De-Identification Profile
0.0.1-current - ci-build

De-Identification Profile, published by IHE IT Infrastructure Technical Committee. This guide is not an authorized publication; it is the continuous build for version 0.0.1-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/ITI.DeIdHandbook/ and changes regularly. See the Directory of published versions

## Example Bundle: ex-DeathCertificateDocument-Bundle-pandemnicIPS-example-patient-1-stage-1

Document Details

Profile: Death Certificate Document

Final Document at 2024-07-01 00:00:00+0000 by Practitioner Jim Black (official) for Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

Document Subject

Profiles: Patient (IPS), Decedent

Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

Marital Status: | Never Married
Contact Detail | 5590 Lockwood Drive Danville VA US
Unknown: | Joe Smith
NVSS SexAtDeath | Female
Spouse Is Alive | Yes
Patient Birth Place | Roanoke VA US

Document Content

## Decedent Demographics

## Death Investigation

## Death Certification

## Decedent Disposition

## Coded Content

## Additional Resources Included in Document

Entry 2 - fullUrl = http://www.example.org/fhir/Patient/Ex-Patient-1-for-secondaryUse-pandemnicIPS-stage-1

Resource Patient:

> Profiles: Patient (IPS), Decedent

> Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

> Marital Status: | Never Married
> Contact Detail | 5590 Lockwood Drive Danville VA US
> Unknown: | Joe Smith
> NVSS SexAtDeath | Female
> Spouse Is Alive | Yes
> Patient Birth Place | Roanoke VA US

Entry 3 - fullUrl = http://www.example.org/fhir/RelatedPerson/DecedentFather-Example1

Resource RelatedPerson:

> Profile: Decedent Father

> active: true

> patient: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

> relationship: father

> name: Decedent Dad(Official)

Entry 4 - fullUrl = http://www.example.org/fhir/RelatedPerson/DecedentMother-Example1

Resource RelatedPerson:

> Profile: Decedent Mother

> active: true

> patient: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

> relationship: mother

> name: Decedent Mom(Name changed for Marriage)

Entry 5 - fullUrl = http://www.example.org/fhir/RelatedPerson/DecedentSpouse-Example1

Resource RelatedPerson:

> Profile: Decedent Spouse

> active: true

> patient: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

> relationship: spouse

> name: Decedent Spouse(Name changed for Marriage)

Entry 6 - fullUrl = http://www.example.org/fhir/Observation/DecedentAge-Example1

Resource Observation:

> Profile: Decedent Age

> status: Final

> code: Age at death

> subject: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

> value: 29 years (Details: UCUM codea = 'a')

Entry 7 - fullUrl = http://www.example.org/fhir/Observation/DecedentUsualWork-Example1

Resource Observation:

> Profile: Decedent Usual Work

> status: Final

> code: History of Usual occupation

> subject: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

> value: Health Care Assistants

> ### Components

> - | Code | Value[x]
> * | History of Occupation Industry | Residential nursing care facilities

Entry 8 - fullUrl = http://www.example.org/fhir/Observation/DecedentPregnancyStatus-Example1

Resource Observation:

> Profile: Decedent Pregnancy

> status: Final

> code: Timing of recent pregnancy in relation to death

> subject: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

> value: Pregnant at time of death

Entry 9 - fullUrl = http://www.example.org/fhir/Observation/DeathDate-Example2

Resource Observation:

> Profile: Death Date

> status: Final

> code: Date and time of death [TimeStamp]

> subject: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

> effective: 2024-06-30 16:39:40-0500

> performer: Practitioner Jane Purple (official)

> value: `Partial Date Time Vital Records:`

> > component

> > code: Date and time pronounced dead [US Standard Certificate of Death]

> > value: 2024-06-30 16:39:40-0500

> > component

> > code: Location of death

> > value: Death in home

Entry 10 - fullUrl = http://www.example.org/fhir/Practitioner/Pronouncer-Example1

Resource Practitioner:

> Profile: US Core Practitioner Profile

> identifier: NPI/9941339101

> name: Jane Purple (Official)

> address: 44 South Street Rockville MD 20854 US

Entry 11 - fullUrl = http://www.example.org/fhir/Observation/MannerOfDeath-Example1

Resource Observation:

> Profile: Manner of Death

> status: Final

> code: Manner of death

> subject: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

> performer: Practitioner Jim Black (official)

> value: Natural death

Entry 12 - fullUrl = http://www.example.org/fhir/Practitioner/Certifier-Example1

Resource Practitioner:

> Profile: Death Certifier

> Practitioner Role: Certifier

> identifier: NPI/9941339100

> name: Jim Black (Official)

> address: 44 South Street Bird in Hand PA 17505 US

Entry 13 - fullUrl = http://www.example.org/fhir/Procedure/DeathCertification-Example1

Resource Procedure:

> Profile: Death Certification Procedure

> identifier: 180

> status: Completed

> code: Death certification

> subject: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

> ### Performers

> - | Function | Actor
> * | Nurse Practitioner | Practitioner Jim Black (official)

Entry 14 - fullUrl = http://www.example.org/fhir/Observation/CauseOfDeathPart1-Example1

Resource Observation:

> Profile: Cause Of Death Part 1

> status: Final

> code: Cause of death [US Standard Certificate of Death]

> subject: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

> performer: Practitioner Jim Black (official)

> value: Covid-19

> > component

> > code: line number

> > value: 1

> > component

> > code: Disease onset to death interval

> > value: 4 hours

Entry 15 - fullUrl = http://www.example.org/fhir/Observation/CauseOfDeathPart1-Example2

Resource Observation:

> Profile: Cause Of Death Part 1

> status: Final

> code: Cause of death [US Standard Certificate of Death]

> subject: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

> performer: Practitioner Jim Black (official)

> value: Eclampsia

> > component

> > code: line number

> > value: 2

> > component

> > code: Disease onset to death interval

> > value: 3 months

Entry 16 - fullUrl = http://www.example.org/fhir/Observation/CauseOfDeathPart2-Example1

Resource Observation:

> Profile: Cause of Death Part 2

> status: Final

> code: Other significant causes or conditions of death

> subject: Jordana Patricia (official) Female, DoB: 1996-08-16 ( Social Beneficiary Identifier: SSN#123456789)

> performer: Practitioner Jim Black (official)

> value: hypertensive heart disease

Entry 17 - fullUrl = http://www.example.org/fhir/Location/DispositionLocation-Example1

Resource Location:

> Profile: Disposition Location

> name: Rosewood Cemetary

> type: Disposition Location

> address: 303 Rosewood Ave Danville VA 24541 US

Entry 18 - fullUrl = http://www.example.org/fhir/Observation/RecordAxisCauseOfDeath-Example1

Resource Observation:

> Profile: Record Axis Cause Of Death

> status: Final

> code: Cause of death record axis code [Automated]

> subject: NCHS generated

> value: COVID-19

> ### Components

> - | Code | Value[x]
> * | position | 1

Entry 19 - fullUrl = http://www.example.org/fhir/Observation/EntityAxisCauseOfDeath-Example1

Resource Observation:

> Profile: Entity Axis Cause Of Death

> status: Final

> code: Cause of death entity axis code [Automated]

> subject: NCHS generated

> value: COVID-19

> > component

> > code: line number

> > value: 1

> > component

> > code: position

> > value: 1