Personal Health Device Implementation Guide
1.0.0 - STU 1

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## Bundled upload of Patient, Device, and Observation resources

This example is a transaction bundle where the Patient and Device resources are using a conditional create transaction. In this manner the PHG specifies a temporary id and uses that temporary id in the bundle where it needs to without waiting for a server response. The PHG also needs to specify a sufficiently selective criterion identifying those resources that only one or none should be found on the server. When a server response is obtained, the actual logical id can be used in the Observations. Subsequent bundles can be sent without the Patient and Device resources since they have already been uploaded.

    {
      "resourceType": "Bundle",
      "id": "1568997631814",
      "type": "transaction",
      "entry": [
        {
          "fullUrl": "urn:oid:1.2.3.0",
          "resource": {
            "resourceType": "Patient",
            "meta": {
              "profile": [
                "http://hl7.org/fhir/uv/phd/StructureDefinition/PhdPatient"
              ]
            },
            "identifier": [
              {
                "type": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                      "code": "MR"
                    }
                  ],
                  "text": "Medical record number"
                },
                "system": "urn:oid:1.2.3.4.5.6.6.8.10",
                "value": "sisansarahId"
              }
            ],
            "name": [
              {
                "family": "Gyannea",
                "given": [
                  "Sisansarah"
                ]
              }
            ]
          },
          "request": {
            "method": "POST",
            "url": "Patient",
            "ifNoneExist": "identifier=urn:oid:1.2.3.4.5.6.6.8.10|sisansarahId"
          }
        },
        {
          "fullUrl": "urn:oid:1.2.3.1",
          "resource": {
            "resourceType": "Device",
            "meta": {
              "profile": [
                "http://hl7.org/fhir/uv/phd/StructureDefinition/PhgDevice"
              ]
            },
            "identifier": [
              {
                "type": {
                  "coding": [
                    {
                      "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers",
                      "code": "SYSID",
                      "display": "IEEE 11073 System Identifier"
                    }
                  ]
                },
                "system": "urn:oid:1.2.840.10004.1.1.1.0.0.1.0.0.1.2680",
                "value": "4C-4E-49-12-34-56-FF-FF"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "urn:iso:std:iso:11073:10101",
                  "code": "531981",
                  "display": "MDC_MOC_VMS_MDS_AHD"
                }
              ],
              "text": "MDC_MOC_VMS_MDS_AHD: Continua compliant Gateway"
            },
            "version": [
              {
                "type": {
                  "coding": [
                    {
                      "system": "urn:iso:std:iso:11073:10101",
                      "code": "532352"
                    }
                  ],
                  "text": "MDC_REG_CERT_DATA_CONTINUA_VERSION: Continua version"
                },
                "value": "6.0"
              }
            ],
            "property": [
              {
                "type": {
                  "coding": [
                    {
                      "system": "urn:iso:std:iso:11073:10101",
                      "code": "532353"
                    }
                  ],
                  "text": "MDC_REG_CERT_DATA_CONTINUA_CERT_DEV_LIST: Continua certified device list"
                },
                "valueCode": [
                  {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaPHD",
                        "code": "4"
                      }
                    ]
                  }
                ]
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "urn:iso:std:iso:11073:10101",
                      "code": "532355"
                    }
                  ],
                  "text": "MDC_REG_CERT_DATA_CONTINUA_AHD_CERT_LIST: Continua certified Health&Fitness interfaces list"
                },
                "valueCode": [
                  {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaHFS",
                        "code": "0"
                      }
                    ]
                  },
                  {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaHFS",
                        "code": "3"
                      }
                    ]
                  },
                  {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaHFS",
                        "code": "7"
                      }
                    ]
                  },
                  {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaHFS",
                        "code": "2"
                      }
                    ]
                  },
                  {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaHFS",
                        "code": "6"
                      }
                    ]
                  }
                ]
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ASN1ToHL7",
                      "code": "532354.0",
                      "display": "regulation-status"
                    }
                  ]
                },
                "valueCode": [
                  {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0136",
                        "code": "Y"
                      }
                    ],
                    "text": "Device is Unregulated"
                  }
                ]
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "urn:iso:std:iso:11073:10101",
                      "code": "68220"
                    }
                  ],
                  "text": "MDC_TIME_SYNC_PROTOCOL: Time synchronization protocol"
                },
                "valueCode": [
                  {
                    "coding": [
                      {
                        "system": "urn:iso:std:iso:11073:10101",
                        "code": "532226"
                      }
                    ],
                    "text": "MDC_TIME_SYNC_NTPV4: NTPV4 time synchronization"
                  }
                ]
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "urn:iso:std:iso:11073:10101",
                      "code": "68221"
                    }
                  ],
                  "text": "MDC_TIME_SYNC_ACCURACY: unknown code 68221"
                },
                "valueQuantity": [
                  {
                    "value": 120000000,
                    "system": "http://unitsofmeasure.org",
                    "code": "us"
                  }
                ]
              }
            ]
          },
          "request": {
            "method": "POST",
            "url": "Device",
            "ifNoneExist": "identifier=urn:oid:1.2.840.10004.1.1.1.0.0.1.0.0.1.2680|4C-4E-49-12-34-56-FF-FF"
          }
        },
        {
          "fullUrl": "urn:oid:1.2.3.2",
          "resource": {
            "resourceType": "Device",
            "meta": {
              "profile": [
                "http://hl7.org/fhir/uv/phd/StructureDefinition/PhdDevice"
              ]
            },
            "identifier": [
              {
                "type": {
                  "coding": [
                    {
                      "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers",
                      "code": "SYSID",
                      "display": "System Identifier"
                    }
                  ]
                },
                "system": "urn:oid:1.2.840.10004.1.1.1.0.0.1.0.0.1.2680",
                "value": "00-1C-05-04-00-00-78-25"
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaDeviceIdentifiers",
                      "code": "BTMAC",
                      "display": "Bluetooth Address"
                    }
                  ]
                },
                "system": "http://hl7.org/fhir/sid/eui-48/bluetooth",
                "value": "00-1C-05-00-78-25"
              }
            ],
            "manufacturer": "Nonin Medical, Inc.",
            "serialNumber": "0400007825",
            "deviceName": [
              {
                "name": "Nonin_Medical_Inc._323552",
                "type": "user-friendly-name"
              }
            ],
            "modelNumber": "Model 3150",
            "type": {
              "coding": [
                {
                  "system": "urn:iso:std:iso:11073:10101",
                  "code": "65573",
                  "display": "MDC_MOC_VMS_MDS_SIMP"
                }
              ],
              "text": "MDC_MOC_VMS_MDS_SIMP: Personal Health Device"
            },
            "specialization": [
              {
                "systemType": {
                  "coding": [
                    {
                      "system": "urn:iso:std:iso:11073:10101",
                      "code": "528388"
                    }
                  ],
                  "text": "MDC_DEV_SPEC_PROFILE_PULS_OXIM: Pulse Oximeter"
                },
                "version": "1"
              }
            ],
            "version": [
              {
                "type": {
                  "coding": [
                    {
                      "system": "urn:iso:std:iso:11073:10101",
                      "code": "531976"
                    }
                  ],
                  "text": "MDC_ID_PROD_SPEC_FW: Firmware revision"
                },
                "value": "0.9C"
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "urn:iso:std:iso:11073:10101",
                      "code": "532352"
                    }
                  ],
                  "text": "MDC_REG_CERT_DATA_CONTINUA_VERSION: Continua version"
                },
                "value": "1.0"
              }
            ],
            "property": [
              {
                "type": {
                  "coding": [
                    {
                      "system": "urn:iso:std:iso:11073:10101",
                      "code": "532353"
                    }
                  ],
                  "text": "MDC_REG_CERT_DATA_CONTINUA_CERT_DEV_LIST: Continua certified device list"
                },
                "valueCode": [
                  {
                    "coding": [
                      {
                        "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ContinuaPHD",
                        "code": "4"
                      }
                    ]
                  }
                ]
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ASN1ToHL7",
                      "code": "532354.0",
                      "display": "regulation-status"
                    }
                  ]
                },
                "valueCode": [
                  {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0136",
                        "code": "N"
                      }
                    ],
                    "text": "Device is Regulated"
                  }
                ]
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "urn:iso:std:iso:11073:10101",
                      "code": "68220"
                    }
                  ],
                  "text": "MDC_TIME_SYNC_PROTOCOL: Time synchronization protocol"
                },
                "valueCode": [
                  {
                    "coding": [
                      {
                        "system": "urn:iso:std:iso:11073:10101",
                        "code": "532224"
                      }
                    ],
                    "text": "MDC_TIME_SYNC_NONE: No time synchronization"
                  }
                ]
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ASN1ToHL7",
                      "code": "68219.0",
                      "display": "mds-time-capab-real-time-clock"
                    }
                  ]
                },
                "valueCode": [
                  {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0136",
                        "code": "Y"
                      }
                    ],
                    "text": "real time clock supported"
                  }
                ]
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ASN1ToHL7",
                      "code": "68219.1",
                      "display": "mds-time-capab-set-clock"
                    }
                  ]
                },
                "valueCode": [
                  {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0136",
                        "code": "Y"
                      }
                    ],
                    "text": "setting the time supported"
                  }
                ]
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "http://hl7.org/fhir/uv/phd/CodeSystem/ASN1ToHL7",
                      "code": "68219.2",
                      "display": "mds-time-capab-relative-time"
                    }
                  ]
                },
                "valueCode": [
                  {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0136",
                        "code": "Y"
                      }
                    ],
                    "text": "relative time supported"
                  }
                ]
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "urn:iso:std:iso:11073:10101",
                      "code": "68222"
                    }
                  ],
                  "text": "MDC_TIME_RES_ABS: Resolution of absolute time clock"
                },
                "valueQuantity": [
                  {
                    "value": 1000000,
                    "system": "http://unitsofmeasure.org",
                    "code": "us"
                  }
                ]
              },
              {
                "type": {
                  "coding": [
                    {
                      "system": "urn:iso:std:iso:11073:10101",
                      "code": "68223"
                    }
                  ],
                  "text": "MDC_TIME_RES_REL: Resolution of relative time clock"
                },
                "valueQuantity": [
                  {
                    "value": 10000,
                    "system": "http://unitsofmeasure.org",
                    "code": "us"
                  }
                ]
              }
            ]
          },
          "request": {
            "method": "POST",
            "url": "Device",
            "ifNoneExist": "identifier=urn:oid:1.2.840.10004.1.1.1.0.0.1.0.0.1.2680|00-1C-05-04-00-00-78-25"
          }
        },
        {
          "fullUrl": "urn:oid:3.1568997631834",
          "resource": {
            "resourceType": "Observation",
            "meta": {
              "profile": [
                "http://hl7.org/fhir/uv/phd/StructureDefinition/PhdCoincidentTimeStampObservation"
              ]
            },
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/observation-gatewayDevice",
                "valueReference": {
                  "reference": "urn:oid:1.2.3.1"
                }
              }
            ],
            "status": "final",
            "code": {
              "coding": [
                {
                  "system": "urn:iso:std:iso:11073:10101",
                  "code": "67975"
                }
              ],
              "text": "MDC_ATTR_TIME_ABS: Uses Absolute time clock"
            },
            "subject": {
              "reference": "urn:oid:1.2.3.0"
            },
            "effectiveDateTime": "2019-09-20T12:40:07.936-04:00",
            "valueDateTime": "2019-09-20T12:40:09.000-04:00",
            "device": {
              "reference": "urn:oid:1.2.3.2"
            }
          },
          "request": {
            "method": "POST",
            "url": "Observation"
          }
        },
        {
          "fullUrl": "urn:oid:1.0.0.1",
          "resource": {
            "resourceType": "Observation",
            "meta": {
              "profile": [
                "http://hl7.org/fhir/uv/phd/StructureDefinition/PhdNumericObservation"
              ]
            },
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/observation-gatewayDevice",
                "valueReference": {
                  "reference": "urn:oid:1.2.3.1"
                }
              }
            ],
            "status": "final",
            "category": [
              {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                    "code": "vital-signs",
                    "display": "Vital Signs"
                  }
                ]
              }
            ],
            "code": {
              "coding": [
                {
                  "system": "urn:iso:std:iso:11073:10101",
                  "code": "150456"
                },
                {
                  "system": "http://loinc.org",
                  "code": "2708-6"
                }
              ],
              "text": "MDC_PULS_OXIM_SAT_O2: Blood 0₂"
            },
            "subject": {
              "reference": "urn:oid:1.2.3.0"
            },
            "effectiveDateTime": "2019-09-20T12:40:16.936-04:00",
            "valueQuantity": {
              "value": 98,
              "system": "http://unitsofmeasure.org",
              "code": "%"
            },
            "device": {
              "reference": "urn:oid:1.2.3.2"
            },
            "derivedFrom": [
              {
                "reference": "urn:oid:3.1568997631834"
              }
            ],
            "component": [
              {
                "code": {
                  "coding": [
                    {
                      "system": "urn:iso:std:iso:11073:10101",
                      "code": "68193"
                    }
                  ],
                  "text": "MDC_ATTR_SUPPLEMENTAL_TYPES: Supplemental information"
                },
                "valueCodeableConcept": {
                  "coding": [
                    {
                      "system": "urn:iso:std:iso:11073:10101",
                      "code": "150588"
                    }
                  ],
                  "text": "MDC_MODALITY_SPOT: Stable mean"
                }
              }
            ]
          },
          "request": {
            "method": "POST",
            "url": "Observation"
          }
        },
        {
          "fullUrl": "urn:oid:1.0.0.2",
          "resource": {
            "resourceType": "Observation",
            "meta": {
              "profile": [
                "http://hl7.org/fhir/uv/phd/StructureDefinition/PhdNumericObservation"
              ]
            },
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/observation-gatewayDevice",
                "valueReference": {
                  "reference": "urn:oid:1.2.3.1"
                }
              }
            ],
            "status": "final",
            "category": [
              {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                    "code": "vital-signs",
                    "display": "Vital Signs"
                  }
                ]
              }
            ],
            "code": {
              "coding": [
                {
                  "system": "urn:iso:std:iso:11073:10101",
                  "code": "149530"
                },
                {
                  "system": "http://loinc.org",
                  "code": "8867-4"
                }
              ],
              "text": "MDC_PULS_OXIM_PULS_RATE: Pulse rate"
            },
            "subject": {
              "reference": "urn:oid:1.2.3.0"
            },
            "effectiveDateTime": "2019-09-20T12:40:16.936-04:00",
            "valueQuantity": {
              "value": 47,
              "system": "http://unitsofmeasure.org",
              "code": "{beat}/min"
            },
            "device": {
              "reference": "urn:oid:1.2.3.2"
            },
            "derivedFrom": [
              {
                "reference": "urn:oid:3.1568997631834"
              }
            ],
            "component": [
              {
                "code": {
                  "coding": [
                    {
                      "system": "urn:iso:std:iso:11073:10101",
                      "code": "68193"
                    }
                  ],
                  "text": "MDC_ATTR_SUPPLEMENTAL_TYPES: Supplemental information"
                },
                "valueCodeableConcept": {
                  "coding": [
                    {
                      "system": "urn:iso:std:iso:11073:10101",
                      "code": "150588"
                    }
                  ],
                  "text": "MDC_MODALITY_SPOT: Stable mean"
                }
              }
            ]
          },
          "request": {
            "method": "POST",
            "url": "Observation"
          }
        }
      ]
    }