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Packagemyhie.v4-test
Resource TypeServiceRequest
Idsr-myhix-template.json
FHIR VersionR4

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Narrative

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Source1

{
  "resourceType": "ServiceRequest",
  "id": "sr-myhix-template",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2023-04-25T11:01:46.170+08:00",
    "source": "sample",
    "profile": [
      "http://fhir.hie.moh.gov.my/StructureDefinition/ServiceRequest-my-core"
    ],
    "security": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-Confidentiality",
        "code": "N"
      }
    ]
  },
  "extension": [
    {
      "url": "http://fhir.hie.moh.gov.my/StructureDefinition/attester-my-core",
      "extension": [
        {
          "url": "mode",
          "valueCode": "professional"
        },
        {
          "url": "time",
          "valueDateTime": "2022-10-05T07:14:38+08:00"
        },
        {
          "url": "party",
          "valueReference": {
            "type": "PractitionerRole",
            "identifier": {
              "system": "http://fhir.hie.moh.gov.my/sid/mmc-no",
              "value": "43217"
            },
            "display": "Murusamy A/L Atharv"
          }
        }
      ]
    }
  ],
  "identifier": [
    {
      "system": "http://fhir.hie.moh.gov.my/sid/service-request-id",
      "value": "HTJ-REF-2304000005"
    }
  ],
  "status": "active",
  "intent": "proposal",
  "category": [
    {
      "coding": [
        {
          "system": "http://fhir.hie.moh.gov.my/CodeSystem/servicerequest-category-my-core",
          "code": "3457005",
          "display": "PatientĀ referral"
        }
      ]
    }
  ],
  "priority": "routine",
  "code": {
    "coding": [
      {
        "display": "Hospital Referral Summary"
      }
    ]
  },
  "subject": {
    "reference": "Patient/patient-sample"
  },
  "encounter": {
    "reference": "Encounter/encounter-sample"
  },
  "authoredOn": "2022-08-30T08:00:46.838+00:00",
  "requester": {
    "type": "PractitionerRole",
    "identifier": {
      "system": "http://fhir.hie.moh.gov.my/sid/mmc-no",
      "value": "76212"
    },
    "display": "Wong Ah Liu"
  },
  "performerType": {
    "coding": [
      {
        "system": "http://fhir.hie.moh.gov.my/CodeSystem/schedule-type-my-core",
        "code": "internal",
        "display": "Internal"
      }
    ]
  },
  "performer": [
    {
      "reference": "Organization/11-05060009",
      "type": "Organization"
    },
    {
      "type": "PractitionerRole",
      "identifier": {
        "system": "http://fhir.hie.moh.gov.my/sid/mmc-no",
        "value": "12345"
      },
      "display": "Arumugan A/L Aryan"
    }
  ],
  "reasonReference": [
    {
      "reference": "Condition/condition-sample"
    }
  ],
  "supportingInfo": [
    {
      "id": "Recipient",
      "type": "PractitionerRole",
      "display": "Zuraidah Binti Abu"
    }
  ],
  "note": [
    {
      "text": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2><strong>Document Set</strong></h2><ul><li><strong>Document unique id: </strong>entry goes here</li><li><strong>Document repository unique id:</strong>&nbsp;entry goes here</li><li><strong>Document title:</strong>&nbsp;entry goes here</li><li><strong>Document confidentiality:</strong>&nbsp;entry goes here</li><li><strong>Document creation time:</strong>&nbsp;entry goes here</li><li><strong>Parent document id:</strong>&nbsp;entry goes here</li><li><strong>Parent document relationship:</strong>&nbsp;entry goes here</li></ul><h2><strong>Custodian</strong></h2><ul><li><strong>OID:</strong>&nbsp;entry goes here</li><li><strong>Name:</strong>&nbsp;entry goes here</li><li><strong>Address:</strong>&nbsp;entry goes here</li></ul><h2><strong>Patient</strong></h2><ul><li><strong>Name:</strong>&nbsp;entry goes here</li><li><strong>Gender:</strong>&nbsp;entry goes here</li><li><strong>DOB:</strong>&nbsp;entry goes here</li><li><strong>Race:</strong>&nbsp;entry goes here</li><li><strong>MRN:</strong>&nbsp;entry goes here</li><li><strong>Address:</strong>&nbsp;entry goes here</li><li><strong>Phone home:</strong>&nbsp;entry goes here</li><li><strong>Phone office:</strong>&nbsp;entry goes here</li><li><strong>Fax:</strong>&nbsp;entry goes here</li><li><strong>Email address:</strong>&nbsp;entry goes here</li><li><strong>National id:</strong>&nbsp;entry goes here</li></ul><h2><strong>Author</strong></h2><ul><li><strong>Name:</strong>&nbsp;entry goes here</li><li><strong>MMC:</strong>&nbsp;entry goes here</li><li><strong>Facility OID:</strong>&nbsp;entry goes here</li><li><strong>Facility name:</strong>&nbsp;entry goes here</li><li><strong>Time:</strong>&nbsp;entry goes here</li></ul><h2><strong>Consultant</strong></h2><ul><li><strong>Name:</strong>&nbsp;entry goes here</li><li><strong>MMC:</strong>&nbsp;entry goes here</li><li><strong>NSR:</strong>&nbsp;entry goes here</li><li><strong>Facility OID:</strong>&nbsp;entry goes here</li><li><strong>Facility name:</strong>&nbsp;entry goes here</li><li><strong>Time:</strong>&nbsp;entry goes here</li></ul><h2><strong>Visit / EncounterAdmission date</strong></h2><ul><li><strong>Discharge date:</strong>&nbsp;entry goes here</li><li><strong>Visit id:</strong>&nbsp;entry goes here</li><li><strong>Time:</strong>&nbsp;entry goes here</li><li><strong>Assign doctor name:</strong>&nbsp;entry goes here</li><li><strong>Assign doctor:</strong>&nbsp;entry goes here</li><li><strong>MMC:</strong>&nbsp;entry goes here</li><li><strong>Assign doctor facility OID:</strong>&nbsp;entry goes here</li><li><strong>Assign doctor facility name:&nbsp;</strong>entry goes here</li><li><strong>Service id:&nbsp;</strong>entry goes here</li><li><strong>Service name:&nbsp;</strong>entry goes here</li></ul><h2><strong>Allergies</strong></h2><ul><li><strong>Allergies and Other Adverse Reactions:</strong>&nbsp;entry goes here</li></ul><h2><strong>Reason for Care</strong></h2><ul><li><strong>Hospital Admission Diagnosis:</strong>&nbsp;entry goes here</li></ul><h2><strong>Other Condition Histories</strong></h2><ul><li><strong>Active Problems:</strong>&nbsp;entry goes here</li><li><strong>Discharge Diagnosis:</strong>&nbsp;entry goes here</li><li><strong>Resolved Problems:</strong>&nbsp;entry goes here</li><li><strong>List of Surgeries:</strong>&nbsp;entry goes here</li></ul><h2><strong>Medication</strong></h2><ul><li><strong>Medications:&nbsp;entry goes here</strong></li></ul><h2><strong>Relevant Studies</strong></h2><ul><li><strong>Results:</strong>&nbsp;entry goes here</li><li><strong>Hospital Discharge:</strong>&nbsp;entry goes here</li><li><strong>Studies Summary:</strong>&nbsp;entry goes here</li></ul><h2><strong>Plans of Care</strong></h2><ul><li><strong>Care Plan:&nbsp;</strong>entry goes here</li></ul><h2><strong>Correspondence Facility</strong></h2><ul><li><strong>OID:</strong>&nbsp;entry goes here</li><li><strong>NameAddress:</strong>&nbsp;entry goes here</li></ul></div>"
    }
  ]
}