Care Plan - C-CDA Templates Implementation
- 1 Introduction
- 2 Concept Requests
- 2.1 Concept Request Tracking
- 2.2 Value Sets
- 2.2.1 Type of Care Plan
- 2.2.2 Patient Engagement in Care Plan
- 2.2.3 Patient Enrollment in Management Plan
- 2.2.4 Care Plan Review By Care Team and Patient
- 2.2.5 Condition
- 2.2.6 Goal
- 2.2.7 Health Status Evaluation Type
- 2.2.8 Outcome
- 2.2.9 Intervention Type
There is active engagement with NLM (US SNOMED-CT authority) and LOINC for needed codes.
Concept Request Tracking
Request Management System
Type of Care Plan
- Case Management
- Disease Management
- Care Plans
Patient Engagement in Care Plan
This value set provides details on what role the patient plays in the specific Care Plan, and their ongoing activity in the plan.
- Unavailable or unable to reach
- Wants additional information
- Has been reached
- Patient not interested or unwilling to engage
Patient Enrollment in Management Plan
Value set to describe the patient (or plan member) enrollment in a specific care/case/management program.
- Eligible for enrollment
- Not eligible for enrollment
- Currently eligible
- Opt-out of enrollment
- No longer enrolled
Care Plan Review By Care Team and Patient
OID: 2.16.840.1.113818.104.22.168 Value set to capture results of a Care Plan review.
Every Care Plan requires one or more associated Health Concerns. The Health Concern has an associated Condition which provides the semantics of what the Health Concern is in regards to (i.e. it names the health concern). For Disease Management plans, this would be the specific diagnosis of interest.
Abnormal Clinical Finding
Abnormal Screening or Diagnostic Study
Barrier to Care
Risk of Disease
Health Status Evaluation Type
OID: 2.16.840.1.113822.214.171.124 For Care Plans which are focused on the management a specific procedure (e.g. perioperative clinical pathways), the focal procedure will be indicated.