FHIR Release 3 (STU)
AdministrationThis page is part of the FHIR Specification (v3.0.2: STU 3). 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 R2
| Patient Administration Work Group | Maturity Level: 5 | Trial Use | Compartments: Patient, Practitioner, RelatedPerson |
This resource has 2 operations associated with it:
| $match | Find patient matches using MPI based logic |
| $everything | Fetch Patient Record |
For more information about operations, including how they are invoked, see Operations.
A Master Patient Index (MPI ) is a service used to manage patient identification in a context where multiple patient databases exist. Healthcare applications and middleware use the MPI to match patients between the databases, and as new patient details are encountered. MPIs are highly specialized applications, often tailored extensively to the institution's particular mix of patients. MPIs can also be run on a regional and national basis.\n\nTo ask an MPI to match a patient, clients use the \"$match\" operation, which accepts a patient resource which may be only partially complete. The data provided is interpreted as an MPI input and passed processed by an algorithm of some kind that uses the data to determine the most appropriate matches in the patient set. \n\nNote that different MPI matching algorithms have different required inputs. The generic $match operation does not specify any particular algorithm, nor a minimum set of information that must be provided when asking for an MPI match operation to be performed, but may implementations will have a set of minimum information, which may be declared in their definition of the $match operation by specifying a profile on the resource parameter, indicating which properties are required in the search.\n\nThe patient resource coming into the operation does not have to be complete, nor does it need to pass validation (i.e. Mandatory fields don't need to be populated), but it does have to be a valid instance. This is due to the resource being used for reference data to match from, and not being stored.
The official URL for this operation definition is
http://hl7.org/fhir/OperationDefinition/Patient-match
Formal Definition (as a OperationDefinition).
URL: [base]/Patient/$match
This is an idempotent operation
| In Parameters: | |||||
| Name | Cardinality | Type | Binding | Profile | Documentation |
| resource | 1..1 | Resource | Use this to provide an entire set of patient details for the MPI to match against (e.g. POST a patient record to Patient/$match). If a patient record is not provided, then one or more of the other parameters must be provided | ||
| onlyCertainMatches | 0..1 | boolean | If there are multiple potential matches, then the match should not return the results with this flag set to true. When false, the server may return multiple results with each result graded accordingly. | ||
| count | 0..1 | integer | The maximum number of records to return. If no value is provided, the server decides how many matches to return. Note that clients should be careful when using this, as it may prevent probable - and valid - matches from being returned | ||
| Out Parameters: | |||||
| Name | Cardinality | Type | Binding | Profile | Documentation |
| return | 1..1 | Bundle | A bundle contain a set of Patient records that represent possible matches, optionally it may also contain an OperationOutcome with further information about the search results (such as warnings or information messages, such as a count of records that were close but eliminated) If the operation was unsuccessful, then an OperationOutcome may be returned along with a BadRequest status Code (e.g. security issue, or insufficient properties in patient fragment - check against profile) Note: as this the only out parameter, it is a resource, and it has the name 'return', the result of this operation is returned directly as a resource | ||
The response from an "mpi" query is a bundle containing patient records, ordered from most likely to least likely. If there are no patient matches, the MPI SHALL return an empty search set with no error, but may include an operation outcome with further advice regarding patient selection. All patient records SHALL have a search score from 0 to 1, where 1 is the most certain match, along with an extension "match-grade" that indicates the MPI's position on the match quality.
Patient match using patient resource: (Request):
POST /open/Patient/$match
[some headers]
{
"resourceType": "Parameters",
"id": "example",
"parameter": [
{
"name": "resource",
"resource": {
"resourceType": "Patient",
"identifier": [
{
"use": "usual",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/v2/0203",
"code": "MR"
}
]
},
"system": "urn:oid:1.2.36.146.595.217.0.1",
"value": "12345"
}
],
"name": [
{
"family": [
"Chalmers"
],
"given": [
"Peter"
]
}
],
"gender": "male",
"birthDate": "1974-12-25"
}
},
{
"name": "count",
"valueInteger": "3"
},
{
"name": "onlyCertainMatches",
"valueBoolean": "false"
}
]
}
Results from imaginary MPI algorithm (Response):
HTTP/1.1 200 OK
[other headers]
{
"resourceType": "Bundle",
"id": "26419249-18b3-45de-b10e-dca0b2e72b",
"meta": {
"lastUpdated": "2016-03-18T03:28:49Z"
},
"type": "searchset",
"total": 2,
"entry": [{
"fullUrl": "http://server/path/Patient/example",
"resource": {
"resourceType": "Patient",
"id": "example",
.. snip ...
},
"search": {
"extension": [{
"url": "http://hl7.org/fhir/StructureDefinition/match-grade",
"valueCode": "certain"
}],
"mode": "match",
"score": 0.9
}
},{
"fullUrl": "http://server/path/Patient/292",
"resource": {
"resourceType": "Patient",
"id": "292",
.. snip ...
},
"search": {
"extension": [{
"url": "http://hl7.org/fhir/StructureDefinition/match-grade",
"valueCode": "possible"
}],
"mode": "match",
"score": 0.2
}
}]
}
This operation is used to return all the information related to the patient described in the resource on which this operation is invoked. The response is a bundle of type "searchset". At a minimum, the patient resource itself is returned, along with any other resources that the server has that are related to the patient, and that are available for the given user. The server also returns whatever resources are needed to support the records - e.g. linked practitioners, medications, locations, organizations etc. The principle intended use for this operation is to provide a patient with access to their entire record (e.g. "Blue Button"). The server SHOULD return at least all resources that it has that are in the patient compartment for the identified patient, and any resource referenced from those, including binaries and attachments. In the US Realm, at a mimimum, the resources returned SHALL include all the data covered by the meaningful use common data elements as defined in DAF . Other applicable implementation guides may make additional rules about how much information that is returned
The official URL for this operation definition is
http://hl7.org/fhir/OperationDefinition/Patient-everything
Formal Definition (as a OperationDefinition).
URL: [base]/Patient/$everything
URL: [base]/Patient/[id]/$everything
This is an idempotent operation
| In Parameters: | |||||
| Name | Cardinality | Type | Binding | Profile | Documentation |
| start | 0..1 | date | The date range relates to care dates, not record currency dates - e.g. all records relating to care provided in a certain date range. If no start date is provided, all records prior to the end date are in scope. | ||
| end | 0..1 | date | The date range relates to care dates, not record currency dates - e.g. all records relating to care provided in a certain date range. If no end date is provided, all records subsequent to the start date are in scope. | ||
| Out Parameters: | |||||
| Name | Cardinality | Type | Binding | Profile | Documentation |
| return | 1..1 | Bundle | The bundle type is "searchset" Note: as this the only out parameter, it is a resource, and it has the name 'return', the result of this operation is returned directly as a resource | ||
The key differences between this operation and simply searching the patient compartment are:
It is assumed that the server has identified and secured the context appropriately, and can either associate the authorization context with a single patient, or determine whether the context has the rights to the nominated patient, if there is one. If there is no nominated patient (e.g. the operation is invoked at the system level) and the context is not associated with a single patient record, then the server should return an error. Specifying the relationship between the context, a user and patient records is outside the scope of this specification.
Get all resources linked to a single patient (Request):
GET /open/Patient/f001/$everything [some headers]
Everything linked to the nominated patient (in this case, built automatically by the publication tooling) (Response):
HTTP/1.1 200 OK
[other headers]
<Bundle xml="http://hl7.org/fhir">
<id value="8993b629-b67d-4c9a-8f2a-4dae84383054"/>
<type value="searchset"/>
<entry>
<fullUrl value="http://hl7.org/fhir/Patient/f001"/>
<resource>
<Patient xmlns="http://hl7.org/fhir">
<id value="f001"/>
<identifier>
<use value="usual"/>
<system value="urn:oid:2.16.840.1.113883.2.4.6.3"/>
<!-- BSN identification system -->
<value value="738472983"/>
</identifier>
<identifier>
<use value="usual"/>
<system value="urn:oid:2.16.840.1.113883.2.4.6.3"/>
<!-- BSN identification system -->
</identifier>
<active value="true"/>
<name>
<use value="usual"/>
<family value="van de Heuvel"/>
<given value="Pieter"/>
<suffix value="MSc"/>
</name>
<telecom>
<system value="phone"/>
<value value="0648352638"/>
<use value="mobile"/>
</telecom>
<telecom>
<system value="email"/>
<value value="p.heuvel@gmail.com"/>
<use value="home"/>
</telecom>
<gender value="male"/>
<birthDate value="1944-11-17"/>
<deceasedBoolean value="false"/>
<address>
<use value="home"/>
<line value="Van Egmondkade 23"/>
<city value="Amsterdam"/>
<postalCode value="1024 RJ"/>
<country value="NLD"/>
<!-- ISO 3166 Codes (Countries) -->
</address>
<maritalStatus>
<coding>
<system value="http://hl7.org/fhir/v3/MaritalStatus"/>
<code value="M"/>
<display value="Married"/>
</coding>
<text value="Getrouwd"/>
</maritalStatus>
<multipleBirthBoolean value="true"/>
<contact>
<relationship>
<coding>
<system value="http://hl7.org/fhir/v2/0131"/>
<code value="C"/>
</coding>
</relationship>
<name>
<use value="usual"/>
<family value="Abels"/>
<given value="Sarah"/>
</name>
<telecom>
<system value="phone"/>
<value value="0690383372"/>
<use value="mobile"/>
</telecom>
</contact>
<communication>
<language>
<coding>
<system value="urn:ietf:bcp:47"/>
<!-- IETF language tag -->
<code value="nl"/>
<display value="Dutch"/>
</coding>
<text value="Nederlands"/>
</language>
<preferred value="true"/>
</communication>
<managingOrganization>
<reference value="Organization/f001"/>
<display value="Burgers University Medical Centre"/>
</managingOrganization>
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Observation/f002"/>
<resource>
<Observation xmlns="http://hl7.org/fhir">
<id value="f002"/>
<!-- urn:oid:2.16.840.1.113883.4.642.1.7 -->
<!-- 2.16.840.1.113883.4.642.1.118 -->
<identifier>
<use value="official"/>
<system value="http://www.bmc.nl/zorgportal/identifiers/observations"/>
<value value="6324"/>
</identifier>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="11555-0"/>
<display value="Base excess in Blood by calculation"/>
</coding>
</code>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<effectivePeriod>
<start value="2013-04-02T10:30:10+01:00"/>
<end value="2013-04-05T10:30:10+01:00"/>
</effectivePeriod>
<issued value="2013-04-03T15:30:10+01:00"/>
<performer>
<reference value="Practitioner/f005"/>
<display value="A. Langeveld"/>
</performer>
<valueQuantity>
<value value="12.6"/>
<unit value="mmol/l"/>
<system value="http://unitsofmeasure.org"/>
<code value="mmol/L"/>
</valueQuantity>
<interpretation>
<coding>
<system value="http://hl7.org/fhir/v2/0078"/>
<code value="H"/>
<display value="High"/>
</coding>
</interpretation>
<referenceRange>
<low>
<value value="7.1"/>
<unit value="mmol/l"/>
<system value="http://unitsofmeasure.org"/>
<code value="mmol/L"/>
</low>
<high>
<value value="11.2"/>
<unit value="mmol/l"/>
<system value="http://unitsofmeasure.org"/>
<code value="mmol/L"/>
</high>
</referenceRange>
</Observation>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Consent/consent-example-notTime"/>
<resource>
<Consent xmlns="http://hl7.org/fhir">
<id value="consent-example-notTime"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on existing jurisdictional policy and are realized in existing systems in Canada.
The default policy is one of implied consent for the provision of care, so these scenarios all deal with withdrawal or withholding consent for that purpose.
In other jurisdictions, where an express consent model is used (Opt-In), these would examples would contain the phrase "consent to" rather
than "withhold" or "withdraw" consent for.
<p>
specific to use-case 6. Withhold or withdraw consent for disclosure of records related published during a timeframe
</p><p>
Patient "P. van de Heuvel" wishes to withhold disclosure of all data from a timeframe to any provider.
</p>
</div>
</text>
<status value="active"/>
<patient>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</patient>
<dateTime value="2015-11-18"/>
<!-- not bound by a timeframe - Consent.period -->
<!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Consent.authority element -->
<organization>
<reference value="Organization/Infoway"/>
<display value="Canada Infoway"/>
</organization>
<!-- the text terms of the consent in lawyer speak -->
<sourceAttachment>
<title value="The terms of the consent in lawyer speak."/>
<!-- likely use url pointer to common text -->
</sourceAttachment>
<!-- this is opt-in - e.g. everything approved unless otherwise stated -->
<policyRule value="http://hl7.org/fhir/ConsentPolicy/opt-in"/>
<except>
<type value="deny"/>
<period>
<start value="2015-01-01"/>
<end value="2015-02-01"/>
</period>
</except>
</Consent>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Condition/f001"/>
<resource>
<Condition xmlns="http://hl7.org/fhir">
<id value="f001"/>
<clinicalStatus value="active"/>
<verificationStatus value="confirmed"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="439401001"/>
<display value="diagnosis"/>
</coding>
</category>
<severity>
<coding>
<system value="http://snomed.info/sct"/>
<code value="6736007"/>
<display value="Moderate"/>
</coding>
</severity>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="368009"/>
<display value="Heart valve disorder"/>
</coding>
</code>
<bodySite>
<coding>
<system value="http://snomed.info/sct"/>
<code value="40768004"/>
<display value="Left thorax"/>
</coding>
<text value="heart structure"/>
</bodySite>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<context>
<reference value="Encounter/f001"/>
</context>
<onsetDateTime value="2011-08-05"/>
<assertedDate value="2011-10-05"/>
<asserter>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</asserter>
<evidence>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="426396005"/>
<display value="Cardiac chest pain"/>
</coding>
</code>
</evidence>
</Condition>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Contract/pcd-example-notAuthor"/>
<resource>
<Contract xmlns="http://hl7.org/fhir">
<id value="pcd-example-notAuthor"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on existing jurisdictional policy and are realized in existing systems in Canada.
The default policy is one of implied consent for the provision of care, so these scenarios all deal with withdrawal or withholding consent for that purpose.
In other jurisdictions, where an express consent model is used (Opt-In), these would examples would contain the phrase "consent to" rather
than "withhold" or "withdraw" consent for.
<p>
specific to use-case 5) Withhold or withdraw consent for disclosure of records that were authored by a specific organization (or service delivery location).
</p><p>
Patient "P. van de Heuvel" wishes to have all of the PHI collected at the Good Health Psychiatric Hospital
restricted from disclosure to every provider.
</p>
</div>
</text>
<issued value="2015-11-18"/>
<!-- not bound by a timeframe - Contract.applies -->
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Contract.authority element -->
<authority>
<reference value="Organization/Infoway"/>
<display value="Canada Infoway"/>
</authority>
<!-- and/or would this [also] go into Contract.domain as a Jurisdiction?? (see the example on UK Pharamacy Juristiction) -->
<domain>
<reference value="Location/Infoway"/>
<display value="Canada Infoway"/>
</domain>
<type>
<coding>
<system value="http://loinc.org"/>
<code value="57016-8"/>
</coding>
</type>
<!-- made up code-system to represent the set of privacy consent sub-types known and published by Canada Infoway -->
<subType>
<coding>
<system value="http://www.infoway-inforoute.ca.org/Consent-subtype-codes"/>
<code value="Opt-In"/>
<display value="Default Authorization with exceptions."/>
</coding>
</subType>
<term>
<type>
<coding>
<!-- made up code system -->
<system value="http://example.org/fhir/consent-term-type-codes"/>
<code value="withhold-authored-by"/>
<display value="Withhold all data authored by specified actor entity."/>
</coding>
</type>
<topic>
<reference value="Organization/2.16.840.1.113883.19.5"/>
<display value="Good Health Clinic"/>
</topic>
<text value="Withhold all data authored by Good Health provider."/>
</term>
<!-- the terms of the consent in friendly consumer speak -->
<friendly>
<contentAttachment>
<title value="The terms of the consent in friendly consumer speak."/>
<!-- likely use url pointer to common text -->
</contentAttachment>
</friendly>
<!-- the legal terms of the consent in lawyer speak -->
<legal>
<contentAttachment>
<title value="The terms of the consent in lawyer speak."/>
<!-- likely use url pointer to common text -->
<!-- I think some think that this should be the pointer to the law by which this consent is derived under. Such as http://lois-laws.justice.gc.ca/eng/acts/P-21/index.html -->
</contentAttachment>
</legal>
</Contract>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Encounter/f001"/>
<resource>
<Encounter xmlns="http://hl7.org/fhir">
<id value="f001"/>
<identifier>
<use value="official"/>
<system value="http://www.amc.nl/zorgportal/identifiers/visits"/>
<value value="v1451"/>
</identifier>
<status value="finished"/>
<class>
<system value="http://hl7.org/fhir/v3/ActCode"/>
<code value="AMB"/> <!-- outpatient -->
<display value="ambulatory"/>
</class>
<type>
<coding>
<system value="http://snomed.info/sct"/>
<code value="270427003"/>
<display value="Patient-initiated encounter"/>
</coding>
</type>
<priority>
<coding>
<system value="http://snomed.info/sct"/>
<code value="310361003"/>
<display value="Non-urgent cardiological admission"/>
</coding>
</priority>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<participant>
<individual>
<reference value="Practitioner/f002"/>
<display value="P. Voigt"/>
</individual>
</participant>
<length>
<value value="140"/>
<unit value="min"/>
<system value="http://unitsofmeasure.org"/>
<code value="min"/>
</length>
<reason>
<coding>
<system value="http://snomed.info/sct"/>
<code value="34068001"/>
<display value="Heart valve replacement"/>
</coding>
</reason>
<hospitalization>
<preAdmissionIdentifier>
<use value="official"/>
<system value="http://www.amc.nl/zorgportal/identifiers/pre-admissions"/>
<value value="93042"/>
</preAdmissionIdentifier>
<!-- <preAdmissionTest>
<coding>
<system value="http://snomed.info/sct"/>
<code value="164847006"/>
<display value="Standard ECG"/>
</coding>
<coding>
<system value="http://snomed.info/sct"/>
<code value="396550006"/>
<display value="Blood test"/>
</coding>
</preAdmissionTest> -->
<admitSource>
<coding>
<system value="http://snomed.info/sct"/>
<code value="305956004"/>
<display value="Referral by physician"/>
</coding>
</admitSource>
<dischargeDisposition>
<coding>
<system value="http://snomed.info/sct"/>
<code value="306689006"/>
<display value="Discharge to home"/>
</coding>
</dischargeDisposition>
</hospitalization>
<serviceProvider>
<reference value="Organization/f001"/>
<display value="Burgers University Medical Center"/>
</serviceProvider>
</Encounter>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Consent/consent-example-notAuthor"/>
<resource>
<Consent xmlns="http://hl7.org/fhir">
<id value="consent-example-notAuthor"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on existing jurisdictional policy and are realized in existing systems in Canada.
The default policy is one of implied consent for the provision of care, so these scenarios all deal with withdrawal or withholding consent for that purpose.
In other jurisdictions, where an express consent model is used (Opt-In), these would examples would contain the phrase "consent to" rather
than "withhold" or "withdraw" consent for.
<p>
specific to use-case 5) Withhold or withdraw consent for disclosure of records that were authored by a specific organization (or service delivery location).
</p><p>
Patient "P. van de Heuvel" wishes to have all of the PHI collected at the Good Health Psychiatric Hospital
restricted from disclosure to every provider.
</p>
</div>
</text>
<status value="active"/>
<patient>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</patient>
<dateTime value="2015-11-18"/>
<!-- not bound by a timeframe - Consent.period -->
<!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Consent.authority element -->
<organization>
<reference value="Organization/Infoway"/>
<display value="Canada Infoway"/>
</organization>
<!-- the text terms of the consent in lawyer speak -->
<sourceAttachment>
<title value="The terms of the consent in lawyer speak."/>
<!-- likely use url pointer to common text -->
</sourceAttachment>
<!-- this is opt-in - e.g. everything approved unless otherwise stated -->
<policyRule value="http://hl7.org/fhir/ConsentPolicy/opt-in"/>
<except>
<type value="deny"/>
<actor>
<role>
<coding>
<system value="http://hl7.org/fhir/v3/ParticipationType"/>
<code value="CST"/>
</coding>
</role>
<reference>
<reference value="Organization/2.16.840.1.113883.19.5"/>
<display value="Good Health Clinic"/>
</reference>
</actor>
</except>
</Consent>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Observation/unsat"/>
<resource>
<Observation xmlns="http://hl7.org/fhir">
<id value="unsat"/>
<!-- urn:oid:2.16.840.1.113883.4.642.1.7 -->
<!-- 2.16.840.1.113883.4.642.1.118 -->
<identifier>
<use value="official"/>
<system value="http://www.bmc.nl/zorgportal/identifiers/observations"/>
<value value="6323"/>
</identifier>
<status value="cancelled"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="15074-8"/>
<display value="Glucose [Moles/volume] in Blood"/>
</coding>
</code>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<effectivePeriod>
<start value="2013-04-02T09:30:10+01:00"/>
<end value="2013-04-05T09:30:10+01:00"/>
</effectivePeriod>
<issued value="2013-04-03T15:30:10+01:00"/>
<performer>
<reference value="Practitioner/f005"/>
<display value="A. Langeveld"/>
</performer>
<dataAbsentReason>
<coding>
<system value="http://snomed.info/sct"/>
<code value="125154007"/>
<display value="Specimen unsatisfactory for evaluation"/>
</coding>
</dataAbsentReason>
<comment value="Tube broken in transit and sample leaked"/>
<referenceRange>
<low>
<value value="3.1"/>
<unit value="mmol/l"/>
<system value="http://unitsofmeasure.org"/>
<code value="mmol/L"/>
</low>
<high>
<value value="6.2"/>
<unit value="mmol/l"/>
<system value="http://unitsofmeasure.org"/>
<code value="mmol/L"/>
</high>
</referenceRange>
</Observation>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Contract/pcd-example-notLabs"/>
<resource>
<Contract xmlns="http://hl7.org/fhir">
<id value="pcd-example-notLabs"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on existing jurisdictional policy and are realized in existing systems in Canada.
The default policy is one of implied consent for the provision of care, so these scenarios all deal with withdrawal or withholding consent for that purpose.
In other jurisdictions, where an express consent model is used (Opt-In), these would examples would contain the phrase "consent to" rather
than "withhold" or "withdraw" consent for.
<p>
specific to use-case 1. Withhold or withdraw consent for disclosure of records related to specific domain (e.g. DI, LAB, etc.)
</p><p>
Patient "P. van de Heuvel" wishes to withhold disclosure of all of her lab orders and results to any provider.
</p>
</div>
</text>
<issued value="2014-08-17"/>
<!-- not bound by a timeframe - Contract.applies -->
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Contract.authority element -->
<authority>
<reference value="Organization/Infoway"/>
<display value="Canada Infoway"/>
</authority>
<!-- and/or would this [also] go into Contract.domain as a Jurisdiction?? (see the example on UK Pharamacy Juristiction) -->
<domain>
<reference value="Location/Infoway"/>
<display value="Canada Infoway"/>
</domain>
<type>
<coding>
<system value="http://loinc.org"/>
<code value="57016-8"/>
</coding>
</type>
<!-- made up code-system to represent the set of privacy consent sub-types known and published by Canada Infoway -->
<subType>
<coding>
<system value="http://www.infoway-inforoute.ca.org/Consent-subtype-codes"/>
<code value="Opt-In"/>
<display value="Default Authorization with exceptions."/>
</coding>
</subType>
<!-- I can easily say to exclude a type of FHIR Resource, but lab-orders is not a direct Resource type. Might we put in FHIR based query parameters? -->
<term>
<type>
<coding>
<!-- made up code system -->
<system value="http://example.org/fhir/consent-term-type-codes"/>
<code value="withhold-object-type"/>
</coding>
</type>
<subType>
<coding>
<system value="http://hl7.org/fhir/resource-types"/>
<code value="ProcedureRequest"/>
</coding>
</subType>
<!-- by not specifying term.actor I assume this means everyone? -->
<text value="Withhold orders from any provider."/>
</term>
<term>
<type>
<coding>
<!-- made up code system -->
<system value="http://example.org/fhir/consent-term-type-codes"/>
<code value="withhold-object-type"/>
</coding>
</type>
<subType>
<coding>
<system value="http://hl7.org/fhir/resource-types"/>
<code value="DiagnosticReport"/>
</coding>
</subType>
<!-- by not specifying term.actor I assume this means everyone? -->
<text value="Withhold order results from any provider."/>
</term>
<!-- the terms of the consent in friendly consumer speak -->
<friendly>
<contentAttachment>
<title value="The terms of the consent in friendly consumer speak."/>
<!-- likely use url pointer to common text -->
</contentAttachment>
</friendly>
<!-- the legal terms of the consent in lawyer speak -->
<legal>
<contentAttachment>
<title value="The terms of the consent in lawyer speak."/>
<!-- likely use url pointer to common text -->
<!-- I think some think that this should be the pointer to the law by which this consent is derived under. Such as http://lois-laws.justice.gc.ca/eng/acts/P-21/index.html -->
</contentAttachment>
</legal>
</Contract>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Observation/ekg"/>
<resource>
<!-- Sampled ECG potentials (Leads I, II, II). There are 2 chunks (numbered as 0 and 1) for each lead. The voltage of each lead is near zero. --><Observation xmlns="http://hl7.org/fhir">
<id value="ekg"/>
<status value="final"/>
<category>
<coding>
<system value="http://hl7.org/fhir/observation-category"/>
<code value="procedure"/>
<display value="Procedure"/>
</coding>
</category>
<code>
<coding>
<system value="urn:oid:2.16.840.1.113883.6.24"/>
<code value="131328"/>
<display value="MDC_ECG_ELEC_POTL"/>
</coding>
</code>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<effectiveDateTime value="2015-02-19T09:30:35+01:00"/>
<performer>
<reference value="Practitioner/f005"/>
<display value="A. Langeveld"/>
</performer>
<device>
<display value="12 lead EKG Device Metric"/>
</device>
<!-- Lead I data chunk 0 -->
<component>
<code>
<coding>
<system value="urn:oid:2.16.840.1.113883.6.24"/>
<code value="131329"/>
<display value="MDC_ECG_ELEC_POTL_I"/>
</coding>
</code>
<valueSampledData>
<!-- Zero potential -->
<origin>
<value value="2048"/>
</origin>
<!-- period in ms = 1000/frequency -->
<period value="10"/>
<!-- factor.value -->
<factor value="1.612"/>
<!-- voltage-min -->
<lowerLimit value="-3300"/>
<!-- voltage-max -->
<upperLimit value="3300"/>
<dimensions value="1"/>
<data value="2041 2043 2037 2047 2060 2062 2051 2023 2014 2027 2034 2033 2040 2047 2047 2053 2058 2064 2059 2063 2061 2052 2053 2038 1966 1885 1884 2009 2129 2166 2137 2102 2086 2077 2067 2067 2060 2059 2062 2062 2060 2057 2045 2047 2057 2054 2042 2029 2027 2018 2007 1995 2001 2012 2024 2039 2068 2092 2111 2125 2131 2148 2137 2138 2128 2128 2115 2099 2097 2096 2101 2101 2091 2073 2076 2077 2084 2081 2088 2092 2070 2069 2074 2077 2075 2068 2064 2060 2062 2074 2075 2074 2075 2063 2058 2058 2064 2064 2070 2074 2067 2060 2062 2063 2061 2059 2048 2052 2049 2048 2051 2059 2059 2066 2077 2073"/>
</valueSampledData>
</component>
<!-- Lead II data chunk 0 -->
<component>
<code>
<coding>
<system value="urn:oid:2.16.840.1.113883.6.24"/>
<code value="131330"/>
<display value="MDC_ECG_ELEC_POTL_II"/>
</coding>
</code>
<valueSampledData>
<!-- Zero potential -->
<origin>
<value value="2048"/>
</origin>
<!-- period in ms = 1000/frequency -->
<period value="10"/>
<!-- factor.value -->
<factor value="1.612"/>
<!-- voltage-min -->
<lowerLimit value="-3300"/>
<!-- voltage-max -->
<upperLimit value="3300"/>
<dimensions value="1"/>
<data value="2041 2043 2037 2047 2060 2062 2051 2023 2014 2027 2034 2033 2040 2047 2047 2053 2058 2064 2059 2063 2061 2052 2053 2038 1966 1885 1884 2009 2129 2166 2137 2102 2086 2077 2067 2067 2060 2059 2062 2062 2060 2057 2045 2047 2057 2054 2042 2029 2027 2018 2007 1995 2001 2012 2024 2039 2068 2092 2111 2125 2131 2148 2137 2138 2128 2128 2115 2099 2097 2096 2101 2101 2091 2073 2076 2077 2084 2081 2088 2092 2070 2069 2074 2077 2075 2068 2064 2060 2062 2074 2075 2074 2075 2063 2058 2058 2064 2064 2070 2074 2067 2060 2062 2063 2061 2059 2048 2052 2049 2048 2051 2059 2059 2066 2077 2073"/>
</valueSampledData>
</component>
<!-- Lead III data chunk 0 -->
<component>
<code>
<coding>
<system value="urn:oid:2.16.840.1.113883.6.24"/>
<code value="131389"/>
<display value="MDC_ECG_ELEC_POTL_III"/>
</coding>
</code>
<valueSampledData>
<!-- Zero potential -->
<origin>
<value value="2048"/>
</origin>
<!-- period in ms = 1000/frequency -->
<period value="10"/>
<!-- factor.value -->
<factor value="1.612"/>
<!-- voltage-min -->
<lowerLimit value="-3300"/>
<!-- voltage-max -->
<upperLimit value="3300"/>
<dimensions value="1"/>
<data value="2041 2043 2037 2047 2060 2062 2051 2023 2014 2027 2034 2033 2040 2047 2047 2053 2058 2064 2059 2063 2061 2052 2053 2038 1966 1885 1884 2009 2129 2166 2137 2102 2086 2077 2067 2067 2060 2059 2062 2062 2060 2057 2045 2047 2057 2054 2042 2029 2027 2018 2007 1995 2001 2012 2024 2039 2068 2092 2111 2125 2131 2148 2137 2138 2128 2128 2115 2099 2097 2096 2101 2101 2091 2073 2076 2077 2084 2081 2088 2092 2070 2069 2074 2077 2075 2068 2064 2060 2062 2074 2075 2074 2075 2063 2058 2058 2064 2064 2070 2074 2067 2060 2062 2063 2061 2059 2048 2052 2049 2048 2051 2059 2059 2066 2077 2073"/>
</valueSampledData>
</component>
</Observation>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/CarePlan/f003"/>
<resource>
<CarePlan xmlns="http://hl7.org/fhir">
<id value="f003"/>
<contained>
<CareTeam>
<id value="careteam"/>
<participant>
<member>
<reference value="Practitioner/f001"/>
<display value="E.M. van den broek"/>
</member>
</participant>
</CareTeam>
</contained>
<contained>
<Goal>
<id value="goal"/>
<status value="achieved"/>
<description>
<text value="Retropharyngeal abscess removal"/>
</description>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<note>
<text value="goal accomplished without complications"/>
</note>
</Goal>
</contained>
<identifier>
<use value="official"/>
<!-- urn:oid:2.16.840.1.113883.4.642.1.36 -->
<system value="http://www.bmc.nl/zorgportal/identifiers/careplans"/>
<value value="CP3953"/>
</identifier>
<status value="completed"/>
<intent value="plan"/>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<period>
<start value="2013-03-08T09:00:10+01:00"/>
<end value="2013-03-08T09:30:10+01:00"/>
</period>
<careTeam>
<reference value="#careteam"/>
</careTeam>
<addresses>
<reference value="Condition/f201"/>
<!--TODO Correcte referentie-->
<display value="?????"/>
</addresses>
<goal>
<reference value="#goal"/>
</goal>
<activity>
<detail>
<category><coding><system value="http://hl7.org/fhir/care-plan-activity-category"/><code value="procedure"/></coding></category>
<!-- urn:oid:2.16.840.1.113883.4.642.1.39 -->
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="172960003"/>
<display value="Incision of retropharyngeal abscess"/>
</coding>
</code>
<status value="completed"/>
<prohibited value="true"/>
<scheduledString value="2011-06-27T09:30:10+01:00"/>
<performer>
<reference value="Practitioner/f001"/>
<display value="E.M. van den broek"/>
</performer>
</detail>
</activity>
</CarePlan>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Condition/f003"/>
<resource>
<Condition xmlns="http://hl7.org/fhir">
<id value="f003"/>
<clinicalStatus value="active"/>
<verificationStatus value="confirmed"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="439401001"/>
<display value="diagnosis"/>
</coding>
</category>
<severity>
<coding>
<system value="http://snomed.info/sct"/>
<code value="371923003"/>
<display value="Mild to moderate"/>
</coding>
</severity>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="18099001"/>
<display value="Retropharyngeal abscess"/>
</coding>
</code>
<bodySite>
<coding>
<system value="http://snomed.info/sct"/>
<code value="280193007"/>
<display value="Entire retropharyngeal area"/>
</coding>
</bodySite>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<context>
<reference value="Encounter/f003"/>
</context>
<onsetDateTime value="2012-02-27"/>
<assertedDate value="2012-02-20"/>
<asserter>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</asserter>
<evidence>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="169068008"/>
<display value="CT of neck"/>
</coding>
</code>
</evidence>
</Condition>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Observation/f004"/>
<resource>
<Observation xmlns="http://hl7.org/fhir">
<id value="f004"/>
<!-- urn:oid:2.16.840.1.113883.4.642.1.7 -->
<identifier>
<use value="official"/>
<system value="http://www.bmc.nl/zorgportal/identifiers/observations"/>
<value value="6326"/>
</identifier>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="789-8"/>
<display value="Erythrocytes [#/volume] in Blood by Automated count"/>
</coding>
</code>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<effectivePeriod>
<start value="2013-04-02T10:30:10+01:00"/>
<end value="2013-04-05T10:30:10+01:00"/>
</effectivePeriod>
<issued value="2013-04-03T15:30:10+01:00"/>
<performer>
<reference value="Practitioner/f005"/>
<display value="A. Langeveld"/>
</performer>
<valueQuantity>
<value value="4.12"/>
<!-- Actually, 4.12E+12 -->
<unit value="10^12/L"/>
<system value="http://unitsofmeasure.org"/>
<code value="10*12/L"/>
</valueQuantity>
<interpretation>
<coding>
<system value="http://hl7.org/fhir/v2/0078"/>
<code value="L"/>
<display value="Low"/>
</coding>
</interpretation>
<!-- this example demonstrates using the reference range text element for stuff that is not easily structured !-->
<referenceRange>
<text value=" 12-14 y Male: 4.4 - 5.2 x 10^12/L ; 12-14 y Female: 4.2 - 4.8 x 10^12/L ; 15-17 y Male: 4.6 - 5.4 x 10^12/L ; 15-17 y Female: 4.2 - 4.8 x 10^12/L ; 18-64 y Male: 4.6 - 5.4 x 10^12/L ; 18-64 y Female: 4.0 - 4.8 x 10^12/L ; 65-74 y Male: 4.3 - 5.3 x 10^12/L ; 65-74 y Female: 4.1 - 4.9 x 10^12/L "/>
</referenceRange>
</Observation>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Consent/consent-example-notOrg"/>
<resource>
<Consent xmlns="http://hl7.org/fhir">
<id value="consent-example-notOrg"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on existing jurisdictional policy and are realized in existing systems in Canada.
The default policy is one of implied consent for the provision of care, so these scenarios all deal with withdrawal or withholding consent for that purpose.
In other jurisdictions, where an express consent model is used (Opt-In), these would examples would contain the phrase "consent to" rather
than "withhold" or "withdraw" consent for.
<p>
specific to use-case 3) Withhold or withdraw consent for disclosure to a specific provider organization
</p><p>
Patient "P. van de Heuvel" ex-spouse is a Physician that is employed by Good Health Clinic. P. decides
that he would like to withdraw/withhold consent to disclose any instance of his health information
to Good Health Clinic.
</p>
</div>
</text>
<status value="active"/>
<patient>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</patient>
<dateTime value="2015-11-18"/>
<!-- not bound by a timeframe - Consent.period -->
<!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Consent.authority element -->
<organization>
<reference value="Organization/Infoway"/>
<display value="Canada Infoway"/>
</organization>
<!-- the text terms of the consent in lawyer speak -->
<sourceAttachment>
<title value="The terms of the consent in lawyer speak."/>
<!-- likely use url pointer to common text -->
</sourceAttachment>
<!-- this is opt-in - e.g. everything approved unless otherwise stated -->
<policyRule value="http://hl7.org/fhir/ConsentPolicy/opt-in"/>
<except>
<!-- no read or write access for this org -->
<type value="deny"/>
<actor>
<role>
<coding>
<system value="http://hl7.org/fhir/v3/ParticipationType"/>
<code value="PRCP"/> <!-- PRCP: recipient of the information -->
</coding>
</role>
<reference>
<reference value="Organization/2.16.840.1.113883.19.5"/>
<display value="Good Health Clinic"/>
</reference>
</actor>
<action>
<coding>
<system value="http://hl7.org/fhir/consentaction"/>
<code value="access"/>
</coding>
</action>
<action>
<coding>
<system value="http://hl7.org/fhir/consentaction"/>
<code value="correct"/>
</coding>
</action>
</except>
</Consent>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Task/example3"/>
<resource>
<Task xmlns="http://hl7.org/fhir">
<id value="example3"/>
<status value="draft"/>
<intent value="order"/>
<code>
<text value="Refill Request"/>
</code>
<focus>
<reference value="MedicationRequest/medrx002"/>
</focus>
<for>
<reference value="Patient/f001"/>
</for>
<authoredOn value="2016-03-10T22:39:32-04:00"/>
<lastModified value="2016-03-10T22:39:32-04:00"/>
<requester>
<agent>
<reference value="Patient/example"/>
</agent>
</requester>
<owner>
<reference value="Practitioner/example"/>
</owner>
</Task>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/DiagnosticReport/f001"/>
<resource>
<DiagnosticReport xmlns="http://hl7.org/fhir">
<!-- ISO 8601 -->
<!-- OID: 2.16.840.1.113883.4.642.1.7 -->
<id value="f001"/>
<contained>
<ProcedureRequest>
<id value="req"/>
<extension url="http://example.org/bodysitecode">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="14975008"/>
<display value="Forearm structure"/>
</coding>
</valueCodeableConcept>
</extension>
<identifier>
<system value="http://www.bmc.nl/zorgportal/identifiers/labresults"/>
<value value="L2381"/>
</identifier>
<status value="active"/>
<intent value="original-order"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="58410-2"/>
<display value="Complete blood count (hemogram) panel - Blood by Automated count"/>
</coding>
</code>
<subject>
<reference value="Patient/f001"/>
<display value="P. van den Heuvel"/>
</subject>
<context>
<reference value="Encounter/f001"/>
</context>
<requester>
<agent>
<reference value="Practitioner/f001"/>
<display value="E.van den Broek"/>
</agent>
</requester>
<note>
<text value="patient almost fainted during procedure"/>
</note>
</ProcedureRequest>
</contained>
<identifier>
<use value="official"/>
<system value="http://www.bmc.nl/zorgportal/identifiers/reports"/>
<value value="nr1239044"/>
</identifier>
<basedOn>
<reference value="#req"/>
</basedOn>
<status value="final"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="252275004"/>
<display value="Haematology test"/>
</coding>
<coding>
<system value="http://hl7.org/fhir/v2/0074"/>
<code value="HM"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="58410-2"/>
<display value="Complete blood count (hemogram) panel - Blood by Automated count"/>
</coding>
</code>
<subject>
<reference value="Patient/f001"/>
<display value="P. van den Heuvel"/>
</subject>
<issued value="2013-05-15T19:32:52+01:00"/>
<performer>
<actor>
<reference value="Organization/f001"/>
<display value="Burgers University Medical Centre"/>
</actor>
</performer>
<result>
<reference value="Observation/f001"/>
</result>
<result>
<reference value="Observation/f002"/>
</result>
<result>
<reference value="Observation/f003"/>
</result>
<result>
<reference value="Observation/f004"/>
</result>
<result>
<reference value="Observation/f005"/>
</result>
<conclusion value="Core lab"/>
</DiagnosticReport>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Condition/f002"/>
<resource>
<Condition xmlns="http://hl7.org/fhir">
<id value="f002"/>
<clinicalStatus value="active"/>
<verificationStatus value="confirmed"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="439401001"/>
<display value="diagnosis"/>
</coding>
</category>
<severity>
<coding>
<system value="http://snomed.info/sct"/>
<code value="24484000"/>
<display value="Severe"/>
</coding>
</severity>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="254637007"/>
<display value="NSCLC - Non-small cell lung cancer"/>
</coding>
</code>
<bodySite>
<coding>
<system value="http://snomed.info/sct"/>
<code value="51185008"/>
<display value="Thorax"/>
</coding>
</bodySite>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<context>
<reference value="Encounter/f002"/>
</context>
<onsetDateTime value="2011-05-05"/>
<assertedDate value="2012-06-03"/>
<asserter>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</asserter>
<stage>
<summary>
<coding>
<system value="http://snomed.info/sct"/>
<code value="258219007"/>
<display value="stage II"/>
</coding>
</summary>
</stage>
<evidence>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="169069000"/>
<display value="CT of thorax"/>
</coding>
</code>
</evidence>
</Condition>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Consent/consent-example-Emergency"/>
<resource>
<Consent xmlns="http://hl7.org/fhir">
<id value="consent-example-Emergency"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<p>
Withhold Authorization for Treatment except for Emegency Treatment
</p><p>
Patient "P. van de Heuvel" wishes to have no data at the Good Health Psychiatric Hospital
available except for Emergency treatment use.
An overall Deny consent Directive, with an exception "Permit" of purposeOfUse "ETREAT"
at "Good Health" hospital, and exception "Deny" all other purposeOfUse from good health hospital.
</p>
</div>
</text>
<status value="active"/>
<patient>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</patient>
<dateTime value="2015-11-18"/>
<!-- not bound by a timeframe - Consent.period -->
<!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Consent.authority element -->
<organization>
<reference value="Organization/Infoway"/>
<display value="Canada Infoway"/>
</organization>
<!-- the text terms of the consent in lawyer speak -->
<sourceAttachment>
<title value="The terms of the consent in lawyer speak."/>
<!-- likely use url pointer to common text -->
</sourceAttachment>
<!--
this is opt-out - e.g. nothing approved unless otherwise stated.
-->
<policyRule value="http://hl7.org/fhir/ConsentPolicy/opt-out"/>
<except>
<type value="permit"/>
<actor>
<role>
<coding>
<system value="http://hl7.org/fhir/v3/ParticipationType"/>
<code value="CST"/>
</coding>
</role>
<reference>
<reference value="Organization/2.16.840.1.113883.19.6"/>
<display value="Good Health Psychiatric Hospital"/>
</reference>
</actor>
<purpose>
<system value="http://hl7.org/fhir/v3/ActReason"/>
<code value="ETREAT"/>
</purpose>
</except>
<!-- this except overrides the other one -->
<except>
<type value="deny"/>
<actor>
<role>
<coding>
<system value="http://hl7.org/fhir/v3/ParticipationType"/>
<code value="CST"/>
</coding>
</role>
<reference>
<reference value="Organization/2.16.840.1.113883.19.6"/>
<display value="Good Health Psychiatric Hospital"/>
</reference>
</actor>
</except>
</Consent>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/RelatedPerson/f001"/>
<resource>
<RelatedPerson xmlns="http://hl7.org/fhir">
<id value="f001"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
Sarah Abels
</div>
</text>
<identifier>
<use value="official"/>
<type><text value="BSN"/></type>
<system value="urn:oid:2.16.840.1.113883.2.4.6.3"/>
<!-- Dutch BSN identification system -->
</identifier>
<patient>
<reference value="Patient/f001"/>
</patient>
<relationship>
<coding>
<system value="http://hl7.org/fhir/v3/RoleCode"/>
<code value="SIGOTHR"/>
</coding>
</relationship>
<name>
<use value="usual"/>
<family value="Abels"/>
<given value="Sarah"/>
</name>
<telecom>
<system value="phone"/>
<value value="0690383372"/>
<use value="mobile"/>
</telecom>
<telecom>
<system value="email"/>
<value value="s.abels@kpn.nl"/>
<use value="home"/>
</telecom>
<gender value="female"/>
</RelatedPerson>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Contract/pcd-example-notOrg"/>
<resource>
<Contract xmlns="http://hl7.org/fhir">
<id value="pcd-example-notOrg"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on existing jurisdictional policy and are realized in existing systems in Canada.
The default policy is one of implied consent for the provision of care, so these scenarios all deal with withdrawal or withholding consent for that purpose.
In other jurisdictions, where an express consent model is used (Opt-In), these would examples would contain the phrase "consent to" rather
than "withhold" or "withdraw" consent for.
<p>
specific to use-case 3) Withhold or withdraw consent for disclosure to a specific provider organization
</p><p>
Patient "P. van de Heuvel" ex-spouse is a Physician that is employed by Good Health Clinic. P. decides
that he would like to withdraw/withhold consent to disclose any instance of his health information
to Good Health Clinic.
</p>
</div>
</text>
<issued value="2015-11-18"/>
<!-- not bound by a timeframe - Contract.applies -->
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Contract.authority element -->
<authority>
<reference value="Organization/Infoway"/>
<display value="Canada Infoway"/>
</authority>
<!-- and/or would this [also] go into Contract.domain as a Jurisdiction?? (see the example on UK Pharamacy Juristiction) -->
<domain>
<reference value="Location/Infoway"/>
<display value="Canada Infoway"/>
</domain>
<type>
<coding>
<system value="http://loinc.org"/>
<code value="57016-8"/>
</coding>
</type>
<!-- made up code-system to represent the set of privacy consent sub-types known and published by Canada Infoway -->
<subType>
<coding>
<system value="http://www.infoway-inforoute.ca.org/Consent-subtype-codes"/>
<code value="Opt-In"/>
<display value="Default Authorization with exceptions."/>
</coding>
</subType>
<term>
<type>
<coding>
<!-- made up code system -->
<system value="http://example.org/fhir/consent-term-type-codes"/>
<code value="withhold-from"/>
<display value="Withhold all data from specified actor entity."/>
</coding>
</type>
<topic>
<reference value="Organization/2.16.840.1.113883.19.5"/>
<display value="Good Health Clinic"/>
</topic>
<!-- by not specifying term.actor I assume this means everyone? -->
<text value="Withhold this order and any results or related objects from any provider."/>
</term>
<!-- the terms of the consent in friendly consumer speak -->
<friendly>
<contentAttachment>
<title value="The terms of the consent in friendly consumer speak."/>
<!-- likely use url pointer to common text -->
</contentAttachment>
</friendly>
<!-- the legal terms of the consent in lawyer speak -->
<legal>
<contentAttachment>
<title value="The terms of the consent in lawyer speak."/>
<!-- likely use url pointer to common text -->
<!-- I think some think that this should be the pointer to the law by which this consent is derived under. Such as http://lois-laws.justice.gc.ca/eng/acts/P-21/index.html -->
</contentAttachment>
</legal>
</Contract>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Observation/f005"/>
<resource>
<Observation xmlns="http://hl7.org/fhir">
<id value="f005"/>
<!-- urn:oid:2.16.840.1.113883.4.642.1.7 -->
<identifier>
<use value="official"/>
<system value="http://www.bmc.nl/zorgportal/identifiers/observations"/>
<value value="6327"/>
</identifier>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="718-7"/>
<display value="Hemoglobin [Mass/volume] in Blood"/>
</coding>
</code>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<effectivePeriod>
<start value="2013-04-05T10:30:10+01:00"/>
<end value="2013-04-05T10:30:10+01:00"/>
</effectivePeriod>
<issued value="2013-04-05T15:30:10+01:00"/>
<performer>
<reference value="Practitioner/f005"/>
<display value="A. Langeveld"/>
</performer>
<valueQuantity>
<value value="7.2"/>
<unit value="g/dl"/>
<system value="http://unitsofmeasure.org"/>
<code value="g/dL"/>
</valueQuantity>
<interpretation>
<coding>
<system value="http://hl7.org/fhir/v2/0078"/>
<code value="L"/>
<display value="Low"/>
</coding>
</interpretation>
<referenceRange>
<low>
<value value="7.5"/>
<unit value="g/dl"/>
<system value="http://unitsofmeasure.org"/>
<code value="g/dL"/>
</low>
<high>
<value value="10"/>
<unit value="g/dl"/>
<system value="http://unitsofmeasure.org"/>
<code value="g/dL"/>
</high>
</referenceRange>
</Observation>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/CarePlan/f002"/>
<resource>
<CarePlan xmlns="http://hl7.org/fhir">
<id value="f002"/>
<contained>
<CareTeam>
<id value="careteam"/>
<participant>
<member>
<reference value="Practitioner/f003"/>
<display value="M.I.M. Versteegh"/>
</member>
</participant>
</CareTeam>
</contained>
<contained>
<Goal>
<id value="goal"/>
<status value="achieved"/>
<description>
<text value="succesful surgery on lung of patient"/>
</description>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<note>
<text value="goal accomplished with minor complications"/>
</note>
</Goal>
</contained>
<identifier>
<use value="official"/>
<!-- urn:oid:2.16.840.1.113883.4.642.1.36 -->
<system value="http://www.bmc.nl/zorgportal/identifiers/careplans"/>
<value value="CP2934"/>
</identifier>
<status value="completed"/>
<intent value="plan"/>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<period>
<start value="2011-07-06"/>
<end value="2013-07-07"/>
</period>
<careTeam>
<reference value="#careteam"/>
</careTeam>
<addresses>
<reference value="Condition/f201"/>
<!--TODO Correcte referentie-->
<display value="?????"/>
</addresses>
<goal>
<reference value="#goal"/>
</goal>
<activity>
<detail>
<category><coding><system value="http://hl7.org/fhir/care-plan-activity-category"/><code value="procedure"/></coding></category>
<!-- urn:oid:2.16.840.1.113883.4.642.1.39 -->
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="359615001"/>
<display value="Partial lobectomy of lung"/>
</coding>
</code>
<status value="completed"/>
<prohibited value="true"/>
<scheduledString value="2011-07-07T09:30:10+01:00"/>
<performer>
<reference value="Practitioner/f003"/>
<display value="M.I.M. Versteegh"/>
</performer>
</detail>
</activity>
</CarePlan>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Consent/consent-example-Out"/>
<resource>
<Consent xmlns="http://hl7.org/fhir">
<id value="consent-example-Out"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on existing jurisdictional policy and are realized in existing systems in Canada.
The default policy is one of implied consent for the provision of care, so these scenarios all deal with withdrawal or withholding consent for that purpose.
In other jurisdictions, where an express consent model is used (Opt-In), these would examples would contain the phrase "consent to" rather
than "withhold" or "withdraw" consent for.
<p>
Specific to use-case 0) Withhold Authorization of sharing data for Treatment
</p><p>
Patient "P. van de Heuvel" wishes to have no data at the Good Health Psychiatric Hospital
available for normal treatment use.
</p>
</div>
</text>
<status value="active"/>
<patient>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</patient>
<dateTime value="2015-11-18"/>
<!-- not bound by a timeframe - Consent.period -->
<actor>
<role>
<coding>
<system value="http://hl7.org/fhir/v3/ParticipationType"/>
<code value="CST"/>
</coding>
</role>
<reference>
<reference value="Organization/2.16.840.1.113883.19.6"/>
<display value="Good Health Psychiatric Hospital"/>
</reference>
</actor>
<!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Consent.authority element -->
<organization>
<reference value="Organization/Infoway"/>
<display value="Canada Infoway"/>
</organization>
<!-- the text terms of the consent in lawyer speak -->
<sourceAttachment>
<title value="The terms of the consent in lawyer speak."/>
<!-- likely use url pointer to common text -->
</sourceAttachment>
<!-- this is opt-out - e.g. everything approved unless otherwise stated -->
<policyRule value="http://hl7.org/fhir/ConsentPolicy/opt-out"/>
</Consent>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Consent/consent-example-basic"/>
<resource>
<Consent xmlns="http://hl7.org/fhir">
<id value="consent-example-basic"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<p>
Authorize Normal access for Treatment
</p><p>
Patient "P. van de Heuvel" wishes to have all of the PHI collected at the Good Health Psychiatric Hospital
available for normal treatment use.
</p>
</div>
</text>
<status value="active"/>
<patient>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</patient>
<!-- bound by a timeframe between 1964 and 2016 - consent.applies -->
<period>
<start value="1964-01-01"/>
<end value="2016-01-01"/>
</period>
<dateTime value="2016-05-11"/>
<organization>
<reference value="Organization/Infoway"/>
<display value="Canada Infoway"/>
</organization>
<!-- the terms of the consent as signed by the patient in ink -->
<sourceAttachment>
<title value="The terms of the consent in lawyer speak."/>
<!-- likely use url pointer to common text -->
</sourceAttachment>
<!-- this is plain out opt-in with no exceptions -->
<policyRule value="http://goodhealth.org/consent/policy/opt-in"/>
</Consent>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Contract/pcd-example-notThem"/>
<resource>
<Contract xmlns="http://hl7.org/fhir">
<id value="pcd-example-notThem"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on existing
jurisdictional policy and are realized in existing systems in Canada. The default policy is
one of implied consent for the provision of care, so these scenarios all deal with withdrawal
or withholding consent for that purpose. In other jurisdictions, where an express consent
model is used (Opt-In), these would examples would contain the phrase "consent to" rather than
"withhold" or "withdraw" consent for. <p> specific to use-case 4) Withhold or withdraw consent
for disclosure to a specific provider agent (an individual within an organization) </p><p>
Patient "P. van de Heuvel" ex-spouse, Bill T Lookafter is a Nurse that is employed by Good
Health Hospital. P. realizes that she may receive treatment at GHH, however she does not
want her ex-spouse to have any access to her IIHI. She indicates that she would like to
withdraw/withhold consent to disclose any instance of her health information to her
ex-spouse as a result of his employment at Good Health Clinic. </p>
</div>
</text>
<issued value="2015-11-18"/>
<!-- not bound by a timeframe - Contract.applies -->
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Contract.authority element -->
<authority>
<reference value="Organization/2"/>
<display value="Canada Infoway"/>
</authority>
<!-- and/or would this [also] go into Contract.domain as a Jurisdiction?? (see the example on UK Pharamacy Juristiction) -->
<domain>
<reference value="Location/ukp"/>
<display value="Canada Infoway"/>
</domain>
<type>
<coding>
<system value="http://loinc.org"/>
<code value="57016-8"/>
</coding>
</type>
<!-- made up code-system to represent the set of privacy consent sub-types known and published by Canada Infoway -->
<subType>
<coding>
<system value="http://www.infoway-inforoute.ca.org/Consent-subtype-codes"/>
<code value="Opt-In"/>
<display value="Default Authorization with exceptions."/>
</coding>
</subType>
<agent>
<actor>
<reference value="Patient/f001"/>
</actor>
</agent>
<signer>
<type>
<system value="http://www.hl7.org/fhir/contractsignertypecodes"/>
<code value="COVPTY"/>
</type>
<party>
<reference value="Patient/f001"/>
</party>
<signature>
<type>
<system value="urn:iso-astm:E1762-95:2013"/>
<code value="1.2.840.10065.1.12.1.1"/>
</type>
<when value="2013-06-08T10:57:34-07:00"/>
<whoReference>
<reference value="Patient/f001"/>
</whoReference>
</signature>
</signer>
<term>
<type>
<coding>
<!-- made up code system -->
<system value="http://example.org/fhir/consent-term-type-codes"/>
<code value="withhold-from"/>
<display value="Withhold all data from specified actor entity."/>
</coding>
</type>
<topic>
<reference value="Practitioner/f204"/>
<display value="Fictive Nurse"/>
</topic>
<text value="Withhold this order and any results or related objects from specified nurse provider."/>
</term>
<!-- the terms of the consent in friendly consumer speak -->
<friendly>
<contentAttachment>
<title value="The terms of the consent in friendly consumer speak."/>
<!-- likely use url pointer to common text -->
</contentAttachment>
</friendly>
<!-- the legal terms of the consent in lawyer speak -->
<legal>
<contentAttachment>
<title value="The terms of the consent in lawyer speak."/>
<!-- likely use url pointer to common text -->
<!-- I think some think that this should be the pointer to the law by which this consent is derived under. Such as http://lois-laws.justice.gc.ca/eng/acts/P-21/index.html -->
</contentAttachment>
</legal>
</Contract>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Encounter/f002"/>
<resource>
<Encounter xmlns="http://hl7.org/fhir">
<id value="f002"/>
<identifier>
<use value="official"/>
<system value="http://www.bmc.nl/zorgportal/identifiers/encounters"/>
<value value="v3251"/>
</identifier>
<status value="finished"/>
<class>
<system value="http://hl7.org/fhir/v3/ActCode"/>
<code value="AMB"/> <!-- outpatient -->
<display value="ambulatory"/>
</class>
<type>
<coding>
<system value="http://snomed.info/sct"/>
<code value="270427003"/>
<display value="Patient-initiated encounter"/>
</coding>
</type>
<priority>
<coding>
<system value="http://snomed.info/sct"/>
<code value="103391001"/>
<display value="Urgent"/>
</coding>
</priority>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<participant>
<individual>
<reference value="Practitioner/f003"/>
<display value="M.I.M Versteegh"/>
</individual>
</participant>
<length>
<value value="140"/>
<unit value="min"/>
<system value="http://unitsofmeasure.org"/>
<code value="min"/>
</length>
<reason>
<coding>
<system value="http://snomed.info/sct"/>
<code value="34068001"/>
<display value="Partial lobectomy of lung"/>
</coding>
</reason>
<hospitalization>
<preAdmissionIdentifier>
<use value="official"/>
<system value="http://www.bmc.nl/zorgportal/identifiers/pre-admissions"/>
<value value="98682"/>
</preAdmissionIdentifier>
<!-- <preAdmissionTest>
<coding>
<system value="http://snomed.info/sct"/>
<code value="399208008"/>
<display value="Chest X-ray"/>
</coding>
<coding>
<system value="http://snomed.info/sct"/>
<code value="396550006"/>
<display value="Blood test"/>
</coding>
</preAdmissionTest> -->
<admitSource>
<coding>
<system value="http://snomed.info/sct"/>
<code value="305997006"/>
<display value="Referral by radiologist"/>
</coding>
</admitSource>
<dischargeDisposition>
<coding>
<system value="http://snomed.info/sct"/>
<code value="306689006"/>
<display value="Discharge to home"/>
</coding>
</dischargeDisposition>
</hospitalization>
<serviceProvider>
<reference value="Organization/f001"/>
<display value="BMC"/>
</serviceProvider>
</Encounter>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Consent/consent-example-notThem"/>
<resource>
<Consent xmlns="http://hl7.org/fhir">
<id value="consent-example-notThem"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on existing jurisdictional policy and are realized in existing systems in Canada.
The default policy is one of implied consent for the provision of care, so these scenarios all deal with withdrawal or withholding consent for that purpose.
In other jurisdictions, where an express consent model is used (Opt-In), these would examples would contain the phrase "consent to" rather
than "withhold" or "withdraw" consent for.
<p>
specific to use-case 4) Withhold or withdraw consent for disclosure to a specific provider agent (an individual within an organization)
</p><p>
Patient "P. van de Heuvel" ex-spouse, Bill T Lookafter is a Nurse that is employed by Good Health Hospital.
P. realizes that she may receive treatment at GHH, however she does not want her ex-spouse to have any
access to her IIHI. She indicates that she would like to withdraw/withhold consent to disclose any instance
of her health information to her ex-spouse as a result of his employment at Good Health Clinic.
</p>
</div>
</text>
<status value="active"/>
<patient>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</patient>
<dateTime value="2015-11-18"/>
<!-- not bound by a timeframe - Consent.period -->
<!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Consent.authority element -->
<organization>
<reference value="Organization/Infoway"/>
<display value="Canada Infoway"/>
</organization>
<!-- the text terms of the consent in lawyer speak -->
<sourceAttachment>
<title value="The terms of the consent in lawyer speak."/>
<!-- likely use url pointer to common text -->
</sourceAttachment>
<!-- this is opt-in - e.g. everything approved unless otherwise stated -->
<policyRule value="http://hl7.org/fhir/ConsentPolicy/opt-in"/>
<except>
<!-- no read or write access for this individual -->
<type value="deny"/>
<actor>
<role>
<coding>
<system value="http://hl7.org/fhir/v3/ParticipationType"/>
<code value="PRCP"/> <!-- PRCP: recipient of the information -->
</coding>
</role>
<reference>
<reference value="Practitioner/f204"/>
<display value="Fictive Nurse"/>
</reference>
</actor>
<action>
<coding>
<system value="http://hl7.org/fhir/consentaction"/>
<code value="access"/>
</coding>
</action>
<action>
<coding>
<system value="http://hl7.org/fhir/consentaction"/>
<code value="correct"/>
</coding>
</action>
</except>
</Consent>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Procedure/f001"/>
<resource>
<Procedure xmlns="http://hl7.org/fhir">
<id value="f001"/>
<status value="completed"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="34068001"/>
<display value="Heart valve replacement"/>
</coding>
</code>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<context>
<reference value="Encounter/f001"/>
</context>
<performedPeriod>
<start value="2011-06-26"/>
<end value="2011-06-27"/>
</performedPeriod>
<performer>
<role>
<coding>
<system value="urn:oid:2.16.840.1.113883.2.4.15.111"/> <!-- "AssignedRoleType" coding system -->
<code value="01.000"/>
<display value="Arts"/>
</coding>
<text value="Care role"/>
</role>
<actor>
<reference value="Practitioner/f002"/>
<display value="P. Voigt"/>
</actor>
</performer>
<reasonCode>
<text value="Heart valve disorder"/>
</reasonCode>
<bodySite>
<coding>
<system value="http://snomed.info/sct"/>
<code value="17401000"/>
<display value="Heart valve structure"/>
</coding>
</bodySite>
<outcome>
<text value="improved blood circulation"/>
</outcome>
<report>
<reference value="DiagnosticReport/f001"/>
<display value="Lab results blood test"/>
</report>
<followUp>
<text value="described in care plan"/>
</followUp>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Consent/consent-example-grantor"/>
<resource>
<Consent xmlns="http://hl7.org/fhir">
<id value="consent-example-grantor"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on a question asked on John Moehrke's blog in the
<a href="http://healthcaresecprivacy.blogspot.com/2016/04/consent-given-to-authorized.html">Consent given to authorized representative</a>
<p>
This is a case where a Patient is giving a limited (read-only) access to an individual.
</p><p>
Patient "P. van de Heuvel" wishes to provide XXX with read-only access to the data at Good Health Psychiatric Hospital
available for patient requested access use.
</p>
</div>
</text>
<status value="active"/>
<patient>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</patient>
<dateTime value="2015-11-18"/>
<!-- not bound by a timeframe - Consent.period -->
<!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Consent.authority element -->
<organization>
<reference value="Organization/Infoway"/>
<display value="Canada Infoway"/>
</organization>
<!-- the text terms of the consent in lawyer speak -->
<sourceAttachment>
<title value="The terms of the consent in lawyer speak."/>
<!-- likely use url pointer to common text -->
</sourceAttachment>
<!-- this is opt-out - e.g. nothing approved unless otherwise stated -->
<policyRule value="http://hl7.org/fhir/ConsentPolicy/opt-out"/>
<except>
<type value="permit"/>
<actor>
<role>
<coding>
<system value="http://hl7.org/fhir/v3/ParticipationType"/>
<code value="CST"/>
</coding>
</role>
<reference>
<reference value="Organization/2.16.840.1.113883.19.6"/>
<display value="Good Health Psychiatric Hospital"/>
</reference>
</actor>
<actor>
<role>
<coding>
<system value="http://hl7.org/fhir/v3/ParticipationType"/>
<code value="PRCP"/>
</coding>
</role>
<reference>
<reference value="Patient/example"/>
<display value="Good Health Clinic"/>
</reference>
</actor>
<action>
<coding>
<system value="http://hl7.org/fhir/consentaction"/>
<code value="access"/>
</coding>
</action>
</except>
</Consent>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Contract/pcd-example-notThis"/>
<resource>
<Contract xmlns="http://hl7.org/fhir">
<id value="pcd-example-notThis"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on existing jurisdictional policy and are realized in existing systems in Canada.
The default policy is one of implied consent for the provision of care, so these scenarios all deal with withdrawal or withholding consent for that purpose.
In other jurisdictions, where an express consent model is used (Opt-In), these would examples would contain the phrase "consent to" rather
than "withhold" or "withdraw" consent for.
<p>
specific to use-case 2. Withhold or withdraw consent for disclosure of a specific record (e.g. Lab Order/Result)
</p><p>
Patient "P. van de Heuvel" Primary Care Provider, Dr. Philip Primary, has ordered a set of lab test which Adam
wishes to keep as private as possible. At the sample collection facility, he indicates that he would
like withhold consent to disclose the order and all results associated with that specific order from
all other providers
</p>
</div>
</text>
<issued value="2015-11-18"/>
<!-- not bound by a timeframe - Contract.applies -->
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Contract.authority element -->
<authority>
<reference value="Organization/Infoway"/>
<display value="Canada Infoway"/>
</authority>
<!-- and/or would this [also] go into Contract.domain as a Jurisdiction?? (see the example on UK Pharamacy Juristiction) -->
<domain>
<reference value="Location/Infoway"/>
<display value="Canada Infoway"/>
</domain>
<type>
<coding>
<system value="http://loinc.org"/>
<code value="57016-8"/>
</coding>
</type>
<!-- made up code-system to represent the set of privacy consent sub-types known and published by Canada Infoway -->
<subType>
<coding>
<system value="http://www.infoway-inforoute.ca.org/Consent-subtype-codes"/>
<code value="Opt-In"/>
<display value="Default Authorization with exceptions."/>
</coding>
</subType>
<!-- I can easily say to exclude a type of FHIR Resource, but lab-orders is not a direct Resource type. Might we put in FHIR based query parameters? -->
<term>
<type>
<coding>
<!-- made up code system -->
<system value="http://example.org/fhir/consent-term-type-codes"/>
<code value="withhold-identified-object-and-related"/>
<display value="Withhold the identified object and any other resources that are related to this object."/>
</coding>
</type>
<topic>
<reference value="ProcedureRequest/example-lipid"/>
</topic>
<!-- by not specifying term.actor I assume this means everyone? -->
<text value="Withhold this order and any results or related objects from any provider."/>
</term>
<!-- the terms of the consent in friendly consumer speak -->
<friendly>
<contentAttachment>
<title value="The terms of the consent in friendly consumer speak."/>
<!-- likely use url pointer to common text -->
</contentAttachment>
</friendly>
<!-- the legal terms of the consent in lawyer speak -->
<legal>
<contentAttachment>
<title value="The terms of the consent in lawyer speak."/>
<!-- likely use url pointer to common text -->
<!-- I think some think that this should be the pointer to the law by which this consent is derived under. Such as http://lois-laws.justice.gc.ca/eng/acts/P-21/index.html -->
</contentAttachment>
</legal>
</Contract>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Encounter/f003"/>
<resource>
<Encounter xmlns="http://hl7.org/fhir">
<id value="f003"/>
<identifier>
<use value="official"/>
<system value="http://www.bmc.nl/zorgportal/identifiers/encounters"/>
<value value="v6751"/>
</identifier>
<status value="finished"/>
<class>
<system value="http://hl7.org/fhir/v3/ActCode"/>
<code value="AMB"/> <!-- outpatient -->
<display value="ambulatory"/>
</class>
<type>
<coding>
<system value="http://snomed.info/sct"/>
<code value="270427003"/>
<display value="Patient-initiated encounter"/>
</coding>
</type>
<priority>
<coding>
<system value="http://snomed.info/sct"/>
<code value="103391001"/>
<display value="Non-urgent ear, nose and throat admission"/>
</coding>
</priority>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<participant>
<individual>
<reference value="Practitioner/f001"/>
<display value="E.M. van den Broek"/>
</individual>
</participant>
<length>
<value value="90"/>
<unit value="min"/>
<system value="http://unitsofmeasure.org"/>
<code value="min"/>
</length>
<reason>
<extension url="http://hl7.org/fhir/StructureDefinition/encounter-primaryDiagnosis">
<valuePositiveInt value="1"/>
</extension>
<coding>
<system value="http://snomed.info/sct"/>
<code value="18099001"/>
<display value="Retropharyngeal abscess"/>
</coding>
</reason>
<hospitalization>
<preAdmissionIdentifier>
<use value="official"/>
<system value="http://www.bmc.nl/zorgportal/identifiers/pre-admissions"/>
<value value="93042"/>
</preAdmissionIdentifier>
<!-- <preAdmissionTest>
<coding>
<system value="http://snomed.info/sct"/>
<code value="168719007"/>
<display value="Neck soft tissue X-ray"/>
</coding>
<coding>
<system value="http://snomed.info/sct"/>
<code value="396550006"/>
<display value="Blood test"/>
</coding>
</preAdmissionTest> -->
<admitSource>
<coding>
<system value="http://snomed.info/sct"/>
<code value="305956004"/>
<display value="Referral by physician"/>
</coding>
</admitSource>
<dischargeDisposition>
<coding>
<system value="http://snomed.info/sct"/>
<code value="306689006"/>
<display value="Discharge to home"/>
</coding>
</dischargeDisposition>
</hospitalization>
<serviceProvider>
<reference value="Organization/f001"/>
</serviceProvider>
</Encounter>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Procedure/f004"/>
<resource>
<Procedure xmlns="http://hl7.org/fhir">
<id value="f004"/>
<status value="completed"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="48387007"/>
<display value="Tracheotomy"/>
</coding>
</code>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<context>
<reference value="Encounter/f003"/>
</context>
<performedPeriod>
<start value="2013-03-22T09:30:10+01:00"/>
<end value="2013-03-22T10:30:10+01:00"/>
</performedPeriod>
<performer>
<role>
<coding>
<system value="urn:oid:2.16.840.1.113883.2.4.15.111"/> <!-- "AssignedRoleType" coding system -->
<code value="01.000"/>
<display value="Arts"/>
</coding>
<text value="Care role"/>
</role>
<actor>
<reference value="Practitioner/f005"/>
<display value="A. Langeveld"/>
</actor>
</performer>
<reasonCode>
<text value="ensure breathing during surgery"/>
</reasonCode>
<bodySite>
<coding>
<system value="http://snomed.info/sct"/>
<code value="83030008"/>
<display value="Retropharyngeal area"/>
</coding>
</bodySite>
<outcome>
<text value="removal of the retropharyngeal abscess"/>
</outcome>
<report>
<reference value="DiagnosticReport/f001"/>
<display value="???????????"/>
</report>
<followUp>
<text value="described in care plan"/>
</followUp>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/CarePlan/f001"/>
<resource>
<CarePlan xmlns="http://hl7.org/fhir">
<id value="f001"/>
<contained>
<CareTeam>
<id value="careteam"/>
<participant>
<member>
<reference value="Practitioner/f002"/>
<display value="P. Voigt"/>
</member>
</participant>
</CareTeam>
</contained>
<contained>
<Goal>
<id value="goal"/>
<status value="achieved"/>
<description>
<text value="recovery surgery on heart of patient"/>
</description>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<note>
<text value="goal accomplished without complications"/>
</note>
</Goal>
</contained>
<identifier>
<use value="official"/>
<!-- urn:oid:2.16.840.1.113883.4.642.1.36 -->
<system value="http://www.bmc.nl/zorgportal/identifiers/careplans"/>
<value value="CP2903"/>
</identifier>
<status value="completed"/>
<intent value="plan"/>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<period>
<start value="2011-06-26"/>
<end value="2011-06-27"/>
</period>
<careTeam>
<reference value="#careteam"/>
</careTeam>
<addresses>
<reference value="Condition/f201"/>
<!--TODO Correcte referentie-->
<display value="?????"/>
</addresses>
<goal>
<reference value="#goal"/>
</goal>
<activity>
<detail>
<category><coding><system value="http://hl7.org/fhir/care-plan-activity-category"/><code value="procedure"/></coding></category>
<!-- urn:oid:2.16.840.1.113883.4.642.1.39 -->
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="64915003"/>
<display value="Operation on heart"/>
</coding>
</code>
<status value="completed"/>
<prohibited value="true"/>
<scheduledString value="2011-06-27T09:30:10+01:00"/>
<performer>
<reference value="Practitioner/f002"/>
<display value="P. Voigt"/>
</performer>
</detail>
</activity>
</CarePlan>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Observation/f003"/>
<resource>
<Observation xmlns="http://hl7.org/fhir">
<id value="f003"/>
<!-- urn:oid:2.16.840.1.113883.4.642.1.7 -->
<!-- 2.16.840.1.113883.4.642.1.118 -->
<identifier>
<use value="official"/>
<system value="http://www.bmc.nl/zorgportal/identifiers/observations"/>
<value value="6325"/>
</identifier>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="11557-6"/>
<display value="Carbon dioxide in blood"/>
</coding>
</code>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<effectivePeriod>
<start value="2013-04-02T10:30:10+01:00"/>
<end value="2013-04-05T10:30:10+01:00"/>
</effectivePeriod>
<issued value="2013-04-03T15:30:10+01:00"/>
<performer>
<reference value="Practitioner/f005"/>
<display value="A. Langeveld"/>
</performer>
<valueQuantity>
<value value="6.2"/>
<unit value="kPa"/>
<system value="http://unitsofmeasure.org"/>
<code value="kPa"/>
</valueQuantity>
<interpretation>
<coding>
<system value="http://hl7.org/fhir/v2/0078"/>
<code value="H"/>
<display value="High"/>
</coding>
</interpretation>
<referenceRange>
<low>
<value value="4.8"/>
<unit value="kPa"/>
<system value="http://unitsofmeasure.org"/>
<code value="kPa"/>
</low>
<high>
<value value="6.0"/>
<unit value="kPa"/>
<system value="http://unitsofmeasure.org"/>
<code value="kPa"/>
</high>
</referenceRange>
</Observation>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Observation/f001"/>
<resource>
<Observation xmlns="http://hl7.org/fhir">
<id value="f001"/>
<!-- urn:oid:2.16.840.1.113883.4.642.1.7 -->
<!-- 2.16.840.1.113883.4.642.1.118 -->
<identifier>
<use value="official"/>
<system value="http://www.bmc.nl/zorgportal/identifiers/observations"/>
<value value="6323"/>
</identifier>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="15074-8"/>
<display value="Glucose [Moles/volume] in Blood"/>
</coding>
</code>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<effectivePeriod>
<start value="2013-04-02T09:30:10+01:00"/>
</effectivePeriod>
<issued value="2013-04-03T15:30:10+01:00"/>
<performer>
<reference value="Practitioner/f005"/>
<display value="A. Langeveld"/>
</performer>
<valueQuantity>
<value value="6.3"/>
<unit value="mmol/l"/>
<system value="http://unitsofmeasure.org"/>
<code value="mmol/L"/>
</valueQuantity>
<interpretation>
<coding>
<system value="http://hl7.org/fhir/v2/0078"/>
<code value="H"/>
<display value="High"/>
</coding>
</interpretation>
<referenceRange>
<low>
<value value="3.1"/>
<unit value="mmol/l"/>
<system value="http://unitsofmeasure.org"/>
<code value="mmol/L"/>
</low>
<high>
<value value="6.2"/>
<unit value="mmol/l"/>
<system value="http://unitsofmeasure.org"/>
<code value="mmol/L"/>
</high>
</referenceRange>
</Observation>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Procedure/f003"/>
<resource>
<Procedure xmlns="http://hl7.org/fhir">
<id value="f003"/>
<status value="completed"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="172960003"/>
<display value="Incision of retropharyngeal abscess"/>
</coding>
</code>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<context>
<reference value="Encounter/f003"/>
</context>
<performedPeriod>
<start value="2013-03-24T09:30:10+01:00"/>
<end value="2013-03-24T10:30:10+01:00"/>
</performedPeriod>
<performer>
<role>
<coding>
<system value="urn:oid:2.16.840.1.113883.2.4.15.111"/> <!-- "AssignedRoleType" coding system -->
<code value="01.000"/>
<display value="Arts"/>
</coding>
<text value="Care role"/>
</role>
<actor>
<reference value="Practitioner/f001"/>
<display value="E.M.J.M. van den broek"/>
</actor>
</performer>
<reasonCode>
<text value="abcess in retropharyngeal area"/>
</reasonCode>
<bodySite>
<coding>
<system value="http://snomed.info/sct"/>
<code value="83030008"/>
<display value="Retropharyngeal area"/>
</coding>
</bodySite>
<outcome>
<text value="removal of the retropharyngeal abscess"/>
</outcome>
<report>
<reference value="DiagnosticReport/f001"/>
<display value="Lab results blood test"/>
</report>
<followUp>
<text value="described in care plan"/>
</followUp>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Procedure/f002"/>
<resource>
<Procedure xmlns="http://hl7.org/fhir">
<id value="f002"/>
<status value="completed"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="359615001"/>
<display value="Partial lobectomy of lung"/>
</coding>
</code>
<subject>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</subject>
<context>
<reference value="Encounter/f002"/>
</context>
<performedPeriod>
<start value="2013-03-08T09:00:10+01:00"/>
<end value="2013-03-08T09:30:10+01:00"/>
</performedPeriod>
<performer>
<role>
<coding>
<system value="urn:oid:2.16.840.1.113883.2.4.15.111"/> <!-- "AssignedRoleType" coding system -->
<code value="01.000"/>
<display value="Arts"/>
</coding>
<text value="Care role"/>
</role>
<actor>
<reference value="Practitioner/f003"/>
<display value="M.I.M. Versteegh"/>
</actor>
</performer>
<reasonCode>
<text value="Malignant tumor of lung"/>
</reasonCode>
<bodySite>
<coding>
<system value="http://snomed.info/sct"/>
<code value="39607008"/>
<display value="Lung structure"/>
</coding>
</bodySite>
<outcome>
<text value="improved blood circulation"/>
</outcome>
<report>
<reference value="DiagnosticReport/f001"/>
<display value="Lab results blood test"/>
</report>
<followUp>
<text value="described in care plan"/>
</followUp>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl value="http://hl7.org/fhir/Consent/consent-example-notThis"/>
<resource>
<Consent xmlns="http://hl7.org/fhir">
<id value="consent-example-notThis"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on existing jurisdictional policy and are realized in existing systems in Canada.
The default policy is one of implied consent for the provision of care, so these scenarios all deal with withdrawal or withholding consent for that purpose.
In other jurisdictions, where an express consent model is used (Opt-In), these would examples would contain the phrase "consent to" rather
than "withhold" or "withdraw" consent for.
<p>
specific to use-case 2. Withhold or withdraw consent for disclosure of a specific record (e.g. Lab Order/Result)
</p><p>
Patient "P. van de Heuvel" Primary Care Provider, Dr. Philip Primary, has ordered a set of lab test which Adam
wishes to keep as private as possible. At the sample collection facility, he indicates that he would
like withhold consent to disclose the order and all results associated with that specific order from
all other providers
</p>
</div>
</text>
<status value="active"/>
<patient>
<reference value="Patient/f001"/>
<display value="P. van de Heuvel"/>
</patient>
<dateTime value="2015-11-18"/>
<!-- not bound by a timeframe - Consent.period -->
<!-- I assume the example given is Canada Infoway wide??? AND I assume it is desired to state that in the Consent.authority element -->
<organization>
<reference value="Organization/Infoway"/>
<display value="Canada Infoway"/>
</organization>
<!-- the text terms of the consent in lawyer speak -->
<sourceAttachment>
<title value="The terms of the consent in lawyer speak."/>
<!-- likely use url pointer to common text -->
</sourceAttachment>
<!-- this is opt-in - e.g. everything approved unless otherwise stated -->
<policyRule value="http://hl7.org/fhir/ConsentPolicy/opt-in"/>
<except>
<type value="deny"/>
<data>
<meaning value="related"/>
<reference>
<reference value="Task/f201"/>
</reference>
</data>
</except>
</Consent>
</resource>
</entry>
</Bundle>
®© HL7.org 2011+. FHIR Release 3 (STU; v3.0.2-11200) generated on Thurs, Oct 24, 2019 11:53+1100. QA Page
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