<?xml version="1.0" encoding="UTF-8"?>

<DeviceRequest xmlns="http://hl7.org/fhir">
  <id value="PFEIG-DeviceRequest-RollingWalker"/>
  <meta>
    <profile value="http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request"/>
  </meta>
  <language value="en"/>
  <text>
    <status value="extensions"/><div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en"><p class="res-header-id"><b>Generated Narrative: DeviceRequest PFEIG-DeviceRequest-RollingWalker</b></p><a name="PFEIG-DeviceRequest-RollingWalker"> </a><a name="hcPFEIG-DeviceRequest-RollingWalker"> </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</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-pfe-device-request.html">Personal Functioning and Engagement Device Request Profile</a></p></div><blockquote><p><b>PFEDeviceRequestLocation</b></p><ul><li>reference: <a href="Location-PFEIG-Org-Loc-02.html">Location Happy Nursing Facility</a></li></ul></blockquote><blockquote><p><b>PFEDeviceRequestUser</b></p><ul><li>user: <a href="Patient-PFEIG-patientBSJ1.html">Betsy Smith-Johnson Female, DoB Unknown ( http://example.org/identifiers/patient#10A3D58WH1600)</a></li><li>relationship: <span title="Codes:{http://hl7.org/fhir/deviceassociation-relationship patient}">Patient</span></li></ul></blockquote><p><b>PFEDeviceRequestClinicalJustification</b>: </p><div><p>Betsy requires a rolling walker to support safe ambulation, transfers, and participation in daily activities while recovering from stroke-related right-sided weakness and deconditioning.</p>
</div><p><b>PFEDeviceRequestAssessment</b>: <a href="Observation-PFEIG-FSC-Hospital-Discharge-Mobility-1-Ob-Question-16.html">Observation Walk 10 feet - functional ability during 3 day assessment period [CMS Assessment]</a></p><p><b>PFEDeviceRequestAssessment</b>: <a href="Observation-PFEIG-FSC-Hospital-Discharge-Mobility-1-Ob-Question-18.html">Observation Walk 50 feet with two turns - functional ability during 3 day assessment period [CMS Assessment]</a></p><p><b>PFEDeviceRequestUseOfDevice</b>: <a href="DeviceUseStatement-PFEIG-FSC-Hospital-Discharge-Mobility-1-UseOfDevice-2.html">DeviceUseStatement: status = active; recordedOn = 2020-07-10 14:34:00-0500</a></p><p><b>Resource Pertains To Goal</b>: <a href="Goal-PFEIG-Goal-WalkingGoal.html">Goal: lifecycleStatus = active; achievementStatus = In Progress; description = Able to walk in room (finding); start[x] = 2024-01-18; note = Betsy will be able to complete functional mobility including navigating around furniture, mainingin balance, and demonstrating good functional endurance for completing activities of daily life, and instrumental activities of daily life, and in order to decrease risk of fall and risk of hospital readmission.</a></p><p><b>basedOn</b>: <a href="ServiceRequest-PFEIG-ServiceRequest-SNFDischargePTRefer.html">ServiceRequest Physical therapy assessment (procedure)</a></p><p><b>status</b>: Active</p><p><b>intent</b>: Order</p><p><b>priority</b>: Routine</p><p><b>code</b>: <span title="Codes:{http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets E0143}">Walker, folding, wheeled, adjustable or fixed height</span></p><h3>Parameters</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">Walker height adjustment</span></td><td><span title="Codes:">Adult standard height</span></td></tr></table><p><b>subject</b>: <a href="Patient-PFEIG-patientBSJ1.html">Betsy Smith-Johnson Female, DoB Unknown ( http://example.org/identifiers/patient#10A3D58WH1600)</a></p><p><b>encounter</b>: <a href="Encounter-PFEIG-Encounter-DeviceRequest-RollingWalker.html">Encounter: status = finished; class = inpatient encounter (ActCode#IMP); period = 2024-07-17 09:30:00-0500 --&gt; 2024-07-17 10:15:00-0500</a></p><p><b>occurrence</b>: 2024-07-18</p><p><b>authoredOn</b>: 2024-07-17</p><p><b>requester</b>: <a href="PractitionerRole-PFEIG-Role-SNFDoc-GeraldPark.html">PractitionerRole Geriatric Medicine (Family Medicine) Physician</a></p><p><b>performer</b>: <a href="Organization-PFEIG-Org-03.html">Organization Sky Harbor Home Health Services</a></p><p><b>reasonCode</b>: <span title="Codes:{http://snomed.info/sct 31031000119102}">Physical deconditioning (finding)</span></p><p><b>reasonReference</b>: </p><ul><li><a href="Condition-PFEIG-Condition-Decondition.html">Condition Physical deconditioning (finding)</a></li><li><a href="Condition-PFEIG-Condition-HemiparesisDiagnosis.html">Condition Right hemiparesis (disorder)</a></li></ul><p><b>insurance</b>: <a href="Coverage-PFEIG-PASCoverage-BSJ1.html">Coverage: identifier = http://example.org/coverage#PAS-987654321; status = active; subscriberId = SUB-123456789; relationship = Self</a></p><p><b>note</b>: </p><blockquote><div><p>Order for a rolling walker to support discharge planning and continued mobility rehabilitation.</p>
</div></blockquote></div>
  </text>
  <extension url="http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-location">
    <extension url="reference">
      <valueReference>
        <reference value="Location/PFEIG-Org-Loc-02"/>
      </valueReference>
    </extension>
  </extension>
  <extension url="http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-user">
    <extension url="user">
      <valueReference>
        <reference value="Patient/PFEIG-patientBSJ1"/>
      </valueReference>
    </extension>
    <extension url="relationship">
      <valueCodeableConcept>
        <coding>
          <system value="http://hl7.org/fhir/deviceassociation-relationship"/>
          <code value="patient"/>
          <display value="Patient"/>
        </coding>
      </valueCodeableConcept>
    </extension>
  </extension>
  <extension url="http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-clinical-justification">
    <valueMarkdown value="Betsy requires a rolling walker to support safe ambulation, transfers, and participation in daily activities while recovering from stroke-related right-sided weakness and deconditioning."/>
  </extension>
  <extension url="http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-assessment">
    <valueReference>
      <reference value="Observation/PFEIG-FSC-Hospital-Discharge-Mobility-1-Ob-Question-16"/>
    </valueReference>
  </extension>
  <extension url="http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-assessment">
    <valueReference>
      <reference value="Observation/PFEIG-FSC-Hospital-Discharge-Mobility-1-Ob-Question-18"/>
    </valueReference>
  </extension>
  <extension url="http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-use-of-device">
    <valueReference>
      <reference value="DeviceUseStatement/PFEIG-FSC-Hospital-Discharge-Mobility-1-UseOfDevice-2"/>
    </valueReference>
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal">
    <valueReference>
      <reference value="Goal/PFEIG-Goal-WalkingGoal"/>
    </valueReference>
  </extension>
  <basedOn>
    <reference value="ServiceRequest/PFEIG-ServiceRequest-SNFDischargePTRefer"/>
  </basedOn>
  <status value="active"/>
  <intent value="order"/>
  <priority value="routine"/>
  <codeCodeableConcept>
    <coding>
      <system value="http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"/>
      <code value="E0143"/>
      <display value="Walker, folding, wheeled, adjustable or fixed height"/>
    </coding>
  </codeCodeableConcept>
  <parameter>
    <code>
      <text value="Walker height adjustment"/>
    </code>
    <valueCodeableConcept>
      <text value="Adult standard height"/>
    </valueCodeableConcept>
  </parameter>
  <subject>
    <reference value="Patient/PFEIG-patientBSJ1"/>
  </subject>
  <encounter>
    <reference value="Encounter/PFEIG-Encounter-DeviceRequest-RollingWalker"/>
  </encounter>
  <occurrenceDateTime value="2024-07-18"/>
  <authoredOn value="2024-07-17"/>
  <requester>
    <extension url="http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-device-request-additional-requester">
      <valueReference>
        <reference value="RelatedPerson/PFEIG-RelatedPerson-CharlesJohnson"/>
      </valueReference>
    </extension>
    <reference value="PractitionerRole/PFEIG-Role-SNFDoc-GeraldPark"/>
  </requester>
  <performer>
    <reference value="Organization/PFEIG-Org-03"/>
  </performer>
  <reasonCode>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="31031000119102"/>
      <display value="Physical deconditioning (finding)"/>
    </coding>
  </reasonCode>
  <reasonReference>
    <reference value="Condition/PFEIG-Condition-Decondition"/>
  </reasonReference>
  <reasonReference>
    <reference value="Condition/PFEIG-Condition-HemiparesisDiagnosis"/>
  </reasonReference>
  <insurance>
    <reference value="Coverage/PFEIG-PASCoverage-BSJ1"/>
  </insurance>
  <note>
    <text value="Order for a rolling walker to support discharge planning and continued mobility rehabilitation."/>
  </note>
</DeviceRequest>