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: CDA with Embedded Text plain

Approval Status: Approved
Task Force Approval: 2020-10-08
SDWG Approval: 2020-12-17

This example shows a CDA document that conforms to the C-CDA Unstructured Document specification using an embedded text plain document (base 64 encoded). When decoded it will show a surgical consult note. Note that the HL7 standard stylesheet will show this natively

This file includes examples of the following templates:

This content is an example of the Unstructured Document Logical Model and is not a FHIR Resource

    
<ClinicalDocument xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="urn:hl7-org:v3" xmlns:cda="urn:hl7-org:v3" xmlns:sdtc="urn:hl7-org:sdtc">
  <!-- This is an example of an unstructured document. See component/nonXMLbody -->
  <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="2014-08-01"/>
  <templateId root="2.16.840.1.113883.10.20.22.1.1" extension="2024-05-01"/> <!-- C-CDA 3.0 -->
  <templateId root="2.16.840.1.113883.10.20.22.1.10" />
  <templateId root="2.16.840.1.113883.10.20.22.1.10" extension="2015-08-01"/>
  <templateId root="2.16.840.1.113883.10.20.22.1.10" extension="2024-05-01"/> <!-- C-CDA 3.0 -->
  <id extension="X451212" root="2.16.840.1.113883.19.5.999535454.1"/>
  <code codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" code="34847-4" displayName="Surgery Consult note"/>
  <title>Community Health and Hospitals: SURGICAL CONSULT</title>
  <effectiveTime value="202004201918-0800"/>
  <confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25" displayName="normal" />
  <languageCode code="en-US"/>
  <setId extension="sTT988" root="2.16.840.1.113883.19.5.99999.19"/>
  <versionNumber value="1"/>
  <recordTarget>
    <patientRole>
      <!-- Fake Social Security Number using the actual SSN OID. -->
      <id extension="111-00-2330" root="2.16.840.1.113883.4.1"/>
      <addr use="HP">
        <streetAddressLine>1357 Amber Drive</streetAddressLine>
        <city>Beaverton</city>
        <state>OR</state>
        <postalCode>97867</postalCode>
        <country>US</country>
      </addr>
      <telecom value="tel:(816)276-6909" use="HP"/>
      <patient>
        <name use="L">
          <given>Juan</given>
          <family>Damore</family>
        </name>
        <administrativeGenderCode code="M" codeSystem="2.16.840.1.113883.5.1" displayName="Male"/>
        <birthTime value="19530302"/>
        <maritalStatusCode code="M" displayName="Married" codeSystem="2.16.840.1.113883.5.2" codeSystemName="MaritalStatusCode"/>
        <religiousAffiliationCode code="1013" codeSystem="2.16.840.1.113883.5.1076"
                                  displayName="Christian (non-Catholic, non-specific)" codeSystemName="HL7 Religious Affiliation" />
        <raceCode code="1002-5" codeSystem="2.16.840.1.113883.6.238"
                  displayName="American Indian or Alaska Native" codeSystemName="Race &amp; Ethnicity - CDC" />
        <ethnicGroupCode code="2186-5" codeSystem="2.16.840.1.113883.6.238"
                         displayName="Not Hispanic or Latino" codeSystemName="Race &amp; Ethnicity - CDC" />
        <languageCommunication>
          <languageCode code="en"/>
          <modeCode code="ESP" displayName="Expressed spoken" codeSystem="2.16.840.1.113883.5.60" codeSystemName="LanguageAbilityMode"/>
          <preferenceInd value="true"/>
        </languageCommunication>
      </patient>
      <providerOrganization>
        <id root="2.16.840.1.113883.19.5.9999.1393"/>
        <name>Community Health Hospital</name>
        <telecom use="WP" value="tel:555-555-5000"/>
        <addr>
          <streetAddressLine>1001 Village Avenue</streetAddressLine>
          <city>Portland</city>
          <state>OR</state>
          <postalCode>99123</postalCode>
          <country>US</country>
        </addr>
      </providerOrganization>
    </patientRole>
  </recordTarget>
  <author>
    <time value="202004201918-0800"/>
    <assignedAuthor>
      <id extension="99999999" root="2.16.840.1.113883.4.6"/>
      <code code="200000000X" codeSystem="2.16.840.1.113883.6.101" displayName="Allopathic &amp; Osteopathic Physicians"/>
      <addr>
        <streetAddressLine>1002 Healthcare Drive </streetAddressLine>
        <city>Portland</city>
        <state>OR</state>
        <postalCode>99123</postalCode>
        <country>US</country>
      </addr>
      <telecom use="WP" value="tel:555-555-1002"/>
      <assignedPerson>
        <name>
          <given>Mostafa</given>
          <family>Balimood</family>
        </name>
      </assignedPerson>
    </assignedAuthor>
  </author>
  <custodian>
    <assignedCustodian>
      <representedCustodianOrganization>
        <id extension="99999999" root="2.16.840.1.113883.4.6"/>
        <name>Community Health and Hospitals</name>
        <telecom value="tel:555-555-1002" use="WP"/>
        <addr use="WP">
          <streetAddressLine>1002 Healthcare Drive </streetAddressLine>
          <city>Portland</city>
          <state>OR</state>
          <postalCode>99123</postalCode>
          <country>US</country>
        </addr>
      </representedCustodianOrganization>
    </assignedCustodian>
  </custodian>
  <component>
    <nonXMLBody>
      <!-- the acceptable mediaType from 2.16.840.1.113883.11.20.7.1 are
           application/msword application/pdf text/plain text/rtf
           text/html image/gif image/tiff image/jpeg image/png -->
      <text mediaType="text/plain" representation="B64">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</text>
    </nonXMLBody>
  </component>
</ClinicalDocument>