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Packagesynapxe.sgcdi
Resource TypeBundle
IdBundleDischargeSummaryRequest.Example.json
FHIR VersionR5

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Narrative

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Source1

{
  "resourceType": "Bundle",
  "meta": {
    "extension": [
      {
        "url": "https://fhir.synapxe.sg/StructureDefinition/ext-artifact",
        "extension": [
          {
            "url": "msgId",
            "valueIdentifier": {
              "system": "https://fhir.synapxe.sg/NamingSystem/msg-id",
              "value": "CR001"
            }
          },
          {
            "url": "msgSequenceId",
            "valueIdentifier": {
              "system": "https://fhir.synapxe.sg/NamingSystem/msg-sequence-id",
              "value": "001"
            }
          },
          {
            "url": "date",
            "valueDateTime": "2026-04-01T15:00:00+08:00"
          }
        ]
      }
    ],
    "profile": [
      "https://fhir.synapxe.sg/StructureDefinition/profile-bundle-dischargesummary"
    ],
    "source": "HPB-IDEAS",
    "tag": [
      {
        "code": "TTSH"
      }
    ]
  },
  "identifier": {
    "system": "https://fhir.synapxe.sg/NamingSystem/record-id",
    "value": "DS-BUNDLE-2026-02-06-001"
  },
  "type": "document",
  "timestamp": "2026-02-06T14:00:00+08:00",
  "entry": [
    {
      "fullUrl": "a5b7c8d9-e4f5-4a3b-8c6d-7e8f9a0b1c2d",
      "resource": {
        "resourceType": "Composition",
        "meta": {
          "profile": [
            "https://fhir.synapxe.sg/StructureDefinition/profile-dischargesummary"
          ]
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Example Discharge Summary</div>"
        },
        "identifier": [
          {
            "system": "https://fhir.synapxe.sg/NamingSystem/record-id",
            "value": "DS-2026-02-06-001"
          },
          {
            "system": "https://fhir.synapxe.sg/NamingSystem/accession-no",
            "value": "ACC-DS-2026-02-06-001"
          }
        ],
        "status": "final",
        "type": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "18842-5",
              "display": "Discharge Summary"
            }
          ]
        },
        "subject": [
          {
            "type": "Patient",
            "identifier": {
              "system": "https://fhir.synapxe.sg/NamingSystem/nric",
              "value": "S1234567A"
            }
          }
        ],
        "encounter": {
          "type": "Encounter",
          "identifier": {
            "system": "https://fhir.synapxe.sg/NamingSystem/event-id",
            "value": "CASE-2026-001234"
          }
        },
        "date": "2026-02-06T14:00:00+08:00",
        "author": [
          {
            "type": "Practitioner",
            "identifier": {
              "system": "https://fhir.synapxe.sg/NamingSystem/mcr",
              "value": "M12345"
            }
          }
        ],
        "title": "Discharge Summary for John Doe - Acute Myocardial Infarction",
        "attester": [
          {
            "mode": {
              "coding": [
                {
                  "system": "http://hl7.org/fhir/CodeSystem/composition-attestation-mode",
                  "code": "official",
                  "display": "Official"
                }
              ]
            },
            "time": "2026-02-06T14:30:00+08:00",
            "party": {
              "type": "Practitioner",
              "identifier": {
                "system": "https://fhir.synapxe.sg/NamingSystem/mcr",
                "value": "M67890"
              },
              "display": "Dr. Michael Tan"
            }
          }
        ],
        "custodian": {
          "type": "Organization",
          "identifier": {
            "system": "https://fhir.synapxe.sg/NamingSystem/hci-code",
            "value": "11234"
          },
          "display": "Singapore General Hospital"
        },
        "note": [
          {
            "text": "Patient admitted for acute myocardial infarction. Underwent successful PCI. Stable for discharge with medications and follow-up arranged."
          }
        ],
        "section": [
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "29548-5",
                  "display": "Diagnosis"
                }
              ]
            },
            "entry": [
              {
                "reference": "c7d9e0f1-a6b7-4c5d-ae8f-9a0b1c2d3e4f"
              }
            ]
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "8648-8",
                  "display": "Hospital course note"
                }
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Clinical Synopsis</h3><p>A 58-year-old male presented to ED with acute chest pain radiating to left arm, associated with diaphoresis and shortness of breath. Initial ECG showed ST elevation in anterior leads. Troponin was significantly elevated. Patient was diagnosed with anterior STEMI and underwent emergency coronary angiography which revealed 90% stenosis of the LAD. Successful PCI with drug-eluting stent placement was performed. Post-procedure recovery was uneventful. Patient remained hemodynamically stable throughout admission. Echo showed LVEF of 45% with anterior wall hypokinesis. Patient counseled on lifestyle modifications, smoking cessation, and importance of medication compliance. Discharged on dual antiplatelet therapy, statin, beta-blocker, and ACE inhibitor. Follow-up arranged with cardiology clinic in 2 weeks.</p></div>"
            }
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "48765-2",
                  "display": "Allergies and adverse reactions Document"
                }
              ]
            },
            "entry": [
              {
                "reference": "d8e0f1a2-b7c8-4d6e-bf9a-0b1c2d3e4f5a"
              }
            ]
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "75310-3",
                  "display": "Health concerns Document"
                }
              ]
            },
            "entry": [
              {
                "reference": "e9f1a2b3-c8d9-4e7f-8a0b-1c2d3e4f5a6b"
              }
            ]
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "30954-2",
                  "display": "Relevant diagnostic tests and laboratory data"
                }
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Investigations</h3><p>ECG: ST elevation in leads V2-V4</p><p>Troponin I: 15.2 ng/mL (elevated)</p><p>Echo: LVEF 45%, anterior wall hypokinesis</p><p>Coronary angiography: 90% LAD stenosis</p></div>"
            }
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "10183-2",
                  "display": "Hospital discharge medications Narrative"
                }
              ]
            },
            "entry": [
              {
                "reference": "f0a2b3c4-d9e0-4f8a-8b1c-2d3e4f5a6b7c"
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          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "29554-3",
                  "display": "Procedure Narrative"
                }
              ]
            },
            "entry": [
              {
                "reference": "b2c4d5e6-f1a2-4b0c-8d3e-4f5a6b7c8d9e"
              }
            ]
          },
          {
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "103595-5",
                  "display": "Certificate of Medical Necessity"
                }
              ]
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          {
            "code": {
              "coding": [
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                  "system": "http://loinc.org",
                  "code": "28570-0",
                  "display": "Procedure note"
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        ]
      }
    },
    {
      "fullUrl": "b6c8d9e0-f5a6-4b4c-9d7e-8f9a0b1c2d3e",
      "resource": {
        "resourceType": "Encounter",
        "meta": {
          "profile": [
            "https://fhir.synapxe.sg/StructureDefinition/profile-ds-encounter"
          ]
        },
        "identifier": [
          {
            "system": "https://fhir.synapxe.sg/NamingSystem/case-no",
            "value": "CASE-2026-001234"
          }
        ],
        "status": "completed",
        "serviceType": [
          {
            "concept": {
              "coding": [
                {
                  "system": "https://fhir.synapxe.sg/CodeSystem/service-speciality",
                  "code": "6",
                  "display": "Cardiology"
                }
              ]
            }
          }
        ],
        "subject": {
          "type": "Patient",
          "identifier": {
            "system": "https://fhir.synapxe.sg/NamingSystem/nric",
            "value": "S1234567A"
          }
        },
        "participant": [
          {
            "actor": {
              "type": "Practitioner",
              "identifier": {
                "system": "https://fhir.synapxe.sg/NamingSystem/mcr",
                "value": "M12345"
              },
              "display": "Dr. Sarah Chen"
            }
          }
        ],
        "actualPeriod": {
          "start": "2026-02-04T08:30:00+08:00",
          "end": "2026-02-06T12:00:00+08:00"
        },
        "diagnosis": [
          {
            "condition": [
              {
                "reference": {
                  "reference": "e1f2a3b4-c5d6-4e7f-a8b9-c0d1e2f3a4b5"
                }
              }
            ]
          }
        ],
        "admission": {
          "dischargeDisposition": {
            "extension": [
              {
                "url": "https://fhir.synapxe.sg/StructureDefinition/ext-outcome",
                "valueCodeableConcept": {
                  "coding": [
                    {
                      "system": "https://fhir.synapxe.sg/CodeSystem/discharge-outcome",
                      "code": "well",
                      "display": "Discharge well with condition treated"
                    }
                  ]
                }
              }
            ],
            "coding": [
              {
                "system": "https://fhir.synapxe.sg/CodeSystem/discharge-disposition-type",
                "code": "09",
                "display": "Followup at SOC"
              }
            ],
            "text": "Followup at SOC"
          }
        },
        "location": [
          {
            "location": {
              "reference": "f2a3b4c5-d6e7-4f8a-b9c0-d1e2f3a4b5c6"
            }
          }
        ]
      }
    },
    {
      "fullUrl": "e1f2a3b4-c5d6-4e7f-a8b9-c0d1e2f3a4b5",
      "resource": {
        "resourceType": "Condition",
        "meta": {
          "profile": [
            "https://fhir.synapxe.sg/StructureDefinition/profile-ds-diagnosis"
          ]
        },
        "clinicalStatus": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
              "code": "active",
              "display": "Active"
            }
          ]
        },
        "category": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/condition-category",
                "code": "encounter-diagnosis",
                "display": "Encounter Diagnosis"
              }
            ]
          }
        ],
        "code": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/sid/icd-10",
              "code": "I21.09",
              "display": "ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall"
            }
          ]
        },
        "subject": {
          "type": "Patient",
          "identifier": {
            "system": "https://fhir.synapxe.sg/NamingSystem/nric",
            "value": "S1234567A"
          }
        },
        "note": [
          {
            "text": "Acute anterior STEMI with 90% LAD stenosis. Successfully treated with PCI and DES placement."
          }
        ]
      }
    },
    {
      "fullUrl": "f2a3b4c5-d6e7-4f8a-b9c0-d1e2f3a4b5c6",
      "resource": {
        "resourceType": "Location",
        "meta": {
          "profile": [
            "https://fhir.synapxe.sg/StructureDefinition/profile-location"
          ]
        },
        "name": "Cardiology Ward 5A",
        "managingOrganization": {
          "type": "Organization",
          "identifier": {
            "system": "https://fhir.synapxe.sg/NamingSystem/hci-code",
            "value": "11234"
          }
        }
      }
    },
    {
      "fullUrl": "c7d9e0f1-a6b7-4c5d-ae8f-9a0b1c2d3e4f",
      "resource": {
        "resourceType": "Condition",
        "meta": {
          "profile": [
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          ]
        },
        "clinicalStatus": {
          "coding": [
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              "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
              "code": "active",
              "display": "Active"
            }
          ]
        },
        "category": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/condition-category",
                "code": "encounter-diagnosis",
                "display": "Encounter Diagnosis"
              }
            ]
          }
        ],
        "code": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/sid/icd-10",
              "code": "I21.09",
              "display": "ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall"
            }
          ]
        },
        "subject": {
          "type": "Patient",
          "identifier": {
            "system": "https://fhir.synapxe.sg/NamingSystem/nric",
            "value": "S1234567A"
          }
        },
        "note": [
          {
            "text": "Acute anterior STEMI. Successfully managed with emergency PCI and drug-eluting stent placement to LAD."
          }
        ]
      }
    },
    {
      "fullUrl": "d8e0f1a2-b7c8-4d6e-bf9a-0b1c2d3e4f5a",
      "resource": {
        "resourceType": "AllergyIntolerance",
        "meta": {
          "profile": [
            "https://fhir.synapxe.sg/StructureDefinition/profile-allergyintolerance"
          ]
        },
        "identifier": [
          {
            "system": "https://fhir.synapxe.sg/NamingSystem/record-id",
            "value": "AI-2026-02-06-001"
          }
        ],
        "clinicalStatus": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
              "code": "active",
              "display": "Active"
            }
          ]
        },
        "verificationStatus": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
              "code": "confirmed",
              "display": "Confirmed"
            }
          ]
        },
        "type": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-type",
              "code": "allergy",
              "display": "Allergy"
            }
          ]
        },
        "category": [
          "medication"
        ],
        "criticality": "high",
        "code": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "372687004",
              "display": "Penicillin"
            }
          ]
        },
        "patient": {
          "type": "Patient",
          "identifier": {
            "system": "https://fhir.synapxe.sg/NamingSystem/nric",
            "value": "S1234567A"
          }
        },
        "reaction": [
          {
            "manifestation": [
              {
                "concept": {
                  "coding": [
                    {
                      "system": "http://snomed.info/sct",
                      "code": "271807003",
                      "display": "Skin rash"
                    }
                  ],
                  "text": "Skin rash"
                }
              }
            ],
            "severity": "moderate"
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        ]
      }
    },
    {
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      "resource": {
        "resourceType": "Flag",
        "meta": {
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          ]
        },
        "status": "active",
        "category": [
          {
            "coding": [
              {
                "system": "https://fhir.synapxe.sg/CodeSystem/medical-alert-codes",
                "code": "FALLS",
                "display": "Falls Risk"
              }
            ]
          }
        ],
        "code": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "225444004",
              "display": "At risk for falls"
            }
          ]
        },
        "subject": {
          "type": "Patient",
          "identifier": {
            "system": "https://fhir.synapxe.sg/NamingSystem/nric",
            "value": "S1234567A"
          }
        },
        "period": {
          "start": "2026-02-04T08:30:00+08:00",
          "end": "2026-02-06T12:00:00+08:00"
        }
      }
    },
    {
      "fullUrl": "f0a2b3c4-d9e0-4f8a-8b1c-2d3e4f5a6b7c",
      "resource": {
        "resourceType": "MedicationRequest",
        "meta": {
          "profile": [
            "https://fhir.synapxe.sg/StructureDefinition/profile-ds-medicationrequest"
          ]
        },
        "identifier": [
          {
            "system": "https://fhir.synapxe.sg/NamingSystem/sequence-no",
            "value": "SEQ-DS-MED-001"
          }
        ],
        "status": "active",
        "intent": "order",
        "medication": {
          "concept": {
            "coding": [
              {
                "system": "https://fhir.synapxe.sg/CodeSystem/med-code",
                "code": "ASP100",
                "display": "Aspirin 100mg Oral Tablet"
              }
            ]
          }
        },
        "subject": {
          "type": "Patient",
          "identifier": {
            "system": "https://fhir.synapxe.sg/NamingSystem/nric",
            "value": "S1234567A"
          }
        },
        "requester": {
          "type": "Practitioner",
          "identifier": {
            "system": "https://fhir.synapxe.sg/NamingSystem/mcr",
            "value": "M12345"
          }
        },
        "reason": [
          {
            "concept": {
              "coding": [
                {
                  "system": "https://fhir.synapxe.sg/CodeSystem/reason-for-medication",
                  "code": "post-pci",
                  "display": "Post PCI Antiplatelet Therapy"
                }
              ]
            }
          }
        ],
        "dosageInstruction": [
          {
            "text": "Take 1 tablet once daily in the morning after food",
            "timing": {
              "repeat": {
                "boundsPeriod": {
                  "start": "2026-02-06T00:00:00+08:00"
                }
              }
            },
            "doseAndRate": [
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                "doseQuantity": {
                  "value": 1,
                  "unit": "tablet",
                  "system": "http://unitsofmeasure.org",
                  "code": "{tablet}"
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              }
            ]
          }
        ]
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    {
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      "resource": {
        "resourceType": "MedicationRequest",
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          "profile": [
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          ]
        },
        "identifier": [
          {
            "system": "https://fhir.synapxe.sg/NamingSystem/sequence-no",
            "value": "SEQ-DS-MED-002"
          }
        ],
        "status": "active",
        "intent": "order",
        "medication": {
          "concept": {
            "coding": [
              {
                "system": "https://fhir.synapxe.sg/CodeSystem/med-code",
                "code": "ATV40",
                "display": "Atorvastatin 40mg Oral Tablet"
              }
            ]
          }
        },
        "subject": {
          "type": "Patient",
          "identifier": {
            "system": "https://fhir.synapxe.sg/NamingSystem/nric",
            "value": "S1234567A"
          }
        },
        "requester": {
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          "identifier": {
            "system": "https://fhir.synapxe.sg/NamingSystem/mcr",
            "value": "M12345"
          }
        },
        "reason": [
          {
            "concept": {
              "coding": [
                {
                  "system": "https://fhir.synapxe.sg/CodeSystem/reason-for-medication",
                  "code": "lipid-lowering",
                  "display": "Lipid Lowering Therapy"
                }
              ]
            }
          }
        ],
        "dosageInstruction": [
          {
            "text": "Take 1 tablet at night before bedtime",
            "timing": {
              "repeat": {
                "boundsPeriod": {
                  "start": "2026-02-06T00:00:00+08:00"
                }
              }
            },
            "doseAndRate": [
              {
                "doseQuantity": {
                  "value": 1,
                  "unit": "tablet",
                  "system": "http://unitsofmeasure.org",
                  "code": "{tablet}"
                }
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl": "b2c4d5e6-f1a2-4b0c-8d3e-4f5a6b7c8d9e",
      "resource": {
        "resourceType": "Procedure",
        "meta": {
          "profile": [
            "https://fhir.synapxe.sg/StructureDefinition/profile-ds-procedure"
          ]
        },
        "status": "completed",
        "category": [
          {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "103693007",
                "display": "Diagnostic procedure"
              }
            ]
          }
        ],
        "code": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "415070008",
              "display": "Percutaneous coronary intervention"
            }
          ]
        },
        "subject": {
          "type": "Patient",
          "identifier": {
            "system": "https://fhir.synapxe.sg/NamingSystem/nric",
            "value": "S1234567A"
          }
        },
        "occurrenceDateTime": "2026-02-04T10:00:00+08:00",
        "performer": [
          {
            "actor": {
              "type": "Practitioner",
              "identifier": {
                "system": "https://fhir.synapxe.sg/NamingSystem/mcr",
                "value": "M54321"
              }
            }
          }
        ],
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