US Core offers some great examples of ValueSet bindings.
This Implementation Guide was created for US patients and US use cases, and the patient profile perfectly illustrates this.
There are extensions for race, ethnicity and tribalAffiliation — all bound to custom ValueSets that are specific to the US population.
Here are examples from the ValueSet bound to the “race” extension:
- American Indian or Alaska Native
- Black or African American
- Native Hawaiian or Other Pacific Islander
While an Irish, French or Australian Implementation Guide might also contain a profile that defines race, none of them would contain these values.
The same applies to a patient’s “tribalAffiliation”. This is not an input box I’ve ever seen on a form in a hospital in Europe.
The TribalEntityUS ValueSet: https://simplifier.net/packages/hl7.fhir.r4.core/4.0.1/files/81379
The above examples illustrate how powerful ValueSet binding can be in FHIR when used for a specific use case.
Many FHIR Implementation Guides like US Core exist at the national level — though not as many as there should be.
They also exist at the domain level, enforcing uniformity by restricting values to carefully defined ValueSets.
FHIR can be used “as is” without incorporating any Implementation Guides or profiles, but it’s at its most powerful when used with strict profiles that enforce data conformity.
Implementation Guide Registry: https://www.fhir.org/guides/registry/
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