care-plan

A per-patient (and per-discipline) aggregate of care-plan items, planned assessments, and schedule entries — sourced from the provider's care-planning record. One care-plan record represents one patient/discipline plan, not a single planned item.

Fields

Field	Type	Required	Description
identifiers	Identifier[]	yes (≥1)	Business identifiers for this care plan.
patientRef	SourceRef	yes	The patient this care plan belongs to.
discipline	string	no	The clinical discipline this plan belongs to, e.g. physiotherapy.
status	string enum	no (defaults active)	One of active, completed, revoked, unknown.
activities	CarePlanActivity[] (below)	no (defaults [])	The plan's individual activities.

Care-plan activity

Field	Type	Required	Description
description	string	yes	Free-text description of the activity.
kind	string enum	yes	One of care-plan-item, planned-assessment, schedule-entry.
scheduledStart	string	no	Free-form schedule field — not a normalized timestamp.
scheduledEnd	string	no	Free-form schedule field — not a normalized timestamp.
location	string	no	Free-text location for the activity.

Example payload

{
  "identifiers": [{ "system": "urn:michels:care-plan", "value": "CP-8001" }],
  "patientRef": {
    "sourceSystem": "michels",
    "resourceType": "patient",
    "sourceId": "pat-1"
  },
  "discipline": "physiotherapy",
  "status": "active",
  "activities": [
    {
      "description": "Daily grip-strength exercises",
      "kind": "care-plan-item",
      "location": "Ward 3B"
    },
    {
      "description": "Barthel Index re-assessment",
      "kind": "planned-assessment",
      "scheduledStart": "2026-07-21"
    },
    {
      "description": "Physiotherapy session",
      "kind": "schedule-entry",
      "scheduledStart": "2026-07-15 09:00",
      "scheduledEnd": "2026-07-15 09:30",
      "location": "Therapy room 2"
    }
  ]
}

As a change-feed event

{
  "sequence": 129,
  "resourceType": "care-plan",
  "canonicalId": "3d6c9e1a-5f8b-4d2a-9c6e-1b4f7a0d3c8e",
  "operation": "create",
  "version": 1,
  "occurredAt": "2026-07-14T11:00:00.000Z",
  "orgSlug": "default",
  "record": {
    "identifiers": [{ "system": "urn:michels:care-plan", "value": "CP-8001" }],
    "patientRef": {
      "sourceSystem": "michels",
      "resourceType": "patient",
      "sourceId": "pat-1"
    },
    "discipline": "physiotherapy",
    "status": "active",
    "activities": [
      {
        "description": "Daily grip-strength exercises",
        "kind": "care-plan-item",
        "location": "Ward 3B"
      },
      {
        "description": "Barthel Index re-assessment",
        "kind": "planned-assessment",
        "scheduledStart": "2026-07-21"
      },
      {
        "description": "Physiotherapy session",
        "kind": "schedule-entry",
        "scheduledStart": "2026-07-15 09:00",
        "scheduledEnd": "2026-07-15 09:30",
        "location": "Therapy room 2"
      }
    ]
  }
}

From the Records API

curl -H "Authorization: Bearer $ROSETTA_SYNC_TOKEN" \
  "https://sync.example.com/api/v1/records/care-plan/3d6c9e1a-5f8b-4d2a-9c6e-1b4f7a0d3c8e"

{
  "id": "3d6c9e1a-5f8b-4d2a-9c6e-1b4f7a0d3c8e",
  "resourceType": "care-plan",
  "version": 1,
  "payload": {
    "identifiers": [{ "system": "urn:michels:care-plan", "value": "CP-8001" }],
    "patientRef": {
      "sourceSystem": "michels",
      "resourceType": "patient",
      "sourceId": "pat-1"
    },
    "discipline": "physiotherapy",
    "status": "active",
    "activities": [
      {
        "description": "Daily grip-strength exercises",
        "kind": "care-plan-item",
        "location": "Ward 3B"
      },
      {
        "description": "Barthel Index re-assessment",
        "kind": "planned-assessment",
        "scheduledStart": "2026-07-21"
      },
      {
        "description": "Physiotherapy session",
        "kind": "schedule-entry",
        "scheduledStart": "2026-07-15 09:00",
        "scheduledEnd": "2026-07-15 09:30",
        "location": "Therapy room 2"
      }
    ]
  },
  "updatedAt": "2026-07-14T11:00:00.000Z",
  "orgSlug": "default",
  "identifiers": [{ "system": "urn:michels:care-plan", "value": "CP-8001" }]
}

Consumption notes

• This is an aggregate updated in place, not an immutable clinical fact — a new change event carries the whole payload again (a full-record event), including all activities, not just the ones that changed. Always overwrite your stored copy rather than merging activities arrays element-wise, and dedupe applied events on (canonicalId, version).
• Expect one record per (patient, discipline) aggregate, not one record per activity.
• planned-assessment activities are plan entries describing an assessment that is scheduled or expected — they are not assessment records. When the instrument is actually completed, it arrives separately as its own assessment record; correlate the two by discipline/patient and description, not by any shared id.
• scheduledStart/scheduledEnd are free-form source strings, not normalized timestamps — do not assume they parse as ISO-8601.
• status defaults to active when the source system doesn't report one explicitly.
• patientRef is a source reference; correlate it to the canonical patient whose identifiers contain the matching business identifier.