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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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="heartland-implementation-tier"/>
  <language value="en"/>
  <text>
    <status value="generated"/>
    <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>
  </text>
  <url
       value="https://fhir.heartlandprotocol.org/CodeSystem/heartland-implementation-tier"/>
  <version value="0.3.0"/>
  <name value="HeartlandImplementationTier"/>
  <title value="HEARTLAND Implementation Tier"/>
  <status value="draft"/>
  <experimental value="true"/>
  <date value="2026-09-29T19:00:36-04:00"/>
  <publisher value="Vicky Muller Ferreira, MD"/>
  <contact>
    <name value="Vicky Muller Ferreira, MD"/>
    <telecom>
      <system value="url"/>
      <value value="https://heartlandprotocol.org"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="vickymuller@heartlandprotocol.org"/>
    </telecom>
  </contact>
  <contact>
    <name value="Vicky Muller Ferreira, MD"/>
    <telecom>
      <system value="email"/>
      <value value="vickymuller@heartlandprotocol.org"/>
      <use value="work"/>
    </telecom>
    <telecom>
      <system value="url"/>
      <value value="https://heartlandprotocol.org"/>
    </telecom>
  </contact>
  <description
               value="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 value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <copyright value="CC-BY 4.0"/>
  <caseSensitive value="true"/>
  <content value="complete"/>
  <count value="3"/>
  <concept>
    <code value="tier-1-minimal"/>
    <display value="Tier 1 - Minimal"/>
    <definition
                value="Resource-constrained capacity. Adapt format, sequence and support; document gaps, named coverage, alternatives and escalation without omitting required care or relevant education."/>
  </concept>
  <concept>
    <code value="tier-2-standard"/>
    <display value="Tier 2 - Standard"/>
    <definition
                value="Intermediate implementation capacity with locally documented staffing, monitoring routes and navigation support. Capacity alone does not establish treatment sequence or deadlines."/>
  </concept>
  <concept>
    <code value="tier-3-advanced"/>
    <display value="Tier 3 - Advanced"/>
    <definition
                value="Expanded implementation capacity, potentially including multidisciplinary and digital support. The label alone does not prove availability, coverage, patient access or better outcomes."/>
  </concept>
</CodeSystem>