This page is part of the electronic Long-Term Services and Supports Implementation Guide (v2.0.0-ballot: STU2 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions
Page standards status: Informative |
{
"resourceType" : "Contract",
"id" : "contract1",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-09-03T10:16:03.512-04:00",
"source" : "#KZ0jzPjXDrhCiMif",
"profile" : [
🔗 "http://hl7.org/fhir/us/eltss/StructureDefinition/Contract-eltss"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Contract</b><a name=\"contract1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Contract "contract1" Version "1" Updated "2020-09-03 10:16:03-0400" </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Contract-eltss.html\">Contract_eltss</a></p></div><blockquote><p><b>signer</b></p><p><b>type</b>: Patient (Details: http://terminology.hl7.org/CodeSystem/contractsignertypecodes code PAT = 'Patient', stated as 'null')</p><p><b>party</b>: <a href=\"Patient-patientBSJ1.html\">Patient/patientBSJ1</a> " SMITH-JOHNSON"</p><h3>Signatures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>When</b></td><td><b>Who</b></td><td><b>Data</b></td></tr><tr><td style=\"display: none\">*</td><td>Consent Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.7 = 'Consent Signature', stated as 'null')</td><td>Apr 2, 2020, 3:00:00 AM</td><td><a href=\"Patient-patientBSJ1.html\">Patient/patientBSJ1</a> " SMITH-JOHNSON"</td><td>(base64 data - 187 bytes)</td></tr></table></blockquote><blockquote><p><b>signer</b></p><p><b>type</b>: Guardian (Details: http://terminology.hl7.org/CodeSystem/contractsignertypecodes code GUARD = 'Guardian', stated as 'null')</p><p><b>party</b>: <a href=\"RelatedPerson-guardian1.html\">RelatedPerson/guardian1</a> " CHARLES"</p><h3>Signatures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>When</b></td><td><b>Who</b></td><td><b>Data</b></td></tr><tr><td style=\"display: none\">*</td><td>Consent Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.7 = 'Consent Signature', stated as 'null')</td><td>Apr 2, 2020, 3:00:00 AM</td><td><a href=\"RelatedPerson-guardian1.html\">RelatedPerson/guardian1</a> " CHARLES"</td><td>(base64 data - 187 bytes)</td></tr></table></blockquote><blockquote><p><b>signer</b></p><p><b>type</b>: Author (Details: http://terminology.hl7.org/CodeSystem/contractsignertypecodes code AUT = 'Author', stated as 'null')</p><p><b>party</b>: <a href=\"Practitioner-planner1.html\">Practitioner/planner1</a> " PLANNER"</p><h3>Signatures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>When</b></td><td><b>Who</b></td><td><b>Data</b></td></tr><tr><td style=\"display: none\">*</td><td>Author's Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.1 = 'Author's Signature', stated as 'null')</td><td>Apr 2, 2020, 3:00:00 AM</td><td><a href=\"Practitioner-planner1.html\">Practitioner/planner1</a> " PLANNER"</td><td>(base64 data - 187 bytes)</td></tr></table></blockquote><blockquote><p><b>signer</b></p><p><b>type</b>: Co-Author (Details: http://terminology.hl7.org/CodeSystem/contractsignertypecodes code COAUTH = 'Co-Author', stated as 'null')</p><p><b>party</b>: <a href=\"Practitioner-caremgr1.html\">Practitioner/caremgr1</a> " MONITOR"</p><h3>Signatures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>When</b></td><td><b>Who</b></td><td><b>Data</b></td></tr><tr><td style=\"display: none\">*</td><td>Author's Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.1 = 'Author's Signature', stated as 'null')</td><td>Apr 2, 2020, 3:00:00 AM</td><td><a href=\"Practitioner-caremgr1.html\">Practitioner/caremgr1</a> " MONITOR"</td><td>(base64 data - 187 bytes)</td></tr></table></blockquote><blockquote><p><b>signer</b></p><p><b>type</b>: Healthcare Provider (Details: http://terminology.hl7.org/CodeSystem/contractsignertypecodes code HPROV = 'Healthcare Provider', stated as 'null')</p><p><b>party</b>: <a href=\"Practitioner-provider3.html\">Practitioner/provider3</a> " EDUCATOR"</p><h3>Signatures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>When</b></td><td><b>Who</b></td><td><b>Data</b></td></tr><tr><td style=\"display: none\">*</td><td>Consent Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.7 = 'Consent Signature', stated as 'null')</td><td>Apr 2, 2020, 3:00:00 AM</td><td><a href=\"Practitioner-provider3.html\">Practitioner/provider3</a> " EDUCATOR"</td><td>(base64 data - 187 bytes)</td></tr></table></blockquote><blockquote><p><b>signer</b></p><p><b>type</b>: Healthcare Provider (Details: http://terminology.hl7.org/CodeSystem/contractsignertypecodes code HPROV = 'Healthcare Provider', stated as 'null')</p><p><b>party</b>: <a href=\"Practitioner-provider2b.html\">Practitioner/provider2b</a> " DRIVER"</p><h3>Signatures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>When</b></td><td><b>Who</b></td><td><b>Data</b></td></tr><tr><td style=\"display: none\">*</td><td>Consent Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.7 = 'Consent Signature', stated as 'null')</td><td>Apr 2, 2020, 3:00:00 AM</td><td><a href=\"Practitioner-provider2b.html\">Practitioner/provider2b</a> " DRIVER"</td><td>(base64 data - 187 bytes)</td></tr></table></blockquote><blockquote><p><b>signer</b></p><p><b>type</b>: Healthcare Provider (Details: http://terminology.hl7.org/CodeSystem/contractsignertypecodes code HPROV = 'Healthcare Provider', stated as 'null')</p><p><b>party</b>: <a href=\"RelatedPerson-son1.html\">RelatedPerson/son1</a> " CHARLES"</p><h3>Signatures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>When</b></td><td><b>Who</b></td><td><b>Data</b></td></tr><tr><td style=\"display: none\">*</td><td>Consent Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.7 = 'Consent Signature', stated as 'null')</td><td>Apr 2, 2020, 3:00:00 AM</td><td><a href=\"RelatedPerson-son1.html\">RelatedPerson/son1</a> " CHARLES"</td><td>(base64 data - 187 bytes)</td></tr></table></blockquote><blockquote><p><b>signer</b></p><p><b>type</b>: Healthcare Provider (Details: http://terminology.hl7.org/CodeSystem/contractsignertypecodes code HPROV = 'Healthcare Provider', stated as 'null')</p><p><b>party</b>: <a href=\"Practitioner-provider4.html\">Practitioner/provider4</a> " TRAINER"</p><h3>Signatures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>When</b></td><td><b>Who</b></td><td><b>Data</b></td></tr><tr><td style=\"display: none\">*</td><td>Consent Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.7 = 'Consent Signature', stated as 'null')</td><td>Apr 2, 2020, 3:00:00 AM</td><td><a href=\"Practitioner-provider4.html\">Practitioner/provider4</a> " TRAINER"</td><td>(base64 data - 187 bytes)</td></tr></table></blockquote></div>"
},
"signer" : [
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "PAT"
},
"party" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"signature" : [
{
"type" : [
{
"system" : "urn:iso-astm:E1762-95:2013",
"code" : "1.2.840.10065.1.12.1.7"
}
],
"when" : "2020-04-02T03:00:00Z",
"who" : {
🔗 "reference" : "Patient/patientBSJ1"
},
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
},
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "GUARD"
},
"party" : {
🔗 "reference" : "RelatedPerson/guardian1"
},
"signature" : [
{
"type" : [
{
"system" : "urn:iso-astm:E1762-95:2013",
"code" : "1.2.840.10065.1.12.1.7"
}
],
"when" : "2020-04-02T03:00:00Z",
"who" : {
🔗 "reference" : "RelatedPerson/guardian1"
},
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
},
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "AUT"
},
"party" : {
🔗 "reference" : "Practitioner/planner1"
},
"signature" : [
{
"type" : [
{
"system" : "urn:iso-astm:E1762-95:2013",
"code" : "1.2.840.10065.1.12.1.1"
}
],
"when" : "2020-04-02T03:00:00Z",
"who" : {
🔗 "reference" : "Practitioner/planner1"
},
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
},
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "COAUTH"
},
"party" : {
🔗 "reference" : "Practitioner/caremgr1"
},
"signature" : [
{
"type" : [
{
"system" : "urn:iso-astm:E1762-95:2013",
"code" : "1.2.840.10065.1.12.1.1"
}
],
"when" : "2020-04-02T03:00:00Z",
"who" : {
🔗 "reference" : "Practitioner/caremgr1"
},
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
},
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "HPROV"
},
"party" : {
🔗 "reference" : "Practitioner/provider3"
},
"signature" : [
{
"type" : [
{
"system" : "urn:iso-astm:E1762-95:2013",
"code" : "1.2.840.10065.1.12.1.7"
}
],
"when" : "2020-04-02T03:00:00Z",
"who" : {
🔗 "reference" : "Practitioner/provider3"
},
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
},
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "HPROV"
},
"party" : {
🔗 "reference" : "Practitioner/provider2b"
},
"signature" : [
{
"type" : [
{
"system" : "urn:iso-astm:E1762-95:2013",
"code" : "1.2.840.10065.1.12.1.7"
}
],
"when" : "2020-04-02T03:00:00Z",
"who" : {
🔗 "reference" : "Practitioner/provider2b"
},
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
},
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "HPROV"
},
"party" : {
🔗 "reference" : "RelatedPerson/son1"
},
"signature" : [
{
"type" : [
{
"system" : "urn:iso-astm:E1762-95:2013",
"code" : "1.2.840.10065.1.12.1.7"
}
],
"when" : "2020-04-02T03:00:00Z",
"who" : {
🔗 "reference" : "RelatedPerson/son1"
},
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
},
{
"type" : {
"system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes",
"code" : "HPROV"
},
"party" : {
🔗 "reference" : "Practitioner/provider4"
},
"signature" : [
{
"type" : [
{
"system" : "urn:iso-astm:E1762-95:2013",
"code" : "1.2.840.10065.1.12.1.7"
}
],
"when" : "2020-04-02T03:00:00Z",
"who" : {
🔗 "reference" : "Practitioner/provider4"
},
"data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw=="
}
]
}
]
}
IG © 2020+ HL7 International / Human and Social Services. Package hl7.fhir.us.eltss#2.0.0-ballot based on FHIR 4.0.1. Generated 2023-12-15
Links: Table of Contents |
QA Report
| Version History |
|
Propose a change