CDA Examples
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CDA Examples, published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/CDA-Examples/ and changes regularly. See the Directory of published versions

Example: Direct Address

Approval Status: Approved
Task Force Approval: 2017-11-02
SDWG Approval: 2017-11-30

This demonstrates a patient with a Patient DirectTrust Address and a Provider Organization with a Covered Entity DirectTrust Address.

This file includes examples of the following templates:

This content is an example of the US Realm Header Logical Model and is not a FHIR Resource

    
<ClinicalDocument xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="urn:hl7-org:v3" xmlns:mif="urn:hl7-org:v3/mif" xmlns:voc="urn:hl7-org:v3/voc"
                  xmlns:sdtc="urn:hl7-org:sdtc">
  <realmCode code="US"/>
  <typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040"/>
  <templateId root="2.16.840.1.113883.10.20.22.1.1"/>
  <templateId root="2.16.840.1.113883.10.20.22.1.1" extension="2024-05-01"/> <!-- C-CDA 3.0 -->
  <id root="2.16.840.1.113883.3.109" extension="bf6b3a62-4293-47b4-9f14-c8829a156f4b"/>
  <code code="34133-9" codeSystem="2.16.840.1.113883.6.1"
        displayName="Summary of episode note" codeSystemName="LOINC" />
  <title>Continuity of Care Document (C-CDA)</title>
  <effectiveTime value="20170528150200-0400"/>
  <confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25"
                       displayName="normal" codeSystemName="HL7 Confidentiality" />
  <languageCode code="en-US"/>
  <recordTarget>
    <patientRole>
      <!-- Here is a public id that has an external meaning based on a root OID that is publically identifiable. -->
      <!-- root="1.3.6.1.4.1.41179.2.4" is the assigningAutorityName for
           Direct Trust's Patient/Consumer addresses "DT.org PATIENT" -->
      <id root="1.3.6.1.4.1.41179.2.4" extension="lisarnelson@direct.myphd.us" assigningAuthorityName="DT.org PATIENT"/>
      <!-- More ids may be used. -->
      <!-- Here is the patient's MRN at RVHS  -->
      <id root="2.16.840.1.113883.1.111.12345" extension="12345-0828" assigningAuthorityName="River Valley Health Services"/>
      <!-- Use the identifiedBy extention to indicate an identifier type.
           If a coded concept is not available in the identifierType Code System, use originalText to describe the identifier type -->
      <sdtc:identifiedBy typeCode="REL">
        <sdtc:alternateIdentification classCode="IDENT">
          <id root="1.3.6.1.4.1.41179.2.4" extension="lisarnelson@direct.myphd.us" />
          <code><originalText>DirectTrust Consumer Identity</originalText></code>
        </sdtc:alternateIdentification>
      </sdtc:identifiedBy>
      <!-- Available Direct Trust identitifier types include the following:
           <sdtc:identifiedBy typeCode="REL">
             <sdtc:alternateIdentification classCode="IDENT">
               <id root="1.3.6.1.4.1.41179.2.3" extension="lisarnelson@direct.myphd.us" />
               <code><originalText>DirectTrust Practitioner Identity</originalText></code>
             </sdtc:alternateIdentification>
           </sdtc:identifiedBy>
           <sdtc:identifiedBy typeCode="REL">
             <sdtc:alternateIdentification classCode="IDENT">
               <id root="1.3.6.1.4.1.41179.2.2" extension="lisarnelson@direct.myphd.us" />
               <code><originalText>DirectTrust Business Associate Identity</originalText></code>
             </sdtc:alternateIdentification>
           </sdtc:identifiedBy>
           <sdtc:identifiedBy typeCode="REL">
             <sdtc:alternateIdentification classCode="IDENT">
               <id root="1.3.6.1.4.1.41179.2.1" extension="lisarnelson@direct.myphd.us" />
               <code><originalText>DirectTrust Covered Entity Identity</originalText></code>
             </sdtc:alternateIdentification>
           </sdtc:identifiedBy> -->
      <sdtc:identifiedBy typeCode="REL">
        <sdtc:alternateIdentification classCode="IDENT">
          <sdtc:id root="2.16.840.1.113883.1.111.12345" extension="12345-0828" />
          <sdtc:code code="MR" codeSystem="2.16.840.1.113883.18.108" codeSystemName="v2-0203" displayName="Medical record number"></sdtc:code>
        </sdtc:alternateIdentification>
      </sdtc:identifiedBy>
      <addr>
        <streetAddressLine>1 Happy Valley Road</streetAddressLine>
        <city>Westerly</city>
        <state>RI</state>
        <postalCode>02891</postalCode>
        <country nullFlavor="UNK"/>
      </addr>
      <telecom use="WP" value="tel:+1-4013482345"/>
      <telecom use="HP" value="tel:+1-4016412345"/>
      <telecom value="mailto:lisanelson@gmail.com"/>
      <telecom value="mailto:lisarnelson@direct.myphd.us"/>
      <patient>
        <name use="L">
          <family>Nelson</family>
          <given qualifier="CL">Lisa</given>
        </name>
        <administrativeGenderCode code="F" codeSystem="2.16.840.1.113883.5.1"
                                  displayName="Female" codeSystemName="HL7 AdministrativeGender" />
        <birthTime value="19620828"/>
        <maritalStatusCode code="M" codeSystem="2.16.840.1.113883.5.2"
                           displayName="Married" codeSystemName="HL7 MaritalStatus" />
        <raceCode code="2106-3" codeSystem="2.16.840.1.113883.6.238"
                  displayName="White" codeSystemName="CDC Race and Ethnicity" />
        <ethnicGroupCode code="2186-5" codeSystem="2.16.840.1.113883.6.238"
                         displayName="Not Hispanic or Latino" codeSystemName="CDC Race and Ethnicity" />
        <languageCommunication>
          <templateId root="2.16.840.1.113883.3.88.11.32.2"/>
          <languageCode code="en"/>
          <preferenceInd value="true"/>
        </languageCommunication>
      </patient>
      <providerOrganization>
        <!-- This is a public id where the root is registered to indicate the National Provider ID -->
        <id root="2.16.840.1.113883.4.6" extension="1417947383" assigningAuthorityName="National Provider ID" />
        <!-- This is a public id where the root indicates this is a Provider Direct Address. -->
        <!-- root="1.3.6.1.4.1.41179.2.1" is the assigningAutorityName for
             Direct Trust's Covered Entity addresses "DT.org CE" -->
        <id root="1.3.6.1.4.1.41179.2.1" extension="rvhs@rvhs.direct.md" assigningAuthorityName="DT.org CE (Covered Entity)"/>
        <!-- By including a root OID attribute for a healthcare organization, you can use this information to
             indicate a patient's MRN id at that organization.-->
        <id root="2.16.840.1.113883.1.111.12345" assigningAuthorityName="River Valley Health Services local patient Medical Record Number" />
        <name>River Valley Health Services</name>
        <telecom use="WP" value="tel:+1-4015394321"/>
        <telecom use="WP" value="mailto:rvhs@rvhs.direct.md"/>
        <addr>
          <streetAddressLine>823 Main Street</streetAddressLine>
          <city>River Valley</city>
          <state>RI</state>
          <postalCode>02832</postalCode>
          <country>US</country>
        </addr>
      </providerOrganization>
    </patientRole>
  </recordTarget>
  <author>
    <time nullFlavor="NI"/>
    <assignedAuthor>
      <id nullFlavor="NI"/>
      <addr nullFlavor="NI"/>
      <telecom nullFlavor="NI"/>
      <assignedAuthoringDevice>
        <manufacturerModelName nullFlavor="NI"/>
        <softwareName nullFlavor="NI"/>
      </assignedAuthoringDevice>
    </assignedAuthor>
  </author>
  <custodian>
    <assignedCustodian>
      <representedCustodianOrganization>
        <id nullFlavor="NI" />
        <name nullFlavor="NI" />
        <telecom nullFlavor="NI" />
        <addr nullFlavor="NI" />
      </representedCustodianOrganization>
    </assignedCustodian>
  </custodian>
  <!-- ... -->
  <component>
    <structuredBody>
      <component>
        <!-- ... -->
      </component>
    </structuredBody>
  </component>
</ClinicalDocument>