This page is part of the FHIR Specification (v3.3.0: R4 Ballot 2). 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
Patient Administration Work Group | Maturity Level: 5 | Normative | Compartments: N/A |
Normative Candidate Note: This page is candidate normative content for R4 in the Patient Package. Once normative, it will lose it's Maturity Level, and breaking changes will no longer be made.
This operation is used to return all the information related to one or more patients described in the resource or context on which this operation is invoked. The response is a bundle of type "searchset". At a minimum, the patient resource(s) itself is returned, along with any other resources that the server has that are related to the patient(s), 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 intended use for this operation is to provide a patient with access to their entire record (e.g. "Blue Button"), or for provider or other user to perform a bulk data download. The server SHOULD return at least all resources that it has that are in the patient compartment for the identified patient(s), 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.
The official URL for this operation definition is
http://hl7.org/fhir/OperationDefinition/Patient-everything
Formal Definition (as a OperationDefinition).
URL: [base]/Patient/$everything
URL: [base]/Patient/[id]/$everything
This is an idempotent operation
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. | ||
_since | 0..1 | instant | Resources updated after this period will be included in the response. The intent of this parameter is to allow a client to request only records that have changed since the last request, based on either the return header time, or or (for asynchronous use), the transaction time | ||
_type | 0..* | code | One or more parameters, each containing one or more comma-delimited FHIR resource types to include in the return resources. In the absense of any specified types, the server returns all resource types | ||
_count | 0..1 | integer | See discussion below on the utility of paging through the results of the $everything operation | ||
Out Parameters: | |||||
Name | Cardinality | Type | Binding | Profile | Documentation |
return | 1..1 | Bundle | The bundle type is "searchset" Note: as this the only out parameter, it is a resource, and it has the name 'return', the result of this operation is returned directly as a resource |
The key differences between this operation and simply searching the patient compartment are:
This frees the client from needing to determine what it could or should ask for, particularly with regard to included resources.
It is assumed that the server has identified and secured the context appropriately, and can either associate the authorization context with a single patient, or determine whether the context has the rights to the nominated patient, if there is one, or can determine an appropriate list of patients to provide data for from the context of the request. If there is no nominated patient (GET /Patient/$everything) and the context is not associated with a single patient record, the actual list of patients is all patients that the user associated with the request has access to. This may be all patients in the family that the patient has access to, or it may be all patients that a care provider has access to, or all patients on the entire record system. In such cases, the server may choose to return an error rather than all the records. Specifying the relationship between the context, a user and patient records is outside the scope of this specification (though see The Smart App Launch Implementation Guide .
When this operation is used to access multiple patient records at once, the return bundle could be rather a lot of data; servers may choose to require that such requests are made asynchronously, and associated with bulk data formats. Alternatively, clients may choose to page through the result set (or servers may require this). Paging through the results is done the same as for Searching, using the _count parameter, and Bundle links. Implementers should note that paging will be slower than simply returning all the results at once (more network traffic, multiple latency delays) but may be required in order not to exhaust available memory reading or writing the whole response in a single package. Unlike searching, there is no inherent user-display order for the $everything operation. Servers might consider sorting the returned resources in descending order of last record update, but are not required to do so
Get all resources linked to a single patient (Request):
GET /open/Patient/f001/$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="04d6bf1c-1b73-4062-a7cb-14f1d4938d50"/> <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/v2/0131"/> <code value="C"/> </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/Consent/consent-example-notThis"/> <resource> <Consent xmlns="http://hl7.org/fhir"> <id value="consent-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> <status value="in-progress"/> <scope> <coding> <system value="http://hl7.org/fhir/consentscope"/> <code value="patient-privacy"/> </coding> </scope> <category> <coding> <system value="http://loinc.org"/> <code value="59284-0"/> </coding> </category> <patient> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </patient> <dateTime value="2015-11-18"/> <!-- not bound by a timeframe - Consent.period --> <!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Consent.authority element --> <organization> <reference value="Organization/f001"/> </organization> <!-- the text terms of the consent in lawyer speak --> <sourceAttachment> <title value="The terms of the consent in lawyer speak."/> <!-- likely use url pointer to common text --> </sourceAttachment> <!-- this is opt-in - e.g. everything approved unless otherwise stated --> <policyRule> <coding> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="OPTIN"/> </coding> </policyRule> <provision> <data> <meaning value="related"/> <reference> <reference value="Task/example3"/> </reference> </data> </provision> </Consent> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Procedure/f003"/> <resource> <Procedure xmlns="http://hl7.org/fhir"> <id value="f003"/> <status value="completed"/> <code> <coding> <system value="http://snomed.info/sct"/> <code value="172960003"/> <display value="Incision of retropharyngeal abscess"/> </coding> </code> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <context> <reference value="Encounter/f003"/> </context> <performedPeriod> <start value="2013-03-24T09:30:10+01:00"/> <end value="2013-03-24T10:30:10+01:00"/> </performedPeriod> <performer> <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> <actor> <reference value="Practitioner/f001"/> <display value="E.M.J.M. van den broek"/> </actor> </performer> <reasonCode> <text value="abcess in retropharyngeal area"/> </reasonCode> <bodySite> <coding> <system value="http://snomed.info/sct"/> <code value="83030008"/> <display value="Retropharyngeal area"/> </coding> </bodySite> <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/Condition/f003"/> <resource> <Condition xmlns="http://hl7.org/fhir"> <id value="f003"/> <clinicalStatus value="active"/> <verificationStatus value="confirmed"/> <category> <coding> <system value="http://snomed.info/sct"/> <code value="439401001"/> <display value="diagnosis"/> </coding> </category> <severity> <coding> <system value="http://snomed.info/sct"/> <code value="371923003"/> <display value="Mild to moderate"/> </coding> </severity> <code> <coding> <system value="http://snomed.info/sct"/> <code value="18099001"/> <display value="Retropharyngeal abscess"/> </coding> </code> <bodySite> <coding> <system value="http://snomed.info/sct"/> <code value="280193007"/> <display value="Entire retropharyngeal area"/> </coding> </bodySite> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <context> <reference value="Encounter/f003"/> </context> <onsetDateTime value="2012-02-27"/> <assertedDate value="2012-02-20"/> <asserter> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </asserter> <evidence> <code> <coding> <system value="http://snomed.info/sct"/> <code value="169068008"/> <display value="CT of neck"/> </coding> </code> </evidence> </Condition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Condition/f001"/> <resource> <Condition xmlns="http://hl7.org/fhir"> <id value="f001"/> <clinicalStatus value="active"/> <verificationStatus value="confirmed"/> <category> <coding> <system value="http://snomed.info/sct"/> <code value="439401001"/> <display value="diagnosis"/> </coding> </category> <severity> <coding> <system value="http://snomed.info/sct"/> <code value="6736007"/> <display value="Moderate"/> </coding> </severity> <code> <coding> <system value="http://snomed.info/sct"/> <code value="368009"/> <display value="Heart valve disorder"/> </coding> </code> <bodySite> <coding> <system value="http://snomed.info/sct"/> <code value="40768004"/> <display value="Left thorax"/> </coding> <text value="heart structure"/> </bodySite> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <context> <reference value="Encounter/f001"/> </context> <onsetDateTime value="2011-08-05"/> <assertedDate value="2011-10-05"/> <asserter> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </asserter> <evidence> <code> <coding> <system value="http://snomed.info/sct"/> <code value="426396005"/> <display value="Cardiac chest pain"/> </coding> </code> </evidence> </Condition> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Consent/consent-example-notTime"/> <resource> <Consent xmlns="http://hl7.org/fhir"> <id value="consent-example-notTime"/> <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 6. Withhold or withdraw consent for disclosure of records related published during a timeframe </p><p> Patient "P. van de Heuvel" wishes to withhold disclosure of all data from a timeframe to any provider. </p> </div> </text> <status value="in-progress"/> <scope> <coding> <system value="http://hl7.org/fhir/consentscope"/> <code value="patient-privacy"/> </coding> </scope> <category> <coding> <system value="http://loinc.org"/> <code value="59284-0"/> </coding> </category> <patient> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </patient> <dateTime value="2015-11-18"/> <!-- not bound by a timeframe - Consent.period --> <!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Consent.authority element --> <organization> <reference value="Organization/f001"/> </organization> <!-- the text terms of the consent in lawyer speak --> <sourceAttachment> <title value="The terms of the consent in lawyer speak."/> <!-- likely use url pointer to common text --> </sourceAttachment> <!-- this is opt-in - e.g. everything approved unless otherwise stated --> <policyRule> <coding> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="OPTIN"/> </coding> </policyRule> <provision> <period> <start value="2015-01-01"/> <end value="2015-02-01"/> </period> </provision> </Consent> </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> <authority> <reference value="Organization/3"/> <display value="Michigan Health"/> </authority> <!-- and/or would this [also] go into Contract.domain as a Jurisdiction?? (see the example on UK Pharamacy Juristiction) --> <domain> <reference value="Location/ukp"/> <display value="UK Pharmacies"/> </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> <offer> <text value="sample"/> </offer> <group> <type> <coding> <!-- made up code system --> <system value="http://example.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="ServiceRequest"/> </coding> </subType> <!-- by not specifying term.actor I assume this means everyone? --> <offer> <text value="Withhold orders from any provider."/> </offer> </group> <group> <type> <coding> <!-- made up code system --> <system value="http://example.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="DiagnosticReport"/> </coding> </subType> <!-- by not specifying term.actor I assume this means everyone? --> <offer> <text value="Withhold order results from any provider."/> </offer> </group> </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/Consent/consent-example-grantor"/> <resource> <Consent xmlns="http://hl7.org/fhir"> <id value="consent-example-grantor"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on a question asked on John Moehrke's blog in the <a href="http://healthcaresecprivacy.blogspot.com/2016/04/consent-given-to-authorized.html">Consent given to authorized representative</a> <p> This is a case where a Patient is giving a limited (read-only) access to an individual. </p><p> Patient "P. van de Heuvel" wishes to provide XXX with read-only access to the data at Good Health Psychiatric Hospital available for patient requested access use. </p> </div> </text> <status value="in-progress"/> <scope> <coding> <system value="http://hl7.org/fhir/consentscope"/> <code value="patient-privacy"/> </coding> </scope> <category> <coding> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="INFAO"/> </coding> </category> <patient> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </patient> <dateTime value="2015-11-18"/> <!-- not bound by a timeframe - Consent.period --> <!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Consent.authority element --> <organization> <reference value="Organization/f001"/> </organization> <!-- the text terms of the consent in lawyer speak --> <sourceAttachment> <title value="The terms of the consent in lawyer speak."/> <!-- likely use url pointer to common text --> </sourceAttachment> <!-- this is opt-out - e.g. nothing approved unless otherwise stated --> <policyRule> <coding> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="OPTOUT"/> </coding> </policyRule> <provision> <actor> <role> <coding> <system value="http://hl7.org/fhir/v3/ParticipationType"/> <code value="CST"/> </coding> </role> <reference> <reference value="Organization/f001"/> </reference> </actor> <actor> <role> <coding> <system value="http://hl7.org/fhir/v3/ParticipationType"/> <code value="PRCP"/> </coding> </role> <reference> <reference value="Patient/example"/> <display value="Good Health Clinic"/> </reference> </actor> <action> <coding> <system value="http://hl7.org/fhir/consentaction"/> <code value="access"/> </coding> </action> </provision> </Consent> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/CarePlan/f001"/> <resource> <CarePlan xmlns="http://hl7.org/fhir"> <id value="f001"/> <contained> <CareTeam> <id value="careteam"/> <participant> <member> <reference value="Practitioner/f002"/> <display value="P. Voigt"/> </member> </participant> </CareTeam> </contained> <contained> <Goal> <id value="goal"/> <status value="achieved"/> <description> <text value="recovery surgery on heart of patient"/> </description> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <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> <status value="completed"/> <intent value="plan"/> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <period> <start value="2011-06-26"/> <end value="2011-06-27"/> </period> <careTeam> <reference value="#careteam"/> </careTeam> <addresses> <reference value="Condition/f201"/> <!--TODO Correcte referentie--> <display value="?????"/> </addresses> <goal> <reference value="#goal"/> </goal> <activity> <detail> <kind value="ServiceRequest"/> <!-- 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"/> <doNotPerform 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/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="2013-04-05T10:30:10+01:00"/> <end value="2013-04-05T10:30:10+01:00"/> </effectivePeriod> <issued value="2013-04-05T15:30:10+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/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"/> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <authority> <reference value="Organization/3"/> <display value="Michigan Health"/> </authority> <!-- and/or would this [also] go into Contract.domain as a Jurisdiction?? (see the example on UK Pharamacy Juristiction) --> <domain> <reference value="Location/ukp"/> <display value="UK Pharmacies"/> </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://example.org/fhir/consent-term-type-codes"/> <code value="withhold-from"/> <display value="Withhold all data from specified actor entity."/> </coding> </type> <offer> <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."/> </offer> <agent> <actor> <reference value="Patient/f001"/> </actor> </agent> </term> <signer> <type> <system value="http://www.hl7.org/fhir/contractsignertypecodes"/> <code value="COVPTY"/> </type> <party> <reference value="Patient/f001"/> </party> <signature> <type> <system value="urn:iso-astm:E1762-95:2013"/> <code value="1.2.840.10065.1.12.1.1"/> </type> <when value="2013-06-08T10:57:34-07:00"/> <whoReference> <reference value="Patient/f001"/> </whoReference> </signature> </signer> <!-- 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> <!-- not bound by a timeframe - Contract.applies --> </Contract> </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> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="AMB"/> <!-- outpatient --> <display value="ambulatory"/> </class> <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> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <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/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> <authority> <reference value="Organization/3"/> <display value="Michigan Health"/> </authority> <!-- and/or would this [also] go into Contract.domain as a Jurisdiction?? (see the example on UK Pharamacy Juristiction) --> <domain> <reference value="Location/ukp"/> <display value="UK Pharmacies"/> </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://example.org/fhir/consent-term-type-codes"/> <code value="withhold-authored-by"/> <display value="Withhold all data authored by specified actor entity."/> </coding> </type> <offer> <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."/> </offer> </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-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> <authority> <reference value="Organization/3"/> <display value="Michigan Health"/> </authority> <!-- and/or would this [also] go into Contract.domain as a Jurisdiction?? (see the example on UK Pharamacy Juristiction) --> <domain> <reference value="Location/ukp"/> <display value="UK Pharmacies"/> </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://example.org/fhir/consent-term-type-codes"/> <code value="withhold-from"/> <display value="Withhold all data from specified actor entity."/> </coding> </type> <offer> <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."/> </offer> </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/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> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="AMB"/> <!-- outpatient --> <display value="ambulatory"/> </class> <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> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <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> <entry> <fullUrl value="http://hl7.org/fhir/List/long"/> <resource> <List xmlns="http://hl7.org/fhir"> <id value="long"/> <status value="current"/> <mode value="changes"/> <date value="2018-02-21T12:17:00+11:00"/> <entry> <item> <reference value="Patient/example"/> </item> </entry> <entry> <item> <reference value="Patient/pat1"/> </item> </entry> <entry> <item> <reference value="Patient/pat2"/> </item> </entry> <entry> <item> <reference value="Patient/pat3"/> </item> </entry> <entry> <item> <reference value="Patient/pat4"/> </item> </entry> <entry> <item> <reference value="Patient/1"/> </item> </entry> <entry> <item> <reference value="Patient/2"/> </item> </entry> <entry> <item> <reference value="Patient/3"/> </item> </entry> <entry> <item> <reference value="Patient/4"/> </item> </entry> <entry> <item> <reference value="Patient/5"/> </item> </entry> <entry> <item> <reference value="Patient/6"/> </item> </entry> <entry> <item> <reference value="Patient/7"/> </item> </entry> <entry> <item> <reference value="Patient/8"/> </item> </entry> <entry> <item> <reference value="Patient/9"/> </item> </entry> <entry> <item> <reference value="Patient/10"/> </item> </entry> <entry> <item> <reference value="Patient/11"/> </item> </entry> <entry> <item> <reference value="Patient/12"/> </item> </entry> <entry> <item> <reference value="Patient/71"/> </item> </entry> <entry> <item> <reference value="Patient/72"/> </item> </entry> <entry> <item> <reference value="Patient/73"/> </item> </entry> <entry> <item> <reference value="Patient/74"/> </item> </entry> <entry> <item> <reference value="Patient/75"/> </item> </entry> <entry> <item> <reference value="Patient/76"/> </item> </entry> <entry> <item> <reference value="Patient/77"/> </item> </entry> <entry> <item> <reference value="Patient/78"/> </item> </entry> <entry> <item> <reference value="Patient/79"/> </item> </entry> <entry> <item> <reference value="Patient/80"/> </item> </entry> <entry> <item> <reference value="Patient/81"/> </item> </entry> <entry> <item> <reference value="Patient/82"/> </item> </entry> <entry> <item> <reference value="Patient/83"/> </item> </entry> <entry> <item> <reference value="Patient/84"/> </item> </entry> <entry> <item> <reference value="Patient/85"/> </item> </entry> <entry> <item> <reference value="Patient/86"/> </item> </entry> <entry> <item> <reference value="Patient/87"/> </item> </entry> <entry> <item> <reference value="Patient/88"/> </item> </entry> <entry> <item> <reference value="Patient/89"/> </item> </entry> <entry> <item> <reference value="Patient/90"/> </item> </entry> <entry> <item> <reference value="Patient/91"/> </item> </entry> <entry> <item> <reference value="Patient/92"/> </item> </entry> <entry> <item> <reference value="Patient/93"/> </item> </entry> <entry> <item> <reference value="Patient/94"/> </item> </entry> <entry> <item> <reference value="Patient/95"/> </item> </entry> <entry> <item> <reference value="Patient/96"/> </item> </entry> <entry> <item> <reference value="Patient/97"/> </item> </entry> <entry> <item> <reference value="Patient/98"/> </item> </entry> <entry> <item> <reference value="Patient/99"/> </item> </entry> <entry> <item> <reference value="Patient/100"/> </item> </entry> <entry> <item> <reference value="Patient/101"/> </item> </entry> <entry> <item> <reference value="Patient/102"/> </item> </entry> <entry> <item> <reference value="Patient/103"/> </item> </entry> <entry> <item> <reference value="Patient/104"/> </item> </entry> <entry> <item> <reference value="Patient/105"/> </item> </entry> <entry> <item> <reference value="Patient/106"/> </item> </entry> <entry> <item> <reference value="Patient/107"/> </item> </entry> <entry> <item> <reference value="Patient/108"/> </item> </entry> <entry> <item> <reference value="Patient/109"/> </item> </entry> <entry> <item> <reference value="Patient/110"/> </item> </entry> <entry> <item> <reference value="Patient/111"/> </item> </entry> <entry> <item> <reference value="Patient/112"/> </item> </entry> <entry> <item> <reference value="Patient/113"/> </item> </entry> <entry> <item> <reference value="Patient/114"/> </item> </entry> <entry> <item> <reference value="Patient/115"/> </item> </entry> <entry> <item> <reference value="Patient/116"/> </item> </entry> <entry> <item> <reference value="Patient/117"/> </item> </entry> <entry> <item> <reference value="Patient/118"/> </item> </entry> <entry> <item> <reference value="Patient/119"/> </item> </entry> <entry> <item> <reference value="Patient/120"/> </item> </entry> <entry> <item> <reference value="Patient/121"/> </item> </entry> <entry> <item> <reference value="Patient/122"/> </item> </entry> <entry> <item> <reference value="Patient/123"/> </item> </entry> <entry> <item> <reference value="Patient/124"/> </item> </entry> <entry> <item> <reference value="Patient/125"/> </item> </entry> <entry> <item> <reference value="Patient/126"/> </item> </entry> <entry> <item> <reference value="Patient/127"/> </item> </entry> <entry> <item> <reference value="Patient/128"/> </item> </entry> <entry> <item> <reference value="Patient/129"/> </item> </entry> <entry> <item> <reference value="Patient/130"/> </item> </entry> <entry> <item> <reference value="Patient/131"/> </item> </entry> <entry> <item> <reference value="Patient/132"/> </item> </entry> <entry> <item> <reference value="Patient/133"/> </item> </entry> <entry> <item> <reference value="Patient/134"/> </item> </entry> <entry> <item> <reference value="Patient/135"/> </item> </entry> <entry> <item> <reference value="Patient/136"/> </item> </entry> <entry> <item> <reference value="Patient/137"/> </item> </entry> <entry> <item> <reference value="Patient/138"/> </item> </entry> <entry> <item> <reference value="Patient/139"/> </item> </entry> <entry> <item> <reference value="Patient/140"/> </item> </entry> <entry> <item> <reference value="Patient/141"/> </item> </entry> <entry> <item> <reference value="Patient/142"/> </item> </entry> <entry> <item> <reference value="Patient/143"/> </item> </entry> <entry> <item> <reference value="Patient/144"/> </item> </entry> <entry> <item> <reference value="Patient/145"/> </item> </entry> <entry> <item> <reference value="Patient/146"/> </item> </entry> <entry> <item> <reference value="Patient/147"/> </item> </entry> <entry> <item> <reference value="Patient/148"/> </item> </entry> <entry> <item> <reference value="Patient/149"/> </item> </entry> <entry> <item> <reference value="Patient/150"/> </item> </entry> <entry> <item> <reference value="Patient/151"/> </item> </entry> <entry> <item> <reference value="Patient/152"/> </item> </entry> <entry> <item> <reference value="Patient/153"/> </item> </entry> <entry> <item> <reference value="Patient/154"/> </item> </entry> <entry> <item> <reference value="Patient/155"/> </item> </entry> <entry> <item> <reference value="Patient/156"/> </item> </entry> <entry> <item> <reference value="Patient/157"/> </item> </entry> <entry> <item> <reference value="Patient/158"/> </item> </entry> <entry> <item> <reference value="Patient/159"/> </item> </entry> <entry> <item> <reference value="Patient/160"/> </item> </entry> <entry> <item> <reference value="Patient/161"/> </item> </entry> <entry> <item> <reference value="Patient/162"/> </item> </entry> <entry> <item> <reference value="Patient/163"/> </item> </entry> <entry> <item> <reference value="Patient/164"/> </item> </entry> <entry> <item> <reference value="Patient/165"/> </item> </entry> <entry> <item> <reference value="Patient/166"/> </item> </entry> <entry> <item> <reference value="Patient/167"/> </item> </entry> <entry> <item> <reference value="Patient/168"/> </item> </entry> <entry> <item> <reference value="Patient/169"/> </item> </entry> <entry> <item> <reference value="Patient/170"/> </item> </entry> <entry> <item> <reference value="Patient/171"/> </item> </entry> <entry> <item> <reference value="Patient/172"/> </item> </entry> <entry> <item> <reference value="Patient/173"/> </item> </entry> <entry> <item> <reference value="Patient/174"/> </item> </entry> <entry> <item> <reference value="Patient/175"/> </item> </entry> <entry> <item> <reference value="Patient/176"/> </item> </entry> <entry> <item> <reference value="Patient/177"/> </item> </entry> <entry> <item> <reference value="Patient/178"/> </item> </entry> <entry> <item> <reference value="Patient/179"/> </item> </entry> <entry> <item> <reference value="Patient/180"/> </item> </entry> <entry> <item> <reference value="Patient/181"/> </item> </entry> <entry> <item> <reference value="Patient/182"/> </item> </entry> <entry> <item> <reference value="Patient/183"/> </item> </entry> <entry> <item> <reference value="Patient/184"/> </item> </entry> <entry> <item> <reference value="Patient/185"/> </item> </entry> <entry> <item> <reference value="Patient/186"/> </item> </entry> <entry> <item> <reference value="Patient/187"/> </item> </entry> <entry> <item> <reference value="Patient/188"/> </item> </entry> <entry> <item> <reference value="Patient/189"/> </item> </entry> <entry> <item> <reference value="Patient/190"/> </item> </entry> <entry> <item> <reference value="Patient/191"/> </item> </entry> <entry> <item> <reference value="Patient/192"/> </item> </entry> <entry> <item> <reference value="Patient/193"/> </item> </entry> <entry> <item> <reference value="Patient/194"/> </item> </entry> <entry> <item> <reference value="Patient/195"/> </item> </entry> <entry> <item> <reference value="Patient/196"/> </item> </entry> <entry> <item> <reference value="Patient/197"/> </item> </entry> <entry> <item> <reference value="Patient/198"/> </item> </entry> <entry> <item> <reference value="Patient/199"/> </item> </entry> <entry> <item> <reference value="Patient/200"/> </item> </entry> <entry> <item> <reference value="Patient/201"/> </item> </entry> <entry> <item> <reference value="Patient/202"/> </item> </entry> <entry> <item> <reference value="Patient/203"/> </item> </entry> <entry> <item> <reference value="Patient/204"/> </item> </entry> <entry> <item> <reference value="Patient/205"/> </item> </entry> <entry> <item> <reference value="Patient/206"/> </item> </entry> <entry> <item> <reference value="Patient/207"/> </item> </entry> <entry> <item> <reference value="Patient/208"/> </item> </entry> <entry> <item> <reference value="Patient/209"/> </item> </entry> <entry> <item> <reference value="Patient/210"/> </item> </entry> <entry> <item> <reference value="Patient/211"/> </item> </entry> <entry> <item> <reference value="Patient/212"/> </item> </entry> <entry> <item> <reference value="Patient/213"/> </item> </entry> <entry> <item> <reference value="Patient/214"/> </item> </entry> <entry> <item> <reference value="Patient/215"/> </item> </entry> <entry> <item> <reference value="Patient/216"/> </item> </entry> <entry> <item> <reference value="Patient/217"/> </item> </entry> <entry> <item> <reference value="Patient/218"/> </item> </entry> <entry> <item> <reference value="Patient/219"/> </item> </entry> <entry> <item> <reference value="Patient/220"/> </item> </entry> <entry> <item> <reference value="Patient/221"/> </item> </entry> <entry> <item> <reference value="Patient/222"/> </item> </entry> <entry> <item> <reference value="Patient/223"/> </item> </entry> <entry> <item> <reference value="Patient/224"/> </item> </entry> <entry> <item> <reference value="Patient/225"/> </item> </entry> <entry> <item> <reference value="Patient/226"/> </item> </entry> <entry> <item> <reference value="Patient/227"/> </item> </entry> <entry> <item> <reference value="Patient/228"/> </item> </entry> <entry> <item> <reference value="Patient/229"/> </item> </entry> <entry> <item> <reference value="Patient/230"/> </item> </entry> <entry> <item> <reference value="Patient/231"/> </item> </entry> <entry> <item> <reference value="Patient/232"/> </item> </entry> <entry> <item> <reference value="Patient/233"/> </item> </entry> <entry> <item> <reference value="Patient/234"/> </item> </entry> <entry> <item> <reference value="Patient/235"/> </item> </entry> <entry> <item> <reference value="Patient/236"/> </item> </entry> <entry> <item> <reference value="Patient/237"/> </item> </entry> <entry> <item> <reference value="Patient/238"/> </item> </entry> <entry> <item> <reference value="Patient/239"/> </item> </entry> <entry> <item> <reference value="Patient/240"/> </item> </entry> <entry> <item> <reference value="Patient/241"/> </item> </entry> <entry> <item> <reference value="Patient/242"/> </item> </entry> <entry> <item> <reference value="Patient/243"/> </item> </entry> <entry> <item> <reference value="Patient/244"/> </item> </entry> <entry> <item> <reference value="Patient/245"/> </item> </entry> <entry> <item> <reference value="Patient/246"/> </item> </entry> <entry> <item> <reference value="Patient/247"/> </item> </entry> <entry> <item> <reference value="Patient/248"/> </item> </entry> <entry> <item> <reference value="Patient/249"/> </item> </entry> <entry> <item> <reference value="Patient/250"/> </item> </entry> <entry> <item> <reference value="Patient/251"/> </item> </entry> <entry> <item> <reference value="Patient/252"/> </item> </entry> <entry> <item> <reference value="Patient/253"/> </item> </entry> <entry> <item> <reference value="Patient/254"/> </item> </entry> <entry> <item> <reference value="Patient/255"/> </item> </entry> <entry> <item> <reference value="Patient/256"/> </item> </entry> <entry> <item> <reference value="Patient/257"/> </item> </entry> <entry> <item> <reference value="Patient/258"/> </item> </entry> <entry> <item> <reference value="Patient/259"/> </item> </entry> <entry> <item> <reference value="Patient/260"/> </item> </entry> <entry> <item> <reference value="Patient/261"/> </item> </entry> <entry> <item> <reference value="Patient/262"/> </item> </entry> <entry> <item> <reference value="Patient/263"/> </item> </entry> <entry> <item> <reference value="Patient/264"/> </item> </entry> <entry> <item> <reference value="Patient/265"/> </item> </entry> <entry> <item> <reference value="Patient/266"/> </item> </entry> <entry> <item> <reference value="Patient/267"/> </item> </entry> <entry> <item> <reference value="Patient/268"/> </item> </entry> <entry> <item> <reference value="Patient/269"/> </item> </entry> <entry> <item> <reference value="Patient/270"/> </item> </entry> <entry> <item> <reference value="Patient/271"/> </item> </entry> <entry> <item> <reference value="Patient/272"/> </item> </entry> <entry> <item> <reference value="Patient/273"/> </item> </entry> <entry> <item> <reference value="Patient/274"/> </item> </entry> <entry> <item> <reference value="Patient/275"/> </item> </entry> <entry> <item> <reference value="Patient/276"/> </item> </entry> <entry> <item> <reference value="Patient/277"/> </item> </entry> <entry> <item> <reference value="Patient/278"/> </item> </entry> <entry> <item> <reference value="Patient/279"/> </item> </entry> <entry> <item> <reference value="Patient/280"/> </item> </entry> <entry> <item> <reference value="Patient/281"/> </item> </entry> <entry> <item> <reference value="Patient/282"/> </item> </entry> <entry> <item> <reference value="Patient/283"/> </item> </entry> <entry> <item> <reference value="Patient/284"/> </item> </entry> <entry> <item> <reference value="Patient/285"/> </item> </entry> <entry> <item> <reference value="Patient/286"/> </item> </entry> <entry> <item> <reference value="Patient/287"/> </item> </entry> <entry> <item> <reference value="Patient/288"/> </item> </entry> <entry> <item> <reference value="Patient/289"/> </item> </entry> <entry> <item> <reference value="Patient/290"/> </item> </entry> <entry> <item> <reference value="Patient/291"/> </item> </entry> <entry> <item> <reference value="Patient/292"/> </item> </entry> <entry> <item> <reference value="Patient/293"/> </item> </entry> <entry> <item> <reference value="Patient/294"/> </item> </entry> <entry> <item> <reference value="Patient/295"/> </item> </entry> <entry> <item> <reference value="Patient/xcda"/> </item> </entry> <entry> <item> <reference value="Patient/xds"/> </item> </entry> <entry> <item> <reference value="Patient/animal"/> </item> </entry> <entry> <item> <reference value="Patient/dicom"/> </item> </entry> <entry> <item> <reference value="Patient/ihe-pcd"/> </item> </entry> <entry> <item> <reference value="Patient/f001"/> </item> </entry> <entry> <item> <reference value="Patient/f201"/> </item> </entry> <entry> <item> <reference value="Patient/glossy"/> </item> </entry> <entry> <item> <reference value="Patient/proband"/> </item> </entry> <entry> <item> <reference value="Patient/genetics-example1"/> </item> </entry> <entry> <item> <reference value="Patient/ch-example"/> </item> </entry> <entry> <item> <reference value="Patient/newborn"/> </item> </entry> <entry> <item> <reference value="Patient/mom"/> </item> </entry> </List> </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/f002"/> <resource> <CarePlan xmlns="http://hl7.org/fhir"> <id value="f002"/> <contained> <CareTeam> <id value="careteam"/> <participant> <member> <reference value="Practitioner/f003"/> <display value="M.I.M. Versteegh"/> </member> </participant> </CareTeam> </contained> <contained> <Goal> <id value="goal"/> <status value="achieved"/> <description> <text value="succesful surgery on lung of patient"/> </description> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <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> <status value="completed"/> <intent value="plan"/> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <period> <start value="2011-07-06"/> <end value="2013-07-07"/> </period> <careTeam> <reference value="#careteam"/> </careTeam> <addresses> <reference value="Condition/f201"/> <!--TODO Correcte referentie--> <display value="?????"/> </addresses> <goal> <reference value="#goal"/> </goal> <activity> <detail> <kind value="ServiceRequest"/> <!-- 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"/> <doNotPerform 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/CarePlan/f003"/> <resource> <CarePlan xmlns="http://hl7.org/fhir"> <id value="f003"/> <contained> <CareTeam> <id value="careteam"/> <participant> <member> <reference value="Practitioner/f001"/> <display value="E.M. van den broek"/> </member> </participant> </CareTeam> </contained> <contained> <Goal> <id value="goal"/> <status value="achieved"/> <description> <text value="Retropharyngeal abscess removal"/> </description> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <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> <status value="completed"/> <intent value="plan"/> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <period> <start value="2013-03-08T09:00:10+01:00"/> <end value="2013-03-08T09:30:10+01:00"/> </period> <careTeam> <reference value="#careteam"/> </careTeam> <addresses> <reference value="Condition/f201"/> <!--TODO Correcte referentie--> <display value="?????"/> </addresses> <goal> <reference value="#goal"/> </goal> <activity> <detail> <kind value="ServiceRequest"/> <!-- 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"/> <doNotPerform 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"/> <status value="completed"/> <code> <coding> <system value="http://snomed.info/sct"/> <code value="48387007"/> <display value="Tracheotomy"/> </coding> </code> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <context> <reference value="Encounter/f003"/> </context> <performedPeriod> <start value="2013-03-22T09:30:10+01:00"/> <end value="2013-03-22T10:30:10+01:00"/> </performedPeriod> <performer> <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> <actor> <reference value="Practitioner/f005"/> <display value="A. Langeveld"/> </actor> </performer> <reasonCode> <text value="ensure breathing during surgery"/> </reasonCode> <bodySite> <coding> <system value="http://snomed.info/sct"/> <code value="83030008"/> <display value="Retropharyngeal area"/> </coding> </bodySite> <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/Consent/consent-example-notThem"/> <resource> <Consent xmlns="http://hl7.org/fhir"> <id value="consent-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> <status value="in-progress"/> <scope> <coding> <system value="http://hl7.org/fhir/consentscope"/> <code value="patient-privacy"/> </coding> </scope> <category> <coding> <system value="http://loinc.org"/> <code value="59284-0"/> </coding> </category> <patient> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </patient> <dateTime value="2015-11-18"/> <!-- not bound by a timeframe - Consent.period --> <!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Consent.authority element --> <organization> <reference value="Organization/f001"/> </organization> <!-- the text terms of the consent in lawyer speak --> <sourceAttachment> <title value="The terms of the consent in lawyer speak."/> <!-- likely use url pointer to common text --> </sourceAttachment> <!-- this is opt-in - e.g. everything approved unless otherwise stated --> <policyRule> <coding> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="OPTIN"/> </coding> </policyRule> <provision> <!-- no read or write access for this individual --> <actor> <role> <coding> <system value="http://hl7.org/fhir/v3/ParticipationType"/> <code value="PRCP"/> <!-- PRCP: recipient of the information --> </coding> </role> <reference> <reference value="Practitioner/f204"/> <display value="Fictive Nurse"/> </reference> </actor> <action> <coding> <system value="http://hl7.org/fhir/consentaction"/> <code value="access"/> </coding> </action> <action> <coding> <system value="http://hl7.org/fhir/consentaction"/> <code value="correct"/> </coding> </action> </provision> </Consent> </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/Procedure/f001"/> <resource> <Procedure xmlns="http://hl7.org/fhir"> <id value="f001"/> <status value="completed"/> <code> <coding> <system value="http://snomed.info/sct"/> <code value="34068001"/> <display value="Heart valve replacement"/> </coding> </code> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <context> <reference value="Encounter/f001"/> </context> <performedPeriod> <start value="2011-06-26"/> <end value="2011-06-27"/> </performedPeriod> <performer> <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> <actor> <reference value="Practitioner/f002"/> <display value="P. Voigt"/> </actor> </performer> <reasonCode> <text value="Heart valve disorder"/> </reasonCode> <bodySite> <coding> <system value="http://snomed.info/sct"/> <code value="17401000"/> <display value="Heart valve structure"/> </coding> </bodySite> <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/Consent/consent-example-notOrg"/> <resource> <Consent xmlns="http://hl7.org/fhir"> <id value="consent-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> <status value="in-progress"/> <scope> <coding> <system value="http://hl7.org/fhir/consentscope"/> <code value="patient-privacy"/> </coding> </scope> <category> <coding> <system value="http://loinc.org"/> <code value="59284-0"/> </coding> </category> <patient> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </patient> <dateTime value="2015-11-18"/> <!-- not bound by a timeframe - Consent.period --> <!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Consent.authority element --> <organization> <reference value="Organization/f001"/> </organization> <!-- the text terms of the consent in lawyer speak --> <sourceAttachment> <title value="The terms of the consent in lawyer speak."/> <!-- likely use url pointer to common text --> </sourceAttachment> <!-- this is opt-in - e.g. everything approved unless otherwise stated --> <policyRule> <coding> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="OPTIN"/> </coding> </policyRule> <provision> <!-- no read or write access for this org --> <type value="deny"/> <actor> <role> <coding> <system value="http://hl7.org/fhir/v3/ParticipationType"/> <code value="PRCP"/> <!-- PRCP: recipient of the information --> </coding> </role> <reference> <reference value="Organization/f001"/> </reference> </actor> <action> <coding> <system value="http://hl7.org/fhir/consentaction"/> <code value="access"/> </coding> </action> <action> <coding> <system value="http://hl7.org/fhir/consentaction"/> <code value="correct"/> </coding> </action> </provision> </Consent> </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> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="AMB"/> <!-- outpatient --> <display value="ambulatory"/> </class> <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> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <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> <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/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> <authority> <reference value="Organization/3"/> <display value="Michigan Health"/> </authority> <!-- and/or would this [also] go into Contract.domain as a Jurisdiction?? (see the example on UK Pharamacy Juristiction) --> <domain> <reference value="Location/ukp"/> <display value="UK Pharmacies"/> </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> <identifier> <system value="http://example.org/fhir/term-items"/> <value value="3347689"/> </identifier> <issued value="2015-11-01"/> <applies> <start value="2015-11-18"/> </applies> <type> <coding> <!-- made up code system --> <system value="http://example.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> <offer> <topic> <reference value="ServiceRequest/lipid"/> </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."/> </offer> </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/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/Condition/f002"/> <resource> <Condition xmlns="http://hl7.org/fhir"> <id value="f002"/> <clinicalStatus value="active"/> <verificationStatus value="confirmed"/> <category> <coding> <system value="http://snomed.info/sct"/> <code value="439401001"/> <display value="diagnosis"/> </coding> </category> <severity> <coding> <system value="http://snomed.info/sct"/> <code value="24484000"/> <display value="Severe"/> </coding> </severity> <code> <coding> <system value="http://snomed.info/sct"/> <code value="254637007"/> <display value="NSCLC - Non-small cell lung cancer"/> </coding> </code> <bodySite> <coding> <system value="http://snomed.info/sct"/> <code value="51185008"/> <display value="Thorax"/> </coding> </bodySite> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <context> <reference value="Encounter/f002"/> </context> <onsetDateTime value="2011-05-05"/> <assertedDate value="2012-06-03"/> <asserter> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </asserter> <stage> <summary> <coding> <system value="http://snomed.info/sct"/> <code value="258219007"/> <display value="stage II"/> </coding> </summary> <type> <coding> <system value="http://snomed.info/sct"/> <code value="260998006"/> <display value="Clinical staging (qualifier value)"/> </coding> </type> </stage> <evidence> <code> <coding> <system value="http://snomed.info/sct"/> <code value="169069000"/> <display value="CT of thorax"/> </coding> </code> </evidence> </Condition> </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"/> </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/Task/example3"/> <resource> <Task xmlns="http://hl7.org/fhir"> <id value="example3"/> <status value="draft"/> <intent value="order"/> <code> <text value="Refill Request"/> </code> <focus> <reference value="MedicationRequest/medrx002"/> </focus> <for> <reference value="Patient/f001"/> </for> <authoredOn value="2016-03-10T22:39:32-04:00"/> <lastModified value="2016-03-10T22:39:32-04:00"/> <requester> <reference value="Patient/example"/> </requester> <owner> <reference value="Practitioner/example"/> </owner> </Task> </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="10^12/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><!-- this example demonstrates using the reference range text element for stuff that is not easily structured !--><referenceRange> <text value=" 12-14 y Male: 4.4 - 5.2 x 10^12/L ; 12-14 y Female: 4.2 - 4.8 x 10^12/L ; 15-17 y Male: 4.6 - 5.4 x 10^12/L ; 15-17 y Female: 4.2 - 4.8 x 10^12/L ; 18-64 y Male: 4.6 - 5.4 x 10^12/L ; 18-64 y Female: 4.0 - 4.8 x 10^12/L ; 65-74 y Male: 4.3 - 5.3 x 10^12/L ; 65-74 y Female: 4.1 - 4.9 x 10^12/L "/> </referenceRange> </Observation> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Consent/consent-example-Out"/> <resource> <Consent xmlns="http://hl7.org/fhir"> <id value="consent-example-Out"/> <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 0) Withhold Authorization of sharing data for Treatment </p><p> Patient "P. van de Heuvel" wishes to have no data at the Good Health Psychiatric Hospital available for normal treatment use. </p> </div> </text> <status value="in-progress"/> <scope> <coding> <system value="http://hl7.org/fhir/consentscope"/> <code value="patient-privacy"/> </coding> </scope> <category> <coding> <system value="http://loinc.org"/> <code value="59284-0"/> </coding> </category> <patient> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </patient> <dateTime value="2015-11-18"/> <!-- not bound by a timeframe - Consent.period --> <!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Consent.authority element --> <organization> <reference value="Organization/f001"/> </organization> <!-- the text terms of the consent in lawyer speak --> <sourceAttachment> <title value="The terms of the consent in lawyer speak."/> <!-- likely use url pointer to common text --> </sourceAttachment> <!-- this is opt-out - e.g. everything approved unless otherwise stated --> <policyRule> <coding> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="OPTOUT"/> </coding> </policyRule> <provision> <actor> <role> <coding> <system value="http://hl7.org/fhir/v3/ParticipationType"/> <code value="CST"/> </coding> </role> <reference> <reference value="Organization/f001"/> </reference> </actor> </provision> </Consent> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Consent/consent-example-notAuthor"/> <resource> <Consent xmlns="http://hl7.org/fhir"> <id value="consent-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> <status value="in-progress"/> <scope> <coding> <system value="http://hl7.org/fhir/consentscope"/> <code value="patient-privacy"/> </coding> </scope> <category> <coding> <system value="http://loinc.org"/> <code value="59284-0"/> </coding> </category> <patient> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </patient> <dateTime value="2015-11-18"/> <!-- not bound by a timeframe - Consent.period --> <organization> <reference value="Organization/f001"/> </organization> <!-- the text terms of the consent in lawyer speak --> <sourceAttachment> <title value="The terms of the consent in lawyer speak."/> <!-- likely use url pointer to common text --> </sourceAttachment> <!-- this is opt-in - e.g. everything approved unless otherwise stated --> <policyRule> <coding> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="OPTIN"/> </coding> </policyRule> <provision> <actor> <role> <coding> <system value="http://hl7.org/fhir/v3/ParticipationType"/> <code value="CST"/> </coding> </role> <reference> <reference value="Organization/f001"/> </reference> </actor> </provision> </Consent> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Consent/consent-example-Emergency"/> <resource> <Consent xmlns="http://hl7.org/fhir"> <id value="consent-example-Emergency"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <p> Withhold Authorization for Treatment rule for Emegency Treatment </p> <p> Patient "P. van de Heuvel" wishes to have no data at the Good Health Psychiatric Hospital available rule for Emergency treatment use. An overall Deny consent Directive, with an exception "Permit" of purposeOfUse "ETREAT" at "Good Health" hospital, and exception "Deny" all other purposeOfUse from good health hospital. </p> </div> </text> <status value="in-progress"/> <scope> <coding> <system value="http://hl7.org/fhir/consentscope"/> <code value="patient-privacy"/> </coding> </scope> <category> <coding> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="EMRGONLY"/> </coding> </category> <patient> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </patient> <dateTime value="2015-11-18"/> <!-- not bound by a timeframe - Consent.period --> <!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Consent.authority element --> <organization> <reference value="Organization/f001"/> </organization> <!-- the text terms of the consent in lawyer speak --> <sourceAttachment> <title value="The terms of the consent in lawyer speak."/> <!-- likely use url pointer to common text --> </sourceAttachment> <!-- this is opt-out - e.g. nothing approved unless otherwise stated. --> <policyRule> <coding> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="OPTOUT"/> </coding> </policyRule> <provision> <actor> <role> <coding> <system value="http://hl7.org/fhir/v3/ParticipationType"/> <code value="CST"/> </coding> </role> <reference> <reference value="Organization/f001"/> </reference> </actor> <purpose> <system value="http://hl7.org/fhir/v3/ActReason"/> <code value="ETREAT"/> </purpose> <!-- this rule overrides the other one --> <provision> <type value="deny"/> <actor> <role> <coding> <system value="http://hl7.org/fhir/v3/ParticipationType"/> <code value="CST"/> </coding> </role> <reference> <reference value="Organization/f001"/> </reference> </actor> </provision> </provision> </Consent> </resource> </entry> <entry> <fullUrl value="http://hl7.org/fhir/Procedure/f002"/> <resource> <Procedure xmlns="http://hl7.org/fhir"> <id value="f002"/> <status value="completed"/> <code> <coding> <system value="http://snomed.info/sct"/> <code value="359615001"/> <display value="Partial lobectomy of lung"/> </coding> </code> <subject> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </subject> <context> <reference value="Encounter/f002"/> </context> <performedPeriod> <start value="2013-03-08T09:00:10+01:00"/> <end value="2013-03-08T09:30:10+01:00"/> </performedPeriod> <performer> <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> <actor> <reference value="Practitioner/f003"/> <display value="M.I.M. Versteegh"/> </actor> </performer> <reasonCode> <text value="Malignant tumor of lung"/> </reasonCode> <bodySite> <coding> <system value="http://snomed.info/sct"/> <code value="39607008"/> <display value="Lung structure"/> </coding> </bodySite> <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/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/Consent/consent-example-basic"/> <resource> <Consent xmlns="http://hl7.org/fhir"> <id value="consent-example-basic"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <p> Authorize Normal access for Treatment </p> <p> Patient "P. van de Heuvel" wishes to have all of the PHI collected at the Good Health Psychiatric Hospital available for normal treatment use. </p> </div> </text> <status value="in-progress"/> <scope> <coding> <system value="http://hl7.org/fhir/consentscope"/> <code value="patient-privacy"/> </coding> </scope> <category> <coding> <system value="http://loinc.org"/> <code value="59284-0"/> </coding> </category> <patient> <reference value="Patient/f001"/> <display value="P. van de Heuvel"/> </patient> <dateTime value="2016-05-11"/> <organization> <reference value="Organization/f001"/> </organization> <!-- the terms of the consent as signed by the patient in ink --> <sourceAttachment> <title value="The terms of the consent in lawyer speak."/> <!-- likely use url pointer to common text --> </sourceAttachment> <!-- this is plain out opt-in with no exceptions --> <policyRule> <coding> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="OPTIN"/> </coding> </policyRule> <provision> <!-- bound by a timeframe between 1964 and 2016 - consent.applies --> <period> <start value="1964-01-01"/> <end value="2016-01-01"/> </period> </provision> </Consent> </resource> </entry> </Bundle>
For more information about operations, including how they are invoked, see Operations.