Health Care Surveys Content Implementation Guide (IG)
1.0.0 - STU1 Release 1 United States of America flag

This page is part of the Making EHR Data MOre available for Research and Public Health (MedMorph) Healthcare Surveys Reporting Content IG (v1.0.0: STU1 Release 1) 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

: Patient Example - XML Representation

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<Patient xmlns="http://hl7.org/fhir">
  <id value="example"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Narrative</b></p><p><b>id</b>: example</p><p><b>meta</b>: </p><p><b>identifier</b>: Medical Record Number: 1032702 (USUAL)</p><p><b>active</b>: true</p><p><b>name</b>: Amy V. Shaw , Amy V. Baxter </p><p><b>telecom</b>: ph: 555-555-5555(HOME), amy.shaw@example.com</p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1987-02-20</p><p><b>address</b>: </p><ul><li>49 Meadow St Mounds OK 74047 US </li><li>183 Mountain View St Mounds OK 74048 US </li></ul></div>
  </text>
  <extension
             url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">
    <extension url="ombCategory">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2106-3"/>
        <display value="White"/>
      </valueCoding>
    </extension>
    <extension url="ombCategory">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="1002-5"/>
        <display value="American Indian or Alaska Native"/>
      </valueCoding>
    </extension>
    <extension url="ombCategory">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2028-9"/>
        <display value="Asian"/>
      </valueCoding>
    </extension>
    <extension url="detailed">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="1586-7"/>
        <display value="Shoshone"/>
      </valueCoding>
    </extension>
    <extension url="detailed">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2036-2"/>
        <display value="Filipino"/>
      </valueCoding>
    </extension>
    <extension url="text">
      <valueString value="Mixed"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity">
    <extension url="ombCategory">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2135-2"/>
        <display value="Hispanic or Latino"/>
      </valueCoding>
    </extension>
    <extension url="detailed">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2184-0"/>
        <display value="Dominican"/>
      </valueCoding>
    </extension>
    <extension url="detailed">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2148-5"/>
        <display value="Mexican"/>
      </valueCoding>
    </extension>
    <extension url="text">
      <valueString value="Hispanic or Latino"/>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex">
    <valueCode value="F"/>
  </extension>
  <identifier>
    <use value="usual"/>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="MR"/>
        <display value="Medical Record Number"/>
      </coding>
      <text value="Medical Record Number"/>
    </type>
    <system value="http://hospital.smarthealthit.org"/>
    <value value="1032702"/>
  </identifier>
  <active value="true"/>
  <name>
    <family value="Shaw"/>
    <given value="Amy"/>
    <given value="V."/>
    <period>
      <start value="2016-12-06"/>
      <end value="2020-07-22"/>
    </period>
  </name>
  <name>
    <family value="Baxter"/>
    <given value="Amy"/>
    <given value="V."/>
    <suffix value="PharmD"/>
    <period>
      <start value="2020-07-22"/>
    </period>
  </name>
  <telecom>
    <system value="phone"/>
    <value value="555-555-5555"/>
    <use value="home"/>
  </telecom>
  <telecom>
    <system value="email"/>
    <value value="amy.shaw@example.com"/>
  </telecom>
  <gender value="female"/>
  <birthDate value="1987-02-20"/>
  <address>
    <line value="49 Meadow St"/>
    <city value="Mounds"/>
    <state value="OK"/>
    <postalCode value="74047"/>
    <country value="US"/>
    <period>
      <start value="2016-12-06"/>
      <end value="2020-07-22"/>
    </period>
  </address>
  <address>
    <line value="183 Mountain View St"/>
    <city value="Mounds"/>
    <state value="OK"/>
    <postalCode value="74048"/>
    <country value="US"/>
    <period>
      <start value="2020-07-22"/>
    </period>
  </address>
</Patient>