HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) - US Realm
2.1.0 - STU 2
US
HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) - US Realm
2.1.0 - STU 2
US
This page is part of the electronic Case Reporting (eCR) (v2.1.0: STU 2) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions 
Bundle bundle-ecr-message-zika of type message
Entry 1 - Full URL = http://example.org/fhir/MessageHeader/messageheader-ecr-requested-eicr
Resource MessageHeader:
Generated Narrative: MessageHeader
Resource MessageHeader "messageheader-ecr-requested-eicr"
Profile: eCR MessageHeader
US Public Health Message Processing Category Extension: consequence
event: Indicates a message containing electronic case report healthcare data sent from clinical care. (Details: http://hl7.org/fhir/us/ecr/CodeSystem/us-ph-message-types-codesystem code eicr-case-report-message = 'Indicates a message containing electronic case report healthcare data sent from clinical care.', stated as 'Indicates a message containing electronic case report healthcare data sent from clinical care.')
Destinations
- Name Target Endpoint * YMCA Acme Message Gateway Device/device-ecr-software-ymca http://example.org/ymca/fhir sender: Organization/organization-ecr-salem-medical-center "Salem Medical Center"
Sources
- Name Software Version Contact Endpoint * Acme Central Patient Registry FooBar Patient Manager 3.1.45.AABB +1 (555) 123 4567 http://example.org/salem-medical-center/fhir reason: Indicates the close of an encounter (US Public Health TriggerDefinition NamedEvents#encounter-close)
Entry 2 - Full URL = http://example.org/fhir/Bundle/bundle-eicr-document-zika
Resource Bundle:
Generated Narrative: Composition
Resource Composition "composition-eicr-zika" Version "22" Updated "2021-08-17 03:24:45+0000"
Information Source: #vMaRLlyzDNjGkVuc!
versionNumber: 1
identifier: id: c03eab8c-11e8-4d0c-ad2a-b385395e27db
status: FINAL
type: Public Health Case Report (LOINC#55751-2)
encounter: Encounter/encounter-eicr-eve-everywoman-outpatient: Ambulatory Office Visit
date: 2018-01-02 10:13:23+0000
author: PractitionerRole/practitionerrole-henry-seven: Henry Seven, MD
title: Initial Public Health Case Report - Zika Example
custodian: Organization/organization-ecr-salem-medical-center: Salem Medical Center "Salem Medical Center"
Reason for Visit Section
title code
Reason for Visit: Bad cough
Chief Complaint
title code
Chief Complaint: Bad cough
History of Present Illness Section
title code
Persistent Cough REPORTED starting on 2018/03/05
Whooping Respiration not reported
Paroxysms Of Coughing REPORTED starting on 2018/03/06
Post-tussive vomiting not reportedProblems Section
title code
entry Common cold (disorder)
id meta
versionId lastUpdated profile category
code
subject onsetDateTime asserter Medications Administered Section
title code
entry Azithromycin 500 MG Oral Tablet
id meta
versionId lastUpdated status medicationCodeableConcept
subject effectivePeriod
start end dosage
route
method
dose
value unit system code Admission Medications Section
title code
entry naloxone HCl 0.4 MG in 1 ML Injection Medications Section
title code
entry Azithromycin 500 MG Oral Tablet Results Section
title code
entry Lymphocytes [#/volume] in Blood by Automated count - Interpretation: High
id meta
versionId lastUpdated profile status category
code
subject effectiveDateTime valueQuantity
interpretation
referenceRange
low
value system code high
value system code Plan of Treatment Section
title code
entry Request for Zika virus envelope (E) gene [Presence] in Serum by Probe and target amplification method
- Trigger code
- Trigger Code:
- Trigger Code Display:
- Trigger Code System:
- Trigger Code Value Set: urn:oid:2.16.840.1.114222.4.11.7508
- Trigger Code Value Set Version: 19/05/2018
id meta
versionId lastUpdated profile status intent category
code
subject performer Immunizations Section
title code
entry pneumococcal polysaccharide vaccine entry Vaccine Credential Patient Assertion Observation Example
- Immunization/immunization-ecr-pneumo: pneumococcal polysaccharide vaccine
- Observation/observation-vaccine-credential-assertion-eve-everywoman: Vaccine Credential Patient Assertion Observation Example
Procedures Section
title code
entry Extracorporeal membrane oxygenation (procedure) Vital Signs Section
title code
entry Blood pressure systolic and diastolic Social History Section
title code
entry eICR Travel History: Eve Everywoman 2018-01
id meta
versionId lastUpdated profile status code
subject effectivePeriod
start end component
code
valueCodeableConcept
component
code
valueCodeableConcept
- Observation/observation-travel-history-eve-everywoman-201801: eICR Travel History: Eve Everywoman 2018-01
- Observation/observation-disability-status-eve-everywoman: US Public Health Disability Status Example
- Observation/observation-us-ph-exposure-contact-info-football-game: US Public Health Exposure Contact Information Example
- Observation/observation-country-of-nationality-eve-everywoman: Country of Nationality Observation Example
- Observation/observation-country-of-residence-eve-everywoman: Country of Residence Observation Example
Pregnancy Section
title code
entry eICR Pregnancy Status Example
id meta
versionId lastUpdated profile us-ph-date-recorded-extension
date-determined-extension
status code
subject effectivePeriod
start valueCodeableConcept
method
component
date-determined-extension
code
valueQuantity
component
date-determined-extension
code
valueDateTime Emergency Outbreak Information Section
title code
entry US Public Health Emergency Outbreak Information Example Past Medical History Section
title code
Past medical history
Review of Systems Section
title code
Review of systems
Additional Document Content
2. http://example.org/fhir/MedicationAdministration/medicationadministration-eve-everywoman-azithromycin (MedicationAdministration/medicationadministration-eve-everywoman-azithromycin)
Generated Narrative: MedicationAdministration
Resource MedicationAdministration "medicationadministration-eve-everywoman-azithromycin" Version "6" Updated "2021-08-17 07:53:28+0000"
Information Source: #O8n4DNqcDuNHPfTJ!
status: COMPLETED
subject: Patient/patient-ecr-eve-everywoman: Eve Everywoman ""
Dosages
- Text Route Method Dose * Two tablets at once Oral route (SNOMED CT#26643006) Swallow - dosing instruction imperative (qualifier value) (SNOMED CT#421521009) 2 TAB (Details: http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm code TAB = 'Tablet') 3. http://example.org/fhir/Procedure/us-ph-procedure-ecmo (Procedure/us-ph-procedure-ecmo)
Generated Narrative: Procedure
Resource Procedure "us-ph-procedure-ecmo" Version "5" Updated "2021-06-28 08:12:56+0000"
Information Source: #A9FdbPgUT95j7Itd!
Profile: eICR Procedure
identifier: id: urn:uuid:b2a737f2-2fdb-49c1-b097-dac173d07afd
status: COMPLETED
code: Extracorporeal membrane oxygenation (procedure) (SNOMED CT#233573008)
subject: Patient/patient-ecr-eve-everywoman ""
FocalDevices
- Manipulated * Device/device-ecmo 4. http://example.org/fhir/MedicationAdministration/medicationadministration-eve-everywoman-naloxone-response (MedicationAdministration/medicationadministration-eve-everywoman-naloxone-response)
Generated Narrative: MedicationAdministration
Resource MedicationAdministration "medicationadministration-eve-everywoman-naloxone-response" Version "5" Updated "2021-08-17 07:53:28+0000"
Information Source: #5sOf7BOr595JpyG7!
US Public Health Therapeutic Medication Response Extension: Patient's condition improved (finding) (SNOMED CT#268910001)
status: COMPLETED
subject: Patient/patient-ecr-eve-everywoman: Eve Everywoman ""
Dosages
- Route Method Dose * Gluteus maximus muscle (SNOMED CT#206007) Inject - dosing instruction imperative (qualifier value) (SNOMED CT#422145002) 1 mL (Details: UCUM code mL = 'mL') 5. http://example.org/fhir/ServiceRequest/servicerequest-eicr-zika (ServiceRequest/servicerequest-eicr-zika)
Generated Narrative: ServiceRequest
Resource ServiceRequest "servicerequest-eicr-zika" Version "5" Updated "2021-08-17 08:02:21+0000"
Information Source: #w4zRDqhjQ9EZHgCs!
Profile: eICR ServiceRequest
identifier: id: 061ef612-344f-4e7b-81a8-1059ae7bbe19
status: COMPLETED
intent: ORDER
category: Diagnostics Procedure (SNOMED CT#103693007 "Diagnostic procedure (procedure)")
code: Zika RT-PCR (LOINC#80825-3 "Zika virus envelope E gene [Presence] in Serum by NAA with probe detection")
subject: Patient/patient-ecr-eve-everywoman: Eve Everywoman ""
performer: Organization/organization-ecr-acme-laboratory: Acme Labs "Acme_Labs"
6. http://example.org/fhir/Condition/condition-eicr-eve-everywoman-common-cold (Condition/condition-eicr-eve-everywoman-common-cold)
Generated Narrative: Condition
Resource Condition "condition-eicr-eve-everywoman-common-cold" Version "6" Updated "2021-07-15 01:54:14+0000"
Information Source: #4g0ZpTNqldHFYLzr!
Profile: US Public Health Condition
category: Problem List Item (Condition Category Codes#problem-list-item)
code: Common cold (disorder) (SNOMED CT#82272006)
subject: Patient/patient-ecr-eve-everywoman: Eve Everywoman ""
onset: 2017-09-23
7. http://example.org/fhir/Encounter/encounter-eicr-eve-everywoman-outpatient (Encounter/encounter-eicr-eve-everywoman-outpatient)
Not done yet
8. http://example.org/fhir/Observation/observation-pregnancy-status-eve-everywoman (Observation/observation-pregnancy-status-eve-everywoman)
Generated Narrative: Observation
Resource Observation "observation-pregnancy-status-eve-everywoman" Version "8" Updated "2021-08-17 07:59:00+0000"
Information Source: #bBlVx7OsNPsZVCbu!
US Public Health Date Recorded Extension: 2017-10-01
US Public Health Date Determined Extension: 2017-10-01
status: FINAL
code: Pregnancy status (LOINC#82810-3)
subject: Patient/patient-ecr-eve-everywoman: Eve Everywoman ""
effective: 2017-08-26 --> (ongoing)
value: Pregnancy (finding) (SNOMED CT#77386006)
method: Diagnostic ultrasonography (procedure) (SNOMED CT#16310003)
component
US Public Health Date Determined Extension: 2017-10-01
code: Gestational age Estimated from patient reported estimated date of conception (LOINC#53691-2)
value: 143 d
component
US Public Health Date Determined Extension: 2017-10-01
code: Delivery date Estimated from date fundal height reaches umb (LOINC#57064-8)
value: 2018-05-01
9. http://example.org/fhir/Observation/observation-vaccine-credential-assertion-eve-everywoman (Observation/observation-vaccine-credential-assertion-eve-everywoman)
Generated Narrative: Observation
Resource Observation "observation-vaccine-credential-assertion-eve-everywoman" Version "2" Updated "2021-08-13 04:25:18+0000"
Information Source: #12yO2DqhRxbXmEOy!
status: FINAL
code: Immunization status - Reported (LOINC#11370-4)
subject: Patient/patient-ecr-eve-everywoman: Eve Everywoman ""
effective: 2020-11-10 10:33:22+0000
value: Yes (expandedYes-NoIndicator#Y)
10. http://example.org/fhir/Observation/observation-us-ph-emergency-outbreak-info-eve-everywoman (Observation/observation-us-ph-emergency-outbreak-info-eve-everywoman)
Generated Narrative: Observation
Resource Observation "observation-us-ph-emergency-outbreak-info-eve-everywoman" Version "4" Updated "2021-07-15 01:22:52+0000"
Information Source: #oAXhG2HyvbL70uEB!
status: FINAL
code: Employee desk distance from mail sorter ()
subject: Patient/patient-ecr-eve-everywoman: Eve Everywoman ""
effective: 2020-11-18 10:33:22+0000
value: 2 m
11. http://example.org/fhir/Observation/observation-country-of-nationality-eve-everywoman (Observation/observation-country-of-nationality-eve-everywoman)
Generated Narrative: Observation
Resource Observation "observation-country-of-nationality-eve-everywoman" Version "1" Updated "2021-08-19 09:30:49+0000"
Information Source: #ABFWLRjmURVC23y1!
Profile: eICR Country of Nationality
status: FINAL
code: Ethnicity / related nationality data (observable entity) (SNOMED CT#186034007)
subject: Patient/patient-ecr-eve-everywoman: Eve Everywoman ""
effective: 2020-11-10 10:33:22+0000
value: Australia (unknown#AU)
12. http://example.org/fhir/Patient/patient-ecr-eve-everywoman (Patient/patient-ecr-eve-everywoman)
Eve L EVERYWOMAN
Identifier 1032702 Address 5101 Peachtree St NE
Atlanta GA USDate of birth 24 November 1974 13. http://example.org/fhir/Immunization/immunization-ecr-pneumo (Immunization/immunization-ecr-pneumo)
Generated Narrative: Immunization
Resource Immunization "immunization-ecr-pneumo" Version "8" Updated "2021-08-17 07:51:35+0000"
Information Source: #EdjaILZHXKHi4bdN!
Profile: US Core Immunization Profile
status: COMPLETED
vaccineCode: pneumococcal polysaccharide PPV23 (PH_VaccinesAdministeredCVX_CDC_NIP#33)
patient: Patient/patient-ecr-eve-everywoman: Eve Everywoman ""
occurrence: 2018-09-01
primarySource: true
14. http://example.org/fhir/Observation/observation-country-of-residence-eve-everywoman (Observation/observation-country-of-residence-eve-everywoman)
Generated Narrative: Observation
Resource Observation "observation-country-of-residence-eve-everywoman" Version "1" Updated "2021-08-13 12:20:14+0000"
Information Source: #HDoLJzr0kfWKFp3F!
Profile: eICR Country of Residence
status: FINAL
code: Country of usual residence (LOINC#77983-5)
subject: Patient/patient-ecr-eve-everywoman: Eve Everywoman ""
effective: 2020-11-10 10:33:22+0000
value: United Kingdom of Great Britain and Northern Ireland (unknown#GB)
15. http://example.org/fhir/PractitionerRole/practitionerrole-henry-seven (PractitionerRole/practitionerrole-henry-seven)
Generated Narrative: PractitionerRole
Resource PractitionerRole "practitionerrole-henry-seven" Version "11" Updated "2021-08-17 08:00:32+0000"
Information Source: #KJ942UxvfdYWoHCF!
Profile: US Public Health PractitionerRole
identifier: id: 9941339108
practitioner: Practitioner/practitioner-us-core-henry-seven: Henry Seven, MD " HENRY"
organization: Organization/organization-ecr-salem-medical-center: Salem Medical Center "Salem Medical Center"
code: Primary Care Clinic/Center (provider-taxonomy#261QP2300X)
specialty: Family practice (SNOMED CT#419772000)
location: Location/location-ecr-salem-medical-center: Salem Medical Center "Clinic Bldg A, Salem Medical Center"
telecom: henry.seven@example.com
16. http://example.org/fhir/Observation/observation-blood-pressure-eve-everywoman (Observation/observation-blood-pressure-eve-everywoman)
Generated Narrative: Observation
Resource Observation "observation-blood-pressure-eve-everywoman" Version "2" Updated "2021-07-19 08:19:31+0000"
Information Source: #2PjceWUbU0gCYVZA!
Profile: US Core Blood Pressure Profile
status: FINAL
category: Vital Signs (Observation Category Codes#vital-signs)
code: Blood pressure systolic and diastolic (LOINC#85354-9 "Blood pressure panel with all children optional")
subject: Patient/patient-ecr-eve-everywoman: Eve Everywoman ""
encounter: : GP Visit
effective: 2020-07-02
component
code: Systolic blood pressure (LOINC#8480-6)
value: 109 mmHg (Details: UCUM code mm[Hg] = 'mm[Hg]')
component
code: Diastolic blood pressure (LOINC#8462-4)
value: 44 mmHg (Details: UCUM code mm[Hg] = 'mm[Hg]')
17. http://example.org/fhir/Observation/observation-us-ph-exposure-contact-info-football-game (Observation/observation-us-ph-exposure-contact-info-football-game)
Generated Narrative: Observation
Resource Observation "observation-us-ph-exposure-contact-info-football-game" Version "4" Updated "2020-12-01 07:17:32+0000"
Information Source: #pMvWUdCWz4XOnrDf!
status: FINAL
category: An interaction between entities that provides opportunity for transmission of a physical, chemical, or biological agent from an exposure source entity to an exposure target entity. (ActClass#EXPOS "exposure")
code: Mass gathering (football game) (Unified Medical Language System#C3841750 "Mass gathering")
subject: Patient/patient-ecr-eve-everywoman: Eve Everywoman ""
focus: Location/location-ecr-city-football-stadium: City Football Stadium "City Football Stadium"
effective: 2020-01-11 06:00:00+0000 --> 2020-01-11 09:30:00+0000
value: City Football Stadium (SNOMED CT#264379009 "Sports stadium (environment)")
18. http://example.org/fhir/Observation/observation-travel-history-eve-everywoman-201801 (Observation/observation-travel-history-eve-everywoman-201801)
Generated Narrative: Observation
Resource Observation "observation-travel-history-eve-everywoman-201801" Version "9" Updated "2021-08-17 07:59:01+0000"
Information Source: #d6PrWfFFuxUIiLtX!
Profile: US Public Health Travel History
status: FINAL
code: Travel History (SNOMED CT#420008001 "Travel")
subject: Patient/patient-ecr-eve-everywoman: Eve Everywoman ""
effective: 2018-01-15 --> 2018-01-30
component
code: Location (ParticipationType#LOC)
value: Fiji (unknown#FJI)
component
code: Location (ParticipationType#LOC)
value: Vanuatu (unknown#VUT)
component
code: Type of activity (attribute) (SNOMED CT#280147009)
value: Active duty military (occupation) (SNOMED CT#702348006)
19. http://example.org/fhir/Observation/observation-disability-status-eve-everywoman (Observation/observation-disability-status-eve-everywoman)
Generated Narrative: Observation
Resource Observation "observation-disability-status-eve-everywoman" Version "2" Updated "2021-06-30 05:33:12+0000"
Information Source: #AVCvf6gXu6hyNuWr!
Profile: US Public Health Disability Status
status: FINAL
code: Are you deaf, or do you have serious difficulty hearing? (LOINC#69856-3)
subject: Patient/patient-ecr-eve-everywoman: Eve Everywoman ""
effective: 2020-11-10 10:33:22+0000
value: true
20. http://example.org/fhir/Observation/observation-us-ph-lab-result-eve-everywoman-lymphocytes (Observation/observation-us-ph-lab-result-eve-everywoman-lymphocytes)
Generated Narrative: Observation
Resource Observation "observation-us-ph-lab-result-eve-everywoman-lymphocytes" Version "4" Updated "2021-07-19 12:27:15+0000"
Information Source: #JUoT9ShFi539tEiO!
Profile: US Public Health Laboratory Result Observation Profile
status: FINAL
category: Laboratory (Observation Category Codes#laboratory)
code: Lymphocytes [#/volume] in Blood by Automated count (LOINC#731-0)
subject: Patient/patient-ecr-eve-everywoman: Eve Everywoman ""
effective: 2018-03-07
value: 5.2 10*3/uL (Details: UCUM code 10*3/uL = '10*3/uL')
interpretation: High (ObservationInterpretation#H)
ReferenceRanges
- Low High * 1 10*3/uL (Details: UCUM code 10*3/uL = '10*3/uL') 4.8 10*3/uL (Details: UCUM code 10*3/uL = '10*3/uL') 21. http://example.org/fhir/Organization/organization-ecr-acme-laboratory (Organization/organization-ecr-acme-laboratory)
Generated Narrative: Organization
Resource Organization "organization-ecr-acme-laboratory" Version "4" Updated "2021-06-30 04:13:19+0000"
Information Source: #xp7CXcY2lPaNsDQL!
Profile: US Public Health Organization
identifier: id: 1144221999
active: true
type: outpatient laboratory (RoleCode#OUTLAB)
name: Acme_Labs
telecom: +1-555-555-4444, mail@acme-labs.com
address: 7777 Laboratory Drive Ann Arbor MI 99999
22. http://example.org/fhir/Location/location-ecr-salem-medical-center (Location/location-ecr-salem-medical-center)
Generated Narrative: Location
Resource Location "location-ecr-salem-medical-center" Version "6" Updated "2021-08-17 07:53:02+0000"
Information Source: #VI2Nm5Ps5HqZ5HXV!
Profile: US Public Health Location
identifier: id: 1144221995
status: ACTIVE
name: Clinic Bldg A, Salem Medical Center
type: Hospital (RoleCode#HOSP)
telecom: ph: (+1) (555)555-3001, fax: (+1) (555)555-3002, mail@smc.org
address: Clinic Bldg A 4444 Healthcare Drive Ann Arbor MI 99999
managingOrganization: Organization/organization-ecr-salem-medical-center "Salem Medical Center"
23. http://example.org/fhir/Location/location-ecr-city-football-stadium (Location/location-ecr-city-football-stadium)
Generated Narrative: Location
Resource Location "location-ecr-city-football-stadium" Version "1" Updated "2020-12-01 01:55:32+0000"
Information Source: #KLUFk4w6CXKqrFEC!
Profile: US Core Location Profile
status: ACTIVE
name: City Football Stadium
type: City Football Stadium (SNOMED CT#264379009 "Sports stadium (environment)")
address: 99 Football Stadium Road My City AZ 8562
24. http://example.org/fhir/Organization/organization-ecr-salem-medical-center (Organization/organization-ecr-salem-medical-center)
Generated Narrative: Organization
Resource Organization "organization-ecr-salem-medical-center" Version "5" Updated "2021-06-30 04:13:19+0000"
Information Source: #xa4yJZjn68xVavoM!
Profile: US Public Health Organization
identifier: id: 55555555
active: true
name: Salem Medical Center
telecom: +1-555-555-1111, mail@salemmedicalcenter.com
address: 22222 Health Authority Drive Ann Arbor MI 99999
25. http://example.org/fhir/Condition/condition-eicr-eve-everywoman-zika (Condition/condition-eicr-eve-everywoman-zika)
Generated Narrative: Condition
Resource Condition "condition-eicr-eve-everywoman-zika" Version "5" Updated "2021-07-15 01:54:14+0000"
Information Source: #rM2Pw6getjoE2UTV!
category: Encounter Diagnosis (Condition Category Codes#encounter-diagnosis)
code: Zika virus disease (disorder) (SNOMED CT#3928002)
subject: Patient/patient-ecr-eve-everywoman: Eve Everywoman ""
onset: 2017-08-23
26. http://example.org/fhir/Practitioner/practitioner-us-core-henry-seven (Practitioner/practitioner-us-core-henry-seven)
Generated Narrative: Practitioner
Resource Practitioner "practitioner-us-core-henry-seven" Version "5" Updated "2021-08-17 08:00:32+0000"
Information Source: #2MfA6kIjmOmtAlIb!
Profile: US Core Practitioner Profile
identifier: id: 9941339108
name: Seven Henry
telecom: henry.seven@example.com
address: BMass Doctors 2100 North Ave Burlington MA 02368 US
Entry 3 - Full URL = http://example.org/fhir/Device/device-ecr-software-ymca
Resource Device:
id: meta:
identifier:
manufacturer: type: version:
value: contact:
url:
Entry 4 - Full URL = http://example.org/fhir/Organization/organization-ecr-salem-medical-center
Resource Organization:
id meta
versionId lastUpdated profile identifier
active type
name telecom
system value telecom
system value address
line city state postalCode
IG © 2020+ HL7 Public Health Work Group (http://www.hl7.org/Special/committees/pher/index.cfm). Package hl7.fhir.us.ecr#2.1.0 based on FHIR 4.0.1. Generated 2022-08-31
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