PACIO Advance Directive Interoperability Implementation Guide
0.1.0 - STU 1 Ballot

This page is part of the PACIO Advance Directive Information Implementation Guide (v0.1.0: STU 1 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

: Example-Smith-Johnson-HealthcareAgentConsent - XML Representation

Raw xml | Download



<Consent xmlns="http://hl7.org/fhir">
  <id value="Example-Smith-Johnson-HealthcareAgentConsent"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-ParticipantConsent"/>
  </meta>
  <text>
    <status value="additional"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>status</b>: active</p><p><b>scope</b>: <span title="Codes: {http://loinc.org 75786-4}">Powers granted to healthcare agent [Reported]</span></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/consentcategorycodes acd}">Advance Directive</span></p><p><b>patient</b>: <a href="Patient-Example-Smith-Johnson-Patient1.html">Betsy Smith-Johnson</a> ; BetsySJ@example.com; gender: female; birthDate: 1950-11-15</p><p><b>dateTime</b>: 2020-08-03</p><h3>Policies</h3><table class="grid"><tr><td>-</td><td><b>Authority</b></td><td><b>Uri</b></td></tr><tr><td>*</td><td><a href="https://www.michigan.gov/">https://www.michigan.gov/</a></td><td><a href="http://www.legislature.mi.gov/(S(tpnclc1ofteerx2x2dppcmdz))/mileg.aspx?page=GetObject&amp;objectname=mcl-386-1998-V-5">http://www.legislature.mi.gov/(S(tpnclc1ofteerx2x2dppcmdz))/mileg.aspx?page=GetObject&amp;objectname=mcl-386-1998-V-5</a></td></tr></table><blockquote><p><b>provision</b></p><p><b>type</b>: permit</p><blockquote><p><b>actor</b></p><p><b>role</b>: <span title="Codes: {http://loinc.org 75783-1}">Primary healthcare agent [Reported]</span></p><p><b>reference</b>: <a href="RelatedPerson-Example-Smith-Johnson-HealthcareAgent1.html"><span title="Codes: {http://terminology.hl7.org/CodeSystem/v3-RoleCode SON}">natural son</span>; Charles Johnson ; CharlesSJ@example.com</a></p></blockquote><blockquote><p><b>actor</b></p><p><b>role</b>: <span title="Codes: {http://loinc.org 75784-9}">First alternate healthcare agent [Reported]</span></p><p><b>reference</b>: <a href="RelatedPerson-Example-Smith-Johnson-HealthcareAgent2.html"><span title="Codes: {http://loinc.org 75784-9}">First alternate healthcare agent [Reported]</span>, <span title="Codes: {http://terminology.hl7.org/CodeSystem/v3-RoleCode DAU}">natural daughter</span>; Debra Johnson ; DebraSJ@example.com</a></p></blockquote><p><b>action</b>: <span title="Codes: {http://loinc.org 75787-2}">Advance directive - request for intubation</span>, <span title="Codes: {http://loinc.org 75788-0}">Advance directive - request for tube feeding</span>, <span title="Codes: {http://loinc.org 75789-8}">Advance directive - request for life support</span>, <span title="Codes: {http://loinc.org 75790-6}">Advance directive - request for IV fluid and support</span>, <span title="Codes: {http://loinc.org 75791-4}">Advance directive - request for antibiotics</span>, <span title="Codes: {http://loinc.org 75792-2}">Advance directive - request for resuscitation that differs from cardiopulmonary resuscitation</span></p><p><b>purpose</b>: <span title="{http://terminology.hl7.org/CodeSystem/v3-ActReason PWATRNY}">power of attorney</span></p></blockquote></div>
  </text>
  <status value="active"/>
  <scope>
    <coding>
      <system value="http://loinc.org"/>
      <code value="75786-4"/>
      <display value="Powers granted to healthcare agent [Reported]"/>
    </coding>
  </scope>
  <category>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/consentcategorycodes"/>
      <code value="acd"/>
    </coding>
  </category>
  <patient>
    <reference value="Patient/Example-Smith-Johnson-Patient1"/>
  </patient>
  <dateTime value="2020-08-03"/>
  <policy>
    <authority value="https://www.michigan.gov/"/>
    <uri
         value="http://www.legislature.mi.gov/(S(tpnclc1ofteerx2x2dppcmdz))/mileg.aspx?page=GetObject&amp;objectname=mcl-386-1998-V-5"/>
  </policy>
  <provision>
    <type value="permit"/>
    <actor>
      <role>
        <coding>
          <system value="http://loinc.org"/>
          <code value="75783-1"/>
          <display value="Primary healthcare agent [Reported]"/>
        </coding>
      </role>
      <reference>
        <reference value="RelatedPerson/Example-Smith-Johnson-HealthcareAgent1"/>
      </reference>
    </actor>
    <actor>
      <role>
        <coding>
          <system value="http://loinc.org"/>
          <code value="75784-9"/>
          <display value="First alternate healthcare agent [Reported]"/>
        </coding>
      </role>
      <reference>
        <reference value="RelatedPerson/Example-Smith-Johnson-HealthcareAgent2"/>
      </reference>
    </actor>
    <action>
      <coding>
        <system
                value="http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIHCADecisionsCS"/>
        <code value="intubation"/>
        <display value="Intubation"/>
      </coding>
    </action>
    <action>
      <coding>
        <system
                value="http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIHCADecisionsCS"/>
        <code value="tube-feeding"/>
        <display value="Tube feeding"/>
      </coding>
    </action>
    <action>
      <coding>
        <system
                value="http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIHCADecisionsCS"/>
        <code value="life-support"/>
        <display value="Life support"/>
      </coding>
    </action>
    <action>
      <coding>
        <system
                value="http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIHCADecisionsCS"/>
        <code value="iv-fluid-and-support"/>
        <display value="IV fluid and support"/>
      </coding>
    </action>
    <action>
      <coding>
        <system
                value="http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIHCADecisionsCS"/>
        <code value="antibiotics"/>
        <display value="Antibiotics"/>
      </coding>
    </action>
    <action>
      <coding>
        <system
                value="http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIHCADecisionsCS"/>
        <code value="resuscitation-non-cpr"/>
        <display value="Non-CPR Resuscitation"/>
      </coding>
    </action>
    <purpose>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
      <code value="PWATRNY"/>
    </purpose>
  </provision>
</Consent>