Example-Smith-Johnson-Bundle1
type: Bundle
node role: treeRoot
resource.id:
  value: Example-Smith-Johnson-Bundle1
bundle.identifier:
  identifier.system:
    value: urn:oid:2.16.840.1.113883.3.3208.101.1
  identifier.value:
    value: 20130607100315-CCDA-CCD
bundle.type:
  value: document
bundle.timestamp:
  value: 2021-03-29T14:25:34.001-05:00
bundle.entry:
  index: 0
  bundle.entry.full url:
    value: http://www.example.org/fhir/Composition/Example-Smith-Johnson-PACPComposition1
  bundle.entry.resource: Example-Smith-Johnson-PACPComposition1
bundle.entry:
  index: 1
  bundle.entry.full url:
    value: http://www.example.org/fhir/Patient/Example-Smith-Johnson-Patient1
  bundle.entry.resource: Example-Smith-Johnson-Patient1
bundle.entry:
  index: 2
  bundle.entry.full url:
    value: http://www.example.org/fhir/RelatedPerson/Example-Smith-Johnson-Notary1
  bundle.entry.resource: Example-Smith-Johnson-Notary1
bundle.entry:
  index: 3
  bundle.entry.full url:
    value: http://www.example.org/fhir/RelatedPerson/Example-Smith-Johnson-HealthcareAgent1
  bundle.entry.resource: Example-Smith-Johnson-HealthcareAgent1
bundle.entry:
  index: 4
  bundle.entry.full url:
    value: http://www.example.org/fhir/RelatedPerson/Example-Smith-Johnson-HealthcareAgent2
  bundle.entry.resource: Example-Smith-Johnson-HealthcareAgent2
bundle.entry:
  index: 5
  bundle.entry.full url:
    value: http://www.example.org/fhir/Consent/Example-Smith-Johnson-HealthcareAgentConsent
  bundle.entry.resource: Example-Smith-Johnson-HealthcareAgentConsent
bundle.entry:
  index: 6
  bundle.entry.full url:
    value: http://www.example.org/fhir/CarePlan/Example-Smith-Johnson-PreferenceCarePlan1
  bundle.entry.resource: Example-Smith-Johnson-PreferenceCarePlan1
bundle.entry:
  index: 7
  bundle.entry.full url:
    value: http://www.example.org/fhir/CarePlan/Example-Smith-Johnson-PreferenceCarePlan2
  bundle.entry.resource: Example-Smith-Johnson-PreferenceCarePlan2
bundle.entry:
  index: 8
  bundle.entry.full url:
    value: http://www.example.org/fhir/CarePlan/Example-Smith-Johnson-PreferenceCarePlan3
  bundle.entry.resource: Example-Smith-Johnson-PreferenceCarePlan3
bundle.entry:
  index: 9
  bundle.entry.full url:
    value: http://www.example.org/fhir/Goal/Example-Smith-Johnson-CareExperiencePreference2
  bundle.entry.resource: Example-Smith-Johnson-CareExperiencePreference2
bundle.entry:
  index: 10
  bundle.entry.full url:
    value: http://www.example.org/fhir/Goal/Example-Smith-Johnson-CareExperiencePreference3
  bundle.entry.resource: Example-Smith-Johnson-CareExperiencePreference3
bundle.entry:
  index: 11
  bundle.entry.full url:
    value: http://www.example.org/fhir/Goal/Example-Smith-Johnson-CareExperiencePreference4
  bundle.entry.resource: Example-Smith-Johnson-CareExperiencePreference4
bundle.entry:
  index: 12
  bundle.entry.full url:
    value: http://www.example.org/fhir/Goal/Example-Smith-Johnson-CareExperiencePreference5
  bundle.entry.resource: Example-Smith-Johnson-CareExperiencePreference5
bundle.entry:
  index: 13
  bundle.entry.full url:
    value: http://www.example.org/fhir/Goal/Example-Smith-Johnson-CareExperiencePreference6
  bundle.entry.resource: Example-Smith-Johnson-CareExperiencePreference6
bundle.entry:
  index: 14
  bundle.entry.full url:
    value: http://www.example.org/fhir/Goal/Example-Smith-Johnson-CareExperiencePreference7
  bundle.entry.resource: Example-Smith-Johnson-CareExperiencePreference7
bundle.entry:
  index: 15
  bundle.entry.full url:
    value: http://www.example.org/fhir/Goal/Example-Smith-Johnson-CareExperiencePreference8
  bundle.entry.resource: Example-Smith-Johnson-CareExperiencePreference8
bundle.entry:
  index: 16
  bundle.entry.full url:
    value: http://www.example.org/fhir/Goal/Example-Smith-Johnson-PersonalInterventionPreference1
  bundle.entry.resource: Example-Smith-Johnson-PersonalInterventionPreference1
bundle.entry:
  index: 17
  bundle.entry.full url:
    value: http://www.example.org/fhir/Goal/Example-Smith-Johnson-PersonalInterventionPreference3
  bundle.entry.resource: Example-Smith-Johnson-PersonalInterventionPreference3
bundle.entry:
  index: 18
  bundle.entry.full url:
    value: http://www.example.org/fhir/Goal/Example-Smith-Johnson-PersonalInterventionPreference5
  bundle.entry.resource: Example-Smith-Johnson-PersonalInterventionPreference5
bundle.entry:
  index: 19
  bundle.entry.full url:
    value: http://www.example.org/fhir/Goal/Example-Smith-Johnson-PersonalInterventionPreference6
  bundle.entry.resource: Example-Smith-Johnson-PersonalInterventionPreference6
bundle.entry:
  index: 20
  bundle.entry.full url:
    value: http://www.example.org/fhir/Goal/Example-Smith-Johnson-PersonalGoal1
  bundle.entry.resource: Example-Smith-Johnson-PersonalGoal1
bundle.entry:
  index: 21
  bundle.entry.full url:
    value: http://www.example.org/fhir/Observation/Example-Smith-Johnson-OrganDonationObservation1
  bundle.entry.resource: Example-Smith-Johnson-OrganDonationObservation1
bundle.entry:
  index: 22
  bundle.entry.full url:
    value: http://www.example.org/fhir/Observation/Example-Smith-Johnson-AutopsyObservation1
  bundle.entry.resource: Example-Smith-Johnson-AutopsyObservation1
bundle.entry:
  index: 23
  bundle.entry.full url:
    value: http://www.example.org/fhir/Observation/Example-Smith-Johnson-DocumentationObservation1
  bundle.entry.resource: Example-Smith-Johnson-DocumentationObservation1
bundle.entry:
  index: 24
  bundle.entry.full url:
    value: http://www.example.org/fhir/Organization/Example-Smith-Johnson-OrganizationCustodian1
  bundle.entry.resource: Example-Smith-Johnson-OrganizationCustodian1

Example-Smith-Johnson-PACPComposition1
type: Composition
resource.id:
  value: Example-Smith-Johnson-PACPComposition1
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PACPComposition
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PACPComposition
resource.language:
  value: en-US
domain resource.text:
  narrative.status:
    value: extensions
  narrative.div: Generated Narrative Resource "Example-Smith-Johnson-PACPComposition1" (Language "en-US") Profile: ADI Personal Advance Care Plan Composition Version Number: 1 Jurisdiction: Michigan (ISO 3166 Part 2 Country Subdivision Codes#US-MI) Data Enterer: See above (Patient/Example-Smith-Johnson-Patient1) identifier: id: 0-87f37989294a408897aacd1fc5d8fd16 status: final type: Patient Personal advance care plan (LOINC#81334-5) category: Advance Directive (LOINC#75320-2) date: 2021-03-29T14:25:34-05:00 author: See above (Patient/Example-Smith-Johnson-Patient1) title: Personal Advance Care Plan Attesters - Extension Mode Party * professional See above (RelatedPerson/Example-Smith-Johnson-Notary1) custodian: See above (Organization/Example-Smith-Johnson-OrganizationCustodian1)
domain resource.extension:
  index: 0
  extension.url:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-versionNumber-extension
  extension.value integer:
    value: 1
domain resource.extension:
  index: 1
  extension.url:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-jurisdiction-extension
  extension.value codeable concept:
    codeable concept.coding:
      index: 0
      coding.system:
        value: urn:iso:std:iso:3166:-2
      coding.code:
        value: US-MI
domain resource.extension:
  index: 2
  extension.url:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-dataEnterer-extension
  extension.value reference:
    link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
    reference.reference:
      value: Patient/Example-Smith-Johnson-Patient1
composition.identifier:
  identifier.system:
    value: urn:oid:2.16.840.1.113883.4.823.1.7124
composition.status:
  value: final
composition.type:
  codeable concept.coding: http://loinc.org/rdf#81334-5
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 81334-5
    coding.display:
      value: Patient Personal advance care plan
composition.category:
  index: 0
  codeable concept.coding: http://loinc.org/rdf#75320-2
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 75320-2
    coding.display:
      value: Advance Directive
composition.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
composition.date:
  value: 2021-03-29T14:25:34-05:00
composition.author:
  index: 0
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
composition.title:
  value: Personal Advance Care Plan
composition.attester:
  index: 0
  element.extension:
    index: 0
    element.extension:
      index: 0
      extension.url:
        value: AttesterRole
      extension.value codeable concept:
        codeable concept.coding: http://loinc.org/rdf#81372-5
    element.extension:
      index: 1
      extension.url:
        value: NotarySealId
    element.extension:
      index: 2
      extension.url:
        value: NotaryCommissionExpirationDate
      extension.value date:
        value: 2022-12-31
    extension.url:
      value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-attestationInformation-extension
  composition.attester.mode:
    value: professional
  composition.attester.party:
    link: http://hl7.org/fhir/us/pacio-adi/RelatedPerson/Example-Smith-Johnson-Notary1
    reference.reference:
      value: RelatedPerson/Example-Smith-Johnson-Notary1
composition.custodian:
  link: http://hl7.org/fhir/us/pacio-adi/Organization/Example-Smith-Johnson-OrganizationCustodian1
  reference.reference:
    value: Organization/Example-Smith-Johnson-OrganizationCustodian1
composition.section:
  index: 0
  composition.section.title:
    value: Appointment of a Primary Healthcare Agent and Alternate Healthcare Agents
  composition.section.code:
    codeable concept.coding: http://loinc.org/rdf#81335-2
      index: 0
      coding.system:
        value: http://loinc.org
      coding.code:
        value: 81335-2
      coding.display:
        value: Healthcare Agent
  composition.section.text:
    narrative.status:
      value: additional
    narrative.div: IF THIS PART OF THE uADD™ IS LEFT BLANK, I DO NOT WANT TO DESIGNATE A HEALTHCARE AGENT AT THIS TIME, AND I DO NOT WANT A DEFAULT HEALTHCARE AGENT DESIGNATED FOR ME UNDER APPLICABLE LAW. I TRUST THE DOCTORS AND NURSES TREATING ME TO MAKE MEDICAL TREATMENT DECISIONS REGARDING MY TREATMENT AND CARE. I am appointing the person or persons below as my healthcare agent and, if applicable, as my alternate healthcare agent(s), and I am granting to each of them the legal authority to make medical treatment decisions on my behalf and to consult with my physician and others. The power to make medical treatment decisions that I am granting to my healthcare agent(s) is expressly subject to, and limited by, the choices that I have expressed elsewhere in my uADD. If my medical treatment choices are not clear, I am authorizing and directing my healthcare agent to make decisions in my best interests and based on what is known of my wishes. Primary Healthcare Agent The person I choose as my Primary Healthcare Agent is: Charles Johnson (Son) CharlesSJ@example.com [SELECTED to act as a healthcare agent on 3/29/2021, at 2:25 PM CDT] [ACCEPTED to act as a healthcare agent on 4/1/2021, at 3:39 PM CDT] First Alternate Healthcare Agent If this healthcare agent is unable or unwilling to make medical treatment decisions for me, or if my spouse is designated as my primary healthcare agent and our marriage is annulled, or we are divorced or legally separated, then my next choice for a healthcare agent is: Debra Johnson (Daughter) DebraSJ@example.com [SELECTED to act as a healthcare agent on 3/29/2021, at 2:25 PM CDT] [As of 4/1/2021, at 3:40 PM CDT, a response is still PENDING] My Healthcare Agent’s General Authority Subject to my medical treatment choices expressed elsewhere in this uADD™ and applicable law that requires otherwise, I grant to my healthcare agent the power to make all choices and medical treatment decisions for me. If I cannot express my own wishes for medical treatment, I would…
  composition.section.entry:
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/RelatedPerson/Example-Smith-Johnson-HealthcareAgent1
    reference.reference:
      value: RelatedPerson/Example-Smith-Johnson-HealthcareAgent1
  composition.section.entry:
    index: 1
    link: http://hl7.org/fhir/us/pacio-adi/RelatedPerson/Example-Smith-Johnson-HealthcareAgent2
    reference.reference:
      value: RelatedPerson/Example-Smith-Johnson-HealthcareAgent2
  composition.section.entry:
    index: 2
    link: http://hl7.org/fhir/us/pacio-adi/Consent/Example-Smith-Johnson-HealthcareAgentConsent
    reference.reference:
      value: Consent/Example-Smith-Johnson-HealthcareAgentConsent
composition.section:
  index: 1
  composition.section.title:
    value: Patient Goals, Preferences, and Priorities for Care Experience
  composition.section.code:
    codeable concept.coding: http://loinc.org/rdf#81338-6
      index: 0
      coding.system:
        value: http://loinc.org
      coding.code:
        value: 81338-6
      coding.display:
        value: Patient Goals, Preferences, and Priorities for Care Experience
  composition.section.text:
    narrative.status:
      value: additional
    narrative.div: MyDirectives® offers people a list of optional questions that can be answered by typing text in a text box or by uploading a video or audio file for each question. Only those questions answered by Betsy Smith-Johnson appear here. For a complete list of questions in My Thoughts, please visit www.MyDirectives.com. In case I’m being cared for by a person(s) who doesn't know me very well, I’d like my following thoughts to be known. My likes / joys: Here are some examples of the things that I would like to have near me, music that I’d like to hear, and other details of my care that would help to keep me happy and relaxed: I love the smell of lavender and the feeling of sunshine on my face. My dislikes / fears: Here is a list of things that I would like to avoid if at all possible, people that I don’t wish to see, and concerns I have about particular family members, pets, and so on: I do not like my feet to be cold. How to care for me: If I become incapacitated and cannot express myself, here is what I would like to tell my healthcare agent, family and friends about how I would like for them to care for me: I want photos of my family where I can see them. My religion: If I appear to be approaching the end of my life, here are some things that I would like for my caregivers to know about my faith and my religion. Please call Father Mark if my condition warrants the services of a priest. Please attempt to notify someone from my religion at the following phone number: If I have included one Catholic My unfinished business: If it appears that I am approaching the end of my life, and I cannot communicate with persons around me, I would want my doctors and nurses, my family, and my friends to know about some unfinished business that I need to address: I want my sister and I to talk again, and miss her. I wish we hadn't disagreed all those years ago and regret the time it has cost us. I'd like to see her face if I were very ill and needed the comfort of family at my side. Laught…
  composition.section.entry:
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-CareExperiencePreference2
    reference.reference:
      value: Goal/Example-Smith-Johnson-CareExperiencePreference2
  composition.section.entry:
    index: 1
    link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-CareExperiencePreference3
    reference.reference:
      value: Goal/Example-Smith-Johnson-CareExperiencePreference3
  composition.section.entry:
    index: 2
    link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-CareExperiencePreference4
    reference.reference:
      value: Goal/Example-Smith-Johnson-CareExperiencePreference4
  composition.section.entry:
    index: 3
    link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-CareExperiencePreference5
    reference.reference:
      value: Goal/Example-Smith-Johnson-CareExperiencePreference5
  composition.section.entry:
    index: 4
    link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-CareExperiencePreference6
    reference.reference:
      value: Goal/Example-Smith-Johnson-CareExperiencePreference6
  composition.section.entry:
    index: 5
    link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-CareExperiencePreference7
    reference.reference:
      value: Goal/Example-Smith-Johnson-CareExperiencePreference7
  composition.section.entry:
    index: 6
    link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-CareExperiencePreference8
    reference.reference:
      value: Goal/Example-Smith-Johnson-CareExperiencePreference8
composition.section:
  index: 2
  composition.section.title:
    value: Patient Goals, preferences, and priorities under certain conditions
  composition.section.code:
    codeable concept.coding: http://loinc.org/rdf#81336-0
      index: 0
      coding.system:
        value: http://loinc.org
      coding.code:
        value: 81336-0

Example-Smith-Johnson-Patient1
type: Patient
resource.id:
  value: Example-Smith-Johnson-Patient1
resource.meta:
  meta.last updated:
    value: 2021-03-29T14:25:34.001-05:00
  meta.profile:
    value: http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient
    index: 0
    link: http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient
resource.language:
  value: en-US
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative Resource "Example-Smith-Johnson-Patient1" Updated "2021-03-29T19:25:34.001Z" (Language "en-US") Profile: US Core Patient Profile identifier: id: 047e62ccf09d4b39a8add708a69b7f38 active: true name: Betsy Smith-Johnson telecom: BetsySJ@example.com gender: female birthDate: 1950-11-15 address: 111 Maple Court San Antonio TX 78212 US (HOME) maritalStatus: unknown (NullFlavor#UNK) Communications - Language Preferred * English (Tags for the Identification of Languages#en) true
patient.identifier:
  index: 0
  identifier.system:
    value: urn:oid:2.16.840.1.113883.4.823.1
patient.active:
  value: true
patient.name:
  index: 0
  human name.use:
    value: usual
  human name.family:
    value: Smith-Johnson
  human name.given:
    value: Betsy
    index: 0
patient.telecom:
  index: 0
  contact point.system:
    value: email
  contact point.use:
    value: home
patient.gender:
  value: female
patient.birth date:
  value: 1950-11-15
patient.address:
  index: 0
  address.use:
    value: home
  address.type:
    value: physical
  address.line:
    value: 111 Maple Court
    index: 0
  address.city:
    value: San Antonio
  address.state:
    value: TX
  address.postal code:
    value: 78212
  address.country:
    value: US
patient.marital status:
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/v3-NullFlavor
    coding.code:
      value: UNK
patient.communication:
  index: 0
  patient.communication.language:
    codeable concept.coding:
      index: 0
      coding.system:
        value: urn:ietf:bcp:47
      coding.code:
        value: en
      coding.display:
        value: English
  patient.communication.preferred:
    value: true

Example-Smith-Johnson-Notary1
type: RelatedPerson
resource.id:
  value: Example-Smith-Johnson-Notary1
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-Participant
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-Participant
domain resource.text:
  narrative.status:
    value: additional
  narrative.div: Notary Charles Xavier
related person.patient:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
related person.name:
  index: 0
  human name.family:
    value: Xavier
  human name.given:
    value: Charles
    index: 0
related person.telecom:
  index: 0
  contact point.system:
    value: email
  contact point.use:
    value: work

Example-Smith-Johnson-HealthcareAgent1
type: RelatedPerson
resource.id:
  value: Example-Smith-Johnson-HealthcareAgent1
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-Participant
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-Participant
domain resource.text:
  narrative.status:
    value: additional
  narrative.div: Primary Healthcare Agent The person I choose as my Primary Healthcare Agent is: Charles Johnson (Son) CharlesSJ@example.com [SELECTED to act as a healthcare agent on 3/29/2021, at 2:25 PM CDT] [ACCEPTED to act as a healthcare agent on 4/1/2021, at 3:39 PM CDT]
related person.patient:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
related person.relationship:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/v3-RoleCode
    coding.code:
      value: SON
    coding.display:
      value: natural son
related person.name:
  index: 0
  human name.family:
    value: Johnson
  human name.given:
    value: Charles
    index: 0
related person.telecom:
  index: 0
  contact point.system:
    value: email
  contact point.use:
    value: home

Example-Smith-Johnson-HealthcareAgent2
type: RelatedPerson
resource.id:
  value: Example-Smith-Johnson-HealthcareAgent2
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-Participant
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-Participant
domain resource.text:
  narrative.status:
    value: additional
  narrative.div: First Alternate Healthcare Agent If this healthcare agent is unable or unwilling to make medical treatment decisions for me, or if my spouse is designated as my primary healthcare agent and our marriage is annulled, or we are divorced or legally separated, then my next choice for a healthcare agent is: Debra Johnson (Daughter) DebraSJ@example.com [SELECTED to act as a healthcare agent on 3/29/2021, at 2:25 PM CDT] [As of 4/1/2021, at 3:40 PM CDT, a response is still PENDING]
related person.patient:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
related person.relationship:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/v3-RoleCode
    coding.code:
      value: DAU
    coding.display:
      value: natural daughter
related person.name:
  index: 0
  human name.family:
    value: Johnson
  human name.given:
    value: Debra
    index: 0
related person.telecom:
  index: 0
  contact point.system:
    value: email
  contact point.use:
    value: home

Example-Smith-Johnson-HealthcareAgentConsent
type: Consent
resource.id:
  value: Example-Smith-Johnson-HealthcareAgentConsent
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-ParticipantConsent
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-ParticipantConsent
domain resource.text:
  narrative.status:
    value: additional
  narrative.div: status: active scope: Powers granted to healthcare agent [Reported] category: Advance Directive patient: Betsy Smith-Johnson ; BetsySJ@example.com; gender: female; birthDate: 1950-11-15 dateTime: 2020-08-03 Policies - Authority Uri * https://www.michigan.gov/ http://www.legislature.mi.gov/(S(tpnclc1ofteerx2x2dppcmdz))/mileg.aspx?page=GetObject&objectname=mcl-386-1998-V-5 provision type: permit actor role: Primary healthcare agent [Reported] reference: natural son; Charles Johnson ; CharlesSJ@example.com actor role: First alternate healthcare agent [Reported] reference: First alternate healthcare agent [Reported], natural daughter; Debra Johnson ; DebraSJ@example.com action: Advance directive - request for intubation, Advance directive - request for tube feeding, Advance directive - request for life support, Advance directive - request for IV fluid and support, Advance directive - request for antibiotics, Advance directive - request for resuscitation that differs from cardiopulmonary resuscitation purpose: power of attorney
consent.status:
  value: active
consent.scope:
  codeable concept.coding: http://loinc.org/rdf#75786-4
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 75786-4
    coding.display:
      value: Powers granted to healthcare agent [Reported]
consent.category:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/consentcategorycodes
    coding.code:
      value: acd
consent.patient:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
consent.date time:
  value: 2020-08-03
consent.policy:
  index: 0
  consent.policy.authority:
    value: https://www.michigan.gov/
  consent.policy.uri:
    value: http://www.legislature.mi.gov/(S(tpnclc1ofteerx2x2dppcmdz))/mileg.aspx
consent.provision:
  consent.provision.type:
    value: permit
  consent.provision.actor:
    index: 0
    consent.provision.actor.role:
      codeable concept.coding: http://loinc.org/rdf#75783-1
        index: 0
    consent.provision.actor.reference:
      link: http://hl7.org/fhir/us/pacio-adi/RelatedPerson/Example-Smith-Johnson-HealthcareAgent1
      reference.reference:
        value: RelatedPerson/Example-Smith-Johnson-HealthcareAgent1
  consent.provision.actor:
    index: 1
    consent.provision.actor.role:
      codeable concept.coding: http://loinc.org/rdf#75784-9
        index: 0
    consent.provision.actor.reference:
      link: http://hl7.org/fhir/us/pacio-adi/RelatedPerson/Example-Smith-Johnson-HealthcareAgent2
      reference.reference:
        value: RelatedPerson/Example-Smith-Johnson-HealthcareAgent2
  consent.provision.action:
    index: 0
    codeable concept.coding:
      index: 0
      coding.system:
        value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIHCADecisionsCS
      coding.code:
        value: intubation
      coding.display:
        value: Intubation
  consent.provision.action:
    index: 1
    codeable concept.coding:
      index: 0
      coding.system:
        value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIHCADecisionsCS
      coding.code:
        value: tube-feeding
      coding.display:
        value: Tube feeding
  consent.provision.action:
    index: 2
    codeable concept.coding:
      index: 0
      coding.system:
        value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIHCADecisionsCS
      coding.code:
        value: life-support
      coding.display:
        value: Life support
  consent.provision.action:
    index: 3
    codeable concept.coding:
      index: 0
      coding.system:
        value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIHCADecisionsCS
      coding.code:
        value: iv-fluid-and-support
      coding.display:
        value: IV fluid and support
  consent.provision.action:
    index: 4
    codeable concept.coding:
      index: 0
      coding.system:
        value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIHCADecisionsCS
      coding.code:
        value: antibiotics
      coding.display:
        value: Antibiotics
  consent.provision.action:
    index: 5
    codeable concept.coding:
      index: 0
      coding.system:
        value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIHCADecisionsCS
      coding.code:
        value: resuscitation-non-cpr
      coding.display:
        value: Non-CPR Resuscitation
  consent.provision.purpose:
    index: 0
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/v3-ActReason
    coding.code:
      value: PWATRNY

Example-Smith-Johnson-PreferenceCarePlan1
type: CarePlan
resource.id:
  value: Example-Smith-Johnson-PreferenceCarePlan1
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PreferenceCarePlan
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PreferenceCarePlan
domain resource.text:
  narrative.status:
    value: additional
  narrative.div: status: active intent: proposal category: Advance care plan subject: Betsy Smith-Johnson ; BetsySJ@example.com; gender: female; birthDate: 1950-11-15 addresses: Unconscious, in a coma, or in a persistent vegetative state with little or no chance of recovery Persistent vegetative state (SNOMED CT 24473007) Irreversible coma (SNOMED CT 73453007) goal: Goals, preferences, and priorities under certain health conditions [Reported]; If I am so sick or seriously injured that I cannot express my own medical treatment preferences, and if I am not expected to live without additional treatment for my illness, disease, condition or injury, then I want my medical care team to know that these are the things that are most important to me: Avoiding prolonged dependence on machines, Not being a physical burden to my family, Dying at home Information to tell doctors if I have a severe, irreversible brain injury or illness and can't dress, feed, or bathe myself, or communicate my medical wishes, but can be kept alive [Reported]; If my health ever deteriorates due to a terminal illness, and my doctors believe I will not be able to interact meaningfully with my family, friends, or surroundings, I would like for them to keep trying life-sustaining treatments until my healthcare agent decides it is time to stop and such treatments and let me die gently. Religious affiliation contact to notify [Reported]; Please attempt to notify someone from my religion at the following phone number: If I have included one: Catholic Religious beliefs [Reported]; If I appear to be approaching the end of my life, here are some things that I would like for my caregivers to know about my faith and my religion. Please call Father Mark if my condition warrants the services of a priest. Decision to inform doctors and nurses about the role religion, faith, or spirituality play in my life [Reported]; Here are some thoughts that I would like for my medical care team and my healthcare agent(s) to know about the role…
domain resource.extension:
  index: 0
  extension.url:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-goal-order-by-descending-priority-extension
  extension.value codeable concept:
    codeable concept.coding:
      index: 0
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/v2-0532
      coding.code:
        value: Y
care plan.status:
  value: active
care plan.intent:
  value: proposal
care plan.category:
  index: 0
  codeable concept.coding: http://snomed.info/id/736366004
    index: 0
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 736366004
    coding.display:
      value: Advance care plan
care plan.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
care plan.addresses:
  index: 0
  reference.display:
    value: Unconscious, in a coma, or in a persistent vegetative state with little or no chance of recovery
care plan.addresses:
  index: 1
  reference.display:
    value: Persistent vegetative state (SNOMED CT 24473007)
care plan.addresses:
  index: 2
  reference.display:
    value: Irreversible coma (SNOMED CT 73453007)
care plan.goal:
  index: 0
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-PersonalGoal1
  reference.reference:
    value: Goal/Example-Smith-Johnson-PersonalGoal1
care plan.goal:
  index: 1
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-PersonalInterventionPreference3
  reference.reference:
    value: Goal/Example-Smith-Johnson-PersonalInterventionPreference3
care plan.goal:
  index: 2
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-CareExperiencePreference6
  reference.reference:
    value: Goal/Example-Smith-Johnson-CareExperiencePreference6
care plan.goal:
  index: 3
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-CareExperiencePreference5
  reference.reference:
    value: Goal/Example-Smith-Johnson-CareExperiencePreference5
care plan.goal:
  index: 4
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-CareExperiencePreference1
  reference.reference:
    value: Goal/Example-Smith-Johnson-CareExperiencePreference1

Example-Smith-Johnson-PreferenceCarePlan2
type: CarePlan
resource.id:
  value: Example-Smith-Johnson-PreferenceCarePlan2
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PreferenceCarePlan
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PreferenceCarePlan
domain resource.text:
  narrative.status:
    value: additional
  narrative.div: status: active intent: proposal category: Advance care plan subject: Betsy Smith-Johnson ; BetsySJ@example.com; gender: female; birthDate: 1950-11-15 addresses: Permanent, sever brain damage and I am unable to recognize my family and friends goal: Goals, preferences, and priorities under certain health conditions [Reported]; If I am so sick or seriously injured that I cannot express my own medical treatment preferences, and if I am not expected to live without additional treatment for my illness, disease, condition or injury, then I want my medical care team to know that these are the things that are most important to me: Avoiding prolonged dependence on machines, Not being a physical burden to my family, Dying at home Information to tell doctors if I have a severe, irreversible brain injury or illness and can't dress, feed, or bathe myself, or communicate my medical wishes, but can be kept alive [Reported]; If my health ever deteriorates due to a terminal illness, and my doctors believe I will not be able to interact meaningfully with my family, friends, or surroundings, I would like for them to keep trying life-sustaining treatments until my healthcare agent decides it is time to stop and such treatments and let me die gently. Religious beliefs [Reported]; If I appear to be approaching the end of my life, here are some things that I would like for my caregivers to know about my faith and my religion. Please call Father Mark if my condition warrants the services of a priest.
care plan.status:
  value: active
care plan.intent:
  value: proposal
care plan.category:
  index: 0
  codeable concept.coding: http://snomed.info/id/736366004
    index: 0
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 736366004
    coding.display:
      value: Advance care plan
care plan.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
care plan.addresses:
  index: 0
  reference.display:
    value: Permanent, sever brain damage and I am unable to recognize my family and friends
care plan.goal:
  index: 0
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-PersonalGoal1
  reference.reference:
    value: Goal/Example-Smith-Johnson-PersonalGoal1
care plan.goal:
  index: 1
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-PersonalInterventionPreference3
  reference.reference:
    value: Goal/Example-Smith-Johnson-PersonalInterventionPreference3
care plan.goal:
  index: 2
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-CareExperiencePreference5
  reference.reference:
    value: Goal/Example-Smith-Johnson-CareExperiencePreference5

Example-Smith-Johnson-PreferenceCarePlan3
type: CarePlan
resource.id:
  value: Example-Smith-Johnson-PreferenceCarePlan3
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PreferenceCarePlan
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PreferenceCarePlan
domain resource.text:
  narrative.status:
    value: additional
  narrative.div: status: active intent: proposal category: Advance care plan subject: Betsy Smith-Johnson ; BetsySJ@example.com; gender: female; birthDate: 1950-11-15 addresses: Terminal illness, lack of meaningful interaction goal: Goals, preferences, and priorities under certain health conditions [Reported]; If I am so sick or seriously injured that I cannot express my own medical treatment preferences, and if I am not expected to live without additional treatment for my illness, disease, condition or injury, then I want my medical care team to know that these are the things that are most important to me: Avoiding prolonged dependence on machines, Not being a physical burden to my family, Dying at home Decision to inform doctors and nurses about the role religion, faith, or spirituality play in my life [Reported]; Here are some thoughts that I would like for my medical care team and my healthcare agent(s) to know about the role that religion, faith or spirituality play in my life: I am Catholic, please call Father Mark at Saint Catherine's on Main Street. My likes and joys [Reported]; Here are some examples of the things that I would like to have near me, music that I’d like to hear, and other details of my care that would help to keep me happy and relaxed: I love the smell of lavender and the feeling of sunshine on my face. My dislikes and fears [Reported]; Here is a list of things that I would like to avoid if at all possible, people that I don’t wish to see, and concerns I have about particular family members, pets, and so on: I do not like my feet to be cold. Goals, preferences, and priorities for care experience [Reported]; How to care for me: If I become incapacitated and cannot express myself, here is what I would like to tell my healthcare agent, family and friends about how I would like for them to care for me: I want photos of my family where I can see them. Religious beliefs [Reported]; If I appear to be approaching the end of my life, here are some things that I would …
care plan.status:
  value: active
care plan.intent:
  value: proposal
care plan.category:
  index: 0
  codeable concept.coding: http://snomed.info/id/736366004
    index: 0
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 736366004
    coding.display:
      value: Advance care plan
care plan.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
care plan.addresses:
  index: 0
  reference.display:
    value: Terminal illness, lack of meaningful interaction
care plan.goal:
  index: 0
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-PersonalGoal1
  reference.reference:
    value: Goal/Example-Smith-Johnson-PersonalGoal1
care plan.goal:
  index: 1
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-CareExperiencePreference1
  reference.reference:
    value: Goal/Example-Smith-Johnson-CareExperiencePreference1
care plan.goal:
  index: 2
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-CareExperiencePreference2
  reference.reference:
    value: Goal/Example-Smith-Johnson-CareExperiencePreference2
care plan.goal:
  index: 3
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-CareExperiencePreference3
  reference.reference:
    value: Goal/Example-Smith-Johnson-CareExperiencePreference3
care plan.goal:
  index: 4
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-CareExperiencePreference4
  reference.reference:
    value: Goal/Example-Smith-Johnson-CareExperiencePreference4
care plan.goal:
  index: 5
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-CareExperiencePreference5
  reference.reference:
    value: Goal/Example-Smith-Johnson-CareExperiencePreference5
care plan.goal:
  index: 6
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-CareExperiencePreference7
  reference.reference:
    value: Goal/Example-Smith-Johnson-CareExperiencePreference7
care plan.goal:
  index: 7
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-PersonalInterventionPreference1
  reference.reference:
    value: Goal/Example-Smith-Johnson-PersonalInterventionPreference1
care plan.goal:
  index: 8
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-PersonalInterventionPreference3
  reference.reference:
    value: Goal/Example-Smith-Johnson-PersonalInterventionPreference3
care plan.goal:
  index: 9
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-PersonalInterventionPreference5
  reference.reference:
    value: Goal/Example-Smith-Johnson-PersonalInterventionPreference5

Example-Smith-Johnson-CareExperiencePreference2
type: Goal
resource.id:
  value: Example-Smith-Johnson-CareExperiencePreference2
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-CareExperiencePreference
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-CareExperiencePreference
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: My likes / joys: Here are some examples of the things that I would like to have near me, music that I’d like to hear, and other details of my care that would help to keep me happy and relaxed: I love the smell of lavender and the feeling of sunshine on my face.
goal.lifecycle status:
  value: proposed
goal.category:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIGoalCategoryCS
    coding.code:
      value: care-experience-preference
    coding.display:
      value: Care experience preference
goal.category:
  index: 1
  codeable concept.coding: http://loinc.org/rdf#81360-0
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 81360-0
    coding.display:
      value: My likes and joys [Reported]
goal.description:
  element.extension:
    index: 0
    element.extension:
      index: 0
      extension.url:
        value: Context
      extension.value string:
        value: Here are some examples of the things that I would like to have near me, music that I’d like to hear, and other details of my care that would help to keep me happy and relaxed
    element.extension:
      index: 1
      extension.url:
        value: Value
      extension.value string:
        value: I love the smell of lavender and the feeling of sunshine on my face.
    extension.url:
      value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-contextualValue-extension
  codeable concept.text:
    value: Here are some examples of the things that I would like to have near me, music that I’d like to hear, and other details of my care that would help to keep me happy and relaxed: I love the smell of lavender and the feeling of sunshine on my face.
goal.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
goal.expressed by:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1

Example-Smith-Johnson-CareExperiencePreference3
type: Goal
resource.id:
  value: Example-Smith-Johnson-CareExperiencePreference3
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-CareExperiencePreference
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-CareExperiencePreference
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: My dislikes / fears: Here is a list of things that I would like to avoid if at all possible, people that I don’t wish to see, and concerns I have about particular family members, pets, and so on: I do not like my feet to be cold.
goal.lifecycle status:
  value: proposed
goal.category:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIGoalCategoryCS
    coding.code:
      value: care-experience-preference
    coding.display:
      value: Care experience preference
goal.category:
  index: 1
  codeable concept.coding: http://loinc.org/rdf#81362-6
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 81362-6
    coding.display:
      value: My dislikes and fears [Reported]
goal.description:
  element.extension:
    index: 0
    element.extension:
      index: 0
      extension.url:
        value: Context
      extension.value string:
        value: Here is a list of things that I would like to avoid if at all possible, people that I don’t wish to see, and concerns I have about particular family members, pets, and so on
    element.extension:
      index: 1
      extension.url:
        value: Value
      extension.value string:
        value: I do not like my feet to be cold.
    extension.url:
      value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-contextualValue-extension
  codeable concept.text:
    value: Here is a list of things that I would like to avoid if at all possible, people that I don’t wish to see, and concerns I have about particular family members, pets, and so on: I do not like my feet to be cold.
goal.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
goal.expressed by:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1

Example-Smith-Johnson-CareExperiencePreference4
type: Goal
resource.id:
  value: Example-Smith-Johnson-CareExperiencePreference4
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-CareExperiencePreference
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-CareExperiencePreference
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: How to care for me: If I become incapacitated and cannot express myself, here is what I would like to tell my healthcare agent, family and friends about how I would like for them to care for me: I want photos of my family where I can see them.
goal.lifecycle status:
  value: proposed
goal.category:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIGoalCategoryCS
    coding.code:
      value: care-experience-preference
    coding.display:
      value: Care experience preference
goal.category:
  index: 1
  codeable concept.coding: http://loinc.org/rdf#81380-8
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 81380-8
    coding.display:
      value: Goals, preferences, and priorities for care experience [Reported]
goal.description:
  element.extension:
    index: 0
    element.extension:
      index: 0
      extension.url:
        value: Context
      extension.value string:
        value: How to care for me: If I become incapacitated and cannot express myself, here is what I would like to tell my healthcare agent, family and friends about how I would like for them to care for me
    element.extension:
      index: 1
      extension.url:
        value: Value
      extension.value string:
        value: I want photos of my family where I can see them.
    extension.url:
      value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-contextualValue-extension
  codeable concept.text:
    value: How to care for me: If I become incapacitated and cannot express myself, here is what I would like to tell my healthcare agent, family and friends about how I would like for them to care for me: I want photos of my family where I can see them.
goal.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
goal.expressed by:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1

Example-Smith-Johnson-CareExperiencePreference5
type: Goal
resource.id:
  value: Example-Smith-Johnson-CareExperiencePreference5
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-CareExperiencePreference
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-CareExperiencePreference
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: My religion: If I appear to be approaching the end of my life, here are some things that I would like for my caregivers to know about my faith and my religion. Please call Father Mark if my condition warrants the services of a priest.
goal.lifecycle status:
  value: proposed
goal.category:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIGoalCategoryCS
    coding.code:
      value: care-experience-preference
    coding.display:
      value: Care experience preference
goal.category:
  index: 1
  codeable concept.coding: http://loinc.org/rdf#81364-2
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 81364-2
    coding.display:
      value: Religious beliefs [Reported]
goal.description:
  element.extension:
    index: 0
    element.extension:
      index: 0
      extension.url:
        value: Context
      extension.value string:
        value: If I appear to be approaching the end of my life, here are some things that I would like for my caregivers to know about my faith and my religion.
    element.extension:
      index: 1
      extension.url:
        value: Value
      extension.value string:
        value: Please call Father Mark if my condition warrants the services of a priest.
    extension.url:
      value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-contextualValue-extension
  codeable concept.text:
    value: If I appear to be approaching the end of my life, here are some things that I would like for my caregivers to know about my faith and my religion. Please call Father Mark if my condition warrants the services of a priest.
goal.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
goal.expressed by:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1

Example-Smith-Johnson-CareExperiencePreference6
type: Goal
resource.id:
  value: Example-Smith-Johnson-CareExperiencePreference6
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-CareExperiencePreference
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-CareExperiencePreference
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Please attempt to notify someone from my religion at the following phone number: If I have included one Catholic
goal.lifecycle status:
  value: proposed
goal.category:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIGoalCategoryCS
    coding.code:
      value: care-experience-preference
    coding.display:
      value: Care experience preference
goal.category:
  index: 1
  codeable concept.coding: http://loinc.org/rdf#81365-9
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 81365-9
    coding.display:
      value: Religious affiliation contact to notify [Reported]
goal.description:
  element.extension:
    index: 0
    element.extension:
      index: 0
      extension.url:
        value: Context
      extension.value string:
        value: Please attempt to notify someone from my religion at the following phone number If I have included one
    element.extension:
      index: 1
      extension.url:
        value: Value
      extension.value string:
        value: Catholic
    extension.url:
      value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-contextualValue-extension
  codeable concept.text:
    value: Please attempt to notify someone from my religion at the following phone number: If I have included one: Catholic
goal.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
goal.expressed by:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1

Example-Smith-Johnson-CareExperiencePreference7
type: Goal
resource.id:
  value: Example-Smith-Johnson-CareExperiencePreference7
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-CareExperiencePreference
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-CareExperiencePreference
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: My unfinished business: If it appears that I am approaching the end of my life, and I cannot communicate with persons around me, I would want my doctors and nurses, my family, and my friends to know about some unfinished business that I need to address: I want my sister and I to talk again, and miss her. I wish we hadn't disagreed all those years ago and regret the time it has cost us. I'd like to see her face if I were very ill and needed the comfort of family at my side.
goal.lifecycle status:
  value: proposed
goal.category:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIGoalCategoryCS
    coding.code:
      value: care-experience-preference
    coding.display:
      value: Care experience preference
goal.category:
  index: 1
  codeable concept.coding: http://loinc.org/rdf#81366-7
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 81366-7
    coding.display:
      value: Unfinished business [Reported]
goal.description:
  element.extension:
    index: 0
    element.extension:
      index: 0
      extension.url:
        value: Context
      extension.value string:
        value: If it appears that I am approaching the end of my life, and I cannot communicate with persons around me, I would want my doctors and nurses, my family, and my friends to know about some unfinished business that I need to address
    element.extension:
      index: 1
      extension.url:
        value: Value
      extension.value string:
        value: I want my sister and I to talk again, and miss her. I wish we hadn't disagreed all those years ago and regret the time it has cost us. I'd like to see her face if I were very ill and needed the comfort of family at my side.
    extension.url:
      value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-contextualValue-extension
  codeable concept.text:
    value: If it appears that I am approaching the end of my life, and I cannot communicate with persons around me, I would want my doctors and nurses, my family, and my friends to know about some unfinished business that I need to address: I want my sister and I to talk again, and miss her. I wish we hadn't disagreed all those years ago and regret the time it has cost us. I'd like to see her face if I were very ill and needed the comfort of family at my side.
goal.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
goal.expressed by:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1

Example-Smith-Johnson-CareExperiencePreference8
type: Goal
resource.id:
  value: Example-Smith-Johnson-CareExperiencePreference8
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-CareExperiencePreference
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-CareExperiencePreference
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Laughter: These are some of my fondest memories from life that have always brought a smile to my face or made me laugh: My dogs make me laugh when they play together, and my grandchildren make me laugh when they put on plays for me. They bring me great joy.
goal.lifecycle status:
  value: proposed
goal.category:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIGoalCategoryCS
    coding.code:
      value: care-experience-preference
    coding.display:
      value: Care experience preference
goal.category:
  index: 1
  codeable concept.coding: http://loinc.org/rdf#81361-8
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 81361-8
    coding.display:
      value: Things that make me laugh [Reported]
goal.description:
  element.extension:
    index: 0
    element.extension:
      index: 0
      extension.url:
        value: Context
      extension.value string:
        value: These are some of my fondest memories from life that have always brought a smile to my face or made me laugh
    element.extension:
      index: 1
      extension.url:
        value: Value
      extension.value string:
        value: My dogs make me laugh when they play together, and my grandchildren make me laugh when they put on plays for me. They bring me great joy.
    extension.url:
      value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-contextualValue-extension
  codeable concept.text:
    value: These are some of my fondest memories from life that have always brought a smile to my face or made me laugh: My dogs make me laugh when they play together, and my grandchildren make me laugh when they put on plays for me. They bring me great joy.
goal.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
goal.expressed by:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1

Example-Smith-Johnson-PersonalInterventionPreference1
type: Goal
resource.id:
  value: Example-Smith-Johnson-PersonalInterventionPreference1
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PersonalInterventionPreference
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PersonalInterventionPreference
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: If I am having significant pain or suffering, I would like my doctors to consult a Supportive and Palliative Care Team to help treat my physical, emotional and spiritual discomfort, and to support my family.
goal.lifecycle status:
  value: proposed
goal.category:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIGoalCategoryCS
    coding.code:
      value: intervention-preference
    coding.display:
      value: Intervention preference
goal.category:
  index: 1
  codeable concept.coding: http://loinc.org/rdf#75780-7
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 75780-7
goal.description:
  element.extension:
    index: 0
    element.extension:
      index: 0
      extension.url:
        value: Context
      extension.value string:
        value: If I am having significant pain or suffering
    element.extension:
      index: 1
      extension.url:
        value: Value
      extension.value string:
        value: I would like my doctors to consult a Supportive and Palliative Care Team to help treat my physical, emotional and spiritual discomfort, and to support my family.
    extension.url:
      value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-contextualValue-extension
  codeable concept.text:
    value: If I am having significant pain or suffering, I would like my doctors to consult a Supportive and Palliative Care Team to help treat my physical, emotional and spiritual discomfort, and to support my family.
goal.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
goal.expressed by:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1

Example-Smith-Johnson-PersonalInterventionPreference3
type: Goal
resource.id:
  value: Example-Smith-Johnson-PersonalInterventionPreference3
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PersonalInterventionPreference
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PersonalInterventionPreference
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: If my health ever deteriorates due to a terminal illness, and my doctors believe I will not be able to interact meaningfully with my family, friends, or surroundings, I would like for them to keep trying life-sustaining treatments until my healthcare agent decides it is time to stop and such treatments and let me die gently.
goal.lifecycle status:
  value: proposed
goal.category:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIGoalCategoryCS
    coding.code:
      value: intervention-preference
    coding.display:
      value: Intervention preference
goal.category:
  index: 1
  codeable concept.coding: http://loinc.org/rdf#75778-1
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 75778-1
    coding.display:
      value: Information to tell doctors if I have a severe, irreversible brain injury or illness and can't dress, feed, or bathe myself, or communicate my medical wishes, but can be kept alive [Reported]
goal.description:
  element.extension:
    index: 0
    element.extension:
      index: 0
      extension.url:
        value: Context
      extension.value string:
        value: If my health ever deteriorates due to a terminal illness, and my doctors believe I will not be able to interact meaningfully with my family, friends, or surroundings
    element.extension:
      index: 1
      extension.url:
        value: Value
      extension.value string:
        value: I would like for them to keep trying life-sustaining treatments until my healthcare agent decides it is time to stop and such treatments and let me die gently.
    extension.url:
      value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-contextualValue-extension
  codeable concept.text:
    value: If my health ever deteriorates due to a terminal illness, and my doctors believe I will not be able to interact meaningfully with my family, friends, or surroundings, I would like for them to keep trying life-sustaining treatments until my healthcare agent decides it is time to stop and such treatments and let me die gently.
goal.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
goal.expressed by:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1

Example-Smith-Johnson-PersonalInterventionPreference5
type: Goal
resource.id:
  value: Example-Smith-Johnson-PersonalInterventionPreference5
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PersonalInterventionPreference
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PersonalInterventionPreference
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: If it were possible to choose, here is where I would like to spend my final days: At home.I would like to receive hospice care at home if possible.
goal.lifecycle status:
  value: proposed
goal.category:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIGoalCategoryCS
    coding.code:
      value: intervention-preference
    coding.display:
      value: Intervention preference
goal.category:
  index: 1
  codeable concept.coding: http://loinc.org/rdf#75780-7
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 75780-7
    coding.display:
      value: Preferred location to spend final days if possible to choose [Reported]
goal.description:
  element.extension:
    index: 0
    element.extension:
      index: 0
      extension.url:
        value: Context
      extension.value string:
        value: If it were possible to choose, here is where I would like to spend my final days
    element.extension:
      index: 1
      extension.url:
        value: Value
      extension.value string:
        value: At home.I would like to receive hospice care at home if possible.
    extension.url:
      value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-contextualValue-extension
  codeable concept.text:
    value: If it were possible to choose, here is where I would like to spend my final days: At home.I would like to receive hospice care at home if possible.
goal.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
goal.expressed by:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1

Example-Smith-Johnson-PersonalInterventionPreference6
type: Goal
resource.id:
  value: Example-Smith-Johnson-PersonalInterventionPreference6
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PersonalInterventionPreference
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PersonalInterventionPreference
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Here are my thoughts on funeral or burial plans: If I were to pass away: Please call Jim Houston, my lawyer, for arrangements I have already made.
goal.lifecycle status:
  value: proposed
goal.category:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIGoalCategoryCS
    coding.code:
      value: intervention-preference
    coding.display:
      value: Intervention preference
goal.category:
  index: 1
  codeable concept.coding: http://loinc.org/rdf#81356-8
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 81356-8
    coding.display:
      value: Death arrangements [Reported]
goal.description:
  element.extension:
    index: 0
    element.extension:
      index: 0
      extension.url:
        value: Context
      extension.value string:
        value: If I were to pass away
    element.extension:
      index: 1
      extension.url:
        value: Value
      extension.value string:
        value: Please call Jim Houston, my lawyer, for arrangements I have already made.
    extension.url:
      value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-contextualValue-extension
  codeable concept.text:
    value: If I were to pass away: Please call Jim Houston, my lawyer, for arrangements I have already made.
goal.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
goal.expressed by:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1

Example-Smith-Johnson-PersonalGoal1
type: Goal
resource.id:
  value: Example-Smith-Johnson-PersonalGoal1
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PersonalGoal
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PersonalGoal
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: If I am so sick or seriously injured that I cannot express my own medical treatment preferences, and if I am not expected to live without additional treatment for my illness, disease, condition or injury, then I want my medical care team to know that these are the things that are most important to me: Avoiding prolonged dependence on machines Not being a physical burden to my family Dying at home
goal.lifecycle status:
  value: proposed
goal.category:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://hl7.org/fhir/us/pacio-adi/CodeSystem/PADIGoalCategoryCS
    coding.code:
      value: personal-goal
    coding.display:
      value: Personal goal
goal.category:
  index: 1
  codeable concept.coding: http://loinc.org/rdf#81378-2
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 81378-2
    coding.display:
      value: Goals, preferences, and priorities under certain health conditions [Reported]
goal.description:
  element.extension:
    index: 0
    element.extension:
      index: 0
      extension.url:
        value: Context
      extension.value string:
        value: If I am so sick or seriously injured that I cannot express my own medical treatment preferences, and if I am not expected to live without additional treatment for my illness, disease, condition or injury, then I want my medical care team to know that these are the things that are most important to me
    element.extension:
      index: 1
      extension.url:
        value: Value
      extension.value string:
        value: Avoiding prolonged dependence on machines
    element.extension:
      index: 2
      extension.url:
        value: Value
      extension.value string:
        value: Not being a physical burden to my family
    element.extension:
      index: 3
      extension.url:
        value: Value
      extension.value string:
        value: Dying at home
    extension.url:
      value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/padi-contextualValue-extension
  codeable concept.text:
    value: If I am so sick or seriously injured that I cannot express my own medical treatment preferences, and if I am not expected to live without additional treatment for my illness, disease, condition or injury, then I want my medical care team to know that these are the things that are most important to me: Avoiding prolonged dependence on machines, Not being a physical burden to my family, Dying at home
goal.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
goal.expressed by:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1

Example-Smith-Johnson-OrganDonationObservation1
type: Observation
resource.id:
  value: Example-Smith-Johnson-OrganDonationObservation1
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-OrganDonationObservation
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-OrganDonationObservation
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Consent to Donate I consent to donate all organs and tissues.
observation.status:
  value: final
observation.code:
  codeable concept.coding: http://loinc.org/rdf#75781-5
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 75781-5
    coding.display:
      value: Thoughts on organ and tissue donations [Reported]
observation.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
observation.value string:
  value: Consent to Donate: I consent to donate all organs and tissues.

Example-Smith-Johnson-AutopsyObservation1
type: Observation
resource.id:
  value: Example-Smith-Johnson-AutopsyObservation1
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-AutopsyObservation
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-AutopsyObservation
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Autopsy I want an autopsy only if there are questions about my death.
observation.status:
  value: final
observation.code:
  codeable concept.coding: http://loinc.org/rdf#75782-3
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 75782-3
    coding.display:
      value: Thoughts regarding autopsy [Reported]
observation.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
observation.value string:
  value: Autopsy: I want an autopsy: only if there are questions about my death.

Example-Smith-Johnson-DocumentationObservation1
type: Observation
resource.id:
  value: Example-Smith-Johnson-DocumentationObservation1
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-DocumentationObservation
    index: 0
    link: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-DocumentationObservation
domain resource.text:
  narrative.status:
    value: additional
  narrative.div: PMOLST Order Observation Order Exists: available here
observation.status:
  value: final
observation.code:
  codeable concept.coding: http://loinc.org/rdf#75320-2
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 75320-2
    coding.display:
      value: Advance Directive
observation.subject:
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
observation.effective date time:
  value: 2021-03-29T14:25:34.001-05:00
observation.performer:
  index: 0
  link: http://hl7.org/fhir/us/pacio-adi/Patient/Example-Smith-Johnson-Patient1
  reference.reference:
    value: Patient/Example-Smith-Johnson-Patient1
observation.value codeable concept:
  codeable concept.coding: http://snomed.info/id/697978002
    index: 0
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 697978002
    coding.display:
      value: Provider orders for life-sustaining treatment

Example-Smith-Johnson-OrganizationCustodian1
type: Organization
resource.id:
  value: Example-Smith-Johnson-OrganizationCustodian1
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
    index: 0
    link: http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative Resource "Example-Smith-Johnson-OrganizationCustodian1" Profile: US Core Organization Profile identifier: id: 44444 active: true name: MyDirectives.com telecom: +1(202)776-7700 address: 740 E. Campbell Rd. Suite 825 Richardson TX 75081 US
organization.identifier:
  index: 0
  identifier.system:
    value: http://hl7.org/fhir/sid/us-npi
  identifier.value:
    value: 44444
organization.active:
  value: true
organization.name:
  value: MyDirectives.com
organization.telecom:
  index: 0
  contact point.system:
    value: phone
  contact point.value:
    value: +1(202)776-7700
  contact point.use:
    value: work
organization.address:
  index: 0
  address.type:
    value: physical
  address.line:
    value: 740 E. Campbell Rd. Suite 825
    index: 0
  address.city:
    value: Richardson
  address.state:
    value: TX
  address.postal code:
    value: 75081
  address.country:
    value: US

http://loinc.org/rdf#81372-5
index: 0
coding.system:
  value: http://loinc.org
coding.code:
  value: 81372-5
coding.display:
  value: Notary

value: notary-1254

value: Patient Goals, preferences, and priorities under certain health conditions

narrative.status:
  value: additional
narrative.div: Care Plan 1 status: active intent: proposal category: Advance care plan subject: Betsy Smith-Johnson ; BetsySJ@example.com; gender: female; birthDate: 1950-11-15 addresses: Unconscious, in a coma, or in a persistent vegetative state with little or no chance of recovery Persistent vegetative state (SNOMED CT 24473007) Irreversible coma (SNOMED CT 73453007) goal: Goals, preferences, and priorities under certain health conditions [Reported]; If I am so sick or seriously injured that I cannot express my own medical treatment preferences, and if I am not expected to live without additional treatment for my illness, disease, condition or injury, then I want my medical care team to know that these are the things that are most important to me: Avoiding prolonged dependence on machines, Not being a physical burden to my family, Dying at home Information to tell doctors if I have a severe, irreversible brain injury or illness and can't dress, feed, or bathe myself, or communicate my medical wishes, but can be kept alive [Reported]; If my health ever deteriorates due to a terminal illness, and my doctors believe I will not be able to interact meaningfully with my family, friends, or surroundings, I would like for them to keep trying life-sustaining treatments until my healthcare agent decides it is time to stop and such treatments and let me die gently. Religious affiliation contact to notify [Reported]; Please attempt to notify someone from my religion at the following phone number: If I have included one: Catholic Religious beliefs [Reported]; If I appear to be approaching the end of my life, here are some things that I would like for my caregivers to know about my faith and my religion. Please call Father Mark if my condition warrants the services of a priest. Decision to inform doctors and nurses about the role religion, faith, or spirituality play in my life [Reported]; Here are some thoughts that I would like for my medical care team and my healthcare agent(s) to know ab…

index: 0
link: http://hl7.org/fhir/us/pacio-adi/CarePlan/Example-Smith-Johnson-PreferenceCarePlan1
reference.reference:
  value: CarePlan/Example-Smith-Johnson-PreferenceCarePlan1

index: 1
link: http://hl7.org/fhir/us/pacio-adi/CarePlan/Example-Smith-Johnson-PreferenceCarePlan2
reference.reference:
  value: CarePlan/Example-Smith-Johnson-PreferenceCarePlan2

index: 2
link: http://hl7.org/fhir/us/pacio-adi/CarePlan/Example-Smith-Johnson-PreferenceCarePlan3
reference.reference:
  value: CarePlan/Example-Smith-Johnson-PreferenceCarePlan3

index: 3
composition.section.title:
  value: Goals, Preferences and Priorities Upon Death
composition.section.code:
  codeable concept.coding: http://loinc.org/rdf#81337-8
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 81337-8
    coding.display:
      value: Patient Goals, Preferences, and Priorities Upon Death
composition.section.text:
  narrative.status:
    value: additional
  narrative.div: Consent to Donate I consent to donate all organs and tissues. Autopsy I want an autopsy only if there are questions about my death. Here are my thoughts on funeral or burial plans: If I were to pass away: Please call Jim Houston, my lawyer, for arrangements I have already made.
composition.section.entry:
  index: 0
  link: http://hl7.org/fhir/us/pacio-adi/Observation/Example-Smith-Johnson-OrganDonationObservation1
  reference.reference:
    value: Observation/Example-Smith-Johnson-OrganDonationObservation1
composition.section.entry:
  index: 1
  link: http://hl7.org/fhir/us/pacio-adi/Observation/Example-Smith-Johnson-AutopsyObservation1
  reference.reference:
    value: Observation/Example-Smith-Johnson-AutopsyObservation1
composition.section.entry:
  index: 2
  link: http://hl7.org/fhir/us/pacio-adi/Goal/Example-Smith-Johnson-PersonalInterventionPreference6
  reference.reference:
    value: Goal/Example-Smith-Johnson-PersonalInterventionPreference6

index: 4
composition.section.title:
  value: Additional Documentation
composition.section.code:
  codeable concept.coding: http://loinc.org/rdf#77599-9
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 77599-9
composition.section.text:
  narrative.status:
    value: generated
  narrative.div: PMOLST Order Observation Order Exists: available here
composition.section.entry:
  index: 0
  link: http://hl7.org/fhir/us/pacio-adi/Observation/Example-Smith-Johnson-DocumentationObservation1
  reference.reference:
    value: Observation/Example-Smith-Johnson-DocumentationObservation1

index: 5
composition.section.title:
  value: Witnesses and Notary
composition.section.code:
  codeable concept.coding: http://loinc.org/rdf#81339-4
    index: 0
    coding.system:
      value: http://loinc.org
    coding.code:
      value: 81339-4
    coding.display:
      value: Witness and Notary Document
composition.section.text:
  narrative.status:
    value: additional
  narrative.div: I am emotionally and mentally competent to make this uADD. I understand the purpose and effect of this uADD, I agree with everything that is written in this uADD, and I have made this uADD knowingly, willingly and after careful deliberation. Signature: Betsy Smith-Johnson Date: 3/29/2021 Statement of Witnesses I declare that the person who signed this uADD, or who asked another to sign this uADD on his/her behalf, is the individual identified in the document, and he/she did so in my presence or otherwise provided satisfactory proof to me of his/her identity. I believe him/her to be of sound mind and at least 18 years of age. I personally witnessed him/her sign this document or ask the person indicated to do so, or I received proof of his/her identity that I believe is adequate, and I believe that he/she did so voluntarily. By signing this document as a witness, I certify that I am: At least 18 years of age. Not related to the person signing this document by blood, marriage or adoption. Not a healthcare agent appointed by the person signing this document. Not directly financially responsible for that person’s healthcare. Not a healthcare provider directly serving the person at this time. Not an employee (other than a social worker or chaplain), officer, director, or partner of a healthcare provider (or any parent organization of such healthcare provider) directly serving the person at this time. Not aware that I am entitled to or have a claim against the person’s estate. Witness Number: Signature: Date:

value: 75783-1

value: Primary healthcare agent [Reported]

value: 75784-9

value: First alternate healthcare agent [Reported]