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Example Contract/C-2121 (JSON)

Financial Management Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Patient

Raw JSON (canonical form + also see JSON Format Specification)

42 CFR Part 2 Consent Directive

{
  "resourceType" : "Contract",
  "id" : "C-2121",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2016-07-19T18:18:42.108-04:00"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Contract</b><a name=\"C-2121\"> </a><a name=\"hcC-2121\"> </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 Contract &quot;C-2121&quot; Version &quot;1&quot; Updated &quot;2016-07-19T18:18:42.108-04:00&quot; </p></div><p><b>status</b>: executed</p><p><b>contentDerivative</b>: Content Registration <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-contract-content-derivative.html\">Contract Content Derivation Codes</a>#registration)</span></p><p><b>issued</b>: 2013-11-01T21:18:27-04:00</p><p><b>applies</b>: 2013-11-01T21:18:27-04:00 --&gt; (ongoing)</p><p><b>subject</b>: <a href=\"patient-example-f201-roel.html\">Patient/f201</a> &quot;Roel&quot;</p><p><b>type</b>: Opt-in consent directive <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (consentdirective-type#OPTIN)</span></p><p><b>subType</b>: Health Care Directive <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-consentcategorycodes.html\">Consent Category Codes</a>#hcd)</span></p><blockquote><p><b>term</b></p><h3>Offers</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Decision</b></td><td><b>Text</b></td></tr><tr><td style=\"display: none\">*</td><td>Statutory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-contracttermtypecodes.html\">Contract Term Type Codes</a>#statutory)</span></td><td>opt-in <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html\">ActCode</a>#OPTIN)</span></td><td>Can't refuse</td></tr></table><h3>Assets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Period</b></td></tr><tr><td style=\"display: none\">*</td><td>2013-11-01T21:18:27-04:00 --&gt; 2019-11-01T21:18:27-04:00</td></tr></table><blockquote><p><b>action</b></p><p><b>type</b>: Action A <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-contractaction.html\">Contract Action Codes</a>#action-a)</span></p><blockquote><p><b>subject</b></p><p><b>reference</b>: <a href=\"organization-example-f001-burgers.html\">Organization/f001: VA Ann Arbor Healthcare System</a> &quot;Burgers University Medical Center&quot;</p><p><b>role</b>: Recipient of restricted health information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (consent-actor-type#IR &quot;Recipient&quot;)</span></p></blockquote><blockquote><p><b>subject</b></p><p><b>reference</b>: <a href=\"organization-example-insurer.html\">Organization/2: Community Mental Health Clinic</a> &quot;XYZ Insurance&quot;</p><p><b>role</b>: Sender of restricted health information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (consent-actor-type#IS &quot;Sender&quot;)</span></p></blockquote><p><b>intent</b>: health program reporting <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActReason.html\">ActReason</a>#HPRGRP)</span></p><p><b>status</b>: Sample <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p></blockquote></blockquote><blockquote><p><b>signer</b></p><p><b>type</b>: SELF (Details: http://mdhhs.org/fhir/consent-signer-type code SELF = 'SELF', stated as 'null')</p><p><b>party</b>: <a href=\"patient-example-f201-roel.html\">Patient/f201: Alice Recruit</a> &quot;Roel&quot;</p><h3>Signatures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>When</b></td><td><b>Who</b></td></tr><tr><td style=\"display: none\">*</td><td>Author's Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.1 = 'Author's Signature', stated as 'null')</td><td>Feb 8, 2017, 9:57:34 AM</td><td><a href=\"patient-example-f201-roel.html\">Patient/f201</a> &quot;Roel&quot;</td></tr></table></blockquote><h3>Legals</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Content[x]</b></td></tr><tr><td style=\"display: none\">*</td><td/></tr></table></div>"
  },
  "status" : "executed",
  "contentDerivative" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/contract-content-derivative",
      "code" : "registration"
    }]
  },
  "issued" : "2013-11-01T21:18:27-04:00",
  "applies" : {
    "start" : "2013-11-01T21:18:27-04:00"
  },
  "subject" : [{
    "reference" : "Patient/f201"
  }],
  "type" : {
    "coding" : [{
      "system" : "http://mdhhs.org/fhir/consentdirective-type",
      "code" : "OPTIN"
    }],
    "text" : "Opt-in consent directive"
  },
  "subType" : [{
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/consentcategorycodes",
      "code" : "hcd"
    }]
  }],
  "term" : [{
    "offer" : {
      "type" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/contracttermtypecodes",
          "code" : "statutory"
        }]
      },
      "decision" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code" : "OPTIN"
        }]
      },
      "text" : "Can't refuse"
    },
    "asset" : [{
      "period" : [{
        "start" : "2013-11-01T21:18:27-04:00",
        "end" : "2019-11-01T21:18:27-04:00"
      }]
    }],
    "action" : [{
      "type" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/contractaction",
          "code" : "action-a"
        }]
      },
      "subject" : [{
        "reference" : [{
          "reference" : "Organization/f001",
          "display" : "VA Ann Arbor Healthcare System"
        }],
        "role" : {
          "coding" : [{
            "system" : "http://mdhhs.org/fhir/consent-actor-type",
            "code" : "IR",
            "display" : "Recipient"
          }],
          "text" : "Recipient of restricted health information"
        }
      },
      {
        "reference" : [{
          "reference" : "Organization/2",
          "display" : "Community Mental Health Clinic"
        }],
        "role" : {
          "coding" : [{
            "system" : "http://mdhhs.org/fhir/consent-actor-type",
            "code" : "IS",
            "display" : "Sender"
          }],
          "text" : "Sender of restricted health information"
        }
      }],
      "intent" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
          "code" : "HPRGRP"
        }]
      },
      "status" : {
        "text" : "Sample"
      }
    }]
  }],
  "signer" : [{
    "type" : {
      "system" : "http://mdhhs.org/fhir/consent-signer-type",
      "code" : "SELF"
    },
    "party" : {
      "reference" : "Patient/f201",
      "display" : "Alice Recruit"
    },
    "signature" : [{
      "type" : [{
        "system" : "urn:iso-astm:E1762-95:2013",
        "code" : "1.2.840.10065.1.12.1.1"
      }],
      "when" : "2017-02-08T10:57:34+01:00",
      "who" : {
        "reference" : "Patient/f201"
      }
    }]
  }],
  "legal" : [{
    "contentAttachment" : {
      "contentType" : "application/pdf",
      "language" : "en-US",
      "url" : "http://org.mihin.ecms/ConsentDirective-2121",
      "title" : "MDHHS-5515 Consent To Share Your Health Information"
    }
  }]
}

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.