This resource defines the characteristics of a message that can be shared between a forensic toxicology system and a medical examiner/coroner system.

This Section describes the expected capabilities of the Electronic Death Registration System (EDRS) Server actor which is responsible for providing responses to the queries submitted by the EDRS Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by EDRS Servers are defined. EDRS Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

This Section describes the expected capabilities of the Toxicology lab Server actor which is responsible for providing responses to the queries submitted by Toxicology lab Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by Toxicology lab Servers are defined. Toxicology lab Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

This Section describes the expected capabilities of the Coroner/Medical Examiner (C/ME) case management system Server actor which is responsible for providing responses to the queries submitted by the C/ME Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by C/ME Servers are defined. C/ME Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

This Bundle profile represents an MDI to EDRS Document Bundle. It contains a Composition - MDI to EDRS.

This Composition profile represents data sent from an MDI information management system to an EDRS.

The Observation - Cause of Death Part 1 profile reflects the ordered causes of death asserted by the death certifier. The cause of death is initially specified with text. The MDI Observation - Cause of Death Part 1 artifact overlaps with the VRDR Cause Of Death Part 1 artifact.

The Observation - Contributing Cause of Death Part 2 profile is used to identify factors contributing to the cause of death as asserted by the death certifier. The MDI Observation - Contributing Cause of Death Part 2 artifact overlaps with the VRDR Cause of Death Part 2 artifact.

This Observation provides the death date, death pronouncer, and date pronounced dead. If the actual date of death is known, set value to type dateTime. If the date of death is not known, and a range is known, set value to type Period. The MDI Observation - Death Date artifact overlaps with the VRDR Death Date artifact.

This Observation provides the certified explanation of how the injury leading to death occurred. The MDI Observation - How Death Injury Occurred artifact overlaps with the VRDR Injury Incident artifact.

This Observation provides the conclusion arrived at upon completion of death investigation regarding the manner of death (e.g., natural, homicide, suicide, accident). The MDI Observation - Manner of Death artifact overlaps with the VRDR Manner of Death artifact.

This Observation provides an indication of the pregnancy status of the decedent. The MDI Observation - Decedent Pregnancy artifact overlaps with the VRDR Decedent Pregnancy Status artifact.

This Observation provides the conclusion arrived at during death investigation regarding the extent to which tobacco use contributed to the death of the decedent. The MDI Observation - Tobacco Use Contributed to Death artifact overlaps with the VRDR Tobacco Use Contributed To Death artifact.

This Observation records if an autopsy was performed, if autopsy findings are available, and the autopsy Performer (US Core Practioner). The MDI Observation - Autopsy Performed Indicator artifact overlaps with the VRDR Autopsy Performed Indicator artifact.

This Procedure records the certification of death by the certifier. The MDI Procedure - Death Certification artifact overlaps with the VRDR Death Certification Procedure artifact.

This Location records the location of death. It is based on US Core Location and further constrains the type element to indicate that this is the location of death. The MDI Location - Death artifact overlaps with the VRDR Death Location artifact.

This Location records the location of an injury. It is based on US Core Location and further constrains the type element to indicate that this is the location of an injury. The MDI Location - Injury artifact overlaps with the VRDR Injury Location artifact.

This Bundle profile represents a Message Bundle from a forensic toxicology laboratory to an MDI information management system. It contain a Message Header and a DiagnosticReport - Toxicology Lab Result to MDI.

This MessageHeader identifies the DiagnosticReport being sent from a forensic toxicology laboratory information system to an MDI information management system.

This profile contains constraints to the US Core Diagnostic Report Profile to address the use case for sending data from a forensic toxicology laboratory information management system to an MDI information management system. 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.

This Specimen profile identifies and describes the 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.

This Observation profile describes forensic toxicology laboratory test results from analysis of a specimen sent by a Medical Examiner, Coroner, or autopsy performer to the laboratory.

Bundle - MDI to EDRS: Freeman example

MDI to EDRS Composition: Freeman example

Observation - Death Date: Freeman death date, location, death pronouncer example

Observation - How Death Injury Occurred: Freeman - Medication ingestion (fentanyl) example

Observation - Manner of Death: Freeman - accidental example

Observation - Decedent Pregnancy: Freeman example

Observation - Tobacco Use: Freeman example

Observation - Contributing Cause of Death Part 2: Freeman example

Observation - Cause of Death Part 1: Freeman example

Procedure - Death Certification: Freeman example

Observation - Autopsy Performed Indicator: Freeman example

Location - Death: Atlanta GA Freeman example

Location - Injury: Atlanta GA Freeman example

Bundle - Message Toxicology to MDI: Freeman example

DiagnosticReport - Toxicology Lab Result to MDI: Freeman example

MessageHeader - Toxicology to MDI: Freeman example

Specimen - Toxicology Lab: Freeman Blood examples

Observation - Toxicology Lab Result: Ethanol Blood Freeman example

Observation - Toxicology Lab Result: 4-anpp Blood Freeman example

Observation - Toxicology Lab Result: Acetylfentanyl Blood Freeman example

Observation - Toxicology Lab Result: Fentanyl Blood Freeman example

Specimen - Toxicology Lab: Freeman Urine example

Observation - Toxicology Lab Result: Ethanol Urine Freeman example

Observation - Toxicology Lab Result: 4-anpp Urine Freeman example

Observation - Toxicology Lab Result: Acetylfentanyl Urine Freeman example

Observation - Toxicology Lab Result: Fentanyl Urine Freeman example

Observation - Toxicology Lab Result: Norfentanyl Urine Freeman example

Observation - Toxicology Lab Result: Xylazine Urine Freeman example

Specimen - Toxicology Lab: Freeman Vitreous Humor example

Observation - Toxicology Lab Result: Ethanol Vitreous Humor Freeman

Specimen - Toxicology Lab: Freeman Bile example

Specimen - Toxicology Lab: Freeman Liver example

Specimen - Toxicology Lab: Freeman Stomach Contents example

Example of US Core Organization - UF Health Pathology Labs, Forensic Toxicology Laboratory

Example of US Core Patient - Alice J. Freeman, decedent

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).

Example of US Core Practitioner - Dr. Bruce Goldberger, toxicologist

Example of US Core Practitioner - Dr. Jane Jones, medical examiner

Example of US Core Practitioner - Dr. Sam Jones, death pronouncer

This Extension contains a tracking number, such as a case number or file number assigned by an MDI information management system or EDRS, and can represent other tracking numbers, if required.

The time portion (DD) of the partial date. The MDI Extension - Date Time artifact overlaps with the VRDR Date Time artifact.

The day portion (DD) of the partial date. The MDI Extension - Date Day artifact overlaps with the VRDR Date Day artifact.

The month portion (MM) of the partial date. The MDI Extension - Date Month artifact overlaps with the VRDR Date Month artifact.

The year portion (YYYY) of the partial date. The MDI Extension - Date Year artifact overlaps with the VRDR Date Year artifact.

Provides values of a partial dateTime The MDI Extension - Partial DateTime artifact overlaps with the VRDR Partial Date Time artifact.

A set of codes that reflect the extent to which tobacco use contributed to the person’s death. Based on Contributory Tobacco Use (NCHS)[2.16.840.1.114222.4.11.6004]. The MDI ValueSet - Contributory Tobacco Use artifact overlaps with the VRDR Tobacco Use Contributed To Death artifact.

A set of codes indicating the type of certifier (Medical Examiner/Coroner, Certifying physician, etc.) The MDI ValueSet - Certifier Types artifact overlaps with the VRDR Certifier Types VS artifact.

This value set contains codes that describe the approach to establishing a date. The MDI ValueSet - Date Establishment Approach artifact overlaps with the VRDR Date of Death Determination Methods Value Set artifact.

A set of codes that reflect whether the decedent was pregnant at or around the time of death. Based on Pregnancy Status (NCHS)[2.16.840.1.114222.4.11.6003]. The MDI ValueSet - Death Pregnancy Status artifact overlaps with the VRDR Pregnancy Status artifact.

A set of codes to reflect the manner that a person died. The MDI ValueSet - Manner of Death artifact overlaps with the VRDR Manner of Death VS artifact.

Code values reflecting the death location of the decedent (e.g., hospital, home, hospice). The MDI ValueSet - Place of Death artifact overlaps with the VRDR Place of Death VS – PHVS_PlaceOfDeath_NCHS artifact.

This value set contains codes to that identify the type of tracking number.

Role of the decedent in a transportation incident resulting in a death-related injury. The MDI ValueSet - Transportation Incident Role artifact overlaps with the VRDR Transportation Incident Role artifact.

A set of codes for specifying the units used when recording age (days, years, etc.). The MDI ValueSet - Units of Age artifact overlaps with the VRDR Units of Age artifact.

Value set with Yes, No and Unknown. The MDI ValueSet - Yes No Unknown artifact overlaps with the VRDR Yes No Unknown artifact.

Valueset with Yes, No, Unknown, and Not Applicable. The MDI ValueSet - Yes No Unknown NotApplicable artifact overlaps with the VRDR Yes No Unknown NotApplicable artifact.

A set of codes used to respond to any question that can be answered Yes, No, or Not Applicable. Based on Yes No Not Applicable (NCHS)[2.16.840.1.114222.4.11.7486]

This code system contains codes for use in MDI.

Codes that reflect whether the decedent was pregnant at or around the time of death. Includes the concepts defined in Pregnancy Status (NCHS)[2.16.840.1.114222.4.11.6003] which are from the PHIN VS (CDC Local Coding System)[2.16.840.1.114222.4.5.274] The MDI CodeSystem - Death Pregnancy Status artifact overlaps with the VRDR Pregnancy Status Codes artifact.

Local Component Codes for observation components that lack an appropriate LOINC code. The MDI CodeSystem - Local Component Codes artifact overlaps with the VRDR Local Component Codes artifact.

Parameters - SNOMED US Version