C-CDA on FHIR
1.1.0 - (FHIR R4) STU Release 1.1

This page is part of the C-CDA on FHIR Implementation Guide (v1.1.0: STU 1.1) based on FHIR R4. This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: Care Plan - JSON Representation

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{
  "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>"
      }
    }
  ]
}