Vital Records Death Reporting (VRDR) FHIR Implementation Guide
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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-UT-1


Generated Narrative: Composition

Resource Composition "DeathCertificateUT-Example1"

Profile: Death Certificate

Filing Format: Electronic (Filing Formats#electronic)

State Specific Field: 20220101

status: FINAL

type: Death certificate (LOINC#64297-5)

date: 2022-12-01 02:46:13-0500

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

title: Death Certificate for Davis Lineberry Jr

Attesters

-ModeParty
*Legal (CompositionAttestationMode#legal)See on this page: Practitioner/PractitionerUT-Example1

Events

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

Decedent Demographics

Death Certification

Death Investigation

Decedent Disposition


Additional Document Content


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

Anonymous Patient Male, DoB: 2021-03-04 ( Social Security number: SSN#429471420)


3. http://www.example.org/fhir/Procedure/ProcedureDeathCertificationUT-Example1 (Procedure/ProcedureDeathCertificationUT-Example1)

Generated Narrative: Procedure

Resource Procedure "ProcedureDeathCertificationUT-Example1"

Profile: Death Certification Procedure

identifier: 161632-1999

status: COMPLETED

code: Death certification (SNOMED CT#308646001)

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

Performers

-FunctionActor
*Death certification and verification by physician (procedure) (SNOMED CT#434641000124105)See on this page: Practitioner/PractitionerUT-Example1


4. http://www.example.org/fhir/Practitioner/PractitionerUT-Example1 (Practitioner/PractitionerUT-Example1)

Generated Narrative: Practitioner

Resource Practitioner "PractitionerUT-Example1"

Profile: Practitioner - Vital Records

identifier: NPI/161632-1999

name: The Scooby Doo (Official)

address: 123 Fake St apt # 123 Salt Lake UT 84111 US (work)


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

Generated Narrative: RelatedPerson

Resource RelatedPerson "MotherUT-Example1"

Profile: Decedent Mother

active: true

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

relationship: mother (RoleCode#MTH)

name: * * * (Official)


6. http://www.example.org/fhir/RelatedPerson/FatherUT-Example1 (RelatedPerson/FatherUT-Example1)

Generated Narrative: RelatedPerson

Resource RelatedPerson "FatherUT-Example1"

Profile: Decedent Father

active: true

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

relationship: father (RoleCode#FTH)

name: * * Lineberry (Official)


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

Generated Narrative: Observation

Resource Observation "InputRaceAndEthnicityUT-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: See on this page: Patient/DecedentUT-Example1

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

value: Cheyenne

component

code: Chinese (Local Component Codes#Chinese)

value: false

component

code: Japanese (Local Component Codes#Japanese)

value: false

component

code: Native Hawaiian (Local Component Codes#NativeHawaiian)

value: false

component

code: Filipino (Local Component Codes#Filipino)

value: false

component

code: Other Asian (Local Component Codes#OtherAsian)

value: false

component

code: Asian Indian (Local Component Codes#AsianIndian)

value: false

component

code: Korean (Local Component Codes#Korean)

value: false

component

code: Samoan (Local Component Codes#Samoan)

value: false

component

code: Vietnamese (Local Component Codes#Vietnamese)

value: false

component

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

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: Hispanic Mexican (Local Component Codes#HispanicMexican)

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

component

code: Hispanic Cuban (Local Component Codes#HispanicCuban)

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

component

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

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

component

code: Hispanic Other (Local Component Codes#HispanicOther)

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


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

Generated Narrative: Observation

Resource Observation "BirthRecordIdentifierUT-Example1"

Profile: Birth Record Identifier Infant

status: FINAL

code: Birth registry number (identifierType#BR)

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

value: 001023

component

code: Birthplace (LOINC#21842-0)

value: CO

component

code: Birth year (LOINC#80904-6)

value: 2021


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

Generated Narrative: Observation

Resource Observation "EducationUT-Example1"

Profile: Observation - Education Level Vital Records

status: FINAL

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

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

value: Elementary School (Education Level#ELEM)


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

Generated Narrative: Observation

Resource Observation "PregnancyUT-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/DecedentUT-Example1

value: Not applicable (NullFlavor#NA)


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

Generated Narrative: Observation

Resource Observation "AutopsyPerformedIndicatorUT-Example1"

Profile: Autopsy Performed Indicator

status: FINAL

code: Autopsy performed (LOINC#85699-7)

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

value: Unknown (NullFlavor#UNK)

Components

-CodeValue[x]
*Were autopsy findings available to complete the cause of death? (LOINC#69436-4)Unknown (NullFlavor#UNK)


12. http://www.example.org/fhir/Observation/CauseOfDeathPart1UT-Example1 (Observation/CauseOfDeathPart1UT-Example1)

Generated Narrative: Observation

Resource Observation "CauseOfDeathPart1UT-Example1"

Profile: Cause Of Death Part 1

status: PRELIMINARY

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

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

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

value: Pending ()

component

code: line number (Local Component Codes#lineNumber)

value: 1

component

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

value: Pending


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

Generated Narrative: Observation

Resource Observation "DeathDateUT-Example1"

Profile: Observation - Death Date

status: FINAL

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

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

effective: 2022-01-17 20:23:00-0500

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

value: ??

Components

-CodeValue[x]
*Location of death (LOINC#58332-8)Death in hospital (SNOMED CT#16983000)


14. http://www.example.org/fhir/Organization/FuneralHomeUT-Example1 (Organization/FuneralHomeUT-Example1)

Generated Narrative: Organization

Resource Organization "FuneralHomeUT-Example1"

Profile: Funeral Home

active: true

type: Funeral Home (Local Organization Type#funeralhome)

name: Colonial Memorial Mortuary

Contacts

-Address
*2128 South State Salt Lake City UT 84115 US


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

Generated Narrative: Observation

Resource Observation "MannerOfDeathUT-Example1"

Profile: Manner of Death

status: FINAL

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

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

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

value: Patient awaiting investigation (SNOMED CT#185973002)


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

Generated Narrative: Observation

Resource Observation "TobaccoUseUT-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/DecedentUT-Example1

value: No (SNOMED CT#373067005)


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

Generated Narrative: Observation

Resource Observation "InjuryIncidentUT-Example1"

Profile: Observation - Injury Incident

status: FINAL

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

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

Components

-CodeValue[x]
*Injury at work? (LOINC#69444-8)Unknown (NullFlavor#UNK)


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

Generated Narrative: Observation

Resource Observation "EmergingIssuesUT-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/DecedentUT-Example1

Components

-CodeValue[x]
*EmergingIssue20 (Local Component Codes#EmergingIssue20)043-A-110234


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

Generated Narrative: Location

Resource Location "DeathLocationUT-Example1"

Profile: Death Location

name: Salt Lake Regional Medical Cen

description: Facility

type: Death Location (Location Type#death)

address: Salt Lake City UT


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

Generated Narrative: Location

Resource Location "DispositionLocationUT-Example1"

Profile: Disposition Location

name: Salt Lake City Cemetery

type: Disposition Location (Location Type#disposition)

address: Salt Lake City UT US


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

Generated Narrative: Observation

Resource Observation "MilitaryServiceUT-Example1"

Profile: Decedent Military Service

status: FINAL

code: Military service (LOINC#55280-2)

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

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


22. http://www.example.org/fhir/Observation/AgeUT-Example1 (Observation/AgeUT-Example1)

Generated Narrative: Observation

Resource Observation "AgeUT-Example1"

Profile: Decedent Age

status: FINAL

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

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

value: 10 Months (Details: UCUM code mo = 'mo')


23. http://www.example.org/fhir/Observation/UsualWorkUT-Example1 (Observation/UsualWorkUT-Example1)

Generated Narrative: Observation

Resource Observation "UsualWorkUT-Example1"

Profile: Observation - Usual Work

status: FINAL

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

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

value: Infant ()

Components

-CodeValue[x]
*Hx of Usual industry (LOINC#21844-6)Never Worked ()


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

Generated Narrative: Observation

Resource Observation "DispositionMethodUT-Example1"

Profile: Decedent Disposition Method

status: FINAL

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

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

value: Burial (SNOMED CT#449971000124106)