PACIO Advance Directive Interoperability Implementation Guide
2.1.0 - STU 2
PACIO Advance Directive Interoperability Implementation Guide
2.1.0 - STU 2
PACIO Advance Directive Interoperability Implementation Guide, published by HL7 International / Patient Empowerment. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-pacio-adi/ and changes regularly. See the Directory of published versions
<Bundle xmlns="http://hl7.org/fhir">
<id value="PMO-Example-Smith-Johnson-Bundle2"/>
<identifier>
<system value="urn:oid:2.16.840.1.113883.3.3208.101.1"/>
</identifier>
<type value="document"/>
<timestamp value="2024-03-29T14:25:34.001-05:00"/>
<entry>
<fullUrl
value="http://www.example.org/fhir/Composition/PMO-Example-Smith-Johnson-PMOComposition1"/>
<resource>
<Composition>
<id value="PMO-Example-Smith-Johnson-PMOComposition1"/>
<meta>
<profile
value="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOComposition"/>
</meta>
<language value="en-US"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en-US" lang="en-US"><a name="Composition_PMO-Example-Smith-Johnson-PMOComposition1"> </a><p class="res-header-id"><b>Generated Narrative: Composition PMO-Example-Smith-Johnson-PMOComposition1</b></p><a name="PMO-Example-Smith-Johnson-PMOComposition1"> </a><a name="hcPMO-Example-Smith-Johnson-PMOComposition1"> </a><a name="PMO-Example-Smith-Johnson-PMOComposition1-en-US"> </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">Language: en-US</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-ADI-PMOComposition.html">ADI PMO Composition</a></p></div><p><b>Composition Version Number</b>: 11546d53-a054-4882-bc0a-ff02aa0ba887c</p><p><b>Jurisdiction</b>: <span title="Codes:{urn:iso:std:iso:3166:-2 US-MI}">Michigan (United States)</span></p><p><b>Data Enterer</b>: <a href="Patient-Example-Smith-Johnson-Patient1.html">Smith-Johnson, Betsy Female, DoB: 1950-11-15 ( http://hl7.org/fhir/sid/us-medicare#United States Medicare Number#10A3D58WH1600)</a></p><p><b>Effective Date</b>: 2024-03-29 14:25:34-0500 --> (ongoing)</p><p><b>identifier</b>: <code>urn:oid:2.16.840.1.113883.4.823.1.7124</code>/0-87f37989294a408897aacd1fc5d8fd16</p><p><b>status</b>: Final</p><p><b>type</b>: <span title="Codes:{http://loinc.org 93037-0}">Portable medical order form</span></p><p><b>category</b>: <span title="Codes:{http://loinc.org 42348-3}">Advance directives</span></p><p><b>date</b>: 2024-03-29 14:25:34-0500</p><p><b>author</b>: <a href="PractitionerRole-Example-Kyle-Anydoc-PractitionerRole1.html">PractitionerRole</a></p><p><b>title</b>: Portable Medical Order</p><p><b>custodian</b>: <a href="Organization-Example-Smith-Johnson-OrganizationCustodian1.html">Organization MyDirectives.com</a></p></div>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber">
<valueString value="11546d53-a054-4882-bc0a-ff02aa0ba887c"/>
</extension>
<extension
url="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-jurisdiction-extension">
<valueCodeableConcept>
<coding>
<system value="urn:iso:std:iso:3166:-2"/>
<code value="US-MI"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension">
<valueReference>🔗
<reference value="Patient/Example-Smith-Johnson-Patient1"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-effective-date-extension">
<valuePeriod>
<start value="2024-03-29T14:25:34-05:00"/>
</valuePeriod>
</extension>
<identifier>
<system value="urn:oid:2.16.840.1.113883.4.823.1.7124"/>
<value value="0-87f37989294a408897aacd1fc5d8fd16"/>
</identifier>
<status value="final"/>
<type>
<coding>
<system value="http://loinc.org"/>
<code value="93037-0"/>
<display value="Portable medical order form"/>
</coding>
</type>
<category>
<coding>
<system value="http://loinc.org"/>
<code value="42348-3"/>
<display value="Advance directives"/>
</coding>
</category>
<subject>🔗
<reference value="Patient/Example-Smith-Johnson-Patient1"/>
</subject>
<date value="2024-03-29T14:25:34-05:00"/>
<author>🔗
<reference
value="PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1"/>
</author>
<title value="Portable Medical Order"/>
<custodian>🔗
<reference
value="Organization/Example-Smith-Johnson-OrganizationCustodian1"/>
</custodian>
<section>
<title value="Portable Medical Orders"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="59772-4"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>PMO Medical Orders</b></p><p><i>Order Exists: <a href="http://www.example.com">available here</a></i></p></div>
</text>
<entry>🔗
<reference
value="ServiceRequest/Example-Smith-Johnson-CPR-ServiceRequest1"/>
</entry>
</section>
<section>
<title value="Additional Documentation"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="77599-9"/>
</coding>
</code>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>PMOLST Order Observation</b></p><p><i>Order Exists: <a href="http://www.example.com">available here</a></i></p></div>
</text>
<entry>🔗
<reference
value="Observation/Example-Smith-Johnson-DocumentationObservation1"/>
</entry>
</section>
<section>
<title value="Witnesses and Notary"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="81339-4"/>
<display value="Witness and Notary Document"/>
</coding>
</code>
<text>
<status value="additional"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p>I am emotionally and mentally competent to make this uADD. I understand the purpose and effect of this uADD, I agree with everything that is written in this uADD, and I have made this uADD knowingly, willingly and after careful deliberation.</p><table><tbody><tr><td><b>Signature:</b></td><td>Betsy Smith-Johnson</td></tr><tr><td><b>Date:</b></td><td>3/29/2024</td></tr></tbody></table><p></p><p><b>Statement of Witnesses</b></p><p></p><p>I declare that the person who signed this uADD, or who asked another to sign this uADD on his/her behalf, is the individual identified in the document, and he/she did so in my presence or otherwise provided satisfactory proof to me of his/her identity. I believe him/her to be of sound mind and at least 18 years of age. I personally witnessed him/her sign this document or ask the person indicated to do so, or I received proof of his/her identity that I believe is adequate, and I believe that he/she did so voluntarily. By signing this document as a witness, I certify that I am:</p><p></p><ul><li>At least 18 years of age.</li><li>Not related to the person signing this document by blood, marriage or adoption.</li><li>Not a healthcare agent appointed by the person signing this document.</li><li>Not directly financially responsible for that person’s healthcare.</li><li>Not a healthcare provider directly serving the person at this time.</li><li>Not an employee (other than a social worker or chaplain), officer, director, or partner of a healthcare provider (or any parent organization of such healthcare provider) directly serving the person at this time.</li><li>Not aware that I am entitled to or have a claim against the person’s estate.</li></ul><p></p><table><tbody><tr><td><b>Witness Number:</b></td><td></td></tr><tr><td><b>Signature:</b></td><td></td></tr><tr><td><b>Date:</b></td><td></td></tr></tbody></table></div>
</text>
</section>
</Composition>
</resource>
</entry>
<entry>
<fullUrl
value="http://www.example.org/fhir/Patient/Example-Smith-Johnson-Patient1"/>
<resource>
<Patient>
<id value="Example-Smith-Johnson-Patient1"/>
<meta>
<lastUpdated value="2021-03-29T14:25:34.001-05:00"/>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
</meta>
<language value="en-US"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en-US" lang="en-US"><a name="Patient_Example-Smith-Johnson-Patient1"> </a><p class="res-header-id"><b>Generated Narrative: Patient Example-Smith-Johnson-Patient1</b></p><a name="Example-Smith-Johnson-Patient1"> </a><a name="hcExample-Smith-Johnson-Patient1"> </a><a name="Example-Smith-Johnson-Patient1-en-US"> </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">Last updated: 2021-03-29 14:25:34-0500; Language: en-US</p><p style="margin-bottom: 0px">Profile: <a href="http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-patient.html">US Core Patient Profile</a></p></div><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Smith-Johnson, Betsy Female, DoB: 1950-11-15 ( http://hl7.org/fhir/sid/us-medicare#United States Medicare Number#10A3D58WH1600)</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Record is active">Active:</td><td>true</td><td style="background-color: #f3f5da" title="Known Marital status of Patient">Marital Status:</td><td colspan="3"><span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-NullFlavor UNK}">unknown</span></td></tr><tr><td style="background-color: #f3f5da" title="Other Id (see the one above)">Other Id:</td><td colspan="3">Medical Record Number/1032702 (use: usual, )</td></tr><tr><td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Detail</td><td colspan="3"><ul><li><a href="mailto:BetsySJ@example.com">BetsySJ@example.com</a></li><li>111 Maple Court San Antonio TX 78212 US (home)</li></ul></td></tr><tr><td style="background-color: #f3f5da" title="Language spoken">Language:</td><td colspan="3"><span title="Codes:{urn:ietf:bcp:47 en}">English</span> (preferred)</td></tr><tr><td style="background-color: #f3f5da" title="Nominated Contact: son">son:</td><td colspan="3"><ul><li>Charles Johnson</li><li>111 Maple Ct, Grand Rapids, MI 49503</li><li>ph: (210) 222-3333</li></ul></td></tr><tr><td style="background-color: #f3f5da" title="Nominated Contact: daughter">daughter:</td><td colspan="3"><ul><li>Debra Johnson</li><li>333 W. Camden St., Baltimore, MD 21201</li><li>ph: (410) 444-5555</li></ul></td></tr><tr><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:</td><td colspan="3"><ul><li>ombCategory: CDC Race and Ethnicity 2106-3: White</li><li>text: White</li></ul></td></tr></table></div>
</text>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2106-3"/>
<display value="White"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="White"/>
</extension>
</extension>
<identifier>
<use value="usual"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MR"/>
<display value="Medical Record Number"/>
</coding>
<text value="Medical Record Number"/>
</type>
<system value="http://hospital.smarthealthit.org"/>
<value value="1032702"/>
</identifier>
<identifier>
<system value="http://hl7.org/fhir/sid/us-medicare"/>
<value value="10A3D58WH1600"/>
</identifier>
<active value="true"/>
<name>
<use value="usual"/>
<text value="Smith-Johnson, Betsy"/>
<family value="Smith-Johnson"/>
<given value="Betsy"/>
</name>
<telecom>
<system value="email"/>
<value value="BetsySJ@example.com"/>
<use value="home"/>
</telecom>
<gender value="female"/>
<birthDate value="1950-11-15"/>
<address>
<use value="home"/>
<type value="physical"/>
<line value="111 Maple Court"/>
<city value="San Antonio"/>
<state value="TX"/>
<postalCode value="78212"/>
<country value="US"/>
</address>
<maritalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-NullFlavor"/>
<code value="UNK"/>
</coding>
</maritalStatus>
<contact>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="SONC"/>
</coding>
</relationship>
<name>
<text value="Charles Johnson"/>
</name>
<telecom>
<system value="phone"/>
<value value="(210) 222-3333"/>
</telecom>
<address>
<text value="111 Maple Ct, Grand Rapids, MI 49503"/>
</address>
</contact>
<contact>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="DAUC"/>
</coding>
</relationship>
<name>
<text value="Debra Johnson"/>
</name>
<telecom>
<system value="phone"/>
<value value="(410) 444-5555"/>
</telecom>
<address>
<text value="333 W. Camden St., Baltimore, MD 21201"/>
</address>
</contact>
<communication>
<language>
<coding>
<system value="urn:ietf:bcp:47"/>
<code value="en"/>
<display value="English"/>
</coding>
</language>
<preferred value="true"/>
</communication>
</Patient>
</resource>
</entry>
<entry>
<fullUrl
value="http://www.example.org/fhir/Patient/Example-Kyle-Anydoc-PractitionerRole1"/>
<resource>
<PractitionerRole>
<id value="Example-Kyle-Anydoc-PractitionerRole1"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="PractitionerRole_Example-Kyle-Anydoc-PractitionerRole1"> </a><p class="res-header-id"><b>Generated Narrative: PractitionerRole Example-Kyle-Anydoc-PractitionerRole1</b></p><a name="Example-Kyle-Anydoc-PractitionerRole1"> </a><a name="hcExample-Kyle-Anydoc-PractitionerRole1"> </a><a name="Example-Kyle-Anydoc-PractitionerRole1-en-US"> </a><p><b>practitioner</b>: <a href="Practitioner-Example-Kyle-Anydoc-Practitioner.html">Practitioner Kyle Anydoc </a></p></div>
</text>
<practitioner>🔗
<reference value="Practitioner/Example-Kyle-Anydoc-Practitioner"/>
</practitioner>
</PractitionerRole>
</resource>
</entry>
<entry>
<fullUrl
value="http://www.example.org/fhir/Patient/Example-Kyle-Anydoc-Practitioner"/>
<resource>
<Practitioner>
<id value="Example-Kyle-Anydoc-Practitioner"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Practitioner_Example-Kyle-Anydoc-Practitioner"> </a><p class="res-header-id"><b>Generated Narrative: Practitioner Example-Kyle-Anydoc-Practitioner</b></p><a name="Example-Kyle-Anydoc-Practitioner"> </a><a name="hcExample-Kyle-Anydoc-Practitioner"> </a><a name="Example-Kyle-Anydoc-Practitioner-en-US"> </a><p><b>identifier</b>: <a href="http://terminology.hl7.org/5.4.0/NamingSystem-npi.html" title="National Provider Identifier">United States National Provider Identifier</a>/21548796354</p><p><b>name</b>: Kyle Anydoc </p><p><b>telecom</b>: <a href="mailto:kanydoc@example.org">kanydoc@example.org</a></p><p><b>address</b>: 567 Healthcare Drive Anytown MA 12345 US (home)</p><p><b>gender</b>: Male</p><h3>Qualifications</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Code</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0360 MD}">Doctor of Medicine</span></td></tr></table></div>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="21548796354"/>
</identifier>
<name>
<family value="Anydoc"/>
<given value="Kyle"/>
<prefix value="Dr."/>
</name>
<telecom>
<system value="email"/>
<value value="kanydoc@example.org"/>
<use value="work"/>
</telecom>
<address>
<use value="home"/>
<line value="567 Healthcare Drive"/>
<city value="Anytown"/>
<state value="MA"/>
<postalCode value="12345"/>
<country value="US"/>
</address>
<gender value="male"/>
<qualification>
<code>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0360"/>
<code value="MD"/>
<display value="Doctor of Medicine"/>
</coding>
</code>
</qualification>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl
value="http://www.example.org/fhir/Patient/Example-Smith-Johnson-CPR-ServiceRequest1"/>
<resource>
<ServiceRequest>
<id value="Example-Smith-Johnson-CPR-ServiceRequest1"/>
<meta>
<profile
value="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOCPRServiceRequest"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_Example-Smith-Johnson-CPR-ServiceRequest1"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest Example-Smith-Johnson-CPR-ServiceRequest1</b></p><a name="Example-Smith-Johnson-CPR-ServiceRequest1"> </a><a name="hcExample-Smith-Johnson-CPR-ServiceRequest1"> </a><a name="Example-Smith-Johnson-CPR-ServiceRequest1-en-US"> </a><p><b>status</b>: Active</p><p><b>intent</b>: Order</p><p><b>category</b>: <span title="Codes:{http://loinc.org 100822-6}">Cardiopulmonary resuscitation orders</span></p><p><b>doNotPerform</b>: true</p><p><b>code</b>: <span title="Codes:{http://snomed.info/sct 89666000}">Cardiopulmonary resuscitation (procedure)</span></p><p><b>orderDetail</b>: <span title="Codes:{http://loinc.org LA33470-8}">Yes CPR</span></p><p><b>subject</b>: <a href="Patient-Example-Smith-Johnson-Patient1.html">Smith-Johnson, Betsy Female, DoB: 1950-11-15 ( http://hl7.org/fhir/sid/us-medicare#United States Medicare Number#10A3D58WH1600)</a></p><p><b>requester</b>: <a href="Practitioner-Example-Kyle-Anydoc-Practitioner.html">Practitioner Kyle Anydoc </a></p></div>
</text>
<status value="active"/>
<intent value="order"/>
<category>
<coding>
<system value="http://loinc.org"/>
<code value="100822-6"/>
<display value="Cardiopulmonary resuscitation orders"/>
</coding>
</category>
<doNotPerform value="true"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="89666000"/>
<display value="Cardiopulmonary resuscitation (procedure)"/>
</coding>
</code>
<orderDetail>
<coding>
<system value="http://loinc.org"/>
<code value="LA33470-8"/>
</coding>
</orderDetail>
<subject>🔗
<reference value="Patient/Example-Smith-Johnson-Patient1"/>
</subject>
<requester>🔗
<reference value="Practitioner/Example-Kyle-Anydoc-Practitioner"/>
</requester>
</ServiceRequest>
</resource>
</entry>
</Bundle>
IG © 2021+ HL7 International / Patient Empowerment. Package hl7.fhir.us.pacio-adi#2.1.0 based on FHIR 4.0.1. Generated 2024-11-01
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