PACIO Advance Healthcare Directive Interoperability Implementation Guide
2.0.0-ballot - STU 2 – Ballot

PACIO Advance Healthcare Directive Interoperability Implementation Guide, published by HL7 International / Patient Empowerment. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/pacio-adi/ and changes regularly. See the Directory of published versions

## : PMO-Example-Smith-Johnson-Bundle2 - XML Representation

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    <Bundle xmlns="http://hl7.org/fhir">
      <id value="PMO-Example-Smith-Johnson-Bundle2"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-Bundle"/>
      </meta>
      <identifier>
        <system value="http://example.org/GoodHealthClinic/id"/>
        <value value="20130607100315-ExamplePMODocument"/>
      </identifier>
      <type value="document"/>
      <timestamp value="2024-03-29T14:25:34.001-05:00"/>
      <entry>
        <fullUrl
                 value="http://www.example.org/fhir/Composition/PMO-Example-Smith-Johnson-PMOComposition1"/>
        <resource>
          <Composition>
            <id value="PMO-Example-Smith-Johnson-PMOComposition1"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOComposition"/>
            </meta>
            <language value="en-US"/>
            <text>
              <status value="extensions"/>
              <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en-US" lang="en-US"><a name="Composition_PMO-Example-Smith-Johnson-PMOComposition1"> </a><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><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>: 2024-03-29T14:25:34-05:00</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#1PA3D58WH16)</a></p><p><b>Participant</b>: <a href="PractitionerRole-Example-Kyle-Anydoc-PractitionerRole1.html">PractitionerRole: telecom = kanydoc@example.org(Work)</a></p><p><b>ADI Expiration Date</b>: 2024-03-29 14:25:34-0500</p><p><b>Performer</b>: <a href="PractitionerRole-Example-Kyle-Anydoc-PractitionerRole1.html">PractitionerRole: telecom = kanydoc@example.org(Work)</a></p><p><b>Informant</b>: <a href="RelatedPerson-Example-Smith-Johnson-HealthcareAgent1.html">RelatedPerson Johnson, Charles</a></p><p><b>Revoke Status</b>: deprecated</p><blockquote><p><b>Clause</b></p><ul><li>Clause: </li></ul></blockquote><div><p>&lt;div xmlns=&quot;http://www.w3.org/1999/xhtml&quot;&gt;&lt;p&gt;Example Clause Statement&lt;/p&gt;&lt;/div&gt;</p>
    </div><p><b>identifier</b>: <code>http://example.org/GoodHealthClinic/id</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 healthcare directives</span></p><p><b>date</b>: 2023-03-29 14:25:34-0500</p><p><b>author</b>: <a href="PractitionerRole-Example-Kyle-Anydoc-PractitionerRole1.html">PractitionerRole: telecom = kanydoc@example.org(Work)</a></p><p><b>title</b>: Portable Medical Order</p><h3>Attesters</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Mode</b></td><td><b>Party</b></td></tr><tr><td style="display: none">*</td><td>Legal</td><td><a href="PractitionerRole-Example-Kyle-Anydoc-PractitionerRole1.html">PractitionerRole: telecom = kanydoc@example.org(Work)</a></td></tr></table><p><b>custodian</b>: <a href="Organization-Example-Smith-Johnson-OrganizationCustodian1.html">Organization example.org</a></p><blockquote><p><b>event</b></p><p><b>detail</b>: </p><ul><li><a href="PractitionerRole-ADI-Facilitator-MSW-MargaretReynolds.html">PractitionerRole primary performer</a></li><li><a href="Consent-Example-Smith-Johnson-HealthcareAgentConsent-Permit.html">Consent: status = active; scope = Goals, preferences, and priorities regarding the appointment of healthcare agents Narrative - Reported; category = Advance Directive</a></li><li><a href="Consent-Example-Smith-Johnson-HealthcareAgentConsent-Deny.html">Consent: status = active; scope = Goals, preferences, and priorities regarding the appointment of healthcare agents Narrative - Reported; category = Advance Directive</a></li></ul></blockquote></div>
            </text>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber">
              <valueString value="2024-03-29T14:25:34-05:00"/>
            </extension>
            <extension
                       url="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension">
              <valueReference>🔗
                <reference value="Patient/Example-Smith-Johnson-Patient1"/>
              </valueReference>
            </extension>
            <extension
                       url="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-healthcareAgentParticipant-extension">
              <valueReference>🔗
                <reference
                           value="PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1"/>
              </valueReference>
            </extension>
            <extension
                       url="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-expiration-date-extension">
              <valueDateTime value="2024-03-29T14:25:34-05:00"/>
            </extension>
            <extension
                       url="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension">
              <valueReference>🔗
                <reference
                           value="PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1"/>
              </valueReference>
            </extension>
            <extension
                       url="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-informant-extension">
              <valueReference>🔗
                <reference
                           value="RelatedPerson/Example-Smith-Johnson-HealthcareAgent1"/>
              </valueReference>
            </extension>
            <extension
                       url="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status">
              <valueCode value="deprecated"/>
            </extension>
            <extension
                       url="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension">
              <extension url="Clause">
                <valueMarkdown
                               value="&lt;div xmlns=&quot;http://www.w3.org/1999/xhtml&quot;&gt;&lt;p&gt;Example Clause Statement&lt;/p&gt;&lt;/div&gt;"/>
              </extension>
            </extension>
            <identifier>
              <system value="http://example.org/GoodHealthClinic/id"/>
              <value value="0-87f37989294a408897aacd1fc5d8fd16"/>
            </identifier>
            <status value="final"/>
            <type>
              <coding>
                <system value="http://loinc.org"/>
                <code value="93037-0"/>
                <display value="Portable medical order form"/>
              </coding>
            </type>
            <category>
              <coding>
                <system value="http://loinc.org"/>
                <code value="42348-3"/>
                <display value="Advance healthcare directives"/>
              </coding>
            </category>
            <subject>🔗
              <reference value="Patient/Example-Smith-Johnson-Patient1"/>
            </subject>
            <date value="2023-03-29T14:25:34-05:00"/>
            <author>🔗
              <reference
                         value="PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1"/>
            </author>
            <title value="Portable Medical Order"/>
            <attester>
              <mode value="legal"/>
              <party>🔗
                <reference
                           value="PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1"/>
              </party>
            </attester>
            <custodian>🔗
              <reference
                         value="Organization/Example-Smith-Johnson-OrganizationCustodian1"/>
            </custodian>
            <event>
              <detail>🔗
                <reference
                           value="PractitionerRole/ADI-Facilitator-MSW-MargaretReynolds"/>
              </detail>
              <detail>🔗
                <reference
                           value="Consent/Example-Smith-Johnson-HealthcareAgentConsent-Permit"/>
              </detail>
              <detail>🔗
                <reference
                           value="Consent/Example-Smith-Johnson-HealthcareAgentConsent-Deny"/>
              </detail>
            </event>
            <section>
              <title value="Portable Medical Orders"/>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="93037-0"/>
                  <display value="Portable medical order form"/>
                </coding>
              </code>
              <text>
                <status value="generated"/>
                <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>
              </text>
              <entry>🔗
                <reference
                           value="ServiceRequest/Example-Smith-Johnson-CPR-ServiceRequest1"/>
              </entry>
            </section>
            <section>
              <title value="Additional Documentation"/>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="77599-9"/>
                </coding>
              </code>
              <text>
                <status value="generated"/>
                <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>
              </text>
              <entry>🔗
                <reference
                           value="Observation/Example-Smith-Johnson-DocumentationObservation2"/>
              </entry>
            </section>
            <section>
              <title value="Witnesses and Notary"/>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="81339-4"/>
                  <display value="Witness and Notary Document"/>
                </coding>
              </code>
              <text>
                <status value="additional"/>
                <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><b>Statement of Witnesses</b></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/><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/><table><tbody><tr><td><b>Witness Number:</b></td><td/></tr><tr><td><b>Signature:</b></td><td/></tr><tr><td><b>Date:</b></td><td/></tr></tbody></table></div>
              </text>
            </section>
          </Composition>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://www.example.org/fhir/Patient/Example-Smith-Johnson-Patient1"/>
        <resource>
          <Patient>
            <id value="Example-Smith-Johnson-Patient1"/>
            <meta>
              <lastUpdated value="2021-03-29T14:25:34.001-05:00"/>
              <profile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
            </meta>
            <language value="en-US"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en-US" lang="en-US"><a name="Patient_Example-Smith-Johnson-Patient1"> </a><p class="res-header-id"><b>Generated Narrative: Patient Example-Smith-Johnson-Patient1</b></p><a name="Example-Smith-Johnson-Patient1"> </a><a name="hcExample-Smith-Johnson-Patient1"> </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">Last updated: 2021-03-29 14:25:34-0500; Language: en-US</p><p style="margin-bottom: 0px">Profile: <a href="http://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-patient.html">US Core Patient Profile</a></p></div><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Smith-Johnson, Betsy Female, DoB: 1950-11-15 ( http://hl7.org/fhir/sid/us-medicare#United States Medicare Number#1PA3D58WH16)</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Record is active">Active:</td><td>true</td><td style="background-color: #f3f5da" title="Known Marital status of Patient">Marital Status:</td><td colspan="3"><span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-NullFlavor UNK}">unknown</span></td></tr><tr><td style="background-color: #f3f5da" title="Other Id (see the one above)">Other Id:</td><td colspan="3">Medical Record Number/1032702 (use: usual, )</td></tr><tr><td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Detail</td><td colspan="3"><ul><li><a href="mailto:BetsySJ@example.com">BetsySJ@example.com</a></li><li>111 Maple Court San Antonio TX 78212 US (home)</li></ul></td></tr><tr><td style="background-color: #f3f5da" title="Language spoken">Language:</td><td colspan="3"><span title="Codes:{urn:ietf:bcp:47 en}">English</span> (preferred)</td></tr><tr><td style="background-color: #f3f5da" title="Nominated Contact: son">son:</td><td colspan="3"><ul><li>Charles Johnson</li><li>111 Maple Ct, Grand Rapids, MI 49503</li><li>ph: (210) 222-3333</li></ul></td></tr><tr><td style="background-color: #f3f5da" title="Nominated Contact: daughter">daughter:</td><td colspan="3"><ul><li>Debra Johnson</li><li>333 W. Camden St., Baltimore, MD 21201</li><li>ph: (410) 444-5555</li></ul></td></tr><tr><td style="background-color: #f3f5da" title="Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality.  The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html#3) which includes over 900 concepts for representing race and ethnicity of which 921 reference race.  The race concepts are grouped by and pre-mapped to the 5 OMB race categories:

     - American Indian or Alaska Native
     - Asian
     - Black or African American
     - Native Hawaiian or Other Pacific Islander
     - White.">US Core Race Extension:</td><td colspan="3"><ul><li>ombCategory: CDC Race and Ethnicity 2106-3: White</li><li>text: White</li></ul></td></tr></table></div>
            </text>
            <extension
                       url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">
              <extension url="ombCategory">
                <valueCoding>
                  <system value="urn:oid:2.16.840.1.113883.6.238"/>
                  <code value="2106-3"/>
                  <display value="White"/>
                </valueCoding>
              </extension>
              <extension url="text">
                <valueString value="White"/>
              </extension>
            </extension>
            <identifier>
              <use value="usual"/>
              <type>
                <coding>
                  <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
                  <code value="MR"/>
                  <display value="Medical Record Number"/>
                </coding>
                <text value="Medical Record Number"/>
              </type>
              <system value="http://example.org/GoodHealthHospital"/>
              <value value="1032702"/>
            </identifier>
            <identifier>
              <system value="http://hl7.org/fhir/sid/us-medicare"/>
              <value value="1PA3D58WH16"/>
            </identifier>
            <active value="true"/>
            <name>
              <use value="usual"/>
              <text value="Smith-Johnson, Betsy"/>
              <family value="Smith-Johnson"/>
              <given value="Betsy"/>
            </name>
            <telecom>
              <system value="email"/>
              <value value="BetsySJ@example.com"/>
              <use value="home"/>
            </telecom>
            <gender value="female"/>
            <birthDate value="1950-11-15"/>
            <address>
              <use value="home"/>
              <type value="physical"/>
              <line value="111 Maple Court"/>
              <city value="San Antonio"/>
              <state value="TX"/>
              <postalCode value="78212"/>
              <country value="US"/>
            </address>
            <maritalStatus>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/v3-NullFlavor"/>
                <code value="UNK"/>
              </coding>
            </maritalStatus>
            <contact>
              <relationship>
                <coding>
                  <system
                          value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
                  <code value="SONC"/>
                </coding>
              </relationship>
              <name>
                <text value="Charles Johnson"/>
              </name>
              <telecom>
                <system value="phone"/>
                <value value="(210) 222-3333"/>
              </telecom>
              <address>
                <text value="111 Maple Ct, Grand Rapids, MI 49503"/>
              </address>
            </contact>
            <contact>
              <relationship>
                <coding>
                  <system
                          value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
                  <code value="DAUC"/>
                </coding>
              </relationship>
              <name>
                <text value="Debra Johnson"/>
              </name>
              <telecom>
                <system value="phone"/>
                <value value="(410) 444-5555"/>
              </telecom>
              <address>
                <text value="333 W. Camden St., Baltimore, MD 21201"/>
              </address>
            </contact>
            <communication>
              <language>
                <coding>
                  <system value="urn:ietf:bcp:47"/>
                  <code value="en"/>
                  <display value="English"/>
                </coding>
              </language>
              <preferred value="true"/>
            </communication>
          </Patient>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://www.example.org/fhir/PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1"/>
        <resource>
          <PractitionerRole>
            <id value="Example-Kyle-Anydoc-PractitionerRole1"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="PractitionerRole_Example-Kyle-Anydoc-PractitionerRole1"> </a><p class="res-header-id"><b>Generated Narrative: PractitionerRole Example-Kyle-Anydoc-PractitionerRole1</b></p><a name="Example-Kyle-Anydoc-PractitionerRole1"> </a><a name="hcExample-Kyle-Anydoc-PractitionerRole1"> </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"/><p style="margin-bottom: 0px">Profile: <a href="http://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-practitionerrole.html">US Core PractitionerRole Profile</a></p></div><p><b>practitioner</b>: <a href="Practitioner-Example-Kyle-Anydoc-Practitioner.html">Practitioner Kyle Anydoc </a></p><p><b>telecom</b>: <a href="mailto:kanydoc@example.org">kanydoc@example.org</a></p></div>
            </text>
            <practitioner>🔗
              <reference value="Practitioner/Example-Kyle-Anydoc-Practitioner"/>
            </practitioner>
            <telecom>
              <system value="email"/>
              <value value="kanydoc@example.org"/>
              <use value="work"/>
            </telecom>
          </PractitionerRole>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://www.example.org/fhir/Practitioner/Example-Kyle-Anydoc-Practitioner"/>
        <resource>
          <Practitioner>
            <id value="Example-Kyle-Anydoc-Practitioner"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Practitioner_Example-Kyle-Anydoc-Practitioner"> </a><p class="res-header-id"><b>Generated Narrative: Practitioner Example-Kyle-Anydoc-Practitioner</b></p><a name="Example-Kyle-Anydoc-Practitioner"> </a><a name="hcExample-Kyle-Anydoc-Practitioner"> </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"/><p style="margin-bottom: 0px">Profile: <a href="http://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-practitioner.html">US Core Practitioner Profile</a></p></div><p><b>identifier</b>: <a href="http://terminology.hl7.org/5.5.0/NamingSystem-npi.html" title="National Provider Identifier">United States National Provider Identifier</a>/1818345971</p><p><b>name</b>: Kyle Anydoc </p><p><b>telecom</b>: <a href="mailto:kanydoc@example.org">kanydoc@example.org</a></p><p><b>address</b>: 567 Healthcare Drive Anytown MA 12345 US (home)</p><p><b>gender</b>: Male</p><h3>Qualifications</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Code</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0360 MD}">Doctor of Medicine</span></td></tr></table></div>
            </text>
            <identifier>
              <system value="http://hl7.org/fhir/sid/us-npi"/>
              <value value="1818345971"/>
            </identifier>
            <name>
              <family value="Anydoc"/>
              <given value="Kyle"/>
              <prefix value="Dr."/>
            </name>
            <telecom>
              <system value="email"/>
              <value value="kanydoc@example.org"/>
              <use value="work"/>
            </telecom>
            <address>
              <use value="home"/>
              <line value="567 Healthcare Drive"/>
              <city value="Anytown"/>
              <state value="MA"/>
              <postalCode value="12345"/>
              <country value="US"/>
            </address>
            <gender value="male"/>
            <qualification>
              <code>
                <coding>
                  <system value="http://terminology.hl7.org/CodeSystem/v2-0360"/>
                  <code value="MD"/>
                  <display value="Doctor of Medicine"/>
                </coding>
              </code>
            </qualification>
          </Practitioner>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://www.example.org/fhir/Organization/Example-Smith-Johnson-OrganizationCustodian1"/>
        <resource>
          <Organization>
            <id value="Example-Smith-Johnson-OrganizationCustodian1"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Organization_Example-Smith-Johnson-OrganizationCustodian1"> </a><p class="res-header-id"><b>Generated Narrative: Organization Example-Smith-Johnson-OrganizationCustodian1</b></p><a name="Example-Smith-Johnson-OrganizationCustodian1"> </a><a name="hcExample-Smith-Johnson-OrganizationCustodian1"> </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"/><p style="margin-bottom: 0px">Profile: <a href="http://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-organization.html">US Core Organization Profile</a></p></div><p><b>identifier</b>: <a href="http://terminology.hl7.org/5.5.0/NamingSystem-npi.html" title="National Provider Identifier">United States National Provider Identifier</a>/1234567893</p><p><b>active</b>: true</p><p><b>name</b>: example.org</p><p><b>telecom</b>: <a href="tel:+1(202)776-7700">+1(202)776-7700</a></p><p><b>address</b>: 740 E. Campbell Rd. Suite 825 Richardson TX 75081 US </p></div>
            </text>
            <identifier>
              <system value="http://hl7.org/fhir/sid/us-npi"/>
              <value value="1234567893"/>
            </identifier>
            <active value="true"/>
            <name value="example.org"/>
            <telecom>
              <system value="phone"/>
              <value value="+1(202)776-7700"/>
              <use value="work"/>
            </telecom>
            <address>
              <type value="physical"/>
              <line value="740 E. Campbell Rd. Suite 825"/>
              <city value="Richardson"/>
              <state value="TX"/>
              <postalCode value="75081"/>
              <country value="US"/>
            </address>
          </Organization>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://www.example.org/fhir/ServiceRequest/Example-Smith-Johnson-CPR-ServiceRequest1"/>
        <resource>
          <ServiceRequest>
            <id value="Example-Smith-Johnson-CPR-ServiceRequest1"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOCPRServiceRequest"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_Example-Smith-Johnson-CPR-ServiceRequest1"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest Example-Smith-Johnson-CPR-ServiceRequest1</b></p><a name="Example-Smith-Johnson-CPR-ServiceRequest1"> </a><a name="hcExample-Smith-Johnson-CPR-ServiceRequest1"> </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"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-ADI-PMOCPRServiceRequest.html">ADI PMO Cardiopulmonary Resuscitation ServiceRequest</a></p></div><p><b>status</b>: Active</p><p><b>intent</b>: Directive</p><p><b>category</b>: <span title="Codes:{http://loinc.org 100822-6}">Cardiopulmonary resuscitation orders</span></p><p><b>doNotPerform</b>: true</p><p><b>code</b>: <span title="Codes:{http://loinc.org LA33470-8}">Yes CPR</span></p><p><b>orderDetail</b>: <span title="Codes:{http://loinc.org LA33470-8}">Yes CPR</span></p><p><b>subject</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#1PA3D58WH16)</a></p><p><b>requester</b>: <a href="Practitioner-Example-Kyle-Anydoc-Practitioner.html">Practitioner Kyle Anydoc </a></p></div>
            </text>
            <status value="active"/>
            <intent value="directive"/>
            <category>
              <coding>
                <system value="http://loinc.org"/>
                <code value="100822-6"/>
                <display value="Cardiopulmonary resuscitation orders"/>
              </coding>
            </category>
            <doNotPerform value="true"/>
            <code>
              <coding>
                <system value="http://loinc.org"/>
                <code value="LA33470-8"/>
              </coding>
            </code>
            <orderDetail>
              <coding>
                <system value="http://loinc.org"/>
                <code value="LA33470-8"/>
              </coding>
            </orderDetail>
            <subject>🔗
              <reference value="Patient/Example-Smith-Johnson-Patient1"/>
            </subject>
            <requester>🔗
              <reference value="Practitioner/Example-Kyle-Anydoc-Practitioner"/>
            </requester>
          </ServiceRequest>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://www.example.org/fhir/Observation/Example-Smith-Johnson-DocumentationObservation2"/>
        <resource>
          <Observation>
            <id value="Example-Smith-Johnson-DocumentationObservation2"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-DocumentationObservation"/>
            </meta>
            <text>
              <status value="additional"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_Example-Smith-Johnson-DocumentationObservation2"> </a><p><b>PMOLST Order Observation</b></p><p><i>Order Exists: <a href="http://www.example.com">available here</a></i></p></div>
            </text>
            <status value="final"/>
            <code>
              <coding>
                <system value="http://loinc.org"/>
                <code value="42348-3"/>
                <display value="Advance healthcare directives"/>
              </coding>
            </code>
            <subject>🔗
              <reference value="Patient/Example-Smith-Johnson-Patient1"/>
            </subject>
            <effectiveDateTime value="2016-05-18T22:33:22Z"/>
            <performer>🔗
              <reference value="Patient/Example-Smith-Johnson-Patient1"/>
            </performer>
            <valueCodeableConcept>
              <coding>
                <system value="http://snomed.info/sct"/>
                <code value="697978002"/>
                <display value="Provider orders for life-sustaining treatment"/>
              </coding>
            </valueCodeableConcept>
          </Observation>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://www.example.org/fhir/PractitionerRole/ADI-Facilitator-MSW-MargaretReynolds"/>
        <resource>
          <PractitionerRole>
            <id value="ADI-Facilitator-MSW-MargaretReynolds"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-Facilitator"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="PractitionerRole_ADI-Facilitator-MSW-MargaretReynolds"> </a><p class="res-header-id"><b>Generated Narrative: PractitionerRole ADI-Facilitator-MSW-MargaretReynolds</b></p><a name="ADI-Facilitator-MSW-MargaretReynolds"> </a><a name="hcADI-Facilitator-MSW-MargaretReynolds"> </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"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-ADI-Facilitator.html">ADI Facilitator</a></p></div><p><b>active</b>: true</p><p><b>practitioner</b>: <a href="Practitioner-Practitioner-MargaretReynolds.html">Margaret A. Reynolds</a></p><p><b>organization</b>: <a href="Organization-Example-Smith-Johnson-OrganizationAssembler1.html">Example Organization</a></p><p><b>code</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-ParticipationType PPRF}">primary performer</span></p><p><b>specialty</b>: <span title="Codes:{http://nucc.org/provider-taxonomy 1041C0700X}">Clinical Social Worker</span></p><p><b>endpoint</b>: <a href="Endpoint-Example-Smith-Johnson-Endpoint2.html">Endpoint Good Health Clinic Endpoint</a></p></div>
            </text>
            <active value="true"/>
            <practitioner>🔗
              <reference value="Practitioner/Practitioner-MargaretReynolds"/>
              <display value="Margaret A. Reynolds"/>
            </practitioner>
            <organization>🔗
              <reference
                         value="Organization/Example-Smith-Johnson-OrganizationAssembler1"/>
              <display value="Example Organization"/>
            </organization>
            <code>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/v3-ParticipationType"/>
                <code value="PPRF"/>
              </coding>
            </code>
            <specialty>
              <coding>
                <system value="http://nucc.org/provider-taxonomy"/>
                <code value="1041C0700X"/>
                <display value="Clinical Social Worker"/>
              </coding>
            </specialty>
            <endpoint>🔗
              <reference value="Endpoint/Example-Smith-Johnson-Endpoint2"/>
            </endpoint>
          </PractitionerRole>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://www.example.org/fhir/Practitioner/Practitioner-MargaretReynolds"/>
        <resource>
          <Practitioner>
            <id value="Practitioner-MargaretReynolds"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Practitioner_Practitioner-MargaretReynolds"> </a><p class="res-header-id"><b>Generated Narrative: Practitioner Practitioner-MargaretReynolds</b></p><a name="Practitioner-MargaretReynolds"> </a><a name="hcPractitioner-MargaretReynolds"> </a><p><b>identifier</b>: <code>http://example.org/fhir/MI-state-license</code>/86420</p><p><b>active</b>: true</p><p><b>name</b>: Margaret Q. Reynolds</p><p><b>telecom</b>: ph: (555) 391-9414</p><p><b>address</b>: 18051 Mack Ave, Detroit, MI 48224</p><p><b>gender</b>: Female</p></div>
            </text>
            <identifier>
              <system value="http://example.org/fhir/MI-state-license"/>
              <value value="86420"/>
            </identifier>
            <active value="true"/>
            <name>
              <text value="Margaret Q. Reynolds"/>
              <family value="Reynolds"/>
              <given value="Margaret"/>
              <given value="Q."/>
            </name>
            <telecom>
              <system value="phone"/>
              <value value="(555) 391-9414"/>
            </telecom>
            <address>
              <text value="18051 Mack Ave, Detroit, MI 48224"/>
              <line value="18051 Mack Ave"/>
              <city value="Detroit"/>
              <state value="MI"/>
              <postalCode value="48224"/>
              <country value="US"/>
            </address>
            <gender value="female"/>
          </Practitioner>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://www.example.org/fhir/Endpoint/Example-Smith-Johnson-Endpoint2"/>
        <resource>
          <Endpoint>
            <id value="Example-Smith-Johnson-Endpoint2"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Endpoint_Example-Smith-Johnson-Endpoint2"> </a><p class="res-header-id"><b>Generated Narrative: Endpoint Example-Smith-Johnson-Endpoint2</b></p><a name="Example-Smith-Johnson-Endpoint2"> </a><a name="hcExample-Smith-Johnson-Endpoint2"> </a><p><b>identifier</b>: <code>https://example.org/GoodHealth-Clinic</code>/PatientCorrection</p><p><b>status</b>: Active</p><p><b>connectionType</b>: <a href="http://terminology.hl7.org/5.5.0/CodeSystem-endpoint-connection-type.html#endpoint-connection-type-hl7-fhir-rest">Endpoint Connection Type hl7-fhir-rest</a>: HL7 FHIR</p><p><b>name</b>: Good Health Clinic Endpoint</p><p><b>payloadType</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-HL7DocumentFormatCodes urn:hl7-org:sdwg:ccda-nonXMLBody:1.1}, {http://terminology.hl7.org/CodeSystem/v3-HL7DocumentFormatCodes urn:hl7-org:sdwg:ccda-structuredBody:1.1}">For documents following C-CDA constraints using a structured body</span></p><p><b>address</b>: <a href="https://example.org/address">https://example.org/address</a></p></div>
            </text>
            <identifier>
              <system value="https://example.org/GoodHealth-Clinic"/>
              <value value="PatientCorrection"/>
            </identifier>
            <status value="active"/>
            <connectionType>
              <system
                      value="http://terminology.hl7.org/CodeSystem/endpoint-connection-type"/>
              <code value="hl7-fhir-rest"/>
              <display value="HL7 FHIR"/>
            </connectionType>
            <name value="Good Health Clinic Endpoint"/>
            <payloadType>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/v3-HL7DocumentFormatCodes"/>
                <code value="urn:hl7-org:sdwg:ccda-nonXMLBody:1.1"/>
              </coding>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/v3-HL7DocumentFormatCodes"/>
                <code value="urn:hl7-org:sdwg:ccda-structuredBody:1.1"/>
              </coding>
              <text
                    value="For documents following C-CDA constraints using a structured body"/>
            </payloadType>
            <address value="https://example.org/address"/>
          </Endpoint>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://www.example.org/fhir/Consent/Example-Smith-Johnson-HealthcareAgentConsent-Permit"/>
        <resource>
          <Consent>
            <id value="Example-Smith-Johnson-HealthcareAgentConsent-Permit"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-ADIConsentPermit"/>
            </meta>
            <text>
              <status value="additional"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Consent_Example-Smith-Johnson-HealthcareAgentConsent-Permit"> </a><p>I am consenting for my son Charles to be my authorized personal representative (primary healthcare agent) and I am permitting him to make decisions on my behalf about intubation.</p></div>
            </text>
            <status value="active"/>
            <scope>
              <coding>
                <system value="http://loinc.org"/>
                <code value="81377-4"/>
                <display
                         value="Goals, preferences, and priorities regarding the appointment of healthcare agents Narrative - Reported"/>
              </coding>
            </scope>
            <category>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/consentcategorycodes"/>
                <version value="1.0.0"/>
                <code value="acd"/>
              </coding>
            </category>
            <patient>🔗
              <reference value="Patient/Example-Smith-Johnson-Patient1"/>
            </patient>
            <policy>
              <uri value="http://example.org/healthcare-agent-policy"/>
            </policy>
            <provision>
              <type value="permit"/>
              <actor>
                <role>
                  <coding>
                    <system value="http://loinc.org"/>
                    <code value="75783-1"/>
                    <display value="Primary healthcare agent [Reported]"/>
                  </coding>
                </role>
                <reference>🔗
                  <reference
                             value="RelatedPerson/Example-Smith-Johnson-HealthcareAgent1"/>
                </reference>
              </actor>
            </provision>
          </Consent>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://www.example.org/fhir/Consent/Example-Smith-Johnson-HealthcareAgentConsent-Deny"/>
        <resource>
          <Consent>
            <id value="Example-Smith-Johnson-HealthcareAgentConsent-Deny"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-ADIConsentDeny"/>
            </meta>
            <text>
              <status value="additional"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Consent_Example-Smith-Johnson-HealthcareAgentConsent-Deny"> </a><p>I am consenting for my son Charles to be my primary healthcare agent and I am denying him to make decisions on my behalf about nutrition.</p></div>
            </text>
            <status value="active"/>
            <scope>
              <coding>
                <system value="http://loinc.org"/>
                <code value="81377-4"/>
                <display
                         value="Goals, preferences, and priorities regarding the appointment of healthcare agents Narrative - Reported"/>
              </coding>
            </scope>
            <category>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/consentcategorycodes"/>
                <version value="1.0.0"/>
                <code value="acd"/>
              </coding>
            </category>
            <patient>🔗
              <reference value="Patient/Example-Smith-Johnson-Patient1"/>
            </patient>
            <policy>
              <uri value="http://example.org/healthcare-agent-policy"/>
            </policy>
            <provision>
              <type value="deny"/>
              <actor>
                <role>
                  <coding>
                    <system value="http://loinc.org"/>
                    <code value="75783-1"/>
                    <display value="Primary healthcare agent [Reported]"/>
                  </coding>
                </role>
                <reference>🔗
                  <reference
                             value="RelatedPerson/Example-Smith-Johnson-HealthcareAgent1"/>
                </reference>
              </actor>
            </provision>
          </Consent>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://www.example.org/fhir/RelatedPerson/Example-Smith-Johnson-HealthcareAgent1"/>
        <resource>
          <RelatedPerson>
            <id value="Example-Smith-Johnson-HealthcareAgent1"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-HealthcareAgentParticipant"/>
            </meta>
            <text>
              <status value="additional"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="RelatedPerson_Example-Smith-Johnson-HealthcareAgent1"> </a><p><b>Primary Healthcare Agent</b></p><p>The person I choose as my Primary Healthcare Agent is:</p><p><i>Charles Johnson</i></p><p><i>(Son)</i></p><p><i>CharlesSJ@example.com</i></p><p>[SELECTED to act as a healthcare agent on 3/29/2021, at 2:25 PM CDT]</p><p>[ACCEPTED to act as a healthcare agent on 4/1/2021, at 3:39 PM CDT]</p></div>
            </text>
            <patient>🔗
              <reference value="Patient/Example-Smith-Johnson-Patient1"/>
            </patient>
            <relationship>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
                <code value="SON"/>
                <display value="natural son"/>
              </coding>
            </relationship>
            <name>
              <text value="Johnson, Charles"/>
              <family value="Johnson"/>
              <given value="Charles"/>
            </name>
            <telecom>
              <system value="email"/>
              <value value="CharlesSJ@example.com"/>
              <use value="home"/>
            </telecom>
          </RelatedPerson>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://www.example.org/fhir/Provenance/Example-Smith-Johnson-PMOProvenance1"/>
        <resource>
          <Provenance>
            <id value="Example-Smith-Johnson-PMOProvenance1"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-Provenance"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Provenance_Example-Smith-Johnson-PMOProvenance1"> </a><p class="res-header-id"><b>Generated Narrative: Provenance Example-Smith-Johnson-PMOProvenance1</b></p><a name="Example-Smith-Johnson-PMOProvenance1"> </a><a name="hcExample-Smith-Johnson-PMOProvenance1"> </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"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-ADI-Provenance.html">ADI Provenance</a></p></div><p>Provenance for <a href="Composition-PMO-Example-Smith-Johnson-PMOComposition1.html">Composition Portable Medical Order</a></p><p>Summary</p><table class="grid"><tr><td>Recorded</td><td>2021-03-29 14:25:34-0500</td></tr></table><p><b>Agents</b></p><table class="grid"><tr><td><b>Type</b></td><td><b>who</b></td></tr><tr><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/provenance-participant-type assembler}">Assembler</span></td><td><a href="Organization-Example-Smith-Johnson-OrganizationAssembler1.html">Organization GoodHealth Clinic</a></td></tr></table></div>
            </text>
            <target>🔗
              <reference
                         value="Composition/PMO-Example-Smith-Johnson-PMOComposition1"/>
            </target>
            <recorded value="2021-03-29T14:25:34.001-05:00"/>
            <agent>
              <type>
                <coding>
                  <system
                          value="http://terminology.hl7.org/CodeSystem/provenance-participant-type"/>
                  <version value="1.0.0"/>
                  <code value="assembler"/>
                  <display value="Assembler"/>
                </coding>
              </type>
              <who>🔗
                <reference
                           value="Organization/Example-Smith-Johnson-OrganizationAssembler1"/>
              </who>
            </agent>
          </Provenance>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://www.example.org/fhir/Organization/Example-Smith-Johnson-OrganizationAssembler1"/>
        <resource>
          <Organization>
            <id value="Example-Smith-Johnson-OrganizationAssembler1"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Organization_Example-Smith-Johnson-OrganizationAssembler1"> </a><p class="res-header-id"><b>Generated Narrative: Organization Example-Smith-Johnson-OrganizationAssembler1</b></p><a name="Example-Smith-Johnson-OrganizationAssembler1"> </a><a name="hcExample-Smith-Johnson-OrganizationAssembler1"> </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"/><p style="margin-bottom: 0px">Profile: <a href="http://hl7.org/fhir/us/core/STU8/StructureDefinition-us-core-organization.html">US Core Organization Profile</a></p></div><p><b>identifier</b>: <code>http://example.org/GoodHealthClinic/id</code>/12c5dcee5089494ca1ca0cb428ed3fff</p><p><b>active</b>: true</p><p><b>name</b>: GoodHealth Clinic</p><p><b>telecom</b>: <a href="tel:+1(202)776-7700">+1(202)776-7700</a></p><p><b>address</b>: 740 E. Campbell Rd. Suite 825 Richardson TX 75081 US </p></div>
            </text>
            <identifier>
              <system value="http://example.org/GoodHealthClinic/id"/>
              <value value="12c5dcee5089494ca1ca0cb428ed3fff"/>
            </identifier>
            <active value="true"/>
            <name value="GoodHealth Clinic"/>
            <telecom>
              <system value="phone"/>
              <value value="+1(202)776-7700"/>
              <use value="work"/>
            </telecom>
            <address>
              <type value="physical"/>
              <line value="740 E. Campbell Rd. Suite 825"/>
              <city value="Richardson"/>
              <state value="TX"/>
              <postalCode value="75081"/>
              <country value="US"/>
            </address>
          </Organization>
        </resource>
      </entry>
    </Bundle>