FHIR IG analytics| Package | hl7.fhir.us.pacio-adi |
| Resource Type | Bundle |
| Id | Bundle-PMO-Example-Smith-Johnson-Bundle2.json |
| FHIR Version | R4 |
No resources found
No resources found
No narrative content found in resource
FHIR
FHIRsmith{
"resourceType": "Bundle",
"id": "PMO-Example-Smith-Johnson-Bundle2",
"meta": {
"profile": [
"http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-Bundle"
]
},
"identifier": {
"system": "http://example.org/GoodHealthClinic/id",
"value": "20130607100315-ExamplePMODocument"
},
"type": "document",
"timestamp": "2024-03-29T14:25:34.001-05:00",
"entry": [
{
"fullUrl": "http://www.example.org/fhir/Composition/PMO-Example-Smith-Johnson-PMOComposition1",
"resource": {
"resourceType": "Composition",
"id": "PMO-Example-Smith-Johnson-PMOComposition1",
"meta": {
"profile": [
"http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOComposition"
]
},
"language": "en-US",
"text": {
"status": "extensions",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en-US\" lang=\"en-US\"><a name=\"Composition_PMO-Example-Smith-Johnson-PMOComposition1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Composition PMO-Example-Smith-Johnson-PMOComposition1</b></p><a name=\"PMO-Example-Smith-Johnson-PMOComposition1\"> </a><a name=\"hcPMO-Example-Smith-Johnson-PMOComposition1\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Language: en-US</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ADI-PMOComposition.html\">ADI PMO Composition</a></p></div><p><b>Composition Version Number</b>: 2024-03-29T14:25:34-05:00</p><p><b>Data Enterer</b>: <a href=\"Patient-Example-Smith-Johnson-Patient1.html\">Smith-Johnson, Betsy Female, DoB: 1950-11-15 ( http://hl7.org/fhir/sid/us-medicare#United States Medicare Number#1PA3D58WH16)</a></p><p><b>Participant</b>: <a href=\"PractitionerRole-Example-Kyle-Anydoc-PractitionerRole1.html\">PractitionerRole: telecom = kanydoc@example.org(Work)</a></p><p><b>ADI Expiration Date</b>: 2024-03-29 14:25:34-0500</p><p><b>Performer</b>: <a href=\"PractitionerRole-Example-Kyle-Anydoc-PractitionerRole1.html\">PractitionerRole: telecom = kanydoc@example.org(Work)</a></p><p><b>Informant</b>: <a href=\"RelatedPerson-Example-Smith-Johnson-HealthcareAgent1.html\">RelatedPerson Johnson, Charles</a></p><p><b>Revoke Status</b>: deprecated</p><blockquote><p><b>Clause</b></p><ul><li>Clause: </li></ul></blockquote><div><p><div xmlns="http://www.w3.org/1999/xhtml"><p>Example Clause Statement</p></div></p>\n</div><p><b>identifier</b>: <code>http://example.org/GoodHealthClinic/id</code>/0-87f37989294a408897aacd1fc5d8fd16</p><p><b>status</b>: Final</p><p><b>type</b>: <span title=\"Codes:{http://loinc.org 93037-0}\">Portable medical order form</span></p><p><b>category</b>: <span title=\"Codes:{http://loinc.org 42348-3}\">Advance healthcare directives</span></p><p><b>date</b>: 2023-03-29 14:25:34-0500</p><p><b>author</b>: <a href=\"PractitionerRole-Example-Kyle-Anydoc-PractitionerRole1.html\">PractitionerRole: telecom = kanydoc@example.org(Work)</a></p><p><b>title</b>: Portable Medical Order</p><h3>Attesters</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Mode</b></td><td><b>Party</b></td></tr><tr><td style=\"display: none\">*</td><td>Legal</td><td><a href=\"PractitionerRole-Example-Kyle-Anydoc-PractitionerRole1.html\">PractitionerRole: telecom = kanydoc@example.org(Work)</a></td></tr></table><p><b>custodian</b>: <a href=\"Organization-Example-Smith-Johnson-OrganizationCustodian1.html\">Organization example.org</a></p><blockquote><p><b>event</b></p><p><b>detail</b>: </p><ul><li><a href=\"PractitionerRole-ADI-Facilitator-MSW-MargaretReynolds.html\">PractitionerRole primary performer</a></li><li><a href=\"Consent-Example-Smith-Johnson-HealthcareAgentConsent-Permit.html\">Consent: status = active; scope = Goals, preferences, and priorities regarding the appointment of healthcare agents Narrative - Reported; category = Advance Directive</a></li><li><a href=\"Consent-Example-Smith-Johnson-HealthcareAgentConsent-Deny.html\">Consent: status = active; scope = Goals, preferences, and priorities regarding the appointment of healthcare agents Narrative - Reported; category = Advance Directive</a></li></ul></blockquote></div>"
},
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber",
"valueString": "2024-03-29T14:25:34-05:00"
},
{
"url": "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension",
"valueReference": {
"reference": "Patient/Example-Smith-Johnson-Patient1"
}
},
{
"url": "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-healthcareAgentParticipant-extension",
"valueReference": {
"reference": "PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1"
}
},
{
"url": "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-expiration-date-extension",
"valueDateTime": "2024-03-29T14:25:34-05:00"
},
{
"url": "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension",
"valueReference": {
"reference": "PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1"
}
},
{
"url": "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-informant-extension",
"valueReference": {
"reference": "RelatedPerson/Example-Smith-Johnson-HealthcareAgent1"
}
},
{
"url": "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status",
"valueCode": "deprecated"
},
{
"extension": [
{
"url": "Clause",
"valueMarkdown": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Example Clause Statement</p></div>"
}
],
"url": "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension"
}
],
"identifier": {
"system": "http://example.org/GoodHealthClinic/id",
"value": "0-87f37989294a408897aacd1fc5d8fd16"
},
"status": "final",
"type": {
"coding": [
{
"system": "http://loinc.org",
"code": "93037-0",
"display": "Portable medical order form"
}
]
},
"category": [
{
"coding": [
{
"system": "http://loinc.org",
"code": "42348-3",
"display": "Advance healthcare directives"
}
]
}
],
"subject": {
"reference": "Patient/Example-Smith-Johnson-Patient1"
},
"date": "2023-03-29T14:25:34-05:00",
"author": [
{
"reference": "PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1"
}
],
"title": "Portable Medical Order",
"attester": [
{
"mode": "legal",
"party": {
"reference": "PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1"
}
}
],
"custodian": {
"reference": "Organization/Example-Smith-Johnson-OrganizationCustodian1"
},
"event": [
{
"detail": [
{
"reference": "PractitionerRole/ADI-Facilitator-MSW-MargaretReynolds"
},
{
"reference": "Consent/Example-Smith-Johnson-HealthcareAgentConsent-Permit"
},
{
"reference": "Consent/Example-Smith-Johnson-HealthcareAgentConsent-Deny"
}
]
}
],
"section": [
{
"title": "Portable Medical Orders",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "93037-0",
"display": "Portable medical order form"
}
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>PMO Medical Orders</b></p><p><i>Order Exists: <a href=\"http://www.example.com\">available here</a></i></p></div>"
},
"entry": [
{
"reference": "ServiceRequest/Example-Smith-Johnson-CPR-ServiceRequest1"
}
]
},
{
"title": "Additional Documentation",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "77599-9"
}
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>PMOLST Order Observation</b></p><p><i>Order Exists: <a href=\"http://www.example.com\">available here</a></i></p></div>"
},
"entry": [
{
"reference": "Observation/Example-Smith-Johnson-DocumentationObservation2"
}
]
},
{
"title": "Witnesses and Notary",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "81339-4",
"display": "Witness and Notary Document"
}
]
},
"text": {
"status": "additional",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>I am emotionally and mentally competent to make this uADD. I understand the purpose and effect of this uADD, I agree with everything that is written in this uADD, and I have made this uADD knowingly, willingly and after careful deliberation.</p><table><tbody><tr><td><b>Signature:</b></td><td>Betsy Smith-Johnson</td></tr><tr><td><b>Date:</b></td><td>3/29/2024</td></tr></tbody></table><p/><p><b>Statement of Witnesses</b></p><p/><p>I declare that the person who signed this uADD, or who asked another to sign this uADD on his/her behalf, is the individual identified in the document, and he/she did so in my presence or otherwise provided satisfactory proof to me of his/her identity. I believe him/her to be of sound mind and at least 18 years of age. I personally witnessed him/her sign this document or ask the person indicated to do so, or I received proof of his/her identity that I believe is adequate, and I believe that he/she did so voluntarily. By signing this document as a witness, I certify that I am:</p><p/><ul><li>At least 18 years of age.</li><li>Not related to the person signing this document by blood, marriage or adoption.</li><li>Not a healthcare agent appointed by the person signing this document.</li><li>Not directly financially responsible for that person’s healthcare.</li><li>Not a healthcare provider directly serving the person at this time.</li><li>Not an employee (other than a social worker or chaplain), officer, director, or partner of a healthcare provider (or any parent organization of such healthcare provider) directly serving the person at this time.</li><li>Not aware that I am entitled to or have a claim against the person’s estate.</li></ul><p/><table><tbody><tr><td><b>Witness Number:</b></td><td/></tr><tr><td><b>Signature:</b></td><td/></tr><tr><td><b>Date:</b></td><td/></tr></tbody></table></div>"
}
}
]
}
},
{
"fullUrl": "http://www.example.org/fhir/Patient/Example-Smith-Johnson-Patient1",
"resource": {
"resourceType": "Patient",
"id": "Example-Smith-Johnson-Patient1",
"meta": {
"lastUpdated": "2021-03-29T14:25:34.001-05:00",
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
]
},
"language": "en-US",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en-US\" lang=\"en-US\"><a name=\"Patient_Example-Smith-Johnson-Patient1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient Example-Smith-Johnson-Patient1</b></p><a name=\"Example-Smith-Johnson-Patient1\"> </a><a name=\"hcExample-Smith-Johnson-Patient1\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Last updated: 2021-03-29 14:25:34-0500; Language: en-US</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-patient.html\">US Core Patient Profile</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Smith-Johnson, Betsy Female, DoB: 1950-11-15 ( http://hl7.org/fhir/sid/us-medicare#United States Medicare Number#1PA3D58WH16)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td>true</td><td style=\"background-color: #f3f5da\" title=\"Known Marital status of Patient\">Marital Status:</td><td colspan=\"3\"><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-NullFlavor UNK}\">unknown</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Other Id (see the one above)\">Other Id:</td><td colspan=\"3\">Medical Record Number/1032702 (use: usual, )</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\"><ul><li><a href=\"mailto:BetsySJ@example.com\">BetsySJ@example.com</a></li><li>111 Maple Court San Antonio TX 78212 US (home)</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Language spoken\">Language:</td><td colspan=\"3\"><span title=\"Codes:{urn:ietf:bcp:47 en}\">English</span> (preferred)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Nominated Contact: son\">son:</td><td colspan=\"3\"><ul><li>Charles Johnson</li><li>111 Maple Ct, Grand Rapids, MI 49503</li><li>ph: (210) 222-3333</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Nominated Contact: daughter\">daughter:</td><td colspan=\"3\"><ul><li>Debra Johnson</li><li>333 W. Camden St., Baltimore, MD 21201</li><li>ph: (410) 444-5555</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html#3) which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\n\n - American Indian or Alaska Native\n - Asian\n - Black or African American\n - Native Hawaiian or Other Pacific Islander\n - White.\">US Core Race Extension:</td><td colspan=\"3\"><ul><li>ombCategory: <a href=\"http://terminology.hl7.org/6.4.0/CodeSystem-CDCREC.html#CDCREC-2106-3\">CDC Race and Ethnicity: 2106-3</a> (White)</li><li>text: White</li></ul></td></tr></table></div>"
},
"extension": [
{
"extension": [
{
"url": "ombCategory",
"valueCoding": {
"system": "urn:oid:2.16.840.1.113883.6.238",
"code": "2106-3",
"display": "White"
}
},
{
"url": "text",
"valueString": "White"
}
],
"url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
}
],
"identifier": [
{
"use": "usual",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "MR",
"display": "Medical Record Number"
}
],
"text": "Medical Record Number"
},
"system": "http://example.org/GoodHealthHospital",
"value": "1032702"
},
{
"system": "http://hl7.org/fhir/sid/us-medicare",
"value": "1PA3D58WH16"
}
],
"active": true,
"name": [
{
"use": "usual",
"text": "Smith-Johnson, Betsy",
"family": "Smith-Johnson",
"given": [
"Betsy"
]
}
],
"telecom": [
{
"system": "email",
"value": "BetsySJ@example.com",
"use": "home"
}
],
"gender": "female",
"birthDate": "1950-11-15",
"address": [
{
"use": "home",
"type": "physical",
"line": [
"111 Maple Court"
],
"city": "San Antonio",
"state": "TX",
"postalCode": "78212",
"country": "US"
}
],
"maritalStatus": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
"code": "UNK"
}
]
},
"contact": [
{
"relationship": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code": "SONC"
}
]
}
],
"name": {
"text": "Charles Johnson"
},
"telecom": [
{
"system": "phone",
"value": "(210) 222-3333"
}
],
"address": {
"text": "111 Maple Ct, Grand Rapids, MI 49503"
}
},
{
"relationship": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code": "DAUC"
}
]
}
],
"name": {
"text": "Debra Johnson"
},
"telecom": [
{
"system": "phone",
"value": "(410) 444-5555"
}
],
"address": {
"text": "333 W. Camden St., Baltimore, MD 21201"
}
}
],
"communication": [
{
"language": {
"coding": [
{
"system": "urn:ietf:bcp:47",
"code": "en",
"display": "English"
}
]
},
"preferred": true
}
]
}
},
{
"fullUrl": "http://www.example.org/fhir/PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1",
"resource": {
"resourceType": "PractitionerRole",
"id": "Example-Kyle-Anydoc-PractitionerRole1",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"PractitionerRole_Example-Kyle-Anydoc-PractitionerRole1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: PractitionerRole Example-Kyle-Anydoc-PractitionerRole1</b></p><a name=\"Example-Kyle-Anydoc-PractitionerRole1\"> </a><a name=\"hcExample-Kyle-Anydoc-PractitionerRole1\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-practitionerrole.html\">US Core PractitionerRole Profile</a></p></div><p><b>practitioner</b>: <a href=\"Practitioner-Example-Kyle-Anydoc-Practitioner.html\">Practitioner Kyle Anydoc </a></p><p><b>telecom</b>: <a href=\"mailto:kanydoc@example.org\">kanydoc@example.org</a></p></div>"
},
"practitioner": {
"reference": "Practitioner/Example-Kyle-Anydoc-Practitioner"
},
"telecom": [
{
"system": "email",
"value": "kanydoc@example.org",
"use": "work"
}
]
}
},
{
"fullUrl": "http://www.example.org/fhir/Practitioner/Example-Kyle-Anydoc-Practitioner",
"resource": {
"resourceType": "Practitioner",
"id": "Example-Kyle-Anydoc-Practitioner",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_Example-Kyle-Anydoc-Practitioner\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner Example-Kyle-Anydoc-Practitioner</b></p><a name=\"Example-Kyle-Anydoc-Practitioner\"> </a><a name=\"hcExample-Kyle-Anydoc-Practitioner\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-practitioner.html\">US Core Practitioner Profile</a></p></div><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.5.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/1818345971</p><p><b>name</b>: Kyle Anydoc </p><p><b>telecom</b>: <a href=\"mailto:kanydoc@example.org\">kanydoc@example.org</a></p><p><b>address</b>: 567 Healthcare Drive Anytown MA 12345 US (home)</p><p><b>gender</b>: Male</p><h3>Qualifications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v2-0360 MD}\">Doctor of Medicine</span></td></tr></table></div>"
},
"identifier": [
{
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "1818345971"
}
],
"name": [
{
"family": "Anydoc",
"given": [
"Kyle"
],
"prefix": [
"Dr."
]
}
],
"telecom": [
{
"system": "email",
"value": "kanydoc@example.org",
"use": "work"
}
],
"address": [
{
"use": "home",
"line": [
"567 Healthcare Drive"
],
"city": "Anytown",
"state": "MA",
"postalCode": "12345",
"country": "US"
}
],
"gender": "male",
"qualification": [
{
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0360",
"code": "MD",
"display": "Doctor of Medicine"
}
]
}
}
]
}
},
{
"fullUrl": "http://www.example.org/fhir/Organization/Example-Smith-Johnson-OrganizationCustodian1",
"resource": {
"resourceType": "Organization",
"id": "Example-Smith-Johnson-OrganizationCustodian1",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_Example-Smith-Johnson-OrganizationCustodian1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization Example-Smith-Johnson-OrganizationCustodian1</b></p><a name=\"Example-Smith-Johnson-OrganizationCustodian1\"> </a><a name=\"hcExample-Smith-Johnson-OrganizationCustodian1\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-organization.html\">US Core Organization Profile</a></p></div><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.5.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/1234567893</p><p><b>active</b>: true</p><p><b>name</b>: example.org</p><p><b>telecom</b>: <a href=\"tel:+1(202)776-7700\">+1(202)776-7700</a></p><p><b>address</b>: 740 E. Campbell Rd. Suite 825 Richardson TX 75081 US </p></div>"
},
"identifier": [
{
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "1234567893"
}
],
"active": true,
"name": "example.org",
"telecom": [
{
"system": "phone",
"value": "+1(202)776-7700",
"use": "work"
}
],
"address": [
{
"type": "physical",
"line": [
"740 E. Campbell Rd. Suite 825"
],
"city": "Richardson",
"state": "TX",
"postalCode": "75081",
"country": "US"
}
]
}
},
{
"fullUrl": "http://www.example.org/fhir/ServiceRequest/Example-Smith-Johnson-CPR-ServiceRequest1",
"resource": {
"resourceType": "ServiceRequest",
"id": "Example-Smith-Johnson-CPR-ServiceRequest1",
"meta": {
"profile": [
"http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOCPRServiceRequest"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_Example-Smith-Johnson-CPR-ServiceRequest1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ServiceRequest Example-Smith-Johnson-CPR-ServiceRequest1</b></p><a name=\"Example-Smith-Johnson-CPR-ServiceRequest1\"> </a><a name=\"hcExample-Smith-Johnson-CPR-ServiceRequest1\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ADI-PMOCPRServiceRequest.html\">ADI PMO Cardiopulmonary Resuscitation ServiceRequest</a></p></div><p><b>status</b>: Active</p><p><b>intent</b>: Directive</p><p><b>category</b>: <span title=\"Codes:{http://loinc.org 100822-6}\">Cardiopulmonary resuscitation orders</span></p><p><b>doNotPerform</b>: true</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org LA33470-8}\">Yes CPR</span></p><p><b>orderDetail</b>: <span title=\"Codes:{http://loinc.org LA33470-8}\">Yes CPR</span></p><p><b>subject</b>: <a href=\"Patient-Example-Smith-Johnson-Patient1.html\">Smith-Johnson, Betsy Female, DoB: 1950-11-15 ( http://hl7.org/fhir/sid/us-medicare#United States Medicare Number#1PA3D58WH16)</a></p><p><b>requester</b>: <a href=\"Practitioner-Example-Kyle-Anydoc-Practitioner.html\">Practitioner Kyle Anydoc </a></p></div>"
},
"status": "active",
"intent": "directive",
"category": [
{
"coding": [
{
"system": "http://loinc.org",
"code": "100822-6",
"display": "Cardiopulmonary resuscitation orders"
}
]
}
],
"doNotPerform": true,
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "LA33470-8"
}
]
},
"orderDetail": [
{
"coding": [
{
"system": "http://loinc.org",
"code": "LA33470-8"
}
]
}
],
"subject": {
"reference": "Patient/Example-Smith-Johnson-Patient1"
},
"requester": {
"reference": "Practitioner/Example-Kyle-Anydoc-Practitioner"
}
}
},
{
"fullUrl": "http://www.example.org/fhir/Observation/Example-Smith-Johnson-DocumentationObservation2",
"resource": {
"resourceType": "Observation",
"id": "Example-Smith-Johnson-DocumentationObservation2",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-adi-documentation"
]
},
"text": {
"status": "additional",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_Example-Smith-Johnson-DocumentationObservation2\"> </a><p><b>PMOLST Order Observation</b></p><p><i>Order Exists: <a href=\"http://www.example.com\">available here</a></i></p></div>"
},
"status": "final",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "45473-6"
}
]
},
"subject": {
"reference": "Patient/Example-Smith-Johnson-Patient1"
},
"effectiveDateTime": "2016-05-18T22:33:22Z",
"performer": [
{
"reference": "Patient/Example-Smith-Johnson-Patient1"
}
],
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "697978002",
"display": "Provider orders for life-sustaining treatment"
}
]
}
}
},
{
"fullUrl": "http://www.example.org/fhir/PractitionerRole/ADI-Facilitator-MSW-MargaretReynolds",
"resource": {
"resourceType": "PractitionerRole",
"id": "ADI-Facilitator-MSW-MargaretReynolds",
"meta": {
"profile": [
"http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-Facilitator"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"PractitionerRole_ADI-Facilitator-MSW-MargaretReynolds\"> </a><p class=\"res-header-id\"><b>Generated Narrative: PractitionerRole ADI-Facilitator-MSW-MargaretReynolds</b></p><a name=\"ADI-Facilitator-MSW-MargaretReynolds\"> </a><a name=\"hcADI-Facilitator-MSW-MargaretReynolds\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ADI-Facilitator.html\">ADI Facilitator</a></p></div><p><b>active</b>: true</p><p><b>practitioner</b>: <a href=\"Practitioner-Practitioner-MargaretReynolds.html\">Margaret A. Reynolds</a></p><p><b>organization</b>: <a href=\"Organization-Example-Smith-Johnson-OrganizationAssembler1.html\">Example Organization</a></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ParticipationType PPRF}\">primary performer</span></p><p><b>specialty</b>: <span title=\"Codes:{http://nucc.org/provider-taxonomy 1041C0700X}\">Clinical Social Worker</span></p><p><b>endpoint</b>: <a href=\"Endpoint-Example-Smith-Johnson-Endpoint2.html\">Endpoint Good Health Clinic Endpoint</a></p></div>"
},
"active": true,
"practitioner": {
"reference": "Practitioner/Practitioner-MargaretReynolds",
"display": "Margaret A. Reynolds"
},
"organization": {
"reference": "Organization/Example-Smith-Johnson-OrganizationAssembler1",
"display": "Example Organization"
},
"code": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
"code": "PPRF"
}
]
}
],
"specialty": [
{
"coding": [
{
"system": "http://nucc.org/provider-taxonomy",
"code": "1041C0700X",
"display": "Clinical Social Worker"
}
]
}
],
"endpoint": [
{
"reference": "Endpoint/Example-Smith-Johnson-Endpoint2"
}
]
}
},
{
"fullUrl": "http://www.example.org/fhir/Practitioner/Practitioner-MargaretReynolds",
"resource": {
"resourceType": "Practitioner",
"id": "Practitioner-MargaretReynolds",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_Practitioner-MargaretReynolds\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner Practitioner-MargaretReynolds</b></p><a name=\"Practitioner-MargaretReynolds\"> </a><a name=\"hcPractitioner-MargaretReynolds\"> </a><p><b>identifier</b>: <code>http://example.org/fhir/MI-state-license</code>/86420</p><p><b>active</b>: true</p><p><b>name</b>: Margaret Q. Reynolds</p><p><b>telecom</b>: ph: (555) 391-9414</p><p><b>address</b>: 18051 Mack Ave, Detroit, MI 48224</p><p><b>gender</b>: Female</p></div>"
},
"identifier": [
{
"system": "http://example.org/fhir/MI-state-license",
"value": "86420"
}
],
"active": true,
"name": [
{
"text": "Margaret Q. Reynolds",
"family": "Reynolds",
"given": [
"Margaret",
"Q."
]
}
],
"telecom": [
{
"system": "phone",
"value": "(555) 391-9414"
}
],
"address": [
{
"text": "18051 Mack Ave, Detroit, MI 48224",
"line": [
"18051 Mack Ave"
],
"city": "Detroit",
"state": "MI",
"postalCode": "48224",
"country": "US"
}
],
"gender": "female"
}
},
{
"fullUrl": "http://www.example.org/fhir/Endpoint/Example-Smith-Johnson-Endpoint2",
"resource": {
"resourceType": "Endpoint",
"id": "Example-Smith-Johnson-Endpoint2",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Endpoint_Example-Smith-Johnson-Endpoint2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Endpoint Example-Smith-Johnson-Endpoint2</b></p><a name=\"Example-Smith-Johnson-Endpoint2\"> </a><a name=\"hcExample-Smith-Johnson-Endpoint2\"> </a><p><b>identifier</b>: <code>https://example.org/GoodHealth-Clinic</code>/PatientCorrection</p><p><b>status</b>: Active</p><p><b>connectionType</b>: <a href=\"http://terminology.hl7.org/7.0.1/CodeSystem-endpoint-connection-type.html#endpoint-connection-type-hl7-fhir-rest\">Endpoint Connection Type: hl7-fhir-rest</a> (HL7 FHIR)</p><p><b>name</b>: Good Health Clinic Endpoint</p><p><b>payloadType</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-HL7DocumentFormatCodes urn:hl7-org:sdwg:ccda-nonXMLBody:1.1}, {http://terminology.hl7.org/CodeSystem/v3-HL7DocumentFormatCodes urn:hl7-org:sdwg:ccda-structuredBody:1.1}\">For documents following C-CDA constraints using a structured body</span></p><p><b>address</b>: <a href=\"https://example.org/address\">https://example.org/address</a></p></div>"
},
"identifier": [
{
"system": "https://example.org/GoodHealth-Clinic",
"value": "PatientCorrection"
}
],
"status": "active",
"connectionType": {
"system": "http://terminology.hl7.org/CodeSystem/endpoint-connection-type",
"code": "hl7-fhir-rest",
"display": "HL7 FHIR"
},
"name": "Good Health Clinic Endpoint",
"payloadType": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-HL7DocumentFormatCodes",
"code": "urn:hl7-org:sdwg:ccda-nonXMLBody:1.1"
},
{
"system": "http://terminology.hl7.org/CodeSystem/v3-HL7DocumentFormatCodes",
"code": "urn:hl7-org:sdwg:ccda-structuredBody:1.1"
}
],
"text": "For documents following C-CDA constraints using a structured body"
}
],
"address": "https://example.org/address"
}
},
{
"fullUrl": "http://www.example.org/fhir/Consent/Example-Smith-Johnson-HealthcareAgentConsent-Permit",
"resource": {
"resourceType": "Consent",
"id": "Example-Smith-Johnson-HealthcareAgentConsent-Permit",
"meta": {
"profile": [
"http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-ADIConsentPermit"
]
},
"text": {
"status": "additional",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Consent_Example-Smith-Johnson-HealthcareAgentConsent-Permit\"> </a><p>I am consenting for my son Charles to be my authorized personal representative (primary healthcare agent) and I am permitting him to make decisions on my behalf about intubation.</p></div>"
},
"status": "active",
"scope": {
"coding": [
{
"system": "http://loinc.org",
"code": "81377-4",
"display": "Goals, preferences, and priorities regarding the appointment of healthcare agents Narrative - Reported"
}
]
},
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/consentcategorycodes",
"version": "1.0.1",
"code": "acd"
}
]
}
],
"patient": {
"reference": "Patient/Example-Smith-Johnson-Patient1"
},
"policy": [
{
"uri": "http://example.org/healthcare-agent-policy"
}
],
"provision": {
"type": "permit",
"actor": [
{
"role": {
"coding": [
{
"system": "http://loinc.org",
"code": "75783-1",
"display": "Primary healthcare agent [Reported]"
}
]
},
"reference": {
"reference": "RelatedPerson/Example-Smith-Johnson-HealthcareAgent1"
}
}
]
}
}
},
{
"fullUrl": "http://www.example.org/fhir/Consent/Example-Smith-Johnson-HealthcareAgentConsent-Deny",
"resource": {
"resourceType": "Consent",
"id": "Example-Smith-Johnson-HealthcareAgentConsent-Deny",
"meta": {
"profile": [
"http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-ADIConsentDeny"
]
},
"text": {
"status": "additional",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Consent_Example-Smith-Johnson-HealthcareAgentConsent-Deny\"> </a><p>I am consenting for my son Charles to be my primary healthcare agent and I am denying him to make decisions on my behalf about nutrition.</p></div>"
},
"status": "active",
"scope": {
"coding": [
{
"system": "http://loinc.org",
"code": "81377-4",
"display": "Goals, preferences, and priorities regarding the appointment of healthcare agents Narrative - Reported"
}
]
},
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/consentcategorycodes",
"version": "1.0.1",
"code": "acd"
}
]
}
],
"patient": {
"reference": "Patient/Example-Smith-Johnson-Patient1"
},
"policy": [
{
"uri": "http://example.org/healthcare-agent-policy"
}
],
"provision": {
"type": "deny",
"actor": [
{
"role": {
"coding": [
{
"system": "http://loinc.org",
"code": "75783-1",
"display": "Primary healthcare agent [Reported]"
}
]
},
"reference": {
"reference": "RelatedPerson/Example-Smith-Johnson-HealthcareAgent1"
}
}
]
}
}
},
{
"fullUrl": "http://www.example.org/fhir/RelatedPerson/Example-Smith-Johnson-HealthcareAgent1",
"resource": {
"resourceType": "RelatedPerson",
"id": "Example-Smith-Johnson-HealthcareAgent1",
"meta": {
"profile": [
"http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-HealthcareAgentParticipant"
]
},
"text": {
"status": "additional",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"RelatedPerson_Example-Smith-Johnson-HealthcareAgent1\"> </a><p><b>Primary Healthcare Agent</b></p><p>The person I choose as my Primary Healthcare Agent is:</p><p><i>Charles Johnson</i></p><p><i>(Son)</i></p><p><i>CharlesSJ@example.com</i></p><p>[SELECTED to act as a healthcare agent on 3/29/2021, at 2:25 PM CDT]</p><p>[ACCEPTED to act as a healthcare agent on 4/1/2021, at 3:39 PM CDT]</p></div>"
},
"patient": {
"reference": "Patient/Example-Smith-Johnson-Patient1"
},
"relationship": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code": "SON",
"display": "natural son"
}
]
}
],
"name": [
{
"text": "Johnson, Charles",
"family": "Johnson",
"given": [
"Charles"
]
}
],
"telecom": [
{
"system": "email",
"value": "CharlesSJ@example.com",
"use": "home"
}
]
}
},
{
"fullUrl": "http://www.example.org/fhir/Provenance/Example-Smith-Johnson-PMOProvenance1",
"resource": {
"resourceType": "Provenance",
"id": "Example-Smith-Johnson-PMOProvenance1",
"meta": {
"profile": [
"http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-Provenance"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Provenance_Example-Smith-Johnson-PMOProvenance1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Provenance Example-Smith-Johnson-PMOProvenance1</b></p><a name=\"Example-Smith-Johnson-PMOProvenance1\"> </a><a name=\"hcExample-Smith-Johnson-PMOProvenance1\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ADI-Provenance.html\">ADI Provenance</a></p></div><p>Provenance for <a href=\"Composition-PMO-Example-Smith-Johnson-PMOComposition1.html\">Composition Portable Medical Order</a></p><p>Summary</p><table class=\"grid\"><tr><td>Recorded</td><td>2021-03-29 14:25:34-0500</td></tr></table><p><b>Agents</b></p><table class=\"grid\"><tr><td><b>Type</b></td><td><b>who</b></td></tr><tr><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/provenance-participant-type assembler}\">Assembler</span></td><td><a href=\"Organization-Example-Smith-Johnson-OrganizationAssembler1.html\">Organization GoodHealth Clinic</a></td></tr></table></div>"
},
"target": [
{
"reference": "Composition/PMO-Example-Smith-Johnson-PMOComposition1"
}
],
"recorded": "2021-03-29T14:25:34.001-05:00",
"agent": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
"version": "1.1.0|1.0.0",
"code": "assembler",
"display": "Assembler"
}
]
},
"who": {
"reference": "Organization/Example-Smith-Johnson-OrganizationAssembler1"
}
}
]
}
},
{
"fullUrl": "http://www.example.org/fhir/Organization/Example-Smith-Johnson-OrganizationAssembler1",
"resource": {
"resourceType": "Organization",
"id": "Example-Smith-Johnson-OrganizationAssembler1",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_Example-Smith-Johnson-OrganizationAssembler1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization Example-Smith-Johnson-OrganizationAssembler1</b></p><a name=\"Example-Smith-Johnson-OrganizationAssembler1\"> </a><a name=\"hcExample-Smith-Johnson-OrganizationAssembler1\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-organization.html\">US Core Organization Profile</a></p></div><p><b>identifier</b>: <code>http://example.org/GoodHealthClinic/id</code>/12c5dcee5089494ca1ca0cb428ed3fff</p><p><b>active</b>: true</p><p><b>name</b>: GoodHealth Clinic</p><p><b>telecom</b>: <a href=\"tel:+1(202)776-7700\">+1(202)776-7700</a></p><p><b>address</b>: 740 E. Campbell Rd. Suite 825 Richardson TX 75081 US </p></div>"
},
"identifier": [
{
"system": "http://example.org/GoodHealthClinic/id",
"value": "12c5dcee5089494ca1ca0cb428ed3fff"
}
],
"active": true,
"name": "GoodHealth Clinic",
"telecom": [
{
"system": "phone",
"value": "+1(202)776-7700",
"use": "work"
}
],
"address": [
{
"type": "physical",
"line": [
"740 E. Campbell Rd. Suite 825"
],
"city": "Richardson",
"state": "TX",
"postalCode": "75081",
"country": "US"
}
]
}
}
]
}