Healthcare Associated Infection Reports (HL7 FHIR® IG : Trial Use v1.0.0 / US Realm)
This page is part of the Healthcare Associated Infection Implementation Guide (v2.0.0: STU 2) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions 
{
"resourceType" : "Bundle",
"id" : "hai-bundle-los-event",
"identifier" : {
"system" : "urn:ietf:rfc:3986",
"value" : "urn:uuid:876e4d4a-e6b6-4898-91ee-811809c3e623"
},
"type" : "collection",
"entry" : [
{
"fullUrl" : "urn:uuid:3ed9a2c6-02a9-41e1-9f43-52ca33ba8618",
"resource" : {
"resourceType" : "QuestionnaireResponse",
"id" : "hai-questionnaireResponse-los-event",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/hai/StructureDefinition/hai-single-person-report-questionnaire-response"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>This QuestionnaireResponse instance is an example of a completed Late Onset Sepsis/Meningitis Event (LOS) Report and is in response to the Questionnaire instance defining this report.</p>\n <h2>Late Onset Sepsis/Meningitis Event (LOS)</h2>\n <table border=\"1\">\n <tbody>\n <tr>\n <td>Facility ID</td>\n <td>urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.1.1:9W</td>\n </tr>\n <tr>\n <td>Event #</td>\n <td>urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.2.1.1.3:31</td>\n </tr>\n <tr>\n <td>Patient ID</td>\n <td>Medical Record Number: 12345</td>\n </tr>\n <tr>\n <td>Social Security #</td>\n <td>12345</td>\n </tr>\n <tr>\n <td>Medicaid #</td>\n <td>959595</td>\n </tr>\n <tr>\n <td>Patient Last Name</td>\n <td>Nuclear</td>\n </tr>\n <tr>\n <td>Patient First Name</td>\n <td>Ned</td>\n </tr>\n <tr>\n <td>Gender</td>\n <td>Male</td>\n </tr>\n <tr>\n <td>Date of Birth</td>\n <td>1954-11-25</td>\n </tr>\n <tr>\n <td>Ethnicity</td>\n <td>Not Hispanic or Latino</td>\n </tr>\n <tr>\n <td>Race</td>\n <td>White</td>\n </tr>\n <tr>\n <td>Event Type</td>\n <td>Late onset sepsis (LOS)</td>\n </tr>\n <tr>\n <td>Date of Event</td>\n <td>2018-01-02</td>\n </tr>\n <tr>\n <td>Date Admitted to Facility</td>\n <td>2018-01-01</td>\n </tr>\n <tr>\n <td>Inborn/Outborn</td>\n <td>Inborn</td>\n </tr>\n <tr>\n <td>Location</td>\n <td>Medical/Surgical Critical Care</td>\n </tr>\n </tbody>\n </table>\n <h2>Risk Factors</h2>\n <table border=\"1\">\n <tbody>\n <tr>\n <td>Central line present prior to event, including umbilical catheter</td>\n <td>Yes</td>\n </tr>\n <tr>\n <td>Birth Weight</td>\n <td>700 g</td>\n </tr>\n <tr>\n <td>Gestational Age</td>\n <td>276 d</td>\n </tr>\n </tbody>\n </table>\n <h2>Event Details</h2>\n <table border=\"1\">\n <tbody>\n <tr>\n <td>Specific Event</td>\n <td>Neonatal Laboratory Confirmed Bloodstream Infection (NLCBI 2)</td>\n </tr>\n <tr>\n <td>Criteria used</td>\n <td>Recognized pathogen from one or more blood specimens</td>\n </tr>\n <tr>\n <td>Died</td>\n <td>Yes</td>\n </tr>\n <tr>\n <td>LOS Contributed to Death</td>\n <td>No</td>\n </tr>\n <tr>\n <td>Discharge date</td>\n <td>2018-01-12</td>\n </tr>\n </tbody>\n </table>\n\n\n <h2>Findings</h2>\n <table border=\"1\">\n <tbody>\n <tr>\n <td>Microorganism identified</td>\n <td>Clostridium symbiosum (organism)</td>\n </tr>\n <tr>\n <td>Pathogen Ranking</td>\n <td>First</td>\n </tr>\n <tr>\n <td>Clarithro Susc Islt</td>\n <td>Resistant</td>\n </tr>\n </tbody>\n </table>\n <h2>Comment</h2>\n <table border=\"1\">\n <tbody>\n <tr>\n <td>Comment</td>\n <td>NHSN text comment that is less than 2000 characters.</td>\n </tr>\n </tbody>\n </table>\n </div>"
},
"identifier" : {
"system" : "urn:oid:2.16.840.1.113883.3.117.1.1.5.2.1.1.2",
"value" : "20202201"
},
"questionnaire" : {
"reference" : "http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-los-event"
},
"status" : "completed",
"subject" : {
"reference" : "urn:uuid:e8f49540-d231-452c-abd5-16e9c6d6375b",
"display" : "hai-patient-1"
},
"author" : {
"reference" : "urn:uuid:65a95666-9ba7-4107-a37b-07957c094b88",
"display" : "hai-authoring-device"
},
"item" : [
{
"linkId" : "facility",
"text" : "Facility ID",
"answer" : [
{
"valueUri" : "urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.1.1:9W"
}
]
},
{
"linkId" : "event-number",
"text" : "Event #",
"answer" : [
{
"valueUri" : "urn:hl7ii:2.16.840.1.113883.3.117.1.1.5.2.1.1.3:31"
}
]
},
{
"linkId" : "event-type",
"text" : "Event Type",
"answer" : [
{
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "765107002",
"display" : "Late-onset neonatal sepsis (disorder)"
}
}
]
},
{
"linkId" : "date-of-event",
"text" : "Date of Event",
"answer" : [
{
"valueDate" : "2018-01-02"
}
]
},
{
"linkId" : "facility-location",
"text" : "Facility Location",
"answer" : [
{
"valueCoding" : {
"system" : "http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.259",
"code" : "1029-8",
"display" : "Medical/Surgical Critical Care"
}
}
]
},
{
"linkId" : "date-admitted-to-facility",
"text" : "Date Admitted to Facility:",
"answer" : [
{
"valueDate" : "2018-01-01"
}
]
},
{
"linkId" : "inborn-outborn-observation",
"text" : "Inborn/Outborn: If the infant was outborn (born at a location other than the reporting hospital), select true. If the infant was inborn (born at the reporting hospital) select false.",
"answer" : [
{
"valueBoolean" : false
}
]
},
{
"linkId" : "risk-factors",
"text" : "Risk Factors: Contains central line present, birth weight, gestational age",
"item" : [
{
"linkId" : "risk-factor-central-line",
"text" : "Risk Factor: Central line present prior to event, including umbilical catheter",
"answer" : [
{
"valueBoolean" : true
}
]
},
{
"linkId" : "risk-factor-birth-weight",
"text" : "Risk Factor: Birth weight (grams)",
"answer" : [
{
"valueQuantity" : {
"value" : 700,
"unit" : "g"
}
}
]
},
{
"linkId" : "risk-factor-gestational-age",
"text" : "Risk Factor: Gestational age (days)",
"answer" : [
{
"valueQuantity" : {
"value" : 276,
"unit" : "d"
}
}
]
}
]
},
{
"linkId" : "event-details",
"text" : "Event Details",
"item" : [
{
"linkId" : "infection-condition",
"text" : "Specific Event",
"answer" : [
{
"valueCoding" : {
"system" : "http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277",
"code" : "3067-6",
"display" : "Neonatal Laboratory Confirmed Bloodstream Infection (NLCBI 2)"
}
}
]
},
{
"linkId" : "criteria-used",
"text" : "Laboratory Criteria Used",
"answer" : [
{
"valueCoding" : {
"system" : "http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277",
"code" : "1951-3",
"display" : "Recognized pathogen from one or more blood cultures"
}
}
]
},
{
"linkId" : "died",
"text" : "Died",
"answer" : [
{
"valueBoolean" : true
}
]
},
{
"linkId" : "los-contributed-to-death",
"text" : "Infection contributed to death",
"answer" : [
{
"valueBoolean" : false
}
]
},
{
"linkId" : "discharge-date",
"text" : "Discharge Date",
"answer" : [
{
"valueDate" : "2018-01-12"
}
]
}
]
},
{
"linkId" : "findings-group",
"text" : "Findings Group: Records whether infection organisms were identified and, if so, records details about them.",
"item" : [
{
"linkId" : "pathogen-identified",
"text" : "Pathogen Identified",
"answer" : [
{
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "48321006",
"display" : "Clostridium symbiosum (organism)"
}
}
]
},
{
"linkId" : "pathogen-ranking",
"text" : "Pathogen Ranking",
"answer" : [
{
"valueCoding" : {
"system" : "http://snomed.info/sct",
"code" : "255216001",
"display" : "First"
}
}
]
},
{
"linkId" : "drug-susceptibility-test-group",
"text" : "Drug Susceptibility Test Group",
"item" : [
{
"linkId" : "drug-susceptibility-test",
"text" : "Drug Susceptibility Test",
"answer" : [
{
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "18907-6",
"display" : "Clarithro Susc Islt"
}
}
]
},
{
"linkId" : "drug-susceptibility-test-interpretation",
"text" : "Drug Susceptibility Test Interpretation",
"answer" : [
{
"valueCoding" : {
"system" : "http://hl7.org/fhir/v3/ObservationInterpretation",
"code" : "R",
"display" : "Resistant"
}
}
]
}
]
}
]
},
{
"linkId" : "nhsn-comment",
"text" : "Comments",
"answer" : [
{
"valueString" : "NHSN text comment that is less than 2000 characters."
}
]
}
]
}
},
{
"fullUrl" : "urn:uuid:e8f49540-d231-452c-abd5-16e9c6d6375b",
"resource" : {
"resourceType" : "Patient",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table>\n <tbody>\n <tr>\n <td>Patient ID</td>\n <td>Medical Record Number: 12345</td>\n </tr>\n <tr>\n <td>Social Security #</td>\n <td>12345</td>\n </tr>\n <tr>\n <td>Medicaid #</td>\n <td>959595</td>\n </tr>\n <tr>\n <td>Patient Last Name</td>\n <td>Nuclear</td>\n </tr>\n <tr>\n <td>Patient First Name</td>\n <td>Ned</td>\n </tr>\n <tr>\n <td>Gender</td>\n <td>Male</td>\n </tr>\n <tr>\n <td>Date of Birth</td>\n <td>1954-11-25</td>\n </tr>\n <tr>\n <td>Ethnicity</td>\n <td>Not Hispanic or Latino</td>\n </tr>\n <tr>\n <td>Race</td>\n <td>White</td>\n </tr>\n </tbody>\n </table>\n </div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race",
"extension" : [
{
"url" : "ombCategory",
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "2106-3",
"display" : "White"
}
},
{
"url" : "text",
"valueString" : "White"
}
]
},
{
"url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity",
"extension" : [
{
"url" : "ombCategory",
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "2186-5",
"display" : "Not Hispanic or Latino"
}
},
{
"url" : "text",
"valueString" : "Not Hispanic or Latino"
}
]
}
],
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/v2/0203",
"code" : "MA"
}
]
},
"system" : "urn:oid:2.16.840.1.113883.19.5",
"value" : "959595"
},
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/v2/0203",
"code" : "SS"
}
]
},
"system" : "urn:oid:2.16.840.1.113883.4.1",
"value" : "12345"
},
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/v2/0203",
"code" : "MR"
}
]
},
"system" : "urn:oid:2.16.840.1.113883.4.338",
"value" : "12345"
}
],
"name" : [
{
"use" : "official",
"family" : "Nuclear",
"given" : [
"Ned"
]
}
],
"gender" : "male",
"birthDate" : "1954-11-25"
}
},
{
"fullUrl" : "urn:uuid:65a95666-9ba7-4107-a37b-07957c094b88",
"resource" : {
"resourceType" : "Device",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p><b>id</b>: hai-authoring-device</p>\n <p><b>Id</b>: 2.16.840.1.113883.3.117.1.1.5.1.1.2:anAuthorID</p>\n </div>"
},
"identifier" : [
{
"system" : "urn:oid:2.16.840.1.113883.3.117.1.1.5.1.1.2",
"value" : "anAuthorId"
}
]
}
}
]
}
© HL7.org 2011+. v1.0.0 based on (v3.0.1) generated on Fri, Mar 8, 2019 08:48+1100.
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