This page is part of the FHIR Specification (v1.4.0: STU 3 Ballot 3). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2
This resource has 2 operations associated with it:
$match | Find patient matches using MPI based logic |
$everything | Fetch Patient Record |
For more information about operations, including how they are invoked, see Operations.
A Master Patient Index (MPI ) is a service used to manage patient identification in a context where multiple patient databases exist. Healthcare applications and middleware use the MPI to match patients between the databases, and as new patient details are encountered. MPIs are highly specialized applications, often tailored extensively to the institution's particular mix of patients. MPIs can also be run on a regional and national basis.
To ask an MPI to match a patient, clients use the "mpi" query, which takes either a candidate patient resource, or a set of normal search parameters defined for patient. The data provided is interpreted as an MPI input and passed to an MPI algorithm of some kind that uses them to determine the most appropriate matches in the patient set.
Note that different MPI matching algorithms have different required inputs. The generic $match operation does not specify any particular algorithm, nor a minimum set of information that must be provided when asking for an MPI match operation to be performed, but may implementations will have a set of minimum information, which may be declared in their definition of the $match operation
Formal Definition (as a OperationDefinition).
URL: [base]/Patient/$match
In Parameters: | |||||
Name | Cardinality | Type | Binding | Profile | Documentation |
patient | 0..1 | Patient | Use this to provide an entire set of patient details for the MPI to match against (e.g. POST a patient record to Patient/$match). If a patient record is not provided, then one or more of the other parameters must be provided | ||
family | 0..1 | (stringstring) | The family name for matching | ||
given | 0..1 | (stringstring) | The given name for matching | ||
gender | 0..1 | (stringtoken) | The gender for matching | ||
birthdate | 0..1 | (stringdate) | The birth date of the patient for matching | ||
identifier | 0..1 | (stringtoken) | An identifier to use for the matching | ||
telecom | 0..1 | (stringtoken) | Some kind of telecom to use for the matching | ||
phone | 0..1 | (stringtoken) | A phone number to use for matching | ||
0..1 | (stringtoken) | An email address to use for matching | |||
postcode | 0..1 | (stringstring) | A postcode to use for matching | ||
userid | 0..1 | (string | This optional parameter is used to pass the user details from a trusted client to the MPI. This may be used by the MPI to restrict the possible matches that are returned, based on the user's rights. For example, a staff member covered by policies, etc., may well get a different result than a patient trying to find their own record. Note that this parameter is used where the user would not be expected to log in to the MPI directly; whether this is appropriate or not is a deployment choice. | ||
count | 0..1 | (integer | The maximum number of records to return. If no value is provided, the server decides how many matches to return. Note that clients should be careful when using this, as it may prevent probable - and valid - matches from being returned | ||
Out Parameters: | |||||
Name | Cardinality | Type | Binding | Profile | Documentation |
return | 1..1 | Bundle | A bundle contain a set of Patient records that represent possible matches Note: as this the only out parameter, it is a resource, and it has the name 'return', the result of this operation is returned directly as a resource |
The response from an "mpi" query is a bundle containing patient records, ordered from most likely to least likely. If there are no patient matches, the MPI SHALL return an empty search set with no error, but may include an operation outcome with further advice regarding patient selection. All patient records SHALL have a search score from 0 to 1, where 1 is the most certain match, along with an extension "match-grade" that indicates the MPI's position on the match quality.
Patient match using patient resource: (Request):
GET /open/Patient/$match?family=chalmers&given=peter&birthdate=1974-12-25 [some headers] POST /open/Patient/$match [some headers] { "resourceType": "Patient", "name": [ { "family": [ "Chalmers" ], "given": [ "Peter" ] } ], "birthDate": "1974-12-25" }
Results from imaginary MPI algorithm (Response):
HTTP/1.1 200 OK [other headers] { "resourceType": "Bundle", "id": "26419249-18b3-45de-b10e-dca0b2e72b", "meta": { "lastUpdated": "2016-03-18T03:28:49Z" }, "type": "searchset", "total": 1, "entry": [{ "fullUrl": "http://server/path/Patient/example", "resource": { "resourceType": "Patient", "id": "example", .. snip ... }, "search": { "extension": [{ "url": "http://hl7.org/fhir/StructureDefinition/match-grade", "valueCode": "certain" }], "mode": "match", "score": 0.9 } },{ "fullUrl": "http://server/path/Patient/292", "resource": { "resourceType": "Patient", "id": "292", .. snip ... }, "search": { "extension": [{ "url": "http://hl7.org/fhir/StructureDefinition/match-grade", "valueCode": "possible" }], "mode": "match", "score": 0.2 } }] }
This operation is used to return all the information related to the patient described in the resource on which this operation is invoked. The response is a bundle of type "searchset". At a minimum, the patient resource itself is returned, along with any other resources that the server has that are related to the patient, and that are available for the given user. The server also returns whatever resources are needed to support the records - e.g. linked practitioners, medications, locations, organizations etc. The principle intended use for this operation is to provide a patient with access to their entire record (e.g. "Blue Button"). The server SHOULD return at least all resources that it has that are in the patient compartment for the identified patient, and any resource referenced from those, including binaries and attachments. In the US Realm, at a mimimum, the resources returned SHALL include all the data covered by the meaningful use common data elements as defined in DAF. Other applicable implementation guides may make additional rules about how much information that is returned
Formal Definition (as a OperationDefinition).
URL: [base]/Patient/$everything
URL: [base]/Patient/[id]/$everything
In Parameters: | |||||
Name | Cardinality | Type | Binding | Profile | Documentation |
start | 0..1 | (date | The date range relates to care dates, not record currency dates - e.g. all records relating to care provided in a certain date range. If no start date is provided, all records prior to the end date are in scope. | ||
end | 0..1 | (date | The date range relates to care dates, not record currency dates - e.g. all records relating to care provided in a certain date range. If no end date is provided, all records subsequent to the start date are in scope. | ||
Out Parameters: | |||||
Name | Cardinality | Type | Binding | Profile | Documentation |
return | 1..1 | Bundle | The bundle type is "searchset" Note: as this the only out parameter, it is a resource, and it has the name 'return', the result of this operation is returned directly as a resource |
The key differences between this operation and simply searching the patient compartment are:
It is assumed that the server has identified and secured the context appropriately, and can either associate the authorization context with a single patient, or determine whether the context has the rights to the nominated patient, if there is one. If there is no nominated patient (e.g. the operation is invoked at the system level) and the context is not associated with a single patient record, then the server should return an error. Specifying the relationship between the context, a user and patient records is outside the scope of this specification.
Get all resources linked to a single patient (Request):
GET /open/Patient/f001/$everything [some headers]
Everything linked to the nominated patient (in this case, built automatically by the publication tooling) (Response):
HTTP/1.1 200 OK [other headers] <Bundle xml="http://hl7.org/fhir"> <id value="99b093b2-58fd-4679-b4e9-40032fe2e4f6"/> <type value="searchset"/> <entry> <fullUrl value="http://hl7.org/fhir/Patient/f001"/> <resource> <Patient xmlns="http://hl7.org/fhir"> <id value="f001"/> <identifier> <use value="usual"/> <system value="urn:oid:2.16.840.1.113883.2.4.6.3"/> <!-- BSN identification system --> <value value="738472983"/> </identifier> <identifier> <use value="usual"/> <system value="urn:oid:2.16.840.1.113883.2.4.6.3"/> <!-- BSN identification system --> </identifier> <active value="true"/> <name> <use value="usual"/> <family value="van de Heuvel"/> <given value="Pieter"/> <suffix value="MSc"/> </name> <telecom> <system value="phone"/> <value value="0648352638"/> <use value="mobile"/> </telecom> <telecom> <system value="email"/> <value value="p.heuvel@gmail.com"/> <use value="home"/> </telecom> <gender value="male"/> <birthDate value="1944-11-17"/> <deceasedBoolean value="false"/> <address> <use value="home"/> <line value="Van Egmondkade 23"/> <city value="Amsterdam"/> <postalCode value="1024 RJ"/> <country value="NLD"/> <!-- ISO 3166 Codes (Countries) --> </address> <maritalStatus> <coding> <system value="http://hl7.org/fhir/v3/MaritalStatus"/> <code value="M"/> <display value="Married"/> </coding> <text value="Getrouwd"/> </maritalStatus> <multipleBirthBoolean value="true"/> <contact> <relationship> <coding> <system value="http://hl7.org/fhir/patient-contact-relationship"/> <code value="partner"/> </coding> </relationship> <name> <use value="usual"/> <family value="Abels"/> <given value="Sarah"/> </name> <telecom> <system value="phone"/> <value value="0690383372"/> <use value="mobile"/> </telecom> </contact> <communication> <language> <coding> <system value="urn:ietf:bcp:47"/> <!-- IETF language tag --> <code value="nl"/> <display value="Dutch"/> </coding> <text value="Nederlands"/> </language> <preferred value="true"/> </communication> <managingOrganization> <reference value="Organization/f001"/> <display value="Burgers University Medical Centre"/> </managingOrganization> </Patient> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Observation/f003"/> <resource> <Observation xmlns="http://hl7.org/fhir"> <id value="f003"/> <!-- urn:oid:2.16.840.1.113883.4.642.1.7 --> <!-- 2.16.840.1.113883.4.642.1.118 --> <identifier> <use value="official"/> <system value="http://www.bmc.nl/zorgportal/identifiers/observations"/> <value value="6325"/> </identifier> <status value="final"/> <code> <coding> <system value="http://loinc.org"/> <code value="11557-6"/> <display value="Carbon dioxide in blood"/> </coding> </code> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <effectivePeriod> <start value="2013-04-02T10:30:10+01:00"/> <end value="2013-04-05T10:30:10+01:00"/> </effectivePeriod> <issued value="2013-04-03T15:30:10+01:00"/> <performer> <reference value="Practitioner/f005"/> <display value="A. Langeveld"/> </performer> <valueQuantity> <value value="6.2"/> <unit value="kPa"/> <system value="http://unitsofmeasure.org"/> <code value="kPa"/> </valueQuantity> <interpretation> <coding> <system value="http://hl7.org/fhir/v2/0078"/> <code value="H"/> <display value="High"/> </coding> </interpretation> <referenceRange> <low> <value value="4.8"/> <unit value="kPa"/> <system value="http://unitsofmeasure.org"/> <code value="kPa"/> </low> <high> <value value="6.0"/> <unit value="kPa"/> <system value="http://unitsofmeasure.org"/> <code value="kPa"/> </high> </referenceRange> </Observation> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Observation/f005"/> <resource> <Observation xmlns="http://hl7.org/fhir"> <id value="f005"/> <!-- urn:oid:2.16.840.1.113883.4.642.1.7 --> <identifier> <use value="official"/> <system value="http://www.bmc.nl/zorgportal/identifiers/observations"/> <value value="6327"/> </identifier> <status value="final"/> <code> <coding> <system value="http://loinc.org"/> <code value="718-7"/> <display value="Hemoglobin [Mass/volume] in Blood"/> </coding> </code> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <effectivePeriod> <start value="2013-04-02T10:30:10+01:00"/> <end value="2013-04-05T10:30:10+01:00"/> </effectivePeriod> <issued value="2013-04-03T15:30:10+01:00"/> <performer> <reference value="Practitioner/f005"/> <display value="A. Langeveld"/> </performer> <valueQuantity> <value value="7.2"/> <unit value="g/dl"/> <system value="http://unitsofmeasure.org"/> <code value="g/dL"/> </valueQuantity> <interpretation> <coding> <system value="http://hl7.org/fhir/v2/0078"/> <code value="L"/> <display value="Low"/> </coding> </interpretation> <referenceRange> <low> <value value="7.5"/> <unit value="g/dl"/> <system value="http://unitsofmeasure.org"/> <code value="g/dL"/> </low> <high> <value value="10"/> <unit value="g/dl"/> <system value="http://unitsofmeasure.org"/> <code value="g/dL"/> </high> </referenceRange> </Observation> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Observation/unsat"/> <resource> <Observation xmlns="http://hl7.org/fhir"> <id value="unsat"/> <!-- urn:oid:2.16.840.1.113883.4.642.1.7 --> <!-- 2.16.840.1.113883.4.642.1.118 --> <identifier> <use value="official"/> <system value="http://www.bmc.nl/zorgportal/identifiers/observations"/> <value value="6323"/> </identifier> <status value="cancelled"/> <code> <coding> <system value="http://loinc.org"/> <code value="15074-8"/> <display value="Glucose [Moles/volume] in Blood"/> </coding> </code> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <effectivePeriod> <start value="2013-04-02T09:30:10+01:00"/> <end value="2013-04-05T09:30:10+01:00"/> </effectivePeriod> <issued value="2013-04-03T15:30:10+01:00"/> <performer> <reference value="Practitioner/f005"/> <display value="A. Langeveld"/> </performer> <dataAbsentReason> <coding> <system value="http://snomed.info/sct"/> <code value="125154007"/> <display value="Specimen unsatisfactory for evaluation"/> </coding> </dataAbsentReason> <comment value="Tube broken in transit and sample leaked"/> <referenceRange> <low> <value value="3.1"/> <unit value="mmol/l"/> <system value="http://unitsofmeasure.org"/> <code value="mmol/L"/> </low> <high> <value value="6.2"/> <unit value="mmol/l"/> <system value="http://unitsofmeasure.org"/> <code value="mmol/L"/> </high> </referenceRange> </Observation> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Encounter/f003"/> <resource> <Encounter xmlns="http://hl7.org/fhir"> <id value="f003"/> <identifier> <use value="official"/> <system value="http://www.bmc.nl/zorgportal/identifiers/encounters"/> <value value="v6751"/> </identifier> <status value="finished"/> <class value="outpatient"/> <type> <coding> <system value="http://snomed.info/sct"/> <code value="270427003"/> <display value="Patient-initiated encounter"/> </coding> </type> <priority> <coding> <system value="http://snomed.info/sct"/> <code value="103391001"/> <display value="Non-urgent ear, nose and throat admission"/> </coding> </priority> <patient> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </patient> <participant> <individual> <reference value="Practitioner/f001"/> <display value="E.M. van den Broek"/> </individual> </participant> <length> <value value="90"/> <unit value="min"/> <system value="http://unitsofmeasure.org"/> <code value="min"/> </length> <reason> <extension url="http://hl7.org/fhir/StructureDefinition/encounter-primaryDiagnosis"> <valuePositiveInt value="1"/> </extension> <coding> <system value="http://snomed.info/sct"/> <code value="18099001"/> <display value="Retropharyngeal abscess"/> </coding> </reason> <hospitalization> <preAdmissionIdentifier> <use value="official"/> <system value="http://www.bmc.nl/zorgportal/identifiers/pre-admissions"/> <value value="93042"/> </preAdmissionIdentifier> <!-- <preAdmissionTest> <coding> <system value="http://snomed.info/sct"/> <code value="168719007"/> <display value="Neck soft tissue X-ray"/> </coding> <coding> <system value="http://snomed.info/sct"/> <code value="396550006"/> <display value="Blood test"/> </coding> </preAdmissionTest> --> <admitSource> <coding> <system value="http://snomed.info/sct"/> <code value="305956004"/> <display value="Referral by physician"/> </coding> </admitSource> <dischargeDisposition> <coding> <system value="http://snomed.info/sct"/> <code value="306689006"/> <display value="Discharge to home"/> </coding> </dischargeDisposition> </hospitalization> <serviceProvider> <reference value="Organization/f001"/> </serviceProvider> </Encounter> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/MedicationOrder/medrx003"/> <resource> <!-- This example is a prescription with an increasing dose --><MedicationOrder xmlns="http://hl7.org/fhir"> <!-- Not sure how to reference an id --> <id value="medrx003"/> <identifier> <use value="official"/> <system value="http://www.bmc.nl/portal/prescriptions"/> <value value="12345"/> </identifier> <status value="active"/> <medicationReference> <!-- Linked to a RESOURCE Medication --> <reference value="Medication/MedicationExample11"/> <display value="prescribed medication"/> </medicationReference> <patient> <!-- Linked to the resource patient who needs the medication --> <reference value="Patient/f001"/> <display value="Eve Everywoman"/> </patient> <encounter> <!-- Linked to a resource Encounter between patient and practitioner--> <reference value="Encounter/f002"/> <display value="encounter who leads to this priscription"/> </encounter> <dateWritten value="2015-01-15"/> <prescriber> <!-- Linked to the practitioner who treats patient --> <reference value="Practitioner/f007"/> <display value="Patrick Pump"/> </prescriber> <reasonCode> <coding> <system value="http://snomed.info/sct"/> <code value="195967001"/> <display value="Asthma"/> </coding> </reasonCode> <dosageInstruction> <text value="Take 1 tablet twice daily for 3 days"/> <additionalInstructions> <coding> <system value="http://snomed.info/sct"/> <code value="311504000"/> <display value="With or after food"/> </coding> </additionalInstructions> <timing> <event value="2015-03-01"/> <repeat> <duration value="3"/> <durationUnit value="d"/> <frequency value="2"/> <period value="1"/> <periodUnit value="d"/> </repeat> </timing> <siteCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="181220002"/> <display value="Entire oral cavity"/> </coding> </siteCodeableConcept> <route> <coding> <system value="http://snomed.info/sct"/> <code value="26643006"/> <display value="Oral Route"/> </coding> </route> <doseQuantity> <value value="1"/> <system value="http://hl7.org/fhir/v3/orderableDrugForm"/> <code value="TAB"/> </doseQuantity> </dosageInstruction> <dosageInstruction> <text value="Take 2 tablet twice daily for 3 days"/> <additionalInstructions> <coding> <system value="http://snomed.info/sct"/> <code value="311504000"/> <display value="With or after food"/> </coding> </additionalInstructions> <timing> <event value="2015-03-04"/> <repeat> <duration value="3"/> <durationUnit value="d"/> <frequency value="2"/> <period value="1"/> <periodUnit value="d"/> </repeat> </timing> <siteCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="181220002"/> <display value="Entire oral cavity"/> </coding> </siteCodeableConcept> <route> <coding> <system value="http://snomed.info/sct"/> <code value="26643006"/> <display value="Oral Route"/> </coding> </route> <doseQuantity> <value value="2"/> <system value="http://hl7.org/fhir/v3/orderableDrugForm"/> <code value="TAB"/> </doseQuantity> </dosageInstruction> <dosageInstruction> <text value="Take 3 tablet twice daily for 3 days"/> <additionalInstructions> <coding> <system value="http://snomed.info/sct"/> <code value="311504000"/> <display value="With or after food"/> </coding> </additionalInstructions> <timing> <event value="2015-03-07"/> <repeat> <duration value="3"/> <durationUnit value="d"/> <frequency value="2"/> <period value="1"/> <periodUnit value="d"/> </repeat> </timing> <siteCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="181220002"/> <display value="Entire oral cavity"/> </coding> </siteCodeableConcept> <route> <coding> <system value="http://snomed.info/sct"/> <code value="26643006"/> <display value="Oral Route"/> </coding> </route> <doseQuantity> <value value="3"/> <system value="http://hl7.org/fhir/v3/orderableDrugForm"/> <code value="TAB"/> </doseQuantity> </dosageInstruction> </MedicationOrder> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/MedicationStatement/example002"/> <resource> <!-- This example is a fully populated example where the patient reports not taking --><MedicationStatement xmlns="http://hl7.org/fhir"> <id value="example002"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <p>Tylenol No. 1 Caplet</p> </div> </text> <status value="completed"/> <medicationReference> <!-- Linked to a RESOURCE Medication --> <reference value="Medication/MedicationExample7"/> </medicationReference> <patient> <reference value="Patient/example"/> </patient> <effectiveDateTime value="2015-01-23"/> <informationSource> <reference value="Patient/f001"/> </informationSource> <dateAsserted value="2015-02-22"/> <wasNotTaken value="true"/> <reasonNotTaken> <coding> <system value="http://snomed.info/sct"/> <code value="166643006"/> <display value="Liver enzymes abnormal"/> </coding> </reasonNotTaken> <note> <text value="Patient can not take acetaminophen as per Dr instructions"/> </note> </MedicationStatement> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/RelatedPerson/f001"/> <resource> <RelatedPerson xmlns="http://hl7.org/fhir"> <id value="f001"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> Sarah Abels </div> </text> <identifier> <use value="official"/> <type><text value="BSN"/></type> <system value="urn:oid:2.16.840.1.113883.2.4.6.3"/> <!-- Dutch BSN identification system --> </identifier> <patient> <reference value="Patient/f001"/> </patient> <relationship> <coding> <system value="http://hl7.org/fhir/v3/RoleCode"/> <code value="SIGOTHR"/> </coding> </relationship> <name> <use value="usual"/> <family value="Abels"/> <given value="Sarah"/> </name> <telecom> <system value="phone"/> <value value="0690383372"/> <use value="mobile"/> </telecom> <telecom> <system value="email"/> <value value="s.abels@kpn.nl"/> <use value="home"/> </telecom> <gender value="female"/> </RelatedPerson> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/CarePlan/f001"/> <resource> <CarePlan xmlns="http://hl7.org/fhir"> <id value="f001"/> <contained> <Goal> <id value="goal"/> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <description value="recovery surgery on heart of patient"/> <status value="achieved"/> <!-- urn:oid:2.16.840.1.113883.4.642.1.38 --> <note> <text value="goal accomplished without complications"/> </note> </Goal> </contained> <identifier> <use value="official"/> <!-- urn:oid:2.16.840.1.113883.4.642.1.36 --> <system value="http://www.bmc.nl/zorgportal/identifiers/careplans"/> <value value="CP2903"/> </identifier> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <status value="completed"/> <!-- urn:oid:2.16.840.1.113883.4.642.1.36 --> <period> <start value="2011-06-26"/> <end value="2011-06-27"/> </period> <modified value="2011-06-27T09:30:10+01:00"/> <addresses> <reference value="Condition/f201"/> <!--TODO Correcte referentie--> <display value="?????"/> </addresses> <participant> <member> <reference value="Practitioner/f002"/> <display value="P. Voigt"/> </member> </participant> <goal> <reference value="#goal"/> </goal> <activity> <detail> <category><coding><system value="http://hl7.org/fhir/care-plan-activity-category"/><code value="procedure"/></coding></category> <!-- urn:oid:2.16.840.1.113883.4.642.1.39 --> <code> <coding> <system value="http://snomed.info/sct"/> <code value="64915003"/> <display value="Operation on heart"/> </coding> </code> <status value="completed"/> <prohibited value="true"/> <scheduledString value="2011-06-27T09:30:10+01:00"/> <performer> <reference value="Practitioner/f002"/> <display value="P. Voigt"/> </performer> </detail> </activity> </CarePlan> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Contract/pcd-example-notAuthor"/> <resource> <Contract xmlns="http://hl7.org/fhir"> <id value="pcd-example-notAuthor"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on existing jurisdictional policy and are realized in existing systems in Canada. The default policy is one of implied consent for the provision of care, so these scenarios all deal with withdrawal or withholding consent for that purpose. In other jurisdictions, where an express consent model is used (Opt-In), these would examples would contain the phrase "consent to" rather than "withhold" or "withdraw" consent for. <p> specific to use-case 5) Withhold or withdraw consent for disclosure of records that were authored by a specific organization (or service delivery location). </p><p> Patient "P. van de Heuvel" wishes to have all of the PHI collected at the Good Health Psychiatric Hospital restricted from disclosure to every provider. </p> </div> </text> <issued value="2015-11-18"/> <!-- not bound by a timeframe - Contract.applies --> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Contract.authority element --> <authority> <reference value="Organization/Infoway"/> <display value="Canada Infoway"/> </authority> <!-- and/or would this [also] go into Contract.domain as a Jurisdiction?? (see the example on UK Pharamacy Juristiction) --> <domain> <reference value="Location/Infoway"/> <display value="Canada Infoway"/> </domain> <type> <coding> <system value="http://loinc.org"/> <code value="57016-8"/> </coding> </type> <!-- made up code-system to represent the set of privacy consent sub-types known and published by Canada Infoway --> <subType> <coding> <system value="http://www.infoway-inforoute.ca.org/Consent-subtype-codes"/> <code value="Opt-In"/> <display value="Default Authorization with exceptions."/> </coding> </subType> <term> <type> <coding> <!-- made up code system --> <system value="http://hl7.org/fhir/consent-term-type-codes"/> <code value="withhold-authored-by"/> <display value="Withhold all data authored by specified actor entity."/> </coding> </type> <topic> <reference value="Organization/2.16.840.1.113883.19.5"/> <display value="Good Health Clinic"/> </topic> <text value="Withhold all data authored by Good Health provider."/> </term> <!-- the terms of the consent in friendly consumer speak --> <friendly> <contentAttachment> <title value="The terms of the consent in friendly consumer speak."/> <!-- likely use url pointer to common text --> </contentAttachment> </friendly> <!-- the legal terms of the consent in lawyer speak --> <legal> <contentAttachment> <title value="The terms of the consent in lawyer speak."/> <!-- likely use url pointer to common text --> <!-- I think some think that this should be the pointer to the law by which this consent is derived under. Such as http://lois-laws.justice.gc.ca/eng/acts/P-21/index.html --> </contentAttachment> </legal> </Contract> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Contract/pcd-example-notThem"/> <resource> <Contract xmlns="http://hl7.org/fhir"> <id value="pcd-example-notThem"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on existing jurisdictional policy and are realized in existing systems in Canada. The default policy is one of implied consent for the provision of care, so these scenarios all deal with withdrawal or withholding consent for that purpose. In other jurisdictions, where an express consent model is used (Opt-In), these would examples would contain the phrase "consent to" rather than "withhold" or "withdraw" consent for. <p> specific to use-case 4) Withhold or withdraw consent for disclosure to a specific provider agent (an individual within an organization) </p><p> Patient "P. van de Heuvel" ex-spouse, Bill T Lookafter is a Nurse that is employed by Good Health Hospital. P. realizes that she may receive treatment at GHH, however she does not want her ex-spouse to have any access to her IIHI. She indicates that she would like to withdraw/withhold consent to disclose any instance of her health information to her ex-spouse as a result of his employment at Good Health Clinic. </p> </div> </text> <issued value="2015-11-18"/> <!-- not bound by a timeframe - Contract.applies --> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Contract.authority element --> <authority> <reference value="Organization/Infoway"/> <display value="Canada Infoway"/> </authority> <!-- and/or would this [also] go into Contract.domain as a Jurisdiction?? (see the example on UK Pharamacy Juristiction) --> <domain> <reference value="Location/Infoway"/> <display value="Canada Infoway"/> </domain> <type> <coding> <system value="http://loinc.org"/> <code value="57016-8"/> </coding> </type> <!-- made up code-system to represent the set of privacy consent sub-types known and published by Canada Infoway --> <subType> <coding> <system value="http://www.infoway-inforoute.ca.org/Consent-subtype-codes"/> <code value="Opt-In"/> <display value="Default Authorization with exceptions."/> </coding> </subType> <term> <type> <coding> <!-- made up code system --> <system value="http://hl7.org/fhir/consent-term-type-codes"/> <code value="withhold-from"/> <display value="Withhold all data from specified actor entity."/> </coding> </type> <topic> <reference value="Practitioner/f204"/> <display value="Fictive Nurse"/> </topic> <text value="Withhold this order and any results or related objects from specified nurse provider."/> </term> <!-- the terms of the consent in friendly consumer speak --> <friendly> <contentAttachment> <title value="The terms of the consent in friendly consumer speak."/> <!-- likely use url pointer to common text --> </contentAttachment> </friendly> <!-- the legal terms of the consent in lawyer speak --> <legal> <contentAttachment> <title value="The terms of the consent in lawyer speak."/> <!-- likely use url pointer to common text --> <!-- I think some think that this should be the pointer to the law by which this consent is derived under. Such as http://lois-laws.justice.gc.ca/eng/acts/P-21/index.html --> </contentAttachment> </legal> </Contract> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/CarePlan/f003"/> <resource> <CarePlan xmlns="http://hl7.org/fhir"> <id value="f003"/> <contained> <Goal> <id value="goal"/> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <description value="Retropharyngeal abscess removal"/> <status value="achieved"/> <!-- urn:oid:2.16.840.1.113883.4.642.1.38 --> <note> <text value="goal accomplished without complications"/> </note> </Goal> </contained> <identifier> <use value="official"/> <!-- urn:oid:2.16.840.1.113883.4.642.1.36 --> <system value="http://www.bmc.nl/zorgportal/identifiers/careplans"/> <value value="CP3953"/> </identifier> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <status value="completed"/> <!-- urn:oid:2.16.840.1.113883.4.642.1.36 --> <period> <start value="2013-03-08T09:00:10+01:00"/> <end value="2013-03-08T09:30:10+01:00"/> </period> <modified value="2013-06-27T09:30:10+01:00"/> <addresses> <reference value="Condition/f201"/> <!--TODO Correcte referentie--> <display value="?????"/> </addresses> <participant> <member> <reference value="Practitioner/f001"/> <display value="E.M. van den broek"/> </member> </participant> <goal> <reference value="#goal"/> </goal> <activity> <detail> <category><coding><system value="http://hl7.org/fhir/care-plan-activity-category"/><code value="procedure"/></coding></category> <!-- urn:oid:2.16.840.1.113883.4.642.1.39 --> <code> <coding> <system value="http://snomed.info/sct"/> <code value="172960003"/> <display value="Incision of retropharyngeal abscess"/> </coding> </code> <status value="completed"/> <prohibited value="true"/> <scheduledString value="2011-06-27T09:30:10+01:00"/> <performer> <reference value="Practitioner/f001"/> <display value="E.M. van den broek"/> </performer> </detail> </activity> </CarePlan> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Procedure/f004"/> <resource> <Procedure xmlns="http://hl7.org/fhir"> <id value="f004"/> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <status value="completed"/> <code> <coding> <system value="http://snomed.info/sct"/> <code value="48387007"/> <display value="Tracheotomy"/> </coding> </code> <bodySite> <coding> <system value="http://snomed.info/sct"/> <code value="83030008"/> <display value="Retropharyngeal area"/> </coding> </bodySite> <reasonCodeableConcept> <text value="ensure breathing during surgery"/> </reasonCodeableConcept> <performer> <actor> <reference value="Practitioner/f005"/> <display value="A. Langeveld"/> </actor> <role> <coding> <system value="urn:oid:2.16.840.1.113883.2.4.15.111"/> <!-- "AssignedRoleType" coding system --> <code value="01.000"/> <display value="Arts"/> </coding> <text value="Care role"/> </role> </performer> <performedPeriod> <start value="2013-03-22T09:30:10+01:00"/> <end value="2013-03-22T10:30:10+01:00"/> </performedPeriod> <encounter> <reference value="Encounter/f003"/> </encounter> <outcome> <text value="removal of the retropharyngeal abscess"/> </outcome> <report> <reference value="DiagnosticReport/f001"/> <display value="???????????"/> </report> <followUp> <text value="described in care plan"/> </followUp> </Procedure> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Procedure/f002"/> <resource> <Procedure xmlns="http://hl7.org/fhir"> <id value="f002"/> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <status value="completed"/> <code> <coding> <system value="http://snomed.info/sct"/> <code value="359615001"/> <display value="Partial lobectomy of lung"/> </coding> </code> <bodySite> <coding> <system value="http://snomed.info/sct"/> <code value="39607008"/> <display value="Lung structure"/> </coding> </bodySite> <reasonCodeableConcept> <text value="Malignant tumor of lung"/> </reasonCodeableConcept> <performer> <actor> <reference value="Practitioner/f003"/> <display value="M.I.M. Versteegh"/> </actor> <role> <coding> <system value="urn:oid:2.16.840.1.113883.2.4.15.111"/> <!-- "AssignedRoleType" coding system --> <code value="01.000"/> <display value="Arts"/> </coding> <text value="Care role"/> </role> </performer> <performedPeriod> <start value="2013-03-08T09:00:10+01:00"/> <end value="2013-03-08T09:30:10+01:00"/> </performedPeriod> <encounter> <reference value="Encounter/f002"/> </encounter> <outcome> <text value="improved blood circulation"/> </outcome> <report> <reference value="DiagnosticReport/f001"/> <display value="Lab results blood test"/> </report> <followUp> <text value="described in care plan"/> </followUp> </Procedure> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Observation/f002"/> <resource> <Observation xmlns="http://hl7.org/fhir"> <id value="f002"/> <!-- urn:oid:2.16.840.1.113883.4.642.1.7 --> <!-- 2.16.840.1.113883.4.642.1.118 --> <identifier> <use value="official"/> <system value="http://www.bmc.nl/zorgportal/identifiers/observations"/> <value value="6324"/> </identifier> <status value="final"/> <code> <coding> <system value="http://loinc.org"/> <code value="11555-0"/> <display value="Base excess in Blood by calculation"/> </coding> </code> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <effectivePeriod> <start value="2013-04-02T10:30:10+01:00"/> <end value="2013-04-05T10:30:10+01:00"/> </effectivePeriod> <issued value="2013-04-03T15:30:10+01:00"/> <performer> <reference value="Practitioner/f005"/> <display value="A. Langeveld"/> </performer> <valueQuantity> <value value="12.6"/> <unit value="mmol/l"/> <system value="http://unitsofmeasure.org"/> <code value="mmol/L"/> </valueQuantity> <interpretation> <coding> <system value="http://hl7.org/fhir/v2/0078"/> <code value="H"/> <display value="High"/> </coding> </interpretation> <referenceRange> <low> <value value="7.1"/> <unit value="mmol/l"/> <system value="http://unitsofmeasure.org"/> <code value="mmol/L"/> </low> <high> <value value="11.2"/> <unit value="mmol/l"/> <system value="http://unitsofmeasure.org"/> <code value="mmol/L"/> </high> </referenceRange> </Observation> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Condition/f001"/> <resource> <Condition xmlns="http://hl7.org/fhir"> <id value="f001"/> <patient> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </patient> <encounter> <reference value="Encounter/f001"/> </encounter> <asserter> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </asserter> <dateRecorded value="2011-10-05"/> <code> <coding> <system value="http://snomed.info/sct"/> <code value="368009"/> <display value="Heart valve disorder"/> </coding> </code> <category> <coding> <system value="http://snomed.info/sct"/> <code value="439401001"/> <display value="diagnosis"/> </coding> </category> <clinicalStatus value="active"/> <verificationStatus value="confirmed"/> <severity> <coding> <system value="http://snomed.info/sct"/> <code value="6736007"/> <display value="Moderate"/> </coding> </severity> <onsetDateTime value="2011-08-05"/> <evidence> <code> <coding> <system value="http://snomed.info/sct"/> <code value="426396005"/> <display value="Cardiac chest pain"/> </coding> </code> </evidence> <bodySite> <coding> <system value="http://snomed.info/sct"/> <code value="40768004"/> <display value="Left thorax"/> </coding> <text value="heart structure"/> </bodySite> </Condition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Encounter/f001"/> <resource> <Encounter xmlns="http://hl7.org/fhir"> <id value="f001"/> <identifier> <use value="official"/> <system value="http://www.amc.nl/zorgportal/identifiers/visits"/> <value value="v1451"/> </identifier> <status value="finished"/> <class value="outpatient"/> <type> <coding> <system value="http://snomed.info/sct"/> <code value="270427003"/> <display value="Patient-initiated encounter"/> </coding> </type> <priority> <coding> <system value="http://snomed.info/sct"/> <code value="310361003"/> <display value="Non-urgent cardiological admission"/> </coding> </priority> <patient> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </patient> <participant> <individual> <reference value="Practitioner/f002"/> <display value="P. Voigt"/> </individual> </participant> <length> <value value="140"/> <unit value="min"/> <system value="http://unitsofmeasure.org"/> <code value="min"/> </length> <reason> <coding> <system value="http://snomed.info/sct"/> <code value="34068001"/> <display value="Heart valve replacement"/> </coding> </reason> <hospitalization> <preAdmissionIdentifier> <use value="official"/> <system value="http://www.amc.nl/zorgportal/identifiers/pre-admissions"/> <value value="93042"/> </preAdmissionIdentifier> <!-- <preAdmissionTest> <coding> <system value="http://snomed.info/sct"/> <code value="164847006"/> <display value="Standard ECG"/> </coding> <coding> <system value="http://snomed.info/sct"/> <code value="396550006"/> <display value="Blood test"/> </coding> </preAdmissionTest> --> <admitSource> <coding> <system value="http://snomed.info/sct"/> <code value="305956004"/> <display value="Referral by physician"/> </coding> </admitSource> <dischargeDisposition> <coding> <system value="http://snomed.info/sct"/> <code value="306689006"/> <display value="Discharge to home"/> </coding> </dischargeDisposition> </hospitalization> <serviceProvider> <reference value="Organization/f001"/> <display value="Burgers University Medical Center"/> </serviceProvider> </Encounter> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/MedicationOrder/medrx005"/> <resource> <!-- This example is a prescription for a drug with a loading dose --><MedicationOrder xmlns="http://hl7.org/fhir"> <id value="medrx005"/> <identifier> <use value="official"/> <system value="http://www.bmc.nl/portal/prescriptions"/> <value value="12345"/> </identifier> <status value="active"/> <medicationReference> <!-- Linked to a RESOURCE Medication --> <reference value="Medication/MedicationExample6"/> <display value="prescribed medication"/> </medicationReference> <patient> <!-- Linked to the resource patient who needs the medication --> <reference value="Patient/f001"/> <display value="Eve Everywoman"/> </patient> <encounter> <!-- Linked to a resource Encounter between patient and practitioner--> <reference value="Encounter/f002"/> <display value="encounter who leads to this priscription"/> </encounter> <dateWritten value="2015-01-15"/> <prescriber> <!-- Linked to the practitioner who treats patient --> <reference value="Practitioner/f007"/> <display value="Patrick Pump"/> </prescriber> <reasonCode> <coding> <system value="http://snomed.info/sct"/> <code value="65363002"/> <display value="Otitis Media"/> </coding> </reasonCode> <dosageInstruction> <text value="Take two capsules to start"/> <additionalInstructions> <coding> <system value="http://snomed.info/sct"/> <code value="311504000"/> <display value="With or after food"/> </coding> </additionalInstructions> <timing> <event value="2015-01-15"/> <repeat> <duration value="1"/> <durationUnit value="d"/> <frequency value="1"/> <period value="1"/> <periodUnit value="d"/> </repeat> </timing> <siteCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="181220002"/> <display value="Entire oral cavity"/> </coding> </siteCodeableConcept> <route> <coding> <system value="http://snomed.info/sct"/> <code value="26643006"/> <display value="Oral Route"/> </coding> </route> <doseQuantity> <value value="2"/> <system value="http://hl7.org/fhir/v3/orderableDrugForm"/> <code value="CAP"/> </doseQuantity> </dosageInstruction> <dosageInstruction> <text value="Take one capsule three times daily"/> <additionalInstructions> <coding> <system value="http://snomed.info/sct"/> <code value="311504000"/> <display value="With or after food"/> </coding> </additionalInstructions> <timing> <event value="2015-01-15"/> <repeat> <duration value="11"/> <durationUnit value="d"/> <frequency value="2"/> <period value="1"/> <periodUnit value="d"/> </repeat> </timing> <siteCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="181220002"/> <display value="Entire oral cavity"/> </coding> </siteCodeableConcept> <route> <coding> <system value="http://snomed.info/sct"/> <code value="26643006"/> <display value="Oral Route"/> </coding> </route> <doseQuantity> <value value="1"/> <system value="http://hl7.org/fhir/v3/orderableDrugForm"/> <code value="CAP"/> </doseQuantity> </dosageInstruction> </MedicationOrder> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/MedicationOrder/medrx001"/> <resource> <!-- This example is a fully populated prescription --><MedicationOrder xmlns="http://hl7.org/fhir"> <id value="medrx001"/> <identifier> <use value="official"/> <system value="http://www.bmc.nl/portal/prescriptions"/> <value value="12345"/> </identifier> <status value="active"/> <medicationReference> <!-- Linked to a RESOURCE Medication --> <reference value="Medication/MedicationExample2"/> <display value="prescribed medication"/> </medicationReference> <patient> <!-- Linked to the resource patient who needs the medication --> <reference value="Patient/f001"/> <display value="Eve Everywoman"/> </patient> <encounter> <!-- Linked to a resource Encounter between patient and practitioner--> <reference value="Encounter/f002"/> <display value="encounter who leads to this priscription"/> </encounter> <dateWritten value="2015-01-15"/> <prescriber> <!-- Linked to the practitioner who treats patient --> <reference value="Practitioner/f007"/> <display value="Patrick Pump"/> </prescriber> <reasonCode> <coding> <system value="http://snomed.info/sct"/> <code value="65363002"/> <display value="Otitis Media"/> </coding> </reasonCode> <dosageInstruction> <text value="Take 5ml three times daily"/> <additionalInstructions> <coding> <system value="http://snomed.info/sct"/> <code value="311504000"/> <display value="With or after food"/> </coding> </additionalInstructions> <timing> <repeat> <frequency value="3"/> <period value="1"/> <periodUnit value="d"/> </repeat> </timing> <siteCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="181220002"/> <display value="Entire oral cavity"/> </coding> </siteCodeableConcept> <route> <coding> <system value="http://snomed.info/sct"/> <code value="26643006"/> <display value="Oral Route"/> </coding> </route> <doseQuantity> <value value="5"/> <unit value="mL"/> <system value="http://unitsofmeasure.org"/> <code value="mL"/> </doseQuantity> </dosageInstruction> <dispenseRequest> <medicationReference> <reference value="Medication/MedicationExample3"/> </medicationReference> <validityPeriod> <start value="2015-01-15"/> <end value="2016-01-15"/> </validityPeriod> <numberOfRepeatsAllowed value="2"/> <quantity> <value value="100"/> <unit value="mL"/> <system value="http://unitsofmeasure.org"/> <code value="mL"/> </quantity> <expectedSupplyDuration> <value value="10"/> <unit value="days"/> <system value="http://unitsofmeasure.org"/> <code value="d"/> </expectedSupplyDuration> </dispenseRequest> <substitution> <type> <coding> <system value="http://hl7.org/fhir"/> <code value="G"/> <display value="Generic Composition"/> </coding> </type> <reason> <coding> <system value="http://hl7.org/fhir"/> <code value="FP"/> <display value="formulary policy"/> </coding> </reason> </substitution> </MedicationOrder> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/MedicationOrder/medrx002"/> <resource> <!-- This example is an example of text only dosage instruction --><MedicationOrder xmlns="http://hl7.org/fhir"> <id value="medrx002"/> <identifier> <use value="official"/> <system value="http://www.bmc.nl/portal/prescriptions"/> <value value="12345"/> </identifier> <status value="active"/> <medicationReference> <!-- Linked to a RESOURCE Medication --> <reference value="Medication/MedicationExample5"/> <display value="prescribed medication"/> </medicationReference> <patient> <!-- Linked to the resource patient who needs the medication --> <reference value="Patient/f001"/> <display value="Eve Everywoman"/> </patient> <encounter> <!-- Linked to a resource Encounter between patient and practitioner--> <reference value="Encounter/f002"/> <display value="encounter who leads to this prescription"/> </encounter> <dateWritten value="2015-03-01"/> <prescriber> <!-- Linked to the practitioner who treats patient --> <reference value="Practitioner/f007"/> <display value="Patricia Primary"/> </prescriber> <reasonCode> <coding> <system value="http://snomed.info/sct"/> <code value="64859006"/> <display value="Osteoporosis"/> </coding> </reasonCode> <dosageInstruction> <text value="Take one tablet daily as directed"/> </dosageInstruction> </MedicationOrder> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Contract/pcd-example-notLabs"/> <resource> <Contract xmlns="http://hl7.org/fhir"> <id value="pcd-example-notLabs"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on existing jurisdictional policy and are realized in existing systems in Canada. The default policy is one of implied consent for the provision of care, so these scenarios all deal with withdrawal or withholding consent for that purpose. In other jurisdictions, where an express consent model is used (Opt-In), these would examples would contain the phrase "consent to" rather than "withhold" or "withdraw" consent for. <p> specific to use-case 1. Withhold or withdraw consent for disclosure of records related to specific domain (e.g. DI, LAB, etc.) </p><p> Patient "P. van de Heuvel" wishes to withhold disclosure of all of her lab orders and results to any provider. </p> </div> </text> <issued value="2014-08-17"/> <!-- not bound by a timeframe - Contract.applies --> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Contract.authority element --> <authority> <reference value="Organization/Infoway"/> <display value="Canada Infoway"/> </authority> <!-- and/or would this [also] go into Contract.domain as a Jurisdiction?? (see the example on UK Pharamacy Juristiction) --> <domain> <reference value="Location/Infoway"/> <display value="Canada Infoway"/> </domain> <type> <coding> <system value="http://loinc.org"/> <code value="57016-8"/> </coding> </type> <!-- made up code-system to represent the set of privacy consent sub-types known and published by Canada Infoway --> <subType> <coding> <system value="http://www.infoway-inforoute.ca.org/Consent-subtype-codes"/> <code value="Opt-In"/> <display value="Default Authorization with exceptions."/> </coding> </subType> <!-- I can easily say to exclude a type of FHIR Resource, but lab-orders is not a direct Resource type. Might we put in FHIR based query parameters? --> <term> <type> <coding> <!-- made up code system --> <system value="http://hl7.org/fhir/consent-term-type-codes"/> <code value="withhold-object-type"/> </coding> </type> <subType> <coding> <system value="http://hl7.org/fhir/resource-types"/> <code value="Order"/> </coding> </subType> <!-- by not specifying term.actor I assume this means everyone? --> <text value="Withhold orders from any provider."/> </term> <term> <type> <coding> <!-- made up code system --> <system value="http://hl7.org/fhir/consent-term-type-codes"/> <code value="withhold-object-type"/> </coding> </type> <subType> <coding> <system value="http://hl7.org/fhir/resource-types"/> <code value="OrderResponse"/> </coding> </subType> <!-- by not specifying term.actor I assume this means everyone? --> <text value="Withhold order results from any provider."/> </term> <!-- the terms of the consent in friendly consumer speak --> <friendly> <contentAttachment> <title value="The terms of the consent in friendly consumer speak."/> <!-- likely use url pointer to common text --> </contentAttachment> </friendly> <!-- the legal terms of the consent in lawyer speak --> <legal> <contentAttachment> <title value="The terms of the consent in lawyer speak."/> <!-- likely use url pointer to common text --> <!-- I think some think that this should be the pointer to the law by which this consent is derived under. Such as http://lois-laws.justice.gc.ca/eng/acts/P-21/index.html --> </contentAttachment> </legal> </Contract> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Contract/pcd-example-notThis"/> <resource> <Contract xmlns="http://hl7.org/fhir"> <id value="pcd-example-notThis"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on existing jurisdictional policy and are realized in existing systems in Canada. The default policy is one of implied consent for the provision of care, so these scenarios all deal with withdrawal or withholding consent for that purpose. In other jurisdictions, where an express consent model is used (Opt-In), these would examples would contain the phrase "consent to" rather than "withhold" or "withdraw" consent for. <p> specific to use-case 2. Withhold or withdraw consent for disclosure of a specific record (e.g. Lab Order/Result) </p><p> Patient "P. van de Heuvel" Primary Care Provider, Dr. Philip Primary, has ordered a set of lab test which Adam wishes to keep as private as possible. At the sample collection facility, he indicates that he would like withhold consent to disclose the order and all results associated with that specific order from all other providers </p> </div> </text> <issued value="2015-11-18"/> <!-- not bound by a timeframe - Contract.applies --> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Contract.authority element --> <authority> <reference value="Organization/Infoway"/> <display value="Canada Infoway"/> </authority> <!-- and/or would this [also] go into Contract.domain as a Jurisdiction?? (see the example on UK Pharamacy Juristiction) --> <domain> <reference value="Location/Infoway"/> <display value="Canada Infoway"/> </domain> <type> <coding> <system value="http://loinc.org"/> <code value="57016-8"/> </coding> </type> <!-- made up code-system to represent the set of privacy consent sub-types known and published by Canada Infoway --> <subType> <coding> <system value="http://www.infoway-inforoute.ca.org/Consent-subtype-codes"/> <code value="Opt-In"/> <display value="Default Authorization with exceptions."/> </coding> </subType> <!-- I can easily say to exclude a type of FHIR Resource, but lab-orders is not a direct Resource type. Might we put in FHIR based query parameters? --> <term> <type> <coding> <!-- made up code system --> <system value="http://hl7.org/fhir/consent-term-type-codes"/> <code value="withhold-identified-object-and-related"/> <display value="Withhold the identified object and any other resources that are related to this object."/> </coding> </type> <topic> <reference value="Order/f201"/> </topic> <!-- by not specifying term.actor I assume this means everyone? --> <text value="Withhold this order and any results or related objects from any provider."/> </term> <!-- the terms of the consent in friendly consumer speak --> <friendly> <contentAttachment> <title value="The terms of the consent in friendly consumer speak."/> <!-- likely use url pointer to common text --> </contentAttachment> </friendly> <!-- the legal terms of the consent in lawyer speak --> <legal> <contentAttachment> <title value="The terms of the consent in lawyer speak."/> <!-- likely use url pointer to common text --> <!-- I think some think that this should be the pointer to the law by which this consent is derived under. Such as http://lois-laws.justice.gc.ca/eng/acts/P-21/index.html --> </contentAttachment> </legal> </Contract> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/MedicationOrder/medrx004"/> <resource> <!-- This is an example of a prescription for an inhaler --><MedicationOrder xmlns="http://hl7.org/fhir"> <id value="medrx004"/> <identifier> <use value="official"/> <system value="http://www.bmc.nl/portal/prescriptions"/> <value value="12345"/> </identifier> <status value="active"/> <medicationReference> <!-- Linked to a RESOURCE Medication --> <reference value="Medication/MedicationExample12"/> <display value="prescribed medication"/> </medicationReference> <patient> <!-- Linked to the resource patient who needs the medication --> <reference value="Patient/f001"/> <display value="Eve Everywoman"/> </patient> <encounter> <!-- Linked to a resource Encounter between patient and practitioner--> <reference value="Encounter/f002"/> <display value="encounter who leads to this priscription"/> </encounter> <dateWritten value="2015-01-15"/> <prescriber> <!-- Linked to the practitioner who treats patient --> <reference value="Practitioner/f007"/> <display value="Patrick Pump"/> </prescriber> <reasonCode> <coding> <system value="http://snomed.info/sct"/> <code value="195967001"/> <display value="Asthma"/> </coding> </reasonCode> <dosageInstruction> <text value="Use 2 puffs twice daily as needed"/> <timing> <repeat> <duration value="3"/> <durationUnit value="d"/> <frequency value="2"/> <period value="1"/> <periodUnit value="d"/> </repeat> </timing> <asNeededBoolean value="true"/> <route> <coding> <system value="http://snomed.info/sct"/> <code value="422237004"/> <display value="Inhalation"/> </coding> </route> <doseQuantity> <value value="2"/> <system value="http://snomed.info/sct"/> <code value="415215001"/> </doseQuantity> </dosageInstruction> </MedicationOrder> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/CarePlan/f002"/> <resource> <CarePlan xmlns="http://hl7.org/fhir"> <id value="f002"/> <contained> <Goal> <id value="goal"/> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <description value="succesful surgery on lung of patient"/> <status value="achieved"/> <!-- urn:oid:2.16.840.1.113883.4.642.1.38 --> <note> <text value="goal accomplished with minor complications"/> </note> </Goal> </contained> <identifier> <use value="official"/> <!-- urn:oid:2.16.840.1.113883.4.642.1.36 --> <system value="http://www.bmc.nl/zorgportal/identifiers/careplans"/> <value value="CP2934"/> </identifier> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <status value="completed"/> <!-- urn:oid:2.16.840.1.113883.4.642.1.36 --> <period> <start value="2011-07-06"/> <end value="2013-07-07"/> </period> <modified value="2011-07-07T09:30:10+01:00"/> <addresses> <reference value="Condition/f201"/> <!--TODO Correcte referentie--> <display value="?????"/> </addresses> <participant> <member> <reference value="Practitioner/f003"/> <display value="M.I.M. Versteegh"/> </member> </participant> <goal> <reference value="#goal"/> </goal> <activity> <detail> <category><coding><system value="http://hl7.org/fhir/care-plan-activity-category"/><code value="procedure"/></coding></category> <!-- urn:oid:2.16.840.1.113883.4.642.1.39 --> <code> <coding> <system value="http://snomed.info/sct"/> <code value="359615001"/> <display value="Partial lobectomy of lung"/> </coding> </code> <status value="completed"/> <prohibited value="true"/> <scheduledString value="2011-07-07T09:30:10+01:00"/> <performer> <reference value="Practitioner/f003"/> <display value="M.I.M. Versteegh"/> </performer> </detail> </activity> </CarePlan> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Procedure/f001"/> <resource> <Procedure xmlns="http://hl7.org/fhir"> <id value="f001"/> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <status value="completed"/> <code> <coding> <system value="http://snomed.info/sct"/> <code value="34068001"/> <display value="Heart valve replacement"/> </coding> </code> <bodySite> <coding> <system value="http://snomed.info/sct"/> <code value="17401000"/> <display value="Heart valve structure"/> </coding> </bodySite> <reasonCodeableConcept> <text value="Heart valve disorder"/> </reasonCodeableConcept> <performer> <actor> <reference value="Practitioner/f002"/> <display value="P. Voigt"/> </actor> <role> <coding> <system value="urn:oid:2.16.840.1.113883.2.4.15.111"/> <!-- "AssignedRoleType" coding system --> <code value="01.000"/> <display value="Arts"/> </coding> <text value="Care role"/> </role> </performer> <performedPeriod> <start value="2011-06-26"/> <end value="2011-06-27"/> </performedPeriod> <encounter> <reference value="Encounter/f001"/> </encounter> <outcome> <text value="improved blood circulation"/> </outcome> <report> <reference value="DiagnosticReport/f001"/> <display value="Lab results blood test"/> </report> <followUp> <text value="described in care plan"/> </followUp> </Procedure> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Observation/f001"/> <resource> <Observation xmlns="http://hl7.org/fhir"> <id value="f001"/> <!-- urn:oid:2.16.840.1.113883.4.642.1.7 --> <!-- 2.16.840.1.113883.4.642.1.118 --> <identifier> <use value="official"/> <system value="http://www.bmc.nl/zorgportal/identifiers/observations"/> <value value="6323"/> </identifier> <status value="final"/> <code> <coding> <system value="http://loinc.org"/> <code value="15074-8"/> <display value="Glucose [Moles/volume] in Blood"/> </coding> </code> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <effectivePeriod> <start value="2013-04-02T09:30:10+01:00"/> <end value="2013-04-05T09:30:10+01:00"/> </effectivePeriod> <issued value="2013-04-03T15:30:10+01:00"/> <performer> <reference value="Practitioner/f005"/> <display value="A. Langeveld"/> </performer> <valueQuantity> <value value="6.3"/> <unit value="mmol/l"/> <system value="http://unitsofmeasure.org"/> <code value="mmol/L"/> </valueQuantity> <interpretation> <coding> <system value="http://hl7.org/fhir/v2/0078"/> <code value="H"/> <display value="High"/> </coding> </interpretation> <referenceRange> <low> <value value="3.1"/> <unit value="mmol/l"/> <system value="http://unitsofmeasure.org"/> <code value="mmol/L"/> </low> <high> <value value="6.2"/> <unit value="mmol/l"/> <system value="http://unitsofmeasure.org"/> <code value="mmol/L"/> </high> </referenceRange> </Observation> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/MedicationOrder/f001"/> <resource> <MedicationOrder xmlns="http://hl7.org/fhir"> <id value="f001"/> <identifier> <use value="official"/> <system value="http://www.bmc/portal/prescriptions"/> <value value="order9837293"/> </identifier> <status value="active"/> <medicationReference> <!-- Linked to a RESOURCE Medication --> <reference value="Medication/f001"/> <display value="prescribed medication"/> </medicationReference> <patient> <!-- Linked to the resource patient who needs the medication --> <reference value="Patient/f001"/> <display value="P. van den Heuvel"/> </patient> <encounter> <!-- Linked to a resource Visit between patient and practitioner--> <!-- TODO: Camiel nog correcte verwijzing (@f001 bestond nog niet) --> <reference value="Encounter/f001"/> <display value="visit who leads to this priscription"/> </encounter> <dateWritten value="2013-05-25T19:32:52+01:00"/> <prescriber> <!-- Linked to the practitioner who treats patient --> <reference value="Practitioner/f006"/> <display value="R.A. van den Berk"/> </prescriber> <reasonCode> <coding> <system value="http://snomed.info/sct"/> <code value="13645005"/> <display value="Chronic obstructive pulmonary disease"/> </coding> </reasonCode> <dosageInstruction> <text value="3 tot 4 maal daags 1 flacon"/> <additionalInstructions> <text value="for use during pregnancy, contact physician"/> </additionalInstructions> <timing> <repeat> <boundsPeriod> <start value="2013-08-04"/> <end value="2013-11-05"/> </boundsPeriod> <frequency value="3"/> <period value="1"/> <periodUnit value="d"/> </repeat> </timing> <siteCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="181220002"/> <display value="Entire oral cavity"/> </coding> </siteCodeableConcept> <route> <coding> <system value="http://snomed.info/sct"/> <code value="394899003"/> <display value="oral administration of treatment"/> </coding> </route> <doseQuantity> <value value="10"/> <unit value="ml"/> <system value="http://unitsofmeasure.org"/> <code value="ml"/> </doseQuantity> </dosageInstruction> <dispenseRequest> <validityPeriod> <start value="2013-04-08"/> <end value="2013-05-30"/> </validityPeriod> <numberOfRepeatsAllowed value="20"/> <quantity> <value value="100"/> <unit value="mcg"/> <system value="urn:oid:2.16.840.1.113883.6.8"/> <!-- http://unitsofmeasure.org (UCUM code system) --> <code value="ug"/> </quantity> <expectedSupplyDuration> <value value="40"/> <unit value="days"/> <system value="urn:oid:2.16.840.1.113883.6.8"/> <!-- http://unitsofmeasure.org (UCUM code system) --> <code value="d"/> </expectedSupplyDuration> </dispenseRequest> </MedicationOrder> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/MedicationOrder/f004"/> <resource> <MedicationOrder xmlns="http://hl7.org/fhir"> <id value="f004"/> <identifier> <use value="official"/> <system value="http://www.bmc.nl/portal/prescriptions"/> <value value="order9845343"/> </identifier> <status value="active"/> <medicationReference> <!-- Linked to a RESOURCE Medication --> <reference value="Medication/f004"/> <display value="prescribed medication"/> </medicationReference> <patient> <!-- Linked to the resource patient who needs the medication --> <reference value="Patient/f001"/> <display value="P. van den Heuvel"/> </patient> <encounter> <!-- Linked to a resource Encounter between patient and practitioner--> <reference value="Encounter/f001"/> <display value="encounter who leads to this priscription"/> </encounter> <dateWritten value="2011-05-01"/> <prescriber> <!-- Linked to the practitioner who treats patient --> <reference value="Practitioner/f007"/> <display value="S.M. Heps"/> </prescriber> <reasonCode> <coding> <system value="http://snomed.info/sct"/> <code value="38341003"/> <display value="High blood pressure"/> </coding> </reasonCode> <dosageInstruction> <timing> <repeat> <boundsPeriod> <start value="2011-05-01"/> </boundsPeriod> <frequency value="1"/> <period value="1"/> <periodUnit value="d"/> </repeat> </timing> <siteCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="181220002"/> <display value="Entire oral cavity"/> </coding> </siteCodeableConcept> <route> <coding> <system value="http://snomed.info/sct"/> <code value="386359008"/> <display value="Administration of drug or medicament via oral route"/> </coding> </route> <doseQuantity> <value value="50"/> <unit value="mg"/> <system value="http://unitsofmeasure.org"/> <code value="mg"/> </doseQuantity> </dosageInstruction> <dispenseRequest> <validityPeriod> <start value="2011-05-01"/> </validityPeriod> <quantity> <value value="90"/> <system value="http://snomed.info/sct"/> <code value="46992007"/> </quantity> </dispenseRequest> </MedicationOrder> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/MedicationOrder/f003"/> <resource> <MedicationOrder xmlns="http://hl7.org/fhir"> <id value="f003"/> <identifier> <use value="official"/> <system value="http://www.bmc.nl/portal/prescriptions"/> <value value="order9845343"/> </identifier> <status value="active"/> <medicationReference> <!-- Linked to a RESOURCE Medication --> <reference value="Medication/f003"/> <display value="prescribed medication"/> </medicationReference> <patient> <!-- Linked to the resource patient who needs the medication --> <reference value="Patient/f001"/> <display value="P. van den Heuvel"/> </patient> <encounter> <!-- Linked to a resource Encounter between patient and practitioner--> <reference value="Encounter/f002"/> <display value="encounter who leads to this priscription"/> </encounter> <dateWritten value="2011-05-01"/> <prescriber> <!-- Linked to the practitioner who treats patient --> <reference value="Practitioner/f007"/> <display value="S.M. Heps"/> </prescriber> <reasonCode> <coding> <system value="http://snomed.info/sct"/> <code value="444780001"/> <display value="High glucose level in blood"/> </coding> </reasonCode> <dosageInstruction> <timing> <repeat> <boundsPeriod> <start value="2011-05-01"/> </boundsPeriod> <frequency value="3"/> <period value="1"/> <periodUnit value="d"/> </repeat> </timing> <siteCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="181220002"/> <display value="Entire oral cavity"/> </coding> </siteCodeableConcept> <route> <coding> <system value="http://snomed.info/sct"/> <code value="386359008"/> <display value="Administration of drug or medicament via oral route"/> </coding> </route> <doseQuantity> <value value="500"/> <unit value="mg"/> <system value="http://unitsofmeasure.org"/> <code value="mg"/> </doseQuantity> </dosageInstruction> <dispenseRequest> <validityPeriod> <start value="2011-05-01"/> </validityPeriod> <quantity> <value value="90"/> <system value="http://snomed.info/sct"/> <code value="46992007"/> </quantity> </dispenseRequest> </MedicationOrder> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/MedicationOrder/f005"/> <resource> <MedicationOrder xmlns="http://hl7.org/fhir"> <id value="f005"/> <identifier> <use value="official"/> <system value="http://www.bmc.nl/portal/prescriptions"/> <value value="order9823343"/> </identifier> <status value="active"/> <medicationReference> <!-- Linked to a RESOURCE Medication --> <reference value="Medication/f005"/> <display value="prescribed medication"/> </medicationReference> <patient> <!-- Linked to the resource patient who needs the medication --> <reference value="Patient/f001"/> <display value="P. van den Heuvel"/> </patient> <encounter> <!-- Linked to a resource Encounter between patient and practitioner--> <reference value="Encounter/f001"/> <display value="encounter who leads to this priscription"/> </encounter> <dateWritten value="2011-05-01"/> <prescriber> <!-- Linked to the practitioner who treats patient --> <reference value="Practitioner/f007"/> <display value="S.M. Heps"/> </prescriber> <reasonCode> <coding> <system value="http://snomed.info/sct"/> <code value="38341003"/> <display value="High blood pressure"/> </coding> </reasonCode> <dosageInstruction> <timing> <repeat> <boundsPeriod> <start value="2011-05-01"/> </boundsPeriod> <frequency value="1"/> <period value="1"/> <periodUnit value="d"/> </repeat> </timing> <siteCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="181220002"/> <display value="Entire oral cavity"/> </coding> </siteCodeableConcept> <route> <coding> <system value="http://snomed.info/sct"/> <code value="386359008"/> <display value="Administration of drug or medicament via oral route"/> </coding> </route> <doseQuantity> <value value="5"/> <unit value="mg"/> <system value="http://unitsofmeasure.org"/> <code value="mg"/> </doseQuantity> </dosageInstruction> <dispenseRequest> <validityPeriod> <start value="2011-05-01"/> </validityPeriod> <quantity> <value value="28"/> <system value="http://snomed.info/sct"/> <code value="46992007"/> </quantity> </dispenseRequest> </MedicationOrder> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Observation/f004"/> <resource> <Observation xmlns="http://hl7.org/fhir"> <id value="f004"/> <!-- urn:oid:2.16.840.1.113883.4.642.1.7 --> <identifier> <use value="official"/> <system value="http://www.bmc.nl/zorgportal/identifiers/observations"/> <value value="6326"/> </identifier> <status value="final"/> <code> <coding> <system value="http://loinc.org"/> <code value="789-8"/> <display value="Erythrocytes [#/volume] in Blood by Automated count"/> </coding> </code> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <effectivePeriod> <start value="2013-04-02T10:30:10+01:00"/> <end value="2013-04-05T10:30:10+01:00"/> </effectivePeriod> <issued value="2013-04-03T15:30:10+01:00"/> <performer> <reference value="Practitioner/f005"/> <display value="A. Langeveld"/> </performer> <valueQuantity> <value value="4.12"/> <!-- Actually, 4.12E+12 --> <unit value="10 trillion/L"/> <system value="http://unitsofmeasure.org"/> <code value="10*12/L"/> </valueQuantity> <interpretation> <coding> <system value="http://hl7.org/fhir/v2/0078"/> <code value="L"/> <display value="Low"/> </coding> </interpretation> <referenceRange> <low> <value value="4.4"/> <!-- for male gender --> <unit value="10^12/L"/> <system value="http://unitsofmeasure.org"/> <code value="10*12/L"/> </low> <high> <value value="5.8"/> <!-- for male gender --> <unit value="10^12/L"/> <system value="http://unitsofmeasure.org"/> <code value="10*12/L"/> </high> </referenceRange> </Observation> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/MedicationOrder/f002"/> <resource> <MedicationOrder xmlns="http://hl7.org/fhir"> <id value="f002"/> <identifier> <use value="official"/> <system value="http://www.bmc.nl/portal/prescriptions"/> <value value="order9837343"/> </identifier> <status value="active"/> <medicationReference> <!-- Linked to a RESOURCE Medication --> <reference value="Medication/f002"/> <display value="prescribed medication"/> </medicationReference> <patient> <!-- Linked to the resource patient who needs the medication --> <reference value="Patient/f001"/> <display value="P. van den Heuvel"/> </patient> <encounter> <!-- Linked to a resource Visit between patient and practitioner--> <reference value="Encounter/f001"/> <display value="encounter who leads to this priscription"/> </encounter> <dateWritten value="2013-04-08"/> <prescriber> <!-- Linked to the practitioner who treats patient --> <reference value="Practitioner/f006"/> <display value="R.A. van den Berk"/> </prescriber> <reasonCode> <coding> <system value="http://snomed.info/sct"/> <code value="28036006"/> <display value="High density lipoprotein cholesterol level"/> </coding> </reasonCode> <dosageInstruction> <timing> <repeat> <boundsPeriod> <start value="2013-08-04"/> </boundsPeriod> <frequency value="1"/> <period value="1"/> <periodUnit value="d"/> </repeat> </timing> <siteCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="181220002"/> <display value="Entire oral cavity"/> </coding> </siteCodeableConcept> <route> <coding> <system value="http://snomed.info/sct"/> <code value="386359008"/> <display value="Administration of drug or medicament via oral route"/> </coding> </route> <doseQuantity> <value value="10"/> <unit value="mg"/> <system value="http://unitsofmeasure.org"/> <code value="mg"/> </doseQuantity> </dosageInstruction> <dispenseRequest> <validityPeriod> <start value="2013-04-08"/> </validityPeriod> <quantity> <value value="90"/> <system value="http://snomed.info/sct"/> <code value="46992007"/> </quantity> </dispenseRequest> </MedicationOrder> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/DiagnosticReport/f001"/> <resource> <DiagnosticReport xmlns="http://hl7.org/fhir"> <id value="f001"/> <contained> <DiagnosticOrder> <id value="req"/> <identifier> <use value="official"/> <system value="http://www.bmc.nl/zorgportal/identifiers/labresults"/> <value value="L2381"/> </identifier> <subject> <reference value="Patient/f001"/> <display value="P. van den Heuvel"/> </subject> <encounter> <reference value="Encounter/f001"/> <!-- TODO Correcte verwijzing --> </encounter><orderer> <reference value="Practitioner/f001"/> <display value="E.van den Broek"/> </orderer> <reason> <text value="patient almost fainted during procedure"/> </reason> <item> <code> <coding> <system value="http://loinc.org"/> <!-- LOINC --> <code value="58410-2"/> <display value="Complete blood count (hemogram) panel - Blood by Automated count"/> </coding> </code> <bodySite> <coding> <system value="http://snomed.info/sct"/> <code value="14975008"/> <display value="Forearm structure"/> </coding> </bodySite> </item> </DiagnosticOrder> </contained> <identifier> <use value="official"/> <system value="http://www.bmc.nl/zorgportal/identifiers/reports"/> <value value="nr1239044"/> </identifier> <status value="final"/> <category> <coding> <system value="http://snomed.info/sct"/> <code value="252275004"/> <display value="Haematology test"/> </coding> <coding> <system value="http://hl7.org/fhir/v2/0074"/> <code value="HM"/> </coding> </category> <code> <coding> <system value="http://loinc.org"/> <code value="58410-2"/> <display value="Complete blood count (hemogram) panel - Blood by Automated count"/> </coding> </code> <!-- ISO 8601 --> <subject> <reference value="Patient/f001"/> <display value="P. van den Heuvel"/> </subject> <effectiveDateTime value="2013-04-02"/> <!-- OID: 2.16.840.1.113883.4.642.1.7 --> <issued value="2013-05-15T19:32:52+01:00"/> <performer> <reference value="Organization/f001"/> <display value="Burgers University Medical Centre"/> </performer> <request> <reference value="#req"/> </request> <result> <reference value="Observation/f001"/> </result> <result> <reference value="Observation/f002"/> </result> <result> <reference value="Observation/f003"/> </result> <result> <reference value="Observation/f004"/> </result> <result> <reference value="Observation/f005"/> </result> <conclusion value="Core lab"/> </DiagnosticReport> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Condition/f002"/> <resource> <Condition xmlns="http://hl7.org/fhir"> <id value="f002"/> <patient> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </patient> <encounter> <reference value="Encounter/f002"/> </encounter> <asserter> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </asserter> <dateRecorded value="2012-06-03"/> <code> <coding> <system value="http://snomed.info/sct"/> <code value="254637007"/> <display value="NSCLC - Non-small cell lung cancer"/> </coding> </code> <category> <coding> <system value="http://snomed.info/sct"/> <code value="439401001"/> <display value="diagnosis"/> </coding> </category> <clinicalStatus value="active"/> <verificationStatus value="confirmed"/> <severity> <coding> <system value="http://snomed.info/sct"/> <code value="24484000"/> <display value="Severe"/> </coding> </severity> <onsetDateTime value="2011-05-05"/> <stage> <summary> <coding> <system value="http://snomed.info/sct"/> <code value="258219007"/> <display value="stage II"/> </coding> </summary> </stage> <evidence> <code> <coding> <system value="http://snomed.info/sct"/> <code value="169069000"/> <display value="CT of thorax"/> </coding> </code> </evidence> <bodySite> <coding> <system value="http://snomed.info/sct"/> <code value="51185008"/> <display value="Thorax"/> </coding> </bodySite> </Condition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Procedure/f003"/> <resource> <Procedure xmlns="http://hl7.org/fhir"> <id value="f003"/> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <status value="completed"/> <code> <coding> <system value="http://snomed.info/sct"/> <code value="172960003"/> <display value="Incision of retropharyngeal abscess"/> </coding> </code> <bodySite> <coding> <system value="http://snomed.info/sct"/> <code value="83030008"/> <display value="Retropharyngeal area"/> </coding> </bodySite> <reasonCodeableConcept> <text value="abcess in retropharyngeal area"/> </reasonCodeableConcept> <performer> <actor> <reference value="Practitioner/f001"/> <display value="E.M.J.M. van den broek"/> </actor> <role> <coding> <system value="urn:oid:2.16.840.1.113883.2.4.15.111"/> <!-- "AssignedRoleType" coding system --> <code value="01.000"/> <display value="Arts"/> </coding> <text value="Care role"/> </role> </performer> <performedPeriod> <start value="2013-03-24T09:30:10+01:00"/> <end value="2013-03-24T10:30:10+01:00"/> </performedPeriod> <encounter> <reference value="Encounter/f003"/> </encounter> <outcome> <text value="removal of the retropharyngeal abscess"/> </outcome> <report> <reference value="DiagnosticReport/f001"/> <display value="Lab results blood test"/> </report> <followUp> <text value="described in care plan"/> </followUp> </Procedure> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/MedicationOrder/medrx006"/> <resource> <MedicationOrder xmlns="http://hl7.org/fhir"> <id value="medrx006"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <p><big>Capecitabine (Recurrent/Metastatic)</big></p> <p>Course:</p> <p>Name: Capecitabine</p> <p>Agent Protocols Options:</p> <p><b>Capecitabine 1000-1250 mg/m^2 PO twice daily D1-14</b></p> <p>Offset: None</p> <p>Cycle length: Q21D</p> </div> </text> <status value="on-hold"> <extension url="http://localhost:3000/MedicationOrder/mscode#original-status"> <valueCode value="pending"/> </extension> </status> <medicationReference> <reference value="Medication/MedicationExample15"/> </medicationReference> <patient> <reference value="Patient/f001"/> </patient> <dosageInstruction> <text value="Capecitabine 1000 mg/m^2 PO twice daily D1-14"/> <timing> <repeat> <duration value="21"/> <durationUnit value="d"/> <frequency value="2"/> <period value="1"/> <periodUnit value="d"/> </repeat> </timing> <route> <coding> <system value="http://snomed.info/sct"/> <code value="394899003"/> <display value="oral administration of treatment"/> </coding> </route> <doseQuantity> <value value="1000"/> <unit value="mg/m^2"/> <system value="http://unitsofmeasure.org"/> <code value="ml"/> </doseQuantity> </dosageInstruction> <dispenseRequest> <quantity> <value value="1700"/> <unit value="mg"/> <system value="http://unitsofmeasure.org"/> <code value="mg"/> </quantity> </dispenseRequest> </MedicationOrder> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Condition/f003"/> <resource> <Condition xmlns="http://hl7.org/fhir"> <id value="f003"/> <patient> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </patient> <encounter> <reference value="Encounter/f003"/> </encounter> <asserter> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </asserter> <dateRecorded value="2012-02-20"/> <!-- first suspected by physician visit --> <code> <coding> <system value="http://snomed.info/sct"/> <code value="18099001"/> <display value="Retropharyngeal abscess"/> </coding> </code> <category> <coding> <system value="http://snomed.info/sct"/> <code value="439401001"/> <display value="diagnosis"/> </coding> </category> <clinicalStatus value="active"/> <verificationStatus value="confirmed"/> <severity> <coding> <system value="http://snomed.info/sct"/> <code value="371923003"/> <display value="Mild to moderate"/> </coding> </severity> <onsetDateTime value="2012-02-27"/> <!-- actual diagnose be E.N.T. specialist --> <evidence> <code> <coding> <system value="http://snomed.info/sct"/> <code value="169068008"/> <display value="CT of neck"/> </coding> </code> </evidence> <bodySite> <coding> <system value="http://snomed.info/sct"/> <code value="280193007"/> <display value="Entire retropharyngeal area"/> </coding> </bodySite> </Condition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Contract/pcd-example-notOrg"/> <resource> <Contract xmlns="http://hl7.org/fhir"> <id value="pcd-example-notOrg"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on existing jurisdictional policy and are realized in existing systems in Canada. The default policy is one of implied consent for the provision of care, so these scenarios all deal with withdrawal or withholding consent for that purpose. In other jurisdictions, where an express consent model is used (Opt-In), these would examples would contain the phrase "consent to" rather than "withhold" or "withdraw" consent for. <p> specific to use-case 3) Withhold or withdraw consent for disclosure to a specific provider organization </p><p> Patient "P. van de Heuvel" ex-spouse is a Physician that is employed by Good Health Clinic. P. decides that he would like to withdraw/withhold consent to disclose any instance of his health information to Good Health Clinic. </p> </div> </text> <issued value="2015-11-18"/> <!-- not bound by a timeframe - Contract.applies --> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Contract.authority element --> <authority> <reference value="Organization/Infoway"/> <display value="Canada Infoway"/> </authority> <!-- and/or would this [also] go into Contract.domain as a Jurisdiction?? (see the example on UK Pharamacy Juristiction) --> <domain> <reference value="Location/Infoway"/> <display value="Canada Infoway"/> </domain> <type> <coding> <system value="http://loinc.org"/> <code value="57016-8"/> </coding> </type> <!-- made up code-system to represent the set of privacy consent sub-types known and published by Canada Infoway --> <subType> <coding> <system value="http://www.infoway-inforoute.ca.org/Consent-subtype-codes"/> <code value="Opt-In"/> <display value="Default Authorization with exceptions."/> </coding> </subType> <term> <type> <coding> <!-- made up code system --> <system value="http://hl7.org/fhir/consent-term-type-codes"/> <code value="withhold-from"/> <display value="Withhold all data from specified actor entity."/> </coding> </type> <topic> <reference value="Organization/2.16.840.1.113883.19.5"/> <display value="Good Health Clinic"/> </topic> <!-- by not specifying term.actor I assume this means everyone? --> <text value="Withhold this order and any results or related objects from any provider."/> </term> <!-- the terms of the consent in friendly consumer speak --> <friendly> <contentAttachment> <title value="The terms of the consent in friendly consumer speak."/> <!-- likely use url pointer to common text --> </contentAttachment> </friendly> <!-- the legal terms of the consent in lawyer speak --> <legal> <contentAttachment> <title value="The terms of the consent in lawyer speak."/> <!-- likely use url pointer to common text --> <!-- I think some think that this should be the pointer to the law by which this consent is derived under. Such as http://lois-laws.justice.gc.ca/eng/acts/P-21/index.html --> </contentAttachment> </legal> </Contract> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Observation/ekg"/> <resource> <!-- Sampled ECG potentials (Leads I, II, II). There are 2 chunks (numbered as 0 and 1) for each lead. The voltage of each lead is near zero. --><Observation xmlns="http://hl7.org/fhir"> <id value="ekg"/> <status value="final"/> <category> <coding> <system value="http://hl7.org/fhir/observation-category"/> <code value="procedure"/> <display value="Procedure"/> </coding> </category> <code> <coding> <system value="urn:oid:2.16.840.1.113883.6.24"/> <code value="131328"/> <display value="MDC_ECG_ELEC_POTL"/> </coding> </code> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <effectiveDateTime value="2015-02-19T09:30:35+01:00"/> <performer> <reference value="Practitioner/f005"/> <display value="A. Langeveld"/> </performer> <device> <display value="12 lead EKG Device Metric"/> </device> <!-- Lead I data chunk 0 --> <component> <code> <coding> <system value="urn:oid:2.16.840.1.113883.6.24"/> <code value="131329"/> <display value="MDC_ECG_ELEC_POTL_I"/> </coding> </code> <valueSampledData> <!-- Zero potential --> <origin> <value value="2048"/> </origin> <!-- period in ms = 1000/frequency --> <period value="10"/> <!-- factor.value --> <factor value="1.612"/> <!-- voltage-min --> <lowerLimit value="-3300"/> <!-- voltage-max --> <upperLimit value="3300"/> <dimensions value="1"/> <data value="2041 2043 2037 2047 2060 2062 2051 2023 2014 2027 2034 2033 2040 2047 2047 2053 2058 2064 2059 2063 2061 2052 2053 2038 1966 1885 1884 2009 2129 2166 2137 2102 2086 2077 2067 2067 2060 2059 2062 2062 2060 2057 2045 2047 2057 2054 2042 2029 2027 2018 2007 1995 2001 2012 2024 2039 2068 2092 2111 2125 2131 2148 2137 2138 2128 2128 2115 2099 2097 2096 2101 2101 2091 2073 2076 2077 2084 2081 2088 2092 2070 2069 2074 2077 2075 2068 2064 2060 2062 2074 2075 2074 2075 2063 2058 2058 2064 2064 2070 2074 2067 2060 2062 2063 2061 2059 2048 2052 2049 2048 2051 2059 2059 2066 2077 2073"/> </valueSampledData> </component> <!-- Lead II data chunk 0 --> <component> <code> <coding> <system value="urn:oid:2.16.840.1.113883.6.24"/> <code value="131330"/> <display value="MDC_ECG_ELEC_POTL_II"/> </coding> </code> <valueSampledData> <!-- Zero potential --> <origin> <value value="2048"/> </origin> <!-- period in ms = 1000/frequency --> <period value="10"/> <!-- factor.value --> <factor value="1.612"/> <!-- voltage-min --> <lowerLimit value="-3300"/> <!-- voltage-max --> <upperLimit value="3300"/> <dimensions value="1"/> <data value="2041 2043 2037 2047 2060 2062 2051 2023 2014 2027 2034 2033 2040 2047 2047 2053 2058 2064 2059 2063 2061 2052 2053 2038 1966 1885 1884 2009 2129 2166 2137 2102 2086 2077 2067 2067 2060 2059 2062 2062 2060 2057 2045 2047 2057 2054 2042 2029 2027 2018 2007 1995 2001 2012 2024 2039 2068 2092 2111 2125 2131 2148 2137 2138 2128 2128 2115 2099 2097 2096 2101 2101 2091 2073 2076 2077 2084 2081 2088 2092 2070 2069 2074 2077 2075 2068 2064 2060 2062 2074 2075 2074 2075 2063 2058 2058 2064 2064 2070 2074 2067 2060 2062 2063 2061 2059 2048 2052 2049 2048 2051 2059 2059 2066 2077 2073"/> </valueSampledData> </component> <!-- Lead III data chunk 0 --> <component> <code> <coding> <system value="urn:oid:2.16.840.1.113883.6.24"/> <code value="131389"/> <display value="MDC_ECG_ELEC_POTL_III"/> </coding> </code> <valueSampledData> <!-- Zero potential --> <origin> <value value="2048"/> </origin> <!-- period in ms = 1000/frequency --> <period value="10"/> <!-- factor.value --> <factor value="1.612"/> <!-- voltage-min --> <lowerLimit value="-3300"/> <!-- voltage-max --> <upperLimit value="3300"/> <dimensions value="1"/> <data value="2041 2043 2037 2047 2060 2062 2051 2023 2014 2027 2034 2033 2040 2047 2047 2053 2058 2064 2059 2063 2061 2052 2053 2038 1966 1885 1884 2009 2129 2166 2137 2102 2086 2077 2067 2067 2060 2059 2062 2062 2060 2057 2045 2047 2057 2054 2042 2029 2027 2018 2007 1995 2001 2012 2024 2039 2068 2092 2111 2125 2131 2148 2137 2138 2128 2128 2115 2099 2097 2096 2101 2101 2091 2073 2076 2077 2084 2081 2088 2092 2070 2069 2074 2077 2075 2068 2064 2060 2062 2074 2075 2074 2075 2063 2058 2058 2064 2064 2070 2074 2067 2060 2062 2063 2061 2059 2048 2052 2049 2048 2051 2059 2059 2066 2077 2073"/> </valueSampledData> </component> </Observation> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Encounter/f002"/> <resource> <Encounter xmlns="http://hl7.org/fhir"> <id value="f002"/> <identifier> <use value="official"/> <system value="http://www.bmc.nl/zorgportal/identifiers/encounters"/> <value value="v3251"/> </identifier> <status value="finished"/> <class value="outpatient"/> <type> <coding> <system value="http://snomed.info/sct"/> <code value="270427003"/> <display value="Patient-initiated encounter"/> </coding> </type> <priority> <coding> <system value="http://snomed.info/sct"/> <code value="103391001"/> <display value="Urgent"/> </coding> </priority> <patient> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </patient> <participant> <individual> <reference value="Practitioner/f003"/> <display value="M.I.M Versteegh"/> </individual> </participant> <length> <value value="140"/> <unit value="min"/> <system value="http://unitsofmeasure.org"/> <code value="min"/> </length> <reason> <coding> <system value="http://snomed.info/sct"/> <code value="34068001"/> <display value="Partial lobectomy of lung"/> </coding> </reason> <hospitalization> <preAdmissionIdentifier> <use value="official"/> <system value="http://www.bmc.nl/zorgportal/identifiers/pre-admissions"/> <value value="98682"/> </preAdmissionIdentifier> <!-- <preAdmissionTest> <coding> <system value="http://snomed.info/sct"/> <code value="399208008"/> <display value="Chest X-ray"/> </coding> <coding> <system value="http://snomed.info/sct"/> <code value="396550006"/> <display value="Blood test"/> </coding> </preAdmissionTest> --> <admitSource> <coding> <system value="http://snomed.info/sct"/> <code value="305997006"/> <display value="Referral by radiologist"/> </coding> </admitSource> <dischargeDisposition> <coding> <system value="http://snomed.info/sct"/> <code value="306689006"/> <display value="Discharge to home"/> </coding> </dischargeDisposition> </hospitalization> <serviceProvider> <reference value="Organization/f001"/> <display value="BMC"/> </serviceProvider> </Encounter> </resource> </entry> </Bundle>