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Packageca.on.oh.erec
Resource TypeBundle
IdBundle-add-servicerequest.json
FHIR VersionR4

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Source1

{
  "resourceType": "Bundle",
  "id": "E959B538-5281-4E70-A6CC-34337EAAB720",
  "meta": {
    "profile": [
      "http://ehealthontario.ca/fhir/StructureDefinition/eReferralBundle|1.0.0"
    ]
  },
  "type": "message",
  "timestamp": "2020-10-09T15:21:51.2112Z",
  "entry": [
    {
      "fullUrl": "urn:uuid:1cad4077-1104-412b-83d5-9a087814c72d",
      "resource": {
        "resourceType": "MessageHeader",
        "id": "4783c82c-683e-491d-b834-3d1b8931bdd9",
        "meta": {
          "profile": [
            "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-MessageHeader|1.0.1"
          ]
        },
        "extension": [
          {
            "url": "http://ehealthontario.ca/fhir/StructureDefinition/ext-routing-options",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "http://ehealthontario.ca/fhir/CodeSystem/ereferral-source-types",
                  "code": "DR",
                  "display": "Referral Source Type - Primary Care Provider"
                }
              ]
            }
          }
        ],
        "eventCoding": {
          "system": "https://ehealthontario.ca/fhir/CodeSystem/message-event-code",
          "code": "add-service-request"
        },
        "destination": [
          {
            "name": "RMS Target",
            "endpoint": "http://rmstarget.org/fhir/$process-message"
          }
        ],
        "author": {
          "reference": "urn:uuid:86fa8373-34c8-440d-9e8f-832c1a571da8",
          "display": "Dr. Jack Jones"
        },
        "source": {
          "name": "RMS Source",
          "software": "Software",
          "version": "1.1.0",
          "contact": {
            "system": "email",
            "value": "tech.support@rmssource.org",
            "rank": 1
          },
          "endpoint": "http://rmssource.org/fhir/$process-message"
        },
        "reason": {
          "text": "Provide assessment for home care service provisioning"
        },
        "focus": [
          {
            "reference": "urn:uuid:7dbecbd9-965f-4b07-b446-53a77cab414e"
          }
        ]
      }
    },
    {
      "fullUrl": "urn:uuid:7dbecbd9-965f-4b07-b446-53a77cab414e",
      "resource": {
        "resourceType": "ServiceRequest",
        "id": "05ed7277-bd41-44ee-b017-9502c3511844",
        "meta": {
          "profile": [
            "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-ServiceRequest|1.0.1"
          ]
        },
        "extension": [
          {
            "url": "http://ehealthontario.ca/fhir/StructureDefinition/ext-routing-options",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "http://ehealthontario.ca/fhir/CodeSystem/ereferral-source-types",
                  "code": "DR",
                  "display": "Referral Source Type - Primary Care Provider"
                }
              ]
            }
          }
        ],
        "identifier": [
          {
            "system": "http://www.rmssource.org/identifiers/ServiceRequest",
            "value": "request-for-assessment"
          }
        ],
        "status": "active",
        "intent": "proposal",
        "category": [
          {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "424008009",
                "display": "Nursing care surveillance"
              }
            ]
          }
        ],
        "priority": "routine",
        "code": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "105385000",
              "display": "Full-time nursing care at home by private nurse"
            }
          ]
        },
        "subject": {
          "reference": "urn:uuid:7f7ad826-f47b-4c18-9d4a-bd3d0988ad3b"
        },
        "authoredOn": "2020-10-09",
        "requester": {
          "reference": "urn:uuid:86fa8373-34c8-440d-9e8f-832c1a571da8",
          "display": "Dr Jack Jones"
        },
        "performer": [
          {
            "reference": "http://rmstarget.org/fhir/HealthcareService/16770"
          }
        ],
        "supportingInfo": [
          {
            "reference": "urn:uuid:9cea3cb8-d24f-4be2-acbf-dbc6c3801493",
            "display": "Referral Form"
          }
        ]
      }
    },
    {
      "fullUrl": "urn:uuid:36fe199e-4cea-4e84-b221-0e4c9058c81c",
      "resource": {
        "resourceType": "Patient",
        "id": "7f7ad826-f47b-4c18-9d4a-bd3d0988ad3b",
        "meta": {
          "profile": [
            "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Patient|1.0.1"
          ]
        },
        "identifier": [
          {
            "extension": [
              {
                "url": "http://ehealthontario.ca/fhir/StructureDefinition/ext-id-health-card-version-code",
                "valueString": "EX"
              }
            ],
            "use": "official",
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "JHN"
                }
              ],
              "text": "Ontario, Canada Personal Health Number"
            },
            "system": "https://fhir.infoway-inforoute.ca/NamingSystem/ca-on-patient-hcn",
            "value": "1234567890"
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "MR"
                }
              ],
              "text": "The Hospital"
            },
            "system": "http://ehealthontario.ca/fhir/NamingSystem/id-example1-uri",
            "value": "ABC12345"
          }
        ],
        "active": true,
        "name": [
          {
            "family": "Doe",
            "given": [
              "Jane"
            ]
          }
        ],
        "telecom": [
          {
            "system": "phone",
            "value": "1 (555) 867 5309",
            "rank": 1
          },
          {
            "system": "email",
            "value": "janedoe@example.com",
            "rank": 2
          }
        ],
        "gender": "female",
        "birthDate": "1951-02-19",
        "deceasedBoolean": false,
        "address": [
          {
            "use": "home",
            "type": "physical",
            "line": [
              "123 Any Street"
            ],
            "city": "Waterloo",
            "state": "ON",
            "postalCode": "N2L 3G1"
          }
        ],
        "contact": [
          {
            "relationship": [
              {
                "coding": [
                  {
                    "system": "http://ehealthontario.ca/fhir/CodeSystem/patient-contact-relationship",
                    "code": "EC",
                    "display": "Emergency Contact"
                  }
                ],
                "text": "Emergency Contact"
              }
            ],
            "name": {
              "family": "McContact",
              "given": [
                "David"
              ]
            },
            "telecom": [
              {
                "system": "phone",
                "value": "(555) 555 1212",
                "rank": 1
              }
            ],
            "address": {
              "line": [
                "50 Another St.",
                "Unit 2"
              ],
              "city": "Waterloo",
              "state": "ON",
              "postalCode": "N2L 3G2"
            }
          }
        ],
        "communication": [
          {
            "language": {
              "coding": [
                {
                  "system": "urn:ietf:bcp:47",
                  "code": "en",
                  "display": "English"
                }
              ],
              "text": "english"
            }
          }
        ],
        "generalPractitioner": [
          {
            "reference": "urn:uuid:86fa8373-34c8-440d-9e8f-832c1a571da8"
          }
        ]
      }
    },
    {
      "fullUrl": "urn:uuid:4ebf8634-51b9-469d-a17e-9aec35f5a23b",
      "resource": {
        "resourceType": "PractitionerRole",
        "id": "86fa8373-34c8-440d-9e8f-832c1a571da8",
        "meta": {
          "profile": [
            "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-PractitionerRole|1.0.0"
          ]
        },
        "identifier": [
          {
            "use": "official",
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "RRI"
                }
              ]
            },
            "system": "http://ehealthontario.ca/fhir/NamingSystem/id-ppr-epid",
            "value": "56442"
          }
        ],
        "active": true,
        "practitioner": {
          "reference": "urn:uuid:8b9f61af-55ce-4ade-9987-f40fe54cc79e",
          "display": "Dr Jack Jones"
        },
        "organization": {
          "reference": "urn:uuid:334ec4c8-7932-4620-86fe-d6b33b3fc7e4",
          "display": "Primary Care Medical Clinics"
        },
        "code": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/practitioner-role",
                "code": "doctor",
                "display": "Doctor"
              }
            ]
          }
        ],
        "specialty": [
          {
            "coding": [
              {
                "system": "https://fhir.infoway-inforoute.ca/CodeSystem/snomedctcaextension",
                "code": "394802001",
                "display": "General medicine"
              }
            ]
          }
        ],
        "location": [
          {
            "reference": "urn:uuid:25470f9e-0092-4997-af53-aa3ef0f50879",
            "display": "279 Yonge St, Barrie, ON L4N 7T9"
          }
        ],
        "telecom": [
          {
            "system": "phone",
            "value": "(555) 987-1234",
            "use": "work",
            "rank": 1
          },
          {
            "system": "fax",
            "value": "(555) 987-1234",
            "use": "work",
            "rank": 3
          },
          {
            "system": "email",
            "value": "jack.jones@example.org",
            "use": "work",
            "rank": 2
          }
        ]
      }
    },
    {
      "fullUrl": "urn:uuid:06c6c4b3-dfbb-4f37-be0d-f8d131ae7d20",
      "resource": {
        "resourceType": "Practitioner",
        "id": "8b9f61af-55ce-4ade-9987-f40fe54cc79e",
        "meta": {
          "profile": [
            "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Practitioner|1.0.0"
          ]
        },
        "identifier": [
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code": "LN"
                }
              ],
              "text": "Ontario Medical License Number"
            },
            "system": "http://infoway-inforoute.ca/fhir/NamingSystem/ca-on-license-physician",
            "value": "111789"
          }
        ],
        "name": [
          {
            "use": "official",
            "family": "Jones",
            "given": [
              "Jack"
            ]
          }
        ],
        "telecom": [
          {
            "system": "phone",
            "value": "(555) 987-1234",
            "use": "work",
            "rank": 1
          },
          {
            "system": "fax",
            "value": "(555) 987-1234",
            "use": "work",
            "rank": 1
          }
        ],
        "address": [
          {
            "use": "work",
            "type": "physical",
            "line": [
              "279 Yonge St"
            ],
            "city": "Barrie",
            "state": "ON",
            "postalCode": "M5B 1N8",
            "country": "CAN"
          }
        ],
        "gender": "male",
        "birthDate": "1979-02-26",
        "qualification": [
          {
            "code": {
              "coding": [
                {
                  "system": "https://fhir.infoway-inforoute.ca/CodeSystem/scptype",
                  "code": "MD"
                }
              ]
            }
          }
        ],
        "communication": [
          {
            "coding": [
              {
                "system": "urn:ietf:bcp:47",
                "code": "en",
                "display": "English"
              }
            ],
            "text": "English"
          }
        ]
      }
    },
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      "fullUrl": "urn:uuid:334ec4c8-7932-4620-86fe-d6b33b3fc7e4",
      "resource": {
        "resourceType": "Organization",
        "id": "334ec4c8-7932-4620-86fe-d6b33b3fc7e4",
        "meta": {
          "profile": [
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          ]
        },
        "type": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                "code": "prov",
                "display": "Healthcare Provider"
              }
            ]
          }
        ],
        "name": "Primary Care Medical Clinics",
        "telecom": [
          {
            "system": "phone",
            "value": "(555) 987-1234",
            "use": "work",
            "rank": 1
          },
          {
            "system": "fax",
            "value": "(555) 987-1234",
            "use": "work",
            "rank": 1
          }
        ],
        "address": [
          {
            "use": "work",
            "type": "physical",
            "line": [
              "279 Yonge St"
            ],
            "city": "Barrie",
            "state": "ON",
            "postalCode": "M5B 1N8",
            "country": "CAN"
          }
        ]
      }
    },
    {
      "fullUrl": "urn:uuid:b602a7ed-e69a-49a1-97d0-2b814163e196",
      "resource": {
        "resourceType": "Location",
        "id": "25470f9e-0092-4997-af53-aa3ef0f50879",
        "meta": {
          "profile": [
            "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Location|1.0.1"
          ]
        },
        "name": "Yonge Street Medical Office",
        "address": {
          "type": "physical",
          "line": [
            "279 Yonge St"
          ],
          "city": "Barrie",
          "state": "ON",
          "postalCode": "M5B 1N8",
          "country": "CAN"
        },
        "position": {
          "longitude": -79.38248,
          "latitude": 43.6556497
        }
      }
    },
    {
      "fullUrl": "urn:uuid:9cea3cb8-d24f-4be2-acbf-dbc6c3801493",
      "resource": {
        "resourceType": "QuestionnaireResponse",
        "id": "9cea3cb8-d24f-4be2-acbf-dbc6c3801493",
        "meta": {
          "profile": [
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          ]
        },
        "identifier": {
          "system": "http://www.rmssource.org/identifiers/questionnaire-ids",
          "value": "9cea3cb8-d24f-4be2-acbf-dbc6c3801493"
        },
        "status": "completed",
        "subject": {
          "reference": "urn:uuid:7f7ad826-f47b-4c18-9d4a-bd3d0988ad3b"
        },
        "authored": "2020-10-09",
        "author": {
          "reference": "urn:uuid:86fa8373-34c8-440d-9e8f-832c1a571da8"
        },
        "item": [
          {
            "linkId": "1",
            "text": "Section 1 Header",
            "item": [
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                "linkId": "1.1",
                "text": "String Question in Section 1",
                "answer": [
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                    "valueString": "String Answer"
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              },
              {
                "linkId": "1.2",
                "text": "Boolean Question in Section 1",
                "answer": [
                  {
                    "valueBoolean": true
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              },
              {
                "linkId": "1.3",
                "text": "Number Question in Section 1",
                "answer": [
                  {
                    "valueInteger": 365
                  }
                ]
              },
              {
                "linkId": "1.4",
                "text": "Decimal question in Section 1",
                "answer": [
                  {
                    "valueDecimal": 364.9
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              {
                "linkId": "1.5",
                "text": "DateTime Question in Section 2",
                "answer": [
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                    "valueDateTime": "2021-05-07T13:28:17Z"
                  }
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            ]
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            "linkId": "2",
            "text": "Section 2 Header",
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                "linkId": "2.1",
                "text": "Integer Question in Section 2",
                "answer": [
                  {
                    "valueInteger": 365
                  }
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              },
              {
                "linkId": "2.2",
                "text": "Multi-Select Question in Section 2",
                "answer": [
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                    "valueString": "tag2"
                  },
                  {
                    "valueString": "tag3"
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              {
                "linkId": "2.3",
                "text": "Date Question in Section 2",
                "answer": [
                  {
                    "valueDate": "2019-09-05"
                  }
                ]
              },
              {
                "linkId": "2.4",
                "text": "Time Question in Section 2",
                "answer": [
                  {
                    "valueTime": "12:34:56"
                  }
                ]
              }
            ]
          },
          {
            "linkId": "3",
            "text": "CONDITIONAL Section 3 with Question",
            "answer": [
              {
                "valueBoolean": true,
                "item": [
                  {
                    "linkId": "3.1",
                    "text": "Conditional Question 1:",
                    "answer": [
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                        "valueString": "ConditionalAnswer1"
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                    ]
                  },
                  {
                    "linkId": "3.2",
                    "text": "Conditional Question 2:",
                    "answer": [
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                        "valueString": "ConditionalAnswer2"
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      }
    }
  ]
}