Conclusions and working assumptions that will guide treatment of the patient, and recommendations for future treatment.

Data Element

Care Plan
Description

NACHC proposes to advance the data class "Care Plan" and its associated FHIR and CDA profiles into USCDI. The USCDI already supports the primary required components of the care plan: Health Concerns, Goals, Interventions (via procedures, immunizations, medications, nutrition and diet) etc) and and Outcomes (via labs, assessments, functional status, etc). The Care Plan is a framework to support care teams and patient-centered care. It is described in the Care Plan Domain Analysis Model (https://docs.google.com/document/d/1OJxtJiQMTVqRa5DtGrlZDd52gV5P8OR7x5suDvdYq4E/edit#heading=h.3c03cjrb5rok) FHIR Care Plan: http://hl7.org/fhir/careplan.html 80777-6Primary care Plan of care note C-CDA Care Plan: CDA-based care plan can be coded in LOINC as : 81215-6Care plan - recommended C-CDA R2.0 and R2.1 sections and is found at the link: https://www.hl7.org/implement/standards/product_brief.cfm?product_id=447 NACHC strongly supports the care plan as a required concept in USCDI. It currently has in production a FHIR care plan tool deployed in 6 FQHCs. Support for transmission of

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