Electronic Long-Term Services and Supports (eLTSS) Release 1 - US Realm

This page is part of the electronic Long-Term Services and Supports Implementation Guide (v1.0.0: STU 1) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

eLTSS Patient Example - XML Representation

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Raw xml 


<Bundle xmlns="http://hl7.org/fhir">
  <id value="patient-patient1"/>
  <type value="collection"/>
<!--      The person (Patient) who is the subject of the document.  -->
  <entry>
    <resource>
      <Patient>
        <id value="patient1"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/us/eltss/StructureDefinition/Patient-eltss"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml">
            <p><b>Person Name:</b> Sally Person</p>
            <p><b>Person Identifier | Type:</b> 123456ABC | MRN</p>
            <p><b>Person Phone:</b> (404) 555 1212</p>
            <p><b>Person Date of Birth:</b> 1935-05-01</p>
            <p><b>Person Address:</b> 2222 Peachtree Street, Atlanta GA, 30318</p>
            <p><b>Emergency Contact Name:</b> Jane Daughter</p>
            <p><b>Emergency Contact Relationship:</b> daughter</p>
            <p><b>Emergency Contact Phone Number:</b> (770) 224 1544</p>
          </div>
        </text>
      <!--  [eLTSS Person Identifier] & [eLTSS Person Identifier Type]   -->
        <identifier>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="MR"/>
            </coding>
            <text value="MRN"/>
          </type>
          <system value="http://www.example.org/Codesystem"/>
          <value value="123456ABC"/>
        </identifier>
      <!--   [eLTSS Person Name]   -->
        <name>
          <text value="Sally Person"/>
          <family value="Person"/>
          <given value="Sally"/>
        </name>
      <!--   [eLTSS Person Phone Number]   -->
        <telecom>
          <system value="phone"/>
          <value value="(404) 555 1212"/>
        </telecom>
        <gender value="female"/>
      <!--   [eLTSS Person Date of Birth]   -->
        <birthDate value="1935-05-01"/>
      <!--   [eLTSS Person Address]   -->
        <address>
          <text value="2222 Peachtree Street, Atlanta GA, 30318"/>
          <line value="2222 Peachtree Street"/>
          <city value="Atlanta"/>
          <district value="Fulton"/>
          <state value="GA"/>
          <postalCode value="30318"/>
        </address>
      <!--   [eLTSS Emergency Contact Name] & [eLTSS Emergency Contact Relationship] & [eLTSS Emergency Contact Phone Number]  -->
        <contact>
          <relationship>
          <!--  code value indicates emergency contact  -->
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0131"/>
              <code value="C"/>
            </coding>
          </relationship>
          <relationship>
          <!--  code value indicates daughter  -->
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
              <code value="DAUC"/>
            </coding>
          </relationship>
          <name>
            <text value="Jane Daughter"/>
            <family value="Daughter"/>
            <given value="Jane"/>
          </name>
          <telecom>
            <system value="phone"/>
            <value value="(770) 224 1544"/>
          </telecom>
        </contact>
      </Patient>
    </resource>
  </entry>
</Bundle>