mcode-patient-bundle-jenny-m - minimal Common Oncology Data Elements (mCODE) Implementation Guide v4.0.0-ballot

minimal Common Oncology Data Elements (mCODE) Implementation Guide, published by HL7 International / Clinical Interoperability Council. This guide is not an authorized publication; it is the continuous build for version 4.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-mCODE-ig/ and changes regularly. See the Directory of published versions

Example Bundle: mcode-patient-bundle-jenny-m

Generated Narrative: Bundle mcode-patient-bundle-jenny-m

Bundle mcode-patient-bundle-jenny-m of type collection

Entry 1 - fullUrl = http://example.org/fhir/Patient/cancer-patient-jenny-m

Resource Patient:

Generated Narrative: Patient cancer-patient-jenny-m

Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
Contact Detail 123 Main St Anytown 12345 United States
Language: English
Contact:
ph: 555-867-5309(Home)
example@example.com
US Core Ethnicity Extension:
ombCategory: CDC Race and Ethnicity 2186-5: Not Hispanic or Latino
text: Not Hispanic or Latino
US Core Birth Sex Extension F
US Core Race Extension:
ombCategory: CDC Race and Ethnicity 2106-3: White
text: White

Entry 2 - fullUrl = http://example.org/fhir/Condition/primary-cancer-condition-jenny-m

Resource Condition:

Generated Narrative: Condition primary-cancer-condition-jenny-m

Histology-Morphology-Behavior Extension: Infiltrating duct carcinoma (morphologic abnormality)
clinicalStatus: Remission
verificationStatus: Confirmed
category: Problem List Item
code: Primary malignant neoplasm of female left breast (disorder)
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
onset: 2018-03-16
asserter: Practitioner Owen Oncologist
Stages
- Summary Assessment Type
* American Joint Committee on Cancer stage IIIC (qualifier value) Observation Clinical TNM stage grouping American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)

Entry 3 - fullUrl = http://example.org/fhir/MedicationRequest/cancer-related-medication-request-cyclophosphamide-jenny-m

Resource MedicationRequest:

Generated Narrative: MedicationRequest cancer-related-medication-request-cyclophosphamide-jenny-m

Procedure Intent Extension: Curative - procedure intent (qualifier value)
status: Active
intent: Order
category: Outpatient
medication: cyclophosphamide
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
authoredOn: 2018-04-12
requester: Practitioner Owen Oncologist
reasonReference: Condition Primary malignant neoplasm of female left breast (disorder)
dosageInstruction
text: cyclophosphamide (600 mg/m² IV), 932.59mg
timing: Once
route: Intravenous route (qualifier value)
DoseAndRates
- Dose[x]
* 932.59 mg (Details: UCUM codemg = 'mg')
maxDosePerPeriod: 1/3 week (Details: UCUM codewk = 'wk')

Entry 4 - fullUrl = http://example.org/fhir/MedicationRequest/cancer-related-medication-request-doxorubicin-jenny-m

Resource MedicationRequest:

Generated Narrative: MedicationRequest cancer-related-medication-request-doxorubicin-jenny-m

Procedure Intent Extension: Curative - procedure intent (qualifier value)
status: Active
intent: Order
category: Outpatient
medication: DOXOrubicin
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
authoredOn: 2018-04-12
requester: Practitioner Owen Oncologist
reasonReference: Condition Primary malignant neoplasm of female left breast (disorder)
dosageInstruction
text: doxorubicin (60 mg/m² IV)
timing: Once
route: Intravenous route (qualifier value)
DoseAndRates
- Rate[x]
* 60 mg/m2 (Details: UCUM codemg/m2 = 'mg/m2')
maxDosePerPeriod: 1/3 week (Details: UCUM codewk = 'wk')

Entry 5 - fullUrl = http://example.org/fhir/MedicationRequest/cancer-related-medication-request-paclitaxel-jenny-m

Resource MedicationRequest:

Generated Narrative: MedicationRequest cancer-related-medication-request-paclitaxel-jenny-m

Procedure Intent Extension: Curative - procedure intent (qualifier value)
status: Active
intent: Order
category: Outpatient
medication: PACLitaxel
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
authoredOn: 2018-04-12
requester: Practitioner Owen Oncologist
reasonReference: Condition Primary malignant neoplasm of female left breast (disorder)
dosageInstruction
text: PACLitaxel (175 mg/m² IV), 272.01mg
timing: Once
route: Intravenous route (qualifier value)
DoseAndRates
- Dose[x]
* 272.01 mg (Details: UCUM codemg = 'mg')
maxDosePerPeriod: 1/3 week (Details: UCUM codewk = 'wk')

Entry 6 - fullUrl = http://example.org/fhir/MedicationRequest/cancer-related-medication-request-anastrozole-jenny-m

Resource MedicationRequest:

Generated Narrative: MedicationRequest cancer-related-medication-request-anastrozole-jenny-m

Procedure Intent Extension: Curative - procedure intent (qualifier value)
status: Active
intent: Order
category: Community
medication: anastrozole
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
authoredOn: 2018-09-30
requester: Practitioner Owen Oncologist
reasonReference: Condition Primary malignant neoplasm of female left breast (disorder)
dosageInstruction
text: 1mg orally once daily
timing: Once
route: Oral route (qualifier value)
DoseAndRates
- Dose[x]
* 1 mg (Details: UCUM codemg = 'mg')
maxDosePerPeriod: 1/1 day (Details: UCUM coded = 'd')

Entry 7 - fullUrl = http://example.org/fhir/Observation/cancer-disease-status-jenny-m

Resource Observation:

Generated Narrative: Observation cancer-disease-status-jenny-m

Cancer Disease Status Evidence Type Extension: Imaging (procedure)
status: Final
code: Cancer Disease Progression
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
focus: Condition Primary malignant neoplasm of female left breast (disorder)
effective: 2018-11-01
performer: Practitioner Owen Oncologist
value: Patient's condition improved (finding)

Entry 8 - fullUrl = http://example.org/fhir/Observation/genomic-variant-jenny-m

Resource Observation:

Generated Narrative: Observation genomic-variant-jenny-m

status: Final
category: Laboratory
code: Genetic variant assessment
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-03-15
performer: Practitioner Owen Oncologist
value: Present
method: Sequencing
component
code: Gene studied [ID]
value: PALB2
component
code: Discrete genetic variant
value: NM_024675.3(PALB2):c.3549C>A (p.Tyr1183Ter)
component
code: Genomic DNA change (gHGVS)
value: NC_000016.10:g.23603471G>T
component
code: Genomic source class [Type]
value: Somatic

Entry 9 - fullUrl = http://example.org/fhir/DiagnosticReport/genomics-report-jenny-m

Resource DiagnosticReport:

Generated Narrative: DiagnosticReport genomics-report-jenny-m

Genetic analysis report (Genetics)
Subject Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
When For 2018-03-15
Reported 2020-03-15 00:00:01+0000
Performer Practitioner Owen Oncologist
Report Details
Code Value Flags Reported
Genetic variant assessment Present Final
DNA region of interest panel Final 2018-03-15 00:00:01+0000

Entry 10 - fullUrl = http://example.org/fhir/Procedure/cancer-related-surgical-procedure-jenny-m

Resource Procedure:

Generated Narrative: Procedure cancer-related-surgical-procedure-jenny-m

Procedure Intent Extension: Curative - procedure intent (qualifier value)
status: Completed
code: Excision of part of breast (procedure)
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
performed: 2018-04-01
asserter: Practitioner Owen Oncologist
reasonReference: Condition Primary malignant neoplasm of female left breast (disorder)
bodySite: Left breast structure (body structure)

Entry 11 - fullUrl = http://example.org/fhir/Observation/cancer-related-comorbidities-jenny-m

Resource Observation:

Generated Narrative: Observation cancer-related-comorbidities-jenny-m

Related Condition Extension: Condition Depressive disorder (disorder)
Related Condition Extension: Condition Anxiety (finding)
Related Condition Extension: Condition Benign hypertensive heart disease without congestive heart failure (disorder)
Related Condition Absent Extension: Obesity (disorder)
Related Condition Absent Extension: Disorder of lung (disorder)
status: Final
category: Social History
code: Co-morbid conditions (finding)
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
focus: Condition Primary malignant neoplasm of female left breast (disorder)
effective: 2018-03-16
performer: Practitioner Owen Oncologist

Entry 12 - fullUrl = http://example.org/fhir/Procedure/radiotherapy-treatment-summary-chest-wall-jenny-m

Resource Procedure:

Generated Narrative: Procedure radiotherapy-treatment-summary-chest-wall-jenny-m

Radiotherapy Number of Sessions Extension: 31
Procedure Intent Extension: Curative - procedure intent
Radiotherapy Modality And Technique Extension
http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality: External beam radiation therapy using photons (procedure)
http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique: Volumetric Modulated Arc Therapy (procedure)
Radiotherapy Modality And Technique Extension
http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality: Teleradiotherapy using electrons
http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique: Three dimensional external beam radiation therapy (procedure)
Radiotherapy Dose Delivered To Volume Extension
volume: BodyStructure: identifier = 1.2.246.352…1 (use: usual, ); location = Chest wall structure (body structure); locationQualifier = Entire (qualifier value); description = Chest Wall
totalDoseDelivered: 6000 cGy (Details: UCUM codecGy = 'cGy')
fractionsDelivered: 30
Radiotherapy Dose Delivered To Volume Extension
volume: BodyStructure: identifier = 1.2.246.352…2 (use: usual, ); location = Mediastinal lymph node structure (body structure); locationQualifier = Right and left (qualifier value); description = Chest Wall Lymph Nodes
totalDoseDelivered: 5000 cGy (Details: UCUM codecGy = 'cGy')
fractionsDelivered: 25
status: Completed
code: Radiotherapy course of treatment
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
performed: 2018-08-15 --> 2018-10-25
asserter: Practitioner Kyle Anydoc
reasonCode: Malignant neoplasm of overlapping sites of right female breast
bodySite: Chest Wall Structure (body structure)

Entry 13 - fullUrl = http://example.org/fhir/Observation/tnm-clinical-stage-group-jenny-m

Resource Observation:

Generated Narrative: Observation tnm-clinical-stage-group-jenny-m

status: Final
category: Imaging
code: Clinical TNM stage grouping
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
focus: Condition Primary malignant neoplasm of female left breast (disorder)
effective: 2018-03-16
performer: Practitioner Owen Oncologist
value: American Joint Committee on Cancer stage IIB (qualifier value)
method: American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)
hasMember:
Observation pT category
Observation pN category
Observation pM category

Entry 14 - fullUrl = http://example.org/fhir/Observation/tnm-clinical-primary-tumor-category-jenny-m

Resource Observation:

Generated Narrative: Observation tnm-clinical-primary-tumor-category-jenny-m

status: Final
category: Imaging
code: cT category
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-03-16
performer: Practitioner Owen Oncologist
value: American Joint Committee on Cancer cT3 (qualifier value)
method: American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)

Entry 15 - fullUrl = http://example.org/fhir/Observation/tnm-clinical-regional-nodes-category-jenny-m

Resource Observation:

Generated Narrative: Observation tnm-clinical-regional-nodes-category-jenny-m

status: Final
category: Imaging
code: cN category
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-03-16
performer: Practitioner Owen Oncologist
value: American Joint Committee on Cancer cN0 (qualifier value)
method: American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)

Entry 16 - fullUrl = http://example.org/fhir/Observation/tnm-clinical-distant-metastases-category-jenny-m

Resource Observation:

Generated Narrative: Observation tnm-clinical-distant-metastases-category-jenny-m

status: Final
category: Imaging
code: cM category
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-03-16
performer: Practitioner Owen Oncologist
value: American Joint Committee on Cancer cM0 (qualifier value)
method: American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)

Entry 17 - fullUrl = http://example.org/fhir/Specimen/human-specimen-left-breast-jenny-m

Resource Specimen:

Generated Narrative: Specimen human-specimen-left-breast-jenny-m

status: Available
type: Tissue
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
Collections
- Collector BodySite
* Practitioner Owen Oncologist Left breast structure (body structure)
Processings
- Time[x]
* 2018-03-06

Entry 18 - fullUrl = http://example.org/fhir/Observation/genomic-region-studied-jenny-m

Resource Observation:

Generated Narrative: Observation genomic-region-studied-jenny-m

status: Final
category: Laboratory
code: DNA region of interest panel
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-03-15
issued: 2018-03-15 00:00:01+0000
performer: Practitioner Owen Oncologist
Components
- Code Value[x]
* Gene studied [ID] BRCA1

Entry 19 - fullUrl = http://example.org/fhir/Observation/ecog-performance-status-jenny-m

Resource Observation:

Generated Narrative: Observation ecog-performance-status-jenny-m

status: Final
category: Survey
code: ECOG Performance Status score
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-04-12
performer: Practitioner Owen Oncologist
value: 0
interpretation: Fully active, able to carry on all pre-disease performance without restriction
method: Physical examination procedure (procedure)

Entry 20 - fullUrl = http://example.org/fhir/Observation/tumor-marker-test-er-jenny-m

Resource Observation:

Generated Narrative: Observation tumor-marker-test-er-jenny-m

status: Final
category: Laboratory
code: Estrogen receptor Ag [Presence] in Breast cancer specimen by Immune stain
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-03-10
performer: Practitioner Owen Oncologist
value: Positive

Entry 21 - fullUrl = http://example.org/fhir/Observation/tumor-marker-test-pr-jenny-m

Resource Observation:

Generated Narrative: Observation tumor-marker-test-pr-jenny-m

status: Final
category: Laboratory
code: Progesterone receptor Ag [Presence] in Breast cancer specimen by Immune stain
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-03-10
performer: Practitioner Owen Oncologist
value: Negative

Entry 22 - fullUrl = http://example.org/fhir/Observation/tumor-marker-test-her2-jenny-m

Resource Observation:

Generated Narrative: Observation tumor-marker-test-her2-jenny-m

status: Final
category: Laboratory
code: HER2 [Interpretation] in Tissue
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-03-10
performer: Practitioner Owen Oncologist
value: Negative

Entry 23 - fullUrl = http://example.org/fhir/Observation/tumor-marker-test-oncotype-dx-jenny-m

Resource Observation:

Generated Narrative: Observation tumor-marker-test-oncotype-dx-jenny-m

status: Final
category: Laboratory
code: Oncotype DX Breast Recurrence Score Assay
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-04-12
performer: Organization Bedrock Medicine
value: 47 Recurrence score (Details: UCUM code1 = '1')
interpretation: High

Entry 24 - fullUrl = http://example.org/fhir/Observation/tumor-size-jenny-m

Resource Observation:

Generated Narrative: Observation tumor-size-jenny-m

status: Final
category: Laboratory
code: Size Tumor
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-04-01 00:00:00+0000
performer: Practitioner Owen Oncologist
method: Gross examination and sampling of tissue specimen (procedure)
specimen: Specimen: identifier = BodyStructure (use: usual, ); status = available; type = Tumor; receivedTime = 2018-04-01
Components
- Code Value[x]
* Size.maximum dimension in Tumor 2.5 centimeters (Details: UCUM codecm = 'cm')

Entry 25 - fullUrl = http://example.org/fhir/Procedure/us-core-procedure-biopsy-jenny-m

Resource Procedure:

Generated Narrative: Procedure us-core-procedure-biopsy-jenny-m

status: Completed
code: Biopsy of breast using ultrasonographic guidance (procedure)
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
performed: 2018-03-06
asserter: Practitioner Mary Obgyn
Performers
- Actor
* Practitioner Mary Obgyn
reasonReference: Condition Primary malignant neoplasm of female left breast (disorder)
bodySite: Left breast structure (body structure)

Entry 26 - fullUrl = http://example.org/fhir/Observation/bodyweight-jenny-m-2018-03-16

Resource Observation:

Generated Narrative: Observation bodyweight-jenny-m-2018-03-16

status: Final
category: Vital Signs
code: Body weight
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-03-06
performer: Practitioner Owen Oncologist
value: 155 lb (Details: UCUM code[lb_av] = '[lb_av]')

Entry 27 - fullUrl = http://example.org/fhir/Observation/us-core-observation-lab-neutrophils-jenny-m

Resource Observation:

Generated Narrative: Observation us-core-observation-lab-neutrophils-jenny-m

status: Final
category: Laboratory
code: Neutrophils [#/volume] in Blood
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-05-20 00:00:00+0000
performer: Practitioner Owen Oncologist
value: 3000 10*3/uL (Details: UCUM code10*3/uL = '10*3/uL')
ReferenceRanges
- Low High Type
* 2500 10*3/uL (Details: UCUM code10*3/uL = '10*3/uL') 5000 10*3/uL (Details: UCUM code10*3/uL = '10*3/uL') Normal Range

Entry 28 - fullUrl = http://example.org/fhir/Organization/us-core-organization-physician-services-inc

Resource Organization:

Generated Narrative: Organization us-core-organization-physician-services-inc

active: true
type: Healthcare Provider
name: Physician Services, Inc.
telecom: ph: 999-999-9999(Work)
address: 123 Corporate Drive Anytown MA 12345 US

Entry 29 - fullUrl = http://example.org/fhir/Observation/us-core-smokingstatus-jenny-m

Resource Observation:

Generated Narrative: Observation us-core-smokingstatus-jenny-m

status: Final
category: Social History
code: Tobacco smoking status
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-03-16
issued: 2018-03-16 00:00:00+0000
performer: Practitioner Owen Oncologist
value: Smokes tobacco daily (finding)

Entry 30 - fullUrl = http://example.org/fhir/Procedure/us-core-procedure-mammogram-jenny-m

Resource Procedure:

Generated Narrative: Procedure us-core-procedure-mammogram-jenny-m

status: Completed
code: Mammography (procedure)
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
performed: 2018-02-01
asserter: Practitioner Mary Obgyn
Performers
- Actor
* Practitioner Jane Radiologist
reasonCode: Screening - procedure intent (qualifier value)

Entry 31 - fullUrl = http://example.org/fhir/FamilyMemberHistory/family-member-history-aunt-jenny-m

Resource FamilyMemberHistory:

Generated Narrative: FamilyMemberHistory family-member-history-aunt-jenny-m

status: Completed
patient: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
relationship: maternal aunt
Conditions
- Code Onset[x]
* Malignant tumor of ovary (disorder) 69 a (Details: UCUM codea = 'a')

Entry 32 - fullUrl = http://example.org/fhir/FamilyMemberHistory/family-member-history-uncle-jenny-m

Resource FamilyMemberHistory:

Generated Narrative: FamilyMemberHistory family-member-history-uncle-jenny-m

status: Completed
patient: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
relationship: paternal uncle
deceased: true
Conditions
- Code ContributedToDeath
* Malignant tumor of pancreas (disorder) true

Entry 33 - fullUrl = http://example.org/fhir/DiagnosticReport/us-core-diagnosticreport-lab-jenny-m

Resource DiagnosticReport:

Generated Narrative: DiagnosticReport us-core-diagnosticreport-lab-jenny-m

Pathology report final diagnosis Narrative (Laboratory)
Subject Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
When For 2018-04-01 00:00:00+0000
Reported 2018-04-05 00:00:00+0000
Performer Practitioner Owen Oncologist
Report Details
Code Value Flags When For
Status of invasion by tumor Negative (qualifier value) Final
Margin involvement in Breast tumor Uninvolved by invasive carcinoma Final
Sentinel lymph nodes with metastasis [#] in Cancer specimen Final
Size Tumor Final
DCIS intraductal extension in Breast cancer specimen Qualitative by Light microscopy DCIS present with extensive intraductal component (EIC) Final
HER2 [Interpretation] in Tissue Negative Final 2018-03-10
Estrogen receptor Ag [Presence] in Breast cancer specimen by Immune stain Positive Final 2018-03-10
Progesterone receptor Ag [Presence] in Breast cancer specimen by Immune stain Negative Final 2018-03-10
Histologic grade [Score] in Breast cancer specimen by Nottingham Nottingham grade 2 Final

Entry 34 - fullUrl = http://example.org/fhir/Observation/observation-smoking-pack-years-jenny-m

Resource Observation:

Generated Narrative: Observation observation-smoking-pack-years-jenny-m

status: Final
category: Social History
code: Cigarette pack-years (observable entity)
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-03-16
performer: Practitioner Owen Oncologist
value: 20 Pack-Years (Details: UCUM code1 = '1')

Entry 35 - fullUrl = http://example.org/fhir/Observation/us-core-observation-lab-tumor-invasion-jenny-m

Resource Observation:

Generated Narrative: Observation us-core-observation-lab-tumor-invasion-jenny-m

status: Final
category: Laboratory
code: Status of invasion by tumor
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-04-01 00:00:00+0000
performer: Practitioner Owen Oncologist
value: Negative (qualifier value)
specimen: Specimen: identifier = BodyStructure (use: usual, ); status = available; type = Tumor; receivedTime = 2018-04-01

Entry 36 - fullUrl = http://example.org/fhir/Observation/us-core-observation-lab-tumor-margins-jenny-m

Resource Observation:

Generated Narrative: Observation us-core-observation-lab-tumor-margins-jenny-m

status: Final
category: Laboratory
code: Margin involvement in Breast tumor
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-04-01 00:00:00+0000
performer: Practitioner Owen Oncologist
value: Uninvolved by invasive carcinoma
specimen: Specimen: identifier = BodyStructure (use: usual, ); status = available; type = Tumor; receivedTime = 2018-04-01

Entry 37 - fullUrl = http://example.org/fhir/Observation/us-core-observation-lab-sentinel-nodes-jenny-m

Resource Observation:

Generated Narrative: Observation us-core-observation-lab-sentinel-nodes-jenny-m

status: Final
category: Laboratory
code: Sentinel lymph nodes with metastasis [#] in Cancer specimen
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-04-01 00:00:00+0000
performer: Practitioner Owen Oncologist
specimen: Specimen: identifier = BodyStructure (use: usual, ); status = available; type = Tumor; receivedTime = 2018-04-01
Components
- Code Value[x]
* Lymph nodes examined [#] in Cancer specimen by Light microscopy 3 Count (Details: UCUM code1 = '1')

Entry 38 - fullUrl = http://example.org/fhir/Observation/us-core-observation-lab-tumor-dcis-jenny-m

Resource Observation:

Generated Narrative: Observation us-core-observation-lab-tumor-dcis-jenny-m

status: Final
category: Laboratory
code: DCIS intraductal extension in Breast cancer specimen Qualitative by Light microscopy
subject: Jenny M Female, DoB: 1965-01-01 ( Medical Record Number: MRN1234 (use: usual, ))
effective: 2018-04-01 00:00:00+0000
performer: Practitioner Owen Oncologist
value: DCIS present with extensive intraductal component (EIC)
specimen: Specimen: identifier = BodyStructure (use: usual, ); status = available; type = Tumor; receivedTime = 2018-04-01

Entry 39 - fullUrl = http://example.org/fhir/Practitioner/us-core-practitioner-owen-oncologist

Resource Practitioner:

Generated Narrative: Practitioner us-core-practitioner-owen-oncologist

identifier: NPI/9988776651
name: Owen Oncologist
address: 123 Corporate Drive Anytown MA 12345 US (work)
gender: Male
Qualifications
- Code
* Doctor of Medicine

Entry 40 - fullUrl = http://example.org/fhir/Practitioner/us-core-practitioner-peter-pathologist

Resource Practitioner:

Generated Narrative: Practitioner us-core-practitioner-peter-pathologist

identifier: NPI/1122334455
name: Peter Pathologist
address: 123 Corporate Drive Anytown MA 12345 US (work)
gender: Female
Qualifications
- Code
* Doctor of Medicine