2026 US Quality Core Implementation Guide
0.5.0 - release United States of America flag

This page is part of the US Quality Core (v0.5.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

US Quality Core Profiles

US Quality Core Profiles

The following table lists the US Quality Core profiles that are part of the IG, which US Core profile they are derived from, if any, and the underlying FHIR resources.

US Quality Core inherits all profiles from QI-Core 6.0.0, but not all profiles included in this guide are required for conformance. Implementations are expected to support profiles with at least one USCDI+ Quality flagged data element, as described in the Summary of Conformance Requirements and the USCDI+ Quality in-scope and out-of-scope profile summaries. Profiles that are not part of the conformance expectations of this guide are marked with an asterisk (*) in the US Quality Core profile column.


US Quality Core (0.5.0) Profile US Core (6.1.0) Profile Base Resource
2.1.1 AdverseEvent    
  US Quality Core AdverseEvent —   AdverseEvent
2.1.2 AllergyIntolerance    
  US Quality Core AllergyIntolerance US Core AllergyIntolerance   AllergyIntolerance
2.1.3 BodyStructure    
  US Quality Core BodyStructure* —   BodyStructure
2.1.4 CarePlan    
  US Quality Core CarePlan US Core CarePlan   CarePlan
2.1.5 CareTeam    
  US Quality Core CareTeam US Core CareTeam   CareTeam
2.1.6 Claim    
  US Quality Core Claim* —   Claim
2.1.7 ClaimResponse    
  US Quality Core ClaimResponse* —   ClaimResponse
2.1.8 Communication    
  US Quality Core Communication* —   Communication
  US Quality Core Communication Not Done* —   Communication
2.1.9 CommunicationRequest    
  US Quality Core CommunicationRequest* —   CommunicationRequest
2.1.10 Condition    
  US Quality Core Condition Encounter Diagnosis US Core Condition Encounter Diagnosis   Condition
  US Quality Core Condition Problems Health Concerns US Core Condition Problems Health Concerns   Condition
2.1.11 Coverage    
  US Quality Core Coverage US Core Coverage   Coverage
2.1.12 Device    
  US Quality Core Device* —   Device
— US Core Implantable Device   Device
2.1.13 DeviceRequest    
  US Quality Core Device Not Requested —   DeviceRequest
  US Quality Core DeviceRequest —   DeviceRequest
2.1.14 DeviceUseStatement    
  US Quality Core DeviceUseStatement* —   DeviceUseStatement
2.1.15 DiagnosticReport    
  US Quality Core DiagnosticReport Profile for Laboratory Results Reporting  US Core DiagnosticReport Profile for Laboratory Results Reporting   DiagnosticReport
  US Quality Core DiagnosticReport Profile for Report and Note Exchange US Core DiagnosticReport Profile for Report and Note Exchange   DiagnosticReport
2.1.16 Encounter    
  US Quality Core Encounter US Core Encounter   Encounter
2.1.17 FamilyMemberHistory    
  US Quality Core FamilyMemberHistory —   FamilyMemberHistory
2.1.18 Flag    
  US Quality Core Flag* —   Flag
2.1.19 Goal    
  US Quality Core Goal US Core Goal   Goal
2.1.20 ImagingStudy    
  US Quality Core ImagingStudy* —   ImagingStudy
2.1.21 Immunization    
  US Quality Core Immunization US Core Immunization   Immunization
  US Quality Core Immunization Not Done US Core Immunization   Immunization
2.1.22 ImmunizationEvaluation    
  US Quality Core ImmunizationEvaluation* —   ImmunizationEvaluation
2.1.23 ImmunizationRecommendation    
  US Quality Core ImmunizationRecommendation* —   ImmunizationRecommendation
2.1.24 Location    
  US Quality Core Location US Core Location   Location
2.1.25 Medication    
  US Quality Core Medication US Core Medication   Medication
2.1.26 MedicationAdministration    
  US Quality Core MedicationAdministration —   MedicationAdministration
  US Quality Core MedicationAdministration Not Done —   MedicationAdministration
2.1.27 MedicationDispense    
  US Quality Core MedicationDispense US Core MedicationDispense   MedicationDispense
  US Quality Core MedicationDispense Declined US Core MedicationDispense   MedicationDispense
2.1.28 MedicationRequest    
  US Quality Core Medication Not Requested US Core MedicationRequest   MedicationRequest
  US Quality Core MedicationRequest US Core MedicationRequest   MedicationRequest
2.1.29 MedicationStatement    
  US Quality Core MedicationStatement* —   MedicationStatement
2.1.30 NutritionOrder    
  US Quality Core NutritionOrder* —   NutritionOrder
2.1.31 Observation    
  US Quality Core Simple Observation US Core Simple Observation   Observation
  US Quality Core Observation Cancelled —   Observation
  US Quality Core NonPatient Observation* —   Observation
  US Quality Core Laboratory Result Observation US Core Laboratory Result Observation   Observation
  US Quality Core Observation Clinical Result US Core Observation Clinical Result   Observation
  US Quality Core Observation Screening Assessment US Core Observation Screening Assessment   Observation
— US Core Vital Signs Observation
— US Core Blood Pressure Observation
— US Core BMI Observation
— US Core Body Height Observation
— US Core Body Temperature Observation
— US Core Body Weight Observation
— US Core Head Circumference Observation
— US Core Heart Rate Observation
— US Core Pediatric BMI for Age Observation Observation
— US Core Pediatric Head Occipital-frontal Circumference Percentile Observation
— US Core Pediatric Weight for Height Observation Observation
— US Core Pulse Oximetry Observation
— US Core Respiratory Rate Observation
— US Core Smoking Status Observation
— US Core Observation Occupation Observation
— US Core Observation Sexual Orientation Observation
— US Core Observation Pregnancy Intent Observation
— US Core Observation Pregnancy Status Observation
2.1.32 Organization    
  US Quality Core Organization US Core Organization   Organization
2.1.33 Patient    
  US Quality Core Patient US Core Patient   Patient
2.1.34 Practitioner    
  US Quality Core Practitioner US Core Practitioner   Practitioner
2.1.35 PractitionerRole    
  US Quality Core PractitionerRole US Core PractitionerRole   PractitionerRole
2.1.36 Procedure    
  US Quality Core Procedure US Core Procedure   Procedure
  US Quality Core Procedure Not Done US Core Procedure   Procedure
2.1.37 QuestionnaireResponse    
  US Quality Core QuestionnaireResponse* US Core QuestionnaireResponse   QuestionnaireResponse
2.1.38 RelatedPerson    
  US Quality Core RelatedPerson   US Core RelatedPerson   RelatedPerson
2.1.39 ServiceRequest    
  US Quality Core Service Not Requested   US Core ServiceRequest   ServiceRequest
  US Quality Core ServiceRequest   US Core ServiceRequest   ServiceRequest
2.1.40 Specimen    
— US Core Specimen   Specimen
2.1.41 Substance    
  US Quality Core Substance* —   Substance
2.1.42 Task    
  US Quality Core Task —   Task
  US Quality Core Task Rejected —   Task

Referencing US Quality Core Profiles

There are a number of US Quality Core profiles inherited directly from US Core profiles, if any, or other FHIR resources (i.e. US Core Implantable Device Profile, FHIR Vital Signs, US Core Smoking Status etc.) and the underlying Reference elements can address the US Core or FHIR profiles for the items referenced. For any other references to base FHIR resources or not formally defined in a US Quality Core Profile, the referenced resource SHALL be a US Quality Core Profile if a US Quality Core Profile exists for the resource type. For example, US Core Smoking Status references US Core Patient profile, the reference to Patient SHALL be a valid US Quality Core Patient.

Note to Implementers: US Quality Core profiles have been developed with the principle that if the profiles only need to provide references to US Quality Core Profiles, that is insufficient to require individual US Quality Core profiles for all US Core profiles. There are edge cases using this approach where the FHIR validator would not validate an assumption made by the measure author, such as that an encounter traced through an observation is a US Quality Core Encounter. We think that general validation of all the resources provided to the context of a measure evaluation can address that risk without the need for deriving specific profiles that only constrain reference types. We seek feedback on this point.

This change will strengthen the requirement to use a US Quality Core profile when using a base FHIR or US Core profile not formally defined in US Quality Core and to use US Quality Core profiles as referenced resources if a US Quality Core Profile exists for that resource.