HL7.FHIR.US.VRDR\DeathCertificateDocument-Example1

This page is part of the Vital Records Mortality and Morbidity Reporting FHIR IG (v2.0.0: STU 2) 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

Example Bundle: DeathCertificateDocument-Example1

Generated Narrative: Composition

Resource Composition "DeathCertificate-Example1"

Profile: Death Certificate

Filing Format: Electronic (Filing Formats CodeSystem#electronic)

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

State Specific Field: State Specific Content

status: FINAL

type: Death certificate (LOINC#64297-5)

date: 2020-11-15 04:39:54-0500

author: Practitioner/Certifier-Example1 " BLACK"

title: Death Certificate

Attesters

Mode

Time

Party

Legal (CompositionAttestationMode#legal)

2020-11-14 04:39:40-0500

Practitioner/Certifier-Example1 " BLACK"

Events

Code

Detail

Diagnostic procedure (SNOMED CT#103693007)

Procedure/DeathCertification-Example1

Decedent Demographics

Death Investigation

Death Certification

Decedent Disposition

Location/DispositionLocation-Example1 "Rosewood Cemetary"
Organization/FuneralHome-Example1 "Lancaster Funeral Home and Crematory"
Observation/DecedentDispositionMethod-Example1
Practitioner/Mortician-Example1 " SMITH"

Additional Document Content

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

Madelyn Patel (OFFICIAL) Female, DoB: ( Social Beneficiary Identifier: 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: Patient/Decedent-Example1 " PATEL"
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: Patient/Decedent-Example1 " PATEL"
relationship: mother (RoleCode#MTH)
name: Decedent Mom(MAIDEN)

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: Patient/Decedent-Example1 " PATEL"
relationship: spouse (RoleCode#SPS)
name: Decedent Spouse(MAIDEN)

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 at death (LOINC#39016-1)
subject: Patient/Decedent-Example1 " PATEL"
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: Input Race and Ethnicity
status: FINAL
code: Race and Ethnicity Data submitted by Jurisdictions to NCHS (Local Observation Codes#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: OtherAsian (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
status: FINAL
code: Birth registry number (identifierType#BR)
subject: Patient/Decedent-Example1 " PATEL"
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: Patient/Decedent-Example1 " PATEL"
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 Narrative (LOINC#55280-2)
subject: Patient/Decedent-Example1 " PATEL"
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: Decedent Usual Work
status: FINAL
code: History of Usual occupation (LOINC#21843-8)
subject: Patient/Decedent-Example1 " PATEL"
value: secretary ()
Components
- Code Value[x]
* History 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: Emerging Issues
status: FINAL
code: Emerging Issues (Local Observation Codes#emergingissues)
subject: Patient/Decedent-Example1 " PATEL"
Components
- Code Value[x]
* EmergingIssue1_1 (Local Component Codes#EmergingIssue1_1) H

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

Generated Narrative: Observation
Resource Observation "DecedentPregnancyStatus-Example1"
Profile: Decedent Pregnancy Status
status: FINAL
code: Timing of recent pregnancy in relation to death (LOINC#69442-2)
subject: Patient/Decedent-Example1 " PATEL"
value: Pregnant at time of death (Pregnancy Status Codes#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: Patient/Decedent-Example1 " PATEL"
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: Death Date
status: FINAL
code: Date and time of death [TimeStamp] (LOINC#81956-5)
subject: Patient/Decedent-Example1 " PATEL"
effective: 2020-11-12 04:39:40-0500
performer: Practitioner/Certifier-Example1 " BLACK"
value:
component
code: Date and time pronounced dead [US Standard Certificate of Death] (LOINC#80616-6)
value: 2020-11-13 04:39:40-0500
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 and time of surgery (LOINC#80992-1)
subject: Patient/Decedent-Example1 " PATEL"
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: Medical examiner or coroner was contacted [US Standard Certificate of Death] (LOINC#74497-9)
subject: Patient/Decedent-Example1 " PATEL"
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: Patient/Decedent-Example1 " PATEL"
performer: Practitioner/Certifier-Example1 " BLACK"
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 Code System#death)
address: Albany NY US
Positions
- Longitude Latitude
* -77.050636 38.889248

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 Code System#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: Injury Incident
status: FINAL
code: Injury incident description Narrative (LOINC#11374-6)
subject: Patient/Decedent-Example1 " PATEL"
effective: 2019-11-02 01:00:00-0500
value: drug toxicity ()
component
code: Did death result from injury at work (LOINC#69444-8)
value: No (v2 Y/N Indicator#N)
component
code: Place of injury Facility (LOINC#69450-5)
value: Home ()
component
code: Transportation role of decedent (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: Certifier
identifier: id: 414444AB
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: id: 180
status: COMPLETED
category: Diagnostic procedure (SNOMED CT#103693007)
code: Death certification (SNOMED CT#308646001)
subject: Patient/Decedent-Example1 " PATEL"
Performers
- Function Actor
* Nurse Practitioner (NullFlavor#OTH "Other") Practitioner/Certifier-Example1 " BLACK"

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: Patient/Decedent-Example1 " PATEL"
performer: Practitioner/Certifier-Example1 " BLACK"
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: Patient/Decedent-Example1 " PATEL"
performer: Practitioner/Certifier-Example1 " BLACK"
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: Patient/Decedent-Example1 " PATEL"
performer: Practitioner/Certifier-Example1 " BLACK"
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 Code System#disposition)
address: 303 Rosewood Ave Danville VA 24541 US
physicalType: Site (Location type#si)

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
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: Patient/Decedent-Example1 " PATEL"
performer: Practitioner/Mortician-Example1 " SMITH"
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 was performed (LOINC#85699-7)
subject: Patient/Decedent-Example1 " PATEL"
value: Yes (v2 Y/N Indicator#Y)
Components
- Code Value[x]
* Autopsy results available (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: US Core Practitioner Profile
identifier: id: 212222AB
name: Ronald Q Smith (OFFICIAL)

Notes:

Instance: DeathCertificateDocument-Example1
InstanceOf: DeathCertificateDocument
Title: "DeathCertificateDocument-Example1"
Description: "DeathCertificateDocument-Example1"
Usage: #example
* identifier.extension[0].url = "http://hl7.org/fhir/us/vrdr/StructureDefinition/CertificateNumber"
* identifier.extension[=].valueString = "000182"
* identifier.extension[+].url = "http://hl7.org/fhir/us/vrdr/StructureDefinition/AuxiliaryStateIdentifier1"
* identifier.extension[=].valueString = "000000000001"
* identifier.extension[+].url = "http://hl7.org/fhir/us/vrdr/StructureDefinition/AuxiliaryStateIdentifier2"
* identifier.extension[=].valueString = "100000000001"
* identifier.system = "http://nchs.cdc.gov/vrdr_id"
* identifier.value = "2020NY000182"
* type = #document
* timestamp = "2020-10-20T14:48:35.401641-04:00"
* entry[0].fullUrl = "http://www.example.org/fhir/Bundle/DeathCertificate-Example1"
* entry[=].resource = DeathCertificate-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Patient/Decedent-Example1"
* entry[=].resource = Decedent-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/RelatedPerson/DecedentFather-Example1"
* entry[=].resource = DecedentFather-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/RelatedPerson/DecedentMother-Example1"
* entry[=].resource = DecedentMother-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/RelatedPerson/DecedentSpouse-Example1"
* entry[=].resource = DecedentSpouse-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/DecedentAge-Example1"
* entry[=].resource = DecedentAge-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/InputRaceAndEthnicity-Example1"
* entry[=].resource = InputRaceAndEthnicity-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/BirthRecordIdentifier-Example1"
* entry[=].resource = BirthRecordIdentifier-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/DecedentEducationLevel-Example1"
* entry[=].resource = DecedentEducationLevel-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/DecedentMilitaryService-Example1"
* entry[=].resource = DecedentMilitaryService-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/DecedentUsualWork-Example1"
* entry[=].resource = DecedentUsualWork-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/EmergingIssues-Example1"
* entry[=].resource = EmergingIssues-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/DecedentPregnancyStatus-Example1"
* entry[=].resource = DecedentPregnancyStatus-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/TobaccoUseContributedToDeath-Example1"
* entry[=].resource = TobaccoUseContributedToDeath-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/DeathDate-Example1"
* entry[=].resource = DeathDate-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/SurgeryDate-Example1"
* entry[=].resource = SurgeryDate-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/ExaminerContacted-Example1"
* entry[=].resource = ExaminerContacted-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/MannerOfDeath-Example1"
* entry[=].resource = MannerOfDeath-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Location/DeathLocation-Example1"
* entry[=].resource = DeathLocation-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Location/InjuryLocation-Example1"
* entry[=].resource = InjuryLocation-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/InjuryIncident-Example1"
* entry[=].resource = InjuryIncident-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Practitioner/Certifier-Example1"
* entry[=].resource = Certifier-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Procedure/DeathCertification-Example1"
* entry[=].resource = DeathCertification-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/CauseOfDeathPart1-Example1"
* entry[=].resource = CauseOfDeathPart1-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/CauseOfDeathPart1-Example2"
* entry[=].resource = CauseOfDeathPart1-Example2
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/CauseOfDeathPart2-Example1"
* entry[=].resource = CauseOfDeathPart2-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Location/DispositionLocation-Example1"
* entry[=].resource = DispositionLocation-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Organization/FuneralHome-Example1"
* entry[=].resource = FuneralHome-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/DecedentDispositionMethod-Example1"
* entry[=].resource = DecedentDispositionMethod-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Observation/AutopsyPerformedIndicator-Example1"
* entry[=].resource = AutopsyPerformedIndicator-Example1
* entry[+].fullUrl = "http://www.example.org/fhir/Practitioner/Mortician-Example1"
* entry[=].resource = Mortician-Example1