Specialty Medication Enrollment
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This page is part of the Specialty Medication Enrollment (v2.0.0: STU2) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: Specialty Rx Task - Consent Request 2 - Completed - JSON Representation

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{
  "resourceType" : "Task",
  "id" : "specialty-rx-task-consent-request-2-completed",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/us/specialty-rx/StructureDefinition/specialty-rx-task-consent-request"
    ]
  },
  "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-2-completed\"> </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 &quot;specialty-rx-task-consent-request-2-completed&quot; </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>: completed</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 the patient complete the attached consent form and capture a PDF of the signed form in a Consent</p><p><b>for</b>: <a href=\"Patient-specialty-rx-patient-1.html\">Patient/specialty-rx-patient-1</a> &quot; DOE&quot;</p><p><b>authoredOn</b>: 2021-12-08</p><p><b>requester</b>: <span>: Our Pharmacy</span></p><p><b>owner</b>: <span>: Jane Smith MD</span></p><p><b>reasonReference</b>: <span>: Humira Injector Pen - 2020-03-10</span></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 href=\"Consent-specialty-rx-consent-requested-1.html\">Consent/specialty-rx-consent-requested-1: Consent form to be completed</a></td></tr></table><h3>Outputs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Completed and signed consent form <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>#completed-consent-reference)</span></td><td><a href=\"Consent-specialty-rx-consent-1.html\">Consent/specialty-rx-consent-1</a></td></tr></table></div>"
  },
  "status" : "completed",
  "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"
      }
    ]
  },
  "description" : "Have the patient complete the attached consent form and capture a PDF of the signed form in a Consent",
  "for" : {
    "reference" : "Patient/specialty-rx-patient-1"
  },
  "authoredOn" : "2021-12-08",
  "requester" : {
    "identifier" : {
      "system" : "http://terminology.hl7.org/CodeSystem/NCPDPProviderIdentificationNumber",
      "value" : "0999017"
    },
    "display" : "Our Pharmacy"
  },
  "owner" : {
    "identifier" : {
      "system" : "http://hl7.org/fhir/sid/us-npi",
      "value" : "9941339108"
    },
    "display" : "Jane Smith MD"
  },
  "reasonReference" : {
    "identifier" : {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "PLAC",
            "display" : "Placer Identifier"
          }
        ]
      },
      "value" : "prescription-70222056"
    },
    "display" : "Humira Injector Pen - 2020-03-10"
  },
  "input" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/specialty-rx/CodeSystem/specialty-rx-task-characteristic",
            "code" : "consent-form-reference",
            "display" : "Consent Form Reference"
          }
        ]
      },
      "valueReference" : {
        "reference" : "Consent/specialty-rx-consent-requested-1",
        "type" : "Consent",
        "display" : "Consent form to be completed"
      }
    }
  ],
  "output" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/specialty-rx/CodeSystem/specialty-rx-task-characteristic",
            "code" : "completed-consent-reference"
          }
        ],
        "text" : "Completed and signed consent form"
      },
      "valueReference" : {
        "reference" : "Consent/specialty-rx-consent-1",
        "type" : "Consent"
      }
    }
  ]
}