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 - XML Representation

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<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 --&gt; (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>