PACIO Advance Healthcare Directive Interoperability Implementation Guide
2.0.0-ballot - STU 2 – Ballot
PACIO Advance Healthcare Directive Interoperability Implementation Guide
2.0.0-ballot - STU 2 – Ballot
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
| Page standards status: Informative |
| JIRA issue | Summary | Applied change |
|---|---|---|
| FHIR-51828 | Should ADI RelatedPerson profiles be derived from US Core RelatedPerson profiles? | Changed ADI Health Agent Participant, ADI Notary, and ADI Witness profiles to derive from US Core RelatedPerson. |
| FHIR-52036 | Profile URLs are broken | Modified the CapabilityStatement to reference HealthcareAgentParticipant and split ConsentPermit/ConsentDeny profiles with corrected URLs. |
| FHIR-52038 | RelatedPerson profiles URLs are broken | Updated the CapabilityStatement to reflect STU2 ballot changes for ADI-HealthcareAgentParticipant and removed references to ADI-Guardian. |
| FHIR-52670 | Change title for Workflow Representation | Changed title to Person-Authored Workflow per resolution description. |
| FHIR-52671 | Promote the Person Authored Document Workflow to a menu option under Person Authored menu item | The system promoted the Person Authored Document Workflow to a menu option under the Person Authored item. |
| FHIR-52683 | Change profile name to ADI Organ Donation Observation | Changed the profile name from "Organ Donation" to "ADI Organ Donation Observation". |
| FHIR-52684 | Change the profile name to ADI Person Authored Care Experience Preference | Changed the profile name from ADI Care Experience Preference to ADI Person-Authored Care Experience Preference. |
| FHIR-52685 | Change the profile name to ADI Person Authored Treatment Intervention Preference | Changed the profile name to ADI Person Authored Treatment Intervention Preference. |
| FHIR-53922 | Update ADI DocumentReference Profile to include accurate context details and field comments | The issue updated ADI DocumentReference Profile descriptions, field comments, and surfaced optional context elements with clarifications. |
| FHIR-55633 | Fix the terminology binding for type and category to align with US Core and FHIR Clinical Document | Terminology binding types and categories made. |
| FHIR-56323 | Missing Rationale for Treatment entry in PMO Composition administrative info section | * Created a new profile called ADIRationaleForTreatment. * Added PMO Composition Administrative Section entry referring to the ADIRationaleForTreatment profile. |
| FHIR-57552 | Fix binding for RelatedPerson.relationship in the Healthcare Agent Profile | Changed binding for RelatedPerson.relationship in the Healthcare Agent Profile. |
| FHIR-57815 | Change the ADI Provenance slice name from assembler to ProvenanceAssembler | Changed the ADI Provenance slice name from assembler to ProvenanceAssembler |
| JIRA issue | Summary | Applied change |
|---|---|---|
| FHIR-51812 | Typo | Corrected the reported typo in FHIR issue FHIR-51812. |
| FHIR-51813 | Suggest using SHALL conformance word | Changed wording and added a link to foundational composition guidance in issue FHIR-51813. |
| FHIR-51814 | AD should ADI | replaced AD with "advance healthcare directive", or AHD as the acronym. |
| FHIR-51815 | Missing element name | Corrected the element name typo from 'element name' to DocumentReference.status. |
| FHIR-51817 | DAR extension URL could be hidden in HTML view | Corrected the DAR extension representation from a direct URL to a hyperlink for dataAbsentReason extension. |
| FHIR-51819 | Some SHALL requirement words are not in bold font | Corrected the markdown formatting for SHALL to bold text. |
| FHIR-51820 | Missing conformance requirement word | Changed narrative wording for fixed values to require base64 encoded attachments. |
| FHIR-51821 | SHOULD or SHALL? | Changed narrative wording for DocumentReference status update requirement from SHOULD or SHALL to SHALL. |
| FHIR-51826 | ADI Healthcare Agent Consent profile is not listed | Added the ADI Healthcare Agent Consent link to the Profiles by Resources Type markdown page. |
| FHIR-51957 | Clarify the reference to 'these documents` | Modified the paragraph to clarify ADI document digitization levels. |
| FHIR-51959 | Remove bullet misrepresenting US Core Conformance requirements misrepresented | Removed text asserting that Data Sources could omit explicit guidance on allowing missing information. |
| FHIR-51962 | Update the How to read this guide section to reflect the current contents | Updated the How to read this guide section to reflect current contents including missing pages. |
| FHIR-52005 | Typo | Corrected the reported typo in FHIR issue FHIR-52005. |
| FHIR-52034 | ADI Facilitator is a PractitionerRole not Practitioner | Corrected the profile's resource type narrative from Practitioner to PractitionerRole. |
| FHIR-52053 | Missing acronym | Added Portable Medical Order (PMO) acronym to Key Terms and Acronyms page. |
| FHIR-52300 | Pronoun misalignment in Workflow Representation image | Fixed pronouns in the content type use case diagram to align with the female patient persona. |
| FHIR-52631 | Add a plain language description | Added plain language summary at the top of the ADI Home page |
| FHIR-52643 | Fix heading for How to Read This Guide | Corrected capitalization in title from How to read this guide to How to Read this Guide. |
| FHIR-52645 | Update the How to Read This Guide Section to improve value of the content | Added robust descriptions for IG parts in the How to Read this Guide section on the Home page. |
| FHIR-52648 | TOC is confusing when compared to IG content organization | Modified sushi-config.yaml to align IG menu organization with table of contents order. |
| FHIR-52651 | 3.1 ADI Content Types | The issue description requested changing the heading to 'Advance Healthcare Directive Document Types'. |
| FHIR-52654 | Eliminate the notion of Content Type 1, 2 and 3. | Changed Content Type 1 and 3 wording to Patient-Authored and Provider-Authored. |
| FHIR-52655 | Use the word "directives" rather than "instructions" in Content Type Overview | Replaced instructions with directives in Content Type Overview |
| FHIR-52663 | Use term Personal ACP rather than PACP | Replaced PACP with Personal ACP in the resolution description. |
| FHIR-52673 | Don't refer to MHAD as Content Type 1 | Replaced 'Content Type 1' with 'MHAD' in the Advance Directive content type name reference. |
| FHIR-52674 | Change section title to Provider Authored Portable Medical Order (PMO) Document | Changed section title to Provider Authored Portable Medical Order Document with hyphenated convention. |
| FHIR-52677 | Eliminate notion of Content Type 3 | Changed narrative text and diagram to reference AD content types by description instead of numbers. |
| FHIR-52680 | Where did the other Use Case descriptions go? | Added better guidance on the statuses and versioning as part of a Document Lifecycle narrative. |
| FHIR-52710 | Modify Introduction Content | The issue description requested modifying text to include MHAD/PAD guidance for the next version. |
| FHIR-52714 | Modify Content within 1.2 Background | Changed narrative in section 1.2 Background per reported suggestion. |
| FHIR-52721 | Modify text for 1.4 External Drivers | Replaced the External Drivers wording in FHIR-52721. |
| FHIR-56825 | Need better guidance on how Advance Directive Document Versions are managed | added better guidance on how Advance Directive Document Versions are managed |
| FHIR-57549 | Change ADI PMO Composition section title from "Life-limiting Condition" to "Serious Advanced Condition" | Changed Composition section title to a name that is consistent with the entry resource to Serious Advanced Condition |
| JIRA issue | Summary | Applied change |
|---|---|---|
| FHIR-51827 | Should ADI Documentation Observation be derived for US Core profile? | Derived the ADI Documentation Observation Profile from US Core and added the specified extension. |
| JIRA issue | Summary | Applied change |
|---|---|---|
| FHIR-52086 | typo | Corrected the typo in author's to authors. |
| FHIR-52540 | Change ONC acronym to ASTP | Replaced ONC acronym with ASTP in resolution description FHIR-52540. |
| FHIR-52542 | Please add primary editor and contibutor information | Added a section containing primary editor and contributor information to the IG. |
| FHIR-52543 | Case correction for "state" to "State" | Corrected the state field from lowercase to uppercase. |
| FHIR-52726 | Update content under 1.7 | Reordered sections under How to Read this Guide to match the ADI top menu dropdown order. |
| FHIR-52727 | Formatting of Content to be Modified | Removed "Type 1" from the title and deleted the first redundant bullet point. |
The following changes occurred since the PACIO ADI STU1 publication in January 2024
Support for new advance healthcare directive document types
Changes to STU1 based profiles
Integrative use cases
IG © 2021+ HL7 International / Patient Empowerment.
Package hl7.fhir.us.pacio-adi#2.0.0-ballot based on FHIR 4.0.1.
Generated
2026-08-20
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