Protocols for Clinical Registry Extraction and Data Submission (CREDS) IG
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This page is part of the Protocols for Clinical Registry Extraction and Data Submission (CREDS) IG (v1.0.0-ballot: STU1 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

: CREDS Submission Bundle Example - JSON Representation

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{
  "resourceType" : "Bundle",
  "id" : "CREDSBundle-Example",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/us/registry-protocols/StructureDefinition/CREDSSubmission"
    ]
  },
  "type" : "collection",
  "entry" : [
    {
      "fullUrl" : "urn:uuid:a4bab684-4bc2-43b7-82a0-199034a5a5b2",
      "resource" : {
        "resourceType" : "MessageHeader",
        "id" : "CREDSMHExample",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MessageHeader</b><a name=\"CREDSMHExample\"> </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 MessageHeader &quot;CREDSMHExample&quot; </p></div><p><b>event</b>: <code>urn:uuid:26aa1208-589a-4978-9cb7-728cc51520aa</code></p><p><b>sender</b>: <a href=\"Organization-VeterinariansHospital.html\">Organization/VeterinariansHospital</a> &quot;Veterinarian's Hospital&quot;</p><p><b>enterer</b>: <a href=\"Practitioner-USCorePractitionerexample.html\">Practitioner/USCorePractitionerexample</a> &quot; BONE&quot;</p><h3>Sources</h3><table class=\"grid\"><tr><td>-</td><td><b>Name</b></td><td><b>Endpoint</b></td></tr><tr><td>*</td><td>CREDS Implementation #2</td><td><a href=\"https://example.org/fhir\">https://example.org/fhir</a></td></tr></table><p><b>reason</b>: Discharge <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-message-reasons-encounter.html\">Example Message Reason Codes</a>#discharge)</span></p><p><b>focus</b>: <a href=\"#Patient_261989c3-688c-4941-b767-d8d4c871217c\">See above (Patient/261989c3-688c-4941-b767-d8d4c871217c)</a></p></div>"
        },
        "eventUri" : "urn:uuid:26aa1208-589a-4978-9cb7-728cc51520aa",
        "sender" : {
          "reference" : "Organization/VeterinariansHospital"
        },
        "enterer" : {
          "reference" : "Practitioner/USCorePractitionerexample"
        },
        "source" : {
          "name" : "CREDS Implementation #2",
          "endpoint" : "https://example.org/fhir"
        },
        "reason" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/message-reasons-encounter",
              "code" : "discharge"
            }
          ]
        },
        "focus" : [
          {
            "reference" : "Patient/261989c3-688c-4941-b767-d8d4c871217c"
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:261989c3-688c-4941-b767-d8d4c871217c",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "261989c3-688c-4941-b767-d8d4c871217c",
        "meta" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/instance-name",
              "valueString" : "Patient Example"
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/instance-description",
              "valueMarkdown" : "This is a patient example for the *US Core Patient Profile*."
            }
          ],
          "profile" : [
            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
          ]
        },
        "text" : {
          "status" : "extensions",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b><a name=\"261989c3-688c-4941-b767-d8d4c871217c\"> </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 Patient &quot;261989c3-688c-4941-b767-d8d4c871217c&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-patient.html\">US Core Patient Profile</a></p></div><blockquote><p><b>US Core Race Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: White (Details: urn:oid:2.16.840.1.113883.6.238 code 2106-3 = '2106-3', stated as 'White')</p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: American Indian or Alaska Native (Details: urn:oid:2.16.840.1.113883.6.238 code 1002-5 = '1002-5', stated as 'American Indian or Alaska Native')</p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: Asian (Details: urn:oid:2.16.840.1.113883.6.238 code 2028-9 = '2028-9', stated as 'Asian')</p><blockquote><p><b>url</b></p><code>detailed</code></blockquote><p><b>value</b>: Shoshone (Details: urn:oid:2.16.840.1.113883.6.238 code 1586-7 = '1586-7', stated as 'Shoshone')</p><blockquote><p><b>url</b></p><code>detailed</code></blockquote><p><b>value</b>: Filipino (Details: urn:oid:2.16.840.1.113883.6.238 code 2036-2 = '2036-2', stated as 'Filipino')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Mixed</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: Hispanic or Latino (Details: urn:oid:2.16.840.1.113883.6.238 code 2135-2 = '2135-2', stated as 'Hispanic or Latino')</p><blockquote><p><b>url</b></p><code>detailed</code></blockquote><p><b>value</b>: Dominican (Details: urn:oid:2.16.840.1.113883.6.238 code 2184-0 = '2184-0', stated as 'Dominican')</p><blockquote><p><b>url</b></p><code>detailed</code></blockquote><p><b>value</b>: Mexican (Details: urn:oid:2.16.840.1.113883.6.238 code 2148-5 = '2148-5', stated as 'Mexican')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Hispanic or Latino</p></blockquote><p><b>US Core Birth Sex Extension</b>: F</p><p><b>identifier</b>: Medical Record Number:\u00a01032702\u00a0(use:\u00a0USUAL)</p><p><b>active</b>: true</p><p><b>name</b>: Amy V. Shaw (OLD), Amy V. Baxter </p><p><b>telecom</b>: ph: 555-555-5555(HOME), <a href=\"mailto:amy.shaw@example.com\">amy.shaw@example.com</a></p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1987-02-20</p><p><b>address</b>: </p><ul><li>49 Meadow St Mounds OK 74047 US (OLD)</li><li>183 Mountain View St Mounds OK 74048 US </li></ul></div>"
        },
        "extension" : [
          {
            "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-race"
          },
          {
            "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-ethnicity"
          },
          {
            "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" : [
          {
            "use" : "old",
            "family" : "Shaw",
            "given" : [
              "Amy",
              "V."
            ],
            "period" : {
              "start" : "2016-12-06",
              "end" : "2020-07-22"
            }
          },
          {
            "family" : "Baxter",
            "given" : [
              "Amy",
              "V."
            ],
            "suffix" : [
              "PharmD"
            ],
            "period" : {
              "start" : "2020-07-22"
            }
          }
        ],
        "telecom" : [
          {
            "system" : "phone",
            "value" : "555-555-5555",
            "use" : "home"
          },
          {
            "system" : "email",
            "value" : "amy.shaw@example.com"
          }
        ],
        "gender" : "female",
        "birthDate" : "1987-02-20",
        "address" : [
          {
            "use" : "old",
            "line" : [
              "49 Meadow St"
            ],
            "city" : "Mounds",
            "state" : "OK",
            "postalCode" : "74047",
            "country" : "US",
            "period" : {
              "start" : "2016-12-06",
              "end" : "2020-07-22"
            }
          },
          {
            "line" : [
              "183 Mountain View St"
            ],
            "city" : "Mounds",
            "state" : "OK",
            "postalCode" : "74048",
            "country" : "US",
            "period" : {
              "start" : "2020-07-22"
            }
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:ba651db0-7b10-4465-a5c4-411ced9e8254",
      "resource" : {
        "resourceType" : "Encounter",
        "id" : "CREDSEncounter",
        "meta" : {
          "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: Encounter</b><a name=\"CREDSEncounter\"> </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 Encounter &quot;CREDSEncounter&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU5.0.1/StructureDefinition-us-core-encounter.html\">US Core Encounter Profile</a></p></div><p><b>status</b>: finished</p><p><b>class</b>: ambulatory (Details: http://terminology.hl7.org/CodeSystem/v3-ActCode code AMB = 'ambulatory', stated as 'null')</p><p><b>type</b>: 99201 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-CPT.html\">Current Procedural Terminology (CPT®)</a>#99201)</span></p><p><b>subject</b>: <a href=\"#Patient_261989c3-688c-4941-b767-d8d4c871217c\">See above (Patient/261989c3-688c-4941-b767-d8d4c871217c)</a></p><h3>Participants</h3><table class=\"grid\"><tr><td>-</td><td><b>Individual</b></td></tr><tr><td>*</td><td><a href=\"Practitioner-USCorePractitionerexample.html\">Practitioner/USCorePractitionerexample</a> &quot; BONE&quot;</td></tr></table><p><b>period</b>: 2020-10-01 17:00:14-0500 --&gt; 2020-10-01 18:00:14-0500</p><h3>Locations</h3><table class=\"grid\"><tr><td>-</td><td><b>Location</b></td></tr><tr><td>*</td><td><a href=\"Location-Enc-location.html\">Location/Enc-location</a> &quot;North Wing of Veterinarian's Hospital&quot;</td></tr></table></div>"
        },
        "status" : "finished",
        "class" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code" : "AMB"
        },
        "type" : [
          {
            "coding" : [
              {
                "system" : "http://www.ama-assn.org/go/cpt",
                "code" : "99201"
              }
            ]
          }
        ],
        "subject" : {
          "reference" : "Patient/261989c3-688c-4941-b767-d8d4c871217c"
        },
        "participant" : [
          {
            "individual" : {
              "reference" : "Practitioner/USCorePractitionerexample"
            }
          }
        ],
        "period" : {
          "start" : "2020-10-01T17:00:14-05:00",
          "end" : "2020-10-01T18:00:14-05:00"
        },
        "location" : [
          {
            "location" : {
              "reference" : "Location/Enc-location"
            }
          }
        ]
      }
    }
  ]
}