This page is part of the CCDA: Consolidated CDA Release (v3.0.0-ballot: CCDA 3.0 Ballot 1) based on FHIR (HL7® FHIR® Standard) v5.0.0. . For a full list of available versions, see the Directory of published versions
This content is an example of the Advance Directive Observation Logical Model and is not a FHIR Resource
<observation classCode="OBS" moodCode="EVN" xmlns="urn:hl7-org:v3" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<!-- ** Advance Directive Observation** -->
<templateId root="2.16.840.1.113883.10.20.22.4.48"
extension="2022-02-14" />
<id root="9b54c3c9-1673-49c7-aef9-b037ed72ed27" />
<code code="75773-2"
displayName="Personal goals, preferences, and priorities for medical
treatment"
codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC">
<translation code="75320-2" displayName="Advance directive"
codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
</code>
<text><reference value="#HealthcareAgents"></reference></text>
<statusCode code="completed"/>
<effectiveTime>
<!-- The time at which the person named this individual to be his or her healthcare agent -->
<low value="20110219"/>
<high nullFlavor="NA"/>
</effectiveTime>
<value xsi:type="CD" code="405083000" displayName="Healthcare decision making"
codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT">
</value>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119" />
<time value="201308011235-0800" />
<assignedAuthor>
<!-- Refers to another author somewhere else in the document -->
<id root="20cf14fb-b65c-4c8c-a54d-b0cca834c18c" />
<addr use="H">
<streetAddressLine>23 Anywhere Street</streetAddressLine>
<city>El Paso</city>
<state>TX</state>
<postalCode>90210</postalCode>
<country>US</country>
</addr>
<telecom value="tel:(999)555-1212" use="WP" />
<assignedPerson>
<name>
<prefix>Mrs.</prefix>
<given>Martha</given>
<family>Jones</family>
</name>
</assignedPerson>
</assignedAuthor>
</author>
<informant typeCode="INF" contextControlCode="OP">
<assignedEntity>
<id root="20cf14fb-b65c-4c8c-a54d-b0cca834c18c" />
</assignedEntity>
</informant>
<participant typeCode="VRF">
<templateId root="2.16.840.1.113883.10.20.1.58" />
<time value="20130213" />
<participantRole>
<id root="20cf14fb-b65c-4c8c-a54d-b0cca834c18c" />
<code code="163W00000X"
codeSystem="2.16.840.1.113883.6.101"
codeSystemName="Health Care Provider Taxonomy (HIPAA)"
displayName="Registered nurse" />
<addr use="H">
<streetAddressLine>23 Anywhere Street</streetAddressLine>
<city>El Paso</city>
<state>TX</state>
<postalCode>90210</postalCode>
<country>US</country>
</addr>
<playingEntity>
<code code="63161005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED-CT" displayName="Principal" />
<name>
<given>Nurse</given>
<family>Florence</family>
<suffix>RN</suffix>
</name>
</playingEntity>
</participantRole>
</participant>
<participant typeCode="CST">
<templateId root="2.16.840.1.113883.10.20.1.58" />
<participantRole classCode="AGNT">
<code code="MTH" codeSystem="2.16.840.1.113883.5.111" displayName="Mother" />
<addr use="H">
<streetAddressLine>23 Anywhere Street</streetAddressLine>
<city>El Paso</city>
<state>TX</state>
<postalCode>90210</postalCode>
<country>US</country>
</addr>
<telecom value="tel:(999)555-1212" use="WP" />
<playingEntity>
<code code="63161005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED-CT" displayName="Principal" />
<name>
<prefix>Mrs.</prefix>
<given>Martha</given>
<family>Jones</family>
</name>
</playingEntity>
</participantRole>
</participant>
<reference typeCode="REFR">
<externalDocument>
<id root="b50b7910-7ffb-4f4c-bbe4-177ed68cbbf3" />
<text mediaType="application/pdf">
<reference value="AdvanceDirective.b50b7910-7ffb-4f4c-bbe4-177ed68cbbf3.pdf" />
</text>
<versionNumber value="1" />
</externalDocument>
</reference>
</observation>