mcode-patient-bundle-jenny-m - minimal Common Oncology Data Elements (mCODE) Implementation Guide v4.0.0-ballot

minimal Common Oncology Data Elements (mCODE) Implementation Guide, published by HL7 International / Clinical Interoperability Council. This guide is not an authorized publication; it is the continuous build for version 4.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-mCODE-ig/ and changes regularly. See the Directory of published versions

Example Bundle: mcode-patient-bundle-jenny-m

Bundle mcode-patient-bundle-jenny-m of type collection

Entry 1 - fullUrl = http://example.org/fhir/Patient/cancer-patient-jenny-m

Resource Patient:

Anonymous Patient Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual))

Entry 2 - fullUrl = http://example.org/fhir/Condition/primary-cancer-condition-jenny-m

Resource Condition:

Generated Narrative: Condition
Resource Condition "primary-cancer-condition-jenny-m"
Profile: Primary Cancer Condition Profile
Histology-Morphology-Behavior Extension: Infiltrating duct carcinoma (morphologic abnormality) (SNOMED CT#82711006)
clinicalStatus: Remission (Condition Clinical Status Codes#remission)
verificationStatus: Confirmed (ConditionVerificationStatus#confirmed)
category: Problem List Item (Condition Category Codes#problem-list-item)
code: Primary malignant neoplasm of female left breast (disorder) (SNOMED CT#353431000119107)
subject: See on this page: Patient/cancer-patient-jenny-m
onset: 2018-03-16
Stages
- Summary Assessment Type
* American Joint Committee on Cancer stage IIIC (qualifier value) (SNOMED CT#1222806003) See on this page: Observation/tnm-clinical-stage-group-jenny-m American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging) (SNOMED CT#897275008)

Entry 3 - fullUrl = http://example.org/fhir/MedicationRequest/cancer-related-medication-request-cyclophosphamide-jenny-m

Resource MedicationRequest:

Generated Narrative: MedicationRequest
Resource MedicationRequest "cancer-related-medication-request-cyclophosphamide-jenny-m"
Profile: Cancer-Related Medication Request Profile
Procedure Intent Extension: Curative - procedure intent (qualifier value) (SNOMED CT#373808002)
status: ACTIVE
intent: ORDER
category: Outpatient (MedicationRequest Category Codes#outpatient)
subject: See on this page: Patient/cancer-patient-jenny-m
authoredOn: 2018-04-12
requester: See on this page: Practitioner/us-core-practitioner-owen-oncologist
dosageInstruction

Entry 4 - fullUrl = http://example.org/fhir/MedicationRequest/cancer-related-medication-request-doxorubicin-jenny-m

Resource MedicationRequest:

Generated Narrative: MedicationRequest
Resource MedicationRequest "cancer-related-medication-request-doxorubicin-jenny-m"
Profile: Cancer-Related Medication Request Profile
Procedure Intent Extension: Curative - procedure intent (qualifier value) (SNOMED CT#373808002)
status: ACTIVE
intent: ORDER
category: Outpatient (MedicationRequest Category Codes#outpatient)
subject: See on this page: Patient/cancer-patient-jenny-m
authoredOn: 2018-04-12
requester: See on this page: Practitioner/us-core-practitioner-owen-oncologist
dosageInstruction

Entry 5 - fullUrl = http://example.org/fhir/MedicationRequest/cancer-related-medication-request-paclitaxel-jenny-m

Resource MedicationRequest:

Generated Narrative: MedicationRequest
Resource MedicationRequest "cancer-related-medication-request-paclitaxel-jenny-m"
Profile: Cancer-Related Medication Request Profile
Procedure Intent Extension: Curative - procedure intent (qualifier value) (SNOMED CT#373808002)
status: ACTIVE
intent: ORDER
category: Outpatient (MedicationRequest Category Codes#outpatient)
subject: See on this page: Patient/cancer-patient-jenny-m
authoredOn: 2018-04-12
requester: See on this page: Practitioner/us-core-practitioner-owen-oncologist
dosageInstruction

Entry 6 - fullUrl = http://example.org/fhir/MedicationRequest/cancer-related-medication-request-anastrozole-jenny-m

Resource MedicationRequest:

Generated Narrative: MedicationRequest
Resource MedicationRequest "cancer-related-medication-request-anastrozole-jenny-m"
Profile: Cancer-Related Medication Request Profile
Procedure Intent Extension: Curative - procedure intent (qualifier value) (SNOMED CT#373808002)
status: ACTIVE
intent: ORDER
category: Community (MedicationRequest Category Codes#community)
subject: See on this page: Patient/cancer-patient-jenny-m
authoredOn: 2018-09-30
requester: See on this page: Practitioner/us-core-practitioner-owen-oncologist
dosageInstruction

Entry 7 - fullUrl = http://example.org/fhir/Observation/cancer-disease-status-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "cancer-disease-status-jenny-m"
Profile: Cancer Disease Status Profile
Cancer Disease Status Evidence Type Extension: Imaging (procedure) (SNOMED CT#363679005)
status: FINAL
code: Cancer Disease Progression (LOINC#97509-4)
subject: See on this page: Patient/cancer-patient-jenny-m
focus: See on this page: Condition/primary-cancer-condition-jenny-m
effective: 2018-11-01
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
value: Patient's condition improved (finding) (SNOMED CT#268910001)

Entry 8 - fullUrl = http://example.org/fhir/Observation/genomic-variant-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "genomic-variant-jenny-m"
Profile: Genomic Variant Profile
status: FINAL
category: Laboratory (Observation Category Codes#laboratory)
code: Genetic variant assessment (LOINC#69548-6)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-03-15
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
value: Present (LOINC#LA9633-4)
method: Sequencing (LOINC#LA26398-0)
component
code: Gene studied ID (LOINC#48018-6)
value: PALB2 (HUGO Gene Nomenclature Committee Genes#HGNC:26144)
component
code: Simple var ID (LOINC#81252-9)
value: NM_024675.3(PALB2):c.3549C>A (p.Tyr1183Ter) (ClinVar Variant ID#128144)
component
code: Struct var HGVS name (LOINC#81290-9)
value: NC_000016.10:g.23603471G>T (Human Genome Variation Society nomenclature#NC_000016.10:g.23603471G>T)
component
code: Genomic source class (LOINC#48002-0)
value: Somatic (LOINC#LA6684-0)

Entry 9 - fullUrl = http://example.org/fhir/DiagnosticReport/genomics-report-jenny-m

Resource DiagnosticReport:

Genetic analysis report (Genetics)
Subject Jenny M female, DoB: 1965-01-01 ( Medical Record Number/MRN1234 (use: usual))
When For 2018-03-15
Reported 2020-03-15 00:00:01+0000
Report Details
Code Value When For Reported
Genetic variant assessment Present 2018-03-15
DNA region of interest panel 2018-03-15 2018-03-15 00:00:01+0000

Entry 10 - fullUrl = http://example.org/fhir/Procedure/cancer-related-surgical-procedure-jenny-m

Resource Procedure:

Generated Narrative: Procedure
Resource Procedure "cancer-related-surgical-procedure-jenny-m"
Profile: Cancer-Related Surgical Procedure Profile
Procedure Intent Extension: Curative - procedure intent (qualifier value) (SNOMED CT#373808002)
status: COMPLETED
code: Excision of part of breast (procedure) (SNOMED CT#64368001)
subject: See on this page: Patient/cancer-patient-jenny-m
bodySite: Left breast structure (body structure) (SNOMED CT#80248007)

Entry 11 - fullUrl = http://example.org/fhir/Observation/cancer-related-comorbidities-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "cancer-related-comorbidities-jenny-m"
Profile: Comorbidities Profile
Related Condition Extension: Condition/us-core-condition-depression-jenny-m
Related Condition Extension: Condition/us-core-condition-anxiety-jenny-m
Related Condition Extension: Condition/us-core-condition-hypertension-jenny-m
Related Condition Absent Extension: Obesity (disorder) (SNOMED CT#414916001)
Related Condition Absent Extension: Disorder of lung (disorder) (SNOMED CT#19829001)
status: FINAL
code: Co-morbid conditions (finding) (SNOMED CT#398192003)
subject: See on this page: Patient/cancer-patient-jenny-m
focus: See on this page: Condition/primary-cancer-condition-jenny-m
effective: 2018-03-16
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist

Entry 12 - fullUrl = http://example.org/fhir/Procedure/radiotherapy-treatment-summary-chest-wall-jenny-m

Resource Procedure:

Generated Narrative: Procedure
Resource Procedure "radiotherapy-treatment-summary-chest-wall-jenny-m"
Profile: Radiotherapy Course Summary Profile
Radiotherapy Number of Sessions Extension: 31
Procedure Intent Extension: Curative - procedure intent (SNOMED CT#373808002)
Radiotherapy Modality And Technique Extension
url
Radiotherapy Modality Extension
value: External beam radiation therapy using photons (procedure) (SNOMED CT#1156506007)
url
Radiotherapy Technique Extension
value: Volumetric Modulated Arc Therapy (procedure) (SNOMED CT#1156530009)
Radiotherapy Modality And Technique Extension
url
Radiotherapy Modality Extension
value: Teleradiotherapy using electrons (SNOMED CT#45643008)
url
Radiotherapy Technique Extension
value: Three dimensional external beam radiation therapy (procedure) (SNOMED CT#1162782007)
Radiotherapy Dose Delivered To Volume Extension
url
volume
value: BodyStructure/jenny-m-chest-wall-treatment-volume
url
totalDoseDelivered
value: 6000 cGy (Details: UCUM code cGy = 'cGy')
url
fractionsDelivered
value: 30
Radiotherapy Dose Delivered To Volume Extension
url
volume
value: BodyStructure/jenny-m-chest-wall-lymph-nodes-treatment-volume
url
totalDoseDelivered
value: 5000 cGy (Details: UCUM code cGy = 'cGy')
url
fractionsDelivered
value: 25
status: COMPLETED
code: Radiotherapy course of treatment (SNOMED CT#1217123003)
subject: See on this page: Patient/cancer-patient-jenny-m
bodySite: Chest Wall Structure (body structure) (SNOMED CT#78904004)

Entry 13 - fullUrl = http://example.org/fhir/Observation/tnm-clinical-stage-group-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "tnm-clinical-stage-group-jenny-m"
Profile: TNM Stage Group Profile
status: FINAL
code: Clinical TNM stage grouping (SNOMED CT#399537006)
subject: See on this page: Patient/cancer-patient-jenny-m
focus: See on this page: Condition/primary-cancer-condition-jenny-m
effective: 2018-03-16
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
value: American Joint Committee on Cancer stage IIB (qualifier value) (SNOMED CT#1222769001)
method: American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging) (SNOMED CT#897275008)
hasMember:
Observation/tnm-pathologic-primary-tumor-category-jenny-m
Observation/tnm-pathologic-regional-nodes-category-jenny-m
Observation/tnm-pathologic-distant-metastases-category-jenny-m

Entry 14 - fullUrl = http://example.org/fhir/Observation/tnm-clinical-primary-tumor-category-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "tnm-clinical-primary-tumor-category-jenny-m"
Profile: TNM Primary Tumor Category Profile
status: FINAL
code: cT category (SNOMED CT#399504009)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-03-16
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
value: American Joint Committee on Cancer cT3 (qualifier value) (SNOMED CT#1228938002)
method: American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging) (SNOMED CT#897275008)

Entry 15 - fullUrl = http://example.org/fhir/Observation/tnm-clinical-regional-nodes-category-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "tnm-clinical-regional-nodes-category-jenny-m"
Profile: TNM Regional Nodes Category Profile
status: FINAL
code: cN category (SNOMED CT#399534004)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-03-16
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
value: American Joint Committee on Cancer cN0 (qualifier value) (SNOMED CT#1229967007)
method: American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging) (SNOMED CT#897275008)

Entry 16 - fullUrl = http://example.org/fhir/Observation/tnm-clinical-distant-metastases-category-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "tnm-clinical-distant-metastases-category-jenny-m"
Profile: TNM Distant Metastases Category Profile
status: FINAL
code: cM category (SNOMED CT#399387003)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-03-16
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
value: American Joint Committee on Cancer cM0 (qualifier value) (SNOMED CT#1229901006)
method: American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging) (SNOMED CT#897275008)

Entry 17 - fullUrl = http://example.org/fhir/Specimen/human-specimen-left-breast-jenny-m

Resource Specimen:

Generated Narrative: Specimen
Resource Specimen "human-specimen-left-breast-jenny-m"
Profile: Human Specimen Profile
status: AVAILABLE
type: Tissue (specimenType#TISS)
subject: See on this page: Patient/cancer-patient-jenny-m
Collections
- Collector BodySite
* See on this page: Practitioner/us-core-practitioner-owen-oncologist Left breast structure (body structure) (SNOMED CT#80248007)
Processings
- Time[x]
* 2018-03-06

Entry 18 - fullUrl = http://example.org/fhir/Observation/genomic-region-studied-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "genomic-region-studied-jenny-m"
Profile: Genomic Region Studied Profile
status: FINAL
category: Laboratory (Observation Category Codes#laboratory)
code: DNA region of interest panel (LOINC#53041-0)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-03-15
issued: Mar 15, 2018, 12:00:01 AM
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
Components
- Code Value[x]
* Gene studied [ID] (LOINC#48018-6) BRCA1 (HUGO Gene Nomenclature Committee Genes#1100; HUGO Gene Nomenclature Committee Genes#1101 "BRCA2"; HUGO Gene Nomenclature Committee Genes#1748 "CDH1"; HUGO Gene Nomenclature Committee Genes#26144 "PALB2"; HUGO Gene Nomenclature Committee Genes#9588 "PTEN"; HUGO Gene Nomenclature Committee Genes#11389 "STK11"; HUGO Gene Nomenclature Committee Genes#11998 "TP53")

Entry 19 - fullUrl = http://example.org/fhir/Observation/ecog-performance-status-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "ecog-performance-status-jenny-m"
Profile: ECOG Performance Status Profile
status: FINAL
category: Clinical Test (US Core Observation Category Extension Codes#clinical-test)
code: ECOG Perform Status score (LOINC#89247-1)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-04-12
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
value: 0
interpretation: Fully active, able to carry on all pre-disease performance without restriction (LOINC#LA9622-7)
method: Physical examination procedure (procedure) (SNOMED CT#5880005)

Entry 20 - fullUrl = http://example.org/fhir/Observation/tumor-marker-test-er-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "tumor-marker-test-er-jenny-m"
Profile: Tumor Marker Test Profile
status: FINAL
category: Laboratory (Observation Category Codes#laboratory)
code: Estrogen receptor Ag [Presence] in Breast cancer specimen by Immune stain (LOINC#85337-4)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-03-10
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
value: Positive (LOINC#LA6576-8)

Entry 21 - fullUrl = http://example.org/fhir/Observation/tumor-marker-test-pr-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "tumor-marker-test-pr-jenny-m"
Profile: Tumor Marker Test Profile
status: FINAL
category: Laboratory (Observation Category Codes#laboratory)
code: Progesterone receptor Ag [Presence] in Breast cancer specimen by Immune stain (LOINC#85339-0)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-03-10
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
value: Negative (LOINC#LA6577-6)

Entry 22 - fullUrl = http://example.org/fhir/Observation/tumor-marker-test-her2-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "tumor-marker-test-her2-jenny-m"
Profile: Tumor Marker Test Profile
status: FINAL
category: Laboratory (Observation Category Codes#laboratory)
code: HER2 [Interpretation] in Tissue (LOINC#48676-1)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-03-10
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
value: Negative (LOINC#LA6577-6)

Entry 23 - fullUrl = http://example.org/fhir/Observation/tumor-marker-test-oncotype-dx-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "tumor-marker-test-oncotype-dx-jenny-m"
Profile: Tumor Marker Test Profile
status: FINAL
category: Laboratory (Observation Category Codes#laboratory)
code: Oncotype DX Breast Recurrence Score Assay (gtr#509910)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-04-12
performer: Organization/us-core-organization-bedrock-medicine "Bedrock Medicine"
value: 47 Recurrence score (Details: UCUM code 1 = '1')
interpretation: High (ObservationInterpretation#H)

Entry 24 - fullUrl = http://example.org/fhir/Observation/tumor-size-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "tumor-size-jenny-m"
Profile: Tumor Size Profile
status: FINAL
category: Laboratory (Observation Category Codes#laboratory)
code: Size Tumor (LOINC#21889-1)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-04-01 00:00:00+0000
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
method: Gross examination and sampling of tissue specimen (procedure) (SNOMED CT#787377000)
specimen: Specimen/tumor-specimen-left-breast-jenny-m
Components
- Code Value[x]
* Size.max.dim Tumor (LOINC#33728-7) 2.5 centimeters (Details: UCUM code cm = 'cm')

Entry 25 - fullUrl = http://example.org/fhir/Procedure/us-core-procedure-biopsy-jenny-m

Resource Procedure:

Generated Narrative: Procedure
Resource Procedure "us-core-procedure-biopsy-jenny-m"
Profile: US Core Procedure Profile
status: COMPLETED
code: Biopsy of breast using ultrasonographic guidance (procedure) (SNOMED CT#723990008)
subject: See on this page: Patient/cancer-patient-jenny-m
Performers
- Actor
* Practitioner/us-core-practitioner-mary-obgyn " OBGYN"
bodySite: Left breast structure (body structure) (SNOMED CT#80248007)

Entry 26 - fullUrl = http://example.org/fhir/Observation/bodyweight-jenny-m-2018-03-16

Resource Observation:

Generated Narrative: Observation
Resource Observation "bodyweight-jenny-m-2018-03-16"
Profile: Observation Body Weight Profile
status: FINAL
category: Vital Signs (Observation Category Codes#vital-signs)
code: Weight (LOINC#29463-7)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-03-06
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
value: 155 lb (Details: UCUM code [lb_av] = '[lb_av]')

Entry 27 - fullUrl = http://example.org/fhir/Observation/us-core-observation-lab-neutrophils-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "us-core-observation-lab-neutrophils-jenny-m"
Profile: US Core Laboratory Result Observation Profile
status: FINAL
category: Laboratory (Observation Category Codes#laboratory)
code: Neutrophils [#/volume] in Blood (LOINC#26499-4)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-05-20 00:00:00+0000
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
value: 3000 10*3/uL (Details: UCUM code 10*3/uL = '10*3/uL')
ReferenceRanges
- Low High Type
* 2500 10*3/uL (Details: UCUM code 10*3/uL = '10*3/uL') 5000 10*3/uL (Details: UCUM code 10*3/uL = '10*3/uL') Normal Range (Observation Reference Range Meaning Codes#normal)

Entry 28 - fullUrl = http://example.org/fhir/Organization/us-core-organization-physician-services-inc

Resource Organization:

Generated Narrative: Organization
Resource Organization "us-core-organization-physician-services-inc"
Profile: US Core Organization Profile
active: true
type: Healthcare Provider (Organization type#prov)
name: Physician Services, Inc.
Contacts
- Telecom Address
* ph: 999-999-9999(WORK) 123 Corporate Drive Anytown MA 12345 US

Entry 29 - fullUrl = http://example.org/fhir/Observation/us-core-smokingstatus-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "us-core-smokingstatus-jenny-m"
Profile: US Core Smoking Status Observation Profile
status: FINAL
category: Social History (Observation Category Codes#social-history)
code: Tobacco smoking status (LOINC#72166-2)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-03-16
issued: Mar 16, 2018, 12:00:00 AM
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
value: Smokes tobacco daily (finding) (SNOMED CT#449868002)

Entry 30 - fullUrl = http://example.org/fhir/Procedure/us-core-procedure-mammogram-jenny-m

Resource Procedure:

Generated Narrative: Procedure
Resource Procedure "us-core-procedure-mammogram-jenny-m"
Profile: US Core Procedure Profile
status: COMPLETED
code: Mammography (procedure) (SNOMED CT#71651007)
subject: See on this page: Patient/cancer-patient-jenny-m
Performers
- Actor
* Practitioner/us-core-practitioner-jane-radiotech " RADIOLOGIST"

Entry 31 - fullUrl = http://example.org/fhir/FamilyMemberHistory/family-member-history-aunt-jenny-m

Resource FamilyMemberHistory:

Generated Narrative: FamilyMemberHistory
Resource FamilyMemberHistory "family-member-history-aunt-jenny-m"
status: COMPLETED
patient: See on this page: Patient/cancer-patient-jenny-m
relationship: maternal aunt (RoleCode#MAUNT)
Conditions
- Code Onset[x]
* Malignant tumor of ovary (disorder) (SNOMED CT#363443007) 69 a (Details: UCUM code a = 'a')

Entry 32 - fullUrl = http://example.org/fhir/FamilyMemberHistory/family-member-history-uncle-jenny-m

Resource FamilyMemberHistory:

Generated Narrative: FamilyMemberHistory
Resource FamilyMemberHistory "family-member-history-uncle-jenny-m"
status: COMPLETED
patient: See on this page: Patient/cancer-patient-jenny-m
relationship: paternal uncle (RoleCode#PUNCLE)
deceased: true
Conditions
- Code ContributedToDeath
* Malignant tumor of pancreas (disorder) (SNOMED CT#363418001) true

Entry 33 - fullUrl = http://example.org/fhir/DiagnosticReport/us-core-diagnosticreport-lab-jenny-m

Resource DiagnosticReport:

Pathology report final diagnosis Narrative (Laboratory)
Subject Jenny M female, DoB: 1965-01-01 ( Medical Record Number/MRN1234 (use: usual))
When For 2018-04-01 00:00:00+0000
Reported 2018-04-05 00:00:00+0000
Report Details
Code Value When For
Status of invasion by tumor Negative (qualifier value) 2018-04-01 00:00:00+0000
Margin involvement in Breast tumor Uninvolved by invasive carcinoma 2018-04-01 00:00:00+0000
Sentinel lymph nodes with metastasis [#] in Cancer specimen 2018-04-01 00:00:00+0000
Size Tumor 2018-04-01 00:00:00+0000
DCIS intraductal extension in Breast cancer specimen Qualitative by Light microscopy DCIS present with extensive intraductal component (EIC) 2018-04-01 00:00:00+0000
HER2 [Interpretation] in Tissue Negative 2018-03-10
Estrogen receptor Ag [Presence] in Breast cancer specimen by Immune stain Positive 2018-03-10
Progesterone receptor Ag [Presence] in Breast cancer specimen by Immune stain Negative 2018-03-10
Histologic grade [Score] in Breast cancer specimen by Nottingham Nottingham grade 2 2018-04-01 00:00:00+0000

Entry 34 - fullUrl = http://example.org/fhir/Observation/observation-smoking-pack-years-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "observation-smoking-pack-years-jenny-m"
status: FINAL
category: Social History (Observation Category Codes#social-history)
code: Cigarette pack-years (observable entity) (SNOMED CT#401201003)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-03-16
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
value: 20 Pack-Years (Details: UCUM code 1 = '1')

Entry 35 - fullUrl = http://example.org/fhir/Observation/us-core-observation-lab-tumor-invasion-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "us-core-observation-lab-tumor-invasion-jenny-m"
Profile: US Core Laboratory Result Observation Profile
status: FINAL
category: Laboratory (Observation Category Codes#laboratory)
code: Status of invasion by tumor (SNOMED CT#370052007)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-04-01 00:00:00+0000
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
value: Negative (qualifier value) (SNOMED CT#260385009)
specimen: Specimen/tumor-specimen-left-breast-jenny-m

Entry 36 - fullUrl = http://example.org/fhir/Observation/us-core-observation-lab-tumor-margins-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "us-core-observation-lab-tumor-margins-jenny-m"
Profile: US Core Laboratory Result Observation Profile
status: FINAL
category: Laboratory (Observation Category Codes#laboratory)
code: Margin involvement in Breast tumor (LOINC#44669-0)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-04-01 00:00:00+0000
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
value: Uninvolved by invasive carcinoma (LOINC#LA27151-2)
specimen: Specimen/tumor-specimen-left-breast-jenny-m

Entry 37 - fullUrl = http://example.org/fhir/Observation/us-core-observation-lab-sentinel-nodes-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "us-core-observation-lab-sentinel-nodes-jenny-m"
Profile: US Core Laboratory Result Observation Profile
status: FINAL
category: Laboratory (Observation Category Codes#laboratory)
code: Sentinel lymph nodes with metastasis [#] in Cancer specimen (LOINC#92832-5)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-04-01 00:00:00+0000
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
specimen: Specimen/tumor-specimen-left-breast-jenny-m
Components
- Code Value[x]
* Lymph nodes examined [#] in Cancer specimen by Light microscopy (LOINC#92833-3) 3 Count (Details: UCUM code 1 = '1')

Entry 38 - fullUrl = http://example.org/fhir/Observation/us-core-observation-lab-tumor-dcis-jenny-m

Resource Observation:

Generated Narrative: Observation
Resource Observation "us-core-observation-lab-tumor-dcis-jenny-m"
Profile: US Core Laboratory Result Observation Profile
status: FINAL
category: Laboratory (Observation Category Codes#laboratory)
code: DCIS intraductal extension in Breast cancer specimen Qualitative by Light microscopy (LOINC#85336-6)
subject: See on this page: Patient/cancer-patient-jenny-m
effective: 2018-04-01 00:00:00+0000
performer: See on this page: Practitioner/us-core-practitioner-owen-oncologist
value: DCIS present with extensive intraductal component (EIC) (LOINC#LA27261-9)
specimen: Specimen/tumor-specimen-left-breast-jenny-m

Entry 39 - fullUrl = http://example.org/fhir/Practitioner/us-core-practitioner-owen-oncologist

Resource Practitioner:

Generated Narrative: Practitioner
Resource Practitioner "us-core-practitioner-owen-oncologist"
Profile: US Core Practitioner Profile
identifier: United States National Provider Identifier/9988776655
name: Owen Oncologist
gender: MALE
address: 123 Corporate Drive Anytown MA 12345 US (work)
Qualifications
- Code
* Doctor of Medicine (degreeLicenseCertificate[2.7]#MD)

Entry 40 - fullUrl = http://example.org/fhir/Practitioner/us-core-practitioner-peter-pathologist

Resource Practitioner:

Generated Narrative: Practitioner
Resource Practitioner "us-core-practitioner-peter-pathologist"
Profile: US Core Practitioner Profile
identifier: United States National Provider Identifier/1122334455
name: Peter Pathologist
gender: FEMALE
address: 123 Corporate Drive Anytown MA 12345 US (work)
Qualifications
- Code
* Doctor of Medicine (degreeLicenseCertificate[2.7]#MD)