C-CDA on FHIR
1.2.0-ballot - CI Build
C-CDA on FHIR
1.2.0-ballot - CI Build
This page is part of the C-CDA on FHIR Implementation Guide (v1.2.0-ballot: STU 1 Ballot 4) based on FHIR R4. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions 
{
"resourceType" : "Composition",
"id" : "Care-Plan-Example",
"meta" : {
"versionId" : "6",
"lastUpdated" : "2020-08-19T04:55:46.030+00:00",
"source" : "#jOiomrQ69OIQipUi",
"profile" : [
"http://hl7.org/fhir/us/ccda/StructureDefinition/Care-Plan-Document"
]
},
"language" : "en-US",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en-US\" lang=\"en-US\">\n <table style=\"border: 1pt inset #00008b; line-height: 10pt; width: 100%;\" class=\"header_table\">\n <tbody>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Document Id</span>\n </td>\n <td class=\"td_header_role_value\">12345</td>\n </tr>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Document Created:</span>\n </td>\n <td class=\"td_header_role_value\">June 15, 2016, 16:14, PST </td>\n </tr>\n </tbody>\n </table>\n <table style=\"border: 1pt inset #00008b; line-height: 10pt; width: 100%;\" class=\"header_table\">\n <tbody>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Care Provision</span>\n </td>\n <td class=\"td_header_role_value\">Care Plan for Amy Shaw</td>\n </tr>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Performer</span>\n </td>\n <td class=\"td_header_role_value\">Ronald Boone, MD</td>\n </tr>\n </tbody>\n </table>\n <table style=\"border: 1pt inset #00008b; line-height: 10pt; width: 100%;\" class=\"header_table\">\n <tbody>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Author</span>\n </td>\n <td class=\"td_header_role_value\">Ronald Boone, MD</td>\n </tr>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Contact info</span>\n </td>\n <td class=\"td_header_role_value\">1003 Healthcare Drive\n\n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Amherst MA 01002, US \n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Tel: +1(555)555-1003\n\n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>\n </td>\n </tr>\n </tbody>\n </table>\n <table style=\"border: 1pt inset #00008b; line-height: 10pt; width: 100%;\" class=\"header_table\">\n <tbody>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Encounter Id</span>\n </td>\n <td class=\"td_header_role_value\">9937012\n 2.16.840.1.113883.19</td>\n </tr>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Encounter Type</span>\n </td>\n <td class=\"td_header_role_value\">Care Plan</td>\n </tr>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Encounter Period</span>\n </td>\n <td class=\"td_header_role_value\"> From June 15, 2016, 16:20 to\n Sept 18, 2016, 18:20 </td>\n </tr>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Encounter Location</span>\n </td>\n <td class=\"td_header_role_value\">Ambulatory Care at Acme\n Laboratories</td>\n </tr>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Responsible party</span>\n </td>\n <td class=\"td_header_role_value\">Ronald Boone, MD</td>\n </tr>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Contact info</span>\n </td>\n <td class=\"td_header_role_value\">1003 Healthcare Drive\n\n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Amherst MA 01002, US \n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Tel: +1(555)555-1003\n\n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>\n </td>\n </tr>\n </tbody>\n </table>\n <table style=\"border: 1pt inset #00008b; line-height: 10pt; width: 100%;\" class=\"header_table\">\n <tbody>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Assigned entity</span>\n </td>\n <td class=\"td_header_role_value\">Acme Laboratories \n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>\n </td>\n </tr>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Emergency contact</span>\n </td>\n <td class=\"td_header_role_value\">Michael Shaw \n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>\n <br/>\n </td>\n </tr>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Contact info</span>\n </td>\n <td class=\"td_header_role_value\">49 Meadow St \n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Amherst MA\n 01003, US \n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Tel: (555)555-1212 \n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>\n </td>\n </tr>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Care giver</span>\n </td>\n <td class=\"td_header_role_value\">Mrs. Lillian White \n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>\n </td>\n </tr>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Contact info</span>\n </td>\n <td class=\"td_header_role_value\">49 Meadow St \n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Amherst MA\n 01003, US \n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Tel: (555)555-1215 \n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>\n </td>\n </tr>\n </tbody>\n </table>\n <table style=\"border: 1pt inset #00008b; line-height: 10pt; width: 100%;\" class=\"header_table\">\n <tbody>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Entered by</span>\n </td>\n <td class=\"td_header_role_value\">Sally Jones</td>\n </tr>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Contact info</span>\n </td>\n <td class=\"td_header_role_value\">1003 Healthcare Drive\n\n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Amherst MA 01002, US \n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Tel: +1(555)555-1003\n\n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>\n </td>\n </tr>\n </tbody>\n </table>\n <table style=\"border: 1pt inset #00008b; line-height: 10pt; width: 100%;\" class=\"header_table\">\n <tbody>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Signed </span>\n </td>\n <td class=\"td_header_role_value\">Ronald Boone at June 15, 2016\n\t\t\t\t\t\t\t\t\t</td>\n </tr>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Contact info</span>\n </td>\n <td class=\"td_header_role_value\">1003 Healthcare Drive\n\n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Amherst MA 01002, US \n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Tel: +1(555)555-1003\n\n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>\n </td>\n </tr>\n </tbody>\n </table>\n <table style=\"border: 1pt inset #00008b; line-height: 10pt; width: 100%;\" class=\"header_table\">\n <tbody>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Informant</span>\n </td>\n <td class=\"td_header_role_value\">Henry Vincent, CPh</td>\n </tr>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Contact info</span>\n </td>\n <td class=\"td_header_role_value\">1007 Pharmacy Drive\n\n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Portland, OR 99123, US \n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Tel: +1(555)555-1215\n\n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>\n </td>\n </tr>\n </tbody>\n </table>\n <table style=\"border: 1pt inset #00008b; line-height: 10pt; width: 100%;\" class=\"header_table\">\n <tbody>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Information recipient:</span>\n </td>\n <td class=\"td_header_role_value\">Primary Physician, MD</td>\n </tr>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Contact info</span>\n </td>\n <td class=\"td_header_role_value\">1005 St. Clair Avenue\n\n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Amherst MA 01002, US \n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Tel: +1(555)555-1666\n\n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>\n </td>\n </tr>\n </tbody>\n </table>\n <table style=\"border: 1pt inset #00008b; line-height: 10pt; width: 100%;\" class=\"header_table\">\n <tbody>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Legal authenticator</span>\n </td>\n <td class=\"td_header_role_value\">Ronald Boone, MD signed at June\n 15, 2016 </td>\n </tr>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Contact info</span>\n </td>\n <td class=\"td_header_role_value\">1003 Healthcare Drive\n\n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Amherst MA 01002, US \n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Tel: +1(555)555-1003\n\n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>\n </td>\n </tr>\n </tbody>\n </table>\n <table style=\"border: 1pt inset #00008b; line-height: 10pt; width: 100%;\" class=\"header_table\">\n <tbody>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Document maintained by</span>\n </td>\n <td class=\"td_header_role_value\">Acme Laboratories</td>\n </tr>\n <tr>\n <td style=\"width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;\" class=\"td_header_role_name\">\n <span class=\"td_label\">Contact info</span>\n </td>\n <td class=\"td_header_role_value\">1003 Healthcare Drive\n\n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Amherst MA 01002, US \n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>Tel: +1(555)555-1003\n\n\n\t\t\t\t\t\t\t\t\t\t\n \n <br/>\n </td>\n </tr>\n </tbody>\n </table>\n </div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/us/ccda/StructureDefinition/DataEntererExtension",
"valueReference" : {
"reference" : "PractitionerRole/ccda-practitionerrole-example"
}
},
{
"url" : "http://hl7.org/fhir/us/ccda/StructureDefinition/VersionNumber",
"valueInteger" : 1
}
],
"identifier" : {
"system" : "urn:ietf:rfc:3986",
"value" : "urn:uuid:39067866-6319-4008-9c6d-3f0176d6826c"
},
"status" : "preliminary",
"type" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "18776-5",
"display" : "Plan of care note"
}
]
},
"subject" : {
"reference" : "Patient/example",
"display" : "Amy V. Shaw"
},
"date" : "2016-06-15T09:10:14Z",
"author" : [
{
"reference" : "PractitionerRole/ccda-practitionerrole-example",
"display" : "Ronald Bone, MD"
}
],
"title" : "Care Plan",
"attester" : [
{
"mode" : "legal",
"time" : "2016-06-15T09:10:14Z",
"party" : {
"reference" : "PractitionerRole/ccda-practitionerrole-example",
"display" : "Ronald Boone, MD"
}
}
],
"custodian" : {
"reference" : "Organization/acme-lab",
"display" : "Acme Lab"
},
"event" : [
{
"code" : [
{
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "73761001",
"display" : "Colonoscopy"
}
]
}
],
"period" : {
"start" : "2016-06-15",
"end" : "2016-09-18"
}
}
],
"section" : [
{
"title" : "Health Concerns Section",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "75310-3",
"display" : "Health concerns Document"
}
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table>\n <tr>\n <td>\n <b>Concern</b>\n </td>\n <td>\n <b>Status</b>\n </td>\n <td>\n <b>Date</b>\n </td>\n </tr>\n <tr>\n <td>Current every day smoker</td>\n <td>Active</td>\n <td>Concern from June 16, 2015</td>\n </tr>\n <tr>\n <td>Respiratory insufficiency</td>\n <td>Completed</td>\n <td>Concern from June 13, 2015</td>\n </tr>\n <tr>\n <td>Pneumonia</td>\n <td>Completed</td>\n <td>June 16, 2015</td>\n </tr>\n </table>\n </div>"
}
},
{
"title" : "Goals Section",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "61146-7",
"display" : "Goals"
}
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table>\n <tr>\n <td>\n <b>Goal</b>\n </td>\n <td>\n <b>Value</b>\n </td>\n <td>\n <b>Date</b>\n </td>\n </tr>\n <tr>\n <td>Pulse oximetry</td>\n <td>92%</td>\n <td>September 2, 2015</td>\n </tr>\n </table>\n </div>"
}
},
{
"title" : "Interventions Section",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "62387-6",
"display" : "Interventions Narrative"
}
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table>\n <tr>\n <td>\n <b>Planned Intervention</b>\n </td>\n <td>\n <b>Status</b>\n </td>\n <td>\n <b>Date</b>\n </td>\n </tr>\n <tr>\n <td>Elevate head of bed</td>\n <td>active</td>\n <td>June 18, 2016</td>\n </tr>\n <tr>\n <td>Oxygen administration by nasal cannula</td>\n <td>active</td>\n <td>June 18, 2016</td>\n </tr>\n <tr>\n <td>pulse oximetry monitoring</td>\n <td>active</td>\n <td>June 18, 2016</td>\n </tr>\n </table>\n </div>"
}
},
{
"title" : "Health Status Evaluations and Outcomes Section",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "11383-7",
"display" : "Patient problem outcome"
}
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table>\n <tr>\n <td>\n <b>Item</b>\n </td>\n <td>\n <b>Outcome</b>\n </td>\n <td>\n <b>Date</b>\n </td>\n </tr>\n <tr>\n <td>Pulse oximetry</td>\n <td>95%</td>\n <td>June 20, 2016</td>\n </tr>\n </table>\n </div>"
}
}
]
}
IG © 2020+ HL7 Structured Documents Working Group. Package hl7.fhir.us.ccda#1.2.0-ballot based on FHIR 4.0.1. Generated 2023-03-27
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