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
Content Type 1 (PACP) Guidance
ADI Content Type 1 Document Structure
The ADI Content Type 1 document defines 7 sections:
Healthcare Agent - Healthcare agents, healthcare agent advisors, and consent by the subject regarding the stated designees’ roles, powers, and limitations.
Goals, Preferences, and Priorities for Certain Conditions – Preferences to be used in treatment or care planning that express a person’s goals, preferences, and priorities for care to be considered under specific situations or conditions.
Goals, Preferences, and Priorities Personal Care Experience – Characteristically these concepts express a person’s priorities for Quality of Life and the related care delivery experiences, personal goals, and preferences for that experience, which can be further grouped and placed into a Personal Priorities Organizer.
Goals, Preferences, and Priorities Upon Death - Goals, preferences, and priorities a person expresses for those events that occur at the time of, or soon after, their death.
Additional Documentation - Observations regarding the existence of other advance directive related information.
Witness & Notary - References and information regarding witnesses and notary.
Administrative Information - Administrative information associated with the personal advance care plan and/or advance directive information.
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The content in these categories of advance directive could include, but are not limited to:
Healthcare agent designation
Antibiotics administration preference
Artificial nutrition and hydration administration preference
Intubation and ventilation procedure preference
Resuscitation procedure preference
Diagnostic testing procedure preference
Preferences relating to palliative and supportive care
Preferences relating to hospice care at the end of life
Organ donation preference
Death arrangement preference
Religious, spiritual, cultural or faith-based values that are important to the individual receiving care
Specific individuals or contacts to notify, likes & joys, dislikes & fears, and various messages or information to be made available
Content type 1 also includes identifying the presence of any type of Portable Medical Order (PMO) such as a POLST or MOLST, and orders such as Do Not Resuscitate (DNR) orders. It also includes identifying other types of person-authored ADI that might exist outside of the document being reviewed. It does not include the specifics of the structured information content of other PMO and/or DNR documents, but instead creates awareness as to the presence of the documents.