Breast Screening NZ FHIR Implementation Guide
1.1.0 - Release

Breast Screening NZ FHIR Implementation Guide - Local Development build (v1.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Resource Profile: BSA Care Plan

Official URL: http://hl7.org.nz/fhir/ig/bsa/StructureDefinition/BsaCarePlan | Version: 1.1.0
Draft as of 2026-07-09 | Computable Name: BSACarePlan

Describes a participant's BSA screening enrolment and pathway status

Usages:

- Examples for this Profile: Bundle/CPB1

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
CarePlan |  | 0..* | CarePlan | Healthcare plan for patient or group
Slices for extension |  | 3..* | Extension | Extension Slice: Unordered, Open by value:url
extension:programmeStatus | S | 1..1 | CodeableConcept | Programme enrollment status URL: https://breastscreening.health.nz/ig/StructureDefinition/programme-status Binding: Programme Status Value Set (required)
extension:pathwayState | S | 1..1 | CodeableConcept | Current pathway state URL: https://breastscreening.health.nz/ig/StructureDefinition/pathway-state Binding: Pathway State Value Set (required)
extension:pathwaySubstate | S | 0..1 | CodeableConcept | Current pathway substate URL: https://breastscreening.health.nz/ig/StructureDefinition/pathway-substate Binding: Pathway Sub-State Value Set (required)
extension:pathwayStateLastModified | S | 1..1 | dateTime | Date pathway state last modified URL: https://breastscreening.health.nz/ig/StructureDefinition/pathway-state-date-last-modified
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
intent | ?!S Σ | 1..1 | code | proposal | plan | order | option Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan. Fixed Value: plan
subject | S Σ | 1..1 | Reference(Patient) | NHI Id of Patient enrolled in breast screening
period | S Σ | 0..1 | Period | Enrollment period
author | S Σ | 0..1 | Reference(Organization) | Lead Provider HPI Org ID
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
CarePlan.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
CarePlan.intent | Base | required | Care Plan Intent | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | CarePlan | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | CarePlan | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | CarePlan | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | CarePlan | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | CarePlan | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from CarePlan

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
CarePlan |  | 0..* | CarePlan | Healthcare plan for patient or group
implicitRules |  | 0..0 |  | A set of rules under which this content was created
Slices for extension |  | 3..* | Extension | Extension Slice: Unordered, Open by value:url
extension:programmeStatus | S | 1..1 | CodeableConcept | Programme enrollment status URL: https://breastscreening.health.nz/ig/StructureDefinition/programme-status Binding: Programme Status Value Set (required)
extension:pathwayState | S | 1..1 | CodeableConcept | Current pathway state URL: https://breastscreening.health.nz/ig/StructureDefinition/pathway-state Binding: Pathway State Value Set (required)
extension:pathwaySubstate | S | 0..1 | CodeableConcept | Current pathway substate URL: https://breastscreening.health.nz/ig/StructureDefinition/pathway-substate Binding: Pathway Sub-State Value Set (required)
extension:pathwayStateLastModified | S | 1..1 | dateTime | Date pathway state last modified URL: https://breastscreening.health.nz/ig/StructureDefinition/pathway-state-date-last-modified
instantiatesCanonical |  | 0..0 |  | Instantiates FHIR protocol or definition
instantiatesUri |  | 0..0 |  | Instantiates external protocol or definition
basedOn |  | 0..0 |  | Fulfills CarePlan
replaces |  | 0..0 |  | CarePlan replaced by this CarePlan
partOf |  | 0..0 |  | Part of referenced CarePlan
status | S | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown
intent | S | 1..1 | code | proposal | plan | order | option Fixed Value: plan
subject | S | 1..1 | Reference(Patient) | NHI Id of Patient enrolled in breast screening
period | S | 0..1 | Period | Enrollment period
author | S | 0..1 | Reference(Organization) | Lead Provider HPI Org ID
contributor |  | 0..0 |  | Who provided the content of the care plan
careTeam |  | 0..0 |  | Who's involved in plan?
addresses |  | 0..0 |  | Health issues this plan addresses
supportingInfo |  | 0..0 |  | Information considered as part of plan
goal |  | 0..0 |  | Desired outcome of plan
activity |  | 0..0 |  | Action to occur as part of plan
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
CarePlan |  | 0..* | CarePlan | Healthcare plan for patient or group
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 3..* | Extension | Extension Slice: Unordered, Open by value:url
extension:programmeStatus | S | 1..1 | CodeableConcept | Programme enrollment status URL: https://breastscreening.health.nz/ig/StructureDefinition/programme-status Binding: Programme Status Value Set (required)
extension:pathwayState | S | 1..1 | CodeableConcept | Current pathway state URL: https://breastscreening.health.nz/ig/StructureDefinition/pathway-state Binding: Pathway State Value Set (required)
extension:pathwaySubstate | S | 0..1 | CodeableConcept | Current pathway substate URL: https://breastscreening.health.nz/ig/StructureDefinition/pathway-substate Binding: Pathway Sub-State Value Set (required)
extension:pathwayStateLastModified | S | 1..1 | dateTime | Date pathway state last modified URL: https://breastscreening.health.nz/ig/StructureDefinition/pathway-state-date-last-modified
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External Ids for this plan
status | ?!S Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
intent | ?!S Σ | 1..1 | code | proposal | plan | order | option Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan. Fixed Value: plan
category | Σ | 0..* | CodeableConcept | Type of plan Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.
title | Σ | 0..1 | string | Human-friendly name for the care plan
description | Σ | 0..1 | string | Summary of nature of plan
subject | S Σ | 1..1 | Reference(Patient) | NHI Id of Patient enrolled in breast screening
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
period | S Σ | 0..1 | Period | Enrollment period
created | Σ | 0..1 | dateTime | Date record was first recorded
author | S Σ | 0..1 | Reference(Organization) | Lead Provider HPI Org ID
note |  | 0..* | Annotation | Comments about the plan
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
CarePlan.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
CarePlan.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
CarePlan.intent | Base | required | Care Plan Intent | 📍4.0.1 | FHIR Std.
CarePlan.category | Base | example | Care Plan Category | 📍4.0.1 | FHIR Std.
CarePlan.activity.outcomeCodeableConcept | Base | example | Care Plan Activity Outcome | 📍4.0.1 | FHIR Std.
CarePlan.activity.detail.​kind | Base | required | Care Plan Activity Kind | 📍4.0.1 | FHIR Std.
CarePlan.activity.detail.​code | Base | example | Procedure Codes (SNOMED CT) | 📍4.0.1 | FHIR Std.
CarePlan.activity.detail.​reasonCode | Base | example | SNOMED CT Clinical Findings | 📍4.0.1 | FHIR Std.
CarePlan.activity.detail.​status | Base | required | CarePlanActivityStatus | 📍4.0.1 | FHIR Std.
CarePlan.activity.detail.​product[x] | Base | example | SNOMED CT Medication Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | CarePlan | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | CarePlan | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | CarePlan | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | CarePlan | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | CarePlan | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from CarePlan

Summary

Mandatory: 3 elements
Must-Support: 9 elements
Fixed: 1 element
Prohibited: 12 elements

Extensions

This structure refers to these extensions:

- https://breastscreening.health.nz/ig/StructureDefinition/programme-status
- https://breastscreening.health.nz/ig/StructureDefinition/pathway-state
- https://breastscreening.health.nz/ig/StructureDefinition/pathway-substate
- https://breastscreening.health.nz/ig/StructureDefinition/pathway-state-date-last-modified

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
CarePlan |  | 0..* | CarePlan | Healthcare plan for patient or group
Slices for extension |  | 3..* | Extension | Extension Slice: Unordered, Open by value:url
extension:programmeStatus | S | 1..1 | CodeableConcept | Programme enrollment status URL: https://breastscreening.health.nz/ig/StructureDefinition/programme-status Binding: Programme Status Value Set (required)
extension:pathwayState | S | 1..1 | CodeableConcept | Current pathway state URL: https://breastscreening.health.nz/ig/StructureDefinition/pathway-state Binding: Pathway State Value Set (required)
extension:pathwaySubstate | S | 0..1 | CodeableConcept | Current pathway substate URL: https://breastscreening.health.nz/ig/StructureDefinition/pathway-substate Binding: Pathway Sub-State Value Set (required)
extension:pathwayStateLastModified | S | 1..1 | dateTime | Date pathway state last modified URL: https://breastscreening.health.nz/ig/StructureDefinition/pathway-state-date-last-modified
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
intent | ?!S Σ | 1..1 | code | proposal | plan | order | option Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan. Fixed Value: plan
subject | S Σ | 1..1 | Reference(Patient) | NHI Id of Patient enrolled in breast screening
period | S Σ | 0..1 | Period | Enrollment period
author | S Σ | 0..1 | Reference(Organization) | Lead Provider HPI Org ID
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
CarePlan.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
CarePlan.intent | Base | required | Care Plan Intent | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | CarePlan | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | CarePlan | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | CarePlan | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | CarePlan | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | CarePlan | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from CarePlan

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
CarePlan |  | 0..* | CarePlan | Healthcare plan for patient or group
implicitRules |  | 0..0 |  | A set of rules under which this content was created
Slices for extension |  | 3..* | Extension | Extension Slice: Unordered, Open by value:url
extension:programmeStatus | S | 1..1 | CodeableConcept | Programme enrollment status URL: https://breastscreening.health.nz/ig/StructureDefinition/programme-status Binding: Programme Status Value Set (required)
extension:pathwayState | S | 1..1 | CodeableConcept | Current pathway state URL: https://breastscreening.health.nz/ig/StructureDefinition/pathway-state Binding: Pathway State Value Set (required)
extension:pathwaySubstate | S | 0..1 | CodeableConcept | Current pathway substate URL: https://breastscreening.health.nz/ig/StructureDefinition/pathway-substate Binding: Pathway Sub-State Value Set (required)
extension:pathwayStateLastModified | S | 1..1 | dateTime | Date pathway state last modified URL: https://breastscreening.health.nz/ig/StructureDefinition/pathway-state-date-last-modified
instantiatesCanonical |  | 0..0 |  | Instantiates FHIR protocol or definition
instantiatesUri |  | 0..0 |  | Instantiates external protocol or definition
basedOn |  | 0..0 |  | Fulfills CarePlan
replaces |  | 0..0 |  | CarePlan replaced by this CarePlan
partOf |  | 0..0 |  | Part of referenced CarePlan
status | S | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown
intent | S | 1..1 | code | proposal | plan | order | option Fixed Value: plan
subject | S | 1..1 | Reference(Patient) | NHI Id of Patient enrolled in breast screening
period | S | 0..1 | Period | Enrollment period
author | S | 0..1 | Reference(Organization) | Lead Provider HPI Org ID
contributor |  | 0..0 |  | Who provided the content of the care plan
careTeam |  | 0..0 |  | Who's involved in plan?
addresses |  | 0..0 |  | Health issues this plan addresses
supportingInfo |  | 0..0 |  | Information considered as part of plan
goal |  | 0..0 |  | Desired outcome of plan
activity |  | 0..0 |  | Action to occur as part of plan
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
CarePlan |  | 0..* | CarePlan | Healthcare plan for patient or group
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 3..* | Extension | Extension Slice: Unordered, Open by value:url
extension:programmeStatus | S | 1..1 | CodeableConcept | Programme enrollment status URL: https://breastscreening.health.nz/ig/StructureDefinition/programme-status Binding: Programme Status Value Set (required)
extension:pathwayState | S | 1..1 | CodeableConcept | Current pathway state URL: https://breastscreening.health.nz/ig/StructureDefinition/pathway-state Binding: Pathway State Value Set (required)
extension:pathwaySubstate | S | 0..1 | CodeableConcept | Current pathway substate URL: https://breastscreening.health.nz/ig/StructureDefinition/pathway-substate Binding: Pathway Sub-State Value Set (required)
extension:pathwayStateLastModified | S | 1..1 | dateTime | Date pathway state last modified URL: https://breastscreening.health.nz/ig/StructureDefinition/pathway-state-date-last-modified
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External Ids for this plan
status | ?!S Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
intent | ?!S Σ | 1..1 | code | proposal | plan | order | option Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan. Fixed Value: plan
category | Σ | 0..* | CodeableConcept | Type of plan Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.
title | Σ | 0..1 | string | Human-friendly name for the care plan
description | Σ | 0..1 | string | Summary of nature of plan
subject | S Σ | 1..1 | Reference(Patient) | NHI Id of Patient enrolled in breast screening
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
period | S Σ | 0..1 | Period | Enrollment period
created | Σ | 0..1 | dateTime | Date record was first recorded
author | S Σ | 0..1 | Reference(Organization) | Lead Provider HPI Org ID
note |  | 0..* | Annotation | Comments about the plan
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
CarePlan.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
CarePlan.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
CarePlan.intent | Base | required | Care Plan Intent | 📍4.0.1 | FHIR Std.
CarePlan.category | Base | example | Care Plan Category | 📍4.0.1 | FHIR Std.
CarePlan.activity.outcomeCodeableConcept | Base | example | Care Plan Activity Outcome | 📍4.0.1 | FHIR Std.
CarePlan.activity.detail.​kind | Base | required | Care Plan Activity Kind | 📍4.0.1 | FHIR Std.
CarePlan.activity.detail.​code | Base | example | Procedure Codes (SNOMED CT) | 📍4.0.1 | FHIR Std.
CarePlan.activity.detail.​reasonCode | Base | example | SNOMED CT Clinical Findings | 📍4.0.1 | FHIR Std.
CarePlan.activity.detail.​status | Base | required | CarePlanActivityStatus | 📍4.0.1 | FHIR Std.
CarePlan.activity.detail.​product[x] | Base | example | SNOMED CT Medication Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | CarePlan | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | CarePlan | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | CarePlan | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | CarePlan | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | CarePlan | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from CarePlan

Summary

Mandatory: 3 elements
Must-Support: 9 elements
Fixed: 1 element
Prohibited: 12 elements

Extensions

This structure refers to these extensions:

- https://breastscreening.health.nz/ig/StructureDefinition/programme-status
- https://breastscreening.health.nz/ig/StructureDefinition/pathway-state
- https://breastscreening.health.nz/ig/StructureDefinition/pathway-substate
- https://breastscreening.health.nz/ig/StructureDefinition/pathway-state-date-last-modified

Other representations of profile: CSV, Excel, Schematron