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CareTeam Profile

Canonical../StructureDefinition/nexus-emr-core-careteam
Statusdraft · 1.26.0
BaseCareTeam (constraint)
SourceFSH · JSON

Nexus EMR profile for CareTeam, capturing the care providers associated with a patient (e.g. most-responsible physician, nurse, midwife, referring physician). Backs the Patient Profile Care Providers section.

Overview

Overview

The Nexus EMR Core CareTeam profile carries the care providers associated with a single patient — the most-responsible physician, nurse, midwife, and referring physician. It backs the "Care Providers" section of the Patient Profile, so in practice one CareTeam describes one patient's provider relationships rather than a team assembled for an episode of care.

subject is 1..1 MS and restricted to Reference(Patient): a CareTeam in this IG always names the patient it serves. The profile declares no effective date. A care team is a relationship, not a dated event, and period is the team's validity window rather than a clinical effective time — the same call NexusEmrCorePractitionerRole makes.

Roles, including the one FHIR has no code for

participant.role is 0..* and bound extensible to http://hl7.org/fhir/ValueSet/participant-role. The roles this IG expects are:

  • 446050000 |Primary care physician| — the most-responsible physician
  • 106292003 |Nurse|
  • 75271001 |Midwife|
  • HL7 v3 ParticipationType REF (referrer) — the referring physician

The referring physician is the case to know about. That concept has no member in the FHIR participant-role value set, so this IG uses the official v3 ParticipationType code instead, which the extensible binding permits precisely because the bound value set holds no applicable concept. Consumers matching roles by code must therefore expect codings from two systems on participant.role, not one, and must not assume every role coding is SNOMED CT. Because the binding is extensible, other roles are legal as well: render an unfamiliar role from its display rather than discarding the participant.

Participants are optional, and members are Practitioners

Two cardinalities are easy to over-assume:

  • participant is 0..*. A CareTeam with no participants at all is conformant, so a consumer must handle an empty team instead of dereferencing the first entry.
  • participant.member is 0..1 and restricted to Reference(Practitioner) only. A participant may therefore name a role with no member — a team that records "referring physician: not identified" is valid — and a member that is an Organization, RelatedPerson, or Patient is not valid here, even though base R4 permits those types.

The Practitioner-only restriction is a current-state decision, not a statement that roles are never organizational. It mirrors how the Patient profile's generalPractitioner is populated today and may be reconciled to PractitionerRole in a later revision, so treat the reference target as something to read defensively rather than something to hard-code around.

Status and exposure

CareTeam.status is inherited unchanged from base R4 (proposed | active | suspended | inactive | entered-in-error, and optional). The profile does not narrow it, so a consumer rendering current care providers filters on status itself rather than assuming every returned CareTeam is active.

meta.source (0..1 MS) identifies the EMR instance and pipeline version the resource came from, and text (0..1 MS) carries the human-readable narrative. The profile is exposed to SMART apps for read, write, and delete (careteam:read, careteam:write, careteam:delete).

Terminology bindings

Path Strength Value set
CareTeam.participant.role extensible participant-role