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 <td style="background-color: #f3f5da" title="Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The ethnicity codes used to represent these concepts are based upon the [CDC ethnicity and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity. The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories: - Hispanic or Latino - Not Hispanic or Latino.">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 <td style="background-color: #f3f5da" title="Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html#3) which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories: - American Indian or Alaska Native - Asian - Black or African American - Native Hawaiian or Other Pacific Islander - White.">US Core Race Extension: ombCategory: CDC Race and Ethnicity 2106-3: White text: White
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)
Infiltrating duct carcinoma (morphologic abnormality)
Primary malignant neoplasm of female left breast (disorder)
American Joint Committee on Cancer stage IIIC (qualifier value)
American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)
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')
Curative - procedure intent (qualifier value)
cyclophosphamide (600 mg/m² IV), 932.59mg
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')
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')
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')
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)
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: T}">NC_000016.10:g.23603471G>T component code: Genomic source class [Type] value: Somatic
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
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)
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
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)
External beam radiation therapy using photons (procedure)
Volumetric Modulated Arc Therapy (procedure)
Three dimensional external beam radiation therapy (procedure)
Malignant neoplasm of overlapping sites of right female breast
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
American Joint Committee on Cancer stage IIB (qualifier value)
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)
American Joint Committee on Cancer cT3 (qualifier value)
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)
American Joint Committee on Cancer cN0 (qualifier value)
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)
American Joint Committee on Cancer cM0 (qualifier value)
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
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
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)
Fully active, able to carry on all pre-disease performance without restriction
Physical examination procedure (procedure)
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
Estrogen receptor Ag [Presence] in Breast cancer specimen by Immune stain
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
Progesterone receptor Ag [Presence] in Breast cancer specimen by Immune stain
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
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
Oncotype DX Breast Recurrence Score Assay
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')
Gross examination and sampling of tissue specimen (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)
Biopsy of breast using ultrasonographic guidance (procedure)
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]')
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
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
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)
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)
Screening - procedure intent (qualifier value)
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')
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
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
Pathology report final diagnosis Narrative
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')
Cigarette pack-years (observable entity)
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
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
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')
Sentinel lymph nodes with metastasis [#] in Cancer specimen
Lymph nodes examined [#] in Cancer specimen by Light microscopy
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
DCIS intraductal extension in Breast cancer specimen Qualitative by Light microscopy
DCIS present with extensive intraductal component (EIC)
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
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