HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) - US Realm, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 2.1.2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/case-reporting/ and changes regularly. See the Directory of published versions
Generated Narrative: Bundle bundle-ecr-message-zika
Bundle bundle-ecr-message-zika of type message
Entry 1 - fullUrl = http://example.org/fhir/MessageHeader/messageheader-ecr-requested-eicr
Resource MessageHeader:
Generated Narrative: MessageHeader messageheader-ecr-requested-eicr
US Public Health Data Encrypted Extension: false
US Public Health Message Processing Category Extension: consequence
event: US Public Health Message Types CodeSystem eicr-case-report-message: Indicates a message containing electronic case report healthcare data sent from clinical care.
Destinations
sender: Organization Salem Medical Center
Sources
Name Software Version Contact Acme Central Patient Registry FooBar Patient Manager 3.1.45.AABB +1 (555) 123 4567 reason: Indicates the close of an encounter
Entry 2 - fullUrl = http://example.org/fhir/Bundle/bundle-eicr-document-zika
Resource Bundle:
Document Subject
Unable to resolve subject ''
Document Content
Reason for Visit Section
title Reason for Visit Sectioncode
Reason for visit Narrative(29299-5)Reason for Visit: Bad cough
Chief Complaint
title Chief complaint Narrative - Reportedcode
Chief complaint Narrative - Reported(10154-3)Chief Complaint: Bad cough
History of Present Illness Section
title History of Present Illness Sectioncode
History of Present illness Narrative(10164-2)Persistent Cough REPORTED starting on 2018/03/05
Whooping Respiration not reported
Paroxysms Of Coughing REPORTED starting on 2018/03/06
Post-tussive vomiting not reportedProblems Section
title Problems Sectioncode
Problem list - Reported(11450-4)entry Common cold (disorder)
id condition-eicr-eve-everywoman-common-coldmeta
versionId 15lastUpdated 2019-10-10T21:21:49.000-04:00profile http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-conditioncategory
Problem List Item(problem-list-item)code
Common cold (disorder)(82272006)subject onsetDateTime 2017-09-23asserter Medications Administered Section
title Medications Administered Sectioncode
Medication administered Narrative(29549-3)entry Azithromycin 500 MG Oral Tablet
id medicationadministration-eve-everywoman-azithromycinmeta
versionId 10lastUpdated 2019-10-05T03:11:22.000-04:00status completedmedicationCodeableConcept
Azithromycin 500 MG Oral Tablet
Azithromycin 500 MG Oral Tablet(248656)subject effectivePeriod
start 2018-03-07end 2018-03-07dosage
route
Oral Route(26643006)method
Swallow - dosing instruction imperative (qualifier value)(421521009)dose
value 2unit TABsystem code TABAdmission Medications Section
title Admission Medications Sectioncode
Medications on admission (narrative)(42346-7)entry 1 ML naloxone hydrochloride 0.4 MG/ML Injection Medications Section
title Medications Sectioncode
History of Medication use Narrative(10160-0)entry Azithromycin 500 MG Oral Tablet Results Section
title Results Sectioncode
Relevant Dx tests/lab data(30954-2)entry Lymphocytes [#/volume] in Blood by Automated count - Interpretation: High
id observation-us-ph-lab-result-eve-everywoman-lymphocytesmeta
versionId 10lastUpdated 2019-10-05T02:50:13.000-04:00profile http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-lab-result-observationstatus finalcategory
Laboratory
Laboratory(laboratory)code
Lymphocytes [#/volume] in Blood by Automated count(731-0)subject effectiveDateTime 2018-03-07valueQuantity
5.2 10*3/uLinterpretation
High(H)referenceRange
low
value 1system code 10*3/uLhigh
value 4.8system code 10*3/uLPlan of Treatment Section
title Plan of Treatment Sectioncode
Plan of care note(18776-5)entry Request for Zika virus envelope (E) gene [Presence] in Serum by Probe and target amplification method
- Trigger code
- Trigger Code:
- Trigger Code Display:
- Trigger Code System:
- Trigger Code Value Set: urn:oid:2.16.840.1.114222.4.11.7508
- Trigger Code Value Set Version: 19/05/2018
id servicerequest-eicr-zikameta
versionId 9lastUpdated 2019-10-23T13:56:36.000-04:00profile http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-servicerequeststatus completedintent ordercategory
Diagnostics Procedure
Diagnostic procedure (procedure)(103693007)code
Zika RT-PCR
Zika virus envelope E gene [Presence] in Serum by NAA with probe detection(80825-3)subject performer Immunizations Section
title Immunizations Sectioncode
History of Immunization Narrative(11369-6)entry pneumococcal polysaccharide vaccine entry Vaccine Credential Patient Assertion Observation Example Procedures Section
title Procedures Sectioncode
History of Procedures Document(47519-4)entry Extracorporeal membrane oxygenation (procedure) Vital Signs Section
title Vital Signs Sectioncode
Vital signs(8716-3)entry Blood pressure systolic and diastolic Social History Section
title Social History Sectioncode
Social history Narrative(29762-2)entry eICR Travel History: Eve Everywoman 2018-01
id observation-travel-history-eve-everywoman-201801meta
versionId 11lastUpdated 2019-10-05T03:15:42.000-04:00profile http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-travel-historystatus finalcode
Travel History
Travel(420008001)subject effectivePeriod
start 2018-01-15end 2018-01-30component
code
Location(LOC)valueCodeableConcept
Fiji(FJI) urn:iso:std:iso:3166component
code
Location(LOC)valueCodeableConcept
Vanuatu(VUT)Pregnancy Section
title Pregnancy Sectioncode
Pregnancy summary Document(90767-5)entry eICR Pregnancy Status Example
id observation-pregnancy-status-eve-everywomanmeta
versionId 13lastUpdated 2019-10-05T03:15:42.000-04:00profile http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-pregnancy-status-observationus-ph-date-recorded-extension
2017-10-01date-determined-extension
2017-10-01status finalcode
Pregnancy Status(82810-3)subject effectivePeriod
start 2017-08-26valueCodeableConcept
Pregnancy (finding)(77386006)method
Ultrasonography (procedure)(16310003)component
date-determined-extension
2017-10-01code
Gestational age Estimated from patient reported estimated date of conception(53691-2)valueQuantity
143 dcomponent
date-determined-extension
2017-10-01code
Delivery date Estimated from date fundal height reaches umb(57064-8)valueDateTime 2018-05-01Emergency Outbreak Information Section
title Emergency Outbreak Information Sectioncode
Public health Note(83910-0)entry US Public Health Emergency Outbreak Information Example Past Medical History Section
title Past Medical History Sectioncode
Past Medical History Narrative(11348-0)Past medical history
Review of Systems Section
title Review of Systems Sectioncode
Review of Systems Section Narrative(10187-3)Review of systems
Additional Resources Included in Document
Entry 1 - fullUrl = http://example.org/fhir/Composition/composition-eicr-zika
Resource Composition:
Generated Narrative: Composition composition-eicr-zika
version: 22; Last updated: 2021-08-17 03:24:45+0000;
Information Source: #vMaRLlyzDNjGkVuc
Composition Version Number: 1
identifier: c03eab8c-11e8-4d0c-ad2a-b385395e27db
status: Final
type: Public Health Case Report
encounter: Ambulatory Office Visit
date: 2018-01-02 22:13:23+0000
author: Henry Seven, MD
title: Initial Public Health Case Report - Zika Example
custodian: Salem Medical Center
Entry 2 - fullUrl = http://example.org/fhir/MedicationAdministration/medicationadministration-eve-everywoman-azithromycin
Resource MedicationAdministration:
Generated Narrative: MedicationAdministration medicationadministration-eve-everywoman-azithromycin
version: 6; Last updated: 2021-08-17 07:53:28+0000;
Information Source: #O8n4DNqcDuNHPfTJ
status: completed
subject: Eve Everywoman
Dosages
Text Route Method Dose Two tablets at once Oral route Swallow - dosing instruction imperative (qualifier value) 2 TAB (Details: Orderable Drug Form codeTAB = 'Tablet') Entry 3 - fullUrl = http://example.org/fhir/Procedure/us-ph-procedure-ecmo
Resource Procedure:
Generated Narrative: Procedure us-ph-procedure-ecmo
version: 5; Last updated: 2021-06-28 08:12:56+0000;
Information Source: #A9FdbPgUT95j7Itd
Profile: eICR Procedure
identifier: Uniform Resource Identifier (URI)/urn:uuid:b2a737f2-2fdb-49c1-b097-dac173d07afd
status: Completed
code: Extracorporeal membrane oxygenation (procedure)
subject: Female, DoB: 1974-11-24 ( Medical Record Number: 1032702 (use: usual, ))
FocalDevices
Entry 4 - fullUrl = http://example.org/fhir/MedicationAdministration/medicationadministration-eve-everywoman-naloxone-response
Resource MedicationAdministration:
Generated Narrative: MedicationAdministration medicationadministration-eve-everywoman-naloxone-response
version: 5; Last updated: 2021-08-17 07:53:28+0000;
Information Source: #5sOf7BOr595JpyG7
US Public Health Therapeutic Medication Response Extension: Patient's condition improved (finding)
status: completed
subject: Eve Everywoman
Dosages
Route Method Dose Gluteus maximus muscle Inject - dosing instruction imperative (qualifier value) 1 mL (Details: UCUM codemL = 'mL') Entry 5 - fullUrl = http://example.org/fhir/ServiceRequest/servicerequest-eicr-zika
Resource ServiceRequest:
Generated Narrative: ServiceRequest servicerequest-eicr-zika
version: 5; Last updated: 2021-08-17 08:02:21+0000;
Information Source: #w4zRDqhjQ9EZHgCs
Profile: eICR ServiceRequest
identifier:
http://lab.smarthealthit.org
/061ef612-344f-4e7b-81a8-1059ae7bbe19status: Completed
intent: Order
category: Diagnostics Procedure
code: No display for ServiceRequest.code (concept: Zika virus envelope E gene [Presence] in Serum by NAA with probe detection)
subject: Eve Everywoman
performer: Acme Labs
Entry 6 - fullUrl = http://example.org/fhir/Condition/condition-eicr-eve-everywoman-common-cold
Resource Condition:
Generated Narrative: Condition condition-eicr-eve-everywoman-common-cold
version: 6; Last updated: 2021-07-15 01:54:14+0000;
Information Source: #4g0ZpTNqldHFYLzr
Profile: US Public Health Condition
category: Problem List Item
code: Common cold (disorder)
subject: Eve Everywoman
onset: 2017-09-23
Entry 7 - fullUrl = http://example.org/fhir/Encounter/encounter-eicr-eve-everywoman-outpatient
Resource Encounter:
Generated Narrative: Encounter encounter-eicr-eve-everywoman-outpatient
version: 5; Last updated: 2021-07-19 03:02:05+0000;
Information Source: #Q5dlT8eND2UI2D6e
Profile: eICR Encounter
identifier:
http://hospital.smarthealthit.org
/9937012status: completed
class: ambulatory
type: Office Visit
subject: Eve Everywoman
serviceProvider: Salem Medical Center, 22222 Health Authority Drive, Ann Arbor MI, 99999
Participants
Type attender diagnosis
eICR Trigger Code Flag Extension
- triggerCodeValueSet: urn:oid:2.16.840.1.114222.4.11.7508
- triggerCodeValueSetVersion: 12/12/2018
- triggerCode: SNOMED CT 3928002: Zika virus disease (disorder)
condition: No display for Encounter.diagnosis.condition (reference: ->Condition Zika virus disease (disorder))
diagnosis
condition: No display for Encounter.diagnosis.condition (reference: ->Condition Common cold (disorder))
Locations
Location Clinic Bldg A, Salem Medical Center, 4646 Brown Rd, Salem, MA 02368 Entry 8 - fullUrl = http://example.org/fhir/Observation/observation-pregnancy-status-eve-everywoman
Resource Observation:
Generated Narrative: Observation observation-pregnancy-status-eve-everywoman
version: 8; Last updated: 2021-08-17 07:59:00+0000;
Information Source: #bBlVx7OsNPsZVCbu
US Public Health Date Recorded Extension: 2017-10-01
US Public Health Date Determined Extension: 2017-10-01
status: Final
code: Pregnancy status
subject: Eve Everywoman
effective: 2017-08-26 --> (ongoing)
value: Pregnancy (finding)
method: Ultrasonography (procedure)
component
US Public Health Date Determined Extension: 2017-10-01
code: Gestational age Estimated from patient reported estimated date of conception
value: 143 d
component
US Public Health Date Determined Extension: 2017-10-01
code: Delivery date Estimated from date fundal height reaches umb
value: 2018-05-01
Entry 9 - fullUrl = http://example.org/fhir/Observation/observation-vaccine-credential-assertion-eve-everywoman
Resource Observation:
Generated Narrative: Observation observation-vaccine-credential-assertion-eve-everywoman
version: 2; Last updated: 2021-08-13 04:25:18+0000;
Information Source: #12yO2DqhRxbXmEOy
status: Final
code: Immunization status - Reported
subject: Eve Everywoman
effective: 2020-11-10 22:33:22+0000
value: Yes
Entry 10 - fullUrl = http://example.org/fhir/Observation/observation-us-ph-emergency-outbreak-info-eve-everywoman
Resource Observation:
Generated Narrative: Observation observation-us-ph-emergency-outbreak-info-eve-everywoman
version: 4; Last updated: 2021-07-15 01:22:52+0000;
Information Source: #oAXhG2HyvbL70uEB
status: Final
code: Employee desk distance from mail sorter
subject: Eve Everywoman
effective: 2020-11-18 22:33:22+0000
value: 2 m
Entry 11 - fullUrl = http://example.org/fhir/Observation/observation-country-of-nationality-eve-everywoman
Resource Observation:
Generated Narrative: Observation observation-country-of-nationality-eve-everywoman
version: 1; Last updated: 2021-08-19 21:30:49+0000;
Information Source: #ABFWLRjmURVC23y1
Profile: eICR Country of Nationality
status: Final
code: Ethnicity / related nationality data (observable entity)
subject: Eve Everywoman
effective: 2020-11-10 22:33:22+0000
value: Australia
Entry 12 - fullUrl = http://example.org/fhir/Patient/patient-ecr-eve-everywoman
Resource Patient:
Eve L EVERYWOMAN
Identifier 1032702 Address 5101 Peachtree St NE
Atlanta GA USDate of birth 24 November 1974 Entry 13 - fullUrl = http://example.org/fhir/Immunization/immunization-ecr-pneumo
Resource Immunization:
Generated Narrative: Immunization immunization-ecr-pneumo
version: 8; Last updated: 2021-08-17 07:51:35+0000;
Information Source: #EdjaILZHXKHi4bdN
Profile: US Core Immunization Profile
status: Completed
vaccineCode: pneumococcal polysaccharide PPV23
patient: Eve Everywoman
occurrence: 2018-09-01
primarySource: true
Entry 14 - fullUrl = http://example.org/fhir/Observation/observation-country-of-residence-eve-everywoman
Resource Observation:
Generated Narrative: Observation observation-country-of-residence-eve-everywoman
version: 1; Last updated: 2021-08-13 00:20:14+0000;
Information Source: #HDoLJzr0kfWKFp3F
Profile: eICR Country of Residence
status: Final
code: Country of usual residence
subject: Eve Everywoman
effective: 2020-11-10 22:33:22+0000
value: United Kingdom of Great Britain and Northern Ireland
Entry 15 - fullUrl = http://example.org/fhir/PractitionerRole/practitionerrole-henry-seven
Resource PractitionerRole:
Generated Narrative: PractitionerRole practitionerrole-henry-seven
version: 11; Last updated: 2021-08-17 08:00:32+0000;
Information Source: #KJ942UxvfdYWoHCF
Profile: US Public Health PractitionerRole
identifier: United States National Provider Identifier/9941339108
practitioner: Henry Seven, MD
organization: Salem Medical Center
code: Primary Care Clinic/Center
specialty: Family practice
location: Salem Medical Center
Entry 16 - fullUrl = http://example.org/fhir/Observation/observation-blood-pressure-eve-everywoman
Resource Observation:
Generated Narrative: Observation observation-blood-pressure-eve-everywoman
version: 2; Last updated: 2021-07-19 08:19:31+0000;
Information Source: #2PjceWUbU0gCYVZA
Profile: US Core Blood Pressure Profile
status: Final
category: Vital Signs
code: Blood pressure systolic and diastolic
subject: Eve Everywoman
encounter: GP Visit
effective: 2020-07-02
component
code: Systolic blood pressure
value: 109 mmHg (Details: UCUM codemm[Hg] = 'mm[Hg]')
component
code: Diastolic blood pressure
value: 44 mmHg (Details: UCUM codemm[Hg] = 'mm[Hg]')
Entry 17 - fullUrl = http://example.org/fhir/Observation/observation-us-ph-exposure-contact-info-football-game
Resource Observation:
Generated Narrative: Observation observation-us-ph-exposure-contact-info-football-game
version: 4; Last updated: 2020-12-01 07:17:32+0000;
Information Source: #pMvWUdCWz4XOnrDf
status: Final
category: An interaction between entities that provides opportunity for transmission of a physical, chemical, or biological agent from an exposure source entity to an exposure target entity.
code: Mass gathering (football game)
subject: Eve Everywoman
focus: City Football Stadium
effective: 2020-01-11 18:00:00+0000 --> 2020-01-11 21:30:00+0000
value: City Football Stadium
Entry 18 - fullUrl = http://example.org/fhir/Observation/observation-travel-history-eve-everywoman-201801
Resource Observation:
Generated Narrative: Observation observation-travel-history-eve-everywoman-201801
version: 9; Last updated: 2021-08-17 07:59:01+0000;
Information Source: #d6PrWfFFuxUIiLtX
Profile: US Public Health Travel History
status: Final
code: Travel History
subject: Eve Everywoman
effective: 2018-01-15 --> 2018-01-30
component
code: Location
value: Fiji
component
code: Location
value: Vanuatu
component
code: Type of activity (attribute)
value: Active duty military (occupation)
Entry 19 - fullUrl = http://example.org/fhir/Observation/observation-disability-status-eve-everywoman
Resource Observation:
Generated Narrative: Observation observation-disability-status-eve-everywoman
version: 2; Last updated: 2021-06-30 05:33:12+0000;
Information Source: #AVCvf6gXu6hyNuWr
Profile: US Public Health Disability Status
status: Final
code: Are you deaf, or do you have serious difficulty hearing
subject: Eve Everywoman
effective: 2020-11-10 22:33:22+0000
value: true
Entry 20 - fullUrl = http://example.org/fhir/Observation/observation-us-ph-lab-result-eve-everywoman-lymphocytes
Resource Observation:
Generated Narrative: Observation observation-us-ph-lab-result-eve-everywoman-lymphocytes
status: Final
category: Laboratory
code: Lymphocytes [#/volume] in Blood by Automated count
subject: Eve Everywoman
effective: 2018-03-07
value: 5.2 10*3/uL (Details: UCUM code10*3/uL = '10*3/uL')
interpretation: High
ReferenceRanges
Low High 1 10*3/uL (Details: UCUM code10*3/uL = '10*3/uL') 4.8 10*3/uL (Details: UCUM code10*3/uL = '10*3/uL') Entry 21 - fullUrl = http://example.org/fhir/Organization/organization-ecr-acme-laboratory
Resource Organization:
Generated Narrative: Organization organization-ecr-acme-laboratory
version: 4; Last updated: 2021-06-30 04:13:19+0000;
Information Source: #xp7CXcY2lPaNsDQL
Profile: US Public Health Organization
identifier:
http://hl7.org.fhir/sid/us-npi
/1144221999active: true
type: outpatient laboratory
name: Acme_Labs
contact
telecom: +1-555-555-4444, mail@acme-labs.com
address: 7777 Laboratory Drive Ann Arbor MI 99999
Entry 22 - fullUrl = http://example.org/fhir/Location/location-ecr-salem-medical-center
Resource Location:
Generated Narrative: Location location-ecr-salem-medical-center
version: 6; Last updated: 2021-08-17 07:53:02+0000;
Information Source: #VI2Nm5Ps5HqZ5HXV
Profile: US Public Health Location
identifier:
http://hl7.org.fhir/sid/us-npi
/1144221995status: Active
name: Clinic Bldg A, Salem Medical Center
type: Hospital
address: Clinic Bldg A 4444 Healthcare Drive Ann Arbor MI 99999
managingOrganization: Organization Salem Medical Center
Entry 23 - fullUrl = http://example.org/fhir/Location/location-ecr-city-football-stadium
Resource Location:
Generated Narrative: Location location-ecr-city-football-stadium
version: 1; Last updated: 2020-12-01 01:55:32+0000;
Information Source: #KLUFk4w6CXKqrFEC
Profile: US Core Location Profile
status: Active
name: City Football Stadium
type: City Football Stadium
address: 99 Football Stadium Road My City AZ 8562
Entry 24 - fullUrl = http://example.org/fhir/Organization/organization-ecr-salem-medical-center
Resource Organization:
Generated Narrative: Organization organization-ecr-salem-medical-center
version: 5; Last updated: 2021-06-30 04:13:19+0000;
Information Source: #xa4yJZjn68xVavoM
Profile: US Public Health Organization
identifier:
http://hl7.org.fhir/sid/us-npi
/55555555active: true
name: Salem Medical Center
contact
telecom: +1-555-555-1111, mail@salemmedicalcenter.com
address: 22222 Health Authority Drive Ann Arbor MI 99999
Entry 25 - fullUrl = http://example.org/fhir/Condition/condition-eicr-eve-everywoman-zika
Resource Condition:
Generated Narrative: Condition condition-eicr-eve-everywoman-zika
version: 5; Last updated: 2021-07-15 01:54:14+0000;
Information Source: #rM2Pw6getjoE2UTV
category: Encounter Diagnosis
code: Zika virus disease (disorder)
subject: Eve Everywoman
onset: 2017-08-23
Entry 26 - fullUrl = http://example.org/fhir/Practitioner/practitioner-us-core-henry-seven
Resource Practitioner:
Generated Narrative: Practitioner practitioner-us-core-henry-seven
version: 5; Last updated: 2021-08-17 08:00:32+0000;
Information Source: #2MfA6kIjmOmtAlIb
Profile: US Core Practitioner Profile
identifier: United States National Provider Identifier/9941339108
name: Seven Henry
telecom: henry.seven@example.com
address: BMass Doctors 2100 North Ave Burlington MA 02368 US
Entry 27 - fullUrl = http://example.org/fhir/Device/device-ecmo
Resource Device:
Manually Created Narrative
UDI
Device Identifier: 99863313444317
CarrierHRF: (01)99863313444316(17)220101(10)M320(21)AC222
EntryType: rfid
Name: ACME Extracorporeal membrane oxygenator
Type: udi-label-name
status: active
manufacturer: ACME Biomedical
expirationDate: 2024-01-01
lotNumber: M321
serialNumber: AC222
modelNumber: 4.0
Entry 3 - fullUrl = http://example.org/fhir/Device/device-ecr-software-ymca
Resource Device:
id: device-ecr-software-ymcameta:
4 2019-10-03T05:07:48.000-04:00identifier:
goodhealth_idmanufacturer: Acme Devices, Inctype: EHRversion:
value: 10.23-23423contact:
url http://acme.comurl: http://acme.com/ymca/software/
Entry 4 - fullUrl = http://example.org/fhir/Organization/organization-ecr-salem-medical-center
Resource Organization:
id organization-ecr-salem-medical-centermeta
versionId 16lastUpdated 2019-10-05T03:15:41.000-04:00profile http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-organizationidentifier
55555555active truetype
Outpatient facility(OF)name Salem Medical Centertelecom
system phonevalue +1-555-555-1111telecom
system value mail@salemmedicalcenter.comaddress
line 22222 Health Authority Drivecity Ann Arborstate MIpostalCode 99999