Birth And Fetal Death (BFDR) - STU2-ballot
2.0.0-Preview1 - trial-use United States of America flag

Birth And Fetal Death (BFDR) - STU2-ballot, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 2.0.0-Preview1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-bfdr/ and changes regularly. See the Directory of published versions

Example Bundle: Bundle - Provider Fetal Death Report - Fetus Not Named

Document Details

Generated Narrative: Bundle Provider fetal death report Document

Document Subject


Document Content

Prenatal records

Clinical information

Fetal delivery information Document [US Standard Report of Fetal Death]

Mother's administrative information

Father's administrative information

Patient's QuestionnaireResponse Section


Additional Resources Included in Document


Entry 1 - fullUrl = http://www.example.org/fhir/Composition/composition-provider-fetal-death-not-named

Resource Composition:

Generated Narrative: Composition composition-provider-fetal-death-not-named

status: Final

type: U.S. standard report of fetal death - 2003 revision

encounter: Encounter: extension = No display for Extension ; identifier = http://hospital.smarthealthit.org#8937015; status = finished; class = inpatient encounter (ActCode#IMP); type = Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.; period = 2019-01-08 10:00:00-0700 --> 2019-01-09 17:00:00-0700

date: 2019-01-09

author: Practitioner Leung Jessica

title: Provider fetal death report Document


Entry 2 - fullUrl = http://www.example.org/fhir/Patient/patient-decedent-fetus-not-named

Resource Patient:

Generated Narrative: Patient patient-decedent-fetus-not-named

null (official) Female, DoB: 2019-01-09 ( Medical Record Number: 9932702 (use: usual, ))


Deceased:trueMultiple Birth:3
Reported Parent Age At Delivery Vital Records:
  • reportedAge: 34 a (Details: UCUM codea = 'a')
  • motherOrFather: mother
Reported Parent Age At Delivery Vital Records:
  • reportedAge: 35 a (Details: UCUM codea = 'a')
  • motherOrFather: father
Patient Birth PlaceAnn Arbor MI 48103
US Core Birth Sex ExtensionF

Entry 3 - fullUrl = http://www.example.org/fhir/Encounter/encounter-maternity-carmen-teresa-lee

Resource Encounter:

Generated Narrative: Encounter encounter-maternity-carmen-teresa-lee

Not done yet

Entry 4 - fullUrl = http://www.example.org/fhir/Patient/patient-mother-carmen-teresa-lee

Resource Patient:

Generated Narrative: Patient patient-mother-carmen-teresa-lee

Carmen Teresa Lee (official) Female, DoB: 1986-02-15 ( Medical Record Number: 9992702 (use: usual, ))


Alt. Name:Carmen Teresa Santos (Name changed for Marriage)
Contact Detail3670 Miller Road Ann Arbor MI 48103 US (home)
Links:
US Core Ethnicity Extension:
Patient Birth PlacePR
US Core Birth Sex ExtensionF
US Core Race Extension:

Entry 5 - fullUrl = http://www.example.org/fhir/Observation/observation-date-of-first-prenatal-care-visit-carmen-teresa-lee

Resource Observation:

Generated Narrative: Observation observation-date-of-first-prenatal-care-visit-carmen-teresa-lee

status: Final

code: Date first prenatal visit

subject: Patient - Mother (Carmen Teresa Lee)

focus: Patient - Decedent Fetus (Fetus Not Named)

effective: 2019-12-02

performer: Practitioner Janet Seito

value: 2018-05-18


Entry 6 - fullUrl = http://www.example.org/fhir/Observation/observation-last-menstrual-period-carmen-teresa-lee

Resource Observation:

Generated Narrative: Observation observation-last-menstrual-period-carmen-teresa-lee

status: Final

code: Last menstrual period start date

subject: Patient - Mother (Carmen Teresa Lee)

effective: 2018-05-02

performer: Practitioner Janet Seito

value: 2018-04-18


Entry 7 - fullUrl = http://www.example.org/fhir/Observation/observation-number-births-now-living-carmen-teresa-lee

Resource Observation:

Generated Narrative: Observation observation-number-births-now-living-carmen-teresa-lee

status: Final

code: [#] Births.still living

subject: Patient - Mother (Carmen Teresa Lee)

effective: 2019-12-02

performer: Practitioner Janet Seito

value: 1


Entry 8 - fullUrl = http://www.example.org/fhir/Observation/observation-number-births-now-dead-carmen-teresa-lee

Resource Observation:

Generated Narrative: Observation observation-number-births-now-dead-carmen-teresa-lee

status: Final

code: Previous live births now dead #

subject: Patient - Mother (Carmen Teresa Lee)

effective: 2019-12-02

performer: Practitioner Janet Seito

value: 0


Entry 9 - fullUrl = http://www.example.org/fhir/Observation/observation-date-of-last-live-birth-carmen-teresa-lee

Resource Observation:

Generated Narrative: Observation observation-date-of-last-live-birth-carmen-teresa-lee

status: Final

code: Date of last live birth

subject: Patient - Mother (Carmen Teresa Lee)

effective: 2019-12-02

performer: Practitioner Janet Seito

value: 2016-01-28


Entry 10 - fullUrl = http://www.example.org/fhir/Observation/observation-mother-height-carmen-teresa-lee

Resource Observation:

Generated Narrative: Observation observation-mother-height-carmen-teresa-lee

status: Final

category: Vital Signs

code: Body height

subject: Patient - Mother (Carmen Teresa Lee)

effective: 2019-01-10

performer: Carmen Teresa Lee (official) Female, DoB: 1986-02-15 ( Medical Record Number: 9992702 (use: usual, ))

value: 65 in (Details: UCUM code[in_i] = '[in_i]')


Entry 11 - fullUrl = http://www.example.org/fhir/Observation/observation-mother-prepregnancy-weight-carmen-teresa-lee

Resource Observation:

Generated Narrative: Observation observation-mother-prepregnancy-weight-carmen-teresa-lee

status: Final

category: Vital Signs

code: Body weight --pre current pregnancy

subject: Patient - Mother (Carmen Teresa Lee)

effective: 2019-12-02

performer: Practitioner Janet Seito

value: 180 [lb_av] (Details: UCUM code[lb_av] = '[lb_av]')


Entry 12 - fullUrl = http://www.example.org/fhir/Observation/observation-mother-received-wic-food-carmen-teresa-lee

Resource Observation:

Generated Narrative: Observation observation-mother-received-wic-food-carmen-teresa-lee

status: Final

code: Mother WIC food recipient

subject: Patient - Mother (Carmen Teresa Lee)

focus: Patient - Decedent Fetus (Fetus Not Named)

effective: 2019-12-02

performer: Carmen Teresa Lee (official) Female, DoB: 1986-02-15 ( Medical Record Number: 9992702 (use: usual, ))

value: No


Entry 13 - fullUrl = http://www.example.org/fhir/Observation/observation-cig-smoking-pregnancy-1-carmen-teresa-lee

Resource Observation:

Generated Narrative: Observation observation-cig-smoking-pregnancy-1-carmen-teresa-lee

status: Final

code: In the 3 months before you got pregnant, how many cigarettes did you smoke on an average day [PhenX]

subject: Patient - Mother (Carmen Teresa Lee)

focus: Patient - Decedent Fetus (Fetus Not Named)

effective: 2019-12-02

performer: Carmen Teresa Lee (official) Female, DoB: 1986-02-15 ( Medical Record Number: 9992702 (use: usual, ))

value: 0


Entry 14 - fullUrl = http://www.example.org/fhir/Observation/observation-cig-smoking-pregnancy-2-carmen-teresa-lee

Resource Observation:

Generated Narrative: Observation observation-cig-smoking-pregnancy-2-carmen-teresa-lee

status: Final

code: Cigarettes smoked per day by Mother--1st trimester

subject: Patient - Mother (Carmen Teresa Lee)

focus: Patient - Decedent Fetus (Fetus Not Named)

effective: 2019-12-02

performer: Carmen Teresa Lee (official) Female, DoB: 1986-02-15 ( Medical Record Number: 9992702 (use: usual, ))

value: 0


Entry 15 - fullUrl = http://www.example.org/fhir/Observation/observation-cig-smoking-pregnancy-3-carmen-teresa-lee

Resource Observation:

Generated Narrative: Observation observation-cig-smoking-pregnancy-3-carmen-teresa-lee

status: Final

code: Cigarettes smoked per day by Mother--2nd trimester

subject: Patient - Mother (Carmen Teresa Lee)

focus: Patient - Decedent Fetus (Fetus Not Named)

effective: 2019-12-02

performer: Carmen Teresa Lee (official) Female, DoB: 1986-02-15 ( Medical Record Number: 9992702 (use: usual, ))

value: 1


Entry 16 - fullUrl = http://www.example.org/fhir/Observation/observation-cig-smoking-pregnancy-4-carmen-teresa-lee

Resource Observation:

Generated Narrative: Observation observation-cig-smoking-pregnancy-4-carmen-teresa-lee

status: Final

code: In the last 3 months of your pregnancy, how many cigarettes did you smoke on an average day [PhenX]

subject: Patient - Mother (Carmen Teresa Lee)

focus: Patient - Decedent Fetus (Fetus Not Named)

effective: 2019-12-02

performer: Carmen Teresa Lee (official) Female, DoB: 1986-02-15 ( Medical Record Number: 9992702 (use: usual, ))

value: 0


Entry 17 - fullUrl = http://www.example.org/fhir/Observation/observation-number-previous-cesareans-carmen-teresa-lee

Resource Observation:

Generated Narrative: Observation observation-number-previous-cesareans-carmen-teresa-lee

status: Final

code: Previous cesarean deliveries #

subject: Patient - Mother (Carmen Teresa Lee)

effective: 2019-12-02

performer: Practitioner Janet Seito

value: 1


Entry 18 - fullUrl = http://www.example.org/fhir/Condition/condition-gestational-diabetes-carmen-teresa-lee

Resource Condition:

Generated Narrative: Condition condition-gestational-diabetes-carmen-teresa-lee

clinicalStatus: Active

category: Problem List Item, Mothers Risk factors in this pregnancy [US Standard Certificate of Live Birth]

code: Gestational diabetes mellitus (disorder)

subject: Patient - Mother (Carmen Teresa Lee)

onset: 2018-12-12


Entry 19 - fullUrl = http://www.example.org/fhir/Observation/observation-fetal-presentation-not-named

Resource Observation:

Generated Narrative: Observation observation-fetal-presentation-not-named

status: Final

code: Fetal presentation--at birth [US Standard Certificate of Live Birth]

subject: Patient - Decedent Fetus (Fetus Not Named)

effective: 2019-12-02

performer: Practitioner Janet Seito

value: Breech presentation (finding)


Entry 20 - fullUrl = http://www.example.org/fhir/Procedure/procedure-final-route-method-delivery-not-named

Resource Procedure:

Generated Narrative: Procedure procedure-final-route-method-delivery-not-named

status: Completed

category: Final route and method of delivery [US Standard Certificate of Live Birth]

code: Spontaneous vaginal delivery

subject: Patient - Mother (Carmen Teresa Lee)


Entry 21 - fullUrl = http://www.example.org/fhir/Observation/observation-birth-weight-not-named

Resource Observation:

Generated Narrative: Observation observation-birth-weight-not-named

status: Final

category: Vital Signs

code: Birth weight Measured

subject: Patient - Decedent Fetus (Fetus Not Named)

effective: 2019-01-10

performer: Practitioner Janet Seito

value: 1530 g (Details: UCUM codeg = 'g')


Entry 22 - fullUrl = http://www.example.org/fhir/Observation/observation-gestational-age-at-delivery-not-named

Resource Observation:

Generated Narrative: Observation observation-gestational-age-at-delivery-not-named

status: Final

code: Gestational age Estimated

subject: Patient - Decedent Fetus (Fetus Not Named)

effective: 2019-12-02

performer: Practitioner Janet Seito

value: 20 wk (Details: UCUM codewk = 'wk')


Entry 23 - fullUrl = http://www.example.org/fhir/Condition/condition-fetal-death-cause-or-condition-not-named

Resource Condition:

Generated Narrative: Condition condition-fetal-death-cause-or-condition-not-named

category: Encounter Diagnosis, Initiating cause or condition of fetal death [US Standard Report of Fetal Death]

code: Premature rupture of membranes (disorder)

subject: Patient - Decedent Fetus (Fetus Not Named)


Entry 24 - fullUrl = http://www.example.org/fhir/Condition/condition-fetal-death-other-significant-cause-not-named

Resource Condition:

Generated Narrative: Condition condition-fetal-death-other-significant-cause-not-named

category: Encounter Diagnosis, Other significant causes or conditions of fetal death [US Standard Report of Fetal Death]

code: Placental insufficiency (disorder)

subject: Patient - Decedent Fetus (Fetus Not Named)


Entry 25 - fullUrl = http://www.example.org/fhir/Observation/observation-fetal-death-time-point-not-named

Resource Observation:

Generated Narrative: Observation observation-fetal-death-time-point-not-named

status: Final

code: Estimated timing of fetal death [US Standard Report of Fetal Death]

subject: Patient - Decedent Fetus (Fetus Not Named)

effective: 2019-12-02

performer: Practitioner Janet Seito

value: Fetal intrapartum death after first assessment (event)


Entry 26 - fullUrl = http://www.example.org/fhir/Observation/observation-autopsy-performed-not-named

Resource Observation:

Generated Narrative: Observation observation-autopsy-performed-not-named

status: Final

code: Autopsy was performed

subject: Patient - Decedent Fetus (Fetus Not Named)

effective: 2019-12-02

performer: Practitioner Janet Seito

value: Yes


Entry 27 - fullUrl = http://www.example.org/fhir/Observation/observation-histological-placental-exam-performed-not-named

Resource Observation:

Generated Narrative: Observation observation-histological-placental-exam-performed-not-named

status: Final

code: Histological placental examination was performed [US Standard Report of Fetal Death]

subject: Patient - Decedent Fetus (Fetus Not Named)

effective: 2019-12-02

performer: Practitioner Janet Seito

value: Performed


Entry 28 - fullUrl = http://www.example.org/fhir/Observation/observation-autopsy-histological-exam-results-used-not-named

Resource Observation:

Generated Narrative: Observation observation-autopsy-histological-exam-results-used-not-named

status: Final

code: Autopsy or histological placental examination results were used [US Standard Report of Fetal Death]

subject: Patient - Decedent Fetus (Fetus Not Named)

effective: 2019-12-02

performer: Practitioner Janet Seito

value: Yes


Entry 29 - fullUrl = http://www.example.org/fhir/Observation/observation-number-deaths-this-delivery-carmen-teresa-lee

Resource Observation:

Generated Narrative: Observation observation-number-deaths-this-delivery-carmen-teresa-lee

status: Final

code: Number of fetal deaths delivered

subject: Patient - Mother (Carmen Teresa Lee)

focus: Patient - Decedent Fetus (Fetus Not Named)

effective: 2019-12-02

performer: Practitioner Janet Seito

value: 1


Entry 30 - fullUrl = http://www.example.org/fhir/Observation/observation-parent-education-level-carmen-teresa-lee

Resource Observation:

Generated Narrative: Observation observation-parent-education-level-carmen-teresa-lee

status: Final

code: Highest level of education Mother

subject: Patient - Decedent Fetus (Fetus Not Named)

focus: Patient - Mother (Carmen Teresa Lee)

effective: 2019-12-02

performer: Carmen Teresa Lee (official) Female, DoB: 1986-02-15 ( Medical Record Number: 9992702 (use: usual, ))

value: 9th through 12th grade; no diploma


Entry 31 - fullUrl = http://www.example.org/fhir/Observation/observation-present-job-carmen-teresa-lee

Resource Observation:

Generated Narrative: Observation observation-present-job-carmen-teresa-lee

status: Final

code: History of Occupation

subject: null (official) Female, DoB: 2019-01-09 ( Medical Record Number: 9932702 (use: usual, ))

focus: RelatedPerson Carmen Teresa Lee (official)

effective: 2019-01-09 --> (ongoing)

value: Secretary

Components

-CodeValue[x]
*History of Occupation industryState Agency

Entry 32 - fullUrl = http://www.example.org/fhir/Observation/observation-present-job-tom-yan-lee

Resource Observation:

Generated Narrative: Observation observation-present-job-tom-yan-lee

status: Final

code: History of Occupation

subject: null (official) Female, DoB: 2019-01-09 ( Medical Record Number: 9932702 (use: usual, ))

focus: RelatedPerson Tom Yan Lee (official)

effective: 2019-01-09 --> (ongoing)

value: Teaching Assistant

Components

-CodeValue[x]
*History of Occupation industryElementary and Secondary Schools

Entry 33 - fullUrl = http://www.example.org/fhir/Observation/observation-input-race-and-ethnicity-carmen-teresa-lee

Resource Observation:

Generated Narrative: Observation observation-input-race-and-ethnicity-carmen-teresa-lee

status: Final

code: Mother Input Race and Ethnicity

subject: Patient - Mother (Carmen Teresa Lee)

component

code: White

value: true

component

code: Black Or African American

value: true

component

code: American Indian Or Alaska Native

value: true

component

code: Asian Indian

value: false

component

code: Chinese

value: false

component

code: Filipino

value: false

component

code: Japanese

value: false

component

code: Korean

value: false

component

code: Vietnamese

value: false

component

code: Other Asian

value: false

component

code: Native Hawaiian

value: false

component

code: Guamanian Or Chamorro

value: false

component

code: Samoan

value: false

component

code: Other Pacific Islander

value: false

component

code: Other Race

value: false

component

code: First Other Asian Literal

value: Malaysian

component

code: First American Indian Or Alaska Native Literal

value: Arikara

component

code: Hispanic Mexican

value: Yes

component

code: Hispanic Cuban

value: Yes

component

code: Hispanic Puerto Rican

value: Yes

component

code: Hispanic Other

value: No


Entry 34 - fullUrl = http://www.example.org/fhir/QuestionnaireResponse/QuestionnaireResponse-patients-fetal-death-carmen-lee

Resource QuestionnaireResponse:

Generated Narrative: QuestionnaireResponse QuestionnaireResponse-patients-fetal-death-carmen-lee

LinkIDTextDefinitionAnswerdoco
.. QuestionnaireResponse-patients-fetal-death-carmen-leeQuestionnaire:Questionnaire - Patient's Worksheet for the Report of Fetal Death
... mother-current-legal-nameWhat is your current legal name?
.... mother-first-nameFirstCarmen
.... mother-middle-nameMiddleTeresa
.... mother-last-nameLastLee
... mother-addressWhere do you usually live - that is - where is your household/residence located?
.... mother-nbr-streetComplete number and street (do not enter rural route numbers)3670 Miller Road
.... mother-cityCity, Town, or Location
.... mother-stateState (or U.S. Territory, Canadian Province)MI
.... mother-zipZip Code48103
... inside-city-limitsIs this household inside city limits (inside the incorporated limits of the city, town, or location where you live)?v2 Y/N Indicator N: No
... mother-mailWhat is your mailing address
.... mother-mail-sameSame as residence [Go to next question]true
... mother-dobWhat is your date of birth?1986-02-15
... mother-birthplaceIn what State, U.S. territory, or foreign country were you born? Please specify one of the following:
.... mother-birthplace-territoryor U.S. territory, i.e., Puerto Rico, U.S. Virgin Islands, Guam, American Samoa or Norther MarianasPR
... mother-educationWhat is the highest level of schooling that you have completed at the time of delivery? (Check the box that best describes your education. If you are currently enrolled, check the box that indicates the previous grade or highest degree received).Education Level SEC: Some secondary or high school education
... mother-ethnicitytrue
... mother-ethnicity-mexicantrue
... mother-ethnicity-puerto-ricantrue
... mother-ethnicity-cubantrue
... mother-ethnicity-otherfalse
... mother-race
.... mother-race-black-or-aatrue
... father-current-legal-nameWhat is the current legal name of your baby's father?
.... father-first-nameFirstTom
.... father-middle-nameMiddleYan
.... father-last-nameLastLee
... father-dobWhat is the father's date of birth?1984-02-27
... father-birthplaceIn what State, U.S. territory, or foreign country was the father born? Please specify one of the following:
.... father-birthplace-stateStateNY
... receive-wicDid you receive WIC (Women, Infants and Children) food for yourself during this pregnancy?v2 Y/N Indicator N: No
... mothers-heightWhat is your height?
.... mothers-height-inchesInches65 [in_i] (Details: UCUM code[in_i] = '[in_i]')
... mothers-prepregnancy-weightlbs180 [lb_av] (Details: UCUM code[lb_av] = '[lb_av]')
... mothers-smokingHow many cigarettes OR packs of cigarettes did you smoke on an average day during each of the following time periods? If you NEVER smoked, enter zero for each time period.
.... mothers-smoking-3-months-priorThree months before pregnancy
..... mothers-smoking-3-months-prior-cig# of cigarettes*0
..... mothers-smoking-3-months-prior-pck# of packs0
.... mothers-smoking-trimester-1First three months of pregnancy
..... mothers-smoking-trimester-1-cig# of cigarettes*0
..... mothers-smoking-trimester-1-pck# of packs0
.... mothers-smoking-trimester-2Second three months of pregnancy
..... mothers-smoking-trimester-2-cig# of cigarettes*0
..... mothers-smoking-trimester-2-pck# of packs0
.... mothers-smoking-trimester-3Third trimester of pregnancy
..... mothers-smoking-trimester-3-cig# of cigarettes*0
..... mothers-smoking-trimester-3-pck# of packs0

doco Documentation for this format

Entry 35 - fullUrl = http://www.example.org/fhir/Practitioner/practitioner-vital-records-janet-seito

Resource Practitioner:

Generated Narrative: Practitioner practitioner-vital-records-janet-seito

identifier: NPI/223347044

name: Janet Seito

Qualifications

-Code
*Osteopath (occupation)

Entry 36 - fullUrl = http://www.example.org/fhir/Location/location-south-hospital

Resource Location:

Generated Narrative: Location location-south-hospital

identifier: NPI/116441967701

status: Active

name: South Hospital

type: Hospital, Birth Location

address: 2100 North Ave Salt Lake City UT 84116 US

Positions

-LongitudeLatitude
*40.8111.9

managingOrganization: Organization - South Hospital


Entry 37 - fullUrl = http://www.example.org/fhir/Organization/organization-south-hospital

Resource Organization:

Generated Narrative: Organization organization-south-hospital

identifier: NPI/5555512

active: true

type: Hospital

name: South Hospital

contact

telecom: +1-555-555-1111, mail@southhospital.com

address: 2100 North Ave Salt Lake City UT 84116 US


Entry 38 - fullUrl = http://www.example.org/fhir/RelatedPerson/relatedperson-mother-carmen-teresa-lee

Resource RelatedPerson:

Generated Narrative: RelatedPerson relatedperson-mother-carmen-teresa-lee

active: true

patient: Patient - Decedent Fetus (Fetus Not Named)

relationship: Gestational Mother

name: Carmen Teresa Lee (Official)

gender: Female

birthDate: 1986-02-15


Entry 39 - fullUrl = http://www.example.org/fhir/RelatedPerson/relatedperson-father-natural-tom-yan-lee

Resource RelatedPerson:

Generated Narrative: RelatedPerson relatedperson-father-natural-tom-yan-lee

active: true

patient: Patient - Decedent Fetus (Fetus Not Named)

relationship: Natural Father

name: Tom Yan Lee (Official)

gender: Male

birthDate: 1984-02-27


Entry 40 - fullUrl = http://www.example.org/fhir/Practitioner/practitioner-vital-records-jessica-leung

Resource Practitioner:

Generated Narrative: Practitioner practitioner-vital-records-jessica-leung

identifier: NPI/223347055

name: Leung Jessica

Qualifications

-Code
*Birth Clerk