This page is part of the Specialty Medication Enrollment (v2.0.0: STU2) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
{
"resourceType" : "Task",
"id" : "specialty-rx-task-consent-request-contained",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/specialty-rx/StructureDefinition/specialty-rx-task-consent-request"
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},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Task</b><a name=\"specialty-rx-task-consent-request-contained\"> </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 Task "specialty-rx-task-consent-request-contained" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-specialty-rx-task-consent-request.html\">Specialty Rx Task - Consent Request</a></p></div><p><b>status</b>: requested</p><p><b>intent</b>: plan</p><p><b>code</b>: Obtain Consent for Product Fulfillment <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-specialty-rx-task-characteristic.html\">Specialty Rx Code System - Task Characteristic</a>#obtain-consent)</span></p><p><b>description</b>: Have patient, Amy Shaw, complete the attached consent form</p><p><b>for</b>: <a href=\"Patient-specialty-rx-patient-1.html\">Patient/specialty-rx-patient-1: Amy Shaw</a> " DOE"</p><p><b>authoredOn</b>: 2022-05-05</p><p><b>requester</b>: <span>: Bryant Avenue Pharmacy</span></p><p><b>owner</b>: <a href=\"Practitioner-specialty-rx-practitioner-1.html\">Practitioner/specialty-rx-practitioner-1: Melissa Jenkins, MD</a> " SMITH"</p><h3>Inputs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Consent Form Reference <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-specialty-rx-task-characteristic.html\">Specialty Rx Code System - Task Characteristic</a>#consent-form-reference)</span></td><td><a name=\"consent-request\"> </a><blockquote><p/><p><a name=\"consent-request\"> </a></p><p><b>status</b>: proposed</p><p><b>scope</b>: Privacy Consent <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-consentscope.html\">Consent Scope Codes</a>#patient-privacy)</span></p><p><b>category</b>: Consent Document <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#59284-0)</span></p><p><b>patient</b>: <a href=\"Patient-specialty-rx-patient-1.html\">Patient/specialty-rx-patient-1: Amy Shaw</a> " DOE"</p><p><b>dateTime</b>: 2022-05-05 09:35:39-0500</p><p><b>performer</b>: <a href=\"Patient-specialty-rx-patient-1.html\">Patient/specialty-rx-patient-1: Amy Shaw</a> " DOE"</p><p><b>organization</b>: <a href=\"Organization-us-core-organization-clinic-1.html\">Organization/us-core-organization-clinic-1: Acme Clinic</a> "Acme Clinic"</p><p><b>source</b>: </p><p><b>policyRule</b>: opt-in <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-ActCode.html\">ActCode</a>#OPTIN)</span></p></blockquote></td></tr></table><hr/><blockquote><p><b>Generated Narrative: Consent #consent-request</b><a name=\"consent-request\"> </a></p><p><b>status</b>: proposed</p><p><b>scope</b>: Privacy Consent <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-consentscope.html\">Consent Scope Codes</a>#patient-privacy)</span></p><p><b>category</b>: Consent Document <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#59284-0)</span></p><p><b>patient</b>: <a href=\"Patient-specialty-rx-patient-1.html\">Patient/specialty-rx-patient-1: Amy Shaw</a> " DOE"</p><p><b>dateTime</b>: 2022-05-05 09:35:39-0500</p><p><b>performer</b>: <a href=\"Patient-specialty-rx-patient-1.html\">Patient/specialty-rx-patient-1: Amy Shaw</a> " DOE"</p><p><b>organization</b>: <a href=\"Organization-us-core-organization-clinic-1.html\">Organization/us-core-organization-clinic-1: Acme Clinic</a> "Acme Clinic"</p><p><b>source</b>: </p><p><b>policyRule</b>: opt-in <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-ActCode.html\">ActCode</a>#OPTIN)</span></p></blockquote></div>"
},
"contained" : [
{
"resourceType" : "Consent",
"id" : "consent-request",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/specialty-rx/StructureDefinition/specialty-rx-consent-requested"
]
},
"status" : "proposed",
"scope" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/consentscope",
"code" : "patient-privacy"
}
]
},
"category" : [
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "59284-0",
"display" : "Consent Document"
}
]
}
],
"patient" : {
"reference" : "Patient/specialty-rx-patient-1",
"display" : "Amy Shaw"
},
"dateTime" : "2022-05-05T09:35:39.415-05:00",
"performer" : [
{
"reference" : "Patient/specialty-rx-patient-1",
"display" : "Amy Shaw"
}
],
"organization" : [
{
"reference" : "Organization/us-core-organization-clinic-1",
"display" : "Acme Clinic"
}
],
"sourceAttachment" : {
"contentType" : "application/pdf",
"data" : "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",
"title" : "Xamproxitelopeldoleodl Patient Consent Form",
"creation" : "2021-12-01T16:35:00.000-05:00"
},
"policyRule" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code" : "OPTIN",
"display" : "opt-in"
}
]
}
}
],
"status" : "requested",
"intent" : "plan",
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/specialty-rx/CodeSystem/specialty-rx-task-characteristic",
"code" : "obtain-consent",
"display" : "Obtain Consent for Product Fulfillment"
}
],
"text" : "Obtain Consent for Product Fulfillment"
},
"description" : "Have patient, Amy Shaw, complete the attached consent form",
"for" : {
"reference" : "Patient/specialty-rx-patient-1",
"identifier" : {
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MR",
"display" : "Medical Record Number"
}
],
"text" : "Medical Record Number"
},
"system" : "https://specialty-fhir.azurewebsites.net/responder/dynamic/fhir",
"value" : "P100001"
},
"display" : "Amy Shaw"
},
"authoredOn" : "2022-05-05",
"requester" : {
"identifier" : {
"use" : "official",
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "5026456111"
},
"display" : "Bryant Avenue Pharmacy"
},
"owner" : {
"reference" : "Practitioner/specialty-rx-practitioner-1",
"identifier" : {
"use" : "official",
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "1111111111"
},
"display" : "Melissa Jenkins, MD"
},
"input" : [
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/specialty-rx/CodeSystem/specialty-rx-task-characteristic",
"code" : "consent-form-reference",
"display" : "Consent Form Reference"
}
],
"text" : "Consent Form Reference"
},
"valueReference" : {
"reference" : "#consent-request",
"type" : "Consent",
"display" : "Xamproxitelopeldoleodl Patient Consent Form"
}
}
]
}
IG © 2021+ HL7 International - Pharmacy. Package hl7.fhir.us.specialty-rx#2.0.0 based on FHIR 4.0.1. Generated 2023-05-04
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