Vital Records Death Reporting (VRDR) FHIR Implementation Guide
3.0.0-ballot - ballot United States of America flag

This page is part of the Vital Records Death Reporting FHIR Implementation Guide (v3.0.0-ballot: STU 3 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.2.0. For a full list of available versions, see the Directory of published versions

Example Bundle: DeathCertificateDocument-Example1

Generated Narrative: Composition

Resource Composition "DeathCertificate-Example1"

Profile: Death Certificate

Filing Format: Electronic (Filing Formats#electronic)

Replacement Status of a Death Record (deprecated): original record (Replacement Status of Death Record Submission CodeSystem#original)

State Specific Field: State Specific Content

status: FINAL

type: Death certificate (LOINC#64297-5)

date: 2020-11-15 16:39:54-0500

author: See on this page: Practitioner/Certifier-Example1

title: Death Certificate

Attesters

-ModeTimeParty
*Legal (CompositionAttestationMode#legal)2020-11-14 16:39:40-0500See on this page: Practitioner/Certifier-Example1

Events

-Detail
*Death certificate (record artifact) (SNOMED CT#307930005), Procedure/DeathCertification-Example1

Decedent Demographics

Death Investigation

Death Certification

Decedent Disposition

Additional Document Content

2. http://www.example.org/fhir/Patient/Decedent-Example1 (Patient/Decedent-Example1)

Anonymous Patient Female, DoB: ( Social Beneficiary Identifier: SSN#987654321)

3. http://www.example.org/fhir/RelatedPerson/DecedentFather-Example1 (RelatedPerson/DecedentFather-Example1)

Generated Narrative: RelatedPerson

Resource RelatedPerson "DecedentFather-Example1"

Profile: Decedent Father

active: true

patient: See on this page: Patient/Decedent-Example1

relationship: father (RoleCode#FTH)

name: Decedent Dad(Official)

4. http://www.example.org/fhir/RelatedPerson/DecedentMother-Example1 (RelatedPerson/DecedentMother-Example1)

Generated Narrative: RelatedPerson

Resource RelatedPerson "DecedentMother-Example1"

Profile: Decedent Mother

active: true

patient: See on this page: Patient/Decedent-Example1

relationship: mother (RoleCode#MTH)

name: Decedent Mom(Name changed for Marriage)

5. http://www.example.org/fhir/RelatedPerson/DecedentSpouse-Example1 (RelatedPerson/DecedentSpouse-Example1)

Generated Narrative: RelatedPerson

Resource RelatedPerson "DecedentSpouse-Example1"

Profile: Decedent Spouse

active: true

patient: See on this page: Patient/Decedent-Example1

relationship: spouse (RoleCode#SPS)

name: Decedent Spouse(Name changed for Marriage)

6. http://www.example.org/fhir/Observation/DecedentAge-Example1 (Observation/DecedentAge-Example1)

Generated Narrative: Observation

Resource Observation "DecedentAge-Example1"

Profile: Decedent Age

status: FINAL

code: Age @ Death Time Patient (LOINC#39016-1)

subject: See on this page: Patient/Decedent-Example1

value: 42 years (Details: UCUM code a = 'a')

7. http://www.example.org/fhir/Observation/InputRaceAndEthnicity-Example1 (Observation/InputRaceAndEthnicity-Example1)

Generated Narrative: Observation

Resource Observation "InputRaceAndEthnicity-Example1"

Profile: Observation - Input Race and Ethnicity Vital Records

status: FINAL

code: Race and Ethnicity Data submitted by Jurisdictions to NCHS (CodeSystem - Local Observation Codes Vital Records#inputraceandethnicity)

subject: : NCHS generated

component

code: White (Local Component Codes#White)

value: true

component

code: Black Or African American (Local Component Codes#BlackOrAfricanAmerican)

value: false

component

code: American Indian Or Alaska Native (Local Component Codes#AmericanIndianOrAlaskanNative)

value: true

component

code: Asian Indian (Local Component Codes#AsianIndian)

value: false

component

code: Chinese (Local Component Codes#Chinese)

value: false

component

code: Filipino (Local Component Codes#Filipino)

value: false

component

code: Japanese (Local Component Codes#Japanese)

value: false

component

code: Korean (Local Component Codes#Korean)

value: false

component

code: Vietnamese (Local Component Codes#Vietnamese)

value: false

component

code: Other Asian (Local Component Codes#OtherAsian)

value: true

component

code: Native Hawaiian (Local Component Codes#NativeHawaiian)

value: false

component

code: Guamanian Or Chamorro (Local Component Codes#GuamanianOrChamorro)

value: false

component

code: Samoan (Local Component Codes#Samoan)

value: false

component

code: Other Pacific Islander (Local Component Codes#OtherPacificIslander)

value: false

component

code: Other Race (Local Component Codes#OtherRace)

value: false

component

code: First Other Asian Literal (Local Component Codes#FirstOtherAsianLiteral)

value: Malaysian

component

code: First American Indian Or Alaska Native Literal (Local Component Codes#FirstAmericanIndianOrAlaskanNativeLiteral)

value: Arikara

component

code: Hispanic Mexican (Local Component Codes#HispanicMexican)

value: Yes (v2 Y/N Indicator#Y)

component

code: Hispanic Cuban (Local Component Codes#HispanicCuban)

value: Yes (v2 Y/N Indicator#Y)

component

code: Hispanic Puerto Rican (Local Component Codes#HispanicPuertoRican)

value: Yes (v2 Y/N Indicator#Y)

component

code: Hispanic Other (Local Component Codes#HispanicOther)

value: No (v2 Y/N Indicator#N)

8. http://www.example.org/fhir/Observation/BirthRecordIdentifier-Example1 (Observation/BirthRecordIdentifier-Example1)

Generated Narrative: Observation

Resource Observation "BirthRecordIdentifier-Example1"

Profile: Birth Record Identifier Infant

status: FINAL

code: Birth registry number (identifierType#BR)

subject: See on this page: Patient/Decedent-Example1

value: 717171

component

code: Birthplace (LOINC#21842-0)

value: YC

component

code: Birth year (LOINC#80904-6)

value: 1961

9. http://www.example.org/fhir/Observation/DecedentEducationLevel-Example1 (Observation/DecedentEducationLevel-Example1)

Generated Narrative: Observation

Resource Observation "DecedentEducationLevel-Example1"

Profile: Decedent Education Level

status: FINAL

code: Highest level of education [US Standard Certificate of Death] (LOINC#80913-7)

subject: See on this page: Patient/Decedent-Example1

value: Some secondary or high school education (Education Level#SEC)

10. http://www.example.org/fhir/Observation/DecedentMilitaryService-Example1 (Observation/DecedentMilitaryService-Example1)

Generated Narrative: Observation

Resource Observation "DecedentMilitaryService-Example1"

Profile: Decedent Military Service

status: FINAL

code: Military service (LOINC#55280-2)

subject: See on this page: Patient/Decedent-Example1

value: Yes (v2 Y/N Indicator#Y)

11. http://www.example.org/fhir/Observation/DecedentUsualWork-Example1 (Observation/DecedentUsualWork-Example1)

Generated Narrative: Observation

Resource Observation "DecedentUsualWork-Example1"

Profile: Observation - Usual Work

status: FINAL

code: Hx of Usual occupation (LOINC#21843-8)

subject: See on this page: Patient/Decedent-Example1

value: secretary ()

Components

-CodeValue[x]
*Hx of Usual industry (LOINC#21844-6)State agency ()

12. http://www.example.org/fhir/Observation/EmergingIssues-Example1 (Observation/EmergingIssues-Example1)

Generated Narrative: Observation

Resource Observation "EmergingIssues-Example1"

Profile: Observation - Emerging Issues Vital Records

status: FINAL

code: Emerging Issues (CodeSystem - Local Observation Codes Vital Records#emergingissues)

subject: See on this page: Patient/Decedent-Example1

component

code: EmergingIssue1_1 (Local Component Codes#EmergingIssue1_1)

value: H

component

code: EmergingIssue1_2 (Local Component Codes#EmergingIssue1_2)

value: I

component

code: EmergingIssue8_1 (Local Component Codes#EmergingIssue8_1)

value: Hi 8_1

component

code: EmergingIssue20 (Local Component Codes#EmergingIssue20)

value: Hi 20_1

13. http://www.example.org/fhir/Observation/DecedentPregnancyStatus-Example1 (Observation/DecedentPregnancyStatus-Example1)

Generated Narrative: Observation

Resource Observation "DecedentPregnancyStatus-Example1"

Profile: Observation - Decedent Pregnancy

status: FINAL

code: Timing of recent pregnancy in relation to death (LOINC#69442-2)

subject: See on this page: Patient/Decedent-Example1

value: Pregnant at time of death (Death Pregnancy Status Codesystem#2)

14. http://www.example.org/fhir/Observation/TobaccoUseContributedToDeath-Example1 (Observation/TobaccoUseContributedToDeath-Example1)

Generated Narrative: Observation

Resource Observation "TobaccoUseContributedToDeath-Example1"

Profile: Tobacco Use Contributed To Death

status: FINAL

code: Did tobacco use contribute to death (LOINC#69443-0)

subject: See on this page: Patient/Decedent-Example1

value: Yes (SNOMED CT#373066001)

15. http://www.example.org/fhir/Observation/DeathDate-Example1 (Observation/DeathDate-Example1)

Generated Narrative: Observation

Resource Observation "DeathDate-Example1"

Profile: Observation - Death Date

status: FINAL

code: Date+time of death (LOINC#81956-5)

subject: See on this page: Patient/Decedent-Example1

effective: 2020-11-12 16:39:40-0500

performer: See on this page: Practitioner/Certifier-Example1

value: ??

component

code: Date and time pronounced dead [US Standard Certificate of Death] (LOINC#80616-6)

value: 2020-11-13 16:39:40-0500

component

code: Location of death (LOINC#58332-8)

value: Death in hospital (SNOMED CT#16983000)

16. http://www.example.org/fhir/Observation/SurgeryDate-Example1 (Observation/SurgeryDate-Example1)

Generated Narrative: Observation

Resource Observation "SurgeryDate-Example1"

Profile: Surgery Date

status: FINAL

code: Date+time of surgery (LOINC#80992-1)

subject: See on this page: Patient/Decedent-Example1

effective: 2019-11-12

17. http://www.example.org/fhir/Observation/ExaminerContacted-Example1 (Observation/ExaminerContacted-Example1)

Generated Narrative: Observation

Resource Observation "ExaminerContacted-Example1"

Profile: Examiner Contacted

status: FINAL

code: Was the medical examiner or coroner contacted? (LOINC#74497-9)

subject: See on this page: Patient/Decedent-Example1

value: Yes (v2 Y/N Indicator#Y)

18. http://www.example.org/fhir/Observation/MannerOfDeath-Example1 (Observation/MannerOfDeath-Example1)

Generated Narrative: Observation

Resource Observation "MannerOfDeath-Example1"

Profile: Manner of Death

status: FINAL

code: Manner of death (LOINC#69449-7)

subject: See on this page: Patient/Decedent-Example1

performer: See on this page: Practitioner/Certifier-Example1

value: Natural death (SNOMED CT#38605008)

19. http://www.example.org/fhir/Location/DeathLocation-Example1 (Location/DeathLocation-Example1)

Generated Narrative: Location

Resource Location "DeathLocation-Example1"

Profile: Death Location

name: Pecan Grove Nursing Home

description: nursing home

type: Death Location (Location Type#death)

address: Albany NY US

Positions

-LongitudeLatitude
*-77.05063638.889248

20. http://www.example.org/fhir/Location/InjuryLocation-Example1 (Location/InjuryLocation-Example1)

Generated Narrative: Location

Resource Location "InjuryLocation-Example1"

Profile: Injury Location

name: Home

description: 5590 Lockwood Drive 20621 US

type: Injury Location (Location Type#injury)

address: 5590 Lockwood Drive 20621 US

21. http://www.example.org/fhir/Observation/InjuryIncident-Example1 (Observation/InjuryIncident-Example1)

Generated Narrative: Observation

Resource Observation "InjuryIncident-Example1"

Profile: Observation - Injury Incident

status: FINAL

code: Injury incident description (LOINC#11374-6)

subject: See on this page: Patient/Decedent-Example1

effective: 2019-11-02 13:00:00-0500

value: drug toxicity ()

component

code: Injury at work? (LOINC#69444-8)

value: No (v2 Y/N Indicator#N)

component

code: Place of injury (LOINC#69450-5)

value: Home ()

component

code: If transportation injury, specify: (LOINC#69451-3)

value: Hoverboard Rider (NullFlavor#OTH "Other")

22. http://www.example.org/fhir/Practitioner/Certifier-Example1 (Practitioner/Certifier-Example1)

Generated Narrative: Practitioner

Resource Practitioner "Certifier-Example1"

Profile: Death Certifier

Practitioner Role: Certifier

identifier: NPI/9941339100

name: Jim Black (Official)

address: 44 South Street Bird in Hand PA 17505 US

Qualifications

-Code
*Death certification and verification by physician (procedure) (SNOMED CT#434641000124105)

23. http://www.example.org/fhir/Procedure/DeathCertification-Example1 (Procedure/DeathCertification-Example1)

Generated Narrative: Procedure

Resource Procedure "DeathCertification-Example1"

Profile: Death Certification Procedure

identifier: 180

status: COMPLETED

code: Death certification (SNOMED CT#308646001)

subject: See on this page: Patient/Decedent-Example1

Performers

-FunctionActor
*Nurse Practitioner (NullFlavor#OTH "Other")See on this page: Practitioner/Certifier-Example1

24. http://www.example.org/fhir/Observation/CauseOfDeathPart1-Example1 (Observation/CauseOfDeathPart1-Example1)

Generated Narrative: Observation

Resource Observation "CauseOfDeathPart1-Example1"

Profile: Cause Of Death Part 1

status: FINAL

code: Cause of death [US Standard Certificate of Death] (LOINC#69453-9)

subject: See on this page: Patient/Decedent-Example1

performer: See on this page: Practitioner/Certifier-Example1

value: Cardiopulmonary arrest ()

component

code: line number (Local Component Codes#lineNumber)

value: 1

component

code: Disease onset to death interval (LOINC#69440-6)

value: 4 hours

25. http://www.example.org/fhir/Observation/CauseOfDeathPart1-Example2 (Observation/CauseOfDeathPart1-Example2)

Generated Narrative: Observation

Resource Observation "CauseOfDeathPart1-Example2"

Profile: Cause Of Death Part 1

status: FINAL

code: Cause of death [US Standard Certificate of Death] (LOINC#69453-9)

subject: See on this page: Patient/Decedent-Example1

performer: See on this page: Practitioner/Certifier-Example1

value: Eclampsia ()

component

code: line number (Local Component Codes#lineNumber)

value: 2

component

code: Disease onset to death interval (LOINC#69440-6)

value: 3 months

26. http://www.example.org/fhir/Observation/CauseOfDeathPart2-Example1 (Observation/CauseOfDeathPart2-Example1)

Generated Narrative: Observation

Resource Observation "CauseOfDeathPart2-Example1"

Profile: Cause of Death Part 2

status: FINAL

code: Other significant causes or conditions of death (LOINC#69441-4)

subject: See on this page: Patient/Decedent-Example1

performer: See on this page: Practitioner/Certifier-Example1

value: hypertensive heart disease ()

27. http://www.example.org/fhir/Location/DispositionLocation-Example1 (Location/DispositionLocation-Example1)

Generated Narrative: Location

Resource Location "DispositionLocation-Example1"

Profile: Disposition Location

name: Rosewood Cemetary

type: Disposition Location (Location Type#disposition)

address: 303 Rosewood Ave Danville VA 24541 US

28. http://www.example.org/fhir/Organization/FuneralHome-Example1 (Organization/FuneralHome-Example1)

Generated Narrative: Organization

Resource Organization "FuneralHome-Example1"

Profile: Funeral Home

active: true

type: Funeral Home (Local Organization Type#funeralhome)

name: Lancaster Funeral Home and Crematory

Contacts

-Address
*211 High Street Lancaster PA 17573 US

29. http://www.example.org/fhir/Observation/DecedentDispositionMethod-Example1 (Observation/DecedentDispositionMethod-Example1)

Generated Narrative: Observation

Resource Observation "DecedentDispositionMethod-Example1"

Profile: Decedent Disposition Method

status: FINAL

code: Body disposition method (LOINC#80905-3)

subject: See on this page: Patient/Decedent-Example1

performer: See on this page: Practitioner/Mortician-Example1

value: Burial (SNOMED CT#449971000124106)

30. http://www.example.org/fhir/Observation/AutopsyPerformedIndicator-Example1 (Observation/AutopsyPerformedIndicator-Example1)

Generated Narrative: Observation

Resource Observation "AutopsyPerformedIndicator-Example1"

Profile: Autopsy Performed Indicator

status: FINAL

code: Autopsy performed (LOINC#85699-7)

subject: See on this page: Patient/Decedent-Example1

value: Yes (v2 Y/N Indicator#Y)

Components

-CodeValue[x]
*Were autopsy findings available to complete the cause of death? (LOINC#69436-4)Yes (v2 Y/N Indicator#Y)

31. http://www.example.org/fhir/Practitioner/Mortician-Example1 (Practitioner/Mortician-Example1)

Generated Narrative: Practitioner

Resource Practitioner "Mortician-Example1"

Profile: Mortician

Practitioner Role: Mortician

identifier: NPI/212222AB

name: Ronald Q Smith (Official)