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