This page is part of the Medicolegal Death Investigation (MDI) (v2.0.0-ballot2: STU 2 Ballot 3) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions
Contents:
This page provides a list of the FHIR artifacts defined as part of this implementation guide.
Minimal server capabilities expected for MDI data exchange partners.
CapabilityStatement - Electronic Death Reporting System (EDRS) Server |
Description of the expected minimum capabilities of the Electronic Death Registration System (EDRS) server, which is responsible for providing responses to the queries submitted by a client. Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements. |
CapabilityStatement - Forensic Toxicology Laboratory Server |
Description of the expected minimum capabilities of the toxicology lab server. |
CapabilityStatement - MDI CMS Server |
Description of expected minimum capabilities of an MDI CMS server, which is responsible for providing responses to the queries submitted by a client. Clients have the option of choosing from this list to access necessary data. |
Profiles defined for exchanging death investigation data between and MDI CMS and EDRS for death certificate development.
Bundle - Document MDI and EDRS |
A container for a document exchanged between an MDI CMS and EDRS (bi-directional exchange) for development of a death certificate. It contains a Composition - MDI and EDRS. |
Composition - MDI and EDRS |
The body of a document exchanged between an MDI CMS and an EDRS for development of a death certificate. |
MDI Cause Of Death Part 1 |
The MDI Cause of Death Part 1 (Observation) profile places constraints on the VRDR Cause of Death Part 1 (Observation) profile, which reflects the ordered causes of death asserted by the death certifier. The cause of death is initially specified with text. Line number can be 1-4. For the MDI use case, a cause of death certifier (coroner or medical examiner) is required in the performer data element, with the option of using a data-absent-reason. |
Profiles defined for exchanging forensic toxicology data.
Bundle - Message Toxicology to MDI |
A container for a message from a forensic toxicology laboratory to an MDI information management system. It contains a MessageHeader - Toxicology to MDI and a DiagnosticReport - Toxicology Lab Result to MDI. |
MessageHeader - Toxicology to MDI |
Identification of a DiagnosticReport - Toxicology Lab Result to MDI being sent in a message from a forensic toxicology laboratory information system to an MDI CMS. |
DiagnosticReport - Toxicology Lab Result to MDI |
The findings and interpretation of diagnostic tests performed during a death investigation and sent from a forensic toxicology laboratory information management system (LIMS) to an MDI CMS. Each analyzed specimen, represented by a Specimen - Toxicology Lab resource, must be referenced by at least one Observation - Toxicology Lab Result and may be referenced by more than one Observation - Toxicology Lab Result. For specimens received but not analyzed, the laboratory should provide a reason for no analysis in the DiagnosticReport.conclusion and/or each unanalyzed specimen’s Specimen - Toxicology Lab Specimen.note. |
Specimen - Toxicology Lab |
Identification and description of a specimen sent by a Medical Examiner, Coroner, or autopsy performer to a toxicology lab for analysis. For specimens received but not analyzed, the laboratory should provide a reason for no analysis in the DiagnosticReport.conclusion and/or each unanalyzed specimen’s Specimen - Toxicology Lab Specimen.note. The laboratory may use the Specimen.condition to describe the state of the specimen via codes from the extensible value set hl7VS-specimenCondition and/or use the Specimen.note to describe details or issues about the specimen. |
Observation - Toxicology Lab Result |
Forensic toxicology laboratory test result from analysis of a specimen sent by a Medical Examiner, Coroner, or autopsy performer to the laboratory. |
Profile defined for exchange of death investigation documents.
DocumentReference - MDI Report |
A reference to a death investigation document, such as an Autopsy Report or Investigator’s Narrative. The content may be included as inline base64 encoded data or be provided by direct reference (e.g., URL). The document type is required and is constrained by US Core to a LOINC value whose SCALE is DOC in the LOINC database or is the HL7 v3 Code System NullFlavor concept ‘unknown’. |
Profiles defined for death certificate review use cases.
Bundle - Message Death Certificate Review |
A container for a message exchanged between an EDRS and an MDI CMS (bi-directional exchange) about a Death Certificate Review. It contains a MessageHeader - Death Certificate Review and a Bundle - Document Death Certificate Review. |
MessageHeader - Death Certificate Review |
Identification of a Bundle - Document Death Certificate Review being sent in a message between an EDRS and an MDI CMS. |
Bundle - Document Death Certificate Review |
A container for a document exchanged between an EDRS and an MDI CMS (bi-directional exchange) for a Death Certificate Review. It contains a Composition - Death Certificate Review. |
Composition - Death Certificate Review |
The body of a document exchanged between an EDRS and an MDI CMS for a death certificate review for the purpose of death data quality improvement, cremation clearance, or other workflow. It can contain EDRS death certificate structured data. |
Observation - Communicable Disease |
Observation indicating if the decedent body harbors a communicable disease. |
Observation - Embalmed |
Observation indicating if the decedent body was embalmed. |
Observation - Medical Information Data Quality |
Observation describing the medical information data quality findings that result from a death certificate review. The value[x] (CodeableConcept) is the medical information data quality review conclusion. Use the Observation.note for details. |
Observation - Personal Information Data Quality |
Observation describing the personal information data quality findings that result from a death certificate review. The value[x] (CodeableConcept) is the personal information data quality review conclusion. Use the Observation.note for details. |
Organization - Crematorium |
Crematorium |
Extensions defined by this IG.
Extension - Cremation Clearance Coroner Status |
This Extension indicates whether the Cremation Clearance is a coroner workflow or not. |
Extension - Cremation Clearance Signature Status |
This Extension indicates whether the Cremation Clearance has been signed or not. |
Extension - Cremation Clearance Authorization Status |
This Extension indicates the authorization status of the Cremation Clearance. |
Extension - Death Certificate Status |
This Extension indicates Death Certificate workflow status. |
Extension - Medical Examiner Certification Affirmation |
This Extension indicates whether the Medical Examiner certification has been affirmed or not. |
Extension - Tracking Number |
Tracking number, such as a case number or file number assigned by an MDI CMS or EDRS, and can represent other tracking numbers, if required.. |
Code systems defined by this IG. Example code systems contain examples of codes typically defined by each implementation or jurisdiction.
Death Certificate Review Example |
This code system contains example codes for death certificate review. |
Medicolegal Death Investigation Codes |
Local codes for items that lack an appropriate LOINC code. This code system is only for use in the MDI use cases supported by this implementation guide and should not be used elsewhere. |
Value sets defined by this IG. Example value sets contain examples of codes typically defined by each implementation or jurisdiction.
Tracking Number Type |
Type of tracking number |
ValueSet - Cremation Clearance Observations example |
This value set contains example codes for Cremation Clearance Observations. |
ValueSet - Cremation Clearance Signed example |
This value set contains example codes for the signature status of the Cremation Clearance. |
ValueSet - Cremation Clearance Status example |
This value set contains example codes for Cremation Clearance status. |
ValueSet - Certified Workflow example |
This value set contains example codes for Death Certificate certification workflow status. |
ValueSet - Death Certificate Review Observations example |
This value set contains example codes for Death Certificate Review Observations. |
ValueSet - Death Certificate Review Reason example |
This value set contains example codes for the reason for a death certificate review. |
ValueSet - Embalmed example |
This value set contains example codes for embalmed status of the Decedent. |
ValueSet - Medical Examiner Certification Affirmation example |
This value set contains example codes for the status of Medical Examiner Certification Affirmation. |
ValueSet - Medical Data Quality Review example |
This value set contains example codes for medical data quality review. |
ValueSet - Personal Data Quality Review example |
This value set contains example codes for personal data quality review. |
Registration example |
This value set contains example codes for Death Certificate registration status. |
Examples of MDI-defined resources for death certificate development.
Bundle - MDI and EDRS - Freeman |
Bundle - MDI and EDRS: Freeman example |
MDI and EDRS Composition - Freeman |
MDI and EDRS Composition: Freeman example |
MDI and EDRS Composition - draft |
MDI and EDRS Composition: Draft example with status=preliminary, author & attester using data-absent-reason extension |
MDI Cause of Death Part 1 - Freeman |
MDI Cause of Death Part 1 (Observation): Freeman example, specifying interval string |
MDI Cause of Death Part 1 - Freeman, quantity interval |
MDI Cause of Death Part 1 (Observation): Freeman example, specifying interval quantity |
Examples of MDI-defined resources for forensic toxicology data exchange.
Bundle - Message Toxicology to MDI - Freeman |
Bundle - Message Toxicology to MDI: Freeman example |
MessageHeader - Toxicology to MDI - Freeman |
MessageHeader - Toxicology to MDI: Freeman example |
MessageDefinition - Toxicology System |
Characteristics of a message that can be shared between a forensic toxicology system and a medical examiner/coroner MDI CMS. |
DiagnosticReport - Toxicology Lab Result to MDI - Freeman |
DiagnosticReport - Toxicology Lab Result to MDI: Freeman example |
Specimen - Toxicology Lab - Freeman Bile |
Specimen - Toxicology Lab: Freeman bile example |
Specimen - Toxicology Lab - Freeman Blood |
Specimen - Toxicology Lab: Freeman blood examples |
Specimen - Toxicology Lab - Freeman Liver |
Specimen - Toxicology Lab: Freeman liver example |
Specimen - Toxicology Lab - Freeman Stomach Contents |
Specimen - Toxicology Lab: Freeman stomach contents example |
Specimen - Toxicology Lab - Freeman Urine |
Specimen - Toxicology Lab: Freeman urine example |
Specimen - Toxicology Lab - Freeman Vitreous Humor |
Specimen - Toxicology Lab: Freeman vitreous humor example |
Observation - Toxicology Lab Result - 4-anpp Blood Freeman |
Observation - Toxicology Lab Result: 4-anpp Blood Freeman example |
Observation - Toxicology Lab Result - 4-anpp Urine Freeman |
Observation - Toxicology Lab Result: 4-anpp Urine Freeman example |
Observation - Toxicology Lab Result - Acetylfentanyl Blood Freeman |
Observation - Toxicology Lab Result: Acetylfentanyl Blood Freeman example |
Observation - Toxicology Lab Result - Acetylfentanyl Urine Freeman |
Observation - Toxicology Lab Result: Acetylfentanyl Urine Freeman example |
Observation - Toxicology Lab Result - Ethanol Blood Freeman |
Observation - Toxicology Lab Result: Ethanol Blood Freeman example |
Observation - Toxicology Lab Result - Ethanol Urine Freeman |
Observation - Toxicology Lab Result: Ethanol Urine Freeman example |
Observation - Toxicology Lab Result - Ethanol Vitreous Humor Freeman |
Observation - Toxicology Lab Result: Ethanol Vitreous Humor Freeman |
Observation - Toxicology Lab Result - Fentanyl Blood Freeman |
Observation - Toxicology Lab Result: Fentanyl Blood Freeman example |
Observation - Toxicology Lab Result - Fentanyl Urine Freeman |
Observation - Toxicology Lab Result: Fentanyl Urine Freeman example |
Observation - Toxicology Lab Result - Norfentanyl Urine Freeman |
Observation - Toxicology Lab Result: Norfentanyl Urine Freeman example |
Observation - Toxicology Lab Result - Xylazine Urine Freeman |
Observation - Toxicology Lab Result: Xylazine Urine Freeman example |
Examples of MDI-defined resources for exchange of death investigation documents.
DocumentReference - MDI Report - Autopsy Report example |
DocumentReference - MDI Report: Autopsy Report example |
DocumentReference - MDI Report - Investigator's Narrative example |
DocumentReference - MDI Report: Investigator's Narrative example |
Examples of MDI-defined resources for death certificate review use cases.
Examples of resources defined elsewhere and included in (used by) MDI examples. These are examples of profiles defined in Vital Records Death Reporting (VRDR), Vital Records Common Library (VRCL), and US Core STU5.01, and the base FHIR R4 specification.
US Core Organization – State Medical Examiner |
Example of US Core Organization - State Medical Examiner Office |
US Core Organization - GA Dept Public Health |
Example of US Core Organization - Georgia State Department of Public Health, Div. Vital Records |
US Core Organization - UF Health Pathology Labs, Forensic Toxicology Laboratory |
Example of US Core Organization - UF Health Pathology Labs, Forensic Toxicology Laboratory |
US Core Patient - Alice J. Freeman |
Example of US Core Patient - Alice J. Freeman, decedent |
US Core Patient - Unknown Name |
US Core Patient: Unknown Name - Decedent where there is no information known about the patient. Assume that the system will assign a tracking number (e.g., medical record number, case number, or other). |
US Core Practitioner - Dr. Bruce Goldberger |
Example of US Core Practitioner - Dr. Bruce Goldberger, toxicologist |
US Core Practitioner – Death Pronouncement Performer |
Example of US Core Practitioner - Death Pronouncement Performer, used in the VRDR Death Date Observation.performer role. |
US Core Practitioner - Dr. J.M. Lehz |
Example of US Core Practitioner - Dr. J.M. Lehz, autopsy performer |
VRDR Autopsy Performed Indicator - Freeman |
Autopsy Performed Indicator: Freeman example (vrdr-autopsy-performed-indicator) |
VRDR Autopsy Performed Indicator |
Example of VRDR Autopsy Performed Indicator (Observation) for death certificate review examples. |
VRDR Cause Of Death Part 1 |
Example of VRDR Cause Of Death Part 1 (Observation) for death certificate review examples. |
VRDR Cause of Death Part 2 - Freeman |
Cause of Death Part 2: Freeman example (vrdr-cause-of-death-part2) |
VRDR Cause of Death Part 2 |
Example of VRDR Cause of Death Part 2 (Observation) for death certificate review examples. |
VRDR Death Certifier |
Example of VRDR Death Certifier (Practitioner) for death certificate review examples. |
Death Certificate for review for cremation clearance request |
VRDR Death Certificate - CCR example 1 |
VRDR Death Certification Procedure - Freeman |
Death Certification Procedure: Freeman example (vrdr-death-certification) |
VRDR Death Certification Procedure |
Example of VRDR Death Certification Procedure for death certificate review examples. |
VRDR Death Date - Freeman |
Death Date: Freeman death date, location, death pronouncer example (vrdr-death-date) |
VRDR Death Date |
Example of VRDR Death Date (Observation) for death certificate review examples. |
VRDR Death Location - Atlanta GA |
Death Location: Atlanta GA, Freeman example (vrdr-death-location) |
VRDR Death Location |
Example of VRDR Death Location (Location) for death certificate review examples. |
VRDR Death Location - Lat/Long |
Death Location: latitude & longitude, other example (vrdr-death-location) |
VRDR Death Location - address string |
Death Location: address as string, Freeman example (vrdr-death-location) |
VRDR Decedent Age |
Example of VRDR Decedent Age (Observation) for death certificate review examples. |
VRDR Decedent |
Example of VRDR Decedent (Patient) for death certificate review examples |
VRDR Disposition Method - Freeman |
Disposition Method: Freeman example (vrdr-decedent-disposition-method) |
VRDR Decedent Disposition Method |
Example of VRDR Decedent Disposition Method (Observation) for death certificate review examples. |
VRDR Decedent Education Level |
Example of VRDR Decedent Education Level (Observation) for death certificate review examples. |
VRDR Decedent Father |
Example of VRDR Decedent Father (RelatedPerson) for death certificate review examples. |
VRDR Decedent Military Service |
Example of VRDR Decedent Military Service (Observation) for death certificate review examples. |
VRDR Decedent Mother |
Example of VRDR Decedent Mother (RelatedPerson) for death certificate review examples. |
VRDR Decedent Pregnancy - Freeman |
Decedent Pregnancy: Freeman example (vrdr-decedent-pregnancy-status) |
VRDR Decedent Pregnancy |
Example of VRDR Decedent Pregnancy (Observation) for death certificate review examples. |
VRDR Decedent Usual Work |
Example of VRDR Decedent Usual Work (Observation) for death certificate review examples. |
VRDR Disposition Location |
Example of VRDR Disposition Location for death certificate review examples. |
VRDR Examiner Contacted |
Example of VRDR Examiner Contacted (Observation) for death certificate review examples. |
VRDR Funeral Home |
Example of VRDR Funeral Home (Organization) for death certificate review examples. |
VRDR Injury Incident - Freeman |
Injury Incident: Freeman medication ingestion example (vrdr-injury-incident) |
VRDR Injury Incident |
Example of VRDR Injury Incident (Observation) for death certificate review examples. |
VRDR Injury Location - Atlanta GA |
Injury Location: Atlanta GA, Freeman example (vrdr-injury-location) |
VRDR Injury Location |
Example of VRDR Injury Location for death certificate review examples. |
VRDR Manner of Death - Freeman |
Manner of Death: Freeman - accidental example (vrdr-manner-of-death) |
VRDR Manner of Death |
Example of VRDR Mortician (Practitioner) for death certificate review examples. |
VRDR Mortician |
Example of VRDR Mortician (Practitioner) for death certificate review examples. |
VRDR Tobacco Use Contributed To Death - Freeman |
Tobacco Use Contributed To Death: Freeman example (vrdr-tobacco-use-contributed-to-death) |
VRDR Tobacco Use Contributed To Death |
Example of VRDR Tobacco Use Contributed To Death (Observation) for death certificate review examples |
VR Practitioner |
Example of VR Practitioner for death certificate review examples. |
Practitioner - Vital Records - Dr. Sam Jones |
Example of Practitioner - Vital Records: Dr. Sam Jones, medical examiner and death pronouncer for Freeman death investigation examples. |
Parameters defined for this IG.
Parameters - SNOMED US Version |
Parameters - SNOMED US Version |