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Example Composition/example-context-establishing-clinical-snapshot (XML)

Responsible Owner: Structured Documents Work GroupStandards Status: InformativeCompartments: Device, Encounter, Patient, Practitioner, RelatedPerson

Raw XML (canonical form + also see XML Format Specification)

Example of a Context-Establishing Clinical Snapshot (id = "example-context-establishing-clinical-snapshot")

<?xml version="1.0" encoding="UTF-8"?>

<Composition xmlns="http://hl7.org/fhir">
  <id value="example-context-establishing-clinical-snapshot"/> 
  <status value="final"/> 
  <type> 
    <coding> 
      <system value="http://loinc.org"/> 
      <code value="60591-5"/> 
      <display value="Patient summary Document"/> 
    </coding> 
    <text value="Current clinical status snapshot"/> 
  </type> 
  <subject> 
    <reference value="Patient/patient-123"/> 
    <display value="Example Patient"/> 
  </subject> 
  <date value="2026-06-24T11:30:00-07:00"/> 
  <author> 
    <reference value="CareTeam/primary-care-team"/> 
    <display value="Example Patient Primary Care Team"/> 
  </author> 
  <title value="Current Clinical Status"/> 
  <attester> 
    <mode> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/composition-attestation-mode"/> 
        <code value="professional"/> 
        <display value="Professional"/> 
      </coding> 
    </mode> 
    <time value="2026-06-24T11:30:00-07:00"/> 
    <party> 
      <reference value="Practitioner/practitioner-1"/> 
      <display value="Some Doctor, MD"/> 
    </party> 
  </attester> 
  <custodian> 
    <reference value="Organization/example-health-system"/> 
    <display value="Example Health System"/> 
  </custodian> 
  <section> 
    <title value="Active Problems"/> 
    <code> 
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="57852-6"/> 
        <display value="Problem list Narrative - Reported"/> 
      </coding> 
    </code> 
    <text> 
      <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml">
        <p> Active problems: type 2 diabetes mellitus and essential hypertension.</p> 
      </div> 
    </text> 
    <entry> 
      <reference value="Condition/diabetes"/> 
    </entry> 
    <entry> 
      <reference value="Condition/hypertension"/> 
    </entry> 
  </section> 
  <section> 
    <title value="Allergies and Adverse Reactions"/> 
    <code> 
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="48765-2"/> 
        <display value="Allergies and adverse reactions Document"/> 
      </coding> 
    </code> 
    <text> 
      <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml">
        <p> Penicillin allergy: urticaria.</p> 
      </div> 
    </text> 
    <entry> 
      <reference value="AllergyIntolerance/penicillin"/> 
    </entry> 
  </section> 
  <section> 
    <title value="Current Medications"/> 
    <code> 
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="10160-0"/> 
        <display value="History of Medication use Narrative"/> 
      </coding> 
    </code> 
    <text> 
      <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml">
        <p> Current medications: metformin and lisinopril.</p> 
      </div> 
    </text> 
    <entry> 
      <reference value="MedicationRequest/metformin"/> 
    </entry> 
    <entry> 
      <reference value="MedicationRequest/lisinopril"/> 
    </entry> 
  </section> 
  <section> 
    <title value="Plan of Care"/> 
    <code> 
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="18776-5"/> 
        <display value="Plan of care note"/> 
      </coding> 
    </code> 
    <text> 
      <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml">
        <p> Continue current therapy and reassess blood pressure and glycated hemoglobin at
           the next visit.</p> 
      </div> 
    </text> 
    <entry> 
      <reference value="CarePlan/chronic-care-plan"/> 
    </entry> 
  </section> 
</Composition> 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.