Story of US Core In the beginning US

Story of US Core

In the beginning…. US Core Profiles Must Support Elements

New US Realm projects were born US Realm Profiles US Core Profiles Must Support Elements US Core reuse + new

USCDI born US Realm Profiles US Core Profiles Must Support Elements Data Elements Required by Regulation (ONC, CMS, etc. ) US Core reuse + new + regulation

New US Realm Profiles – Scenario #1 US Realm Profiles US Core Profiles Must Support Elements Data Elements Required by Regulation (ONC, CMS, etc. ) Full US Core reuse + new + regulation

New US Realm Profiles – Scenario #2 US Core Profiles US Realm Profiles Must Support Elements Data Elements Required by Regulation (ONC, CMS, etc. ) Partial US Core reuse + new + regulation

New US Realm Profiles – Scenario #3 US Realm Profiles US Core Profiles Must Support Elements Data Elements Required by Regulation (ONC, CMS, etc. )

US FHIR Core Overall Principles (see prior USRSC Principles) US FHIR Core supports many use cases: Clinical, Quality, Payment, etc. USRSC needs to have visibility on Implementation Guides and profiles developed US Realm Overall need to track/monitor US realm develop to understand variability and reusability of profiles CGP need to be consulted on deviations

No US Realm SC or CGP Approval Required IF an IG developer can use the US FHIR Core Profiles as-is ● THEN then no additional rules apply IF an IG developer needs to add on (new constraints/vocabs/extensions) to an existing US FHIR Core Profile ● ● THEN IG developer needs to check HL 7 FHIR Registry for existing profiles, constraints, extensions that may overlap Add an new entry [Why = US Realm Policy issue that we need to track what’s going on]

US Realm SC or CGP Approval Required IF an IG developer needs to change an existing US FHIR Core Profile ● THEN must present deviation to CGP ○ IF in rule set, CGP reviews ■ ○ (USRSC needs to develop auto-pilot rules for CGP to apply for deviations) ELSE IF not in rule set IG Developer must present to USRSC IF an IG developer needs to do less than an existing US FHIR Core Profile ● ● ● THEN the IG developer must log a JIRA tracker, with a label to indicate that the US FHIR Core Profile should be changed to relax an existing constraint AND must present deviation to CGP to receive approval Identified Problematic Pattern: Must Support element not used in Use Case ○ Race/ethnicity/birth sex/telecom/etc.