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

Examples Summary

Page standards status: Informative

Example Summary

  • Person-Authored Advance Directive (source form only)
  • Person-Authored Advance Directive (expanded entries)
  • Provider-Authored Portable Medical Order (expanded entries)
Note: patient and clinical data in the narrative example below are linked to the relevant FHIR examples using this styling.

Person-Authored Advance Healthcare Directive (source form only)

Purpose: Demonstrates a structured document with the minimal amount of structured content. The document includes header information and a single structured section containing the source document as a PDF or scanned image file (.jpg, .png, etc.).

User Story: In this story, Betsy Smith-Johnson is a 76-year old female who is living at home and is documenting her mental health care preferences. She appoints a healthcare agent to make decisions about her mental health care should she not be able to communicate her needs. She manually documents her preferences in a form provided by her state, and saved in PDF format. She shares the form with her primary care physician who then scans it into the EHR chart using specialized advance care planning software that creates the minimally structured document.

Relevant Profiles:


Example 1: ADI Source Form Sequence Diagram


Person-Authored Advance Directive (expanded entries)

TBD (insert persona summary for the PACP and link to relevant PACP profiles). Focus on the PACP with the Healthcare Agent (e.g.: Charles Johnson, son of BSJ).

Purpose: Demonstrates a structured document with Standardized sections that are used to organize the human-readable narrative and machine-processable entries. In addition to the source form document, this document also includes header information and structured data for elements that include:

  • healthcare agent consent
  • treatment intervention preferences
  • care preferences

User Story: In this story, Betsy Smith-Johnson is a 76-year old female who is living at home and is documenting her mental health care preferences. She appoints a healthcare agent to make decisions about her mental health care should she not be able to communicate her needs. She manually documents her preferences in a form provided by her state, and saved in PDF format. She shares the form with her primary care physician who then scans it into the EHR chart using specialized advance care planning software that creates the minimally structured document.

Relevant Profiles:

Provider-Authored Portable Medical Order (expanded entries)

TBD (insert persona summary for the PMO and link to relevant PMO profiles) Focus on the PMO Medical Orders Section