PACIO Advance Healthcare Directive Interoperability Implementation Guide
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PACIO Advance Healthcare Directive Interoperability Implementation Guide, published by HL7 International / Patient Empowerment. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-pacio-adi/ and changes regularly. See the Directory of published versions

: Portable Medical Order - TTL Representation

Page standards status: Informative

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix loinc: <http://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 -------------------------------------------------------------------

<http://hl7.org/fhir/Composition/PMO-Example-Smith-Johnson-PMOComposition1> a fhir:Composition ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "PMO-Example-Smith-Johnson-PMOComposition1"] ;
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOComposition" ;
       fhir:index 0 ;
       fhir:link <http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOComposition>
     ]
  ] ;
  fhir:Resource.language [ fhir:value "en-US"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "extensions" ] ;
     fhir:Narrative.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><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>: 2024-03-29T14:25:34-05:00</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#1PA3D58WH16)</a></p><p><b>Participant</b>: <a href=\"PractitionerRole-Example-Kyle-Anydoc-PractitionerRole1.html\">PractitionerRole: telecom = kanydoc@example.org(Work)</a></p><p><b>ADI Expiration Date</b>: 2024-03-29 14:25:34-0500</p><p><b>Performer</b>: <a href=\"PractitionerRole-Example-Kyle-Anydoc-PractitionerRole1.html\">PractitionerRole: telecom = kanydoc@example.org(Work)</a></p><p><b>Informant</b>: <a href=\"RelatedPerson-Example-Smith-Johnson-HealthcareAgent1.html\">RelatedPerson Johnson, Charles</a></p><p><b>Revoke Status</b>: deprecated</p><blockquote><p><b>Clause</b></p><ul><li>Clause: </li></ul></blockquote><div><p>&lt;div xmlns=\"http://www.w3.org/1999/xhtml\"&gt;&lt;p&gt;Example Clause Statement&lt;/p&gt;&lt;/div&gt;</p>\n</div><p><b>identifier</b>: <code>http://example.org/GoodHealthClinic/id</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 107903-7}\">Clinical note</span>, <span title=\"Codes:{http://loinc.org 42348-3}\">Advance healthcare directives</span></p><p><b>date</b>: 2023-03-29 14:25:34-0500</p><p><b>author</b>: <a href=\"PractitionerRole-Example-Kyle-Anydoc-PractitionerRole1.html\">PractitionerRole: telecom = kanydoc@example.org(Work)</a></p><p><b>title</b>: Portable Medical Order</p><h3>Attesters</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Mode</b></td><td><b>Party</b></td></tr><tr><td style=\"display: none\">*</td><td>Legal</td><td><a href=\"PractitionerRole-Example-Kyle-Anydoc-PractitionerRole1.html\">PractitionerRole: telecom = kanydoc@example.org(Work)</a></td></tr></table><p><b>custodian</b>: <a href=\"Organization-Example-Smith-Johnson-OrganizationCustodian1.html\">Organization example.org</a></p><blockquote><p><b>event</b></p><p><b>detail</b>: </p><ul><li><a href=\"PractitionerRole-ADI-Facilitator-MSW-MargaretReynolds.html\">PractitionerRole primary performer</a></li><li><a href=\"Consent-Example-Smith-Johnson-HealthcareAgentConsent-Permit.html\">Example-Smith-Johnson-HealthcareAgentConsent-Permit</a></li><li><a href=\"Consent-Example-Smith-Johnson-HealthcareAgentConsent-Deny.html\">Example-Smith-Johnson-HealthcareAgentConsent-Deny</a></li></ul></blockquote></div>"
  ] ;
  fhir:DomainResource.extension [
     fhir:index 0 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber" ] ;
     fhir:Extension.valueString [ fhir:value "2024-03-29T14:25:34-05:00" ]
  ], [
     fhir:index 1 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension" ] ;
     fhir:Extension.valueReference [
       fhir:link <http://hl7.org/fhir/Patient/Example-Smith-Johnson-Patient1> ;
       fhir:Reference.reference [ fhir:value "Patient/Example-Smith-Johnson-Patient1" ]
     ]
  ], [
     fhir:index 2 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-healthcareAgentParticipant-extension" ] ;
     fhir:Extension.valueReference [
       fhir:link <http://hl7.org/fhir/PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1> ;
       fhir:Reference.reference [ fhir:value "PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1" ]
     ]
  ], [
     fhir:index 3 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-expiration-date-extension" ] ;
     fhir:Extension.valueDateTime [ fhir:value "2024-03-29T14:25:34-05:00"^^xsd:dateTime ]
  ], [
     fhir:index 4 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-performer-extension" ] ;
     fhir:Extension.valueReference [
       fhir:link <http://hl7.org/fhir/PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1> ;
       fhir:Reference.reference [ fhir:value "PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1" ]
     ]
  ], [
     fhir:index 5 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-informant-extension" ] ;
     fhir:Extension.valueReference [
       fhir:link <http://hl7.org/fhir/RelatedPerson/Example-Smith-Johnson-HealthcareAgent1> ;
       fhir:Reference.reference [ fhir:value "RelatedPerson/Example-Smith-Johnson-HealthcareAgent1" ]
     ]
  ], [
     fhir:index 6 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-document-revoke-status" ] ;
     fhir:Extension.valueCode [ fhir:value "deprecated" ]
  ], [
     fhir:index 7 ;
     fhir:Element.extension [
       fhir:index 0 ;
       fhir:Extension.url [ fhir:value "Clause" ] ;
       fhir:Extension.valueMarkdown [ fhir:value "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Example Clause Statement</p></div>" ]
     ] ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension" ]
  ] ;
  fhir:Composition.identifier [
     fhir:Identifier.system [ fhir:value "http://example.org/GoodHealthClinic/id" ] ;
     fhir:Identifier.value [ fhir:value "0-87f37989294a408897aacd1fc5d8fd16" ]
  ] ;
  fhir:Composition.status [ fhir:value "final"] ;
  fhir:Composition.type [
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       a loinc:93037-0 ;
       fhir:Coding.system [ fhir:value "http://loinc.org" ] ;
       fhir:Coding.code [ fhir:value "93037-0" ] ;
       fhir:Coding.display [ fhir:value "Portable medical order form" ]
     ]
  ] ;
  fhir:Composition.category [
     fhir:index 0 ;
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       a loinc:107903-7 ;
       fhir:Coding.system [ fhir:value "http://loinc.org" ] ;
       fhir:Coding.code [ fhir:value "107903-7" ] ;
       fhir:Coding.display [ fhir:value "Clinical note" ]
     ]
  ], [
     fhir:index 1 ;
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       a loinc:42348-3 ;
       fhir:Coding.system [ fhir:value "http://loinc.org" ] ;
       fhir:Coding.code [ fhir:value "42348-3" ] ;
       fhir:Coding.display [ fhir:value "Advance healthcare directives" ]
     ]
  ] ;
  fhir:Composition.subject [
     fhir:link <http://hl7.org/fhir/Patient/Example-Smith-Johnson-Patient1> ;
     fhir:Reference.reference [ fhir:value "Patient/Example-Smith-Johnson-Patient1" ]
  ] ;
  fhir:Composition.date [ fhir:value "2023-03-29T14:25:34-05:00"^^xsd:dateTime] ;
  fhir:Composition.author [
     fhir:index 0 ;
     fhir:link <http://hl7.org/fhir/PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1> ;
     fhir:Reference.reference [ fhir:value "PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1" ]
  ] ;
  fhir:Composition.title [ fhir:value "Portable Medical Order"] ;
  fhir:Composition.attester [
     fhir:index 0 ;
     fhir:Composition.attester.mode [ fhir:value "legal" ] ;
     fhir:Composition.attester.party [
       fhir:link <http://hl7.org/fhir/PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1> ;
       fhir:Reference.reference [ fhir:value "PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1" ]
     ]
  ] ;
  fhir:Composition.custodian [
     fhir:link <http://hl7.org/fhir/Organization/Example-Smith-Johnson-OrganizationCustodian1> ;
     fhir:Reference.reference [ fhir:value "Organization/Example-Smith-Johnson-OrganizationCustodian1" ]
  ] ;
  fhir:Composition.event [
     fhir:index 0 ;
     fhir:Composition.event.detail [
       fhir:index 0 ;
       fhir:link <http://hl7.org/fhir/PractitionerRole/ADI-Facilitator-MSW-MargaretReynolds> ;
       fhir:Reference.reference [ fhir:value "PractitionerRole/ADI-Facilitator-MSW-MargaretReynolds" ]
     ], [
       fhir:index 1 ;
       fhir:link <http://hl7.org/fhir/Consent/Example-Smith-Johnson-HealthcareAgentConsent-Permit> ;
       fhir:Reference.reference [ fhir:value "Consent/Example-Smith-Johnson-HealthcareAgentConsent-Permit" ]
     ], [
       fhir:index 2 ;
       fhir:link <http://hl7.org/fhir/Consent/Example-Smith-Johnson-HealthcareAgentConsent-Deny> ;
       fhir:Reference.reference [ fhir:value "Consent/Example-Smith-Johnson-HealthcareAgentConsent-Deny" ]
     ]
  ] ;
  fhir:Composition.section [
     fhir:index 0 ;
     fhir:Composition.section.title [ fhir:value "Example Source Form - Betsy Smith-Johnson" ] ;
     fhir:Composition.section.code [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/pacio-adi/CodeSystem/adi-temp-cs" ] ;
         fhir:Coding.code [ fhir:value "advance_directive_source_form" ]
       ]
     ] ;
     fhir:Composition.section.text [
       fhir:Narrative.status [ fhir:value "additional" ] ;
       fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>I understand the purpose and effect of this Advance Directive, I agree with everything that is written in this form, and I have made this advance directive knowingly, willingly and after careful deliberation.</p></div>"
     ] ;
     fhir:Composition.section.entry [
       fhir:index 0 ;
       fhir:link <http://hl7.org/fhir/Binary/Example-Stub-SourceForm-Smith-Johnson-Binary> ;
       fhir:Reference.reference [ fhir:value "Binary/Example-Stub-SourceForm-Smith-Johnson-Binary" ]
     ]
  ], [
     fhir:index 1 ;
     fhir:Composition.section.title [ fhir:value "Portable Medical Orders" ] ;
     fhir:Composition.section.code [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         a loinc:93037-0 ;
         fhir:Coding.system [ fhir:value "http://loinc.org" ] ;
         fhir:Coding.code [ fhir:value "93037-0" ] ;
         fhir:Coding.display [ fhir:value "Portable medical order form" ]
       ]
     ] ;
     fhir:Composition.section.text [
       fhir:Narrative.status [ fhir:value "generated" ] ;
       fhir:Narrative.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:Composition.section.entry [
       fhir:index 0 ;
       fhir:link <http://hl7.org/fhir/ServiceRequest/Example-Smith-Johnson-CPR-ServiceRequest1> ;
       fhir:Reference.reference [ fhir:value "ServiceRequest/Example-Smith-Johnson-CPR-ServiceRequest1" ]
     ]
  ], [
     fhir:index 2 ;
     fhir:Composition.section.title [ fhir:value "Additional Documentation" ] ;
     fhir:Composition.section.code [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         a loinc:77599-9 ;
         fhir:Coding.system [ fhir:value "http://loinc.org" ] ;
         fhir:Coding.code [ fhir:value "77599-9" ]
       ]
     ] ;
     fhir:Composition.section.text [
       fhir:Narrative.status [ fhir:value "generated" ] ;
       fhir:Narrative.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:Composition.section.entry [
       fhir:index 0 ;
       fhir:link <http://hl7.org/fhir/Observation/Example-Smith-Johnson-DocumentationObservation2> ;
       fhir:Reference.reference [ fhir:value "Observation/Example-Smith-Johnson-DocumentationObservation2" ]
     ]
  ], [
     fhir:index 3 ;
     fhir:Composition.section.title [ fhir:value "Witnesses and Notary" ] ;
     fhir:Composition.section.code [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         a loinc:81339-4 ;
         fhir:Coding.system [ fhir:value "http://loinc.org" ] ;
         fhir:Coding.code [ fhir:value "81339-4" ] ;
         fhir:Coding.display [ fhir:value "Witness and Notary Document" ]
       ]
     ] ;
     fhir:Composition.section.text [
       fhir:Narrative.status [ fhir:value "additional" ] ;
       fhir:Narrative.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><b>Statement of Witnesses</b></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/><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/><table><tbody><tr><td><b>Witness Number:</b></td><td/></tr><tr><td><b>Signature:</b></td><td/></tr><tr><td><b>Date:</b></td><td/></tr></tbody></table></div>"
     ]
  ] .

<http://hl7.org/fhir/Patient/Example-Smith-Johnson-Patient1> a fhir:Patient .

<http://hl7.org/fhir/PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1> a fhir:PractitionerRole .

<http://hl7.org/fhir/RelatedPerson/Example-Smith-Johnson-HealthcareAgent1> a fhir:RelatedPerson .

<http://hl7.org/fhir/Organization/Example-Smith-Johnson-OrganizationCustodian1> a fhir:Organization .

<http://hl7.org/fhir/PractitionerRole/ADI-Facilitator-MSW-MargaretReynolds> a fhir:PractitionerRole .

<http://hl7.org/fhir/Consent/Example-Smith-Johnson-HealthcareAgentConsent-Permit> a fhir:Consent .

<http://hl7.org/fhir/Consent/Example-Smith-Johnson-HealthcareAgentConsent-Deny> a fhir:Consent .

<http://hl7.org/fhir/Binary/Example-Stub-SourceForm-Smith-Johnson-Binary> a fhir:Binary .

<http://hl7.org/fhir/ServiceRequest/Example-Smith-Johnson-CPR-ServiceRequest1> a fhir:ServiceRequest .

<http://hl7.org/fhir/Observation/Example-Smith-Johnson-DocumentationObservation2> a fhir:Observation .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/Composition/PMO-Example-Smith-Johnson-PMOComposition1.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/Composition/PMO-Example-Smith-Johnson-PMOComposition1.ttl> .