MyHealtheVet PHR FHIR API
0.3.9-current - ci-build United States of America flag

MyHealtheVet PHR FHIR API, published by VA Digital Services. This guide is not an authorized publication; it is the continuous build for version 0.3.9-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/department-of-veterans-affairs/mhv-fhir-phr-mapping/ and changes regularly. See the Directory of published versions

Resource Profile: VA MHV PHR ECG

Official URL: https://department-of-veterans-affairs.github.io/mhv-fhir-phr-mapping/StructureDefinition/VA.MHV.PHR.ecg Version: 0.3.9-current
Standards status: Trial-use Maturity Level: 1 Computable Name: MHVecg

A profile on the DocumentReference resource for MHV PHR exposing ECG/EKG (ClinicalProcedureTO) using FHIR API.

For API details see:

  • DocumentReference shows all uses of DocumentReference. Including Notes, Discharge Summary, EKG, and Imaging.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from MHVdocumentReference

NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..* MHVdocumentReference A reference to a document
... Slices for identifier 1..* Identifier Other identifiers for the document
Slice: Unordered, Open by pattern:use
.... identifier:TOid 1..1 Identifier Other identifiers for the document
..... use 1..1 code usual | official | temp | secondary | old (If known)
Required Pattern: usual
..... system C 0..1 uri urn:oid:2.16.840.1.113883.4.349.4.{stationNbr}
TOid-startswithoid: ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr}
..... value 0..1 string `ClinicalProcedureTO` | `.` | {ClinicalProcedureTO.id}
... status 1..1 code May indicate entered-in-error
... type
.... coding 1..* Coding Code defined by a terminology system
.... Slices for coding Content/Rules for all slices
..... coding:LO 1..1 Coding Code defined by a terminology system
Required Pattern: At least the following
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 11524-6
... category 2..* CodeableConcept Categorization of document
... Slices for category Content/Rules for all slices
.... category:LO 1..1 CodeableConcept Categorization of document
Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: LP29708-2
... subject 1..1 Reference(US Core Patient Profile) Who/what is the subject of the document
... date 0..1 instant When this document reference was created
... content
.... attachment
..... contentType 0..1 code Mime type of the content, with charset etc.
..... data 0..1 base64Binary Data inline, base64ed
..... title 0..1 string Label to display in place of the data
..... creation 0..0
... context
.... encounter 0..0
.... related 0..* Reference(VA MHV PHR Location | Location) {c} Related identifiers or resources

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
TOid-startswithoiderrorDocumentReference.identifier:TOid.systemID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr}
: value.startsWith('urn:oid:2.16.840.1.113883.4.349.4.')
NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..* MHVdocumentReference A reference to a document
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 1..* Identifier Other identifiers for the document
Slice: Unordered, Open by pattern:use
.... identifier:TOid SΣ 1..1 Identifier Other identifiers for the document
..... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Required Pattern: usual
..... system ΣC 0..1 uri urn:oid:2.16.840.1.113883.4.349.4.{stationNbr}
TOid-startswithoid: ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr}
Example General: http://www.acme.com/identifiers/patient
..... value Σ 0..1 string `ClinicalProcedureTO` | `.` | {ClinicalProcedureTO.id}
Example General: 123456
... status ?!SΣ 1..1 code May indicate entered-in-error
Binding: DocumentReferenceStatus (required)
... type SΣ 1..1 CodeableConcept Kind of document (LOINC if possible)
Binding: US Core DocumentReference Type (required): All LOINC values whose SCALE is DOC in the LOINC database and the HL7 v3 Code System NullFlavor concept 'unknown'

Additional BindingsPurpose
US Core Clinical Note Type Min Binding
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by pattern:system
..... coding:LO Σ 1..1 Coding Code defined by a terminology system
Binding: Known DocumentReference types (required)

Required Pattern: At least the following
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 11524-6
...... system Σ 1..1 uri Identity of the terminology system
Required Pattern: http://loinc.org
... Slices for category SΣ 2..* CodeableConcept Categorization of document
Slice: Unordered, Open by pattern:$this
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.


.... category:us-core SΣ 0..* CodeableConcept Categorization of document
Binding: US Core DocumentReference Category (required): The US Core DocumentReferences Type Value Set is a 'starter set' of categories supported for fetching and storing clinical notes.


.... category:LO SΣ 1..1 CodeableConcept Categorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.



Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: LP29708-2
... subject SΣ 1..1 Reference(US Core Patient Profile) Who/what is the subject of the document
... date SΣ 0..1 instant When this document reference was created
... author SΣ 0..* Reference(US Core Practitioner Profile) {c} Who and/or what authored the document
... authenticator S 0..1 Reference(VA MHV PHR Practitioner | Practitioner) {c} Who/what authenticated the document
.... Slices for extension Content/Rules for all slices
..... when S 0..1 dateTime When the authentication happened
URL: https://department-of-veterans-affairs.github.io/mhv-fhir-phr-mapping/StructureDefinition/noteAuthenticatedWhen
... content SΣ 1..1 BackboneElement Document referenced
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... attachment SΣC 1..1 Attachment Where to access the document
us-core-6: DocumentReference.content.attachment.url or DocumentReference.content.attachment.data or both SHALL be present.
..... contentType SΣ 0..1 code Mime type of the content, with charset etc.
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.


Example General: text/plain; charset=UTF-8, image/png
..... data SC 0..1 base64Binary Data inline, base64ed
..... title SΣ 0..1 string Label to display in place of the data
Example General: Official Corporate Logo
... context SΣ 0..1 BackboneElement Clinical context of document
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... period SΣ 0..1 Period Time of service that is being documented
.... related S 0..* Reference(VA MHV PHR Location | Location) {c} Related identifiers or resources

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
DocumentReference.identifier:TOid.userequiredPattern: usual
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
DocumentReference.statusrequiredDocumentReferenceStatus
http://hl7.org/fhir/ValueSet/document-reference-status
from the FHIR Standard
DocumentReference.typerequiredUSCoreDocumentReferenceType
Additional Bindings Purpose
US Core Clinical Note Type Min Binding
http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-type
DocumentReference.type.coding:LOrequiredPattern: LOINC Code 11524-6
https://department-of-veterans-affairs.github.io/mhv-fhir-phr-mapping/ValueSet/DocumentReferenceTypeVS
from this IG
DocumentReference.categoryexampleDocumentClassValueSet
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard
DocumentReference.category:us-corerequiredUSCoreDocumentReferenceCategory
http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-category
DocumentReference.category:LOexamplePattern: LOINC Code LP29708-2
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard
DocumentReference.relatesTo.coderequiredDocumentRelationshipType
http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1
from the FHIR Standard
DocumentReference.content.attachment.contentTyperequiredMime Types (a valid code from urn:ietf:bcp:13)
http://hl7.org/fhir/ValueSet/mimetypes|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
TOid-startswithoiderrorDocumentReference.identifier:TOid.systemID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr}
: value.startsWith('urn:oid:2.16.840.1.113883.4.349.4.')
NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..* MHVdocumentReference A reference to a document
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 1..* Identifier Other identifiers for the document
Slice: Unordered, Open by pattern:use
.... identifier:TOid SΣ 1..1 Identifier Other identifiers for the document
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Required Pattern: usual
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system ΣC 0..1 uri urn:oid:2.16.840.1.113883.4.349.4.{stationNbr}
TOid-startswithoid: ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr}
Example General: http://www.acme.com/identifiers/patient
..... value Σ 0..1 string `ClinicalProcedureTO` | `.` | {ClinicalProcedureTO.id}
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... status ?!SΣ 1..1 code May indicate entered-in-error
Binding: DocumentReferenceStatus (required)
... type SΣ 1..1 CodeableConcept Kind of document (LOINC if possible)
Binding: US Core DocumentReference Type (required): All LOINC values whose SCALE is DOC in the LOINC database and the HL7 v3 Code System NullFlavor concept 'unknown'

Additional BindingsPurpose
US Core Clinical Note Type Min Binding
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by pattern:system
..... coding:LO Σ 1..1 Coding Code defined by a terminology system
Binding: Known DocumentReference types (required)

Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 11524-6
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Required Pattern: http://loinc.org
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 0..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... Slices for category SΣ 2..* CodeableConcept Categorization of document
Slice: Unordered, Open by pattern:$this
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.


.... category:us-core SΣ 0..* CodeableConcept Categorization of document
Binding: US Core DocumentReference Category (required): The US Core DocumentReferences Type Value Set is a 'starter set' of categories supported for fetching and storing clinical notes.


.... category:LO SΣ 1..1 CodeableConcept Categorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.



Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: LP29708-2
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(US Core Patient Profile) Who/what is the subject of the document
... date SΣ 0..1 instant When this document reference was created
... author SΣ 0..* Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device) {c} Who and/or what authored the document
... authenticator S 0..1 Reference(VA MHV PHR Practitioner | Practitioner) {c} Who/what authenticated the document
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... when S 0..1 dateTime When the authentication happened
URL: https://department-of-veterans-affairs.github.io/mhv-fhir-phr-mapping/StructureDefinition/noteAuthenticatedWhen
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... content SΣ 1..1 BackboneElement Document referenced
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... attachment SΣC 1..1 Attachment Where to access the document
us-core-6: DocumentReference.content.attachment.url or DocumentReference.content.attachment.data or both SHALL be present.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... contentType SΣ 0..1 code Mime type of the content, with charset etc.
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.


Example General: text/plain; charset=UTF-8, image/png
..... data SC 0..1 base64Binary Data inline, base64ed
..... title SΣ 0..1 string Label to display in place of the data
Example General: Official Corporate Logo
... context SΣ 0..1 BackboneElement Clinical context of document
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... period SΣ 0..1 Period Time of service that is being documented
.... related S 0..* Reference(VA MHV PHR Location | Location) {c} Related identifiers or resources

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
DocumentReference.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
DocumentReference.identifier:TOid.userequiredPattern: usual
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
DocumentReference.identifier:TOid.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
DocumentReference.statusrequiredDocumentReferenceStatus
http://hl7.org/fhir/ValueSet/document-reference-status
from the FHIR Standard
DocumentReference.typerequiredUSCoreDocumentReferenceType
Additional Bindings Purpose
US Core Clinical Note Type Min Binding
http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-type
DocumentReference.type.coding:LOrequiredPattern: LOINC Code 11524-6
https://department-of-veterans-affairs.github.io/mhv-fhir-phr-mapping/ValueSet/DocumentReferenceTypeVS
from this IG
DocumentReference.categoryexampleDocumentClassValueSet
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard
DocumentReference.category:us-corerequiredUSCoreDocumentReferenceCategory
http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-category
DocumentReference.category:LOexamplePattern: LOINC Code LP29708-2
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard
DocumentReference.authenticator.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
DocumentReference.relatesTo.coderequiredDocumentRelationshipType
http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1
from the FHIR Standard
DocumentReference.content.attachment.contentTyperequiredMime Types (a valid code from urn:ietf:bcp:13)
http://hl7.org/fhir/ValueSet/mimetypes|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
TOid-startswithoiderrorDocumentReference.identifier:TOid.systemID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr}
: value.startsWith('urn:oid:2.16.840.1.113883.4.349.4.')

This structure is derived from MHVdocumentReference

Summary

Mandatory: 4 elements
Prohibited: 2 elements

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of DocumentReference.identifier

Maturity: 1

Differential View

This structure is derived from MHVdocumentReference

NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..* MHVdocumentReference A reference to a document
... Slices for identifier 1..* Identifier Other identifiers for the document
Slice: Unordered, Open by pattern:use
.... identifier:TOid 1..1 Identifier Other identifiers for the document
..... use 1..1 code usual | official | temp | secondary | old (If known)
Required Pattern: usual
..... system C 0..1 uri urn:oid:2.16.840.1.113883.4.349.4.{stationNbr}
TOid-startswithoid: ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr}
..... value 0..1 string `ClinicalProcedureTO` | `.` | {ClinicalProcedureTO.id}
... status 1..1 code May indicate entered-in-error
... type
.... coding 1..* Coding Code defined by a terminology system
.... Slices for coding Content/Rules for all slices
..... coding:LO 1..1 Coding Code defined by a terminology system
Required Pattern: At least the following
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 11524-6
... category 2..* CodeableConcept Categorization of document
... Slices for category Content/Rules for all slices
.... category:LO 1..1 CodeableConcept Categorization of document
Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: LP29708-2
... subject 1..1 Reference(US Core Patient Profile) Who/what is the subject of the document
... date 0..1 instant When this document reference was created
... content
.... attachment
..... contentType 0..1 code Mime type of the content, with charset etc.
..... data 0..1 base64Binary Data inline, base64ed
..... title 0..1 string Label to display in place of the data
..... creation 0..0
... context
.... encounter 0..0
.... related 0..* Reference(VA MHV PHR Location | Location) {c} Related identifiers or resources

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
TOid-startswithoiderrorDocumentReference.identifier:TOid.systemID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr}
: value.startsWith('urn:oid:2.16.840.1.113883.4.349.4.')

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..* MHVdocumentReference A reference to a document
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 1..* Identifier Other identifiers for the document
Slice: Unordered, Open by pattern:use
.... identifier:TOid SΣ 1..1 Identifier Other identifiers for the document
..... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Required Pattern: usual
..... system ΣC 0..1 uri urn:oid:2.16.840.1.113883.4.349.4.{stationNbr}
TOid-startswithoid: ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr}
Example General: http://www.acme.com/identifiers/patient
..... value Σ 0..1 string `ClinicalProcedureTO` | `.` | {ClinicalProcedureTO.id}
Example General: 123456
... status ?!SΣ 1..1 code May indicate entered-in-error
Binding: DocumentReferenceStatus (required)
... type SΣ 1..1 CodeableConcept Kind of document (LOINC if possible)
Binding: US Core DocumentReference Type (required): All LOINC values whose SCALE is DOC in the LOINC database and the HL7 v3 Code System NullFlavor concept 'unknown'

Additional BindingsPurpose
US Core Clinical Note Type Min Binding
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by pattern:system
..... coding:LO Σ 1..1 Coding Code defined by a terminology system
Binding: Known DocumentReference types (required)

Required Pattern: At least the following
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 11524-6
...... system Σ 1..1 uri Identity of the terminology system
Required Pattern: http://loinc.org
... Slices for category SΣ 2..* CodeableConcept Categorization of document
Slice: Unordered, Open by pattern:$this
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.


.... category:us-core SΣ 0..* CodeableConcept Categorization of document
Binding: US Core DocumentReference Category (required): The US Core DocumentReferences Type Value Set is a 'starter set' of categories supported for fetching and storing clinical notes.


.... category:LO SΣ 1..1 CodeableConcept Categorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.



Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: LP29708-2
... subject SΣ 1..1 Reference(US Core Patient Profile) Who/what is the subject of the document
... date SΣ 0..1 instant When this document reference was created
... author SΣ 0..* Reference(US Core Practitioner Profile) {c} Who and/or what authored the document
... authenticator S 0..1 Reference(VA MHV PHR Practitioner | Practitioner) {c} Who/what authenticated the document
.... Slices for extension Content/Rules for all slices
..... when S 0..1 dateTime When the authentication happened
URL: https://department-of-veterans-affairs.github.io/mhv-fhir-phr-mapping/StructureDefinition/noteAuthenticatedWhen
... content SΣ 1..1 BackboneElement Document referenced
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... attachment SΣC 1..1 Attachment Where to access the document
us-core-6: DocumentReference.content.attachment.url or DocumentReference.content.attachment.data or both SHALL be present.
..... contentType SΣ 0..1 code Mime type of the content, with charset etc.
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.


Example General: text/plain; charset=UTF-8, image/png
..... data SC 0..1 base64Binary Data inline, base64ed
..... title SΣ 0..1 string Label to display in place of the data
Example General: Official Corporate Logo
... context SΣ 0..1 BackboneElement Clinical context of document
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... period SΣ 0..1 Period Time of service that is being documented
.... related S 0..* Reference(VA MHV PHR Location | Location) {c} Related identifiers or resources

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
DocumentReference.identifier:TOid.userequiredPattern: usual
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
DocumentReference.statusrequiredDocumentReferenceStatus
http://hl7.org/fhir/ValueSet/document-reference-status
from the FHIR Standard
DocumentReference.typerequiredUSCoreDocumentReferenceType
Additional Bindings Purpose
US Core Clinical Note Type Min Binding
http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-type
DocumentReference.type.coding:LOrequiredPattern: LOINC Code 11524-6
https://department-of-veterans-affairs.github.io/mhv-fhir-phr-mapping/ValueSet/DocumentReferenceTypeVS
from this IG
DocumentReference.categoryexampleDocumentClassValueSet
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard
DocumentReference.category:us-corerequiredUSCoreDocumentReferenceCategory
http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-category
DocumentReference.category:LOexamplePattern: LOINC Code LP29708-2
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard
DocumentReference.relatesTo.coderequiredDocumentRelationshipType
http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1
from the FHIR Standard
DocumentReference.content.attachment.contentTyperequiredMime Types (a valid code from urn:ietf:bcp:13)
http://hl7.org/fhir/ValueSet/mimetypes|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
TOid-startswithoiderrorDocumentReference.identifier:TOid.systemID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr}
: value.startsWith('urn:oid:2.16.840.1.113883.4.349.4.')

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..* MHVdocumentReference A reference to a document
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 1..* Identifier Other identifiers for the document
Slice: Unordered, Open by pattern:use
.... identifier:TOid SΣ 1..1 Identifier Other identifiers for the document
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Required Pattern: usual
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system ΣC 0..1 uri urn:oid:2.16.840.1.113883.4.349.4.{stationNbr}
TOid-startswithoid: ID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr}
Example General: http://www.acme.com/identifiers/patient
..... value Σ 0..1 string `ClinicalProcedureTO` | `.` | {ClinicalProcedureTO.id}
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... status ?!SΣ 1..1 code May indicate entered-in-error
Binding: DocumentReferenceStatus (required)
... type SΣ 1..1 CodeableConcept Kind of document (LOINC if possible)
Binding: US Core DocumentReference Type (required): All LOINC values whose SCALE is DOC in the LOINC database and the HL7 v3 Code System NullFlavor concept 'unknown'

Additional BindingsPurpose
US Core Clinical Note Type Min Binding
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by pattern:system
..... coding:LO Σ 1..1 Coding Code defined by a terminology system
Binding: Known DocumentReference types (required)

Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 11524-6
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 1..1 uri Identity of the terminology system
Required Pattern: http://loinc.org
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 0..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... Slices for category SΣ 2..* CodeableConcept Categorization of document
Slice: Unordered, Open by pattern:$this
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.


.... category:us-core SΣ 0..* CodeableConcept Categorization of document
Binding: US Core DocumentReference Category (required): The US Core DocumentReferences Type Value Set is a 'starter set' of categories supported for fetching and storing clinical notes.


.... category:LO SΣ 1..1 CodeableConcept Categorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.



Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: LP29708-2
...... display 0..1 string Representation defined by the system
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(US Core Patient Profile) Who/what is the subject of the document
... date SΣ 0..1 instant When this document reference was created
... author SΣ 0..* Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device) {c} Who and/or what authored the document
... authenticator S 0..1 Reference(VA MHV PHR Practitioner | Practitioner) {c} Who/what authenticated the document
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... when S 0..1 dateTime When the authentication happened
URL: https://department-of-veterans-affairs.github.io/mhv-fhir-phr-mapping/StructureDefinition/noteAuthenticatedWhen
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... content SΣ 1..1 BackboneElement Document referenced
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... attachment SΣC 1..1 Attachment Where to access the document
us-core-6: DocumentReference.content.attachment.url or DocumentReference.content.attachment.data or both SHALL be present.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... contentType SΣ 0..1 code Mime type of the content, with charset etc.
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.


Example General: text/plain; charset=UTF-8, image/png
..... data SC 0..1 base64Binary Data inline, base64ed
..... title SΣ 0..1 string Label to display in place of the data
Example General: Official Corporate Logo
... context SΣ 0..1 BackboneElement Clinical context of document
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... period SΣ 0..1 Period Time of service that is being documented
.... related S 0..* Reference(VA MHV PHR Location | Location) {c} Related identifiers or resources

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
DocumentReference.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
DocumentReference.identifier:TOid.userequiredPattern: usual
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
DocumentReference.identifier:TOid.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
DocumentReference.statusrequiredDocumentReferenceStatus
http://hl7.org/fhir/ValueSet/document-reference-status
from the FHIR Standard
DocumentReference.typerequiredUSCoreDocumentReferenceType
Additional Bindings Purpose
US Core Clinical Note Type Min Binding
http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-type
DocumentReference.type.coding:LOrequiredPattern: LOINC Code 11524-6
https://department-of-veterans-affairs.github.io/mhv-fhir-phr-mapping/ValueSet/DocumentReferenceTypeVS
from this IG
DocumentReference.categoryexampleDocumentClassValueSet
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard
DocumentReference.category:us-corerequiredUSCoreDocumentReferenceCategory
http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-category
DocumentReference.category:LOexamplePattern: LOINC Code LP29708-2
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard
DocumentReference.authenticator.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
DocumentReference.relatesTo.coderequiredDocumentRelationshipType
http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1
from the FHIR Standard
DocumentReference.content.attachment.contentTyperequiredMime Types (a valid code from urn:ietf:bcp:13)
http://hl7.org/fhir/ValueSet/mimetypes|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
TOid-startswithoiderrorDocumentReference.identifier:TOid.systemID system must start with urn:oid:2.16.840.1.113883.4.349.4. The next would be the {stationNbr}
: value.startsWith('urn:oid:2.16.840.1.113883.4.349.4.')

This structure is derived from MHVdocumentReference

Summary

Mandatory: 4 elements
Prohibited: 2 elements

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of DocumentReference.identifier

Maturity: 1

 

Other representations of profile: CSV, Excel, Schematron

Notes:

  • The mock example
  • maps to ClinicalProcedureTO schema.
  • mapping to VIA
  • based on US-Core for Clinical Notes
  • should have meta.profile set to https://department-of-veterans-affairs.github.io/mhv-fhir-phr-mapping/StructureDefinition/VA.MHV.PHR.ecg to indicate the intent to be compliant with this profile
  • must also have category of Cardiology (LP29708-2)
  • .identifier holds the ClinicalProcedureTO.id
  • must have type of LOINC 11524-6
  • content.attachment.title = ELECTROCARDIOGRAM

Mapping Concerns

  • MHV is no longer pulling ECG because the only thing we get is historic, all current ECG just give us the date only.