ELTSS 0.1.0 - STU1 Ballot 1
This page is part of the electronic Long-Term Services and Supports Implementation Guide (v0.1.0: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions 
{
"resourceType" : "Bundle",
"id" : "contract-contract1",
"type" : "collection",
"entry" : [
{
"fullUrl" : "http://example.org/eLTSS/planner",
"resource" : {
"resourceType" : "Practitioner",
"id" : "planner1",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/eltss/StructureDefinition/practitioner-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p><b>Support Planner / Phone:</b> Mark Planner / (678) 555 1221</p>\n </div>"
},
"identifier" : [
{
"system" : "http://www.acme.org/practitioners",
"value" : "23"
}
],
"name" : [
{
"text" : "Mark Planner",
"family" : "Planner",
"given" : [
"Mark"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "(678) 555 1221"
}
]
}
},
{
"fullUrl" : "http://example.org/eLTSS/caremgr",
"resource" : {
"resourceType" : "Practitioner",
"id" : "caremgr1",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/eltss/StructureDefinition/practitioner-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p><b>Plan Monitor / Phone:</b> Sam Monitor / (770) 224 1599</p>\n </div>"
},
"identifier" : [
{
"system" : "http://www.acme.org/practitioners",
"value" : "24"
}
],
"name" : [
{
"text" : "Sam Monitor",
"family" : "Monitor",
"given" : [
"Sam"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "(770) 224 1599"
}
]
}
},
{
"fullUrl" : "http://example.org/eLTSS/provider1",
"resource" : {
"resourceType" : "Practitioner",
"id" : "provider1",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/eltss/StructureDefinition/practitioner-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p><b>Provider:</b> Lisa Performer </p>\n </div>"
},
"identifier" : [
{
"system" : "http://www.acme.org/practitioners",
"value" : "987654"
}
],
"name" : [
{
"text" : "Lisa Performer",
"family" : "Performer",
"given" : [
"Lisa"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "(404) 555 1213"
}
]
}
},
{
"fullUrl" : "http://example.org/eLTSS/provider2",
"resource" : {
"resourceType" : "Organization",
"id" : "provider2",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p><b>Organization:</b> The Transporter</p>\n </div>"
},
"identifier" : [
{
"value" : "24680"
}
],
"name" : "The Transporter, Inc.",
"telecom" : [
{
"system" : "phone",
"value" : "(404) 555 1313"
}
],
"address" : [
{
"text" : "111 Business Street, Atlanta GA, 30318"
}
]
}
},
{
"fullUrl" : "http://example.org/eLTSS/provider3",
"resource" : {
"resourceType" : "Practitioner",
"id" : "provider3",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/eltss/StructureDefinition/practitioner-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p><b>Practitioner:</b> Bill Driver</p>\n </div>"
},
"identifier" : [
{
"system" : "http://www.acme.org/practitioners",
"value" : "11223344"
}
],
"name" : [
{
"text" : "Bill Driver",
"family" : "Driver",
"given" : [
"Bill"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "(678) 111 2222"
}
]
}
},
{
"fullUrl" : "http://example.org/eLTSS/contract",
"resource" : {
"resourceType" : "Contract",
"id" : "contract1",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/eltss/StructureDefinition/contract-eltss"
]
},
"text" : {
"status" : "additional",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>eLTSS Signature in Contract form [eLTSS Support Planner Signature], [eLTSS Support Planner Printed Name], [eLTSS Support Planner Signature Date] </p>\n </div>"
},
"signer" : [
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "AUT"
},
"party" : {
"reference" : "Practitioner/planner1"
},
"signature" : [
{
"type" : [
{
"code" : "1.2.840.10065.1.12.1.1"
}
],
"when" : "2018-04-02T03:00:00Z",
"who" : {
"reference" : "Practitioner/planner1"
},
"sigFormat" : "image/jpeg",
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
},
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "HPROV"
},
"party" : {
"reference" : "Practitioner/provider1"
},
"signature" : [
{
"type" : [
{
"code" : "1.2.840.10065.1.12.1.7"
}
],
"when" : "2018-04-02T03:00:00Z",
"who" : {
"reference" : "Practitioner/provider1"
},
"sigFormat" : "image/jpeg",
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
},
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "HPROV"
},
"party" : {
"reference" : "Organization/provider2"
},
"signature" : [
{
"type" : [
{
"code" : "1.2.840.10065.1.12.1.7"
}
],
"when" : "2018-04-02T03:00:00Z",
"who" : {
"reference" : "Practitioner/provider3"
},
"sigFormat" : "image/jpeg",
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
}
]
}
}
]
}
Implementation Guide © 2017+ HL7 International Community-Based Care and Privacy Work Group hl7.fhir.us.eltss#0.1.0 based on FHIR v4.0.0 generated 27/03/2019.
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