PACIO Advance Directive Interoperability Implementation Guide
2.1.0 - STU 2 United States of America flag

PACIO Advance Directive Interoperability Implementation Guide, published by HL7 International / Patient Empowerment. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-pacio-adi/ and changes regularly. See the Directory of published versions

: Portable Medical Order - JSON Representation

Raw json | Download


{
  "resourceType" : "Composition",
  "id" : "PMO-Example-Smith-Johnson-PMOComposition1",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOComposition"
    ]
  },
  "language" : "en-US",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en-US\" lang=\"en-US\"><p class=\"res-header-id\"><b>Generated Narrative: Composition PMO-Example-Smith-Johnson-PMOComposition1</b></p><a name=\"PMO-Example-Smith-Johnson-PMOComposition1\"> </a><a name=\"hcPMO-Example-Smith-Johnson-PMOComposition1\"> </a><a name=\"PMO-Example-Smith-Johnson-PMOComposition1-en-US\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Language: en-US</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ADI-PMOComposition.html\">ADI PMO Composition</a></p></div><p><b>Composition Version Number</b>: 11546d53-a054-4882-bc0a-ff02aa0ba887c</p><p><b>Jurisdiction</b>: <span title=\"Codes:{urn:iso:std:iso:3166:-2 US-MI}\">Michigan (United States)</span></p><p><b>Data Enterer</b>: <a href=\"Patient-Example-Smith-Johnson-Patient1.html\">Smith-Johnson, Betsy Female, DoB: 1950-11-15 ( http://hl7.org/fhir/sid/us-medicare#United States Medicare Number#10A3D58WH1600)</a></p><p><b>Effective Date</b>: 2024-03-29 14:25:34-0500 --&gt; (ongoing)</p><p><b>identifier</b>: <code>urn:oid:2.16.840.1.113883.4.823.1.7124</code>/0-87f37989294a408897aacd1fc5d8fd16</p><p><b>status</b>: Final</p><p><b>type</b>: <span title=\"Codes:{http://loinc.org 93037-0}\">Portable medical order form</span></p><p><b>category</b>: <span title=\"Codes:{http://loinc.org 42348-3}\">Advance directives</span></p><p><b>date</b>: 2024-03-29 14:25:34-0500</p><p><b>author</b>: <a href=\"PractitionerRole-Example-Kyle-Anydoc-PractitionerRole1.html\">PractitionerRole</a></p><p><b>title</b>: Portable Medical Order</p><p><b>custodian</b>: <a href=\"Organization-Example-Smith-Johnson-OrganizationCustodian1.html\">Organization MyDirectives.com</a></p></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber",
      "valueString" : "11546d53-a054-4882-bc0a-ff02aa0ba887c"
    },
    {
      "url" : "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-jurisdiction-extension",
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "urn:iso:std:iso:3166:-2",
            "code" : "US-MI"
          }
        ]
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension",
      "valueReference" : {
        🔗 "reference" : "Patient/Example-Smith-Johnson-Patient1"
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-effective-date-extension",
      "valuePeriod" : {
        "start" : "2024-03-29T14:25:34-05:00"
      }
    }
  ],
  "identifier" : {
    "system" : "urn:oid:2.16.840.1.113883.4.823.1.7124",
    "value" : "0-87f37989294a408897aacd1fc5d8fd16"
  },
  "status" : "final",
  "type" : {
    "coding" : [
      {
        "system" : "http://loinc.org",
        "code" : "93037-0",
        "display" : "Portable medical order form"
      }
    ]
  },
  "category" : [
    {
      "coding" : [
        {
          "system" : "http://loinc.org",
          "code" : "42348-3",
          "display" : "Advance directives"
        }
      ]
    }
  ],
  "subject" : {
    🔗 "reference" : "Patient/Example-Smith-Johnson-Patient1"
  },
  "date" : "2024-03-29T14:25:34-05:00",
  "author" : [
    {
      🔗 "reference" : "PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1"
    }
  ],
  "title" : "Portable Medical Order",
  "custodian" : {
    🔗 "reference" : "Organization/Example-Smith-Johnson-OrganizationCustodian1"
  },
  "section" : [
    {
      "title" : "Portable Medical Orders",
      "code" : {
        "coding" : [
          {
            "system" : "http://loinc.org",
            "code" : "59772-4"
          }
        ]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>PMO Medical Orders</b></p><p><i>Order Exists: <a href=\"http://www.example.com\">available here</a></i></p></div>"
      },
      "entry" : [
        {
          🔗 "reference" : "ServiceRequest/Example-Smith-Johnson-CPR-ServiceRequest1"
        }
      ]
    },
    {
      "title" : "Additional Documentation",
      "code" : {
        "coding" : [
          {
            "system" : "http://loinc.org",
            "code" : "77599-9"
          }
        ]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>PMOLST Order Observation</b></p><p><i>Order Exists: <a href=\"http://www.example.com\">available here</a></i></p></div>"
      },
      "entry" : [
        {
          🔗 "reference" : "Observation/Example-Smith-Johnson-DocumentationObservation1"
        }
      ]
    },
    {
      "title" : "Witnesses and Notary",
      "code" : {
        "coding" : [
          {
            "system" : "http://loinc.org",
            "code" : "81339-4",
            "display" : "Witness and Notary Document"
          }
        ]
      },
      "text" : {
        "status" : "additional",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>I am emotionally and mentally competent to make this uADD. I understand the purpose and effect of this uADD, I agree with everything that is written in this uADD, and I have made this uADD knowingly, willingly and after careful deliberation.</p><table><tbody><tr><td><b>Signature:</b></td><td>Betsy Smith-Johnson</td></tr><tr><td><b>Date:</b></td><td>3/29/2024</td></tr></tbody></table><p></p><p><b>Statement of Witnesses</b></p><p></p><p>I declare that the person who signed this uADD, or who asked another to sign this uADD on his/her behalf, is the individual identified in the document, and he/she did so in my presence or otherwise provided satisfactory proof to me of his/her identity. I believe him/her to be of sound mind and at least 18 years of age. I personally witnessed him/her sign this document or ask the person indicated to do so, or I received proof of his/her identity that I believe is adequate, and I believe that he/she did so voluntarily. By signing this document as a witness, I certify that I am:</p><p></p><ul><li>At least 18 years of age.</li><li>Not related to the person signing this document by blood, marriage or adoption.</li><li>Not a healthcare agent appointed by the person signing this document.</li><li>Not directly financially responsible for that person’s healthcare.</li><li>Not a healthcare provider directly serving the person at this time.</li><li>Not an employee (other than a social worker or chaplain), officer, director, or partner of a healthcare provider (or any parent organization of such healthcare provider) directly serving the person at this time.</li><li>Not aware that I am entitled to or have a claim against the person’s estate.</li></ul><p></p><table><tbody><tr><td><b>Witness Number:</b></td><td></td></tr><tr><td><b>Signature:</b></td><td></td></tr><tr><td><b>Date:</b></td><td></td></tr></tbody></table></div>"
      }
    }
  ]
}