Generated Narrative: Organization BHAOrganizationExample

identifier: United States National Provider Identifier/1234567893

active: true

type: Provider

name: Community Health Clinic

telecom: ph: (+1) 555-555-5555, hq@chc.example.org

address: 100 Hope Place Denver CO 11111 USA

Generated Narrative: Patient BHAClientExampleCentral

Last updated: 2025-03-03 09:30:00+0000

Profile: BHA Client Profile

Arjun Patel (official) Male, DoB: 1974-10-09 ( Social Security number)

Marital Status:Married
Other Id:State Identifier/1234567893
Contact Detail8200 South Broadway Littleton CO 80122 (home)
Language:English (preferred)
US Core Ethnicity Extension:
US Core Birth Sex ExtensionM
US Core Race Extension:

Generated Narrative: EpisodeOfCare BHAEpisodeOfCareExampleCentralBH

Last updated: 2025-03-03 09:30:00+0000

Profile: BHA EpisodeOfCare Profile

status: Finished

type: Mental Health

Diagnoses

-ConditionRole
*Mental Health DiagnosisAdmission diagnosis

patient: Arjun Patel

managingOrganization: Community Health Clinic

period: 2023-01-15 --> 2025-03-03

Generated Narrative: Condition BHAEpisodeDiagnosisExampleCentralBH

clinicalStatus: Active

verificationStatus: Confirmed

category: Encounter Diagnosis, Mental Health

code: Mental Health Outpatient

subject: Arjun Patel

Generated Narrative: QuestionnaireResponse BHAAdmissionQuestionnaireResponseExampleCentral

LinkIDTextDefinitionAnswerdoco
.. BHAAdmissionQuestionnaireResponseExampleCentralQuestionnaire:BHA Admission Questionnaire
... lastUpdated2025-03-03T09:30:00Z
... SERVICE_IDENTIFIERService IdentifierBHA Service Identifier Codes: 30 (Mental Health Outpatient)
... FIRST_CONTACT_DATEDate of First Contact2023-01-15
... FIRST_APPOINTMENT_OFFERED_DATEDate of First Appointment Offered2023-01-20
... MEDICATION_ASSISTED_THERAPYMedication Assisted Therapyfalse
... REFERRAL_SOURCEReferral SourceBHA Referral Source: 1 (Individual (self, family, friend))
... ARRESTS_PAST_30_DAYSArrests in Past 30 Days0
... EMPLOYMENT_STATUSEmployment StatusBHA Employment Status: 02 (Employed Part Time (<35 hours/week))
... LIVING_SITUATIONLiving SituationBHA Living Situation: 2 (Inpatient)
... MONTHLY_INCOMEMonthly Income2800
... PRIMARY_INCOME_SOURCEPrimary Source of income/support for client (or for client's parent if client >18 years of age)BHA Income Source: 1 (Wages)
... PREGNANCY_STATUSPregnancy Statusfalse
... WITHIN_1_YEAR_POSTPARTUM_STATUSWithin 1 Year Postpartum Statusfalse
... SPECIAL_CONNECTIONS_ENROLLMENTEnrollment in Special Connectionsfalse
... ACT_ENROLLMENTEnrollment in ACT?false
... ASCENT_ENROLLMENTEnrollment in Ascent (FEP)?false
... NUMBER_DEPENDENT_CHILDRENNumber of Dependent Children0
... SELF_HELP_ATTENDANCESelf Help Attendance (Last 30 days at admission)/ Peer Support Attendance2
... TOTAL_SUBSTANCE_USE_PRIOR_TREATMENTSubstance Use Prior Treatment (Total Lifetime admissions)0
... PSYCHIATRIC_HOSPITAL_ADMISSIONPsychiatric Hospital Admission (Last 30 days)false
... LEGAL_STATUSLegal StatusBHA Legal Status: 02 (Court-directed voluntary)
... CRIMINAL_JUSTICE_INVOLVEMENTCriminal Justice Involvementfalse
... EDUCATION_LEVELEducation LevelBHA Education Level: 14 (Some College)
... SCHOOL_ATTENDANCE_STATUSSchool Attendance Status (in the previous 3 months)BHA School Attendance Status: 03 (Not Applicable)
... PSYCHIATRIC_ER_VISIT_6_MONTHSVisit to Psychiatric ER in last 6 months0
... COMMUNICATION_ACCOMMODATIONSCommunication Accommodationsfalse
... episodeOfCareEpisode of Care InformationEpisodeOfCare: status = finished; type = Mental Health; period = 2023-01-15 --> 2025-03-03
... diagnosisDiagnosis InformationMental disorder, not otherwise specified

doco Documentation for this format

Generated Narrative: QuestionnaireResponse BHADischargeQuestionnaireResponseExampleCentral

LinkIDTextDefinitionAnswerdoco
.. BHADischargeQuestionnaireResponseExampleCentralQuestionnaire:BHA Discharge Questionnaire
... lastUpdated2025-03-03T17:00:00Z
... DATE_OF_LAST_CONTACTDate of Last Contact2025-03-03T16:30:00Z
... DISCHARGE_DATEDischarge Date2025-03-03T17:00:00Z
... DISCHARGE_TYPEDischarge TypeBHA Discharge Type: 01 (Treatment Completed At This Facility)
... END_OF_TREATMENT_REASONEnd of Treatment ReasonBHA End of Treatment Reasons: 2 (Client Decision)
... ARRESTS_PAST_30_DAYSArrests in Past 30 Days0
... EMPLOYMENT_STATUSEmployment StatusBHA Employment Status: 01 (Employed Full Time (35+ hours/week))
... LIVING_SITUATIONLiving SituationBHA Living Situation: 1 (Correctional facility / Jail)
... SELF_HELP_ATTENDANCESelf Help Attendance / Peer Support Attendance (Last 30 days at discharge)1
... EDUCATION_LEVELEducation LevelBHA Education Level: 14 (Some College)
... SCHOOL_ATTENDANCE_STATUSSchool Attendance Status (in the previous 3 months)BHA School Attendance Status: 03 (Not Applicable)
... LEGAL_STATUSLegal StatusBHA Legal Status: 02 (Court-directed voluntary)
... episodeOfCareEpisode of Care InformationEpisodeOfCare: status = finished; type = Mental Health; period = 2023-01-15 --> 2025-03-03
... diagnosisDiagnosis InformationMental disorder, not otherwise specified

doco Documentation for this format