HEARTLAND FHIR candidate 0.3.0 — draft, experimental R4 4.0.1 reference. Prepared for technical review; not evidence of clinical validation or vendor interoperability.

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: HEARTLAND Implementation Tier

Draft as of 2026-09-29

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{
  "resourceType" : "CodeSystem",
  "id" : "heartland-implementation-tier",
  "language" : "en",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem heartland-implementation-tier</b></p><a name=\"heartland-implementation-tier\"> </a><a name=\"hcheartland-implementation-tier\"> </a><p>This case-sensitive code system <code>https://fhir.heartlandprotocol.org/CodeSystem/heartland-implementation-tier</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">tier-1-minimal<a name=\"heartland-implementation-tier-tier-1-minimal\"> </a></td><td>Tier 1 - Minimal</td><td>Resource-constrained capacity. Adapt format, sequence and support; document gaps, named coverage, alternatives and escalation without omitting required care or relevant education.</td></tr><tr><td style=\"white-space:nowrap\">tier-2-standard<a name=\"heartland-implementation-tier-tier-2-standard\"> </a></td><td>Tier 2 - Standard</td><td>Intermediate implementation capacity with locally documented staffing, monitoring routes and navigation support. Capacity alone does not establish treatment sequence or deadlines.</td></tr><tr><td style=\"white-space:nowrap\">tier-3-advanced<a name=\"heartland-implementation-tier-tier-3-advanced\"> </a></td><td>Tier 3 - Advanced</td><td>Expanded implementation capacity, potentially including multidisciplinary and digital support. The label alone does not prove availability, coverage, patient access or better outcomes.</td></tr></table></div>"
  },
  "url" : "https://fhir.heartlandprotocol.org/CodeSystem/heartland-implementation-tier",
  "version" : "0.3.0",
  "name" : "HeartlandImplementationTier",
  "title" : "HEARTLAND Implementation Tier",
  "status" : "draft",
  "experimental" : true,
  "date" : "2026-09-29T19:00:36-04:00",
  "publisher" : "Vicky Muller Ferreira, MD",
  "contact" : [
    {
      "name" : "Vicky Muller Ferreira, MD",
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://heartlandprotocol.org"
        },
        {
          "system" : "email",
          "value" : "vickymuller@heartlandprotocol.org"
        }
      ]
    },
    {
      "name" : "Vicky Muller Ferreira, MD",
      "telecom" : [
        {
          "system" : "email",
          "value" : "vickymuller@heartlandprotocol.org",
          "use" : "work"
        },
        {
          "system" : "url",
          "value" : "https://heartlandprotocol.org"
        }
      ]
    }
  ],
  "description" : "Declared facility implementation capacity tiers, retaining historical code identities. Capacity informs delivery format, sequence and support; it does not determine clinical eligibility, permit delayed risk-led care or exclude educational domains. All eight domains are offered at every tier. These labels are not a scored readiness instrument or proof of actual coverage.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "copyright" : "CC-BY 4.0",
  "caseSensitive" : true,
  "content" : "complete",
  "count" : 3,
  "concept" : [
    {
      "code" : "tier-1-minimal",
      "display" : "Tier 1 - Minimal",
      "definition" : "Resource-constrained capacity. Adapt format, sequence and support; document gaps, named coverage, alternatives and escalation without omitting required care or relevant education."
    },
    {
      "code" : "tier-2-standard",
      "display" : "Tier 2 - Standard",
      "definition" : "Intermediate implementation capacity with locally documented staffing, monitoring routes and navigation support. Capacity alone does not establish treatment sequence or deadlines."
    },
    {
      "code" : "tier-3-advanced",
      "display" : "Tier 3 - Advanced",
      "definition" : "Expanded implementation capacity, potentially including multidisciplinary and digital support. The label alone does not prove availability, coverage, patient access or better outcomes."
    }
  ]
}