NHSN Reporting: Adverse Drug Events - Hypoglycemia
1.0.0 - STU 1

This page is part of the NHSN Reporting of Adverse Drug Events - Hypoglycemia (v1.0.0: STU 1 on FHIR R4) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: Bundle - ADE Hypoglycemia example - JSON Representation

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{
  "resourceType" : "Bundle",
  "id" : "bundle-document-ade",
  "identifier" : {
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:uuid:3183BE72-A852-4A00-A795-56477F9868D8"
  },
  "type" : "document",
  "timestamp" : "2021-02-11T20:09:23.976+10:00",
  "entry" : [
    {
      "fullUrl" : "http://example.org/fhir/Composition/composition-ade-hypoglycemia-example",
      "resource" : {
        "resourceType" : "Composition",
        "id" : "composition-ade-hypoglycemia-example",
        "meta" : {
          "versionId" : "8",
          "lastUpdated" : "2021-03-30T01:37:24.450+00:00",
          "source" : "#lwoI0OgIeAoj7r0g",
          "profile" : [
            "http://hl7.org/fhir/us/nhsn-ade/StructureDefinition/Composition-ade-hypoglycemia"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 2eec4326-bf29-4428-8d02-a334a19cfc17</p><p><b>status</b>: final</p><p><b>type</b>: <span title=\"Codes: {http://loinc.org 85893-6}\">Adverse event note</span></p><p><b>encounter</b>: <a href=\"#Encounter_encounter-inpatient-example\">See above (Encounter/encounter-inpatient-example)</a></p><p><b>date</b>: Jan 4, 2021 9:10:14 AM</p><p><b>author</b>: <a href=\"#Practitioner_practitioner-ed-endocrinols-example\">Dr. Ed Endocrinols. Generated Summary: id: 9941339108; Edward Endocrinols </a></p><p><b>title</b>: Adverse Event Note</p><p><b>confidentiality</b>: N</p><h3>Attesters</h3><table class=\"grid\"><tr><td>-</td><td><b>Mode</b></td><td><b>Time</b></td><td><b>Party</b></td></tr><tr><td>*</td><td>legal</td><td>Jan 4, 2021 9:10:14 AM</td><td><a href=\"#Practitioner_practitioner-ed-endocrinols-example\">Dr. Ed Endocrinols. Generated Summary: id: 9941339108; Edward Endocrinols </a></td></tr></table><p><b>custodian</b>: <a href=\"#Organization_organization-hospital-physician-group-example\">Hospitalists of the World. Generated Summary: id: 1144221847; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: Hospitalists of the World; Phone: (+1) 734-677-7777, hq@hotw.org</a></p></div>"
        },
        "identifier" : {
          "value" : "2eec4326-bf29-4428-8d02-a334a19cfc17"
        },
        "status" : "final",
        "type" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "85893-6",
              "display" : "Adverse event note"
            }
          ]
        },
        "subject" : {
          "reference" : "Patient/patient-harry-hypoglycemic-example",
          "display" : "Harry Hypoglycemic"
        },
        "encounter" : {
          "reference" : "Encounter/encounter-inpatient-example"
        },
        "date" : "2021-01-04T09:10:14Z",
        "author" : [
          {
            "reference" : "Practitioner/practitioner-ed-endocrinols-example",
            "display" : "Dr. Ed Endocrinols"
          }
        ],
        "title" : "Adverse Event Note",
        "confidentiality" : "N",
        "attester" : [
          {
            "mode" : "legal",
            "time" : "2021-01-04T09:10:14Z",
            "party" : {
              "reference" : "Practitioner/practitioner-ed-endocrinols-example",
              "display" : "Dr. Ed Endocrinols"
            }
          }
        ],
        "custodian" : {
          "reference" : "Organization/organization-hospital-physician-group-example",
          "display" : "Hospitalists of the World"
        },
        "section" : [
          {
            "title" : "Results Section",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "30954-2",
                  "display" : "Relevant diagnostic tests/laboratory data Narrative"
                }
              ]
            },
            "entry" : [
              {
                "reference" : "Observation/observation-lab-ade-hh",
                "display" : "Observation: Lab Test - Fasting glucose [Mass/volume] in Capillary blood"
              }
            ]
          },
          {
            "title" : "Medication Section",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "10160-0",
                  "display" : "History of Medication use Narrative"
                }
              ]
            },
            "entry" : [
              {
                "reference" : "MedicationAdministration/medicationadministration-metformin-example",
                "display" : "MedicationAdminstration: metformin hydrochloride 100 MG/ML Extended Release Suspension"
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/MedicationAdministration/medicationadministration-metformin-example",
      "resource" : {
        "resourceType" : "MedicationAdministration",
        "id" : "medicationadministration-metformin-example",
        "meta" : {
          "versionId" : "2",
          "lastUpdated" : "2021-01-14T05:46:36.398+00:00",
          "source" : "#9DA5wo4YZ8MCCJ6f",
          "profile" : [
            "http://hl7.org/fhir/us/nhsn-ade/StructureDefinition/MedicationAdministration-Antidiabetics"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: completed</p><p><b>medication</b>: <span title=\"Codes: {http://www.nlm.nih.gov/research/umls/rxnorm 2200518}\">metformin hydrochloride 100 MG/ML Extended Release Suspension</span></p><p><b>subject</b>: <a href=\"#Patient_patient-harry-hypoglycemic-example\">Harry Hypoglycemic. Generated Summary: Medical Record Number: 1032702 (USUAL); active; Harry Hypoglycemic ; Phone: 555-555-5555, harry.hypoglycemic@example.com; gender: male; birthDate: 1990-06-09</a></p><p><b>context</b>: <a href=\"#Encounter_encounter-inpatient-example\">See above (Encounter/encounter-inpatient-example)</a></p><p><b>effective</b>: Jan 4, 2021 3:30:00 AM</p><h3>Performers</h3><table class=\"grid\"><tr><td>-</td><td><b>Actor</b></td></tr><tr><td>*</td><td><a href=\"#Practitioner_practitioner-ed-endocrinols-example\">Ed Endocrinols. Generated Summary: id: 9941339108; Edward Endocrinols </a></td></tr></table><h3>Dosages</h3><table class=\"grid\"><tr><td>-</td><td><b>Route</b></td><td><b>Dose</b></td></tr><tr><td>*</td><td><span title=\"Codes: {http://snomed.info/sct 26643006}\">Oral route (qualifier value)</span></td><td>100 mg/mL</td></tr></table></div>"
        },
        "status" : "completed",
        "medicationCodeableConcept" : {
          "coding" : [
            {
              "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
              "code" : "2200518",
              "display" : "metformin hydrochloride 100 MG/ML Extended Release Suspension"
            }
          ],
          "text" : "metformin hydrochloride 100 MG/ML Extended Release Suspension"
        },
        "subject" : {
          "reference" : "Patient/patient-harry-hypoglycemic-example",
          "display" : "Harry Hypoglycemic"
        },
        "context" : {
          "reference" : "Encounter/encounter-inpatient-example"
        },
        "effectiveDateTime" : "2021-01-04T04:30:00+01:00",
        "performer" : [
          {
            "actor" : {
              "reference" : "Practitioner/practitioner-ed-endocrinols-example",
              "display" : "Ed Endocrinols"
            }
          }
        ],
        "dosage" : {
          "route" : {
            "coding" : [
              {
                "system" : "http://snomed.info/sct",
                "code" : "26643006",
                "display" : "Oral route (qualifier value)"
              }
            ]
          },
          "dose" : {
            "value" : 100,
            "unit" : "mg/mL",
            "system" : "http://unitsofmeasure.org",
            "code" : "mg/mL"
          }
        }
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/Observation/observation-lab-ade-hh",
      "resource" : {
        "resourceType" : "Observation",
        "id" : "observation-lab-ade-hh",
        "meta" : {
          "versionId" : "3",
          "lastUpdated" : "2021-03-30T01:37:24.455+00:00",
          "source" : "#eaJfR5tWjHVOt22c",
          "profile" : [
            "http://hl7.org/fhir/us/nhsn-ade/StructureDefinition/Observation-lab-blood-glucose"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span></p><p><b>code</b>: <span title=\"Codes: {http://loinc.org 1556-0}\">Fasting glucose [Mass/volume] in Capillary blood</span></p><p><b>subject</b>: <a href=\"#Patient_patient-harry-hypoglycemic-example\">Harry Hypoglycemic. Generated Summary: Medical Record Number: 1032702 (USUAL); active; Harry Hypoglycemic ; Phone: 555-555-5555, harry.hypoglycemic@example.com; gender: male; birthDate: 1990-06-09</a></p><p><b>effective</b>: 2020-08-04</p><p><b>value</b>: 60 mg/dL</p></div>"
        },
        "status" : "final",
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                "code" : "laboratory",
                "display" : "Laboratory"
              }
            ],
            "text" : "Laboratory"
          }
        ],
        "code" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "1556-0",
              "display" : "Fasting glucose [Mass/volume] in Capillary blood"
            }
          ],
          "text" : "Fasting glucose [Mass/volume] in Capillary blood"
        },
        "subject" : {
          "reference" : "Patient/patient-harry-hypoglycemic-example",
          "display" : "Harry Hypoglycemic"
        },
        "effectiveDateTime" : "2020-08-04",
        "valueQuantity" : {
          "value" : 60,
          "unit" : "mg/dL",
          "system" : "http://unitsofmeasure.org"
        }
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/Patient/patient-harry-hypoglycemic-example",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "patient-harry-hypoglycemic-example",
        "meta" : {
          "versionId" : "2",
          "lastUpdated" : "2021-03-30T01:37:24.710+00:00",
          "source" : "#NNccy4B9zEObY7xE",
          "profile" : [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n                        <div class=\"hapiHeaderText\">Harry <b>HYPOGLYCEMIC </b>\n                        </div>\n                        <table class=\"hapiPropertyTable\">\n                            <tbody>\n                                <tr>\n                                    <td>Identifier</td>\n                                    <td>1032702</td>\n                                </tr>\n                                <tr>\n                                    <td>Address</td>\n                                    <td>\n                                        <span>123 Main St. </span>\n                                        <br/>\n                                        <span>Denver </span>\n                                        <span>CO </span>\n                                        <span>US </span>\n                                    </td>\n                                </tr>\n                                <tr>\n                                    <td>Date of birth</td>\n                                    <td>\n                                        <span>09 June 1990</span>\n                                    </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" : "ombCategory",
                "valueCoding" : {
                  "system" : "urn:oid:2.16.840.1.113883.6.238",
                  "code" : "1002-5",
                  "display" : "American Indian or Alaska Native"
                }
              },
              {
                "url" : "ombCategory",
                "valueCoding" : {
                  "system" : "urn:oid:2.16.840.1.113883.6.238",
                  "code" : "2028-9",
                  "display" : "Asian"
                }
              },
              {
                "url" : "detailed",
                "valueCoding" : {
                  "system" : "urn:oid:2.16.840.1.113883.6.238",
                  "code" : "1586-7",
                  "display" : "Shoshone"
                }
              },
              {
                "url" : "detailed",
                "valueCoding" : {
                  "system" : "urn:oid:2.16.840.1.113883.6.238",
                  "code" : "2036-2",
                  "display" : "Filipino"
                }
              },
              {
                "url" : "text",
                "valueString" : "Mixed"
              }
            ]
          },
          {
            "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" : "2135-2",
                  "display" : "Hispanic or Latino"
                }
              },
              {
                "url" : "detailed",
                "valueCoding" : {
                  "system" : "urn:oid:2.16.840.1.113883.6.238",
                  "code" : "2184-0",
                  "display" : "Dominican"
                }
              },
              {
                "url" : "detailed",
                "valueCoding" : {
                  "system" : "urn:oid:2.16.840.1.113883.6.238",
                  "code" : "2148-5",
                  "display" : "Mexican"
                }
              },
              {
                "url" : "text",
                "valueString" : "Hispanic or Latino"
              }
            ]
          },
          {
            "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
            "valueCode" : "F"
          }
        ],
        "identifier" : [
          {
            "use" : "usual",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "MR",
                  "display" : "Medical Record Number"
                }
              ],
              "text" : "Medical Record Number"
            },
            "system" : "http://hospital.smarthealthit.org",
            "value" : "1032702"
          }
        ],
        "active" : true,
        "name" : [
          {
            "family" : "Hypoglycemic",
            "given" : [
              "Harry"
            ],
            "period" : {
              "start" : "1990-06-09"
            }
          }
        ],
        "telecom" : [
          {
            "system" : "phone",
            "value" : "555-555-5555",
            "use" : "home"
          },
          {
            "system" : "email",
            "value" : "harry.hypoglycemic@example.com"
          }
        ],
        "gender" : "male",
        "birthDate" : "1990-06-09",
        "address" : [
          {
            "line" : [
              "123 Main St."
            ],
            "city" : "Denver",
            "state" : "CO",
            "postalCode" : "80204",
            "country" : "US",
            "period" : {
              "start" : "1990-06-09"
            }
          }
        ]
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/Encounter/encounter-inpatient-example",
      "resource" : {
        "resourceType" : "Encounter",
        "id" : "encounter-inpatient-example",
        "meta" : {
          "versionId" : "1",
          "lastUpdated" : "2020-12-24T16:04:02.731+00:00",
          "source" : "#0iVdQ7vmh3cAIABY",
          "profile" : [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: finished</p><p><b>class</b>: <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode IMP}\">inpatient encounter</span></p><p><b>type</b>: <span title=\"Codes: {http://snomed.info/sct 24882007}\">Medical consultation on hospital inpatient</span></p><p><b>subject</b>: <a href=\"#Patient_patient-harry-hypoglycemic-example\">See above (Patient/patient-harry-hypoglycemic-example)</a></p><p><b>period</b>: Jan 4, 2021 10:00:14 PM --&gt; (ongoing)</p></div>"
        },
        "status" : "finished",
        "class" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code" : "IMP",
          "display" : "inpatient encounter"
        },
        "type" : [
          {
            "coding" : [
              {
                "system" : "http://snomed.info/sct",
                "code" : "24882007",
                "display" : "Medical consultation on hospital inpatient"
              }
            ],
            "text" : "Medical consultation on hospital inpatient"
          }
        ],
        "subject" : {
          "reference" : "Patient/patient-harry-hypoglycemic-example"
        },
        "period" : {
          "start" : "2021-01-04T17:00:14-05:00"
        }
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/Practitioner/practitioner-ed-endocrinols-example",
      "resource" : {
        "resourceType" : "Practitioner",
        "id" : "practitioner-ed-endocrinols-example",
        "meta" : {
          "versionId" : "1",
          "lastUpdated" : "2020-12-24T15:44:43.712+00:00",
          "source" : "#YoohXn50YQm3jkn8",
          "profile" : [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 9941339108</p><p><b>name</b>: Edward Endocrinols </p></div>"
        },
        "identifier" : [
          {
            "system" : "http://hl7.org.fhir/sid/us-npi",
            "value" : "9941339108"
          }
        ],
        "name" : [
          {
            "family" : "Endocrinols",
            "given" : [
              "Edward"
            ],
            "prefix" : [
              "Dr"
            ]
          }
        ]
      }
    },
    {
      "fullUrl" : "http://example.org/fhir/Organization/organization-hospital-physician-group-example",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "organization-hospital-physician-group-example",
        "meta" : {
          "versionId" : "1",
          "lastUpdated" : "2020-12-24T15:44:43.706+00:00",
          "source" : "#QNqacR8YkaVwX6t3",
          "profile" : [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 1144221847</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: Hospitalists of the World</p><p><b>telecom</b>: ph: (+1) 734-677-7777, <a href=\"mailto:hq@hotw.org\">hq@hotw.org</a></p><p><b>address</b>: 111 Any St. Denver CO 80204 USA </p></div>"
        },
        "identifier" : [
          {
            "system" : "http://hl7.org.fhir/sid/us-npi",
            "value" : "1144221847"
          }
        ],
        "active" : true,
        "type" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
                "code" : "prov",
                "display" : "Healthcare Provider"
              }
            ]
          }
        ],
        "name" : "Hospitalists of the World",
        "telecom" : [
          {
            "system" : "phone",
            "value" : "(+1) 734-677-7777"
          },
          {
            "system" : "email",
            "value" : "hq@hotw.org"
          }
        ],
        "address" : [
          {
            "line" : [
              "111 Any St."
            ],
            "city" : "Denver",
            "state" : "CO",
            "postalCode" : "80204",
            "country" : "USA"
          }
        ]
      }
    }
  ]
}