Physical Activity Implementation Guide
1.0.0 - STU Release 1 United States of America flag

This page is part of the U.S. Physical Activity IG (v1.0.0: STU 1.0) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: Scenario 1 - Exercise Prescription - JSON Representation

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{
  "resourceType" : "ExampleScenario",
  "id" : "Scen1ExercisePrescriptionScenario",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: ExampleScenario</b><a name=\"Scen1ExercisePrescriptionScenario\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource ExampleScenario &quot;Scen1ExercisePrescriptionScenario&quot; </p></div><p><b>url</b>: <code>http://hl7.org/fhir/us/physical-activity/ExampleScenario/Scen1ExercisePrescriptionScenario</code></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: ExercisePrescription</p><p><b>status</b>: draft</p><p><b>date</b>: 2023-08-25 16:04:38+0000</p><p><b>publisher</b>: HL7 International - Patient Care WG</p><p><b>contact</b>: HL7 International - Patient Care WG: <a href=\"http://www.hl7.org/Special/committees/patientcare\">http://www.hl7.org/Special/committees/patientcare</a></p><p><b>jurisdiction</b>: United States of America <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-ISO3166Part1.html\">ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code</a>#US)</span></p><blockquote><p><b>actor</b></p><p><b>actorId</b>: patientApp</p><p><b>type</b>: entity</p><p><b>name</b>: Patient App</p><p><b>description</b>: A patient app used to query resources related to the exercise plan</p></blockquote><blockquote><p><b>actor</b></p><p><b>actorId</b>: goodHealth</p><p><b>type</b>: entity</p><p><b>name</b>: EHR</p><p><b>description</b>: EHR that records patient's exercise plan</p></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: Scen1query1</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: Query for patient physical activity care plans</p><p><b>description</b>: Query for CarePlans for a patient: `GET https://goodhealth.example.org/fhir/CarePlan?patient=Patient/Scen1PatientKhatun&amp;status=active,on-hold&amp;category=http%3A//hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes|PhysicalActivity`</p></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: Scen1query2</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: Query for patient physical activity goals</p><p><b>description</b>: Query for Goals for a patient: `GET https://goodhealth.example.org/fhir/Goal?patient=Patient/Scen1PatientKhatun&amp;status=active,on-hold,completed&amp;category=http%3A//hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes|PhysicalActivity`</p></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: Scen1query3</p><p><b>resourceType</b>: Binary</p><p><b>name</b>: Query for patient exercise prescriptions and referrals</p><p><b>description</b>: Query for ServiceRequests for a patient: `GET https://goodhealth.example.org/fhir/ServiceRequest?patient=Patient/Scen1PatientKhatun&amp;status=active,on-hold&amp;category=http%3A//hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes|PhysicalActivity`</p></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: Scen1CarePlan</p><p><b>resourceType</b>: CarePlan</p><p><b>name</b>: Patient physical activity care plan</p><p><b>description</b>: CarePlan describing proposed exercise regime</p><blockquote><p><b>version</b></p><p><b>Extension Definition for ExampleScenario.instance.version.title for Version 5.0</b>: Initial CarePlan</p><p><b>Extension Definition for ExampleScenario.instance.version.content for Version 5.0</b>: <a href=\"CarePlan-Scen1CarePlanV1.html\">CarePlan/Scen1CarePlanV1</a></p><p><b>versionId</b>: 1</p><p><b>description</b>: Planning for jogging and stationary bike</p></blockquote><blockquote><p><b>version</b></p><p><b>Extension Definition for ExampleScenario.instance.version.title for Version 5.0</b>: Updated CarePlan</p><p><b>Extension Definition for ExampleScenario.instance.version.content for Version 5.0</b>: <a href=\"CarePlan-Scen1CarePlanV2.html\">CarePlan/Scen1CarePlanV2</a></p><p><b>versionId</b>: 2</p><p><b>description</b>: Planning for increased stationary bike</p></blockquote></blockquote><blockquote><p><b>instance</b></p><p><b>resourceId</b>: Scen1Goal</p><p><b>resourceType</b>: Goal</p><p><b>name</b>: Physical Activity weekly target</p><p><b>description</b>: Goal indicating target number of minutes/week of moderate-vigorous physical activity</p><blockquote><p><b>version</b></p><p><b>Extension Definition for ExampleScenario.instance.version.title for Version 5.0</b>: Initial goal</p><p><b>Extension Definition for ExampleScenario.instance.version.content for Version 5.0</b>: <a href=\"Goal-Scen1GoalV1.html\">Goal/Scen1GoalV1</a></p><p><b>versionId</b>: 1</p><p><b>description</b>: Initial value of 100 mins/week</p></blockquote><blockquote><p><b>version</b></p><p><b>Extension Definition for ExampleScenario.instance.version.title for Version 5.0</b>: Initial goal</p><p><b>Extension Definition for ExampleScenario.instance.version.content for Version 5.0</b>: <a href=\"Goal-Scen1GoalV2.html\">Goal/Scen1GoalV2</a></p><p><b>versionId</b>: 1</p><p><b>description</b>: Initial value of 100 mins/week-completed</p></blockquote></blockquote><blockquote><p><b>instance</b></p><p><b>Extension Definition for ExampleScenario.instance.content for Version 5.0</b>: <a href=\"Goal-Scen1Goal2.html\">Goal/Scen1Goal2</a></p><p><b>resourceId</b>: Scen1Goal2</p><p><b>resourceType</b>: Bundle</p><p><b>name</b>: Updated goal</p><p><b>description</b>: Updated value of 150 mins/week</p></blockquote><blockquote><p><b>instance</b></p><p><b>Extension Definition for ExampleScenario.instance.content for Version 5.0</b>: <a href=\"Bundle-Scen1CarePlanBundle1.html\">Bundle/Scen1CarePlanBundle1</a></p><p><b>resourceId</b>: Scen1CarePlanBundle1</p><p><b>resourceType</b>: Bundle</p><p><b>name</b>: Initial care plan search response bundle</p><p><b>description</b>: Only contains 1 plan, though in practice, more than one is possible</p><h3>ContainedInstances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td><td><b>VersionId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1CarePlan</td><td>1</td></tr></table></blockquote><blockquote><p><b>instance</b></p><p><b>Extension Definition for ExampleScenario.instance.content for Version 5.0</b>: <a href=\"Bundle-Scen1CarePlanBundle2.html\">Bundle/Scen1CarePlanBundle2</a></p><p><b>resourceId</b>: Scen1CarePlanBundle2</p><p><b>resourceType</b>: Bundle</p><p><b>name</b>: Second care plan search response bundle</p><p><b>description</b>: In a real system, the id would be the same as the original</p><h3>ContainedInstances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td><td><b>VersionId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1CarePlan</td><td>2</td></tr></table></blockquote><blockquote><p><b>instance</b></p><p><b>Extension Definition for ExampleScenario.instance.content for Version 5.0</b>: <a href=\"Bundle-Scen1GoalBundle1.html\">Bundle/Scen1GoalBundle1</a></p><p><b>resourceId</b>: Scen1GoalBundle1</p><p><b>resourceType</b>: Bundle</p><p><b>name</b>: Initial goal search response bundle</p><p><b>description</b>: There could be multiple goals, but in the scenario there's only one.</p><h3>ContainedInstances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td><td><b>VersionId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1Goal</td><td>1</td></tr></table></blockquote><blockquote><p><b>instance</b></p><p><b>Extension Definition for ExampleScenario.instance.content for Version 5.0</b>: <a href=\"Bundle-Scen1GoalBundle2.html\">Bundle/Scen1GoalBundle2</a></p><p><b>resourceId</b>: Scen1GoalBundle2</p><p><b>resourceType</b>: Bundle</p><p><b>name</b>: Second goal search response bundle</p><p><b>description</b>: In a real system, the id would be the same as the original</p><h3>ContainedInstances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1Goal2</td></tr></table></blockquote><blockquote><p><b>instance</b></p><p><b>Extension Definition for ExampleScenario.instance.content for Version 5.0</b>: <a href=\"ServiceRequest-Scen1ExerciseRx.html\">ServiceRequest/Scen1ExerciseRx</a></p><p><b>resourceId</b>: Scen1ExerciseRx</p><p><b>resourceType</b>: ServiceRequest</p><p><b>name</b>: Prescription for exercise</p><p><b>description</b>: Expressed as a ServiceRequest with performer of the patient</p></blockquote><blockquote><p><b>instance</b></p><p><b>Extension Definition for ExampleScenario.instance.content for Version 5.0</b>: <a href=\"Bundle-Scen1ExerciseRxBundle.html\">Bundle/Scen1ExerciseRxBundle</a></p><p><b>resourceId</b>: Scen1ExerciseRxBundle</p><p><b>resourceType</b>: Bundle</p><p><b>name</b>: Search result of exercise prescriptions and referrals</p><p><b>description</b>: There could be a mix of an exercise prescription plus referrals, but in this case there's only the prescription.</p><h3>ContainedInstances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1ExerciseRx</td></tr></table></blockquote><blockquote><p><b>instance</b></p><p><b>Extension Definition for ExampleScenario.instance.content for Version 5.0</b>: <a href=\"Observation-Scen1ObservationDaysPerWeek.html\">Observation/Scen1ObservationDaysPerWeek</a></p><p><b>resourceId</b>: Scen1ObservationDaysPerWeek</p><p><b>resourceType</b>: Observation</p><p><b>name</b>: Example physical activity days per week record</p><p><b>description</b>: Average days per week of moderate-to-vigorous physical activity.</p></blockquote><blockquote><p><b>instance</b></p><p><b>Extension Definition for ExampleScenario.instance.content for Version 5.0</b>: <a href=\"Observation-Scen1ObservationMinsPerDay.html\">Observation/Scen1ObservationMinsPerDay</a></p><p><b>resourceId</b>: Scen1ObservationMinsPerDay</p><p><b>resourceType</b>: Observation</p><p><b>name</b>: Example physical activity minutes per day record</p><p><b>description</b>: Average minutes per day of moderate-to-vigorous physical activity.</p></blockquote><blockquote><p><b>instance</b></p><p><b>Extension Definition for ExampleScenario.instance.content for Version 5.0</b>: <a href=\"Observation-Scen1ObservationMinsPerWeek.html\">Observation/Scen1ObservationMinsPerWeek</a></p><p><b>resourceId</b>: Scen1ObservationMinsPerWeek</p><p><b>resourceType</b>: Observation</p><p><b>name</b>: Example physical activity minutes per week record</p><p><b>description</b>: Average minutes per week of moderate-to-vigorous physical activity.</p></blockquote><blockquote><p><b>instance</b></p><p><b>Extension Definition for ExampleScenario.instance.content for Version 5.0</b>: <a href=\"Observation-Scen1ObservationStrengthDaysPerWeek.html\">Observation/Scen1ObservationStrengthDaysPerWeek</a></p><p><b>resourceId</b>: Scen1ObservationStrengthDaysPerWeek</p><p><b>resourceType</b>: Observation</p><p><b>name</b>: Example strength days per week record</p><p><b>description</b>: Average days per week of muscle-strengthening physical activity.</p></blockquote><blockquote><p><b>process</b></p><p><b>title</b>: Day after appointment</p><p><b>description</b>: The patient accesses the care plan, goals and exercise prescription made available on the EHR</p><p><b>preConditions</b>: Encounter (and other supporting) resources created</p><p><b>postConditions</b>: Patient app has retrieved exercise plan related resources</p><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 1</p><p><b>type</b>: search-type</p><p><b>name</b>: Query CarePlan</p><p><b>initiator</b>: patientApp</p><p><b>receiver</b>: goodHealth</p><p><b>description</b>: Patient app queries exercise CarePlan describing proposed exercise regime.</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1query1</td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1CarePlanBundle1</td></tr></table></blockquote></blockquote><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 2</p><p><b>type</b>: search-type</p><p><b>name</b>: Query Goal</p><p><b>initiator</b>: patientApp</p><p><b>receiver</b>: goodHealth</p><p><b>description</b>: Patient app queries Goals (100 minutes/week).</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1query2</td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1GoalBundle1</td></tr></table></blockquote></blockquote><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 3</p><p><b>type</b>: search-type</p><p><b>name</b>: Query ServiceRequest</p><p><b>initiator</b>: patientApp</p><p><b>receiver</b>: goodHealth</p><p><b>description</b>: Patient app queries ServiceRequest (order for ‘exercise’).</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1query3</td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1ExerciseRxBundle</td></tr></table></blockquote></blockquote></blockquote><blockquote><p><b>process</b></p><p><b>title</b>: A couple of weeks later</p><p><b>description</b>: The exchange noted here would actually occur many times (though not necessarily regularly).  Only a single set of data is shown for simplicity.</p><p><b>preConditions</b>: Patient app is able to write records to EHR</p><p><b>postConditions</b>: EHR has weekly activity level observations</p><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 5</p><p><b>type</b>: create</p><p><b>name</b>: Post days/week</p><p><b>initiator</b>: patientApp</p><p><b>receiver</b>: goodHealth</p><p><b>description</b>: Patient app posts average days per week of moderate-to-vigorous physical activity. `POST https://goodhealth.example.org/fhir/Observation`</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1ObservationDaysPerWeek</td></tr></table></blockquote></blockquote><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 6</p><p><b>type</b>: create</p><p><b>name</b>: Post minutes/day</p><p><b>initiator</b>: patientApp</p><p><b>receiver</b>: goodHealth</p><p><b>description</b>: Patient app posts average minutes per day of moderate-to-vigorous physical activity. `POST https://goodhealth.example.org/fhir/Observation`</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1ObservationMinsPerDay</td></tr></table></blockquote></blockquote><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 7</p><p><b>type</b>: create</p><p><b>name</b>: Post minutes/week</p><p><b>initiator</b>: patientApp</p><p><b>receiver</b>: goodHealth</p><p><b>description</b>: Patient app posts average minutes per week of moderate-to-vigorous physical activity. `POST https://goodhealth.example.org/fhir/Observation`</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1ObservationMinsPerWeek</td></tr></table></blockquote></blockquote><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 8</p><p><b>type</b>: create</p><p><b>name</b>: Post stength days/week</p><p><b>initiator</b>: patientApp</p><p><b>receiver</b>: goodHealth</p><p><b>description</b>: Patient app posts average days per week of muscle-strengthening physical activity. `POST https://goodhealth.example.org/fhir/Observation`</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1ObservationStrengthDaysPerWeek</td></tr></table></blockquote></blockquote></blockquote><blockquote><p><b>process</b></p><p><b>title</b>: A little more than 6 months after first appointment</p><p><b>description</b>: In practice, the patient app would likely check for new CarePlans and Goals each time it launches.  However, this is the first time there'd be something new to retrieve.</p><p><b>preConditions</b>: CarePlan and Goal have been updated in EHR</p><p><b>postConditions</b>: Patient app retrieves updated CarePlan and Goal</p><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 9</p><p><b>type</b>: search-type</p><p><b>name</b>: Query revised CarePlan</p><p><b>initiator</b>: patientApp</p><p><b>receiver</b>: goodHealth</p><p><b>description</b>: Patient app queries revised CarePlan with providers notes.</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1query1</td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1CarePlanBundle2</td></tr></table></blockquote></blockquote><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 10</p><p><b>type</b>: search-type</p><p><b>name</b>: Query revised Goal</p><p><b>initiator</b>: patientApp</p><p><b>receiver</b>: goodHealth</p><p><b>description</b>: Patient app queries new Goals.</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1query2</td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1GoalBundle2</td></tr></table></blockquote></blockquote><blockquote><p><b>step</b></p><blockquote><p><b>operation</b></p><p><b>number</b>: 11</p><p><b>type</b>: search-type</p><p><b>name</b>: Query ServiceRequest</p><p><b>initiator</b>: patientApp</p><p><b>receiver</b>: goodHealth</p><p><b>description</b>: The results of this search are the same as the initial call because the exercise 'prescription' has not changed.</p><h3>Requests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1query3</td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ResourceId</b></td></tr><tr><td style=\"display: none\">*</td><td>Scen1ExerciseRxBundle</td></tr></table></blockquote></blockquote></blockquote></div>"
  },
  "url" : "http://hl7.org/fhir/us/physical-activity/ExampleScenario/Scen1ExercisePrescriptionScenario",
  "version" : "1.0.0",
  "name" : "ExercisePrescription",
  "status" : "draft",
  "date" : "2023-08-25T16:04:38+00:00",
  "publisher" : "HL7 International - Patient Care WG",
  "contact" : [
    {
      "name" : "HL7 International - Patient Care WG",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/patientcare"
        }
      ]
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "actor" : [
    {
      "actorId" : "patientApp",
      "type" : "entity",
      "name" : "Patient App",
      "description" : "A patient app used to query resources related to the exercise plan"
    },
    {
      "actorId" : "goodHealth",
      "type" : "entity",
      "name" : "EHR",
      "description" : "EHR that records patient's exercise plan"
    }
  ],
  "instance" : [
    {
      "resourceId" : "Scen1query1",
      "resourceType" : "Binary",
      "name" : "Query for patient physical activity care plans",
      "description" : "Query for CarePlans for a patient: `GET https://goodhealth.example.org/fhir/CarePlan?patient=Patient/Scen1PatientKhatun&status=active,on-hold&category=http%3A//hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes|PhysicalActivity`"
    },
    {
      "resourceId" : "Scen1query2",
      "resourceType" : "Binary",
      "name" : "Query for patient physical activity goals",
      "description" : "Query for Goals for a patient: `GET https://goodhealth.example.org/fhir/Goal?patient=Patient/Scen1PatientKhatun&status=active,on-hold,completed&category=http%3A//hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes|PhysicalActivity`"
    },
    {
      "resourceId" : "Scen1query3",
      "resourceType" : "Binary",
      "name" : "Query for patient exercise prescriptions and referrals",
      "description" : "Query for ServiceRequests for a patient: `GET https://goodhealth.example.org/fhir/ServiceRequest?patient=Patient/Scen1PatientKhatun&status=active,on-hold&category=http%3A//hl7.org/fhir/us/physical-activity/CodeSystem/pa-temporary-codes|PhysicalActivity`"
    },
    {
      "resourceId" : "Scen1CarePlan",
      "resourceType" : "CarePlan",
      "name" : "Patient physical activity care plan",
      "description" : "CarePlan describing proposed exercise regime",
      "version" : [
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title",
              "valueString" : "Initial CarePlan"
            },
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content",
              "valueReference" : {
                "reference" : "CarePlan/Scen1CarePlanV1"
              }
            }
          ],
          "versionId" : "1",
          "description" : "Planning for jogging and stationary bike"
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title",
              "valueString" : "Updated CarePlan"
            },
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content",
              "valueReference" : {
                "reference" : "CarePlan/Scen1CarePlanV2"
              }
            }
          ],
          "versionId" : "2",
          "description" : "Planning for increased stationary bike"
        }
      ]
    },
    {
      "resourceId" : "Scen1Goal",
      "resourceType" : "Goal",
      "name" : "Physical Activity weekly target",
      "description" : "Goal indicating target number of minutes/week of moderate-vigorous physical activity",
      "version" : [
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title",
              "valueString" : "Initial goal"
            },
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content",
              "valueReference" : {
                "reference" : "Goal/Scen1GoalV1"
              }
            }
          ],
          "versionId" : "1",
          "description" : "Initial value of 100 mins/week"
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.title",
              "valueString" : "Initial goal"
            },
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.version.content",
              "valueReference" : {
                "reference" : "Goal/Scen1GoalV2"
              }
            }
          ],
          "versionId" : "1",
          "description" : "Initial value of 100 mins/week-completed"
        }
      ]
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.content",
          "valueReference" : {
            "reference" : "Goal/Scen1Goal2"
          }
        }
      ],
      "resourceId" : "Scen1Goal2",
      "resourceType" : "Bundle",
      "name" : "Updated goal",
      "description" : "Updated value of 150 mins/week"
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.content",
          "valueReference" : {
            "reference" : "Bundle/Scen1CarePlanBundle1"
          }
        }
      ],
      "resourceId" : "Scen1CarePlanBundle1",
      "resourceType" : "Bundle",
      "name" : "Initial care plan search response bundle",
      "description" : "Only contains 1 plan, though in practice, more than one is possible",
      "containedInstance" : [
        {
          "resourceId" : "Scen1CarePlan",
          "versionId" : "1"
        }
      ]
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.content",
          "valueReference" : {
            "reference" : "Bundle/Scen1CarePlanBundle2"
          }
        }
      ],
      "resourceId" : "Scen1CarePlanBundle2",
      "resourceType" : "Bundle",
      "name" : "Second care plan search response bundle",
      "description" : "In a real system, the id would be the same as the original",
      "containedInstance" : [
        {
          "resourceId" : "Scen1CarePlan",
          "versionId" : "2"
        }
      ]
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.content",
          "valueReference" : {
            "reference" : "Bundle/Scen1GoalBundle1"
          }
        }
      ],
      "resourceId" : "Scen1GoalBundle1",
      "resourceType" : "Bundle",
      "name" : "Initial goal search response bundle",
      "description" : "There could be multiple goals, but in the scenario there's only one.",
      "containedInstance" : [
        {
          "resourceId" : "Scen1Goal",
          "versionId" : "1"
        }
      ]
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.content",
          "valueReference" : {
            "reference" : "Bundle/Scen1GoalBundle2"
          }
        }
      ],
      "resourceId" : "Scen1GoalBundle2",
      "resourceType" : "Bundle",
      "name" : "Second goal search response bundle",
      "description" : "In a real system, the id would be the same as the original",
      "containedInstance" : [
        {
          "resourceId" : "Scen1Goal2"
        }
      ]
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.content",
          "valueReference" : {
            "reference" : "ServiceRequest/Scen1ExerciseRx"
          }
        }
      ],
      "resourceId" : "Scen1ExerciseRx",
      "resourceType" : "ServiceRequest",
      "name" : "Prescription for exercise",
      "description" : "Expressed as a ServiceRequest with performer of the patient"
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.content",
          "valueReference" : {
            "reference" : "Bundle/Scen1ExerciseRxBundle"
          }
        }
      ],
      "resourceId" : "Scen1ExerciseRxBundle",
      "resourceType" : "Bundle",
      "name" : "Search result of exercise prescriptions and referrals",
      "description" : "There could be a mix of an exercise prescription plus referrals, but in this case there's only the prescription.",
      "containedInstance" : [
        {
          "resourceId" : "Scen1ExerciseRx"
        }
      ]
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.content",
          "valueReference" : {
            "reference" : "Observation/Scen1ObservationDaysPerWeek"
          }
        }
      ],
      "resourceId" : "Scen1ObservationDaysPerWeek",
      "resourceType" : "Observation",
      "name" : "Example physical activity days per week record",
      "description" : "Average days per week of moderate-to-vigorous physical activity."
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.content",
          "valueReference" : {
            "reference" : "Observation/Scen1ObservationMinsPerDay"
          }
        }
      ],
      "resourceId" : "Scen1ObservationMinsPerDay",
      "resourceType" : "Observation",
      "name" : "Example physical activity minutes per day record",
      "description" : "Average minutes per day of moderate-to-vigorous physical activity."
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.content",
          "valueReference" : {
            "reference" : "Observation/Scen1ObservationMinsPerWeek"
          }
        }
      ],
      "resourceId" : "Scen1ObservationMinsPerWeek",
      "resourceType" : "Observation",
      "name" : "Example physical activity minutes per week record",
      "description" : "Average minutes per week of moderate-to-vigorous physical activity."
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-ExampleScenario.instance.content",
          "valueReference" : {
            "reference" : "Observation/Scen1ObservationStrengthDaysPerWeek"
          }
        }
      ],
      "resourceId" : "Scen1ObservationStrengthDaysPerWeek",
      "resourceType" : "Observation",
      "name" : "Example strength days per week record",
      "description" : "Average days per week of muscle-strengthening physical activity."
    }
  ],
  "process" : [
    {
      "title" : "Day after appointment",
      "description" : "The patient accesses the care plan, goals and exercise prescription made available on the EHR",
      "preConditions" : "Encounter (and other supporting) resources created",
      "postConditions" : "Patient app has retrieved exercise plan related resources",
      "step" : [
        {
          "operation" : {
            "number" : "1",
            "type" : "search-type",
            "name" : "Query CarePlan",
            "initiator" : "patientApp",
            "receiver" : "goodHealth",
            "description" : "Patient app queries exercise CarePlan describing proposed exercise regime.",
            "request" : {
              "resourceId" : "Scen1query1"
            },
            "response" : {
              "resourceId" : "Scen1CarePlanBundle1"
            }
          }
        },
        {
          "operation" : {
            "number" : "2",
            "type" : "search-type",
            "name" : "Query Goal",
            "initiator" : "patientApp",
            "receiver" : "goodHealth",
            "description" : "Patient app queries Goals (100 minutes/week).",
            "request" : {
              "resourceId" : "Scen1query2"
            },
            "response" : {
              "resourceId" : "Scen1GoalBundle1"
            }
          }
        },
        {
          "operation" : {
            "number" : "3",
            "type" : "search-type",
            "name" : "Query ServiceRequest",
            "initiator" : "patientApp",
            "receiver" : "goodHealth",
            "description" : "Patient app queries ServiceRequest (order for ‘exercise’).",
            "request" : {
              "resourceId" : "Scen1query3"
            },
            "response" : {
              "resourceId" : "Scen1ExerciseRxBundle"
            }
          }
        }
      ]
    },
    {
      "title" : "A couple of weeks later",
      "description" : "The exchange noted here would actually occur many times (though not necessarily regularly).  Only a single set of data is shown for simplicity.",
      "preConditions" : "Patient app is able to write records to EHR",
      "postConditions" : "EHR has weekly activity level observations",
      "step" : [
        {
          "operation" : {
            "number" : "5",
            "type" : "create",
            "name" : "Post days/week",
            "initiator" : "patientApp",
            "receiver" : "goodHealth",
            "description" : "Patient app posts average days per week of moderate-to-vigorous physical activity. `POST https://goodhealth.example.org/fhir/Observation`",
            "request" : {
              "resourceId" : "Scen1ObservationDaysPerWeek"
            }
          }
        },
        {
          "operation" : {
            "number" : "6",
            "type" : "create",
            "name" : "Post minutes/day",
            "initiator" : "patientApp",
            "receiver" : "goodHealth",
            "description" : "Patient app posts average minutes per day of moderate-to-vigorous physical activity. `POST https://goodhealth.example.org/fhir/Observation`",
            "request" : {
              "resourceId" : "Scen1ObservationMinsPerDay"
            }
          }
        },
        {
          "operation" : {
            "number" : "7",
            "type" : "create",
            "name" : "Post minutes/week",
            "initiator" : "patientApp",
            "receiver" : "goodHealth",
            "description" : "Patient app posts average minutes per week of moderate-to-vigorous physical activity. `POST https://goodhealth.example.org/fhir/Observation`",
            "request" : {
              "resourceId" : "Scen1ObservationMinsPerWeek"
            }
          }
        },
        {
          "operation" : {
            "number" : "8",
            "type" : "create",
            "name" : "Post stength days/week",
            "initiator" : "patientApp",
            "receiver" : "goodHealth",
            "description" : "Patient app posts average days per week of muscle-strengthening physical activity. `POST https://goodhealth.example.org/fhir/Observation`",
            "request" : {
              "resourceId" : "Scen1ObservationStrengthDaysPerWeek"
            }
          }
        }
      ]
    },
    {
      "title" : "A little more than 6 months after first appointment",
      "description" : "In practice, the patient app would likely check for new CarePlans and Goals each time it launches.  However, this is the first time there'd be something new to retrieve.",
      "preConditions" : "CarePlan and Goal have been updated in EHR",
      "postConditions" : "Patient app retrieves updated CarePlan and Goal",
      "step" : [
        {
          "operation" : {
            "number" : "9",
            "type" : "search-type",
            "name" : "Query revised CarePlan",
            "initiator" : "patientApp",
            "receiver" : "goodHealth",
            "description" : "Patient app queries revised CarePlan with providers notes.",
            "request" : {
              "resourceId" : "Scen1query1"
            },
            "response" : {
              "resourceId" : "Scen1CarePlanBundle2"
            }
          }
        },
        {
          "operation" : {
            "number" : "10",
            "type" : "search-type",
            "name" : "Query revised Goal",
            "initiator" : "patientApp",
            "receiver" : "goodHealth",
            "description" : "Patient app queries new Goals.",
            "request" : {
              "resourceId" : "Scen1query2"
            },
            "response" : {
              "resourceId" : "Scen1GoalBundle2"
            }
          }
        },
        {
          "operation" : {
            "number" : "11",
            "type" : "search-type",
            "name" : "Query ServiceRequest",
            "initiator" : "patientApp",
            "receiver" : "goodHealth",
            "description" : "The results of this search are the same as the initial call because the exercise 'prescription' has not changed.",
            "request" : {
              "resourceId" : "Scen1query3"
            },
            "response" : {
              "resourceId" : "Scen1ExerciseRxBundle"
            }
          }
        }
      ]
    }
  ]
}