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 
<Bundle xmlns="http://hl7.org/fhir">
<id value="mcode-patient-bundle-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-patient-bundle"/>
</meta>
<type value="collection"/>
<entry>
<fullUrl value="http://example.org/fhir/Patient/cancer-patient-jenny-m"/>
<resource>
<Patient>
<id value="cancer-patient-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-patient"/>
</meta>
<text>
<status value="extensions"/>
<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 (use: USUAL)</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>
</text>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2106-3"/>
<display value="White"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="White"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2186-5"/>
<display value="Not Hispanic or Latino"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="Not Hispanic or Latino"/>
</extension>
</extension>
<identifier>
<use value="usual"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MR"/>
<display value="Medical Record Number"/>
</coding>
</type>
<system value="http://hospital.example.org"/>
<value value="MRN1234"/>
</identifier>
<name>
<family value="M"/>
<given value="Jenny"/>
</name>
<gender value="female"/>
<birthDate value="1965-01-01"/>
<address>
<line value="123 Main St"/>
<city value="Anytown"/>
<postalCode value="12345"/>
<country value="United States"/>
</address>
<contact>
<telecom>
<system value="phone"/>
<value value="555-867-5309"/>
<use value="home"/>
</telecom>
<telecom>
<system value="email"/>
<value value="example@example.com"/>
</telecom>
</contact>
<communication>
<language>
<coding>
<system value="urn:ietf:bcp:47"/>
<code value="en-US"/>
</coding>
<text value="English"/>
</language>
</communication>
</Patient>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Condition/primary-cancer-condition-jenny-m"/>
<resource>
<Condition>
<id value="primary-cancer-condition-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-primary-cancer-condition"/>
</meta>
<text>
<status value="extensions"/>
<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>
</text>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="413448000"/>
<display
value="Adenocarcinoma, no subtype, intermediate grade (morphologic abnormality)"/>
</coding>
</valueCodeableConcept>
</extension>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="remission"/>
</coding>
</clinicalStatus>
<verificationStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="confirmed"/>
</coding>
</verificationStatus>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-category"/>
<code value="problem-list-item"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="353431000119107"/>
<display
value="Primary malignant neoplasm of female left breast (disorder)"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<onsetDateTime value="2018-03-16"/>
<asserter>
<reference
value="Practitioner/us-core-practitioner-owen-oncologist"/>
</asserter>
<stage>
<summary>
<coding>
<system value="http://cancerstaging.org"/>
<code value="3C"/>
</coding>
</summary>
<assessment>
<reference value="Observation/tnm-clinical-stage-group-jenny-m"/>
</assessment>
</stage>
</Condition>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/MedicationRequest/cancer-related-medication-request-cyclophosphamide-jenny-m"/>
<resource>
<MedicationRequest>
<id
value="cancer-related-medication-request-cyclophosphamide-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-related-medication-request"/>
</meta>
<text>
<status value="extensions"/>
<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>
</text>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="373808002"/>
<display value="Curative - procedure intent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</extension>
<status value="active"/>
<intent value="order"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/medicationrequest-category"/>
<code value="outpatient"/>
</coding>
</category>
<medicationCodeableConcept>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="3002"/>
<display value="cyclophosphamide"/>
</coding>
</medicationCodeableConcept>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<authoredOn value="2018-04-12"/>
<requester>
<reference
value="Practitioner/us-core-practitioner-owen-oncologist"/>
</requester>
<reasonReference>
<reference value="Condition/primary-cancer-condition-jenny-m"/>
</reasonReference>
<dosageInstruction>
<text value="cyclophosphamide (600 mg/m² IV), 932.59mg"/>
<timing>
<repeat>
<boundsPeriod>
<start value="2018-04-01"/>
</boundsPeriod>
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct"/>
<code value="47625008"/>
<display value="Intravenous route (qualifier value)"/>
</coding>
</route>
<doseAndRate>
<doseQuantity>
<value value="932.59"/>
<unit value="mg"/>
<system value="http://unitsofmeasure.org"/>
<code value="mg"/>
</doseQuantity>
</doseAndRate>
<maxDosePerPeriod>
<numerator>
<value value="1"/>
</numerator>
<denominator>
<value value="3"/>
<unit value="week"/>
<system value="http://unitsofmeasure.org"/>
<code value="wk"/>
</denominator>
</maxDosePerPeriod>
</dosageInstruction>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/cancer-disease-status-jenny-m"/>
<resource>
<Observation>
<id value="cancer-disease-status-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-disease-status"/>
</meta>
<text>
<status value="extensions"/>
<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>
</text>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-disease-status-evidence-type">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="363679005"/>
<display value="Imaging (procedure)"/>
</coding>
</valueCodeableConcept>
</extension>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="97509-4"/>
<display value="Cancer Disease Progression"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<focus>
<reference value="Condition/primary-cancer-condition-jenny-m"/>
</focus>
<effectiveDateTime value="2018-11-01"/>
<performer>
<reference
value="Practitioner/us-core-practitioner-owen-oncologist"/>
</performer>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="268910001"/>
<display value="Patient's condition improved (finding)"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/genomic-variant-jenny-m"/>
<resource>
<Observation>
<id value="genomic-variant-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-genomic-variant"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="69548-6"/>
<display value="Genetic variant assessment"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-15"/>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA9633-4"/>
<display value="Present"/>
</coding>
</valueCodeableConcept>
<method>
<coding>
<system value="http://loinc.org"/>
<code value="LA26398-0"/>
<display value="Sequencing"/>
</coding>
</method>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="48018-6"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://www.genenames.org"/>
<code value="HGNC:26144"/>
<display value="PALB2"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="81252-9"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://www.ncbi.nlm.nih.gov/clinvar"/>
<code value="128144"/>
<display
value="NM_024675.3(PALB2):c.3549C>A (p.Tyr1183Ter)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="81290-9"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://varnomen.hgvs.org"/>
<code value="NC_000016.10:g.23603471G>T"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="48002-0"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA6684-0"/>
<display value="Somatic"/>
</coding>
</valueCodeableConcept>
</component>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/DiagnosticReport/genomics-report-jenny-m"/>
<resource>
<DiagnosticReport>
<id value="genomics-report-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-genomics-report"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
<code value="LAB"/>
</coding>
</category>
<category>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
<code value="GE"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="81247-9"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-15"/>
<issued value="2020-03-15T00:00:01+00:00"/>
<specimen>
<reference value="Specimen/genomic-specimen-left-breast-jenny-m"/>
</specimen>
<result>
<reference value="Observation/genomic-variant-jenny-m"/>
</result>
<result>
<reference value="Observation/genomic-region-studied-jenny-m"/>
</result>
</DiagnosticReport>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Procedure/cancer-related-surgical-procedure-jenny-m"/>
<resource>
<Procedure>
<id value="cancer-related-surgical-procedure-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-related-surgical-procedure"/>
</meta>
<text>
<status value="extensions"/>
<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>
</text>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="373808002"/>
<display value="Curative - procedure intent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</extension>
<status value="completed"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="387713003"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="64368001"/>
<display value="Partial mastectomy (procedure)"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<performedDateTime value="2018-04-01"/>
<asserter>
<reference
value="Practitioner/us-core-practitioner-owen-oncologist"/>
</asserter>
<reasonReference>
<reference value="Condition/primary-cancer-condition-jenny-m"/>
</reasonReference>
<bodySite>
<coding>
<system value="http://snomed.info/sct"/>
<code value="80248007"/>
<display value="Left breast structure (body structure)"/>
</coding>
</bodySite>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Procedure/radiotherapy-treatment-summary-chest-wall-jenny-m"/>
<resource>
<Procedure>
<id value="radiotherapy-treatment-summary-chest-wall-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-course-summary"/>
</meta>
<text>
<status value="extensions"/>
<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>
</text>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions">
<valueUnsignedInt value="31"/>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="373808002"/>
<display value="Curative - procedure intent"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
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 value="http://snomed.info/sct"/>
<code value="1156506007"/>
<display
value="External beam radiation therapy using photons (procedure)"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="1156530009"/>
<display
value="Volumetric Modulated Arc Therapy (procedure)"/>
</coding>
</valueCodeableConcept>
</extension>
</extension>
<extension
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 value="http://snomed.info/sct"/>
<code value="45643008"/>
<display value="Teleradiotherapy using electrons"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="1162782007"/>
<display
value="Three dimensional external beam radiation therapy (procedure)"/>
</coding>
</valueCodeableConcept>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume">
<extension url="volume">
<valueReference>
<reference
value="BodyStructure/jenny-m-chest-wall-treatment-volume"/>
</valueReference>
</extension>
<extension url="totalDoseDelivered">
<valueQuantity>
<value value="6000"/>
<system value="http://unitsofmeasure.org"/>
<code value="cGy"/>
</valueQuantity>
</extension>
<extension url="fractionsDelivered">
<valueUnsignedInt value="30"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume">
<extension url="volume">
<valueReference>
<reference
value="BodyStructure/jenny-m-chest-wall-lymph-nodes-treatment-volume"/>
</valueReference>
</extension>
<extension url="totalDoseDelivered">
<valueQuantity>
<value value="5000"/>
<system value="http://unitsofmeasure.org"/>
<code value="cGy"/>
</valueQuantity>
</extension>
<extension url="fractionsDelivered">
<valueUnsignedInt value="25"/>
</extension>
</extension>
<status value="completed"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="108290001"/>
<display
value="Radiation oncology AND/OR radiotherapy (procedure)"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="1217123003"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<performedPeriod>
<start value="2018-08-15"/>
<end value="2018-10-25"/>
</performedPeriod>
<asserter>
<reference value="Practitioner/us-core-practitioner-kyle-anydoc"/>
</asserter>
<reasonCode>
<coding>
<system value="http://hl7.org/fhir/sid/icd-10-cm"/>
<code value="C50.811"/>
<display
value="Malignant neoplasm of overlapping sites of right female breast"/>
</coding>
</reasonCode>
<bodySite>
<coding>
<system value="http://snomed.info/sct"/>
<code value="78904004"/>
<display value="Chest Wall Structure (body structure)"/>
</coding>
</bodySite>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/tnm-clinical-stage-group-jenny-m"/>
<resource>
<Observation>
<id value="tnm-clinical-stage-group-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-stage-group"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="21908-9"/>
<display value="Stage group.clinical Cancer"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-16"/>
<valueCodeableConcept>
<coding>
<system value="http://cancerstaging.org"/>
<code value="2B"/>
<display value="IIB"/>
</coding>
</valueCodeableConcept>
<method>
<coding>
<system value="http://snomed.info/sct"/>
<code value="897275008"/>
<display
value="American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)"/>
</coding>
</method>
<hasMember>
<reference
value="Observation/tnm-pathologic-primary-tumor-category-jenny-m"/>
</hasMember>
<hasMember>
<reference
value="Observation/tnm-pathologic-regional-nodes-category-jenny-m"/>
</hasMember>
<hasMember>
<reference
value="Observation/tnm-pathologic-distant-metastases-category-jenny-m"/>
</hasMember>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/tnm-clinical-primary-tumor-category-jenny-m"/>
<resource>
<Observation>
<id value="tnm-clinical-primary-tumor-category-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tnm-primary-tumor-category"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="21905-5"/>
<display value="Primary tumor.clinical [Class] Cancer"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-16"/>
<valueCodeableConcept>
<coding>
<system value="http://cancerstaging.org"/>
<code value="cT3"/>
</coding>
</valueCodeableConcept>
<method>
<coding>
<system value="http://snomed.info/sct"/>
<code value="897275008"/>
<display
value="American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)"/>
</coding>
</method>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/tnm-clinical-regional-nodes-category-jenny-m"/>
<resource>
<Observation>
<id value="tnm-clinical-regional-nodes-category-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tnm-regional-nodes-category"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="21906-3"/>
<display value="Regional lymph nodes.clinical [Class] Cancer"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-16"/>
<valueCodeableConcept>
<coding>
<system value="http://cancerstaging.org"/>
<code value="cN0"/>
</coding>
</valueCodeableConcept>
<method>
<coding>
<system value="http://snomed.info/sct"/>
<code value="897275008"/>
<display
value="American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)"/>
</coding>
</method>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/tnm-clinical-distant-metastases-category-jenny-m"/>
<resource>
<Observation>
<id value="tnm-clinical-distant-metastases-category-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tnm-distant-metastases-category"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="21907-1"/>
<display value="Distant metastases.clinical [Class] Cancer"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-16"/>
<valueCodeableConcept>
<coding>
<system value="http://cancerstaging.org"/>
<code value="cM0"/>
</coding>
</valueCodeableConcept>
<method>
<coding>
<system value="http://snomed.info/sct"/>
<code value="897275008"/>
<display
value="American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)"/>
</coding>
</method>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Specimen/genomic-specimen-left-breast-jenny-m"/>
<resource>
<Specimen>
<id value="genomic-specimen-left-breast-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-genomic-specimen"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="available"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0487"/>
<code value="TISS"/>
</coding>
</type>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<collection>
<collector>
<reference
value="Practitioner/us-core-practitioner-owen-oncologist"/>
</collector>
<bodySite>
<coding>
<system value="http://snomed.info/sct"/>
<code value="80248007"/>
<display value="Left breast structure (body structure)"/>
</coding>
</bodySite>
</collection>
<processing>
<timeDateTime value="2018-03-06"/>
</processing>
</Specimen>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/genomic-region-studied-jenny-m"/>
<resource>
<Observation>
<id value="genomic-region-studied-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-genomic-region-studied"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="53041-0"/>
<display value="DNA region of interest panel"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-15"/>
<issued value="2018-03-15T00:00:01+00:00"/>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="48018-6"/>
<display value="Gene studied [ID]"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://www.genenames.org"/>
<code value="1100"/>
<display value="BRCA1"/>
</coding>
<coding>
<system value="http://www.genenames.org"/>
<code value="1101"/>
<display value="BRCA2"/>
</coding>
<coding>
<system value="http://www.genenames.org"/>
<code value="1748"/>
<display value="CDH1"/>
</coding>
<coding>
<system value="http://www.genenames.org"/>
<code value="26144"/>
<display value="PALB2"/>
</coding>
<coding>
<system value="http://www.genenames.org"/>
<code value="9588"/>
<display value="PTEN"/>
</coding>
<coding>
<system value="http://www.genenames.org"/>
<code value="11389"/>
<display value="STK11"/>
</coding>
<coding>
<system value="http://www.genenames.org"/>
<code value="11998"/>
<display value="TP53"/>
</coding>
</valueCodeableConcept>
</component>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/ecog-performance-status-jenny-m"/>
<resource>
<Observation>
<id value="ecog-performance-status-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-ecog-performance-status"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="survey"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="89247-1"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-04-12"/>
<performer>
<reference
value="Practitioner/us-core-practitioner-owen-oncologist"/>
</performer>
<valueInteger value="0"/>
<interpretation>
<coding>
<system value="http://loinc.org"/>
<code value="LA9622-7"/>
<display
value="Fully active, able to carry on all pre-disease performance without restriction"/>
</coding>
</interpretation>
<method>
<coding>
<system value="http://snomed.info/sct"/>
<code value="5880005"/>
<display value="Physical examination procedure (procedure)"/>
</coding>
</method>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/tumor-marker-test-er-jenny-m"/>
<resource>
<Observation>
<id value="tumor-marker-test-er-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor-marker-test"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="85337-4"/>
<display
value="Estrogen receptor Ag [Presence] in Breast cancer specimen by Immune stain"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-10"/>
<performer>
<reference
value="Practitioner/us-core-practitioner-owen-oncologist"/>
</performer>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA6576-8"/>
<display value="Positive"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/tumor-marker-test-pr-jenny-m"/>
<resource>
<Observation>
<id value="tumor-marker-test-pr-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor-marker-test"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="85339-0"/>
<display
value="Progesterone receptor Ag [Presence] in Breast cancer specimen by Immune stain"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-10"/>
<performer>
<reference
value="Practitioner/us-core-practitioner-owen-oncologist"/>
</performer>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA6577-6"/>
<display value="Negative"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/tumor-marker-test-her2-jenny-m"/>
<resource>
<Observation>
<id value="tumor-marker-test-her2-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor-marker-test"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="48676-1"/>
<display value="HER2 [Interpretation] in Tissue"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-10"/>
<performer>
<reference
value="Practitioner/us-core-practitioner-owen-oncologist"/>
</performer>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA6577-6"/>
<display value="Negative"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/tumor-marker-test-oncotype-dx-jenny-m"/>
<resource>
<Observation>
<id value="tumor-marker-test-oncotype-dx-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor-marker-test"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://www.ncbi.nlm.nih.gov/gtr"/>
<code value="509910"/>
<display value="Oncotype DX Breast Recurrence Score Assay"/>
</coding>
<text value="Oncotype DX Breast Recurrence Score Assay"/>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-04-12"/>
<performer>
<reference
value="Organization/us-core-organization-bedrock-medicine"/>
</performer>
<valueQuantity>
<value value="47"/>
<unit value="Recurrence score"/>
<system value="http://unitsofmeasure.org"/>
<code value="{ScoreOf}"/>
</valueQuantity>
<interpretation>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation"/>
<code value="H"/>
<display value="High"/>
</coding>
</interpretation>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/MedicationRequest/cancer-related-medication-request-doxorubicin-jenny-m"/>
<resource>
<MedicationRequest>
<id value="cancer-related-medication-request-doxorubicin-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-related-medication-request"/>
</meta>
<text>
<status value="extensions"/>
<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>
</text>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="373808002"/>
<display value="Curative - procedure intent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</extension>
<status value="active"/>
<intent value="order"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/medicationrequest-category"/>
<code value="outpatient"/>
</coding>
</category>
<medicationCodeableConcept>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="3639"/>
<display value="DOXOrubicin"/>
</coding>
</medicationCodeableConcept>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<authoredOn value="2018-04-12"/>
<requester>
<reference
value="Practitioner/us-core-practitioner-owen-oncologist"/>
</requester>
<reasonReference>
<reference value="Condition/primary-cancer-condition-jenny-m"/>
</reasonReference>
<dosageInstruction>
<text value="doxorubicin (60 mg/m² IV)"/>
<timing>
<repeat>
<boundsPeriod>
<start value="2018-04-01"/>
</boundsPeriod>
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct"/>
<code value="47625008"/>
<display value="Intravenous route (qualifier value)"/>
</coding>
</route>
<doseAndRate>
<rateQuantity>
<value value="60"/>
<unit value="mg/m2"/>
<system value="http://unitsofmeasure.org"/>
<code value="mg/m2"/>
</rateQuantity>
</doseAndRate>
<maxDosePerPeriod>
<numerator>
<value value="1"/>
</numerator>
<denominator>
<value value="3"/>
<unit value="week"/>
<system value="http://unitsofmeasure.org"/>
<code value="wk"/>
</denominator>
</maxDosePerPeriod>
</dosageInstruction>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/MedicationRequest/cancer-related-medication-request-paclitaxel-jenny-m"/>
<resource>
<MedicationRequest>
<id value="cancer-related-medication-request-paclitaxel-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-related-medication-request"/>
</meta>
<text>
<status value="extensions"/>
<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>
</text>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="373808002"/>
<display value="Curative - procedure intent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</extension>
<status value="active"/>
<intent value="order"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/medicationrequest-category"/>
<code value="outpatient"/>
</coding>
</category>
<medicationCodeableConcept>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="56946"/>
<display value="PACLitaxel"/>
</coding>
</medicationCodeableConcept>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<authoredOn value="2018-04-12"/>
<requester>
<reference
value="Practitioner/us-core-practitioner-owen-oncologist"/>
</requester>
<reasonReference>
<reference value="Condition/primary-cancer-condition-jenny-m"/>
</reasonReference>
<dosageInstruction>
<text value="PACLitaxel (175 mg/m² IV), 272.01mg"/>
<timing>
<repeat>
<boundsPeriod>
<start value="2018-04-12"/>
</boundsPeriod>
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct"/>
<code value="47625008"/>
<display value="Intravenous route (qualifier value)"/>
</coding>
</route>
<doseAndRate>
<doseQuantity>
<value value="272.01"/>
<unit value="mg"/>
<system value="http://unitsofmeasure.org"/>
<code value="mg"/>
</doseQuantity>
</doseAndRate>
<maxDosePerPeriod>
<numerator>
<value value="1"/>
</numerator>
<denominator>
<value value="3"/>
<unit value="week"/>
<system value="http://unitsofmeasure.org"/>
<code value="wk"/>
</denominator>
</maxDosePerPeriod>
</dosageInstruction>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/MedicationRequest/cancer-related-medication-request-anastrozole-jenny-m"/>
<resource>
<MedicationRequest>
<id value="cancer-related-medication-request-anastrozole-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-related-medication-request"/>
</meta>
<text>
<status value="extensions"/>
<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>
</text>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="373808002"/>
<display value="Curative - procedure intent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</extension>
<status value="active"/>
<intent value="order"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/medicationrequest-category"/>
<code value="community"/>
</coding>
</category>
<medicationCodeableConcept>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="84857"/>
<display value="anastrozole"/>
</coding>
</medicationCodeableConcept>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<authoredOn value="2018-09-30"/>
<requester>
<reference
value="Practitioner/us-core-practitioner-owen-oncologist"/>
</requester>
<reasonReference>
<reference value="Condition/primary-cancer-condition-jenny-m"/>
</reasonReference>
<dosageInstruction>
<text value="1mg orally once daily"/>
<timing>
<repeat>
<boundsPeriod>
<start value="2018-09-30"/>
</boundsPeriod>
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct"/>
<code value="26643006"/>
<display value="Oral route (qualifier value)"/>
</coding>
</route>
<doseAndRate>
<doseQuantity>
<value value="1"/>
<unit value="mg"/>
<system value="http://unitsofmeasure.org"/>
<code value="mg"/>
</doseQuantity>
</doseAndRate>
<maxDosePerPeriod>
<numerator>
<value value="1"/>
</numerator>
<denominator>
<value value="1"/>
<unit value="day"/>
<system value="http://unitsofmeasure.org"/>
<code value="d"/>
</denominator>
</maxDosePerPeriod>
</dosageInstruction>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/cancer-related-mcode-comorbidities-elixhauser-jenny-m"/>
<resource>
<Observation>
<id value="cancer-related-mcode-comorbidities-elixhauser-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbidities-elixhauser"/>
</meta>
<text>
<status value="extensions"/>
<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>
</text>
<status value="final"/>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
<code value="comorbidities-elixhauser"/>
<display value="Elixhauser Comorbidity Panel"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-16"/>
<performer>
<reference
value="Practitioner/us-core-practitioner-owen-oncologist"/>
</performer>
<component>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-reference">
<valueReference>
<reference
value="Condition/us-core-condition-depression-jenny-m"/>
</valueReference>
</extension>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
<code value="DEPRESS"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="52101004"/>
<display value="Present (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-reference">
<valueReference>
<reference
value="Condition/us-core-condition-hypertension-jenny-m"/>
</valueReference>
</extension>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
<code value="HTN_CX"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="52101004"/>
<display value="Present (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
<code value="ARTH"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="2667000"/>
<display value="Absent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
<code value="CHF"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="2667000"/>
<display value="Absent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
<code value="LUNG_CHRONIC"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="2667000"/>
<display value="Absent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
<code value="DIAB_UNCX"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="2667000"/>
<display value="Absent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
<code value="DIAB_CX"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="2667000"/>
<display value="Absent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
<code value="OBESE"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="2667000"/>
<display value="Absent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
<code value="PERIVASC"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="2667000"/>
<display value="Absent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
<code value="PULMCIRC"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="2667000"/>
<display value="Absent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
<code value="RENLFL_MOD"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="2667000"/>
<display value="Absent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/bodyweight-jenny-m-2018-03-16"/>
<resource>
<Observation>
<id value="bodyweight-jenny-m-2018-03-16"/>
<meta>
<profile
value="http://hl7.org/fhir/StructureDefinition/bodyweight"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="vital-signs"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="29463-7"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-06"/>
<valueQuantity>
<value value="155"/>
<unit value="lb"/>
<system value="http://unitsofmeasure.org"/>
<code value="[lb_av]"/>
</valueQuantity>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/us-core-observation-lab-neutrophils-jenny-m"/>
<resource>
<Observation>
<id value="us-core-observation-lab-neutrophils-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="26499-4"/>
<display value="Neutrophils [#/volume] in Blood"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-05-20T00:00:00Z"/>
<valueQuantity>
<value value="3000"/>
<unit value="10*3/uL"/>
<system value="http://unitsofmeasure.org"/>
<code value="10*3/uL"/>
</valueQuantity>
<referenceRange>
<low>
<value value="2500"/>
<unit value="10*3/uL"/>
<system value="http://unitsofmeasure.org"/>
<code value="10*3/uL"/>
</low>
<high>
<value value="5000"/>
<unit value="10*3/uL"/>
<system value="http://unitsofmeasure.org"/>
<code value="10*3/uL"/>
</high>
<appliesTo>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/referencerange-meaning"/>
<code value="normal"/>
<display value="Normal Range"/>
</coding>
</appliesTo>
</referenceRange>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Organization/us-core-organization-physician-services-inc"/>
<resource>
<Organization>
<id value="us-core-organization-physician-services-inc"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<active value="true"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/organization-type"/>
<code value="prov"/>
<display value="Healthcare Provider"/>
</coding>
</type>
<name value="Physician Services, Inc."/>
<telecom>
<system value="phone"/>
<value value="999-999-9999"/>
<use value="work"/>
</telecom>
<address>
<line value="123 Corporate Drive"/>
<city value="Anytown"/>
<state value="MA"/>
<postalCode value="12345"/>
<country value="US"/>
</address>
</Organization>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/us-core-smokingstatus-jenny-m"/>
<resource>
<Observation>
<id value="us-core-smokingstatus-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="social-history"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="72166-2"/>
<display value="Tobacco smoking status"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-16"/>
<issued value="2018-03-16T00:00:00Z"/>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="449868002"/>
<display value="Smokes tobacco daily (finding)"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/us-core-procedure-biopsy-jenny-m"/>
<resource>
<Procedure>
<id value="us-core-procedure-biopsy-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="completed"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="723990008"/>
<display
value="Biopsy of breast using ultrasonographic guidance (procedure)"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<performedDateTime value="2018-03-06"/>
<asserter>
<reference value="Practitioner/us-core-practitioner-mary-obgyn"/>
</asserter>
<performer>
<actor>
<reference value="Practitioner/us-core-practitioner-mary-obgyn"/>
</actor>
</performer>
<reasonReference>
<reference value="Condition/primary-cancer-condition-jenny-m"/>
</reasonReference>
<bodySite>
<coding>
<system value="http://snomed.info/sct"/>
<code value="80248007"/>
<display value="Left breast structure (body structure)"/>
</coding>
</bodySite>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/us-core-procedure-mammogram-jenny-m"/>
<resource>
<Procedure>
<id value="us-core-procedure-mammogram-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="completed"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="71651007"/>
<display value="Mammography (procedure)"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<performedDateTime value="2018-02-01"/>
<asserter>
<reference value="Practitioner/us-core-practitioner-mary-obgyn"/>
</asserter>
<performer>
<actor>
<reference
value="Practitioner/us-core-practitioner-jane-radiotech"/>
</actor>
</performer>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/FamilyMemberHistory/family-member-history-aunt-jenny-m"/>
<resource>
<FamilyMemberHistory>
<id value="family-member-history-aunt-jenny-m"/>
<text>
<status value="generated"/>
<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>
</text>
<status value="completed"/>
<patient>
<reference value="Patient/cancer-patient-jenny-m"/>
</patient>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="MAUNT"/>
<display value="maternal aunt"/>
</coding>
</relationship>
<condition>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="363443007"/>
<display value="Malignant tumor of ovary (disorder)"/>
</coding>
</code>
<onsetAge>
<value value="69"/>
<system value="http://unitsofmeasure.org"/>
<code value="a"/>
</onsetAge>
</condition>
</FamilyMemberHistory>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Procedure/us-core-procedure-mammogram-jenny-m"/>
<resource>
<Procedure>
<id value="us-core-procedure-mammogram-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="completed"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="71651007"/>
<display value="Mammography (procedure)"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<performedDateTime value="2018-02-01"/>
<asserter>
<reference value="Practitioner/us-core-practitioner-mary-obgyn"/>
</asserter>
<performer>
<actor>
<reference
value="Practitioner/us-core-practitioner-jane-radiotech"/>
</actor>
</performer>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/FamilyMemberHistory/family-member-history-uncle-jenny-m"/>
<resource>
<FamilyMemberHistory>
<id value="family-member-history-uncle-jenny-m"/>
<text>
<status value="generated"/>
<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>
</text>
<status value="completed"/>
<patient>
<reference value="Patient/cancer-patient-jenny-m"/>
</patient>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="PUNCLE"/>
<display value="paternal uncle"/>
</coding>
</relationship>
<deceasedBoolean value="true"/>
<condition>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="363418001"/>
<display value="Malignant tumor of pancreas (disorder)"/>
</coding>
</code>
<contributedToDeath value="true"/>
</condition>
</FamilyMemberHistory>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/DiagnosticReport/us-core-diagnosticreport-lab-jenny-m"/>
<resource>
<DiagnosticReport>
<id value="us-core-diagnosticreport-lab-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-lab"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
<code value="LAB"/>
</coding>
</category>
<category>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
<code value="SP"/>
<display value="Surgical Pathology"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="22637-3"/>
<display value="Pathology report final diagnosis Narrative"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-04-01T00:00:00Z"/>
<issued value="2018-04-05T00:00:00Z"/>
<performer>
<reference
value="Organization/us-core-organization-physician-services-inc"/>
</performer>
<resultsInterpreter>
<reference
value="Practitioner/us-core-practitioner-peter-pathologist"/>
</resultsInterpreter>
<specimen>
<reference value="Specimen/tumor-specimen-left-breast-jenny-m"/>
</specimen>
<result>
<reference
value="Observation/us-core-observation-lab-tumor-invasion-jenny-m"/>
</result>
<result>
<reference
value="Observation/us-core-observation-lab-tumor-margins-jenny-m"/>
</result>
<result>
<reference
value="Observation/us-core-observation-lab-sentinel-nodes-jenny-m"/>
</result>
<result>
<reference value="Observation/tumor-size-jenny-m"/>
</result>
<result>
<reference
value="Observation/us-core-observation-lab-tumor-dcis-jenny-m"/>
</result>
<result>
<reference value="Observation/tumor-marker-test-her2-jenny-m"/>
</result>
<result>
<reference value="Observation/tumor-marker-test-er-jenny-m"/>
</result>
<result>
<reference value="Observation/tumor-marker-test-pr-jenny-m"/>
</result>
<result>
<reference
value="Observation/us-core-observation-lab-tumor-grade-jenny-m"/>
</result>
</DiagnosticReport>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/observation-smoking-pack-years-jenny-m"/>
<resource>
<Observation>
<id value="observation-smoking-pack-years-jenny-m"/>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="social-history"/>
<display value="Social History"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="401201003"/>
<display value="Cigarette pack-years (observable entity)"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-16"/>
<valueQuantity>
<value value="20"/>
<unit value="Pack-Years"/>
<system value="http://unitsofmeasure.org"/>
<code value="{PackYears}"/>
</valueQuantity>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/us-core-observation-lab-tumor-invasion-jenny-m"/>
<resource>
<Observation>
<id value="us-core-observation-lab-tumor-invasion-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="370052007"/>
<display value="Status of invasion by tumor"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-04-01T00:00:00Z"/>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="260385009"/>
<display value="Negative (qualifier value)"/>
</coding>
</valueCodeableConcept>
<specimen>
<reference value="Specimen/tumor-specimen-left-breast-jenny-m"/>
</specimen>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/us-core-observation-lab-tumor-margins-jenny-m"/>
<resource>
<Observation>
<id value="us-core-observation-lab-tumor-margins-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="44669-0"/>
<display value="Margin involvement in Breast tumor"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-04-01T00:00:00Z"/>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA27151-2"/>
<display value="Uninvolved by invasive carcinoma"/>
</coding>
</valueCodeableConcept>
<specimen>
<reference value="Specimen/tumor-specimen-left-breast-jenny-m"/>
</specimen>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/us-core-observation-lab-sentinel-nodes-jenny-m"/>
<resource>
<Observation>
<id value="us-core-observation-lab-sentinel-nodes-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="92832-5"/>
<display
value="Sentinel lymph nodes with metastasis [#] in Cancer specimen"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-04-01T00:00:00Z"/>
<specimen>
<reference value="Specimen/tumor-specimen-left-breast-jenny-m"/>
</specimen>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="92833-3"/>
<display
value="Lymph nodes examined [#] in Cancer specimen by Light microscopy"/>
</coding>
</code>
<valueQuantity>
<value value="3"/>
<unit value="Count"/>
<system value="http://unitsofmeasure.org"/>
<code value="{Count}"/>
</valueQuantity>
</component>
</Observation>
</resource>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/Observation/tumor-size-jenny-m"/>
<resource>
<Observation>
<id value="tumor-size-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor-size"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="21889-1"/>
<display value="Size Tumor"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-04-01T00:00:00Z"/>
<method>
<coding>
<system value="http://loinc.org"/>
<code value="24419-4"/>
<display value="Pathology report gross observation"/>
</coding>
</method>
<specimen>
<reference value="Specimen/tumor-specimen-left-breast-jenny-m"/>
</specimen>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="33728-7"/>
</coding>
</code>
<valueQuantity>
<value value="2.5"/>
<unit value="centimeters"/>
<system value="http://unitsofmeasure.org"/>
<code value="cm"/>
</valueQuantity>
</component>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/us-core-observation-lab-tumor-dcis-jenny-m"/>
<resource>
<Observation>
<id value="us-core-observation-lab-tumor-dcis-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="85336-6"/>
<display
value="DCIS intraductal extension in Breast cancer specimen Qualitative by Light microscopy"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-04-01T00:00:00Z"/>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA27261-9"/>
<display
value="DCIS present with extensive intraductal component (EIC)"/>
</coding>
</valueCodeableConcept>
<specimen>
<reference value="Specimen/tumor-specimen-left-breast-jenny-m"/>
</specimen>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Practitioner/us-core-practitioner-owen-oncologist"/>
<resource>
<Practitioner>
<id value="us-core-practitioner-owen-oncologist"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/>
</meta>
<text>
<status value="generated"/>
<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: 9988776655</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>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="9988776655"/>
</identifier>
<name>
<family value="Oncologist"/>
<given value="Owen"/>
<prefix value="Dr."/>
</name>
<address>
<use value="work"/>
<line value="123 Corporate Drive"/>
<city value="Anytown"/>
<state value="MA"/>
<postalCode value="12345"/>
<country value="US"/>
</address>
<gender value="male"/>
<qualification>
<code>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0360"/>
<version value="2.7"/>
<code value="MD"/>
</coding>
</code>
</qualification>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Practitioner/us-core-practitioner-peter-pathologist"/>
<resource>
<Practitioner>
<id value="us-core-practitioner-peter-pathologist"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/>
</meta>
<text>
<status value="generated"/>
<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: 1122334455</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>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="1122334455"/>
</identifier>
<name>
<family value="Pathologist"/>
<given value="Peter"/>
<prefix value="Dr."/>
</name>
<address>
<use value="work"/>
<line value="123 Corporate Drive"/>
<city value="Anytown"/>
<state value="MA"/>
<postalCode value="12345"/>
<country value="US"/>
</address>
<gender value="female"/>
<qualification>
<code>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0360"/>
<version value="2.7"/>
<code value="MD"/>
</coding>
</code>
</qualification>
</Practitioner>
</resource>
</entry>
</Bundle>
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
Links: Table of Contents |
QA Report
| Version History |
|
Propose a change