Da Vinci Payer Data Exchange
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Da Vinci Payer Data Exchange, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

: Treatment Attestation Example 1 - JSON Representation

Page standards status: Informative

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{
  "resourceType" : "Consent",
  "id" : "treatment-attestation-ex1",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/provider-treatment-relationship-consent"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Consent treatment-attestation-ex1</b></p><a name=\"treatment-attestation-ex1\"> </a><a name=\"hctreatment-attestation-ex1\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-provider-treatment-relationship-consent.html\">Provider Attestation to Treatment Relationship</a></p></div><p><b>status</b>: Active</p><p><b>scope</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/consentscope treatment}\">Treatment</span></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/consentcategorycodes treat}\">Treatment</span>, <span title=\"Codes:{http://loinc.org 64292-6}\">Release of information consent</span></p><p><b>patient</b>: <a href=\"https://simplifier.net/resolve?scope=hl7.fhir.us.core.3.1.1@3.1.1&amp;canonical=http://hl7.org/fhir/us/core/Patient/patient-prov-001\">Patient/patient-prov-001</a></p><p><b>dateTime</b>: 2024-12-10 14:30:00+0000</p><p><b>performer</b>: <a href=\"https://simplifier.net/resolve?scope=hl7.fhir.us.core.3.1.1@3.1.1&amp;canonical=http://hl7.org/fhir/us/core/Practitioner/provider-001\">Dr. Susan Smith, MD</a></p><p><b>organization</b>: <a href=\"https://simplifier.net/resolve?scope=hl7.fhir.us.core.3.1.1@3.1.1&amp;canonical=http://hl7.org/fhir/us/core/Organization/provider-org-001\">Springfield Medical Center</a></p><p><b>source</b>: <a href=\"https://simplifier.net/resolve?scope=hl7.fhir.us.core.3.1.1@3.1.1&amp;canonical=http://hl7.org/fhir/us/core/DocumentReference/treatment-attestation-form-001\">Provider Attestation Form</a></p><h3>Policies</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Authority</b></td><td><b>Uri</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"https://simplifier.net/resolve?scope=hl7.fhir.us.core.3.1.1@3.1.1&amp;canonical=https://example.org/compliance\">https://example.org/compliance</a></td><td><a href=\"https://simplifier.net/resolve?scope=hl7.fhir.us.core.3.1.1@3.1.1&amp;canonical=https://example.org/provider-attestation-policy\">https://example.org/provider-attestation-policy</a></td></tr></table><blockquote><p><b>provision</b></p><p><b>type</b>: Opt In</p><p><b>period</b>: 2024-01-15 --&gt; (ongoing)</p><h3>Actors</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Role</b></td><td><b>Reference</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ParticipationType IRCP}\">information recipient</span></td><td><a href=\"https://simplifier.net/resolve?scope=hl7.fhir.us.core.3.1.1@3.1.1&amp;canonical=http://hl7.org/fhir/us/core/Practitioner/provider-001\">Dr. Susan Smith</a></td></tr></table><p><b>purpose</b>: <a href=\"http://terminology.hl7.org/6.3.0/CodeSystem-v3-ActReason.html#v3-ActReason-TREATMENT\">ActReason: TREATMENT</a> (Treatment)</p></blockquote></div>"
  },
  "status" : "active",
  "scope" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/consentscope",
        "code" : "treatment"
      }
    ]
  },
  "category" : [
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/consentcategorycodes",
          "code" : "treat",
          "display" : "Treatment"
        }
      ]
    },
    {
      "coding" : [
        {
          "system" : "http://loinc.org",
          "code" : "64292-6",
          "display" : "Release of information consent"
        }
      ]
    }
  ],
  "patient" : {
    "reference" : "Patient/patient-prov-001"
  },
  "dateTime" : "2024-12-10T14:30:00Z",
  "performer" : [
    {
      "reference" : "Practitioner/provider-001",
      "display" : "Dr. Susan Smith, MD"
    }
  ],
  "organization" : [
    {
      "reference" : "Organization/provider-org-001",
      "display" : "Springfield Medical Center"
    }
  ],
  "sourceReference" : {
    "reference" : "DocumentReference/treatment-attestation-form-001",
    "display" : "Provider Attestation Form"
  },
  "policy" : [
    {
      "authority" : "https://example.org/compliance",
      "uri" : "https://example.org/provider-attestation-policy"
    }
  ],
  "provision" : {
    "type" : "permit",
    "period" : {
      "start" : "2024-01-15"
    },
    "actor" : [
      {
        "role" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
              "code" : "IRCP",
              "display" : "information recipient"
            }
          ]
        },
        "reference" : {
          "reference" : "Practitioner/provider-001",
          "display" : "Dr. Susan Smith"
        }
      }
    ],
    "purpose" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
        "code" : "TREATMENT",
        "display" : "Treatment"
      }
    ]
  }
}