Australian Digital Health Agency FHIR Implementation Guide
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Australian Digital Health Agency FHIR Implementation Guide, published by Australian Digital Health Agency. This guide is not an authorized publication; it is the continuous build for version 1.2.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/AuDigitalHealth/ci-fhir-r4/ and changes regularly. See the Directory of published versions

: National Cancer Screening Program Participation View (Bundle) for Mr Zhang Wei (16 MAY 2022) - JSON Representation

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{
  "resourceType" : "Bundle",
  "id" : "ncspv-doc-03",
  "meta" : // Bundle for 'data out' from MHR to CIS 
  {
    "lastUpdated" : "2022-02-15T07:15:15+10:00",
    "profile" : [
      🔗 "http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-bundle-document-1"
    ]
  },
  "identifier" : {
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:uuid:bc7db961-b74e-4f76-955d-8948d14cee24"
  },
  "type" : "document",
  "timestamp" : "2022-05-16T13:45:15+10:00",
  "entry" : [
    //     COMPOSITION    
    {
      "fullUrl" : "urn:uuid:3f25cb71-1ecc-406d-94fc-012308834145",
      "resource" : {
        "resourceType" : "Composition",
        "id" : "ncspv-03",
        "meta" : {
          "profile" : [
            🔗 "http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-composition-document-1"
          ]
        },
        "language" : "en-AU",
        "text" : // Workaround to trigger IG Publisher generated narrative 
        {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en-AU\" lang=\"en-AU\">\n                        <h1>National Cancer Screening Register Program View</h1>\n                        <h3>16/02/2022 | 01:45 PM | My Health Record</h3>\n                        <p><b>View metadata</b>: id: urn:uuid:75e5fe3d-7520-4a74-8eff-ab39f148c835s  <b>status</b>: final</p>\n                    </div>"
        },
        "identifier" : {
          "system" : "urn:ietf:rfc:3986",
          "value" : "urn:uuid:75e5fe3d-7520-4a74-8eff-ab39f148c835"
        },
        "status" : "final",
        "type" : {
          "coding" : [
            {
              "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1",
              "code" : "100.32040",
              "display" : "National Cancer Screening Program Participation View"
            }
          ]
        },
        "category" : [
          {
            "coding" : [
              {
                "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1",
                "code" : "100.32039",
                "display" : "Disease Screening Program Participation Record"
              }
            ]
          }
        ],
        "subject" : {
          "reference" : "urn:uuid:5262f368-8f3e-43ae-be0f-f54541d4329e",
          "identifier" : {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "NI",
                  "display" : "National unique individual identifier"
                }
              ],
              "text" : "IHI"
            },
            "system" : "http://ns.electronichealth.net.au/id/hi/ihi/1.0",
            "value" : "8003608000228437"
          }
        },
        "date" : "2022-05-16T13:45:15+10:00",
        "author" : [
          {
            "reference" : "urn:uuid:12247b36-1383-42ca-abb4-daa0ebbd82d2",
            "identifier" : {
              "type" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org.au/CodeSystem/v2-0203",
                    "code" : "NDI",
                    "display" : "National Device Identifier"
                  }
                ],
                "text" : "PAI-D"
              },
              "system" : "http://ns.electronichealth.net.au/id/pcehr/paid/1.0",
              "value" : "8003640003000026"
            }
          }
        ],
        "title" : "National Cancer Screening Register Program View",
        "custodian" : {
          "reference" : "urn:uuid:d0bc0370-08f3-4b6d-b32d-e463535982f7",
          "identifier" : {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org.au/CodeSystem/v2-0203",
                  "code" : "NOI",
                  "display" : "National Organisation Identifier"
                }
              ],
              "text" : "PAI-O"
            },
            "system" : "http://ns.electronichealth.net.au/id/pcehr/paio/1.0",
            "value" : "8003640001000036"
          }
        },
        "section" : [
          {
            "title" : "Programs",
            "code" : {
              "coding" : [
                {
                  "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1",
                  "code" : "101.32046",
                  "display" : "Health Program Information"
                }
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n                            <table style=\"border-collapse:collapse;border-spacing:0;width:100%;\">\n                                <caption>National Bowel Cancer Screening Program Participation</caption>\n                                <tr>\n                                    <th style=\"border-collapse:collapse;border-spacing:0;font-family:Arial, sans-serif;font-size:14px;font-weight:normal;padding:10px 5px;border-style:solid;border-width:1px;overflow:hidden;word-break:normal;border-color:black;font-weight:bold;background-color:#9b9b9b;border-color:#000000;text-align:left;vertical-align:top\">Participant Status</th>\n                                    <th style=\"border-collapse:collapse;border-spacing:0;font-family:Arial, sans-serif;font-size:14px;font-weight:normal;padding:10px 5px;border-style:solid;border-width:1px;overflow:hidden;word-break:normal;border-color:black;font-weight:bold;background-color:#9b9b9b;border-color:#000000;text-align:left;vertical-align:top\">Participant Status Period</th>\n                                    <th style=\"border-collapse:collapse;border-spacing:0;font-family:Arial, sans-serif;font-size:14px;font-weight:normal;padding:10px 5px;border-style:solid;border-width:1px;overflow:hidden;word-break:normal;border-color:black;font-weight:bold;background-color:#9b9b9b;border-color:#000000;text-align:left;vertical-align:top\">Defer flag</th>\n                                    <th style=\"border-collapse:collapse;border-spacing:0;font-family:Arial, sans-serif;font-size:14px;font-weight:normal;padding:10px 5px;border-style:solid;border-width:1px;overflow:hidden;word-break:normal;border-color:black;font-weight:bold;background-color:#9b9b9b;border-color:#000000;text-align:left;vertical-align:top\">Next Action</th>\n                                </tr>\n                                <tr>\n                                    <td style=\"border-collapse:collapse;border-spacing:0;font-family:Arial, sans-serif;font-size:14px;padding:10px 5px;border-style:solid;border-width:1px;overflow:hidden;word-break:normal;border-color:black;border-color:#000000;text-align:left;vertical-align:top\">New to Screening</td>\n                                    <td style=\"border-collapse:collapse;border-spacing:0;font-family:Arial, sans-serif;font-size:14px;padding:10px 5px;border-style:solid;border-width:1px;overflow:hidden;word-break:normal;border-color:black;border-color:#000000;text-align:left;vertical-align:top\">05/02/2022 to 05/08/2022</td>\n                                    <td style=\"border-collapse:collapse;border-spacing:0;font-family:Arial, sans-serif;font-size:14px;padding:10px 5px;border-style:solid;border-width:1px;overflow:hidden;word-break:normal;border-color:black;border-color:#000000;text-align:left;vertical-align:top\">Yes</td>\n                                    <td style=\"border-collapse:collapse;border-spacing:0;font-family:Arial, sans-serif;font-size:14px;padding:10px 5px;border-style:solid;border-width:1px;overflow:hidden;word-break:normal;border-color:black;border-color:#000000;text-align:left;vertical-align:top\">Due Now (eligible since 50th birthday)</td>\n                                </tr>\n                            </table>\n                        </div>"
            },
            "entry" : [
              {
                "reference" : "urn:uuid:c722b26d-cbde-4a61-9d73-de71e117dcfd"
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:5262f368-8f3e-43ae-be0f-f54541d4329e",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "mhr-zhang-wei",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n                        <h3>\n                            <b>Mr Zhang Wei</b>\n                        </h3>\n                        <p>\n                            <b>IHI:</b> 8003608000228437   <b>Medicare Number:</b> 29533070311\n                        </p>\n                        <p>\n                            <b>Date Of Birth:</b> 1972-05-03 \n                        </p>\n                        <p>\n                            <b>Country of Birth:</b> China    <b>Year of Arrival:</b> 2017\n                        </p>\n                        <p>\n                            <b>Indigenous Status:</b> Neither Aboriginal nor Torres Strait Islander origin\n                        </p>\n                        \n                        <p>\n                            <b>Interpreter Required?</b> Yes   <b>Preferred Language:</b> Cantonese (yue)\n                        </p>\n                    </div>"
        },
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/patient-birthPlace",
            "valueAddress" : {
              "text" : "China",
              "country" : "CHN"
            }
          },
          {
            "url" : "http://hl7.org.au/fhir/StructureDefinition/indigenous-status",
            "valueCoding" : {
              "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/australian-indigenous-status-1",
              "code" : "4",
              "display" : "Neither Aboriginal nor Torres Strait Islander origin"
            }
          },
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired",
            "valueBoolean" : true
          },
          {
            "url" : "http://hl7.org.au/fhir/StructureDefinition/date-of-arrival",
            "valueDate" : "2017"
          }
        ],
        "identifier" : [
          {
            "extension" : [
              {
                "url" : "http://hl7.org.au/fhir/StructureDefinition/ihi-status",
                "valueCoding" : {
                  "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/ihi-status-1",
                  "code" : "active"
                }
              },
              {
                "url" : "http://hl7.org.au/fhir/StructureDefinition/ihi-record-status",
                "valueCoding" : {
                  "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/ihi-record-status-1",
                  "code" : "verified",
                  "display" : "verified"
                }
              }
            ],
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "NI"
                }
              ],
              "text" : "IHI"
            },
            "system" : "http://ns.electronichealth.net.au/id/hi/ihi/1.0",
            "value" : "8003608000228437"
          },
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "MC"
                }
              ],
              "text" : "Medicare Number"
            },
            "system" : "http://ns.electronichealth.net.au/id/medicare-number",
            "value" : "29533070311"
          }
        ],
        "name" : [
          {
            "family" : "Zhang",
            "given" : [
              "Wei"
            ],
            "prefix" : [
              "Mr"
            ]
          }
        ],
        "gender" : "male",
        "birthDate" : "1972-05-03",
        "_birthDate" : {
          "extension" : [
            {
              "url" : "http://hl7.org.au/fhir/StructureDefinition/date-accuracy-indicator",
              "valueCoding" : {
                "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/date-accuracy-indicator-1",
                "code" : "AAA",
                "display" : "Day, month and year are accurate"
              }
            }
          ]
        },
        "communication" : [
          {
            "language" : {
              "coding" : [
                {
                  "system" : "urn:ietf:bcp:47",
                  "code" : "yue"
                }
              ],
              "text" : "Cantonese"
            },
            "preferred" : true
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:12247b36-1383-42ca-abb4-daa0ebbd82d2",
      "resource" : {
        "resourceType" : "Device",
        "id" : "mhr-01",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Device_mhr-01\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Device mhr-01</b></p><a name=\"mhr-01\"> </a><a name=\"hcmhr-01\"> </a><a name=\"mhr-01-en-AU\"> </a><p><b>identifier</b>: PAI-D/8003640003000026</p><h3>DeviceNames</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Name</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>My Health Record system</td><td>other</td></tr></table><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 1084991000168108}\">My Health Record system</span></p><p><b>owner</b>: <a href=\"Bundle-ncspv-doc-03.html#urn-uuid-d0bc0370-08f3-4b6d-b32d-e463535982f7\">Bundle: identifier = UUID:bc7db961-b74e-4f76-955d-8948d14cee24; type = document; timestamp = 2022-05-16 13:45:15+1000</a></p></div>"
        },
        "identifier" : [
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org.au/CodeSystem/v2-0203",
                  "code" : "NDI",
                  "display" : "National Device Identifier"
                }
              ],
              "text" : "PAI-D"
            },
            "system" : "http://ns.electronichealth.net.au/id/pcehr/paid/1.0",
            "value" : "8003640003000026"
          }
        ],
        "deviceName" : [
          {
            "name" : "My Health Record system",
            "type" : "other"
          }
        ],
        "type" : {
          "coding" : [
            {
              "system" : "http://snomed.info/sct",
              "code" : "1084991000168108",
              "display" : "My Health Record system"
            }
          ],
          "text" : "My Health Record system"
        },
        "owner" : {
          "reference" : "urn:uuid:d0bc0370-08f3-4b6d-b32d-e463535982f7"
        }
      }
    },
    {
      "fullUrl" : "urn:uuid:d0bc0370-08f3-4b6d-b32d-e463535982f7",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "mhr-operator",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_mhr-operator\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization mhr-operator</b></p><a name=\"mhr-operator\"> </a><a name=\"hcmhr-operator\"> </a><a name=\"mhr-operator-en-AU\"> </a><p><b>identifier</b>: PAI-O/8003640001000036</p><p><b>name</b>: My Health Record system operator</p></div>"
        },
        "identifier" : [
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org.au/CodeSystem/v2-0203",
                  "code" : "NOI",
                  "display" : "National Organisation Identifier"
                }
              ],
              "text" : "PAI-O"
            },
            "system" : "http://ns.electronichealth.net.au/id/pcehr/paio/1.0",
            "value" : "8003640001000036"
          }
        ],
        "name" : "My Health Record system operator"
      }
    },
    {
      "fullUrl" : "urn:uuid:eaadd89b-cded-4872-a1ff-d1230e9e7495",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "ncsr-operator",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_ncsr-operator\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization ncsr-operator</b></p><a name=\"ncsr-operator\"> </a><a name=\"hcncsr-operator\"> </a><a name=\"ncsr-operator-en-AU\"> </a><p><b>identifier</b>: PAI-O/TBD</p><p><b>name</b>: National Cancer Screening Register system operator</p><p><b>partOf</b>: <a href=\"Bundle-ncspv-doc-03.html#urn-uuid-a73db507-e5ed-4865-a20e-45062fb2c7f4\">Bundle: identifier = UUID:bc7db961-b74e-4f76-955d-8948d14cee24; type = document; timestamp = 2022-05-16 13:45:15+1000</a></p></div>"
        },
        "identifier" : [
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org.au/CodeSystem/v2-0203",
                  "code" : "NOI",
                  "display" : "National Organisation Identifier"
                }
              ],
              "text" : "PAI-O"
            },
            "system" : "http://ns.electronichealth.net.au/id/pcehr/paio/1.0",
            "value" : "TBD"
          }
        ],
        "name" : "National Cancer Screening Register system operator",
        "partOf" : {
          "reference" : "urn:uuid:a73db507-e5ed-4865-a20e-45062fb2c7f4"
        }
      }
    },
    {
      "fullUrl" : "urn:uuid:a73db507-e5ed-4865-a20e-45062fb2c7f4",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "servicesau",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_servicesau\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization servicesau</b></p><a name=\"servicesau\"> </a><a name=\"hcservicesau\"> </a><a name=\"servicesau-en-AU\"> </a><p><b>identifier</b>: ABN/90794605008</p><p><b>type</b>: <span title=\"Codes:\">Commonwealth Government Entity</span></p><p><b>name</b>: Services Australia</p><p><b>telecom</b>: <a href=\"https://www.servicesaustralia.gov.au/\">https://www.servicesaustralia.gov.au/</a></p></div>"
        },
        "identifier" : [
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "XX"
                }
              ],
              "text" : "ABN"
            },
            "system" : "http://hl7.org.au/id/abn",
            "value" : "90794605008"
          }
        ],
        "type" : [
          {
            "text" : "Commonwealth Government Entity"
          }
        ],
        "name" : "Services Australia",
        "telecom" : [
          {
            "system" : "url",
            "value" : "https://www.servicesaustralia.gov.au/",
            "use" : "work"
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:c722b26d-cbde-4a61-9d73-de71e117dcfd",
      "resource" : // 14.	Forecast status validity period is not provided in this scenario
      {
        "resourceType" : "Observation",
        "id" : "nbcsp-02",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_nbcsp-02\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation nbcsp-02</b></p><a name=\"nbcsp-02\"> </a><a name=\"hcnbcsp-02\"> </a><a name=\"nbcsp-02-en-AU\"> </a><p><b>identifier</b>: <code>urn:ietf:rfc:4122</code>/24fd20c0-5a07-4e5e-98da-d7d3d498613a</p><p><b>status</b>: Final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org.au/CodeSystem/observation-category program}\">Cancer screening program</span></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 1602081000168109}\">National Bowel Cancer Screening Program Participation</span></p><p><b>subject</b>: <a href=\"Bundle-ncspv-doc-03.html#urn-uuid-5262f368-8f3e-43ae-be0f-f54541d4329e\">Bundle: identifier = UUID:bc7db961-b74e-4f76-955d-8948d14cee24; type = document; timestamp = 2022-05-16 13:45:15+1000</a></p><p><b>effective</b>: 2022-05-14</p><p><b>performer</b>: <a href=\"Bundle-ncspv-doc-03.html#urn-uuid-eaadd89b-cded-4872-a1ff-d1230e9e7495\">Bundle: identifier = UUID:bc7db961-b74e-4f76-955d-8948d14cee24; type = document; timestamp = 2022-05-16 13:45:15+1000</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 1603781000168102}\">Participant status</span></p><p><b>value</b>: <span title=\"Codes:{http://snomed.info/sct 1602001000168101}\">Actively Screening</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 1603791000168104}\">Participant status period</span></p><p><b>value</b>: 2022-02-05 --&gt; 2022-08-05</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 1603871000168108}\">Defer flag</span></p><p><b>value</b>: true</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 1604041000168107}\">Next screening action</span></p><p><b>value</b>: <span title=\"Codes:\">Due Now (eligible since 50th birthday)</span></p></blockquote></div>"
        },
        "identifier" : [
          // Scenario: New to NBCSP, deferred participation (2022)
    Scenario Description: Patient is aged 50 and first Bowel Program round has opened. 
    Person has been sent invitation, but defers for 6 months as they are travelling overseas. Date deferral was recorded is 10 Feb 2022.  
          // update to id from pcehr doc registration?
          {
            "system" : "urn:ietf:rfc:4122",
            "value" : "24fd20c0-5a07-4e5e-98da-d7d3d498613a"
          }
        ],
        "status" : "final",
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org.au/CodeSystem/observation-category",
                "code" : "program",
                "display" : "Program"
              }
            ],
            "text" : "Cancer screening program"
          }
        ],
        "code" : {
          "coding" : [
            {
              "system" : "http://snomed.info/sct",
              "code" : "1602081000168109",
              "display" : "National bowel cancer screening program participation"
            }
          ],
          "text" : "National Bowel Cancer Screening Program Participation"
        },
        "subject" : {
          "reference" : "urn:uuid:5262f368-8f3e-43ae-be0f-f54541d4329e",
          "identifier" : {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "NI",
                  "display" : "National unique individual identifier"
                }
              ],
              "text" : "IHI"
            },
            "system" : "http://ns.electronichealth.net.au/id/hi/ihi/1.0",
            "value" : "8003608000228437"
          }
        },
        "effectiveDateTime" : "2022-05-14",
        "performer" : [
          // Records date this program participation information is asserted as 'true' 
          {
            "reference" : "urn:uuid:eaadd89b-cded-4872-a1ff-d1230e9e7495",
            "identifier" : {
              "type" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org.au/CodeSystem/v2-0203",
                    "code" : "NOI",
                    "display" : "National Organisation Identifier"
                  }
                ],
                "text" : "PAI-O"
              },
              "system" : "http://ns.electronichealth.net.au/id/pcehr/paio/1.0",
              "value" : "TBD"
            }
          }
        ],
        "component" : [
          // 1.	Program participation status 
          {
            "code" : {
              "coding" : [
                {
                  "system" : "http://snomed.info/sct",
                  "code" : "1603781000168102",
                  "display" : "Program participation status"
                }
              ],
              "text" : "Participant status"
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://snomed.info/sct",
                  "code" : "1602001000168101",
                  "display" : "Active participation"
                }
              ],
              "text" : "Actively Screening"
            }
          },
          {
            "code" : {
              "coding" : [
                {
                  "system" : "http://snomed.info/sct",
                  "code" : "1603791000168104",
                  "display" : "Program participation status period"
                }
              ],
              "text" : "Participant status period"
            },
            "valuePeriod" : // Patient deferred for 6 months so keeps status of New to screening for a 6 month period
            {
              "start" : "2022-02-05",
              "end" : "2022-08-05"
            }
          },
          {
            "code" : {
              "coding" : [
                {
                  "system" : "http://snomed.info/sct",
                  "code" : "1603871000168108",
                  "display" : "Program participation suspension indicator"
                }
              ],
              "text" : "Defer flag"
            },
            "valueBoolean" : true
          },
          // Patient deferred
          {
            "code" : {
              "coding" : [
                {
                  "system" : "http://snomed.info/sct",
                  "code" : "1604041000168107",
                  "display" : "Program forecast status"
                }
              ],
              "text" : "Next screening action"
            },
            "valueCodeableConcept" : {
              "text" : "Due Now (eligible since 50th birthday)"
            }
          }
        ]
      }
    }
  ]
}