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
@prefix fhir: <http://hl7.org/fhir/> .
@prefix loinc: <https://loinc.org/rdf/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:Composition ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "PMO-Example-Smith-Johnson-PMOComposition1"] ; #
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOComposition"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOComposition> ] )
] ; #
fhir:language [ fhir:v "en-US"] ; #
fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en-US\" lang=\"en-US\"><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>"
] ; #
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber"^^xsd:anyURI ] ;
fhir:value [ fhir:v "11546d53-a054-4882-bc0a-ff02aa0ba887c" ]
] [
fhir:url [ fhir:v "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-jurisdiction-extension"^^xsd:anyURI ] ;
fhir:value [
a fhir:CodeableConcept ;
( fhir:coding [
fhir:system [ fhir:v "urn:iso:std:iso:3166:-2"^^xsd:anyURI ] ;
fhir:code [ fhir:v "US-MI" ] ] ) ]
] [
fhir:url [ fhir:v "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension"^^xsd:anyURI ] ;
fhir:value [
a fhir:Reference ;
fhir:reference [ fhir:v "Patient/Example-Smith-Johnson-Patient1" ] ]
] [
fhir:url [ fhir:v "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-effective-date-extension"^^xsd:anyURI ] ;
fhir:value [
a fhir:Period ;
fhir:start [ fhir:v "2024-03-29T14:25:34-05:00"^^xsd:dateTime ] ]
] ) ; #
fhir:identifier [
fhir:system [ fhir:v "urn:oid:2.16.840.1.113883.4.823.1.7124"^^xsd:anyURI ] ;
fhir:value [ fhir:v "0-87f37989294a408897aacd1fc5d8fd16" ]
] ; #
fhir:status [ fhir:v "final"] ; #
fhir:type [
( fhir:coding [
a loinc:93037-0 ;
fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "93037-0" ] ;
fhir:display [ fhir:v "Portable medical order form" ] ] )
] ; #
fhir:category ( [
( fhir:coding [
a loinc:42348-3 ;
fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "42348-3" ] ;
fhir:display [ fhir:v "Advance directives" ] ] )
] ) ; #
fhir:subject [
fhir:reference [ fhir:v "Patient/Example-Smith-Johnson-Patient1" ]
] ; #
fhir:date [ fhir:v "2024-03-29T14:25:34-05:00"^^xsd:dateTime] ; #
fhir:author ( [
fhir:reference [ fhir:v "PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1" ]
] ) ; #
fhir:title [ fhir:v "Portable Medical Order"] ; #
fhir:custodian [
fhir:reference [ fhir:v "Organization/Example-Smith-Johnson-OrganizationCustodian1" ]
] ; #
fhir:section ( [
fhir:title [ fhir:v "Portable Medical Orders" ] ;
fhir:code [
( fhir:coding [
a loinc:59772-4 ;
fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "59772-4" ] ] ) ] ;
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<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>" ] ;
( fhir:entry [
fhir:reference [ fhir:v "ServiceRequest/Example-Smith-Johnson-CPR-ServiceRequest1" ] ] )
] [
fhir:title [ fhir:v "Additional Documentation" ] ;
fhir:code [
( fhir:coding [
a loinc:77599-9 ;
fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "77599-9" ] ] ) ] ;
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<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>" ] ;
( fhir:entry [
fhir:reference [ fhir:v "Observation/Example-Smith-Johnson-DocumentationObservation1" ] ] )
] [
fhir:title [ fhir:v "Witnesses and Notary" ] ;
fhir:code [
( fhir:coding [
a loinc:81339-4 ;
fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "81339-4" ] ;
fhir:display [ fhir:v "Witness and Notary Document" ] ] ) ] ;
fhir:text [
fhir:status [ fhir:v "additional" ] ;
fhir:div "<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>" ]
] ) . #
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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