Release 4

Consent-example-signature.xml

Community Based Collaborative Care Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Patient

Raw XML (canonical form + also see XML Format Specification)

Jump past Narrative

Consent Example with a signature (id = "consent-example-signature")

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

<Consent xmlns="http://hl7.org/fhir">
  <id value="consent-example-signature"/> 
  <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative with Details</b> </p> <p> <b> id</b> : consent-example-signature</p> <p> <b> identifier</b> : 494e0c7a-a69e-4fb4-9d02-6aae747790d7</p> <p> <b> status</b> : active</p> <p> <b> scope</b> : Privacy Consent <span> (Details : {http://terminology.hl7.org/CodeSystem/consentscope code 'patient-privacy'
           = 'Privacy Consent)</span> </p> <p> <b> category</b> : Notice of Privacy Practices <span> (Details : {http://terminology.hl7.org/CodeSystem/consentcategorycodes code 'npp' = 'Notice
           of Privacy Practices)</span> </p> <p> <b> patient</b> : <a> Patient/72</a> </p> <p> <b> dateTime</b> : May 26, 2016 12:41:10 AM</p> <p> <b> performer</b> : <a> Patient/72</a> </p> <p> <b> organization</b> : <a> Organization/f001</a> </p> <p> <b> policyRule</b> : opt-in <span> (Details : {http://terminology.hl7.org/CodeSystem/v3-ActCode code 'OPTIN' = 'opt-in)</span> </p> <blockquote> <p> <b> provision</b> </p> <p> <b> period</b> : Oct 10, 2015 --&gt; Oct 10, 2016</p> <h3> Actors</h3> <table> <tr> <td> -</td> <td> <b> Role</b> </td> <td> <b> Reference</b> </td> </tr> <tr> <td> *</td> <td> primary information recipient <span> (Details : {http://terminology.hl7.org/CodeSystem/v3-ParticipationType code 'PRCP' = 'primary
                 information recipient)</span> </td> <td> <a> Practitioner/13</a> </td> </tr> </table> <h3> Provisions</h3> <table> <tr> <td> -</td> </tr> <tr> <td> *</td> </tr> </table> </blockquote> </div> </text> <identifier> 
    <system value="urn:oid:2.16.840.1.113883.3.72.5.9.1"/> 
    <value value="494e0c7a-a69e-4fb4-9d02-6aae747790d7"/> 
    <!--    consent GUID generated by application    -->
  </identifier> 
  <status value="active"/> 
  <scope> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/consentscope"/> 
      <code value="patient-privacy"/> 
    </coding> 
  </scope> 
  <category> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/consentcategorycodes"/> 
      <code value="npp"/> 
    </coding> 
  </category> 
  <patient> 
    <reference value="Patient/72"/> 
    <!--    one of the stock examples    -->
  </patient> 
  <dateTime value="2016-05-26T00:41:10-04:00"/> 
  <performer> 
    <reference value="Patient/72"/> 
    <!--    author is patient themselves, and they sign    -->
  </performer> 
  <!--    this consent relates to sharing data with a specific recipient    -->
  <organization> 
    <reference value="Organization/f001"/> 
  </organization> 
  <!--    no source for this one - it is the signed master    -->
  <policyRule> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/> 
      <code value="OPTIN"/> 
    </coding> 
  </policyRule> 
  <!--    here's an opt-in: share CDA documents of type Discharge Summary 
    + Summarization of Episode Note from a specific author    -->
  <provision> 
    <period> 
      <start value="2015-10-10"/> 
      <end value="2016-10-10"/> 
    </period> 
    <actor> 
      <role> 
        <coding> 
          <system value="http://terminology.hl7.org/CodeSystem/v3-ParticipationType"/> 
          <code value="PRCP"/> 
        </coding> 
      </role> 
      <reference> 
        <reference value="Practitioner/13"/> 
        <!--    Stock practitioner    -->
      </reference> 
    </actor> 
    <provision> 
      <type value="permit"/> 
      <actor> 
        <role> 
          <coding> 
            <system value="http://terminology.hl7.org/CodeSystem/v3-ParticipationType"/> 
            <code value="AUT"/> 
          </coding> 
        </role> 
        <reference> 
          <reference value="Practitioner/xcda-author"/> 
        </reference> 
      </actor> 
      <!--    CDA documents    -->
      <class> 
        <system value="urn:ietf:bcp:13"/> 
        <code value="application/hl7-cda+xml"/> 
      </class> 
      <!--    code rules    -->
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="34133-9"/> 
        </coding> 
      </code> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="18842-5"/> 
        </coding> 
      </code> 
    </provision> 
  </provision> 
</Consent> 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.