R4 Ballot #1 (Mixed Normative/Trial use)
This page is part of the FHIR Specification (v3.3.0: R4 Ballot 2). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3
Contract-example-42cfr-part2.xml

Financial Management Work Group
Maturity Level: N/A
Ballot Status: Informative
Compartments: Not linked to any defined compartments
Raw XML (canonical form)
Jump past Narrative
42 CFR Part 2 Consent Directive (id = "C-2121")
<Contract xmlns="http://hl7.org/fhir">
  <id value="C-2121"/> 
  <meta> 
    <versionId value="1"/> 
    <lastUpdated value="2016-07-19T18:18:42.108-04:00"/> 
  </meta> 

  <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative with Details</b> </p> <p> <b> id</b> : C-2121</p> <p> <b> meta</b> : </p> <p> <b> status</b> : executed</p> <p> <b> contentDerivative</b> : Content Registration <span> (Details : {http://hl7.org/fhir/contract-content-derivative code 'registration' = 'Content
           Registration)</span> </p> <p> <b> issued</b> : 01/11/2013 9:18:27 PM</p> <p> <b> applies</b> : 01/11/2013 9:18:27 PM --&gt; (ongoing)</p> <p> <b> subject</b> : <a> Patient/f201</a> </p> <p> <b> type</b> : Opt-in consent directive <span> (Details : {http://org.mdhhs.fhir.consentdirective-type code 'OPTIN' = 'OPTIN)</span> </p> <p> <b> subType</b> : Health Care Directive <span> (Details : {http://hl7.org/fhir/consentcategorycodes code 'hcd' = 'Health Care Directive)</span> </p> <blockquote> <p> <b> term</b> </p> <h3> Offers</h3> <table> <tr> <td> -</td> <td> <b> Type</b> </td> <td> <b> Decision</b> </td> <td> <b> Text</b> </td> </tr> <tr> <td> *</td> <td> statutory <span> (Details : {http://hl7.org/fhir/contract-term-type code 'statutory' = 'statutory)</span> </td> <td> opt-in <span> (Details : {http://hl7.org/fhir/v3/ActCode code 'OPTIN' = 'opt-in)</span> </td> <td> Can't refuse</td> </tr> </table> <blockquote> <p> <b> asset</b> </p> <p> <b> dataPeriod</b> : 01/11/2013 9:18:27 PM --&gt; 01/11/2019 9:18:27 PM</p> <h3> Data</h3> <table> <tr> <td> -</td> <td> <b> Meaning</b> </td> <td> <b> Reference</b> </td> </tr> <tr> <td> *</td> <td> instance</td> <td> Some data</td> </tr> </table> <p> <b> securityLabel</b> : Restricted (Details: http://hl7.org/fhir/v3/Confidentiality code R = 'restricted', stated
             as 'Restricted'), substance abuse information sensitivity (Details: http://hl7.org/fhir/v3/ActCode
             code ETH = 'substance abuse information sensitivity', stated as 'substance abuse information
             sensitivity'), 42 CFR Part2 (Details: http://hl7.org/fhir/v3/ActCode code 42CFRPart2 =
             '42 CFR Part2', stated as 'null'), treatment (Details: http://hl7.org/fhir/v3/ActReason
             code TREAT = 'treatment', stated as 'treatment'), healthcare payment (Details: http://hl7.org/fhir/v
            3/ActReason code HPAYMT = 'healthcare payment', stated as 'healthcare payment'), healthcare
             operations (Details: http://hl7.org/fhir/v3/ActReason code HOPERAT = 'healthcare operations',
             stated as 'healthcare operations'), persist security label (Details: http://hl7.org/fhir/v3/ActCode
             code PERSISTLABEL = 'persist security label', stated as 'persist security label'), privacy
             mark (Details: http://hl7.org/fhir/v3/ActCode code PRIVMARK = 'privacy mark', stated as
             'privacy mark'), no redisclosure without consent directive (Details: http://hl7.org/fhir/v3/ActCode
             code NORDSCLCD = 'no redisclosure without consent directive', stated as 'no redisclosure
             without consent directive')</p> </blockquote> <blockquote> <p> <b> agent</b> </p> <p> <b> actor</b> : <a> VA Ann Arbor Healthcare System</a> </p> <p> <b> role</b> : Recipient of restricted health information <span> (Details : {http://org.mdhhs.fhir.consent-actor-type code 'IR' = 'IR', given as 'Recipient'})</span> </p> </blockquote> <blockquote> <p> <b> agent</b> </p> <p> <b> actor</b> : <a> Community Mental Health Clinic</a> </p> <p> <b> role</b> : Sender of restricted health information <span> (Details : {http://org.mdhhs.fhir.consent-actor-type code 'IS' = 'IS', given as 'Sender'})</span> </p> </blockquote> <p> <b> action</b> : Action A <span> (Details : {http://www.hl7.org/fhir/contractaction code 'action-a' = 'Action A)</span> </p> <p> <b> actionReason</b> : health program reporting <span> (Details : {http://hl7.org/fhir/v3/ActReason code 'HPRGRP' = 'health program reporting)</span> </p> </blockquote> <h3> Signers</h3> <table> <tr> <td> -</td> <td> <b> Type</b> </td> <td> <b> Party</b> </td> <td> <b> Signature</b> </td> </tr> <tr> <td> *</td> <td> SELF (Details: http://org.mdhhs.fhir.consent-signer-type code SELF = 'SELF', stated as
             'null')</td> <td> <a> Alice Recruit</a> </td> <td/>  </tr> </table> <h3> Legals</h3> <table> <tr> <td> -</td> <td> <b> Content[x]</b> </td> </tr> <tr> <td> *</td> <td/>  </tr> </table> </div> </text> <status value="executed"/> 

  <contentDerivative> 
    <coding> 
      <system value="http://hl7.org/fhir/contract-content-derivative"/> 
      <code value="registration"/> 
    </coding> 
  </contentDerivative> 

  <issued value="2013-11-01T21:18:27-04:00"/> 

  <applies> 
    <start value="2013-11-01T21:18:27-04:00"/> 
  </applies> 

  <subject> 
    <reference value="Patient/f201"/> 
  </subject> 

  <type> 
    <coding> 
      <system value="http://org.mdhhs.fhir.consentdirective-type"/> 
      <code value="OPTIN"/> 
    </coding> 
    <text value="Opt-in consent directive"/> 
  </type> 
  <subType> 
    <coding> 
      <system value="http://hl7.org/fhir/consentcategorycodes"/> 
      <code value="hcd"/> 
<!--         <code value="MDHHS-5515"/>
      <display
        value="Michigan MDHHS-5515 Consent to Share Behavioral Health Information for
       Care Coordination Purposes"
      />    -->
    </coding> 
  </subType> 

  <term> 
    <offer> 
      <type> 
        <coding> 
          <system value="http://hl7.org/fhir/contract-term-type"/> 
          <code value="statutory"/> 
        </coding> 
      </type> 
      <decision> 
        <coding> 
          <system value="http://hl7.org/fhir/v3/ActCode"/> 
          <code value="OPTIN"/> 
        </coding> 
      </decision> 
      <text value="Can't refuse"/> 
    </offer> 
    
    <asset> 
      <dataPeriod> 
        <start value="2013-11-01T21:18:27-04:00"/> 
        <end value="2019-11-01T21:18:27-04:00"/> 
      </dataPeriod> 
      <data> 
        <meaning value="instance"/> 
        <reference> 
          <display value="Some data"/> 
        </reference> 
      </data> 
      <securityLabel> 
        <system value="http://hl7.org/fhir/v3/Confidentiality"/> 
        <code value="R"/> 
        <display value="Restricted"/> 
      </securityLabel> 
      <securityLabel> 
        <system value="http://hl7.org/fhir/v3/ActCode"/> 
        <code value="ETH"/> 
        <display value="substance abuse information sensitivity"/> 
      </securityLabel> 
      <securityLabel> 
        <system value="http://hl7.org/fhir/v3/ActCode"/> 
        <code value="42CFRPart2"/> 
      </securityLabel> 
      <securityLabel> 
        <system value="http://hl7.org/fhir/v3/ActReason"/> 
        <code value="TREAT"/> 
        <display value="treatment"/> 
      </securityLabel> 
      <securityLabel> 
        <system value="http://hl7.org/fhir/v3/ActReason"/> 
        <code value="HPAYMT"/> 
        <display value="healthcare payment"/> 
      </securityLabel> 
      <securityLabel> 
        <system value="http://hl7.org/fhir/v3/ActReason"/> 
        <code value="HOPERAT"/> 
        <display value="healthcare operations"/> 
      </securityLabel> 
      <securityLabel> 
        <system value="http://hl7.org/fhir/v3/ActCode"/> 
        <code value="PERSISTLABEL"/> 
        <display value="persist security label"/> 
      </securityLabel> 
      <securityLabel> 
        <system value="http://hl7.org/fhir/v3/ActCode"/> 
        <code value="PRIVMARK"/> 
        <display value="privacy mark"/> 
      </securityLabel> 
      <securityLabel> 
        <system value="http://hl7.org/fhir/v3/ActCode"/> 
        <code value="NORDSCLCD"/> 
        <display value="no redisclosure without consent directive"/> 
      </securityLabel> 
    </asset> 

    <agent> 
      <actor> 
        <reference value="Organization/f001"/> 
        <display value="VA Ann Arbor Healthcare System"/> 
      </actor> 
      <role> 
        <coding> 
          <system value="http://org.mdhhs.fhir.consent-actor-type"/> 
          <code value="IR"/> 
          <display value="Recipient"/> 
        </coding> 
        <text value="Recipient of restricted health information"/> 
      </role> 
    </agent> 
    <agent> 
      <actor> 
        <reference value="Organization/2"/> 
        <display value="Community Mental Health Clinic"/> 
      </actor> 
      <role> 
        <coding> 
          <system value="http://org.mdhhs.fhir.consent-actor-type"/> 
          <code value="IS"/> 
          <display value="Sender"/> 
        </coding> 
        <text value="Sender of restricted health information"/> 
      </role> 
    </agent> 

    <action> 
      <coding> 
        <system value="http://www.hl7.org/fhir/contractaction"/> 
        <code value="action-a"/> 
      </coding> 
    </action> 
    
    <actionReason> 
      <coding> 
        <system value="http://hl7.org/fhir/v3/ActReason"/> 
        <code value="HPRGRP"/> 
      </coding> 
    </actionReason> 

  </term> 

  <signer> 
    <type> 
      <system value="http://org.mdhhs.fhir.consent-signer-type"/> 
      <code value="SELF"/> 
    </type> 
    <party> 
      <reference value="Patient/f201"/> 
      <display value="Alice Recruit"/> 
    </party> 
    <signature> 
      <type> 
        <system value="urn:iso-astm:E1762-95:2013"/> 
        <code value="1.2.840.10065.1.12.1.1"/> 
      </type> 
      <when value="2017-02-08T10:57:34+01:00"/> 
      <whoReference> 
        <reference value="Patient/f201"/> 
      </whoReference> 
    </signature> 
  </signer> 

  <legal> 
    <contentAttachment> 
      <contentType value="application/pdf"/> 
      <language value="en-US"/> 
      <url value="http://org.mihin.ecms/ConsentDirective-2121"/> 
      <title value="MDHHS-5515 Consent To Share Your Health Information"/> 
    </contentAttachment> 
  </legal> 
</Contract>
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.