Da Vinci Unsolicited Notifications
1.0.0 - STU1 Release

Da Vinci Unsolicited Notifications, published by HL7 International - Infrastructure and Messaging Work Group. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/HL7/davinci-alerts/ and changes regularly. See the Directory of published versions

Da Vinci Notifications Patient Admit/Transfer/Discharge Use Case

Introduction

This use case demonstrates how the Da Vinci Notifications IG framework is used to define the Da Vinci Notification Bundle for admissions, transfers, and discharges and how to send a notification between a Sender and a Recipient/Intermediary.

Use Case Background

The intent of this use case is to focus on the beginning and end of patient encounters. The following list illustrates the type of events that this use case covers.1

  • admission to the emergency department
  • admission to a hospital or equivalent facility as an inpatient
  • admission to to a health care facility for a predetermined length of time, usually less than 24 hours
  • admission to a hospital or equivalent facility for observation
  • admission to a healthcare facility on a nonresident basis for example, for an outpatient medical procedure or surgery
  • transfer from the emergency room to an inpatient status
  • discharge to the patient’s home environment
  • discharge or transfer to a long-term care facility
  • discharge or transfer to a post-acute care rehabilitation facility
  • notification that the patient expired during the encounter

Having the ability to send notifications to update physicians and care management teams when a patient has a significant encounters (such as inpatient, ER visits, surgery etc.) is key to improving patient care. The intent of these notifications is not to replace existing data exchange mechanisms, for example the discharge summary; but rather to notify of the event and provide enough data to gather more information, if desired. These notifications improve post-discharge transitions, promote communication between providers and encourage follow up care. The expectation for this use case is that the business rules for triggering the notification is the same that is used for an HL7 V2 ADT A01 message. Figure 6 illustrates how some of the admit, transfer and discharge data elements corresponded to the resource in the message bundle.

Transfer notifications should only be used if:

  • Your organization calls it a “transfer” when the patient moves from the emergency room to an inpatient status
  • Your organizations calls it a “transfer” when a patient moves from inpatient to another facility like an inpatient rehab facility.

You should not use transfer notifications:

  • If your facility only uses admit and discharge transactions for the above scenarios
  • For bed changes within the same facility, i.e. ICU to a step-down.
Figure 6
bundle_graphic.svg

FHIR Resources for Admission, Transfer, and Discharge Notifications

To carry information regarding admission, transfer, and discharge event messages, the required resources for the message Bundle need to be defined. The core components of the Bundle are defined in the Framework page and include the MessageHeader and the “root” resource represented by the MessageHeader.focus. For admission, transfer and discharge, the Encounter is the focus of the event as shown in igure 7. For this scenario, the Da Vinci Admit/Transfer/Discharge Notification Encounter Profile - which is based on the US Core Encounter Profile - is used:

Figure 7
admit_message_graph1.svg

The other “required if present” resources defined in the framework are those referenced by MessageHeader.author, MessageHeader.responsible, MessageHeader.sender and those referenced by the Da Vinci Admit/Transfer/Discharge Notification Encounter Profile. These combine to make up a ‘generic’ Encounter message bundle structure illustrated in Figure 8 below:

Figure 8
admit_message_graph2.svg

The following additional resources (or rather profiles) have been determined to be “required if present” by the Da Vinci community to fulfill the data item requirements specific to admissions and discharge.

  • US Core Condition
  • Da Vinci Admit/Transfer/Discharge Notification Coverage

Adding these additional components results in the following resource graph showing all the required resources and their relationships for the admission and discharge notification use case shown in Figure 9:

Figure 9
admit_message_graph3.svg

An alternate representation of this graph is a table with each row representing an “edge” - an ordered pair of the form (source profile, target profile):

Link Source Profile Path Target Profile Min Max
1 Da Vinci Notification MessageHeader Profile MessageHeader.focus Da Vinci Admit/Transfer/Discharge Notification Encounter Profile 1 1
2 Da Vinci Admit/Transfer/Discharge Notification Encounter Profile Encounter.location US Core Location Profile 1 *
3 Da Vinci Admit/Transfer/Discharge Notification Encounter Profile Encounter.participant.individual US Core Practitioner Profile 0 *
4 Da Vinci Admit/Transfer/Discharge Notification Encounter Profile Encounter.subject US Core Patient Profile 1 1
5 Da Vinci Admit/Transfer/Discharge Notification Coverage Profile Coverage.beneficary US Core Patient Profile 0 1
6 US Core Condition Profile Condition.encounter Da Vinci Admit/Transfer/Discharge Notification Encounter Profile 0 *
7 Da Vinci Notification MessageHeader Profile MessageHeader.sender US Core Practitioner Profile|US Core PractitionerRole Profile|US Core Organization Profile 0 1
8 Da Vinci Notification MessageHeader Profile MessageHeader.responsible US Core Practitioner Profile|US Core PractitionerRole Profile|US Core Organization Profile 0 1
9 Da Vinci Notification MessageHeader Profile MessageHeader.author US Core Practitioner Profile|US Core PractitionerRole Profile 0 1

Note that an Admit/Transfer/Discharge Bundle may contain more or less resources than this graph illustrates since:
a) having additional resources in the message bundle is not prohibited as long as the resources are reference by or reference another resource in the message bundle and
b) not all the resources listed above may be present in the source system. For example, including a diagnosis on an admit/transfer/discharge notification allows the recipient to determine if additional action is required, but an encounter diagnosis may not be available until well after discharge. (For a more detailed discussion of when required resources may be absent, see the section on Must Support)

Admit/Transfer/Discharge Message Profiles

The following FHIR Profiles can be used to formally define this resource graph for the admission, transfer, and discharge events. Note that except for the first profile listed below, these profiles constrain their references to other profiles within the same bundle.

Examples

Da Vinci Notification Bundles such as these examples can be assembled based on any of the above definitions.

  • Bundle/admit-notification-intermediate-translate-bundle
  • Bundle/transfer-notification-message-bundle-01
  • Bundle/discharge-notification-message-bundle-01
  • Bundle/admit-notification-message-bundle-01
  • Bundle/admit-notification-intermediate-transmit-bundle
  • Pushing Unsolicited Admit/Transfer/Discharge Notification

    In the interaction shown in Figure 10, the HealthCare facility is acting in the role of the Notification Sender and the Notification Recipient can be any of the actors listed on the home page. To notify the Notification Recipients/Intermediary of an admit or discharge event, the Notification Sender uses $process-message operation to submit the Notification Message to appropriate FHIR endpoints. Not shown in Figure 10 is that when the Intermediary successfully receives and processes the notifications, it subsequently forwards the data to the end users.

    Figure 10
    $process_message_admit_wf.svg


    Example Transactions

    The following example transactions show examples of using the $process-message operation to send a notification messages.

    Examples

    Scenario:

    ‘Patient Y has been admitted to Provider X ‘s facility. Acting in the role of Sender, Provider X alerts Payer Z, who is acting in the Recipient role, of the admission. The Notification is transacted as the [$process-message] operation. The body of the operation is a Message Bundle containing:’

    1. The Message Header which is the first resource in the bundle and contains the the message event code - that identifies the nature of the notification.
    2. The other resources in the bundle depend on the type of the notification use case and may be defined by FHIR Profiles.

    An HTTP Status success code is returned on successful submission.

    Push Notification using the $process-message

    POST [base]/$process-message

    Request body

    {
      "resourceType": "Bundle",
      "id": "admit-notification-message-bundle-01",
      "meta": {
        "lastUpdated": "2020-08-17T17:15:12.011868Z",
        "profile": [
          "http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/notifications-bundle"
        ]
      },
      "type": "message",
      "timestamp": "2020-08-17T17:15:12.011868Z",
      "entry": [
        {
          "fullUrl": "urn:uuid:31ab7fe2-e0ad-11ea-bf7c-864d2e68a322",
          "resource": {
            "resourceType": "MessageHeader",
            "id": "31ab7fe2-e0ad-11ea-bf7c-864d2e68a322",
            "meta": {
              "profile": [
                "http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/notifications-messageheader",
                "http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/admit-notification-messageheader"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>event</b>: <span title=\"{http://hl7.org/fhir/us/davinci-alerts/CodeSystem/notification-event notification-admit}\">Admit Notification</span></p><h3>Destinations</h3><table class=\"grid\"><tr><td>-</td><td><b>Name</b></td><td><b>Endpoint</b></td></tr><tr><td>*</td><td>Intermediary-Simulator</td><td><a href=\"https://example.org/Endpoints/DaVinci-Notifications-Intermediary\">https://example.org/Endpoints/DaVinci-Notifications-Intermediary</a></td></tr></table><p><b>sender</b>: <a href=\"#Organization_a9f20dc1-5147-3789-bcef-bbecb41c5983\">HOLY FAMILY HOSPITAL. Generated Summary: id: a9f20dc1-5147-3789-bcef-bbecb41c5983; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: HOLY FAMILY HOSPITAL; ph: 9786870156</a></p><p><b>author</b>: <a href=\"#Practitioner_0000016f-57cb-cdac-0000-00000000014a\">Dr. Janeth814 Jakubowski832. Generated Summary: id: 330; active; Janeth814 Jakubowski832 ; Janeth814.Jakubowski832@example.com(WORK); gender: female</a></p><h3>Sources</h3><table class=\"grid\"><tr><td>-</td><td><b>Name</b></td><td><b>Software</b></td><td><b>Version</b></td><td><b>Contact</b></td><td><b>Endpoint</b></td></tr><tr><td>*</td><td>Acme Central Patient Registry</td><td>FooBar Patient Manager</td><td>3.1.45.AABB</td><td>ph: +1 (555) 123 4567</td><td><a href=\"https://example.org/Endpoints/P456\">https://example.org/Endpoints/P456</a></td></tr></table><p><b>responsible</b>: <a href=\"#Organization_a9f20dc1-5147-3789-bcef-bbecb41c5983\">HOLY FAMILY HOSPITAL. Generated Summary: id: a9f20dc1-5147-3789-bcef-bbecb41c5983; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: HOLY FAMILY HOSPITAL; ph: 9786870156</a></p><p><b>focus</b>: <a href=\"#Encounter_5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82\">Admit Notification(Unknown (qualifier value)). Generated Summary: id: Elden718Halvorson12420181021T2122150700; status: in-progress; <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode EMER}\">emergency</span>; <span title=\"Codes: {http://snomed.info/sct 261665006}\">Unknown (qualifier value)</span>; period: Oct 22, 2018, 4:22:15 AM --&gt; Oct 22, 2018, 5:22:15 AM</a></p></div>"
            },
            "eventCoding": {
              "system": "http://hl7.org/fhir/us/davinci-alerts/CodeSystem/notification-event",
              "code": "notification-admit",
              "display": "Admit Notification"
            },
            "destination": [
              {
                "name": "Intermediary-Simulator",
                "endpoint": "https://example.org/Endpoints/DaVinci-Notifications-Intermediary"
              }
            ],
            "sender": {
              "reference": "urn:uuid:a9f20dc1-5147-3789-bcef-bbecb41c5983",
              "display": "HOLY FAMILY HOSPITAL"
            },
            "author": {
              "reference": "urn:uuid:0000016f-57cb-cdac-0000-00000000014a",
              "display": "Dr. Janeth814 Jakubowski832"
            },
            "source": {
              "name": "Acme Central Patient Registry",
              "software": "FooBar Patient Manager",
              "version": "3.1.45.AABB",
              "contact": {
                "system": "phone",
                "value": "+1 (555) 123 4567"
              },
              "endpoint": "https://example.org/Endpoints/P456"
            },
            "responsible": {
              "reference": "urn:uuid:a9f20dc1-5147-3789-bcef-bbecb41c5983",
              "display": "HOLY FAMILY HOSPITAL"
            },
            "focus": [
              {
                "reference": "urn:uuid:5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82",
                "display": "Admit Notification(Unknown (qualifier value))"
              }
            ]
          }
        },
        {
          "fullUrl": "urn:uuid:5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82",
          "resource": {
            "resourceType": "Encounter",
            "id": "5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82",
            "meta": {
              "versionId": "54",
              "lastUpdated": "2020-04-28T21:32:21.199+00:00",
              "source": "#DlfWMd7j9EX8TaLI",
              "profile": [
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter",
                "http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/adt-notification-encounter"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>identifier</b>: id: Elden718Halvorson12420181021T2122150700</p><p><b>status</b>: in-progress</p><p><b>class</b>: <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode EMER}\">emergency</span></p><p><b>type</b>: <span title=\"Codes: {http://snomed.info/sct 261665006}\">Unknown (qualifier value)</span></p><p><b>subject</b>: <a href=\"#Patient_06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b\">Mr. Elden718 Halvorson124. Generated Summary: id: 06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b, Medical Record Number: 06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b, Social Security Number: 999-87-1037, Driver's License: S99952689; Elden718 Halvorson124 (OFFICIAL); ph: 555-903-1143(HOME); gender: male; birthDate: 2000-10-15; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus S}\">Never Married</span>; </a></p><h3>Participants</h3><table class=\"grid\"><tr><td>-</td><td><b>Individual</b></td></tr><tr><td>*</td><td><a href=\"#Practitioner_0000016f-57cb-cdac-0000-00000000014a\">Dr. Janeth814 Jakubowski832. Generated Summary: id: 330; active; Janeth814 Jakubowski832 ; Janeth814.Jakubowski832@example.com(WORK); gender: female</a></td></tr></table><p><b>period</b>: Oct 22, 2018, 4:22:15 AM --&gt; Oct 22, 2018, 5:22:15 AM</p><h3>Locations</h3><table class=\"grid\"><tr><td>-</td><td><b>Location</b></td></tr><tr><td>*</td><td><a href=\"#Location_09188b81-0d1d-453c-b0fa-203ef88c794c\">HOLY FAMILY HOSPITAL. Generated Summary: status: active; name: HOLY FAMILY HOSPITAL; ph: 9786870156</a></td></tr></table><p><b>serviceProvider</b>: <a href=\"#Organization_a9f20dc1-5147-3789-bcef-bbecb41c5983\">HOLY FAMILY HOSPITAL. Generated Summary: id: a9f20dc1-5147-3789-bcef-bbecb41c5983; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: HOLY FAMILY HOSPITAL; ph: 9786870156</a></p></div>"
            },
            "identifier": [
              {
                "system": "http://example.org",
                "value": "Elden718Halvorson12420181021T2122150700"
              }
            ],
            "status": "in-progress",
            "class": {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
              "code": "EMER"
            },
            "type": [
              {
                "coding": [
                  {
                    "system": "http://snomed.info/sct",
                    "code": "261665006",
                    "display": "Unknown (qualifier value)"
                  }
                ],
                "text": "Unknown (qualifier value)"
              }
            ],
            "subject": {
              "reference": "urn:uuid:06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b",
              "display": "Mr. Elden718 Halvorson124"
            },
            "participant": [
              {
                "individual": {
                  "reference": "urn:uuid:0000016f-57cb-cdac-0000-00000000014a",
                  "display": "Dr. Janeth814 Jakubowski832"
                }
              }
            ],
            "period": {
              "start": "2018-10-21T21:22:15-07:00",
              "end": "2018-10-21T22:22:15-07:00"
            },
            "location": [
              {
                "location": {
                  "reference": "urn:uuid:09188b81-0d1d-453c-b0fa-203ef88c794c",
                  "display": "HOLY FAMILY HOSPITAL"
                }
              }
            ],
            "serviceProvider": {
              "reference": "urn:uuid:a9f20dc1-5147-3789-bcef-bbecb41c5983",
              "display": "HOLY FAMILY HOSPITAL"
            }
          }
        },
        {
          "fullUrl": "urn:uuid:06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b",
          "resource": {
            "resourceType": "Patient",
            "id": "06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b",
            "meta": {
              "versionId": "4",
              "lastUpdated": "2020-04-28T20:27:52.935+00:00",
              "source": "#pPvYTutotnO7vQfK",
              "profile": [
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
              ]
            },
            "text": {
              "status": "extensions",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><blockquote><p><b>US Core Race Extension</b></p><h3>Urls</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2106-3}\">White</span></p><h3>Urls</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: White</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><h3>Urls</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2186-5}\">Not Hispanic or Latino</span></p><h3>Urls</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>Mother's Maiden Name</b>: </p><p><b>US Core Birth Sex Extension</b>: </p><p><b>Birth Place</b>: </p><p><b>identifier</b>: id: 06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b, Medical Record Number: 06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b, Social Security Number: 999-87-1037, Driver's License: S99952689</p><p><b>name</b>: Elden718 Halvorson124 (OFFICIAL)</p><p><b>telecom</b>: ph: 555-903-1143(HOME)</p><p><b>gender</b>: male</p><p><b>birthDate</b>: 2000-10-15</p><p><b>address</b>: 715 Crona Corner Methuen MA 01844 US </p><p><b>maritalStatus</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus S}\">Never Married</span></p><p><b>multipleBirth</b>: false</p><h3>Communications</h3><table class=\"grid\"><tr><td>-</td><td><b>Language</b></td></tr><tr><td>*</td><td><span title=\"Codes: {urn:ietf:bcp:47 en-US}\">English</span></td></tr></table></div>"
            },
            "extension": [
              {
                "extension": [
                  {
                    "url": "ombCategory",
                    "valueCoding": {
                      "system": "urn:oid:2.16.840.1.113883.6.238",
                      "code": "2106-3",
                      "display": "White"
                    }
                  },
                  {
                    "url": "text",
                    "valueString": "White"
                  }
                ],
                "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
              },
              {
                "extension": [
                  {
                    "url": "ombCategory",
                    "valueCoding": {
                      "system": "urn:oid:2.16.840.1.113883.6.238",
                      "code": "2186-5",
                      "display": "Not Hispanic or Latino"
                    }
                  },
                  {
                    "url": "text",
                    "valueString": "Not Hispanic or Latino"
                  }
                ],
                "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName",
                "valueString": "Marge692 Yost751"
              },
              {
                "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
                "valueCode": "M"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/patient-birthPlace",
                "valueAddress": {
                  "city": "Rockland",
                  "state": "Massachusetts",
                  "country": "US"
                }
              }
            ],
            "identifier": [
              {
                "system": "https://github.com/synthetichealth/synthea",
                "value": "06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b"
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                      "code": "MR",
                      "display": "Medical Record Number"
                    }
                  ],
                  "text": "Medical Record Number"
                },
                "system": "http://hospital.smarthealthit.org",
                "value": "06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b"
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                      "code": "SS",
                      "display": "Social Security Number"
                    }
                  ],
                  "text": "Social Security Number"
                },
                "system": "http://hl7.org/fhir/sid/us-ssn",
                "value": "999-87-1037"
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                      "code": "DL",
                      "display": "Driver's license number"
                    }
                  ],
                  "text": "Driver's License"
                },
                "system": "urn:oid:2.16.840.1.113883.4.3.25",
                "value": "S99952689"
              }
            ],
            "name": [
              {
                "use": "official",
                "family": "Halvorson124",
                "given": [
                  "Elden718"
                ],
                "prefix": [
                  "Mr."
                ]
              }
            ],
            "telecom": [
              {
                "system": "phone",
                "value": "555-903-1143",
                "use": "home"
              }
            ],
            "gender": "male",
            "birthDate": "2000-10-15",
            "address": [
              {
                "extension": [
                  {
                    "extension": [
                      {
                        "url": "latitude",
                        "valueDecimal": 42.757779285956644
                      },
                      {
                        "url": "longitude",
                        "valueDecimal": -71.14760946593316
                      }
                    ],
                    "url": "http://hl7.org/fhir/StructureDefinition/geolocation"
                  }
                ],
                "line": [
                  "715 Crona Corner"
                ],
                "city": "Methuen",
                "state": "MA",
                "postalCode": "01844",
                "country": "US"
              }
            ],
            "maritalStatus": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                  "code": "S",
                  "display": "Never Married"
                }
              ],
              "text": "Never Married"
            },
            "multipleBirthBoolean": false,
            "communication": [
              {
                "language": {
                  "coding": [
                    {
                      "system": "urn:ietf:bcp:47",
                      "code": "en-US",
                      "display": "English (Region=United States)"
                    }
                  ],
                  "text": "English"
                }
              }
            ]
          }
        },
        {
          "fullUrl": "urn:uuid:09188b81-0d1d-453c-b0fa-203ef88c794c",
          "resource": {
            "resourceType": "Location",
            "id": "09188b81-0d1d-453c-b0fa-203ef88c794c",
            "meta": {
              "versionId": "4",
              "lastUpdated": "2020-04-28T20:27:53.156+00:00",
              "source": "#pPvYTutotnO7vQfK",
              "profile": [
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-location"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>status</b>: active</p><p><b>name</b>: HOLY FAMILY HOSPITAL</p><p><b>telecom</b>: ph: 9786870156</p><p><b>address</b>: 70 EAST STREET METHUEN MA 01844 US </p><h3>Positions</h3><table class=\"grid\"><tr><td>-</td><td><b>Longitude</b></td><td><b>Latitude</b></td></tr><tr><td>*</td><td>-71.178588</td><td>42.742751</td></tr></table><p><b>managingOrganization</b>: <a href=\"#Organization_a9f20dc1-5147-3789-bcef-bbecb41c5983\">HOLY FAMILY HOSPITAL. Generated Summary: id: a9f20dc1-5147-3789-bcef-bbecb41c5983; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: HOLY FAMILY HOSPITAL; ph: 9786870156</a></p></div>"
            },
            "status": "active",
            "name": "HOLY FAMILY HOSPITAL",
            "telecom": [
              {
                "system": "phone",
                "value": "9786870156"
              }
            ],
            "address": {
              "line": [
                "70 EAST STREET"
              ],
              "city": "METHUEN",
              "state": "MA",
              "postalCode": "01844",
              "country": "US"
            },
            "position": {
              "longitude": -71.178588,
              "latitude": 42.742751
            },
            "managingOrganization": {
              "reference": "urn:uuid:a9f20dc1-5147-3789-bcef-bbecb41c5983",
              "display": "HOLY FAMILY HOSPITAL"
            }
          }
        },
        {
          "fullUrl": "urn:uuid:0000016f-57cb-cdac-0000-00000000014a",
          "resource": {
            "resourceType": "Practitioner",
            "id": "0000016f-57cb-cdac-0000-00000000014a",
            "meta": {
              "versionId": "4",
              "lastUpdated": "2020-04-28T20:27:53.186+00:00",
              "source": "#pPvYTutotnO7vQfK",
              "profile": [
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>identifier</b>: id: 330</p><p><b>active</b>: true</p><p><b>name</b>: Janeth814 Jakubowski832 </p><p><b>telecom</b>: Janeth814.Jakubowski832@example.com(WORK)</p><p><b>address</b>: 70 EAST STREET METHUEN MA 01844 US </p><p><b>gender</b>: female</p></div>"
            },
            "identifier": [
              {
                "system": "http://hl7.org/fhir/sid/us-npi",
                "value": "330"
              }
            ],
            "active": true,
            "name": [
              {
                "family": "Jakubowski832",
                "given": [
                  "Janeth814"
                ],
                "prefix": [
                  "Dr."
                ]
              }
            ],
            "telecom": [
              {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct",
                    "valueBoolean": true
                  }
                ],
                "system": "email",
                "value": "Janeth814.Jakubowski832@example.com",
                "use": "work"
              }
            ],
            "address": [
              {
                "line": [
                  "70 EAST STREET"
                ],
                "city": "METHUEN",
                "state": "MA",
                "postalCode": "01844",
                "country": "US"
              }
            ],
            "gender": "female"
          }
        },
        {
          "fullUrl": "urn:uuid:a9f20dc1-5147-3789-bcef-bbecb41c5983",
          "resource": {
            "resourceType": "Organization",
            "id": "a9f20dc1-5147-3789-bcef-bbecb41c5983",
            "meta": {
              "versionId": "4",
              "lastUpdated": "2020-04-28T20:27:52.708+00:00",
              "source": "#pPvYTutotnO7vQfK",
              "profile": [
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>identifier</b>: id: a9f20dc1-5147-3789-bcef-bbecb41c5983</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: HOLY FAMILY HOSPITAL</p><p><b>telecom</b>: ph: 9786870156</p><p><b>address</b>: 70 EAST STREET METHUEN MA 01844 US </p></div>"
            },
            "identifier": [
              {
                "system": "https://github.com/synthetichealth/synthea",
                "value": "a9f20dc1-5147-3789-bcef-bbecb41c5983"
              }
            ],
            "active": true,
            "type": [
              {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                    "code": "prov",
                    "display": "Healthcare Provider"
                  }
                ],
                "text": "Healthcare Provider"
              }
            ],
            "name": "HOLY FAMILY HOSPITAL",
            "telecom": [
              {
                "system": "phone",
                "value": "9786870156"
              }
            ],
            "address": [
              {
                "line": [
                  "70 EAST STREET"
                ],
                "city": "METHUEN",
                "state": "MA",
                "postalCode": "01844",
                "country": "US"
              }
            ]
          }
        },
        {
          "fullUrl": "urn:uuid:4ac41715-fcbd-421c-8796-9b2c9706dd3f",
          "resource": {
            "resourceType": "Condition",
            "id": "4ac41715-fcbd-421c-8796-9b2c9706dd3f",
            "meta": {
              "versionId": "10",
              "lastUpdated": "2020-04-28T20:28:00.008+00:00",
              "source": "#cabiJIK51sD2iz4N",
              "profile": [
                "http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/adt-notification-condition",
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>clinicalStatus</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical active}\">Active</span></p><p><b>verificationStatus</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}\">Confirmed</span></p><p><b>category</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/condition-category encounter-diagnosis}\">Encounter Diagnosis</span></p><p><b>code</b>: <span title=\"Codes: {http://example.org/fhir/conditions 1234}\">Examplitis</span></p><p><b>subject</b>: <a href=\"#Patient_06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b\">See above (Patient/06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b)</a></p><p><b>encounter</b>: <a href=\"#Encounter_5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82\">See above (Encounter/5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82)</a></p><p><b>onset</b>: Oct 22, 2018, 4:22:15 AM</p><p><b>recordedDate</b>: Oct 22, 2018, 4:22:15 AM</p></div>"
            },
            "clinicalStatus": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
                  "code": "active"
                }
              ]
            },
            "verificationStatus": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
                  "code": "confirmed"
                }
              ]
            },
            "category": [
              {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/condition-category",
                    "code": "encounter-diagnosis",
                    "display": "Encounter Diagnosis"
                  }
                ]
              }
            ],
            "code": {
              "coding": [
                {
                  "system": "http://example.org/fhir/conditions",
                  "code": "1234",
                  "display": "Examplitis"
                }
              ],
              "text": "Examplitis"
            },
            "subject": {
              "reference": "urn:uuid:06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b"
            },
            "encounter": {
              "reference": "urn:uuid:5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82"
            },
            "onsetDateTime": "2018-10-21T21:22:15-07:00",
            "recordedDate": "2018-10-21T21:22:15-07:00"
          }
        },
        {
          "fullUrl": "urn:uuid:cc6ac2fe-2bf4-11ea-a5f5-a4d18ccf5172",
          "resource": {
            "resourceType": "Coverage",
            "id": "cc6ac2fe-2bf4-11ea-a5f5-a4d18ccf5172",
            "meta": {
              "versionId": "10",
              "lastUpdated": "2020-04-28T20:27:52.686+00:00",
              "source": "#pPvYTutotnO7vQfK",
              "profile": [
                "http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/adt-notification-coverage"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>status</b>: active</p><p><b>type</b>: <span title=\"Codes: \">Blue Cross Blue Shield</span></p><p><b>subscriberId</b>: 12345</p><p><b>beneficiary</b>: <a href=\"#Patient_06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b\">See above (Patient/06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b)</a></p><p><b>payor</b>: <a href=\"#Organization_cc6ac93e-2bf4-11ea-a5f5-a4d18ccf5172\">Blue Cross Blue Shield. Generated Summary: id: 0000010005; active; name: Blue Cross Blue Shield; ph: 1-800-262-2583(WORK)</a></p></div>"
            },
            "status": "active",
            "type": {
              "text": "Blue Cross Blue Shield"
            },
            "subscriberId": "12345",
            "beneficiary": {
              "reference": "urn:uuid:06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b"
            },
            "payor": [
              {
                "reference": "urn:uuid:cc6ac93e-2bf4-11ea-a5f5-a4d18ccf5172",
                "display": "Blue Cross Blue Shield"
              }
            ]
          }
        },
        {
          "fullUrl": "urn:uuid:cc6ac93e-2bf4-11ea-a5f5-a4d18ccf5172",
          "resource": {
            "resourceType": "Organization",
            "id": "cc6ac93e-2bf4-11ea-a5f5-a4d18ccf5172",
            "meta": {
              "versionId": "10",
              "lastUpdated": "2020-04-28T20:27:53.069+00:00",
              "source": "#pPvYTutotnO7vQfK",
              "profile": [
                "http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-organization"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>identifier</b>: id: 0000010005</p><p><b>active</b>: true</p><p><b>name</b>: Blue Cross Blue Shield</p><p><b>telecom</b>: ph: 1-800-262-2583(WORK)</p><p><b>address</b>: Michigan Plaza Chicago IL 60007 </p></div>"
            },
            "identifier": [
              {
                "system": "http://hl7.org/fhir/sid/us-npi",
                "value": "0000010005"
              }
            ],
            "active": true,
            "name": "Blue Cross Blue Shield",
            "telecom": [
              {
                "system": "phone",
                "value": "1-800-262-2583",
                "use": "work"
              }
            ],
            "address": [
              {
                "line": [
                  "Michigan Plaza"
                ],
                "city": "Chicago",
                "state": "IL",
                "postalCode": "60007"
              }
            ]
          }
        }
      ]
    }
    

    Response Headers:

    HTTP/1.1 200 OK
    [other headers]
    

    OperationOutcome:

    {
        "id": "intermediary-response",
        "issue": [
            {
                "code": "informational",
                "details": {
                    "text": "The message was received and the message has been fully processed"
                },
                "severity": "information"
            }
        ],
        "resourceType": "OperationOutcome",
        "text": {
            "div": "<div><p><b>Operation Outcome for :</b></p><p>All OK</p><table class=\"grid\"><tr><td><b>Severity</b></td><td><b>Location</b></td><td><b>Details</b></td><td><b>Diagnostics</b></td><td><b>Type</b></td></tr><tr><td>information</td><td/><td>The message was received and the message has been fully processed</td><td/><td>informational</td></tr></table></div>",
            "status": "generated"
        }
    }
    


    Examples

    Scenario:

    Patient Y has been moved from the Provider X ‘s emergency room to an inpatient status. Provider X ‘s considers this a “transfer” event. Acting in the role of Sender, Provider X alerts Payer Z, who is acting in the Recipient role, of the transfer. The Notification is transacted as the [$process-message] operation. The body of the operation is a Message Bundle containing:

    1. The Message Header which is the first resource in the bundle and contains the the message event code - that identifies the nature of the notification.
    2. The other resources in the bundle depend on the type of the notification use case and may be defined by FHIR Profiles.

    An HTTP Status success code is returned on successful submission.

    Push Notification using the $process-message

    POST [base]/$process-message

    Request body

    {
      "resourceType": "Bundle",
      "id": "transfer-notification-message-bundle-01",
      "meta": {
        "lastUpdated": "2020-08-17T18:57:26.887078Z",
        "profile": [
          "http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/notifications-bundle"
        ]
      },
      "type": "message",
      "timestamp": "2020-08-17T18:57:26.887078Z",
      "entry": [
        {
          "fullUrl": "urn:uuid:7a5df5f4-e0bb-11ea-834a-864d2e68a322",
          "resource": {
            "resourceType": "MessageHeader",
            "id": "7a5df5f4-e0bb-11ea-834a-864d2e68a322",
            "meta": {
              "profile": [
                "http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/notifications-messageheader",
                "http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/transfer-notification-messageheader"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>event</b>: <span title=\"{http://hl7.org/fhir/us/davinci-alerts/CodeSystem/notification-event notification-transfer}\">Transfer Notification</span></p><h3>Destinations</h3><table class=\"grid\"><tr><td>-</td><td><b>Name</b></td><td><b>Endpoint</b></td></tr><tr><td>*</td><td>Intermediary-Simulator</td><td><a href=\"https://example.org/Endpoints/DaVinci-Notifications-Intermediary\">https://example.org/Endpoints/DaVinci-Notifications-Intermediary</a></td></tr></table><p><b>sender</b>: <a href=\"#Organization_a9f20dc1-5147-3789-bcef-bbecb41c5983\">HOLY FAMILY HOSPITAL. Generated Summary: id: a9f20dc1-5147-3789-bcef-bbecb41c5983; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: HOLY FAMILY HOSPITAL; ph: 9786870156</a></p><p><b>author</b>: <a href=\"#Practitioner_0000016f-57cb-cdac-0000-00000000014a\">Dr. Janeth814 Jakubowski832. Generated Summary: id: 330; active; Janeth814 Jakubowski832 ; Janeth814.Jakubowski832@example.com(WORK); gender: female</a></p><h3>Sources</h3><table class=\"grid\"><tr><td>-</td><td><b>Name</b></td><td><b>Software</b></td><td><b>Version</b></td><td><b>Contact</b></td><td><b>Endpoint</b></td></tr><tr><td>*</td><td>Acme Central Patient Registry</td><td>FooBar Patient Manager</td><td>3.1.45.AABB</td><td>ph: +1 (555) 123 4567</td><td><a href=\"https://example.org/Endpoints/P456\">https://example.org/Endpoints/P456</a></td></tr></table><p><b>responsible</b>: <a href=\"#Organization_a9f20dc1-5147-3789-bcef-bbecb41c5983\">HOLY FAMILY HOSPITAL. Generated Summary: id: a9f20dc1-5147-3789-bcef-bbecb41c5983; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: HOLY FAMILY HOSPITAL; ph: 9786870156</a></p><p><b>focus</b>: <a href=\"#Encounter_5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82\">Transfer Notification(Examplotomy Encounter). Generated Summary: id: Elden718Halvorson12420181021T2122150700; status: in-progress; <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode IMP}\">inpatient encounter</span>; <span title=\"Codes: {http://example.org/fhir/encounters 1234}\">Examplotomy Encounter</span>; period: Oct 22, 2018, 4:22:15 AM --&gt; Oct 22, 2018, 5:22:15 AM</a></p></div>"
            },
            "eventCoding": {
              "system": "http://hl7.org/fhir/us/davinci-alerts/CodeSystem/notification-event",
              "code": "notification-transfer",
              "display": "Transfer Notification"
            },
            "destination": [
              {
                "name": "Intermediary-Simulator",
                "endpoint": "https://example.org/Endpoints/DaVinci-Notifications-Intermediary"
              }
            ],
            "sender": {
              "reference": "urn:uuid:a9f20dc1-5147-3789-bcef-bbecb41c5983",
              "display": "HOLY FAMILY HOSPITAL"
            },
            "author": {
              "reference": "urn:uuid:0000016f-57cb-cdac-0000-00000000014a",
              "display": "Dr. Janeth814 Jakubowski832"
            },
            "source": {
              "name": "Acme Central Patient Registry",
              "software": "FooBar Patient Manager",
              "version": "3.1.45.AABB",
              "contact": {
                "system": "phone",
                "value": "+1 (555) 123 4567"
              },
              "endpoint": "https://example.org/Endpoints/P456"
            },
            "responsible": {
              "reference": "urn:uuid:a9f20dc1-5147-3789-bcef-bbecb41c5983",
              "display": "HOLY FAMILY HOSPITAL"
            },
            "focus": [
              {
                "reference": "urn:uuid:5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82",
                "display": "Transfer Notification(Examplotomy Encounter)"
              }
            ]
          }
        },
        {
          "fullUrl": "urn:uuid:5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82",
          "resource": {
            "resourceType": "Encounter",
            "id": "5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82",
            "meta": {
              "versionId": "55",
              "lastUpdated": "2020-04-28T21:32:28.234+00:00",
              "source": "#XuOGgQteQKG8lTEO",
              "profile": [
                "http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/adt-notification-encounter",
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>identifier</b>: id: Elden718Halvorson12420181021T2122150700</p><p><b>status</b>: in-progress</p><p><b>class</b>: <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode IMP}\">inpatient encounter</span></p><p><b>type</b>: <span title=\"Codes: {http://example.org/fhir/encounters 1234}\">Examplotomy Encounter</span></p><p><b>subject</b>: <a href=\"#Patient_06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b\">Mr. Elden718 Halvorson124. Generated Summary: id: 06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b, Medical Record Number: 06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b, Social Security Number: 999-87-1037, Driver's License: S99952689; Elden718 Halvorson124 (OFFICIAL); ph: 555-903-1143(HOME); gender: male; birthDate: 2000-10-15; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus S}\">Never Married</span>; </a></p><h3>Participants</h3><table class=\"grid\"><tr><td>-</td><td><b>Individual</b></td></tr><tr><td>*</td><td><a href=\"#Practitioner_0000016f-57cb-cdac-0000-00000000014a\">Dr. Janeth814 Jakubowski832. Generated Summary: id: 330; active; Janeth814 Jakubowski832 ; Janeth814.Jakubowski832@example.com(WORK); gender: female</a></td></tr></table><p><b>period</b>: Oct 22, 2018, 4:22:15 AM --&gt; Oct 22, 2018, 5:22:15 AM</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td>-</td><td><b>AdmitSource</b></td></tr><tr><td>*</td><td><span title=\"Codes: {http://terminology.hl7.org/CodeSystem/admit-source emd}\">Transfer from accident/emergency department</span></td></tr></table><h3>Locations</h3><table class=\"grid\"><tr><td>-</td><td><b>Location</b></td></tr><tr><td>*</td><td><a href=\"#Location_09188b81-0d1d-453c-b0fa-203ef88c794c\">HOLY FAMILY HOSPITAL. Generated Summary: status: active; name: HOLY FAMILY HOSPITAL; ph: 9786870156</a></td></tr></table><p><b>serviceProvider</b>: <a href=\"#Organization_a9f20dc1-5147-3789-bcef-bbecb41c5983\">HOLY FAMILY HOSPITAL. Generated Summary: id: a9f20dc1-5147-3789-bcef-bbecb41c5983; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: HOLY FAMILY HOSPITAL; ph: 9786870156</a></p></div>"
            },
            "identifier": [
              {
                "system": "http://example.org",
                "value": "Elden718Halvorson12420181021T2122150700"
              }
            ],
            "status": "in-progress",
            "class": {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
              "code": "IMP"
            },
            "type": [
              {
                "coding": [
                  {
                    "system": "http://example.org/fhir/encounters",
                    "code": "1234",
                    "display": "Examplotomy Encounter"
                  }
                ],
                "text": "Examplotomy Encounter"
              }
            ],
            "subject": {
              "reference": "urn:uuid:06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b",
              "display": "Mr. Elden718 Halvorson124"
            },
            "participant": [
              {
                "individual": {
                  "reference": "urn:uuid:0000016f-57cb-cdac-0000-00000000014a",
                  "display": "Dr. Janeth814 Jakubowski832"
                }
              }
            ],
            "period": {
              "start": "2018-10-21T21:22:15-07:00",
              "end": "2018-10-21T22:22:15-07:00"
            },
            "hospitalization": {
              "admitSource": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/admit-source",
                    "code": "emd",
                    "display": "From accident/emergency department"
                  }
                ],
                "text": "Transfer from accident/emergency department"
              }
            },
            "location": [
              {
                "location": {
                  "reference": "urn:uuid:09188b81-0d1d-453c-b0fa-203ef88c794c",
                  "display": "HOLY FAMILY HOSPITAL"
                }
              }
            ],
            "serviceProvider": {
              "reference": "urn:uuid:a9f20dc1-5147-3789-bcef-bbecb41c5983",
              "display": "HOLY FAMILY HOSPITAL"
            }
          }
        },
        {
          "fullUrl": "urn:uuid:06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b",
          "resource": {
            "resourceType": "Patient",
            "id": "06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b",
            "meta": {
              "versionId": "4",
              "lastUpdated": "2020-04-28T20:27:52.935+00:00",
              "source": "#pPvYTutotnO7vQfK",
              "profile": [
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
              ]
            },
            "text": {
              "status": "extensions",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><blockquote><p><b>US Core Race Extension</b></p><h3>Urls</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2106-3}\">White</span></p><h3>Urls</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: White</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><h3>Urls</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2186-5}\">Not Hispanic or Latino</span></p><h3>Urls</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>Mother's Maiden Name</b>: </p><p><b>US Core Birth Sex Extension</b>: </p><p><b>Birth Place</b>: </p><p><b>identifier</b>: id: 06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b, Medical Record Number: 06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b, Social Security Number: 999-87-1037, Driver's License: S99952689</p><p><b>name</b>: Elden718 Halvorson124 (OFFICIAL)</p><p><b>telecom</b>: ph: 555-903-1143(HOME)</p><p><b>gender</b>: male</p><p><b>birthDate</b>: 2000-10-15</p><p><b>address</b>: 715 Crona Corner Methuen MA 01844 US </p><p><b>maritalStatus</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus S}\">Never Married</span></p><p><b>multipleBirth</b>: false</p><h3>Communications</h3><table class=\"grid\"><tr><td>-</td><td><b>Language</b></td></tr><tr><td>*</td><td><span title=\"Codes: {urn:ietf:bcp:47 en-US}\">English</span></td></tr></table></div>"
            },
            "extension": [
              {
                "extension": [
                  {
                    "url": "ombCategory",
                    "valueCoding": {
                      "system": "urn:oid:2.16.840.1.113883.6.238",
                      "code": "2106-3",
                      "display": "White"
                    }
                  },
                  {
                    "url": "text",
                    "valueString": "White"
                  }
                ],
                "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
              },
              {
                "extension": [
                  {
                    "url": "ombCategory",
                    "valueCoding": {
                      "system": "urn:oid:2.16.840.1.113883.6.238",
                      "code": "2186-5",
                      "display": "Not Hispanic or Latino"
                    }
                  },
                  {
                    "url": "text",
                    "valueString": "Not Hispanic or Latino"
                  }
                ],
                "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName",
                "valueString": "Marge692 Yost751"
              },
              {
                "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
                "valueCode": "M"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/patient-birthPlace",
                "valueAddress": {
                  "city": "Rockland",
                  "state": "Massachusetts",
                  "country": "US"
                }
              }
            ],
            "identifier": [
              {
                "system": "https://github.com/synthetichealth/synthea",
                "value": "06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b"
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                      "code": "MR",
                      "display": "Medical Record Number"
                    }
                  ],
                  "text": "Medical Record Number"
                },
                "system": "http://hospital.smarthealthit.org",
                "value": "06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b"
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                      "code": "SS",
                      "display": "Social Security Number"
                    }
                  ],
                  "text": "Social Security Number"
                },
                "system": "http://hl7.org/fhir/sid/us-ssn",
                "value": "999-87-1037"
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                      "code": "DL",
                      "display": "Driver's license number"
                    }
                  ],
                  "text": "Driver's License"
                },
                "system": "urn:oid:2.16.840.1.113883.4.3.25",
                "value": "S99952689"
              }
            ],
            "name": [
              {
                "use": "official",
                "family": "Halvorson124",
                "given": [
                  "Elden718"
                ],
                "prefix": [
                  "Mr."
                ]
              }
            ],
            "telecom": [
              {
                "system": "phone",
                "value": "555-903-1143",
                "use": "home"
              }
            ],
            "gender": "male",
            "birthDate": "2000-10-15",
            "address": [
              {
                "extension": [
                  {
                    "extension": [
                      {
                        "url": "latitude",
                        "valueDecimal": 42.757779285956644
                      },
                      {
                        "url": "longitude",
                        "valueDecimal": -71.14760946593316
                      }
                    ],
                    "url": "http://hl7.org/fhir/StructureDefinition/geolocation"
                  }
                ],
                "line": [
                  "715 Crona Corner"
                ],
                "city": "Methuen",
                "state": "MA",
                "postalCode": "01844",
                "country": "US"
              }
            ],
            "maritalStatus": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                  "code": "S",
                  "display": "Never Married"
                }
              ],
              "text": "Never Married"
            },
            "multipleBirthBoolean": false,
            "communication": [
              {
                "language": {
                  "coding": [
                    {
                      "system": "urn:ietf:bcp:47",
                      "code": "en-US",
                      "display": "English (Region=United States)"
                    }
                  ],
                  "text": "English"
                }
              }
            ]
          }
        },
        {
          "fullUrl": "urn:uuid:09188b81-0d1d-453c-b0fa-203ef88c794c",
          "resource": {
            "resourceType": "Location",
            "id": "09188b81-0d1d-453c-b0fa-203ef88c794c",
            "meta": {
              "versionId": "4",
              "lastUpdated": "2020-04-28T20:27:53.156+00:00",
              "source": "#pPvYTutotnO7vQfK",
              "profile": [
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-location"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>status</b>: active</p><p><b>name</b>: HOLY FAMILY HOSPITAL</p><p><b>telecom</b>: ph: 9786870156</p><p><b>address</b>: 70 EAST STREET METHUEN MA 01844 US </p><h3>Positions</h3><table class=\"grid\"><tr><td>-</td><td><b>Longitude</b></td><td><b>Latitude</b></td></tr><tr><td>*</td><td>-71.178588</td><td>42.742751</td></tr></table><p><b>managingOrganization</b>: <a href=\"#Organization_a9f20dc1-5147-3789-bcef-bbecb41c5983\">HOLY FAMILY HOSPITAL. Generated Summary: id: a9f20dc1-5147-3789-bcef-bbecb41c5983; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: HOLY FAMILY HOSPITAL; ph: 9786870156</a></p></div>"
            },
            "status": "active",
            "name": "HOLY FAMILY HOSPITAL",
            "telecom": [
              {
                "system": "phone",
                "value": "9786870156"
              }
            ],
            "address": {
              "line": [
                "70 EAST STREET"
              ],
              "city": "METHUEN",
              "state": "MA",
              "postalCode": "01844",
              "country": "US"
            },
            "position": {
              "longitude": -71.178588,
              "latitude": 42.742751
            },
            "managingOrganization": {
              "reference": "urn:uuid:a9f20dc1-5147-3789-bcef-bbecb41c5983",
              "display": "HOLY FAMILY HOSPITAL"
            }
          }
        },
        {
          "fullUrl": "urn:uuid:0000016f-57cb-cdac-0000-00000000014a",
          "resource": {
            "resourceType": "Practitioner",
            "id": "0000016f-57cb-cdac-0000-00000000014a",
            "meta": {
              "versionId": "4",
              "lastUpdated": "2020-04-28T20:27:53.186+00:00",
              "source": "#pPvYTutotnO7vQfK",
              "profile": [
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>identifier</b>: id: 330</p><p><b>active</b>: true</p><p><b>name</b>: Janeth814 Jakubowski832 </p><p><b>telecom</b>: Janeth814.Jakubowski832@example.com(WORK)</p><p><b>address</b>: 70 EAST STREET METHUEN MA 01844 US </p><p><b>gender</b>: female</p></div>"
            },
            "identifier": [
              {
                "system": "http://hl7.org/fhir/sid/us-npi",
                "value": "330"
              }
            ],
            "active": true,
            "name": [
              {
                "family": "Jakubowski832",
                "given": [
                  "Janeth814"
                ],
                "prefix": [
                  "Dr."
                ]
              }
            ],
            "telecom": [
              {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct",
                    "valueBoolean": true
                  }
                ],
                "system": "email",
                "value": "Janeth814.Jakubowski832@example.com",
                "use": "work"
              }
            ],
            "address": [
              {
                "line": [
                  "70 EAST STREET"
                ],
                "city": "METHUEN",
                "state": "MA",
                "postalCode": "01844",
                "country": "US"
              }
            ],
            "gender": "female"
          }
        },
        {
          "fullUrl": "urn:uuid:a9f20dc1-5147-3789-bcef-bbecb41c5983",
          "resource": {
            "resourceType": "Organization",
            "id": "a9f20dc1-5147-3789-bcef-bbecb41c5983",
            "meta": {
              "versionId": "4",
              "lastUpdated": "2020-04-28T20:27:52.708+00:00",
              "source": "#pPvYTutotnO7vQfK",
              "profile": [
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>identifier</b>: id: a9f20dc1-5147-3789-bcef-bbecb41c5983</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: HOLY FAMILY HOSPITAL</p><p><b>telecom</b>: ph: 9786870156</p><p><b>address</b>: 70 EAST STREET METHUEN MA 01844 US </p></div>"
            },
            "identifier": [
              {
                "system": "https://github.com/synthetichealth/synthea",
                "value": "a9f20dc1-5147-3789-bcef-bbecb41c5983"
              }
            ],
            "active": true,
            "type": [
              {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                    "code": "prov",
                    "display": "Healthcare Provider"
                  }
                ],
                "text": "Healthcare Provider"
              }
            ],
            "name": "HOLY FAMILY HOSPITAL",
            "telecom": [
              {
                "system": "phone",
                "value": "9786870156"
              }
            ],
            "address": [
              {
                "line": [
                  "70 EAST STREET"
                ],
                "city": "METHUEN",
                "state": "MA",
                "postalCode": "01844",
                "country": "US"
              }
            ]
          }
        },
        {
          "fullUrl": "urn:uuid:4ac41715-fcbd-421c-8796-9b2c9706dd3f",
          "resource": {
            "resourceType": "Condition",
            "id": "4ac41715-fcbd-421c-8796-9b2c9706dd3f",
            "meta": {
              "versionId": "10",
              "lastUpdated": "2020-04-28T20:28:00.008+00:00",
              "source": "#cabiJIK51sD2iz4N",
              "profile": [
                "http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/adt-notification-condition",
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>clinicalStatus</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical active}\">Active</span></p><p><b>verificationStatus</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}\">Confirmed</span></p><p><b>category</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/condition-category encounter-diagnosis}\">Encounter Diagnosis</span></p><p><b>code</b>: <span title=\"Codes: {http://example.org/fhir/conditions 1234}\">Examplitis</span></p><p><b>subject</b>: <a href=\"#Patient_06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b\">See above (Patient/06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b)</a></p><p><b>encounter</b>: <a href=\"#Encounter_5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82\">See above (Encounter/5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82)</a></p><p><b>onset</b>: Oct 22, 2018, 4:22:15 AM</p><p><b>recordedDate</b>: Oct 22, 2018, 4:22:15 AM</p></div>"
            },
            "clinicalStatus": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
                  "code": "active"
                }
              ]
            },
            "verificationStatus": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
                  "code": "confirmed"
                }
              ]
            },
            "category": [
              {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/condition-category",
                    "code": "encounter-diagnosis",
                    "display": "Encounter Diagnosis"
                  }
                ]
              }
            ],
            "code": {
              "coding": [
                {
                  "system": "http://example.org/fhir/conditions",
                  "code": "1234",
                  "display": "Examplitis"
                }
              ],
              "text": "Examplitis"
            },
            "subject": {
              "reference": "urn:uuid:06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b"
            },
            "encounter": {
              "reference": "urn:uuid:5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82"
            },
            "onsetDateTime": "2018-10-21T21:22:15-07:00",
            "recordedDate": "2018-10-21T21:22:15-07:00"
          }
        },
        {
          "fullUrl": "urn:uuid:cc6ac2fe-2bf4-11ea-a5f5-a4d18ccf5172",
          "resource": {
            "resourceType": "Coverage",
            "id": "cc6ac2fe-2bf4-11ea-a5f5-a4d18ccf5172",
            "meta": {
              "versionId": "10",
              "lastUpdated": "2020-04-28T20:27:52.686+00:00",
              "source": "#pPvYTutotnO7vQfK",
              "profile": [
                "http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/adt-notification-coverage"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>status</b>: active</p><p><b>type</b>: <span title=\"Codes: \">Blue Cross Blue Shield</span></p><p><b>subscriberId</b>: 12345</p><p><b>beneficiary</b>: <a href=\"#Patient_06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b\">See above (Patient/06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b)</a></p><p><b>payor</b>: <a href=\"#Organization_cc6ac93e-2bf4-11ea-a5f5-a4d18ccf5172\">Blue Cross Blue Shield. Generated Summary: id: 0000010005; active; name: Blue Cross Blue Shield; ph: 1-800-262-2583(WORK)</a></p></div>"
            },
            "status": "active",
            "type": {
              "text": "Blue Cross Blue Shield"
            },
            "subscriberId": "12345",
            "beneficiary": {
              "reference": "urn:uuid:06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b"
            },
            "payor": [
              {
                "reference": "urn:uuid:cc6ac93e-2bf4-11ea-a5f5-a4d18ccf5172",
                "display": "Blue Cross Blue Shield"
              }
            ]
          }
        },
        {
          "fullUrl": "urn:uuid:cc6ac93e-2bf4-11ea-a5f5-a4d18ccf5172",
          "resource": {
            "resourceType": "Organization",
            "id": "cc6ac93e-2bf4-11ea-a5f5-a4d18ccf5172",
            "meta": {
              "versionId": "10",
              "lastUpdated": "2020-04-28T20:27:53.069+00:00",
              "source": "#pPvYTutotnO7vQfK",
              "profile": [
                "http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-organization"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>identifier</b>: id: 0000010005</p><p><b>active</b>: true</p><p><b>name</b>: Blue Cross Blue Shield</p><p><b>telecom</b>: ph: 1-800-262-2583(WORK)</p><p><b>address</b>: Michigan Plaza Chicago IL 60007 </p></div>"
            },
            "identifier": [
              {
                "system": "http://hl7.org/fhir/sid/us-npi",
                "value": "0000010005"
              }
            ],
            "active": true,
            "name": "Blue Cross Blue Shield",
            "telecom": [
              {
                "system": "phone",
                "value": "1-800-262-2583",
                "use": "work"
              }
            ],
            "address": [
              {
                "line": [
                  "Michigan Plaza"
                ],
                "city": "Chicago",
                "state": "IL",
                "postalCode": "60007"
              }
            ]
          }
        }
      ]
    }
    

    Response Headers:

    HTTP/1.1 200 OK
    [other headers]
    

    OperationOutcome:

    {
        "id": "intermediary-response",
        "issue": [
            {
                "code": "informational",
                "details": {
                    "text": "The message was received and the message has been fully processed"
                },
                "severity": "information"
            }
        ],
        "resourceType": "OperationOutcome",
        "text": {
            "div": "<div><p><b>Operation Outcome for :</b></p><p>All OK</p><table class=\"grid\"><tr><td><b>Severity</b></td><td><b>Location</b></td><td><b>Details</b></td><td><b>Diagnostics</b></td><td><b>Type</b></td></tr><tr><td>information</td><td/><td>The message was received and the message has been fully processed</td><td/><td>informational</td></tr></table></div>",
            "status": "generated"
        }
    }
    


    Examples

    Scenario:

    Patient Y has been discharged from Provider X ‘s facility. Acting in the role of Sender, Provider X notifies Payer Z, who is acting in the Recipient role, of the discharge. The Notification is transacted as the [$process-message] operation. The body of the operation is a Message Bundle containing:

    1. The Message Header which is the first resource in the bundle and contains the the message event code - that identifies the nature of the notification.
    2. The other resources in the bundle depend on the type of the notification use case and may be defined by the FHIR Profiles.

    An HTTP Status success code is returned on successful submission.

    Push Notification using the $process-message

    POST [base]/$process-message

    Request body

    {
      "resourceType": "Bundle",
      "id": "discharge-notification-message-bundle-01",
      "meta": {
        "lastUpdated": "2020-08-17T19:00:15.888493Z",
        "profile": [
          "http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/notifications-bundle"
        ]
      },
      "type": "message",
      "timestamp": "2020-08-17T19:00:15.888493Z",
      "entry": [
        {
          "fullUrl": "urn:uuid:df0bb058-e0bb-11ea-a11a-864d2e68a322",
          "resource": {
            "resourceType": "MessageHeader",
            "id": "df0bb058-e0bb-11ea-a11a-864d2e68a322",
            "meta": {
              "profile": [
                "http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/notifications-messageheader",
                "http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/discharge-notification-messageheader"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>event</b>: <span title=\"{http://hl7.org/fhir/us/davinci-alerts/CodeSystem/notification-event notification-discharge}\">Discharge Notification</span></p><h3>Destinations</h3><table class=\"grid\"><tr><td>-</td><td><b>Name</b></td><td><b>Endpoint</b></td></tr><tr><td>*</td><td>Intermediary-Simulator</td><td><a href=\"https://example.org/Endpoints/DaVinci-Notifications-Intermediary\">https://example.org/Endpoints/DaVinci-Notifications-Intermediary</a></td></tr></table><p><b>sender</b>: <a href=\"#Organization_a9f20dc1-5147-3789-bcef-bbecb41c5983\">HOLY FAMILY HOSPITAL. Generated Summary: id: a9f20dc1-5147-3789-bcef-bbecb41c5983; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: HOLY FAMILY HOSPITAL; ph: 9786870156</a></p><p><b>author</b>: <a href=\"#Practitioner_0000016f-57cb-cdac-0000-00000000014a\">Dr. Janeth814 Jakubowski832. Generated Summary: id: 330; active; Janeth814 Jakubowski832 ; Janeth814.Jakubowski832@example.com(WORK); gender: female</a></p><h3>Sources</h3><table class=\"grid\"><tr><td>-</td><td><b>Name</b></td><td><b>Software</b></td><td><b>Version</b></td><td><b>Contact</b></td><td><b>Endpoint</b></td></tr><tr><td>*</td><td>Acme Central Patient Registry</td><td>FooBar Patient Manager</td><td>3.1.45.AABB</td><td>ph: +1 (555) 123 4567</td><td><a href=\"https://example.org/Endpoints/P456\">https://example.org/Endpoints/P456</a></td></tr></table><p><b>responsible</b>: <a href=\"#Organization_a9f20dc1-5147-3789-bcef-bbecb41c5983\">HOLY FAMILY HOSPITAL. Generated Summary: id: a9f20dc1-5147-3789-bcef-bbecb41c5983; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: HOLY FAMILY HOSPITAL; ph: 9786870156</a></p><p><b>focus</b>: <a href=\"#Encounter_5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82\">Discharge Notification(Examplotomy Encounter). Generated Summary: id: Elden718Halvorson12420181021T2122150700; status: finished; <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode IMP}\">inpatient encounter</span>; <span title=\"Codes: {http://example.org/fhir/encounters 1234}\">Examplotomy Encounter</span>; period: Oct 22, 2018, 4:22:15 AM --&gt; Oct 24, 2018, 5:22:15 AM</a></p></div>"
            },
            "eventCoding": {
              "system": "http://hl7.org/fhir/us/davinci-alerts/CodeSystem/notification-event",
              "code": "notification-discharge",
              "display": "Discharge Notification"
            },
            "destination": [
              {
                "name": "Intermediary-Simulator",
                "endpoint": "https://example.org/Endpoints/DaVinci-Notifications-Intermediary"
              }
            ],
            "sender": {
              "reference": "urn:uuid:a9f20dc1-5147-3789-bcef-bbecb41c5983",
              "display": "HOLY FAMILY HOSPITAL"
            },
            "author": {
              "reference": "urn:uuid:0000016f-57cb-cdac-0000-00000000014a",
              "display": "Dr. Janeth814 Jakubowski832"
            },
            "source": {
              "name": "Acme Central Patient Registry",
              "software": "FooBar Patient Manager",
              "version": "3.1.45.AABB",
              "contact": {
                "system": "phone",
                "value": "+1 (555) 123 4567"
              },
              "endpoint": "https://example.org/Endpoints/P456"
            },
            "responsible": {
              "reference": "urn:uuid:a9f20dc1-5147-3789-bcef-bbecb41c5983",
              "display": "HOLY FAMILY HOSPITAL"
            },
            "focus": [
              {
                "reference": "urn:uuid:5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82",
                "display": "Discharge Notification(Examplotomy Encounter)"
              }
            ]
          }
        },
        {
          "fullUrl": "urn:uuid:5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82",
          "resource": {
            "resourceType": "Encounter",
            "id": "5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82",
            "meta": {
              "versionId": "56",
              "lastUpdated": "2020-04-28T21:32:34.376+00:00",
              "source": "#TtGHW1V3SxiqqQj4",
              "profile": [
                "http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/adt-notification-encounter",
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>identifier</b>: id: Elden718Halvorson12420181021T2122150700</p><p><b>status</b>: finished</p><p><b>class</b>: <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode IMP}\">inpatient encounter</span></p><p><b>type</b>: <span title=\"Codes: {http://example.org/fhir/encounters 1234}\">Examplotomy Encounter</span></p><p><b>subject</b>: <a href=\"#Patient_06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b\">Mr. Elden718 Halvorson124. Generated Summary: id: 06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b, Medical Record Number: 06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b, Social Security Number: 999-87-1037, Driver's License: S99952689; Elden718 Halvorson124 (OFFICIAL); ph: 555-903-1143(HOME); gender: male; birthDate: 2000-10-15; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus S}\">Never Married</span>; </a></p><h3>Participants</h3><table class=\"grid\"><tr><td>-</td><td><b>Individual</b></td></tr><tr><td>*</td><td><a href=\"#Practitioner_0000016f-57cb-cdac-0000-00000000014a\">Dr. Janeth814 Jakubowski832. Generated Summary: id: 330; active; Janeth814 Jakubowski832 ; Janeth814.Jakubowski832@example.com(WORK); gender: female</a></td></tr></table><p><b>period</b>: Oct 22, 2018, 4:22:15 AM --&gt; Oct 24, 2018, 5:22:15 AM</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td>-</td><td><b>DischargeDisposition</b></td></tr><tr><td>*</td><td><span title=\"Codes: {http://www.nubc.org/patient-discharge 1}\">Discharge to Home or Self Care (Routine Discharge)</span></td></tr></table><h3>Locations</h3><table class=\"grid\"><tr><td>-</td><td><b>Location</b></td></tr><tr><td>*</td><td><a href=\"#Location_09188b81-0d1d-453c-b0fa-203ef88c794c\">HOLY FAMILY HOSPITAL. Generated Summary: status: active; name: HOLY FAMILY HOSPITAL; ph: 9786870156</a></td></tr></table><p><b>serviceProvider</b>: <a href=\"#Organization_a9f20dc1-5147-3789-bcef-bbecb41c5983\">HOLY FAMILY HOSPITAL. Generated Summary: id: a9f20dc1-5147-3789-bcef-bbecb41c5983; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: HOLY FAMILY HOSPITAL; ph: 9786870156</a></p></div>"
            },
            "identifier": [
              {
                "system": "http://example.org",
                "value": "Elden718Halvorson12420181021T2122150700"
              }
            ],
            "status": "finished",
            "class": {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
              "code": "IMP"
            },
            "type": [
              {
                "coding": [
                  {
                    "system": "http://example.org/fhir/encounters",
                    "code": "1234",
                    "display": "Examplotomy Encounter"
                  }
                ],
                "text": "Examplotomy Encounter"
              }
            ],
            "subject": {
              "reference": "urn:uuid:06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b",
              "display": "Mr. Elden718 Halvorson124"
            },
            "participant": [
              {
                "individual": {
                  "reference": "urn:uuid:0000016f-57cb-cdac-0000-00000000014a",
                  "display": "Dr. Janeth814 Jakubowski832"
                }
              }
            ],
            "period": {
              "start": "2018-10-21T21:22:15-07:00",
              "end": "2018-10-23T22:22:15-07:00"
            },
            "hospitalization": {
              "dischargeDisposition": {
                "coding": [
                  {
                    "system": "http://www.nubc.org/patient-discharge",
                    "code": "1",
                    "display": "Discharge to Home or Self Care (Routine Discharge)"
                  }
                ],
                "text": "Discharge to Home or Self Care (Routine Discharge)"
              }
            },
            "location": [
              {
                "location": {
                  "reference": "urn:uuid:09188b81-0d1d-453c-b0fa-203ef88c794c",
                  "display": "HOLY FAMILY HOSPITAL"
                }
              }
            ],
            "serviceProvider": {
              "reference": "urn:uuid:a9f20dc1-5147-3789-bcef-bbecb41c5983",
              "display": "HOLY FAMILY HOSPITAL"
            }
          }
        },
        {
          "fullUrl": "urn:uuid:06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b",
          "resource": {
            "resourceType": "Patient",
            "id": "06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b",
            "meta": {
              "versionId": "4",
              "lastUpdated": "2020-04-28T20:27:52.935+00:00",
              "source": "#pPvYTutotnO7vQfK",
              "profile": [
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
              ]
            },
            "text": {
              "status": "extensions",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><blockquote><p><b>US Core Race Extension</b></p><h3>Urls</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2106-3}\">White</span></p><h3>Urls</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: White</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><h3>Urls</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: <span title=\"{urn:oid:2.16.840.1.113883.6.238 2186-5}\">Not Hispanic or Latino</span></p><h3>Urls</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>Mother's Maiden Name</b>: </p><p><b>US Core Birth Sex Extension</b>: </p><p><b>Birth Place</b>: </p><p><b>identifier</b>: id: 06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b, Medical Record Number: 06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b, Social Security Number: 999-87-1037, Driver's License: S99952689</p><p><b>name</b>: Elden718 Halvorson124 (OFFICIAL)</p><p><b>telecom</b>: ph: 555-903-1143(HOME)</p><p><b>gender</b>: male</p><p><b>birthDate</b>: 2000-10-15</p><p><b>address</b>: 715 Crona Corner Methuen MA 01844 US </p><p><b>maritalStatus</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus S}\">Never Married</span></p><p><b>multipleBirth</b>: false</p><h3>Communications</h3><table class=\"grid\"><tr><td>-</td><td><b>Language</b></td></tr><tr><td>*</td><td><span title=\"Codes: {urn:ietf:bcp:47 en-US}\">English</span></td></tr></table></div>"
            },
            "extension": [
              {
                "extension": [
                  {
                    "url": "ombCategory",
                    "valueCoding": {
                      "system": "urn:oid:2.16.840.1.113883.6.238",
                      "code": "2106-3",
                      "display": "White"
                    }
                  },
                  {
                    "url": "text",
                    "valueString": "White"
                  }
                ],
                "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
              },
              {
                "extension": [
                  {
                    "url": "ombCategory",
                    "valueCoding": {
                      "system": "urn:oid:2.16.840.1.113883.6.238",
                      "code": "2186-5",
                      "display": "Not Hispanic or Latino"
                    }
                  },
                  {
                    "url": "text",
                    "valueString": "Not Hispanic or Latino"
                  }
                ],
                "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/patient-mothersMaidenName",
                "valueString": "Marge692 Yost751"
              },
              {
                "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
                "valueCode": "M"
              },
              {
                "url": "http://hl7.org/fhir/StructureDefinition/patient-birthPlace",
                "valueAddress": {
                  "city": "Rockland",
                  "state": "Massachusetts",
                  "country": "US"
                }
              }
            ],
            "identifier": [
              {
                "system": "https://github.com/synthetichealth/synthea",
                "value": "06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b"
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                      "code": "MR",
                      "display": "Medical Record Number"
                    }
                  ],
                  "text": "Medical Record Number"
                },
                "system": "http://hospital.smarthealthit.org",
                "value": "06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b"
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                      "code": "SS",
                      "display": "Social Security Number"
                    }
                  ],
                  "text": "Social Security Number"
                },
                "system": "http://hl7.org/fhir/sid/us-ssn",
                "value": "999-87-1037"
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                      "code": "DL",
                      "display": "Driver's license number"
                    }
                  ],
                  "text": "Driver's License"
                },
                "system": "urn:oid:2.16.840.1.113883.4.3.25",
                "value": "S99952689"
              }
            ],
            "name": [
              {
                "use": "official",
                "family": "Halvorson124",
                "given": [
                  "Elden718"
                ],
                "prefix": [
                  "Mr."
                ]
              }
            ],
            "telecom": [
              {
                "system": "phone",
                "value": "555-903-1143",
                "use": "home"
              }
            ],
            "gender": "male",
            "birthDate": "2000-10-15",
            "address": [
              {
                "extension": [
                  {
                    "extension": [
                      {
                        "url": "latitude",
                        "valueDecimal": 42.757779285956644
                      },
                      {
                        "url": "longitude",
                        "valueDecimal": -71.14760946593316
                      }
                    ],
                    "url": "http://hl7.org/fhir/StructureDefinition/geolocation"
                  }
                ],
                "line": [
                  "715 Crona Corner"
                ],
                "city": "Methuen",
                "state": "MA",
                "postalCode": "01844",
                "country": "US"
              }
            ],
            "maritalStatus": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                  "code": "S",
                  "display": "Never Married"
                }
              ],
              "text": "Never Married"
            },
            "multipleBirthBoolean": false,
            "communication": [
              {
                "language": {
                  "coding": [
                    {
                      "system": "urn:ietf:bcp:47",
                      "code": "en-US",
                      "display": "English (Region=United States)"
                    }
                  ],
                  "text": "English"
                }
              }
            ]
          }
        },
        {
          "fullUrl": "urn:uuid:09188b81-0d1d-453c-b0fa-203ef88c794c",
          "resource": {
            "resourceType": "Location",
            "id": "09188b81-0d1d-453c-b0fa-203ef88c794c",
            "meta": {
              "versionId": "4",
              "lastUpdated": "2020-04-28T20:27:53.156+00:00",
              "source": "#pPvYTutotnO7vQfK",
              "profile": [
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-location"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>status</b>: active</p><p><b>name</b>: HOLY FAMILY HOSPITAL</p><p><b>telecom</b>: ph: 9786870156</p><p><b>address</b>: 70 EAST STREET METHUEN MA 01844 US </p><h3>Positions</h3><table class=\"grid\"><tr><td>-</td><td><b>Longitude</b></td><td><b>Latitude</b></td></tr><tr><td>*</td><td>-71.178588</td><td>42.742751</td></tr></table><p><b>managingOrganization</b>: <a href=\"#Organization_a9f20dc1-5147-3789-bcef-bbecb41c5983\">HOLY FAMILY HOSPITAL. Generated Summary: id: a9f20dc1-5147-3789-bcef-bbecb41c5983; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: HOLY FAMILY HOSPITAL; ph: 9786870156</a></p></div>"
            },
            "status": "active",
            "name": "HOLY FAMILY HOSPITAL",
            "telecom": [
              {
                "system": "phone",
                "value": "9786870156"
              }
            ],
            "address": {
              "line": [
                "70 EAST STREET"
              ],
              "city": "METHUEN",
              "state": "MA",
              "postalCode": "01844",
              "country": "US"
            },
            "position": {
              "longitude": -71.178588,
              "latitude": 42.742751
            },
            "managingOrganization": {
              "reference": "urn:uuid:a9f20dc1-5147-3789-bcef-bbecb41c5983",
              "display": "HOLY FAMILY HOSPITAL"
            }
          }
        },
        {
          "fullUrl": "urn:uuid:0000016f-57cb-cdac-0000-00000000014a",
          "resource": {
            "resourceType": "Practitioner",
            "id": "0000016f-57cb-cdac-0000-00000000014a",
            "meta": {
              "versionId": "4",
              "lastUpdated": "2020-04-28T20:27:53.186+00:00",
              "source": "#pPvYTutotnO7vQfK",
              "profile": [
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>identifier</b>: id: 330</p><p><b>active</b>: true</p><p><b>name</b>: Janeth814 Jakubowski832 </p><p><b>telecom</b>: Janeth814.Jakubowski832@example.com(WORK)</p><p><b>address</b>: 70 EAST STREET METHUEN MA 01844 US </p><p><b>gender</b>: female</p></div>"
            },
            "identifier": [
              {
                "system": "http://hl7.org/fhir/sid/us-npi",
                "value": "330"
              }
            ],
            "active": true,
            "name": [
              {
                "family": "Jakubowski832",
                "given": [
                  "Janeth814"
                ],
                "prefix": [
                  "Dr."
                ]
              }
            ],
            "telecom": [
              {
                "extension": [
                  {
                    "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-direct",
                    "valueBoolean": true
                  }
                ],
                "system": "email",
                "value": "Janeth814.Jakubowski832@example.com",
                "use": "work"
              }
            ],
            "address": [
              {
                "line": [
                  "70 EAST STREET"
                ],
                "city": "METHUEN",
                "state": "MA",
                "postalCode": "01844",
                "country": "US"
              }
            ],
            "gender": "female"
          }
        },
        {
          "fullUrl": "urn:uuid:a9f20dc1-5147-3789-bcef-bbecb41c5983",
          "resource": {
            "resourceType": "Organization",
            "id": "a9f20dc1-5147-3789-bcef-bbecb41c5983",
            "meta": {
              "versionId": "4",
              "lastUpdated": "2020-04-28T20:27:52.708+00:00",
              "source": "#pPvYTutotnO7vQfK",
              "profile": [
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>identifier</b>: id: a9f20dc1-5147-3789-bcef-bbecb41c5983</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: HOLY FAMILY HOSPITAL</p><p><b>telecom</b>: ph: 9786870156</p><p><b>address</b>: 70 EAST STREET METHUEN MA 01844 US </p></div>"
            },
            "identifier": [
              {
                "system": "https://github.com/synthetichealth/synthea",
                "value": "a9f20dc1-5147-3789-bcef-bbecb41c5983"
              }
            ],
            "active": true,
            "type": [
              {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/organization-type",
                    "code": "prov",
                    "display": "Healthcare Provider"
                  }
                ],
                "text": "Healthcare Provider"
              }
            ],
            "name": "HOLY FAMILY HOSPITAL",
            "telecom": [
              {
                "system": "phone",
                "value": "9786870156"
              }
            ],
            "address": [
              {
                "line": [
                  "70 EAST STREET"
                ],
                "city": "METHUEN",
                "state": "MA",
                "postalCode": "01844",
                "country": "US"
              }
            ]
          }
        },
        {
          "fullUrl": "urn:uuid:4ac41715-fcbd-421c-8796-9b2c9706dd3f",
          "resource": {
            "resourceType": "Condition",
            "id": "4ac41715-fcbd-421c-8796-9b2c9706dd3f",
            "meta": {
              "versionId": "10",
              "lastUpdated": "2020-04-28T20:28:00.008+00:00",
              "source": "#cabiJIK51sD2iz4N",
              "profile": [
                "http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/adt-notification-condition",
                "http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>clinicalStatus</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical active}\">Active</span></p><p><b>verificationStatus</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}\">Confirmed</span></p><p><b>category</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/condition-category encounter-diagnosis}\">Encounter Diagnosis</span></p><p><b>code</b>: <span title=\"Codes: {http://example.org/fhir/conditions 1234}\">Examplitis</span></p><p><b>subject</b>: <a href=\"#Patient_06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b\">See above (Patient/06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b)</a></p><p><b>encounter</b>: <a href=\"#Encounter_5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82\">See above (Encounter/5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82)</a></p><p><b>onset</b>: Oct 22, 2018, 4:22:15 AM</p><p><b>recordedDate</b>: Oct 22, 2018, 4:22:15 AM</p></div>"
            },
            "clinicalStatus": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
                  "code": "active"
                }
              ]
            },
            "verificationStatus": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
                  "code": "confirmed"
                }
              ]
            },
            "category": [
              {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/condition-category",
                    "code": "encounter-diagnosis",
                    "display": "Encounter Diagnosis"
                  }
                ]
              }
            ],
            "code": {
              "coding": [
                {
                  "system": "http://example.org/fhir/conditions",
                  "code": "1234",
                  "display": "Examplitis"
                }
              ],
              "text": "Examplitis"
            },
            "subject": {
              "reference": "urn:uuid:06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b"
            },
            "encounter": {
              "reference": "urn:uuid:5fe62cd5-bfcf-4d3b-a1e9-80d6f75d6f82"
            },
            "onsetDateTime": "2018-10-21T21:22:15-07:00",
            "recordedDate": "2018-10-21T21:22:15-07:00"
          }
        },
        {
          "fullUrl": "urn:uuid:cc6ac2fe-2bf4-11ea-a5f5-a4d18ccf5172",
          "resource": {
            "resourceType": "Coverage",
            "id": "cc6ac2fe-2bf4-11ea-a5f5-a4d18ccf5172",
            "meta": {
              "versionId": "10",
              "lastUpdated": "2020-04-28T20:27:52.686+00:00",
              "source": "#pPvYTutotnO7vQfK",
              "profile": [
                "http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/adt-notification-coverage"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>status</b>: active</p><p><b>type</b>: <span title=\"Codes: \">Blue Cross Blue Shield</span></p><p><b>subscriberId</b>: 12345</p><p><b>beneficiary</b>: <a href=\"#Patient_06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b\">See above (Patient/06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b)</a></p><p><b>payor</b>: <a href=\"#Organization_cc6ac93e-2bf4-11ea-a5f5-a4d18ccf5172\">Blue Cross Blue Shield. Generated Summary: id: 0000010005; active; name: Blue Cross Blue Shield; ph: 1-800-262-2583(WORK)</a></p></div>"
            },
            "status": "active",
            "type": {
              "text": "Blue Cross Blue Shield"
            },
            "subscriberId": "12345",
            "beneficiary": {
              "reference": "urn:uuid:06e1f0dd-5fbe-4480-9bb4-6b54ec02d31b"
            },
            "payor": [
              {
                "reference": "urn:uuid:cc6ac93e-2bf4-11ea-a5f5-a4d18ccf5172",
                "display": "Blue Cross Blue Shield"
              }
            ]
          }
        },
        {
          "fullUrl": "urn:uuid:cc6ac93e-2bf4-11ea-a5f5-a4d18ccf5172",
          "resource": {
            "resourceType": "Organization",
            "id": "cc6ac93e-2bf4-11ea-a5f5-a4d18ccf5172",
            "meta": {
              "versionId": "10",
              "lastUpdated": "2020-04-28T20:27:53.069+00:00",
              "source": "#pPvYTutotnO7vQfK",
              "profile": [
                "http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-organization"
              ]
            },
            "text": {
              "status": "generated",
              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>identifier</b>: id: 0000010005</p><p><b>active</b>: true</p><p><b>name</b>: Blue Cross Blue Shield</p><p><b>telecom</b>: ph: 1-800-262-2583(WORK)</p><p><b>address</b>: Michigan Plaza Chicago IL 60007 </p></div>"
            },
            "identifier": [
              {
                "system": "http://hl7.org/fhir/sid/us-npi",
                "value": "0000010005"
              }
            ],
            "active": true,
            "name": "Blue Cross Blue Shield",
            "telecom": [
              {
                "system": "phone",
                "value": "1-800-262-2583",
                "use": "work"
              }
            ],
            "address": [
              {
                "line": [
                  "Michigan Plaza"
                ],
                "city": "Chicago",
                "state": "IL",
                "postalCode": "60007"
              }
            ]
          }
        }
      ]
    }
    

    Response Headers:

    HTTP/1.1 200 OK
    [other headers]
    

    OperationOutcome:

    {
        "id": "intermediary-response",
        "issue": [
            {
                "code": "informational",
                "details": {
                    "text": "The message was received and the message has been fully processed"
                },
                "severity": "information"
            }
        ],
        "resourceType": "OperationOutcome",
        "text": {
            "div": "<div><p><b>Operation Outcome for :</b></p><p>All OK</p><table class=\"grid\"><tr><td><b>Severity</b></td><td><b>Location</b></td><td><b>Details</b></td><td><b>Diagnostics</b></td><td><b>Type</b></td></tr><tr><td>information</td><td/><td>The message was received and the message has been fully processed</td><td/><td>informational</td></tr></table></div>",
            "status": "generated"
        }
    }