minimal Common Oncology Data Elements (mCODE) Implementation Guide
2.1.0 - STU 2.1
minimal Common Oncology Data Elements (mCODE) Implementation Guide
2.1.0 - STU 2.1
This page is part of the HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU1 (v2.1.0: STU 2) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions 
{
"resourceType" : "Bundle",
"id" : "mcode-patient-bundle-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-patient-bundle"
]
},
"type" : "collection",
"entry" : [
{
"fullUrl" : "http://example.org/fhir/Patient/cancer-patient-jenny-m",
"resource" : {
"resourceType" : "Patient",
"id" : "cancer-patient-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-patient"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b><a name=\"cancer-patient-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Patient "cancer-patient-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-cancer-patient.html\">Cancer Patient Profile</a></p></div><blockquote><p><b>US Core Race Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: White (Details: urn:oid:2.16.840.1.113883.6.238 code 2106-3 = 'White', stated as 'White')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: White</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><blockquote><p><b>url</b></p><code>ombCategory</code></blockquote><p><b>value</b>: Not Hispanic or Latino (Details: urn:oid:2.16.840.1.113883.6.238 code 2186-5 = 'Not Hispanic or Latino', stated as 'Not Hispanic or Latino')</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>identifier</b>: Medical Record Number: MRN1234\u00a0(use:\u00a0USUAL)</p><p><b>name</b>: Jenny M </p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1965-01-01</p><p><b>address</b>: 123 Main St Anytown 12345 United States </p><h3>Contacts</h3><table class=\"grid\"><tr><td>-</td><td><b>Telecom</b></td></tr><tr><td>*</td><td>ph: 555-867-5309(HOME), <a href=\"mailto:example@example.com\">example@example.com</a></td></tr></table><h3>Communications</h3><table class=\"grid\"><tr><td>-</td><td><b>Language</b></td></tr><tr><td>*</td><td>English <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-ietf3066.html\">Tags for the Identification of Languages</a>#en-US)</span></td></tr></table></div>"
},
"extension" : [
{
"extension" : [
{
"url" : "ombCategory",
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "2106-3",
"display" : "White"
}
},
{
"url" : "text",
"valueString" : "White"
}
],
"url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
},
{
"extension" : [
{
"url" : "ombCategory",
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "2186-5",
"display" : "Not Hispanic or Latino"
}
},
{
"url" : "text",
"valueString" : "Not Hispanic or Latino"
}
],
"url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
}
],
"identifier" : [
{
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MR",
"display" : "Medical Record Number"
}
]
},
"system" : "http://hospital.example.org",
"value" : "MRN1234"
}
],
"name" : [
{
"family" : "M",
"given" : [
"Jenny"
]
}
],
"gender" : "female",
"birthDate" : "1965-01-01",
"address" : [
{
"line" : [
"123 Main St"
],
"city" : "Anytown",
"postalCode" : "12345",
"country" : "United States"
}
],
"contact" : [
{
"telecom" : [
{
"system" : "phone",
"value" : "555-867-5309",
"use" : "home"
},
{
"system" : "email",
"value" : "example@example.com"
}
]
}
],
"communication" : [
{
"language" : {
"coding" : [
{
"system" : "urn:ietf:bcp:47",
"code" : "en-US"
}
],
"text" : "English"
}
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Condition/primary-cancer-condition-jenny-m",
"resource" : {
"resourceType" : "Condition",
"id" : "primary-cancer-condition-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-primary-cancer-condition"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Condition</b><a name=\"primary-cancer-condition-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Condition "primary-cancer-condition-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-primary-cancer-condition.html\">Primary Cancer Condition Profile</a></p></div><p><b>Histology-Morphology-Behavior Extension</b>: Adenocarcinoma, no subtype, intermediate grade (morphologic abnormality) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#413448000)</span></p><p><b>clinicalStatus</b>: Remission <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-condition-clinical.html\">Condition Clinical Status Codes</a>#remission)</span></p><p><b>verificationStatus</b>: Confirmed <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-condition-ver-status.html\">ConditionVerificationStatus</a>#confirmed)</span></p><p><b>category</b>: Problem List Item <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-condition-category.html\">Condition Category Codes</a>#problem-list-item)</span></p><p><b>code</b>: Primary malignant neoplasm of female left breast (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#353431000119107)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>onset</b>: 2018-03-16</p><p><b>asserter</b>: <a href=\"#Practitioner_us-core-practitioner-owen-oncologist\">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><h3>Stages</h3><table class=\"grid\"><tr><td>-</td><td><b>Summary</b></td><td><b>Assessment</b></td></tr><tr><td>*</td><td>3C <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (cancerstaging.org#3C)</span></td><td><a href=\"#Observation_tnm-clinical-stage-group-jenny-m\">See above (Observation/tnm-clinical-stage-group-jenny-m)</a></td></tr></table></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "413448000",
"display" : "Adenocarcinoma, no subtype, intermediate grade (morphologic abnormality)"
}
]
}
}
],
"clinicalStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "remission"
}
]
},
"verificationStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code" : "confirmed"
}
]
},
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/condition-category",
"code" : "problem-list-item"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "353431000119107",
"display" : "Primary malignant neoplasm of female left breast (disorder)"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"onsetDateTime" : "2018-03-16",
"asserter" : {
"reference" : "Practitioner/us-core-practitioner-owen-oncologist"
},
"stage" : [
{
"summary" : {
"coding" : [
{
"system" : "http://cancerstaging.org",
"code" : "3C"
}
]
},
"assessment" : [
{
"reference" : "Observation/tnm-clinical-stage-group-jenny-m"
}
]
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/MedicationRequest/cancer-related-medication-request-cyclophosphamide-jenny-m",
"resource" : {
"resourceType" : "MedicationRequest",
"id" : "cancer-related-medication-request-cyclophosphamide-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-related-medication-request"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MedicationRequest</b><a name=\"cancer-related-medication-request-cyclophosphamide-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MedicationRequest "cancer-related-medication-request-cyclophosphamide-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-cancer-related-medication-request.html\">Cancer-Related Medication Request Profile</a></p></div><p><b>Procedure Intent Extension</b>: Curative - procedure intent (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#373808002)</span></p><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>category</b>: Outpatient <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-medicationrequest-category.html\">MedicationRequest Category Codes</a>#outpatient)</span></p><p><b>medication</b>: cyclophosphamide <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-rxNorm.html\">RxNorm</a>#3002)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>authoredOn</b>: 2018-04-12</p><p><b>requester</b>: <a href=\"#Practitioner_us-core-practitioner-owen-oncologist\">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>reasonReference</b>: <a href=\"#Condition_primary-cancer-condition-jenny-m\">See above (Condition/primary-cancer-condition-jenny-m)</a></p><blockquote><p><b>dosageInstruction</b></p><p><b>text</b>: cyclophosphamide (600 mg/m² IV), 932.59mg</p><p><b>timing</b>: Starting 2018-04-01, Once</p><p><b>route</b>: Intravenous route (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#47625008)</span></p><blockquote><p><b>doseAndRate</b></p></blockquote><p><b>maxDosePerPeriod</b>: 1/3 week<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code wk = 'wk')</span></p></blockquote></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "373808002",
"display" : "Curative - procedure intent (qualifier value)"
}
]
}
}
],
"status" : "active",
"intent" : "order",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
"code" : "outpatient"
}
]
}
],
"medicationCodeableConcept" : {
"coding" : [
{
"system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
"code" : "3002",
"display" : "cyclophosphamide"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"authoredOn" : "2018-04-12",
"requester" : {
"reference" : "Practitioner/us-core-practitioner-owen-oncologist"
},
"reasonReference" : [
{
"reference" : "Condition/primary-cancer-condition-jenny-m"
}
],
"dosageInstruction" : [
{
"text" : "cyclophosphamide (600 mg/m² IV), 932.59mg",
"timing" : {
"repeat" : {
"boundsPeriod" : {
"start" : "2018-04-01"
}
}
},
"route" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "47625008",
"display" : "Intravenous route (qualifier value)"
}
]
},
"doseAndRate" : [
{
"doseQuantity" : {
"value" : 932.59,
"unit" : "mg",
"system" : "http://unitsofmeasure.org",
"code" : "mg"
}
}
],
"maxDosePerPeriod" : {
"numerator" : {
"value" : 1
},
"denominator" : {
"value" : 3,
"unit" : "week",
"system" : "http://unitsofmeasure.org",
"code" : "wk"
}
}
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/cancer-disease-status-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "cancer-disease-status-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-disease-status"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"cancer-disease-status-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "cancer-disease-status-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-cancer-disease-status.html\">Cancer Disease Status Profile</a></p></div><p><b>Cancer Disease Status Evidence Type Extension</b>: Imaging (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#363679005)</span></p><p><b>status</b>: final</p><p><b>code</b>: Cancer Disease Progression <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#97509-4)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>focus</b>: <a href=\"#Condition_primary-cancer-condition-jenny-m\">See above (Condition/primary-cancer-condition-jenny-m)</a></p><p><b>effective</b>: 2018-11-01</p><p><b>performer</b>: <a href=\"#Practitioner_us-core-practitioner-owen-oncologist\">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>value</b>: Patient's condition improved (finding) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#268910001)</span></p></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-disease-status-evidence-type",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "363679005",
"display" : "Imaging (procedure)"
}
]
}
}
],
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "97509-4",
"display" : "Cancer Disease Progression"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"focus" : [
{
"reference" : "Condition/primary-cancer-condition-jenny-m"
}
],
"effectiveDateTime" : "2018-11-01",
"performer" : [
{
"reference" : "Practitioner/us-core-practitioner-owen-oncologist"
}
],
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "268910001",
"display" : "Patient's condition improved (finding)"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/genomic-variant-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "genomic-variant-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-genomic-variant"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"genomic-variant-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "genomic-variant-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-genomic-variant.html\">Genomic Variant Profile</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Laboratory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#laboratory)</span></p><p><b>code</b>: Genetic variant assessment <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#69548-6)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-15</p><p><b>value</b>: Present <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA9633-4)</span></p><p><b>method</b>: Sequencing <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA26398-0)</span></p><blockquote><p><b>component</b></p><p><b>code</b>: Gene studied [ID] <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#48018-6)</span></p><p><b>value</b>: PALB2 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-hgnc.html\">HUGO Gene Nomenclature Committee Genes</a>#HGNC:26144)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Discrete genetic variant <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#81252-9)</span></p><p><b>value</b>: NM_024675.3(PALB2):c.3549C>A (p.Tyr1183Ter) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-ClinVarV.html\">ClinVar Variant ID</a>#128144)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Genomic DNA change (gHGVS) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#81290-9)</span></p><p><b>value</b>: NC_000016.10:g.23603471G>T <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-hgvs.html\">Human Genome Variation Society nomenclature</a>#NC_000016.10:g.23603471G>T)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Genomic source class [Type] <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#48002-0)</span></p><p><b>value</b>: Somatic <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA6684-0)</span></p></blockquote></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "laboratory"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "69548-6",
"display" : "Genetic variant assessment"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-03-15",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "LA9633-4",
"display" : "Present"
}
]
},
"method" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "LA26398-0",
"display" : "Sequencing"
}
]
},
"component" : [
{
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "48018-6"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://www.genenames.org",
"code" : "HGNC:26144",
"display" : "PALB2"
}
]
}
},
{
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "81252-9"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://www.ncbi.nlm.nih.gov/clinvar",
"code" : "128144",
"display" : "NM_024675.3(PALB2):c.3549C>A (p.Tyr1183Ter)"
}
]
}
},
{
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "81290-9"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://varnomen.hgvs.org",
"code" : "NC_000016.10:g.23603471G>T"
}
]
}
},
{
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "48002-0"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "LA6684-0",
"display" : "Somatic"
}
]
}
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/DiagnosticReport/genomics-report-jenny-m",
"resource" : {
"resourceType" : "DiagnosticReport",
"id" : "genomics-report-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-genomics-report"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: DiagnosticReport</b><a name=\"genomics-report-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource DiagnosticReport "genomics-report-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-genomics-report.html\">Genomics Report Profile</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Laboratory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v2-0074.html\">diagnosticServiceSectionId</a>#LAB)</span>, Genetics <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v2-0074.html\">diagnosticServiceSectionId</a>#GE)</span></p><p><b>code</b>: Master HL7 genetic variant reporting panel <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#81247-9)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-15</p><p><b>issued</b>: 15 Mar 2020, 11:00:01 am</p><p><b>specimen</b>: <a href=\"#Specimen_genomic-specimen-left-breast-jenny-m\">See above (Specimen/genomic-specimen-left-breast-jenny-m)</a></p><p><b>result</b>: </p><ul><li><a href=\"#Observation_genomic-variant-jenny-m\">See above (Observation/genomic-variant-jenny-m)</a></li><li><a href=\"#Observation_genomic-region-studied-jenny-m\">See above (Observation/genomic-region-studied-jenny-m)</a></li></ul></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
"code" : "LAB"
}
]
},
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
"code" : "GE"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "81247-9"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-03-15",
"issued" : "2020-03-15T00:00:01+00:00",
"specimen" : [
{
"reference" : "Specimen/genomic-specimen-left-breast-jenny-m"
}
],
"result" : [
{
"reference" : "Observation/genomic-variant-jenny-m"
},
{
"reference" : "Observation/genomic-region-studied-jenny-m"
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Procedure/cancer-related-surgical-procedure-jenny-m",
"resource" : {
"resourceType" : "Procedure",
"id" : "cancer-related-surgical-procedure-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-related-surgical-procedure"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Procedure</b><a name=\"cancer-related-surgical-procedure-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Procedure "cancer-related-surgical-procedure-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-cancer-related-surgical-procedure.html\">Cancer-Related Surgical Procedure Profile</a></p></div><p><b>Procedure Intent Extension</b>: Curative - procedure intent (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#373808002)</span></p><p><b>status</b>: completed</p><p><b>category</b>: Surgical procedure (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#387713003)</span></p><p><b>code</b>: Partial mastectomy (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64368001)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>performed</b>: 2018-04-01</p><p><b>asserter</b>: <a href=\"#Practitioner_us-core-practitioner-owen-oncologist\">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>reasonReference</b>: <a href=\"#Condition_primary-cancer-condition-jenny-m\">See above (Condition/primary-cancer-condition-jenny-m)</a></p><p><b>bodySite</b>: Left breast structure (body structure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#80248007)</span></p></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "373808002",
"display" : "Curative - procedure intent (qualifier value)"
}
]
}
}
],
"status" : "completed",
"category" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "387713003"
}
]
},
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "64368001",
"display" : "Partial mastectomy (procedure)"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"performedDateTime" : "2018-04-01",
"asserter" : {
"reference" : "Practitioner/us-core-practitioner-owen-oncologist"
},
"reasonReference" : [
{
"reference" : "Condition/primary-cancer-condition-jenny-m"
}
],
"bodySite" : [
{
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "80248007",
"display" : "Left breast structure (body structure)"
}
]
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Procedure/radiotherapy-treatment-summary-chest-wall-jenny-m",
"resource" : {
"resourceType" : "Procedure",
"id" : "radiotherapy-treatment-summary-chest-wall-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-course-summary"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Procedure</b><a name=\"radiotherapy-treatment-summary-chest-wall-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Procedure "radiotherapy-treatment-summary-chest-wall-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-radiotherapy-course-summary.html\">Radiotherapy Course Summary Profile</a></p></div><p><b>Radiotherapy Number of Sessions Extension</b>: 31</p><p><b>Procedure Intent Extension</b>: Curative - procedure intent <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#373808002)</span></p><blockquote><p><b>Radiotherapy Modality And Technique Extension</b></p><blockquote><p><b>url</b></p><a href=\"StructureDefinition-mcode-radiotherapy-modality.html\">Radiotherapy Modality Extension</a></blockquote><p><b>value</b>: External beam radiation therapy using photons (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#1156506007)</span></p><blockquote><p><b>url</b></p><a href=\"StructureDefinition-mcode-radiotherapy-technique.html\">Radiotherapy Technique Extension</a></blockquote><p><b>value</b>: Volumetric Modulated Arc Therapy (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#1156530009)</span></p></blockquote><blockquote><p><b>Radiotherapy Modality And Technique Extension</b></p><blockquote><p><b>url</b></p><a href=\"StructureDefinition-mcode-radiotherapy-modality.html\">Radiotherapy Modality Extension</a></blockquote><p><b>value</b>: Teleradiotherapy using electrons <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#45643008)</span></p><blockquote><p><b>url</b></p><a href=\"StructureDefinition-mcode-radiotherapy-technique.html\">Radiotherapy Technique Extension</a></blockquote><p><b>value</b>: Three dimensional external beam radiation therapy (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#1162782007)</span></p></blockquote><blockquote><p><b>Radiotherapy Dose Delivered To Volume Extension</b></p><blockquote><p><b>url</b></p><code>volume</code></blockquote><p><b>value</b>: <a href=\"BodyStructure-jenny-m-chest-wall-treatment-volume.html\">BodyStructure/jenny-m-chest-wall-treatment-volume</a></p><blockquote><p><b>url</b></p><code>totalDoseDelivered</code></blockquote><p><b>value</b>: 6000 cGy<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code cGy = 'cGy')</span></p><blockquote><p><b>url</b></p><code>fractionsDelivered</code></blockquote><p><b>value</b>: 30</p></blockquote><blockquote><p><b>Radiotherapy Dose Delivered To Volume Extension</b></p><blockquote><p><b>url</b></p><code>volume</code></blockquote><p><b>value</b>: <a href=\"BodyStructure-jenny-m-chest-wall-lymph-nodes-treatment-volume.html\">BodyStructure/jenny-m-chest-wall-lymph-nodes-treatment-volume</a></p><blockquote><p><b>url</b></p><code>totalDoseDelivered</code></blockquote><p><b>value</b>: 5000 cGy<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code cGy = 'cGy')</span></p><blockquote><p><b>url</b></p><code>fractionsDelivered</code></blockquote><p><b>value</b>: 25</p></blockquote><p><b>status</b>: completed</p><p><b>category</b>: Radiation oncology AND/OR radiotherapy (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#108290001)</span></p><p><b>code</b>: Radiotherapy course of treatment <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#1217123003)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>performed</b>: 2018-08-15 --> 2018-10-25</p><p><b>asserter</b>: <a href=\"Practitioner-us-core-practitioner-kyle-anydoc.html\">Practitioner/us-core-practitioner-kyle-anydoc</a> " ANYDOC"</p><p><b>reasonCode</b>: Malignant neoplasm of overlapping sites of right female breast <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-icd10CM.html\">International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)</a>#C50.811)</span></p><p><b>bodySite</b>: Chest Wall Structure (body structure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#78904004)</span></p></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions",
"valueUnsignedInt" : 31
},
{
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "373808002",
"display" : "Curative - procedure intent"
}
]
}
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "1156506007",
"display" : "External beam radiation therapy using photons (procedure)"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "1156530009",
"display" : "Volumetric Modulated Arc Therapy (procedure)"
}
]
}
}
],
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "45643008",
"display" : "Teleradiotherapy using electrons"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "1162782007",
"display" : "Three dimensional external beam radiation therapy (procedure)"
}
]
}
}
],
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique"
},
{
"extension" : [
{
"url" : "volume",
"valueReference" : {
"reference" : "BodyStructure/jenny-m-chest-wall-treatment-volume"
}
},
{
"url" : "totalDoseDelivered",
"valueQuantity" : {
"value" : 6000,
"system" : "http://unitsofmeasure.org",
"code" : "cGy"
}
},
{
"url" : "fractionsDelivered",
"valueUnsignedInt" : 30
}
],
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume"
},
{
"extension" : [
{
"url" : "volume",
"valueReference" : {
"reference" : "BodyStructure/jenny-m-chest-wall-lymph-nodes-treatment-volume"
}
},
{
"url" : "totalDoseDelivered",
"valueQuantity" : {
"value" : 5000,
"system" : "http://unitsofmeasure.org",
"code" : "cGy"
}
},
{
"url" : "fractionsDelivered",
"valueUnsignedInt" : 25
}
],
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume"
}
],
"status" : "completed",
"category" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "108290001",
"display" : "Radiation oncology AND/OR radiotherapy (procedure)"
}
]
},
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "1217123003"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"performedPeriod" : {
"start" : "2018-08-15",
"end" : "2018-10-25"
},
"asserter" : {
"reference" : "Practitioner/us-core-practitioner-kyle-anydoc"
},
"reasonCode" : [
{
"coding" : [
{
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "C50.811",
"display" : "Malignant neoplasm of overlapping sites of right female breast"
}
]
}
],
"bodySite" : [
{
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "78904004",
"display" : "Chest Wall Structure (body structure)"
}
]
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/tnm-clinical-stage-group-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "tnm-clinical-stage-group-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-stage-group"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"tnm-clinical-stage-group-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "tnm-clinical-stage-group-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-cancer-stage-group.html\">Cancer Stage Group Profile</a></p></div><p><b>status</b>: final</p><p><b>code</b>: Stage group.clinical Cancer <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#21908-9)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-16</p><p><b>value</b>: IIB <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (cancerstaging.org#2B)</span></p><p><b>method</b>: American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#897275008)</span></p><p><b>hasMember</b>: </p><ul><li><a href=\"Observation-tnm-pathologic-primary-tumor-category-jenny-m.html\">Observation/tnm-pathologic-primary-tumor-category-jenny-m</a></li><li><a href=\"Observation-tnm-pathologic-regional-nodes-category-jenny-m.html\">Observation/tnm-pathologic-regional-nodes-category-jenny-m</a></li><li><a href=\"Observation-tnm-pathologic-distant-metastases-category-jenny-m.html\">Observation/tnm-pathologic-distant-metastases-category-jenny-m</a></li></ul></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "21908-9",
"display" : "Stage group.clinical Cancer"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-03-16",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://cancerstaging.org",
"code" : "2B",
"display" : "IIB"
}
]
},
"method" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "897275008",
"display" : "American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)"
}
]
},
"hasMember" : [
{
"reference" : "Observation/tnm-pathologic-primary-tumor-category-jenny-m"
},
{
"reference" : "Observation/tnm-pathologic-regional-nodes-category-jenny-m"
},
{
"reference" : "Observation/tnm-pathologic-distant-metastases-category-jenny-m"
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/tnm-clinical-primary-tumor-category-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "tnm-clinical-primary-tumor-category-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tnm-primary-tumor-category"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"tnm-clinical-primary-tumor-category-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "tnm-clinical-primary-tumor-category-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-tnm-primary-tumor-category.html\">TNM Primary Tumor Category Profile</a></p></div><p><b>status</b>: final</p><p><b>code</b>: Primary tumor.clinical [Class] Cancer <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#21905-5)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-16</p><p><b>value</b>: cT3 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (cancerstaging.org#cT3)</span></p><p><b>method</b>: American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#897275008)</span></p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "21905-5",
"display" : "Primary tumor.clinical [Class] Cancer"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-03-16",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://cancerstaging.org",
"code" : "cT3"
}
]
},
"method" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "897275008",
"display" : "American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/tnm-clinical-regional-nodes-category-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "tnm-clinical-regional-nodes-category-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tnm-regional-nodes-category"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"tnm-clinical-regional-nodes-category-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "tnm-clinical-regional-nodes-category-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-tnm-regional-nodes-category.html\">TNM Regional Nodes Category Profile</a></p></div><p><b>status</b>: final</p><p><b>code</b>: Regional lymph nodes.clinical [Class] Cancer <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#21906-3)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-16</p><p><b>value</b>: cN0 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (cancerstaging.org#cN0)</span></p><p><b>method</b>: American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#897275008)</span></p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "21906-3",
"display" : "Regional lymph nodes.clinical [Class] Cancer"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-03-16",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://cancerstaging.org",
"code" : "cN0"
}
]
},
"method" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "897275008",
"display" : "American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/tnm-clinical-distant-metastases-category-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "tnm-clinical-distant-metastases-category-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tnm-distant-metastases-category"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"tnm-clinical-distant-metastases-category-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "tnm-clinical-distant-metastases-category-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-tnm-distant-metastases-category.html\">TNM Distant Metastases Category Profile</a></p></div><p><b>status</b>: final</p><p><b>code</b>: Distant metastases.clinical [Class] Cancer <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#21907-1)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-16</p><p><b>value</b>: cM0 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (cancerstaging.org#cM0)</span></p><p><b>method</b>: American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#897275008)</span></p></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "21907-1",
"display" : "Distant metastases.clinical [Class] Cancer"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-03-16",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://cancerstaging.org",
"code" : "cM0"
}
]
},
"method" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "897275008",
"display" : "American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Specimen/genomic-specimen-left-breast-jenny-m",
"resource" : {
"resourceType" : "Specimen",
"id" : "genomic-specimen-left-breast-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-genomic-specimen"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Specimen</b><a name=\"genomic-specimen-left-breast-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Specimen "genomic-specimen-left-breast-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-genomic-specimen.html\">Genomic Specimen Profile</a></p></div><p><b>status</b>: available</p><p><b>type</b>: Tissue <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v2-0487.html\">specimenType</a>#TISS)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><h3>Collections</h3><table class=\"grid\"><tr><td>-</td><td><b>Collector</b></td><td><b>BodySite</b></td></tr><tr><td>*</td><td><a href=\"#Practitioner_us-core-practitioner-owen-oncologist\">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></td><td>Left breast structure (body structure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#80248007)</span></td></tr></table><h3>Processings</h3><table class=\"grid\"><tr><td>-</td><td><b>Time[x]</b></td></tr><tr><td>*</td><td>2018-03-06</td></tr></table></div>"
},
"status" : "available",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0487",
"code" : "TISS"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"collection" : {
"collector" : {
"reference" : "Practitioner/us-core-practitioner-owen-oncologist"
},
"bodySite" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "80248007",
"display" : "Left breast structure (body structure)"
}
]
}
},
"processing" : [
{
"timeDateTime" : "2018-03-06"
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/genomic-region-studied-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "genomic-region-studied-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-genomic-region-studied"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"genomic-region-studied-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "genomic-region-studied-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-genomic-region-studied.html\">Genomic Region Studied Profile</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Laboratory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#laboratory)</span></p><p><b>code</b>: DNA region of interest panel <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#53041-0)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-15</p><p><b>issued</b>: 15 Mar 2018, 11:00:01 am</p><h3>Components</h3><table class=\"grid\"><tr><td>-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Gene studied [ID] <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#48018-6)</span></td><td>BRCA1 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-hgnc.html\">HUGO Gene Nomenclature Committee Genes</a>#1100; <a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-hgnc.html\">HUGO Gene Nomenclature Committee Genes</a>#1101 "BRCA2"; <a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-hgnc.html\">HUGO Gene Nomenclature Committee Genes</a>#1748 "CDH1"; <a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-hgnc.html\">HUGO Gene Nomenclature Committee Genes</a>#26144 "PALB2"; <a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-hgnc.html\">HUGO Gene Nomenclature Committee Genes</a>#9588 "PTEN"; <a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-hgnc.html\">HUGO Gene Nomenclature Committee Genes</a>#11389 "STK11"; <a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-hgnc.html\">HUGO Gene Nomenclature Committee Genes</a>#11998 "TP53")</span></td></tr></table></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "laboratory"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "53041-0",
"display" : "DNA region of interest panel"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-03-15",
"issued" : "2018-03-15T00:00:01+00:00",
"component" : [
{
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "48018-6",
"display" : "Gene studied [ID]"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://www.genenames.org",
"code" : "1100",
"display" : "BRCA1"
},
{
"system" : "http://www.genenames.org",
"code" : "1101",
"display" : "BRCA2"
},
{
"system" : "http://www.genenames.org",
"code" : "1748",
"display" : "CDH1"
},
{
"system" : "http://www.genenames.org",
"code" : "26144",
"display" : "PALB2"
},
{
"system" : "http://www.genenames.org",
"code" : "9588",
"display" : "PTEN"
},
{
"system" : "http://www.genenames.org",
"code" : "11389",
"display" : "STK11"
},
{
"system" : "http://www.genenames.org",
"code" : "11998",
"display" : "TP53"
}
]
}
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/ecog-performance-status-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "ecog-performance-status-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-ecog-performance-status"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"ecog-performance-status-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "ecog-performance-status-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-ecog-performance-status.html\">ECOG Performance Status Profile</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Survey <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#survey)</span></p><p><b>code</b>: ECOG Performance Status score <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#89247-1)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-04-12</p><p><b>performer</b>: <a href=\"#Practitioner_us-core-practitioner-owen-oncologist\">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>value</b>: 0</p><p><b>interpretation</b>: Fully active, able to carry on all pre-disease performance without restriction <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA9622-7)</span></p><p><b>method</b>: Physical examination procedure (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#5880005)</span></p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "survey"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "89247-1"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-04-12",
"performer" : [
{
"reference" : "Practitioner/us-core-practitioner-owen-oncologist"
}
],
"valueInteger" : 0,
"interpretation" : [
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "LA9622-7",
"display" : "Fully active, able to carry on all pre-disease performance without restriction"
}
]
}
],
"method" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "5880005",
"display" : "Physical examination procedure (procedure)"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/tumor-marker-test-er-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "tumor-marker-test-er-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor-marker-test"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"tumor-marker-test-er-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "tumor-marker-test-er-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-tumor-marker-test.html\">Tumor Marker Test Profile</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Laboratory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#laboratory)</span></p><p><b>code</b>: Estrogen receptor Ag [Presence] in Breast cancer specimen by Immune stain <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#85337-4)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-10</p><p><b>performer</b>: <a href=\"#Practitioner_us-core-practitioner-owen-oncologist\">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>value</b>: Positive <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA6576-8)</span></p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "laboratory"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "85337-4",
"display" : "Estrogen receptor Ag [Presence] in Breast cancer specimen by Immune stain"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-03-10",
"performer" : [
{
"reference" : "Practitioner/us-core-practitioner-owen-oncologist"
}
],
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "LA6576-8",
"display" : "Positive"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/tumor-marker-test-pr-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "tumor-marker-test-pr-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor-marker-test"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"tumor-marker-test-pr-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "tumor-marker-test-pr-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-tumor-marker-test.html\">Tumor Marker Test Profile</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Laboratory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#laboratory)</span></p><p><b>code</b>: Progesterone receptor Ag [Presence] in Breast cancer specimen by Immune stain <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#85339-0)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-10</p><p><b>performer</b>: <a href=\"#Practitioner_us-core-practitioner-owen-oncologist\">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>value</b>: Negative <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA6577-6)</span></p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "laboratory"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "85339-0",
"display" : "Progesterone receptor Ag [Presence] in Breast cancer specimen by Immune stain"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-03-10",
"performer" : [
{
"reference" : "Practitioner/us-core-practitioner-owen-oncologist"
}
],
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "LA6577-6",
"display" : "Negative"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/tumor-marker-test-her2-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "tumor-marker-test-her2-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor-marker-test"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"tumor-marker-test-her2-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "tumor-marker-test-her2-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-tumor-marker-test.html\">Tumor Marker Test Profile</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Laboratory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#laboratory)</span></p><p><b>code</b>: HER2 [Interpretation] in Tissue <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#48676-1)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-10</p><p><b>performer</b>: <a href=\"#Practitioner_us-core-practitioner-owen-oncologist\">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>value</b>: Negative <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA6577-6)</span></p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "laboratory"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "48676-1",
"display" : "HER2 [Interpretation] in Tissue"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-03-10",
"performer" : [
{
"reference" : "Practitioner/us-core-practitioner-owen-oncologist"
}
],
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "LA6577-6",
"display" : "Negative"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/tumor-marker-test-oncotype-dx-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "tumor-marker-test-oncotype-dx-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor-marker-test"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"tumor-marker-test-oncotype-dx-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "tumor-marker-test-oncotype-dx-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-tumor-marker-test.html\">Tumor Marker Test Profile</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Laboratory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#laboratory)</span></p><p><b>code</b>: Oncotype DX Breast Recurrence Score Assay <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (gtr#509910)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-04-12</p><p><b>performer</b>: <a href=\"Organization-us-core-organization-bedrock-medicine.html\">Organization/us-core-organization-bedrock-medicine</a> "Bedrock Medicine"</p><p><b>value</b>: 47 Recurrence score<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code {ScoreOf} = '{ScoreOf}')</span></p><p><b>interpretation</b>: High <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-ObservationInterpretation.html\">ObservationInterpretation</a>#H)</span></p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "laboratory"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://www.ncbi.nlm.nih.gov/gtr",
"code" : "509910",
"display" : "Oncotype DX Breast Recurrence Score Assay"
}
],
"text" : "Oncotype DX Breast Recurrence Score Assay"
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-04-12",
"performer" : [
{
"reference" : "Organization/us-core-organization-bedrock-medicine"
}
],
"valueQuantity" : {
"value" : 47,
"unit" : "Recurrence score",
"system" : "http://unitsofmeasure.org",
"code" : "{ScoreOf}"
},
"interpretation" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
"code" : "H",
"display" : "High"
}
]
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/MedicationRequest/cancer-related-medication-request-doxorubicin-jenny-m",
"resource" : {
"resourceType" : "MedicationRequest",
"id" : "cancer-related-medication-request-doxorubicin-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-related-medication-request"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MedicationRequest</b><a name=\"cancer-related-medication-request-doxorubicin-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MedicationRequest "cancer-related-medication-request-doxorubicin-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-cancer-related-medication-request.html\">Cancer-Related Medication Request Profile</a></p></div><p><b>Procedure Intent Extension</b>: Curative - procedure intent (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#373808002)</span></p><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>category</b>: Outpatient <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-medicationrequest-category.html\">MedicationRequest Category Codes</a>#outpatient)</span></p><p><b>medication</b>: DOXOrubicin <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-rxNorm.html\">RxNorm</a>#3639)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>authoredOn</b>: 2018-04-12</p><p><b>requester</b>: <a href=\"#Practitioner_us-core-practitioner-owen-oncologist\">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>reasonReference</b>: <a href=\"#Condition_primary-cancer-condition-jenny-m\">See above (Condition/primary-cancer-condition-jenny-m)</a></p><blockquote><p><b>dosageInstruction</b></p><p><b>text</b>: doxorubicin (60 mg/m² IV)</p><p><b>timing</b>: Starting 2018-04-01, Once</p><p><b>route</b>: Intravenous route (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#47625008)</span></p><blockquote><p><b>doseAndRate</b></p></blockquote><p><b>maxDosePerPeriod</b>: 1/3 week<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code wk = 'wk')</span></p></blockquote></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "373808002",
"display" : "Curative - procedure intent (qualifier value)"
}
]
}
}
],
"status" : "active",
"intent" : "order",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
"code" : "outpatient"
}
]
}
],
"medicationCodeableConcept" : {
"coding" : [
{
"system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
"code" : "3639",
"display" : "DOXOrubicin"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"authoredOn" : "2018-04-12",
"requester" : {
"reference" : "Practitioner/us-core-practitioner-owen-oncologist"
},
"reasonReference" : [
{
"reference" : "Condition/primary-cancer-condition-jenny-m"
}
],
"dosageInstruction" : [
{
"text" : "doxorubicin (60 mg/m² IV)",
"timing" : {
"repeat" : {
"boundsPeriod" : {
"start" : "2018-04-01"
}
}
},
"route" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "47625008",
"display" : "Intravenous route (qualifier value)"
}
]
},
"doseAndRate" : [
{
"rateQuantity" : {
"value" : 60,
"unit" : "mg/m2",
"system" : "http://unitsofmeasure.org",
"code" : "mg/m2"
}
}
],
"maxDosePerPeriod" : {
"numerator" : {
"value" : 1
},
"denominator" : {
"value" : 3,
"unit" : "week",
"system" : "http://unitsofmeasure.org",
"code" : "wk"
}
}
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/MedicationRequest/cancer-related-medication-request-paclitaxel-jenny-m",
"resource" : {
"resourceType" : "MedicationRequest",
"id" : "cancer-related-medication-request-paclitaxel-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-related-medication-request"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MedicationRequest</b><a name=\"cancer-related-medication-request-paclitaxel-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MedicationRequest "cancer-related-medication-request-paclitaxel-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-cancer-related-medication-request.html\">Cancer-Related Medication Request Profile</a></p></div><p><b>Procedure Intent Extension</b>: Curative - procedure intent (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#373808002)</span></p><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>category</b>: Outpatient <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-medicationrequest-category.html\">MedicationRequest Category Codes</a>#outpatient)</span></p><p><b>medication</b>: PACLitaxel <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-rxNorm.html\">RxNorm</a>#56946)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>authoredOn</b>: 2018-04-12</p><p><b>requester</b>: <a href=\"#Practitioner_us-core-practitioner-owen-oncologist\">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>reasonReference</b>: <a href=\"#Condition_primary-cancer-condition-jenny-m\">See above (Condition/primary-cancer-condition-jenny-m)</a></p><blockquote><p><b>dosageInstruction</b></p><p><b>text</b>: PACLitaxel (175 mg/m² IV), 272.01mg</p><p><b>timing</b>: Starting 2018-04-12, Once</p><p><b>route</b>: Intravenous route (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#47625008)</span></p><blockquote><p><b>doseAndRate</b></p></blockquote><p><b>maxDosePerPeriod</b>: 1/3 week<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code wk = 'wk')</span></p></blockquote></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "373808002",
"display" : "Curative - procedure intent (qualifier value)"
}
]
}
}
],
"status" : "active",
"intent" : "order",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
"code" : "outpatient"
}
]
}
],
"medicationCodeableConcept" : {
"coding" : [
{
"system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
"code" : "56946",
"display" : "PACLitaxel"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"authoredOn" : "2018-04-12",
"requester" : {
"reference" : "Practitioner/us-core-practitioner-owen-oncologist"
},
"reasonReference" : [
{
"reference" : "Condition/primary-cancer-condition-jenny-m"
}
],
"dosageInstruction" : [
{
"text" : "PACLitaxel (175 mg/m² IV), 272.01mg",
"timing" : {
"repeat" : {
"boundsPeriod" : {
"start" : "2018-04-12"
}
}
},
"route" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "47625008",
"display" : "Intravenous route (qualifier value)"
}
]
},
"doseAndRate" : [
{
"doseQuantity" : {
"value" : 272.01,
"unit" : "mg",
"system" : "http://unitsofmeasure.org",
"code" : "mg"
}
}
],
"maxDosePerPeriod" : {
"numerator" : {
"value" : 1
},
"denominator" : {
"value" : 3,
"unit" : "week",
"system" : "http://unitsofmeasure.org",
"code" : "wk"
}
}
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/MedicationRequest/cancer-related-medication-request-anastrozole-jenny-m",
"resource" : {
"resourceType" : "MedicationRequest",
"id" : "cancer-related-medication-request-anastrozole-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-related-medication-request"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MedicationRequest</b><a name=\"cancer-related-medication-request-anastrozole-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MedicationRequest "cancer-related-medication-request-anastrozole-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-cancer-related-medication-request.html\">Cancer-Related Medication Request Profile</a></p></div><p><b>Procedure Intent Extension</b>: Curative - procedure intent (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#373808002)</span></p><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>category</b>: Community <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-medicationrequest-category.html\">MedicationRequest Category Codes</a>#community)</span></p><p><b>medication</b>: anastrozole <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-rxNorm.html\">RxNorm</a>#84857)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>authoredOn</b>: 2018-09-30</p><p><b>requester</b>: <a href=\"#Practitioner_us-core-practitioner-owen-oncologist\">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>reasonReference</b>: <a href=\"#Condition_primary-cancer-condition-jenny-m\">See above (Condition/primary-cancer-condition-jenny-m)</a></p><blockquote><p><b>dosageInstruction</b></p><p><b>text</b>: 1mg orally once daily</p><p><b>timing</b>: Starting 2018-09-30, Once</p><p><b>route</b>: Oral route (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#26643006)</span></p><blockquote><p><b>doseAndRate</b></p></blockquote><p><b>maxDosePerPeriod</b>: 1/1 day<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code d = 'd')</span></p></blockquote></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "373808002",
"display" : "Curative - procedure intent (qualifier value)"
}
]
}
}
],
"status" : "active",
"intent" : "order",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
"code" : "community"
}
]
}
],
"medicationCodeableConcept" : {
"coding" : [
{
"system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
"code" : "84857",
"display" : "anastrozole"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"authoredOn" : "2018-09-30",
"requester" : {
"reference" : "Practitioner/us-core-practitioner-owen-oncologist"
},
"reasonReference" : [
{
"reference" : "Condition/primary-cancer-condition-jenny-m"
}
],
"dosageInstruction" : [
{
"text" : "1mg orally once daily",
"timing" : {
"repeat" : {
"boundsPeriod" : {
"start" : "2018-09-30"
}
}
},
"route" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "26643006",
"display" : "Oral route (qualifier value)"
}
]
},
"doseAndRate" : [
{
"doseQuantity" : {
"value" : 1,
"unit" : "mg",
"system" : "http://unitsofmeasure.org",
"code" : "mg"
}
}
],
"maxDosePerPeriod" : {
"numerator" : {
"value" : 1
},
"denominator" : {
"value" : 1,
"unit" : "day",
"system" : "http://unitsofmeasure.org",
"code" : "d"
}
}
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/cancer-related-mcode-comorbidities-elixhauser-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "cancer-related-mcode-comorbidities-elixhauser-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbidities-elixhauser"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"cancer-related-mcode-comorbidities-elixhauser-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "cancer-related-mcode-comorbidities-elixhauser-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-comorbidities-elixhauser.html\">Comorbidities Elixhauser Profile</a></p></div><p><b>status</b>: final</p><p><b>code</b>: Elixhauser Comorbidity Panel <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-loinc-requested-cs.html\">Requested LOINC Codes Code System</a>#comorbidities-elixhauser)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-16</p><p><b>performer</b>: <a href=\"#Practitioner_us-core-practitioner-owen-oncologist\">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><blockquote><p><b>component</b></p><p><b>Comorbid Condition Reference Extension</b>: <a href=\"Condition-us-core-condition-depression-jenny-m.html\">Condition/us-core-condition-depression-jenny-m</a></p><p><b>code</b>: Depression (Elixhauser comorbidity category) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-loinc-requested-cs.html\">Requested LOINC Codes Code System</a>#DEPRESS)</span></p><p><b>value</b>: Present (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#52101004)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>Comorbid Condition Reference Extension</b>: <a href=\"Condition-us-core-condition-hypertension-jenny-m.html\">Condition/us-core-condition-hypertension-jenny-m</a></p><p><b>code</b>: Hypertension, complicated (Elixhauser comorbidity category) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-loinc-requested-cs.html\">Requested LOINC Codes Code System</a>#HTN_CX)</span></p><p><b>value</b>: Present (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#52101004)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Arthropathies (Elixhauser comorbidity category) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-loinc-requested-cs.html\">Requested LOINC Codes Code System</a>#ARTH)</span></p><p><b>value</b>: Absent (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#2667000)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Congestive heart failure (Elixhauser comorbidity category) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-loinc-requested-cs.html\">Requested LOINC Codes Code System</a>#CHF)</span></p><p><b>value</b>: Absent (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#2667000)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Chronic pulmonary disease (Elixhauser comorbidity category) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-loinc-requested-cs.html\">Requested LOINC Codes Code System</a>#LUNG_CHRONIC)</span></p><p><b>value</b>: Absent (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#2667000)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Diabetes without chronic complications (Elixhauser comorbidity category) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-loinc-requested-cs.html\">Requested LOINC Codes Code System</a>#DIAB_UNCX)</span></p><p><b>value</b>: Absent (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#2667000)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Diabetes with chronic complications (Elixhauser comorbidity category) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-loinc-requested-cs.html\">Requested LOINC Codes Code System</a>#DIAB_CX)</span></p><p><b>value</b>: Absent (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#2667000)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Obesity (Elixhauser comorbidity category) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-loinc-requested-cs.html\">Requested LOINC Codes Code System</a>#OBESE)</span></p><p><b>value</b>: Absent (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#2667000)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Peripheral vascular disease (Elixhauser comorbidity category) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-loinc-requested-cs.html\">Requested LOINC Codes Code System</a>#PERIVASC)</span></p><p><b>value</b>: Absent (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#2667000)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Pulmonary circulation disease (Elixhauser comorbidity category) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-loinc-requested-cs.html\">Requested LOINC Codes Code System</a>#PULMCIRC)</span></p><p><b>value</b>: Absent (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#2667000)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Renal failure, moderate (Elixhauser comorbidity category) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-loinc-requested-cs.html\">Requested LOINC Codes Code System</a>#RENLFL_MOD)</span></p><p><b>value</b>: Absent (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#2667000)</span></p></blockquote></div>"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs",
"code" : "comorbidities-elixhauser",
"display" : "Elixhauser Comorbidity Panel"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-03-16",
"performer" : [
{
"reference" : "Practitioner/us-core-practitioner-owen-oncologist"
}
],
"component" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-reference",
"valueReference" : {
"reference" : "Condition/us-core-condition-depression-jenny-m"
}
}
],
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs",
"code" : "DEPRESS"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "52101004",
"display" : "Present (qualifier value)"
}
]
}
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-reference",
"valueReference" : {
"reference" : "Condition/us-core-condition-hypertension-jenny-m"
}
}
],
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs",
"code" : "HTN_CX"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "52101004",
"display" : "Present (qualifier value)"
}
]
}
},
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs",
"code" : "ARTH"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "2667000",
"display" : "Absent (qualifier value)"
}
]
}
},
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs",
"code" : "CHF"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "2667000",
"display" : "Absent (qualifier value)"
}
]
}
},
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs",
"code" : "LUNG_CHRONIC"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "2667000",
"display" : "Absent (qualifier value)"
}
]
}
},
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs",
"code" : "DIAB_UNCX"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "2667000",
"display" : "Absent (qualifier value)"
}
]
}
},
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs",
"code" : "DIAB_CX"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "2667000",
"display" : "Absent (qualifier value)"
}
]
}
},
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs",
"code" : "OBESE"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "2667000",
"display" : "Absent (qualifier value)"
}
]
}
},
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs",
"code" : "PERIVASC"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "2667000",
"display" : "Absent (qualifier value)"
}
]
}
},
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs",
"code" : "PULMCIRC"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "2667000",
"display" : "Absent (qualifier value)"
}
]
}
},
{
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs",
"code" : "RENLFL_MOD"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "2667000",
"display" : "Absent (qualifier value)"
}
]
}
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/bodyweight-jenny-m-2018-03-16",
"resource" : {
"resourceType" : "Observation",
"id" : "bodyweight-jenny-m-2018-03-16",
"meta" : {
"profile" : [
"http://hl7.org/fhir/StructureDefinition/bodyweight"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"bodyweight-jenny-m-2018-03-16\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "bodyweight-jenny-m-2018-03-16" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/R4/bodyweight.html\">Observation Body Weight Profile</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Vital Signs <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#vital-signs)</span></p><p><b>code</b>: Body weight <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#29463-7)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-06</p><p><b>value</b>: 155 lb<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code [lb_av] = '[lb_av]')</span></p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "vital-signs"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "29463-7"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-03-06",
"valueQuantity" : {
"value" : 155,
"unit" : "lb",
"system" : "http://unitsofmeasure.org",
"code" : "[lb_av]"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/us-core-observation-lab-neutrophils-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "us-core-observation-lab-neutrophils-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"us-core-observation-lab-neutrophils-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "us-core-observation-lab-neutrophils-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-observation-lab.html\">US Core Laboratory Result Observation Profile</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Laboratory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#laboratory)</span></p><p><b>code</b>: Neutrophils [#/volume] in Blood <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#26499-4)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-05-20 00:00:00+0000</p><p><b>value</b>: 3000 10*3/uL<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code 10*3/uL = '10*3/uL')</span></p><h3>ReferenceRanges</h3><table class=\"grid\"><tr><td>-</td><td><b>Low</b></td><td><b>High</b></td><td><b>AppliesTo</b></td></tr><tr><td>*</td><td>2500 10*3/uL<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code 10*3/uL = '10*3/uL')</span></td><td>5000 10*3/uL<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code 10*3/uL = '10*3/uL')</span></td><td>Normal Range <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-referencerange-meaning.html\">Observation Reference Range Meaning Codes</a>#normal)</span></td></tr></table></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "laboratory"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "26499-4",
"display" : "Neutrophils [#/volume] in Blood"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-05-20T00:00:00Z",
"valueQuantity" : {
"value" : 3000,
"unit" : "10*3/uL",
"system" : "http://unitsofmeasure.org",
"code" : "10*3/uL"
},
"referenceRange" : [
{
"low" : {
"value" : 2500,
"unit" : "10*3/uL",
"system" : "http://unitsofmeasure.org",
"code" : "10*3/uL"
},
"high" : {
"value" : 5000,
"unit" : "10*3/uL",
"system" : "http://unitsofmeasure.org",
"code" : "10*3/uL"
},
"appliesTo" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/referencerange-meaning",
"code" : "normal",
"display" : "Normal Range"
}
]
}
]
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Organization/us-core-organization-physician-services-inc",
"resource" : {
"resourceType" : "Organization",
"id" : "us-core-organization-physician-services-inc",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b><a name=\"us-core-organization-physician-services-inc\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Organization "us-core-organization-physician-services-inc" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-organization.html\">US Core Organization Profile</a></p></div><p><b>active</b>: true</p><p><b>type</b>: Healthcare Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-organization-type.html\">Organization type</a>#prov)</span></p><p><b>name</b>: Physician Services, Inc.</p><p><b>telecom</b>: ph: 999-999-9999(WORK)</p><p><b>address</b>: 123 Corporate Drive Anytown MA 12345 US </p></div>"
},
"active" : true,
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/organization-type",
"code" : "prov",
"display" : "Healthcare Provider"
}
]
}
],
"name" : "Physician Services, Inc.",
"telecom" : [
{
"system" : "phone",
"value" : "999-999-9999",
"use" : "work"
}
],
"address" : [
{
"line" : [
"123 Corporate Drive"
],
"city" : "Anytown",
"state" : "MA",
"postalCode" : "12345",
"country" : "US"
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/us-core-smokingstatus-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "us-core-smokingstatus-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"us-core-smokingstatus-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "us-core-smokingstatus-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-smokingstatus.html\">US Core Smoking Status Observation Profile</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Social History <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#social-history)</span></p><p><b>code</b>: Tobacco smoking status <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#72166-2)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-16</p><p><b>issued</b>: 16 Mar 2018, 11:00:00 am</p><p><b>value</b>: Smokes tobacco daily (finding) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#449868002)</span></p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "social-history"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "72166-2",
"display" : "Tobacco smoking status"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-03-16",
"issued" : "2018-03-16T00:00:00Z",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "449868002",
"display" : "Smokes tobacco daily (finding)"
}
]
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/us-core-procedure-biopsy-jenny-m",
"resource" : {
"resourceType" : "Procedure",
"id" : "us-core-procedure-biopsy-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Procedure</b><a name=\"us-core-procedure-biopsy-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Procedure "us-core-procedure-biopsy-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html\">US Core Procedure Profile</a></p></div><p><b>status</b>: completed</p><p><b>code</b>: Biopsy of breast using ultrasonographic guidance (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#723990008)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>performed</b>: 2018-03-06</p><p><b>asserter</b>: <a href=\"Practitioner-us-core-practitioner-mary-obgyn.html\">Practitioner/us-core-practitioner-mary-obgyn</a> " OBGYN"</p><h3>Performers</h3><table class=\"grid\"><tr><td>-</td><td><b>Actor</b></td></tr><tr><td>*</td><td><a href=\"Practitioner-us-core-practitioner-mary-obgyn.html\">Practitioner/us-core-practitioner-mary-obgyn</a> " OBGYN"</td></tr></table><p><b>reasonReference</b>: <a href=\"#Condition_primary-cancer-condition-jenny-m\">See above (Condition/primary-cancer-condition-jenny-m)</a></p><p><b>bodySite</b>: Left breast structure (body structure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#80248007)</span></p></div>"
},
"status" : "completed",
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "723990008",
"display" : "Biopsy of breast using ultrasonographic guidance (procedure)"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"performedDateTime" : "2018-03-06",
"asserter" : {
"reference" : "Practitioner/us-core-practitioner-mary-obgyn"
},
"performer" : [
{
"actor" : {
"reference" : "Practitioner/us-core-practitioner-mary-obgyn"
}
}
],
"reasonReference" : [
{
"reference" : "Condition/primary-cancer-condition-jenny-m"
}
],
"bodySite" : [
{
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "80248007",
"display" : "Left breast structure (body structure)"
}
]
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/us-core-procedure-mammogram-jenny-m",
"resource" : {
"resourceType" : "Procedure",
"id" : "us-core-procedure-mammogram-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Procedure</b><a name=\"us-core-procedure-mammogram-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Procedure "us-core-procedure-mammogram-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html\">US Core Procedure Profile</a></p></div><p><b>status</b>: completed</p><p><b>code</b>: Mammography (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#71651007)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>performed</b>: 2018-02-01</p><p><b>asserter</b>: <a href=\"Practitioner-us-core-practitioner-mary-obgyn.html\">Practitioner/us-core-practitioner-mary-obgyn</a> " OBGYN"</p><h3>Performers</h3><table class=\"grid\"><tr><td>-</td><td><b>Actor</b></td></tr><tr><td>*</td><td><a href=\"Practitioner-us-core-practitioner-jane-radiotech.html\">Practitioner/us-core-practitioner-jane-radiotech</a> " RADIOLOGIST"</td></tr></table></div>"
},
"status" : "completed",
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "71651007",
"display" : "Mammography (procedure)"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"performedDateTime" : "2018-02-01",
"asserter" : {
"reference" : "Practitioner/us-core-practitioner-mary-obgyn"
},
"performer" : [
{
"actor" : {
"reference" : "Practitioner/us-core-practitioner-jane-radiotech"
}
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/FamilyMemberHistory/family-member-history-aunt-jenny-m",
"resource" : {
"resourceType" : "FamilyMemberHistory",
"id" : "family-member-history-aunt-jenny-m",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: FamilyMemberHistory</b><a name=\"family-member-history-aunt-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource FamilyMemberHistory "family-member-history-aunt-jenny-m" </p></div><p><b>status</b>: completed</p><p><b>patient</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>relationship</b>: maternal aunt <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-RoleCode.html\">RoleCode</a>#MAUNT)</span></p><h3>Conditions</h3><table class=\"grid\"><tr><td>-</td><td><b>Code</b></td><td><b>Onset[x]</b></td></tr><tr><td>*</td><td>Malignant tumor of ovary (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#363443007)</span></td><td>69 a<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code a = 'a')</span></td></tr></table></div>"
},
"status" : "completed",
"patient" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"relationship" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code" : "MAUNT",
"display" : "maternal aunt"
}
]
},
"condition" : [
{
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "363443007",
"display" : "Malignant tumor of ovary (disorder)"
}
]
},
"onsetAge" : {
"value" : 69,
"system" : "http://unitsofmeasure.org",
"code" : "a"
}
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Procedure/us-core-procedure-mammogram-jenny-m",
"resource" : {
"resourceType" : "Procedure",
"id" : "us-core-procedure-mammogram-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Procedure</b><a name=\"us-core-procedure-mammogram-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Procedure "us-core-procedure-mammogram-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-procedure.html\">US Core Procedure Profile</a></p></div><p><b>status</b>: completed</p><p><b>code</b>: Mammography (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#71651007)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>performed</b>: 2018-02-01</p><p><b>asserter</b>: <a href=\"Practitioner-us-core-practitioner-mary-obgyn.html\">Practitioner/us-core-practitioner-mary-obgyn</a> " OBGYN"</p><h3>Performers</h3><table class=\"grid\"><tr><td>-</td><td><b>Actor</b></td></tr><tr><td>*</td><td><a href=\"Practitioner-us-core-practitioner-jane-radiotech.html\">Practitioner/us-core-practitioner-jane-radiotech</a> " RADIOLOGIST"</td></tr></table></div>"
},
"status" : "completed",
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "71651007",
"display" : "Mammography (procedure)"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"performedDateTime" : "2018-02-01",
"asserter" : {
"reference" : "Practitioner/us-core-practitioner-mary-obgyn"
},
"performer" : [
{
"actor" : {
"reference" : "Practitioner/us-core-practitioner-jane-radiotech"
}
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/FamilyMemberHistory/family-member-history-uncle-jenny-m",
"resource" : {
"resourceType" : "FamilyMemberHistory",
"id" : "family-member-history-uncle-jenny-m",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: FamilyMemberHistory</b><a name=\"family-member-history-uncle-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource FamilyMemberHistory "family-member-history-uncle-jenny-m" </p></div><p><b>status</b>: completed</p><p><b>patient</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>relationship</b>: paternal uncle <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-RoleCode.html\">RoleCode</a>#PUNCLE)</span></p><p><b>deceased</b>: true</p><h3>Conditions</h3><table class=\"grid\"><tr><td>-</td><td><b>Code</b></td><td><b>ContributedToDeath</b></td></tr><tr><td>*</td><td>Malignant tumor of pancreas (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#363418001)</span></td><td>true</td></tr></table></div>"
},
"status" : "completed",
"patient" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"relationship" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code" : "PUNCLE",
"display" : "paternal uncle"
}
]
},
"deceasedBoolean" : true,
"condition" : [
{
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "363418001",
"display" : "Malignant tumor of pancreas (disorder)"
}
]
},
"contributedToDeath" : true
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/DiagnosticReport/us-core-diagnosticreport-lab-jenny-m",
"resource" : {
"resourceType" : "DiagnosticReport",
"id" : "us-core-diagnosticreport-lab-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-lab"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: DiagnosticReport</b><a name=\"us-core-diagnosticreport-lab-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource DiagnosticReport "us-core-diagnosticreport-lab-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-diagnosticreport-lab.html\">US Core DiagnosticReport Profile for Laboratory Results Reporting</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Laboratory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v2-0074.html\">diagnosticServiceSectionId</a>#LAB)</span>, Surgical Pathology <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v2-0074.html\">diagnosticServiceSectionId</a>#SP)</span></p><p><b>code</b>: Pathology report final diagnosis Narrative <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#22637-3)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-04-01 00:00:00+0000</p><p><b>issued</b>: 5 Apr 2018, 10:00:00 am</p><p><b>performer</b>: <a href=\"#Organization_us-core-organization-physician-services-inc\">See above (Organization/us-core-organization-physician-services-inc)</a></p><p><b>resultsInterpreter</b>: <a href=\"#Practitioner_us-core-practitioner-peter-pathologist\">See above (Practitioner/us-core-practitioner-peter-pathologist)</a></p><p><b>specimen</b>: <a href=\"Specimen-tumor-specimen-left-breast-jenny-m.html\">Specimen/tumor-specimen-left-breast-jenny-m</a></p><p><b>result</b>: </p><ul><li><a href=\"#Observation_us-core-observation-lab-tumor-invasion-jenny-m\">See above (Observation/us-core-observation-lab-tumor-invasion-jenny-m)</a></li><li><a href=\"#Observation_us-core-observation-lab-tumor-margins-jenny-m\">See above (Observation/us-core-observation-lab-tumor-margins-jenny-m)</a></li><li><a href=\"#Observation_us-core-observation-lab-sentinel-nodes-jenny-m\">See above (Observation/us-core-observation-lab-sentinel-nodes-jenny-m)</a></li><li><a href=\"#Observation_tumor-size-jenny-m\">See above (Observation/tumor-size-jenny-m)</a></li><li><a href=\"#Observation_us-core-observation-lab-tumor-dcis-jenny-m\">See above (Observation/us-core-observation-lab-tumor-dcis-jenny-m)</a></li><li><a href=\"#Observation_tumor-marker-test-her2-jenny-m\">See above (Observation/tumor-marker-test-her2-jenny-m)</a></li><li><a href=\"#Observation_tumor-marker-test-er-jenny-m\">See above (Observation/tumor-marker-test-er-jenny-m)</a></li><li><a href=\"#Observation_tumor-marker-test-pr-jenny-m\">See above (Observation/tumor-marker-test-pr-jenny-m)</a></li><li><a href=\"Observation-us-core-observation-lab-tumor-grade-jenny-m.html\">Observation/us-core-observation-lab-tumor-grade-jenny-m</a></li></ul></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
"code" : "LAB"
}
]
},
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
"code" : "SP",
"display" : "Surgical Pathology"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "22637-3",
"display" : "Pathology report final diagnosis Narrative"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-04-01T00:00:00Z",
"issued" : "2018-04-05T00:00:00Z",
"performer" : [
{
"reference" : "Organization/us-core-organization-physician-services-inc"
}
],
"resultsInterpreter" : [
{
"reference" : "Practitioner/us-core-practitioner-peter-pathologist"
}
],
"specimen" : [
{
"reference" : "Specimen/tumor-specimen-left-breast-jenny-m"
}
],
"result" : [
{
"reference" : "Observation/us-core-observation-lab-tumor-invasion-jenny-m"
},
{
"reference" : "Observation/us-core-observation-lab-tumor-margins-jenny-m"
},
{
"reference" : "Observation/us-core-observation-lab-sentinel-nodes-jenny-m"
},
{
"reference" : "Observation/tumor-size-jenny-m"
},
{
"reference" : "Observation/us-core-observation-lab-tumor-dcis-jenny-m"
},
{
"reference" : "Observation/tumor-marker-test-her2-jenny-m"
},
{
"reference" : "Observation/tumor-marker-test-er-jenny-m"
},
{
"reference" : "Observation/tumor-marker-test-pr-jenny-m"
},
{
"reference" : "Observation/us-core-observation-lab-tumor-grade-jenny-m"
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/observation-smoking-pack-years-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "observation-smoking-pack-years-jenny-m",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"observation-smoking-pack-years-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "observation-smoking-pack-years-jenny-m" </p></div><p><b>status</b>: final</p><p><b>category</b>: Social History <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#social-history)</span></p><p><b>code</b>: Cigarette pack-years (observable entity) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#401201003)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-16</p><p><b>value</b>: 20 Pack-Years<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code {PackYears} = '{PackYears}')</span></p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "social-history",
"display" : "Social History"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "401201003",
"display" : "Cigarette pack-years (observable entity)"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-03-16",
"valueQuantity" : {
"value" : 20,
"unit" : "Pack-Years",
"system" : "http://unitsofmeasure.org",
"code" : "{PackYears}"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/us-core-observation-lab-tumor-invasion-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "us-core-observation-lab-tumor-invasion-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"us-core-observation-lab-tumor-invasion-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "us-core-observation-lab-tumor-invasion-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-observation-lab.html\">US Core Laboratory Result Observation Profile</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Laboratory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#laboratory)</span></p><p><b>code</b>: Status of invasion by tumor <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#370052007)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-04-01 00:00:00+0000</p><p><b>value</b>: Negative (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#260385009)</span></p><p><b>specimen</b>: <a href=\"Specimen-tumor-specimen-left-breast-jenny-m.html\">Specimen/tumor-specimen-left-breast-jenny-m</a></p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "laboratory"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "370052007",
"display" : "Status of invasion by tumor"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-04-01T00:00:00Z",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "260385009",
"display" : "Negative (qualifier value)"
}
]
},
"specimen" : {
"reference" : "Specimen/tumor-specimen-left-breast-jenny-m"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/us-core-observation-lab-tumor-margins-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "us-core-observation-lab-tumor-margins-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"us-core-observation-lab-tumor-margins-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "us-core-observation-lab-tumor-margins-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-observation-lab.html\">US Core Laboratory Result Observation Profile</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Laboratory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#laboratory)</span></p><p><b>code</b>: Margin involvement in Breast tumor <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#44669-0)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-04-01 00:00:00+0000</p><p><b>value</b>: Uninvolved by invasive carcinoma <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA27151-2)</span></p><p><b>specimen</b>: <a href=\"Specimen-tumor-specimen-left-breast-jenny-m.html\">Specimen/tumor-specimen-left-breast-jenny-m</a></p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "laboratory"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "44669-0",
"display" : "Margin involvement in Breast tumor"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-04-01T00:00:00Z",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "LA27151-2",
"display" : "Uninvolved by invasive carcinoma"
}
]
},
"specimen" : {
"reference" : "Specimen/tumor-specimen-left-breast-jenny-m"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/us-core-observation-lab-sentinel-nodes-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "us-core-observation-lab-sentinel-nodes-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"us-core-observation-lab-sentinel-nodes-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "us-core-observation-lab-sentinel-nodes-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-observation-lab.html\">US Core Laboratory Result Observation Profile</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Laboratory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#laboratory)</span></p><p><b>code</b>: Sentinel lymph nodes with metastasis [#] in Cancer specimen <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#92832-5)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-04-01 00:00:00+0000</p><p><b>specimen</b>: <a href=\"Specimen-tumor-specimen-left-breast-jenny-m.html\">Specimen/tumor-specimen-left-breast-jenny-m</a></p><h3>Components</h3><table class=\"grid\"><tr><td>-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Lymph nodes examined [#] in Cancer specimen by Light microscopy <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#92833-3)</span></td><td>3 Count<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code {Count} = '{Count}')</span></td></tr></table></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "laboratory"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "92832-5",
"display" : "Sentinel lymph nodes with metastasis [#] in Cancer specimen"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-04-01T00:00:00Z",
"specimen" : {
"reference" : "Specimen/tumor-specimen-left-breast-jenny-m"
},
"component" : [
{
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "92833-3",
"display" : "Lymph nodes examined [#] in Cancer specimen by Light microscopy"
}
]
},
"valueQuantity" : {
"value" : 3,
"unit" : "Count",
"system" : "http://unitsofmeasure.org",
"code" : "{Count}"
}
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/tumor-size-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "tumor-size-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor-size"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"tumor-size-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "tumor-size-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-mcode-tumor-size.html\">Tumor Size Profile</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Laboratory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#laboratory)</span></p><p><b>code</b>: Size Tumor <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#21889-1)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-04-01 00:00:00+0000</p><p><b>method</b>: Pathology report gross observation <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#24419-4)</span></p><p><b>specimen</b>: <a href=\"Specimen-tumor-specimen-left-breast-jenny-m.html\">Specimen/tumor-specimen-left-breast-jenny-m</a></p><h3>Components</h3><table class=\"grid\"><tr><td>-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Size.maximum dimension in Tumor <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#33728-7)</span></td><td>2.5 centimeters<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code cm = 'cm')</span></td></tr></table></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "laboratory"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "21889-1",
"display" : "Size Tumor"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-04-01T00:00:00Z",
"method" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "24419-4",
"display" : "Pathology report gross observation"
}
]
},
"specimen" : {
"reference" : "Specimen/tumor-specimen-left-breast-jenny-m"
},
"component" : [
{
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "33728-7"
}
]
},
"valueQuantity" : {
"value" : 2.5,
"unit" : "centimeters",
"system" : "http://unitsofmeasure.org",
"code" : "cm"
}
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/us-core-observation-lab-tumor-dcis-jenny-m",
"resource" : {
"resourceType" : "Observation",
"id" : "us-core-observation-lab-tumor-dcis-jenny-m",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Observation</b><a name=\"us-core-observation-lab-tumor-dcis-jenny-m\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Observation "us-core-observation-lab-tumor-dcis-jenny-m" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-observation-lab.html\">US Core Laboratory Result Observation Profile</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Laboratory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#laboratory)</span></p><p><b>code</b>: DCIS intraductal extension in Breast cancer specimen Qualitative by Light microscopy <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#85336-6)</span></p><p><b>subject</b>: <a href=\"#Patient_cancer-patient-jenny-m\">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-04-01 00:00:00+0000</p><p><b>value</b>: DCIS present with extensive intraductal component (EIC) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA27261-9)</span></p><p><b>specimen</b>: <a href=\"Specimen-tumor-specimen-left-breast-jenny-m.html\">Specimen/tumor-specimen-left-breast-jenny-m</a></p></div>"
},
"status" : "final",
"category" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/observation-category",
"code" : "laboratory"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "85336-6",
"display" : "DCIS intraductal extension in Breast cancer specimen Qualitative by Light microscopy"
}
]
},
"subject" : {
"reference" : "Patient/cancer-patient-jenny-m"
},
"effectiveDateTime" : "2018-04-01T00:00:00Z",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "LA27261-9",
"display" : "DCIS present with extensive intraductal component (EIC)"
}
]
},
"specimen" : {
"reference" : "Specimen/tumor-specimen-left-breast-jenny-m"
}
}
},
{
"fullUrl" : "http://example.org/fhir/Practitioner/us-core-practitioner-owen-oncologist",
"resource" : {
"resourceType" : "Practitioner",
"id" : "us-core-practitioner-owen-oncologist",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Practitioner</b><a name=\"us-core-practitioner-owen-oncologist\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Practitioner "us-core-practitioner-owen-oncologist" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-practitioner.html\">US Core Practitioner Profile</a></p></div><p><b>identifier</b>: id:\u00a09988776655</p><p><b>name</b>: Owen Oncologist </p><p><b>address</b>: 123 Corporate Drive Anytown MA 12345 US (WORK)</p><p><b>gender</b>: male</p><h3>Qualifications</h3><table class=\"grid\"><tr><td>-</td><td><b>Code</b></td></tr><tr><td>*</td><td>Doctor of Medicine <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (degreeLicenseCertificate[2.7]#MD)</span></td></tr></table></div>"
},
"identifier" : [
{
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "9988776655"
}
],
"name" : [
{
"family" : "Oncologist",
"given" : [
"Owen"
],
"prefix" : [
"Dr."
]
}
],
"address" : [
{
"use" : "work",
"line" : [
"123 Corporate Drive"
],
"city" : "Anytown",
"state" : "MA",
"postalCode" : "12345",
"country" : "US"
}
],
"gender" : "male",
"qualification" : [
{
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0360",
"version" : "2.7",
"code" : "MD"
}
]
}
}
]
}
},
{
"fullUrl" : "http://example.org/fhir/Practitioner/us-core-practitioner-peter-pathologist",
"resource" : {
"resourceType" : "Practitioner",
"id" : "us-core-practitioner-peter-pathologist",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Practitioner</b><a name=\"us-core-practitioner-peter-pathologist\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Practitioner "us-core-practitioner-peter-pathologist" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-practitioner.html\">US Core Practitioner Profile</a></p></div><p><b>identifier</b>: id:\u00a01122334455</p><p><b>name</b>: Peter Pathologist </p><p><b>address</b>: 123 Corporate Drive Anytown MA 12345 US (WORK)</p><p><b>gender</b>: female</p><h3>Qualifications</h3><table class=\"grid\"><tr><td>-</td><td><b>Code</b></td></tr><tr><td>*</td><td>Doctor of Medicine <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (degreeLicenseCertificate[2.7]#MD)</span></td></tr></table></div>"
},
"identifier" : [
{
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "1122334455"
}
],
"name" : [
{
"family" : "Pathologist",
"given" : [
"Peter"
],
"prefix" : [
"Dr."
]
}
],
"address" : [
{
"use" : "work",
"line" : [
"123 Corporate Drive"
],
"city" : "Anytown",
"state" : "MA",
"postalCode" : "12345",
"country" : "US"
}
],
"gender" : "female",
"qualification" : [
{
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0360",
"version" : "2.7",
"code" : "MD"
}
]
}
}
]
}
}
]
}
IG © 2022+ HL7 International Clinical Interoperability Council. Package hl7.fhir.us.mcode#2.1.0 based on FHIR 4.0.1. Generated 2023-03-21
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