core Implementation Guide STU 3.1.1 - US Realm See the standard at http://hl7.org/fhir/us/core/STU3.1.1.	Expiration Nov 2021
	HL7 FHIR® Profile: US-Core, Release 1.0.0 STU Please see the resource detail for link and download instructions.	Expiration Mar 2019

ADDITIONAL DETAILS

For an important clarification of the term “Must Support” as used in this guide, see the US Core Clarification Letter from 2020 October. The complete clarification statement with examples is posted at http://www.hl7.org/announce/. 

US Core 5.0.1 is a technical correction to US Core 5.0.0 to correct critical errata and update value set presentation. Detailed links to the changes are available on the specification's Change Log page.

These requirements were originally developed, balloted, and published in FHIR DSTU2 as part of the Office of the National Coordinator for Health Information Technology (ONC) sponsored Data Access Framework (DAF) project. For more information on how DAF became US Core see the US Core change notes.

TOPICS

• Healthcare Devices
• Laboratory
• Patient Care
• Pharmacy

BALLOT TYPE

• STU

STATUS DATE

2026-05-30

RESPONSIBLE WORK GROUPS

PRODUCT TYPE

• Implementation Guide

STAKEHOLDERS

• Clinical and Public Health Laboratories
• Clinical Decision Support Systems Vendors
• EHR, PHR Vendors
• Emergency Services Providers
• Equipment Vendors
• Health Care IT Vendors
• Healthcare Institutions
• Immunization Registries
• Local and State Departments of Health
• Medical Imaging Service Providers
• Pharmaceutical Vendors
• Regulatory Agency

FAMILY

• FHIR

CURRENT STATE

• Active

REALM

• US Realm