C-CDA on FHIR Implementation Guide STU 1 (v1.0.0)

This page is part of the C-CDA on FHIR Implementation Guide (v1.0.0: STU 1) based on FHIR R3. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions



<Composition xmlns="http://hl7.org/fhir">
  <id value="CCDA-on-FHIR-Continuity-of-Care-Document-Example"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/ccda/StructureDefinition/CCDA-on-FHIR-Continuity-of-Care-Document"/>
  </meta>
  <language value="en-US"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
            <table style="border: 1pt inset #00008b; line-height: 10pt; width: 100%;" class="header_table">
                <tbody>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Document Id</span>
                        </td>
                        <td class="td_header_role_value">12345</td>
                    </tr>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Document Created:</span>
                        </td>
                        <td class="td_header_role_value">June 15, 2016, 16:14, PST </td>
                    </tr>
                </tbody>
            </table>
            <table style="border: 1pt inset #00008b; line-height: 10pt; width: 100%;" class="header_table">
                <tbody>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Care Provision</span>
                        </td>
                        <td class="td_header_role_value">Summary of Episode for Amy Shaw</td>
                    </tr>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Performer </span>
                        </td>
                        <td class="td_header_role_value">Ronald Boone, MD</td>
                    </tr>
                </tbody>
            </table>
            <table style="border: 1pt inset #00008b; line-height: 10pt; width: 100%;" class="header_table">
                <tbody>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Author</span>
                        </td>
                        <td class="td_header_role_value">Ronald Boone, MD</td>
                    </tr>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Contact info</span>
                        </td>
                        <td class="td_header_role_value">1003 Healthcare Drive<br/>Amherst MA 01002, US<br/>Tel:  +1(555)555-1003<br/>
                        </td>
                    </tr>
                </tbody>
            </table>
            <table style="border: 1pt inset #00008b; line-height: 10pt; width: 100%;" class="header_table">
                <tbody>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Encounter Id</span>
                        </td>
                        <td class="td_header_role_value">9937012 2.16.840.1.113883.19</td>
                    </tr>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Event Type</span>
                        </td>
                        <td class="td_header_role_value">Summary of Episode</td>
                    </tr>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Event Date</span>
                        </td>
                        <td class="td_header_role_value"> From June 15, 2016, 16:20 to June 15, 2016, 18:20  </td>
                    </tr>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Encounter Location</span>
                        </td>
                        <td class="td_header_role_value">Ambulatory Care at Community Health and Hospitals</td>
                    </tr>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Responsible party</span>
                        </td>
                        <td class="td_header_role_value">Ronald Boone, MD</td>
                    </tr>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Contact info</span>
                        </td>
                        <td class="td_header_role_value">1003 Healthcare Drive<br/>Amherst MA 01002, US<br/>Tel:  +1(555)555-1003<br/>
                        </td>
                    </tr>
                </tbody>
            </table>
            <table style="border: 1pt inset #00008b; line-height: 10pt; width: 100%;" class="header_table">
                <tbody>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Assigned entity</span>
                        </td>
                        <td class="td_header_role_value">Community Health and Hospitals<br/>
                        </td>
                    </tr>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Emergency contact</span>
                        </td>
                        <td class="td_header_role_value">Michael Shaw<br/>
                            <br/>
                        </td>
                    </tr>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Contact info</span>
                        </td>
                        <td class="td_header_role_value">49 Meadow St<br/>Amherst MA 01003, US<br/>Tel:  (555)555-1212<br/>
                        </td>
                    </tr>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Care giver</span>
                        </td>
                        <td class="td_header_role_value">Mrs. Lillian White<br/>
                        </td>
                    </tr>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Contact info</span>
                        </td>
                        <td class="td_header_role_value">49 Meadow St<br/>Amherst MA 01003, US<br/>Tel:  (555)555-1215<br/>
                        </td>
                    </tr>
                </tbody>
            </table>
            <table style="border: 1pt inset #00008b; line-height: 10pt; width: 100%;" class="header_table">
                <tbody>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Entered by</span>
                        </td>
                        <td class="td_header_role_value">Sally Jones</td>
                    </tr>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Contact info</span>
                        </td>
                        <td class="td_header_role_value">1003 Healthcare Drive<br/>Amherst MA 01002, US<br/>Tel:  +1(555)555-1003<br/>
                        </td>
                    </tr>
                </tbody>
            </table>
            <table style="border: 1pt inset #00008b; line-height: 10pt; width: 100%;" class="header_table">
                <tbody>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Signed </span>
                        </td>
                        <td class="td_header_role_value">Ronald Boone at June 15, 2016 </td>
                    </tr>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Contact info</span>
                        </td>
                        <td class="td_header_role_value">1003 Healthcare Drive<br/>Amherst MA 01002, US<br/>Tel:  +1(555)555-1003<br/>
                        </td>
                    </tr>
                </tbody>
            </table>
            <table style="border: 1pt inset #00008b; line-height: 10pt; width: 100%;" class="header_table">
                <tbody>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Informant</span>
                        </td>
                        <td class="td_header_role_value">Henry Vincent, CPh</td>
                    </tr>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Contact info</span>
                        </td>
                        <td class="td_header_role_value">1007 Pharmacy Drive<br/>Portland, OR 99123, US<br/>Tel:  +1(555)555-1215<br/>
                        </td>
                    </tr>
                </tbody>
            </table>
            <table style="border: 1pt inset #00008b; line-height: 10pt; width: 100%;" class="header_table">
                <tbody>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Information recipient:</span>
                        </td>
                        <td class="td_header_role_value">Primary Physician, MD</td>
                    </tr>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Contact info</span>
                        </td>
                        <td class="td_header_role_value">1005 St. Clair Avenue<br/>Amherst MA 01002, US<br/>Tel:  +1(555)555-1666<br/>
                        </td>
                    </tr>
                </tbody>
            </table>
            <table style="border: 1pt inset #00008b; line-height: 10pt; width: 100%;" class="header_table">
                <tbody>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Legal authenticator</span>
                        </td>
                        <td class="td_header_role_value">Ronald Boone, MD signed at June 15, 2016 </td>
                    </tr>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Contact info</span>
                        </td>
                        <td class="td_header_role_value">1003 Healthcare Drive<br/>Amherst MA 01002, US<br/>Tel:  +1(555)555-1003<br/>
                        </td>
                    </tr>
                </tbody>
            </table>
            <table style="border: 1pt inset #00008b; line-height: 10pt; width: 100%;" class="header_table">
                <tbody>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Document maintained by</span>
                        </td>
                        <td class="td_header_role_value">Community Health and Hospitals</td>
                    </tr>
                    <tr>
                        <td style="width: 20%; background-color: #3399ff; padding: 0.1cm 0.2cm; vertical-align: top; background-color: #ffffcc;" class="td_header_role_name">
                            <span class="td_label">Contact info</span>
                        </td>
                        <td class="td_header_role_value">1003 Healthcare Drive<br/>Amherst MA 01002, US<br/>Tel:  +1(555)555-1003<br/>
                        </td>
                    </tr>
                </tbody>
            </table>
        </div>
  </text>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:uuid:7e63fe21-7285-46c6-b72f-e58a61341195"/>
  </identifier>
  <status value="preliminary"/>
  <type>
    <coding>
      <system value="http://loinc.org"/>
      <code value="34133-9"/>
      <display value="Summary of episode note"/>
    </coding>
  </type>
<!--   Patient Resource   -->
  <subject>
    <reference value="Patient/patient-1"/>
    <display value="Amy V. Shaw"/>
  </subject>
  <date value="2016-02-28T09:10:14Z"/>
<!--   Practitioner Resource  -->
  <author>
    <reference value="Practitioner/practitioner-1"/>
    <display value="Ronald Boone, MD"/>
  </author>
  <title value="Continuity of Care Document"/>
  <confidentiality value="N"/>
  <attester>
    <mode value="legal"/>
    <time value="2016-06-15T09:10:14Z"/>
    <party>
      <reference value="Practitioner/practitioner-1"/>
      <display value="Ronald Boone, MD"/>
    </party>
  </attester>
<!--   Organization Resource  -->
  <custodian>
    <reference value="Organization/organization-1"/>
    <display value="Community Health and Hospitals"/>
  </custodian>
  <event>
    <code>
      <coding>
        <system value="http://hl7.org/fhir/v3/ActClass"/>
        <code value="PCPR"/>
        <display value="Care Provision"/>
      </coding>
    </code>
    <period>
      <start value="2016-06-15"/>
      <end value="2016-08-20"/>
    </period>
  </event>
<!--   Encounter Resource  -->
<!--  <encounter><reference value="http://fhirtest.uhn.ca/baseDstu3/Encounter/117630"/></encounter> -->
<!--   Allergies and Intolerances Section Narrative  -->
  <section>
    <title value="Allergies and Intolerances Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="48765-2"/>
        <display value="Allergies and adverse reactions"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
                <table>
                    <tr>
                        <td>
                            <b>Substance</b>
                        </td>
                        <td>
                            <b>Overall Severity</b>
                        </td>
                        <td>
                            <b>Reaction</b>
                        </td>
                        <td>
                            <b>Reaction Severity</b>
                        </td>
                        <td>
                            <b>Status</b>
                        </td>
                    </tr>
                    <tr>
                        <td>Cashew Nut</td>
                        <td>Severe</td>
                        <td>Anaphylactic reaction</td>
                        <td>Mild</td>
                        <td>Active</td>
                    </tr>
                </table>
            </div>
    </text>
    <mode value="snapshot"/>
    <orderedBy>
      <coding>
        <system value="http://hl7.org/fhir/list-order"/>
        <code value="event-date"/>
        <display value="Sorted by Event Date"/>
      </coding>
    </orderedBy>
  <!--       Allergy and Intolerance Section Resource  -->
    <entry>
      <reference value="AllergyIntolerance/allergy-intolerance"/>
    </entry>
  </section>
<!--   Medication Section Narrative  -->
  <section>
    <title value="Medication Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="10160-0"/>
        <display value="History of Medication Use"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
                <table>
                    <tr>
                        <td>
                            <b>Medication</b>
                        </td>
                        <td>
                            <b>Directions</b>
                        </td>
                        <td>
                            <b>Start Date</b>
                        </td>
                        <td>
                            <b>Status</b>
                        </td>
                        <td>
                            <b>Indications</b>
                        </td>
                        <td>
                            <b>Fill Instructions</b>
                        </td>
                    </tr>
                    <tr>
                        <td>Amoxicillin</td>
                        <td>Amoxicillin Powder, for Suspension 250mg/5ml</td>
                        <td>2016/02/28</td>
                        <td>Active</td>
                        <td>Pneumonia</td>
                        <td>Generic substitution allowed</td>
                    </tr>
                </table>
            </div>
    </text>
  <!--   Medication Section Resource  -->
    <entry>
      <reference value="MedicationStatement/medication-statement"/>
    </entry>
  </section>
<!--   Problem Section Narrative   -->
  <section>
    <title value="Problem Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="11450-4"/>
        <display value="Problem list"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
                <table>
                    <tr>
                        <td>
                            <b>Problem Name</b>
                        </td>
                        <td>
                            <b>Type</b>
                        </td>
                        <td>
                            <b>Onset Date</b>
                        </td>
                        <td>
                            <b>Abatement Date</b>
                        </td>
                        <td>
                            <b>Status</b>
                        </td>
                    </tr>
                    <tr>
                        <td>Fever</td>
                        <td>Condition</td>
                        <td>2016/02/28</td>
                        <td>2016/03/01</td>
                        <td>Complete</td>
                    </tr>
                </table>
            </div>
    </text>
  <!--   Problem Section Condition Resource   -->
    <entry>
      <reference value="Condition/condition-problem"/>
    </entry>
  </section>
<!--   Procedures Section Narrative   -->
  <section>
    <title value="Procedures Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="47519-4"/>
        <display value="History of procedures"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
                <table>
                    <tr>
                        <td>
                            <b>Procedure Name</b>
                        </td>
                        <td>
                            <b>Body Site</b>
                        </td>
                        <td>
                            <b>Performer</b>
                        </td>
                        <td>
                            <b>Date Performed</b>
                        </td>
                        <td>
                            <b>Reason</b>
                        </td>
                    </tr>
                    <tr>
                        <td>Appendectomy (Procedure)</td>
                        <td>Abdomen</td>
                        <td>Dr. Adam Everyman</td>
                        <td>2016/06/15</td>
                        <td>Generalized abdominal pain 24 hours. Localized in RIF with rebound and guarding</td>
                    </tr>
                </table>
            </div>
    </text>
  <!--   Procedures Section Resource   -->
    <entry>
      <reference value="Procedure/procedure-rehab"/>
    </entry>
  </section>
<!--   Results Section Narrative  -->
  <section>
    <title value="Results Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="30954-2"/>
        <display value="Relevant diagnostic tests and laboratory data"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
                <table>
                    <tr>
                        <td>
                            <b>Result Type</b>
                        </td>
                        <td>
                            <b>Quantity Value</b>
                        </td>
                        <td>
                            <b>Date</b>
                        </td>
                        <td>
                            <b>Status</b>
                        </td>
                    </tr>
                    <tr>
                        <td>Glucose [Moles/volume] in Blood</td>
                        <td>6.3 mmol/l</td>
                        <td>2016/06/15</td>
                        <td>Final</td>
                    </tr>
                </table>
            </div>
    </text>
  <!--   Result Section Observation Resource   -->
    <entry>
      <reference value="Observation/observation-lab-urine"/>
    </entry>
  </section>
<!--   Advance Directive Section Narrative  -->
  <section>
    <title value="Advance Directives Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="42348-3"/>
        <display value="Advance directives"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
                <table>
                    <tr>
                        <td>
                            <b>Name</b>
                        </td>
                        <td>
                            <b>Applies Period</b>
                        </td>
                    </tr>
                    <tr>
                        <td>Resuscitation</td>
                        <td>2010/01/01 - 2025/01/01</td>
                    </tr>
                </table>
            </div>
    </text>
  </section>
<!--   Encounters Section Narrative  -->
  <section>
    <title value="Encounters Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="46240-8"/>
        <display value="Encounters"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
                <table>
                    <tr>
                        <td>
                            <b>Encounter</b>
                        </td>
                        <td>
                            <b>Performer</b>
                        </td>
                        <td>
                            <b>Location</b>
                        </td>
                        <td>
                            <b>Date</b>
                        </td>
                    </tr>
                    <tr>
                        <td>Checkup Examination</td>
                        <td>Dr. S. Steene</td>
                        <td>Community Urgent Care Center</td>
                        <td>2016/04/18</td>
                    </tr>
                </table>
            </div>
    </text>
  </section>
<!--   Family History Section Narrative  -->
<!--   Family History Section Resource  -->
<!--   <entry><reference value="http://hl7.org/fhir/familymemberhistory-example.xml"/></entry> -->
  <section>
    <title value="Family History Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="10157-6"/>
        <display value="History of family member diseases"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
                <table>
                    <tr>
                        <td>
                            <b>Relationship</b>
                        </td>
                        <td>
                            <b>Diagnosis</b>
                        </td>
                        <td>
                            <b>Age at Onset</b>
                        </td>
                    </tr>
                    <tr>
                        <td>Father</td>
                        <td>Myocardial Infarction(cause of Death)</td>
                        <td>57</td>
                    </tr>
                    <tr>
                        <td>Father</td>
                        <td>Diabetes</td>
                        <td>40</td>
                    </tr>
                </table>
            </div>
    </text>
  </section>
<!--   Functional Status Section Narrative  -->
  <section>
    <title value="Functional Status Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="47420-5"/>
        <display value="Functional status assessment"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
                <table>
                    <tr>
                        <td>
                            <b>Functional or Cognitive Finding</b>
                        </td>
                        <td>
                            <b>Observation</b>
                        </td>
                        <td>
                            <b>Observation Date</b>
                        </td>
                        <td>
                            <b>Condition Status</b>
                        </td>
                    </tr>
                    <tr>
                        <td>Ambulation (Dependent to Independent</td>
                        <td>Independently able</td>
                        <td>2016/06/15</td>
                        <td>Active</td>
                    </tr>
                    <tr>
                        <td>Finding of Functional Performance and Activity</td>
                        <td>Dyspnea</td>
                        <td>2016/06/15</td>
                        <td>Active</td>
                    </tr>
                    <tr>
                        <td>Cognitive Function Finding</td>
                        <td>Memory Impairment</td>
                        <td>2010/04/17</td>
                        <td>Active</td>
                    </tr>
                </table>
            </div>
    </text>
  </section>
<!--   Immunization Section Narrative   -->
  <section>
    <title value="Immunizations Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="11369-6"/>
        <display value="History of immunization"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
                <table>
                    <tr>
                        <td>
                            <b>Vaccine</b>
                        </td>
                        <td>
                            <b>Date</b>
                        </td>
                        <td>
                            <b>Status</b>
                        </td>
                    </tr>
                    <tr>
                        <td>Fluvax (Influenza)</td>
                        <td>2014/05/29</td>
                        <td>Completed</td>
                    </tr>
                </table>
            </div>
    </text>
  <!--   Immunization Section Resource  -->
    <entry>
      <reference value="Immunization/immunization"/>
    </entry>
  </section>
<!--   Nutrition Section Narrative  -->
  <section>
    <title value="Nutrition Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="61144-2"/>
        <display value="Diet and nutrition"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
                <table>
                    <tr>
                        <td>
                            <b>Date</b>
                        </td>
                        <td>
                            <b>Nutritional Status</b>
                        </td>
                        <td>
                            <b>Diet</b>
                        </td>
                    </tr>
                    <tr>
                        <td>2016/06/15</td>
                        <td>Well nourished</td>
                        <td>Low sodium diet, excessive carbohydrate</td>
                    </tr>
                    <tr>
                        <td>2016/06/15</td>
                        <td>Slight dehydration</td>
                        <td>High protein, low fibre</td>
                    </tr>
                </table>
            </div>
    </text>
  </section>
<!--   Mental Status Section Narrative  -->
  <section>
    <title value="Mental Status Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="10190-7"/>
        <display value="Mental status"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
                <table>
                    <tr>
                        <td>
                            <b>Date</b>
                        </td>
                        <td>
                            <b>Mental Status</b>
                        </td>
                        <td>
                            <b>Support System</b>
                        </td>
                    </tr>
                    <tr>
                        <td>2016/06/15</td>
                        <td>Good</td>
                        <td>Not required</td>
                    </tr>
                    <tr>
                        <td>2012/04/29</td>
                        <td>Dimentia</td>
                        <td>Daily Home Care</td>
                    </tr>
                </table>
            </div>
    </text>
  </section>
<!--   Social History Section Narrative  -->
  <section>
    <title value="Social History Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="29762-2"/>
        <display value="Social history"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
                <table>
                    <tr>
                        <td>
                            <b>Social History Element</b>
                        </td>
                        <td>
                            <b>Description</b>
                        </td>
                        <td>
                            <b>Effective Dates</b>
                        </td>
                    </tr>
                    <tr>
                        <td>Smoking</td>
                        <td>1 pack tobacco per day</td>
                        <td>2010/01/01 - 2016/06/15</td>
                    </tr>
                </table>
            </div>
    </text>
    <entry>
    <!--   Social History Section Observation Resource  -->
      <reference value="Observation/observation-smoker"/>
    </entry>
  </section>
<!--   Plan of Treatment Section Narrative  -->
  <section>
    <title value="Plan of Treatment Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="18776-5"/>
        <display value="Plan of treatment"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
                <table>
                    <tr>
                        <td>
                            <b>Planned Activity</b>
                        </td>
                        <td>
                            <b>Period</b>
                        </td>
                        <td>
                            <b>Status</b>
                        </td>
                    </tr>
                    <tr>
                        <td>Colonoscopy</td>
                        <td>2016/06/15 - 2015/06/15</td>
                        <td>Completed</td>
                    </tr>
                    <tr>
                        <td>Recommendation to Exercise</td>
                        <td>2016/06/15</td>
                        <td>Ongoing</td>
                    </tr>
                </table>
            </div>
    </text>
  </section>
<!--   Payers Section Narrative  -->
  <section>
    <title value="Payers Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="48768-6"/>
        <display value="Payers"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
                <table>
                    <tr>
                        <td>
                            <b>Payer Name</b>
                        </td>
                        <td>
                            <b>Policy ID</b>
                        </td>
                        <td>
                            <b>Policy Holder</b>
                        </td>
                    </tr>
                    <tr>
                        <td>United Healthcare</td>
                        <td>12341</td>
                        <td>Self</td>
                    </tr>
                    <tr>
                        <td>Cigna</td>
                        <td>53123</td>
                        <td>Spouse</td>
                    </tr>
                </table>
            </div>
    </text>
  </section>
<!--   Medication Equipment Section Narrative  -->
  <section>
    <title value="Medical Equipment Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="46264-8"/>
        <display value="Medical equipment"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
                <table>
                    <tr>
                        <td>
                            <b>Supply/Device</b>
                        </td>
                        <td>
                            <b>Date Supplied</b>
                        </td>
                    </tr>
                    <tr>
                        <td>Automatic Implantable cardioverter/defbrillator</td>
                        <td>2015/05/29</td>
                    </tr>
                    <tr>
                        <td>Wheelchair</td>
                        <td>2016/06/15</td>
                    </tr>
                </table>
            </div>
    </text>
  </section>
<!--   Vital Signs Section Narrative  -->
  <section>
    <title value="Vital Signs Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="8716-3"/>
        <display value="Vital signs"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
                <table>
                    <tr>
                        <td>
                            <b>Vital Sign</b>
                        </td>
                        <td>
                            <b>Date</b>
                        </td>
                        <td>
                            <b>Value</b>
                        </td>
                    </tr>
                    <tr>
                        <td>Temperature</td>
                        <td>2016/06/15</td>
                        <td>39 Degrees Celcius</td>
                    </tr>
                </table>
            </div>
    </text>
  <!--   Vital Signs Section Observation Resource  -->
    <entry>
      <reference value="Observation/observation-vitals-temp"/>
    </entry>
  </section>
</Composition>