PACIO Advance Directive Interoperability Implementation Guide
2.1.0 - STU 2 United States of America flag

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 and changes regularly. See the Directory of published versions

Key Terms and Acronyms

Term Definition
Advance directives An individual's advance medical goals, preferences, and priorities for care in the event the individual is unable to communicate this information to medical teams for themselves due to a health crisis. An advance directive may encompass all of the following: living will, medical power of attorney, combined living will and medical power of attorney.
ADI Advance Directive Interoperability
Patient Living Will

Clinical information generated by a patient, or a patient agent (proxy), acting in a non-clinical role to provide clinically relevant information. The patient agent may not have a legally defined relationship with the patient (e.g. a close friend).

These are statutory defined documents (i.e., states). All documents are focused on relevant clinical information as determined by a patient or their proxy related to the wishes for potential future events.

Patient Personal Advance Care Plan (PACP)

This term may be used as either the document or section code for the Personal Advance Care Plan. This term was created for, but is not limited in use to, the HL7 Implementation Guide for CDA Release 2: Personal Advance Care Plan Document (US Realm) Draft Standard for Trial Use Release 1.0.

It may include patient goals, preferences, and priorities under certain health conditions; patient goals, preferences, and priorities upon death; patient goals, preferences, and priorities for care experience; witness and notary document; and patient healthcare agent.

Patient story

Patient stories are fictitious illustrative personal stories that are included to show the personal nature of the information being shared and demonstrate the value of having and sharing personal advance care plan information or, alternatively, the negative outcomes that arise when this information is not available in a high-quality, standardized, sharable digital format.

Personas are used to model, summarize and communicate research about people who have been observed or researched in some way. A persona is depicted as a specific person but is not a real individual; rather, it is synthesized from observations of many people.

Power of attorney

A power of attorney or POA is a legal document which authorizes someone to act on behalf of someone else. The person granting the power of attorney is known as the principal, granter, or donor, while the person authorized to act is called an agent, attorney-in-fact, or attorney. There are many different types of POAs, and each can be further customized to suit the requirements of the granter. In short, it all depends on the content of the contract. Power of attorney documents in LOINC represent a medical or durable power of attorney.

These are statutory defined documents (i.e., states). All documents are focused on details related to power of attorney.

Use case A use case is a list of technical actions or event steps typically defining the interactions between a role and a system to achieve a goal. The actor can be a human or other external system. Technical scenarios that describe systems interactions between technical actors to implement the use case.