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VA Technical Reference Model v 26.1

HL7 FHIR US Core Implementation Guide
HL7 FHIR US Core Implementation Guide Standard or Specification

General Information

Technologies must be operated and maintained in accordance with Federal and Department security and privacy policies and guidelines. More information on the proper use of the TRM can be found on the TRM Proper Use Tab/Section.

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Description: This guide and the US Core profiles have become the foundation for US Realm FHIR implementation guides. This annual release reflects changes to U.S. Core Data for Interoperability (USCDI) v3 and comments and requests from the US Realm FHIR community. (The Future of US Core page outlines this approach to yearly updates.) US Core has benefitted from testing and guidance by the Argonaut Project Team. Their feedback continues to lay the groundwork for documenting the US Core Profile design, interactions, requirements, and guidelines for patient data access and ONC Certification testing. Under the guidance of HL7 and the HL7 US Realm Steering Committee, the content will expand in future versions to meet the needs specific to the US Realm.

The US Core Implementation Guide is based on FHIR Version R4. It defines the minimum constraints on the FHIR resources to create the US Core Profiles. The elements, extensions, vocabularies, and value sets that SHALL be present are identified, and how they are used is defined. It also documents the minimum FHIR RESTful interactions for each US Core Profiles to access patient data. Establishing the “floor” of standards to promote interoperability and adoption through common implementation allows for further standards development evolution for specific use cases.
Technology/Standard Usage Requirements: Users must ensure their use of this technology/standard is consistent with VA policies and standards, including, but not limited to, VA Handbooks 6102 and 6500; VA Directives 6004, 6513, and 6517; and National Institute of Standards and Technology (NIST) standards, including Federal Information Processing Standards (FIPS). Users must ensure sensitive data is properly protected in compliance with all VA regulations. Prior to use of this technology, users should check with their supervisor, Information System Security Officer (ISSO), Facility Chief Information Officer (CIO), or local Office of Information and Technology (OI&T) representative to ensure that all actions are consistent with current VA policies and procedures prior to implementation.
Section 508 Information:
Decision: View Decisions
Decision Source: TRM Mgmt Group
Decision Process: One-VA TRM v25.9
Decision Date: 09/11/2025 at 23:49:43 UTC
Aliases: "HL7 FHIR US Core Implementation Guide Edition 8.0.0 - US Realm", "HL7 FHIR IG: US-Core, R1 STU4", DAF, Data Access Framework, US-Core, US Core, USCore, USCDI
Introduced By: TRM Request
Standards Body: HL7
Cage Code: 3ZPX5
- The information contained on this page is accurate as of the Decision Date (09/11/2025 at 23:49:43 UTC).