CarePlan

Overview

The CarePlan resource describes the intended care delivery approach for a patient, group, or community over a specific time period. It coordinates care activities, goals, and interventions across multiple healthcare providers and settings.

Important: Always validate CarePlan resource support and available operations by retrieving the current CapabilityStatement from /metadata before implementing integrations.

Resource Schema

The CarePlan resource follows the HL7 FHIR R4 CarePlan specification with Netsmart-specific extensions.

Key elements include:

• status - Draft, active, on-hold, revoked, completed, entered-in-error, unknown
• intent - Proposal, plan, order, option
• subject - Patient or group the plan is for
• period - Time period the plan covers
• author - Who is responsible for the plan
• goal - Desired outcomes
• activity - Planned activities and interventions
• addresses - Health issues addressed by the plan

Example CarePlan Resource

{
  "resourceType": "CarePlan",
  "id": "12345",
  "status": "active",
  "intent": "plan",
  "title": "Diabetes Management Plan",
  "description": "Comprehensive diabetes care plan including medication, diet, and exercise",
  "subject": {
    "reference": "Patient/12345"
  },
  "period": {
    "start": "2024-01-15",
    "end": "2024-07-15"
  },
  "created": "2024-01-15",
  "author": {
    "reference": "Practitioner/67890"
  },
  "addresses": [{
    "reference": "Condition/diabetes-12345"
  }],
  "goal": [{
    "reference": "Goal/hba1c-target"
  }],
  "activity": [{
    "detail": {
      "kind": "MedicationRequest",
      "code": {
        "coding": [{
          "system": "http://snomed.info/sct",
          "code": "33747000",
          "display": "Glucose monitoring"
        }]
      },
      "status": "in-progress",
      "description": "Monitor blood glucose twice daily"
    }
  }]
}

Supported Profiles

This API supports the following FHIR profiles:

• HL7 FHIR R4 CarePlan

Operations

The General Purpose FHIR R4 CarePlan resource supports the following standard operations. However, support varies by the targeted CareRecord or solution.

CareRecord / Solution	Create	Read	Update	Search
GEHRIMED	-	Yes	-	Yes
myAvatar	Yes	Yes	Yes	Yes
myEvolv	-	Yes	-	Yes
myUnity	-	Yes	-	Yes
Referral Manager	-	-	-	-

Search

info

Not all Netsmart solutions support CarePlan search. See supported operations table above and consult your target solution's documentation for more information.

This resource supports a combination of standard and custom search parameters in addition to the common parameters.

Standard Parameters

Name	Type	Description
date	date	Time period plan covers
patient	reference	Who the care plan is for

Search Examples

The POST method is recommended as it keeps health information out of the URL.

Production

Search Care Plans by Patient

curl -X POST https://fhir.netsmartcloud.com/v4/CarePlan/_search \
    -H "Authorization: {Bearer Token}" \
    -H "Accept: application/fhir+json" \
    -H "Content-Type: application/x-form-urlencoded" \
    -d "patient=Patient/123" \
    

Preview

Search Care Plans by Patient

curl -X POST https://fhirtest.netsmartcloud.com/v4/CarePlan/_search \
    -H "Authorization: {Bearer Token}" \
    -H "Accept: application/fhir+json" \
    -H "Content-Type: application/x-form-urlencoded" \
    -d "patient=Patient/123" \
    

Error Handling

For information about error responses when working with CarePlan resources, see Common Errors.

Common CarePlan-related errors include:

• Missing required patient reference
• Invalid status or intent values
• Malformed period dates
• Invalid goal or condition references

Integration Patterns

Care Coordination

CarePlans coordinate multiple aspects of patient care:

# Get patient's active care plans with related goals
curl -X GET "https://fhir.netsmartcloud.com/v4/CarePlan?patient=12345&status=active&_include=CarePlan:goal" \
    -H "Authorization: Bearer {token}" \
    -H "Accept: application/fhir+json"

Care Plan Monitoring

Track care plan progress and outcomes:

# Get care plan with activities and conditions
curl -X GET "https://fhir.netsmartcloud.com/v4/CarePlan/12345?_include=CarePlan:addresses&_include=CarePlan:goal" \
    -H "Authorization: Bearer {token}" \
    -H "Accept: application/fhir+json"

Workflow Integration

CarePlans often drive clinical workflows:

# Find care plans by date range
curl -X GET "https://fhir.netsmartcloud.com/v4/CarePlan?patient=12345&date=ge2024-01-01&date=le2024-12-31" \
    -H "Authorization: Bearer {token}" \
    -H "Accept: application/fhir+json"

Relationships to Other Resources

The CarePlan resource connects to many other resources in care coordination:

• Patient - The individual receiving care
• Goal - Desired outcomes defined in the care plan
• Condition - Health issues addressed by the plan
• Practitioner - Healthcare providers involved in care
• Encounter - Clinical encounters related to care plan execution
• MedicationRequest - Medications prescribed as part of care
• Procedure - Procedures planned or performed
• Organization - Healthcare organizations providing care

Support

For questions about CarePlan resource implementation or care coordination workflows, contact Netsmart support through your designated support channels.