<custodian> <reference value="urn:uuid:12bba528-a08a-448b-946b-7e8008044025" /> </custodian> <section> <title value="Admission details" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="886781000000108" /> <display value="Admission details" /> </coding> </code> <text> <status value="extensions" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table width="100%"> <tbody> <tr> <th>Reason for admission</th> <td>ECG: inferior ischaemia</td> </tr> <tr> <th>Admission method</th> <td>Accident and emergency or dental casualty department of the Health Care Provider</td> </tr> <tr> <th>Source of admission</th> <td>NHS other Hospital Provider - Ward for general Patients or the younger physically disabled or A and E department</td> </tr> <tr> <th>Date/time of admission</th> <td>12-Feb-2015 09:00</td> </tr> </tbody> </table> </div> </text> <entry> <reference value="urn:uuid:4f36b35a-ad18-4ea9-a3fb-c893f709e88a" /> </entry> </section> <section> <title value="Allergies and adverse reactions" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="886921000000105" /> <display value="Allergies and adverse reactions" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table width="100%"> <tbody> <tr> <th>Causative agent</th> <td>Penicillin -class of antibiotic-</td> </tr> <tr> <th>Reaction details</th> <td> <p>Description of reaction: Eruption due to drug</p> <p>Date recorded: 12 February 2015</p> <p>Severity: Mild</p> <p>Certainty: Certain</p> <p>Comment: No swelling</p> </td> </tr> </tbody> </table> </div> </text> <entry> <reference value="urn:uuid:95e8f8d0-dfc3-4c72-a9dc-7ba1ccd1fab4" /> </entry> </section> <section> <title value="Assessment scales" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="887141000000103" /> <display value="Assessment scales" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table width="100%"> <tbody> <tr> <th>Assessment scale</th> <td>TIMI assessment</td> </tr> </tbody> </table> </div> </text> </section> <section> <title value="Clinical summary" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="887181000000106" /> <display value="Clinical summary" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table width="100%"> <tbody> <tr> <th>Clinical Summary</th> </tr> <tr> <td> <p>60 year old man complaining of chest pain lasting around 2 hours.</p> <p>Examination unremarkable.</p> <p>Inferior ischaemic changes on ECGs.</p> <p>Coronary angiogram demonstrated diseased RCA, drug eluting stent successfully placed.</p> <p>Appropriate secondary prevention medications prescribed for follow up with Cardiac Rehabilitation team.</p> </td> </tr> </tbody> </table> </div> </text> </section> <section> <title value="Diagnoses" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="887161000000102" /> <display value="Diagnoses" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table width="100%"> <tbody> <tr> <th>Diagnosis name</th> <td>Chest pain</td> </tr> <tr> <th>Comment</th> <td>Patient arrived in Accident and Emergency complaining of chest pain and admitted to ward for further tests.</td> </tr> <tr> <th>Diagnosis name</th> <td>Coronary arteriosclerosis</td> </tr> <tr> <th>Comment</th> <td>The coronary angiogram indicates a diseased RCA.</td> </tr> <tr> <th>Diagnosis name</th> <td>ECG: inferior ischaemia</td> </tr> <tr> <th>Comment</th> <td>ECG shows inferior ischaemic changes.</td> </tr> </tbody> </table> </div> </text> <entry> <reference value="urn:uuid:caf5f17d-e73d-4aaa-a406-dab1717da0c4" /> </entry> </section> <section> <title value="Discharge details" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="886811000000106" /> <display value="Discharge details" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table width="100%"> <tbody> <tr> <th>Discharging consultant</th> <td> <p>Prefix: Dr</p> <p>Given Name: Paul</p> <p>Family Name: Rastall</p> </td> </tr> <tr> <th>Discharging specialty/department</th> <td>Cardiology</td> </tr> <tr> <th>Discharge location</th> <td> <p>Name: Cramer ward</p> <p>Identifier: RR8CRAM</p> </td> </tr> <tr> <th>Date/time of discharge</th> <td>16-Feb-2015 15:00</td> </tr> <tr> <th>Discharge method</th> <td>Patient discharged on clinical advice or with clinical consent</td> </tr> <tr> <th>Discharge destination</th> <td>Discharge type: Usual place of residence unless listed below, for example, a private dwelling whether owner occupied or owned by Local Authority, housing association or other landlord. This includes wardened accommodation but not residential accommodation where health care is provided. It also includes Patients with no fixed abode.</td> </tr> </tbody> </table> </div> </text> <entry> <reference value="urn:uuid:4f36b35a-ad18-4ea9-a3fb-c893f709e88a" /> </entry> <entry> <reference value="urn:uuid:6239b7a7-380d-46ff-a1c5-7abc4e68f8bc" /> </entry> </section> <section> <title value="Distribution list" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="887261000000109" /> <display value="Distribution list" /> </coding> </code> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table width="100%"> <tbody> <tr> <th>Name</th> <td> <p>Prefix: Mrs</p> <p>Given Name: Angela</p> <p>Family Name: Jones</p> </td> </tr> <tr> <th>Role</th> <td>Community Nurse</td> </tr> <tr> <th>Organisation</th> <td>Leeds Community Healthcare NHS Trust</td> </tr> </tbody> </table> <table width="100%"> <tbody> <tr> <th>Name</th> <td> <p>Prefix: Dr</p> <p>Given Name: John</p> <p>Family Name: Lorenzo</p> </td> </tr> <tr> <th>Role</th> <td>General Medical Practitioner</td> </tr> <tr> <th>Organisation</th> <td>MGP Medical Centre</td> </tr> </tbody> </table> </div> </text> <entry> <reference value="urn:uuid:8ece9986-9af0-4882-b0cf-23a96ea7b509" /> </entry> <entry> <reference value="urn:uuid:5e414a77-d394-4248-a631-00e45ddb64a0" /> </entry> </section> <section> <title value="GP practice" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="886711000000101" /> <display value="GP practice" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table width="100%"> <tbody> <tr> <th>GP name</th> <td> <p>Prefix: Dr</p> <p>Given Name: John</p> <p>Family Name: Lorenzo</p> </td> </tr> <tr> <th>GP practice details</th> <td> <p>Name: MGP Medical Centre</p> <p>Address:</p> <p>Address Line: 1 MGP House, Overtown</p> <p>City: Leeds</p> <p>Post Code: LS21 7PA</p> </td> </tr> </tbody> </table> </div> </text> <entry> <reference value="urn:uuid:f9f24f89-646b-4a19-a6b1-cabfa3b612e1" /> </entry> </section> <section> <title value="Individual requirements" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="1052901000000109" /> <display value="Individual requirement" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table width="100%"> <tbody> <tr> <th>Individual requirements</th> <td>Hospital needs to arrange for transportation to the patient's home.</td> </tr> </tbody> </table> </div> </text> </section> <section> <title value="Information and advice given" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="1052951000000105" /> <display value="Information and advice given" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table width="100%"> <tbody> <tr> <th>Information and advice given</th> <td> <p>Patient seen by Cardiac Rehab and information given regarding the diagnosis and possible life style changes when he is discharged.</p> <p>Richard is concerned about whether he can drive and asks about this as he is a self employed electrician.</p> <p>Dr Paul Rastall advised him that he should not to drive for at least a week, but reassured him that he should be able to drive once recovered and said he will arrange for a community follow-up.</p> </td> </tr> </tbody> </table> </div> </text> </section> <section> <title value="Investigation results" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="1082101000000102" /> <display value="Investigation results" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table> <tbody> <tr> <th>Investigation result</th> </tr> <tr> <td> <pre>Full Blood Count TestValueUnitsReference Range White Cell Count11.1x10*9/L3.5 - 10.0 Red Cell Count5.0x10*12/L4.25 - 5.75 Haemoglobin150g/L13.0 - 17.0 Haematocrit0.2300.400 - 0.500 Mean Cell Volume90fL84 - 98 Mean Cell Hb33.0pg27.5 - 32.0 Mean Cell Hb Con34.0pg31.0 - 35.0 RDW12.0%< 14.5 Platelet Count300x10*9/L150 - 400 Machine Differential Test ValueUnits Reference Range Neutrophils7.0x10*9/L1.7 - 7.5 Lymphocytes3.5x10*9/L1.0 - 3.5 Monocytes0.3x10*9/L< 0.6 Eosinophils0.4x10*9/L< 0.4 Basophils0.1x10*9/L< 0.1 LUCs0.2x10*9/L< 0.4</pre> </td> </tr> </tbody> </table> </div> </text> </section> <section> <title value="Medications and medical devices" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="933361000000108" /> <display value="Medications and medical devices" /> </coding> </code> <text> <status value="extensions" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table width="100%"> <tbody> <tr> <th>Medication item</th> <td>Medication name: Ramipril 2.5mg tablets</td> <td>Form: Chewable tablet</td> <td>Route: Oral</td> <td>Dose directions description: One 2.5mg tablet once a day.</td> </tr> <tr> <th>Medication change</th> <td colspan="4">Status: Continued</td> </tr> </tbody> </table> <table width="100%"> <tbody> <tr> <th>Medication item</th> <td>Medication name: Aspirin 75mg gastro-resistant tablets</td> <td>Form: Chewable tablet</td> <td>Route: Oral</td> <td>Dose directions description: Take one 75mg tablet once a day.</td> </tr> <tr> <th>Medication change</th> <td colspan="4">Status: Continued</td> </tr> </tbody> </table> <table width="100%"> <tbody> <tr> <th>Medication item</th> <td>Medication name: Clopidogrel 75mg tablets</td> <td>Form: Chewable tablet</td> <td>Route: Oral</td> <td>Dose directions description: Take one 75mg tablet daily for one year then stop.</td> </tr> <tr> <th>Medication change</th> <td colspan="4">Status: Added</td> </tr> </tbody> </table> <table width="100%"> <tbody> <tr> <th>Medication item</th> <td>Medication name: Simvastatin 40mg tablets</td> <td>Form: Chewable tablet</td> <td>Route: Oral</td> <td>Dose directions description: Take one 40mg tablet once a day.</td> </tr> <tr> <th>Medication change</th> <td colspan="4">Status: Continued</td> </tr> </tbody> </table> <table width="100%"> <tbody> <tr> <th>Medication item</th> <td>Medication name: Bisoprolol 5mg tablets</td> <td>Form: Chewable tablet</td> <td>Route: Oral</td> <td>Dose directions description: Take one 5mg tablet daily.</td> </tr> <tr> <th>Course details</th> <td colspan="4">Comment/recommendation: Uptitrate according to BP and HR</td> </tr> <tr> <th>Medication change</th> <td colspan="4">Status: Continued</td> </tr> </tbody> </table> </div> </text> <entry> <reference value="urn:uuid:d0710501-2e32-4cbd-bd63-a14354bbcd0f" /> </entry> </section> <section> <title value="Patient and carer concerns, expectations and wishes" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="1052941000000107" /> <display value="Patient and carer concerns, expectations and wishes" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table width="100%"> <tbody> <tr> <th>Patient and carer concerns, expectations and wishes</th> <td>The carer is concerned about the possibility of the patient suffering from a heart attack, bearing a similarity to the illness of the mother of the patient. The patient is worried about the impact of their illness on their ability to work and drive.</td> </tr> </tbody> </table> </div> </text> </section> <section> <title value="Patient demographics" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="886731000000109" /> <display value="Patient demographics" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table width="100%"> <tbody> <tr> <th>Patient name</th> <td> <p>Prefix: Mr</p> <p>Given Name: Richard</p> <p>Family Name: Smith</p> </td> </tr> <tr> <th>Date of birth</th> <td>1 January 1957</td> </tr> <tr> <th>Gender</th> <td>Male</td> </tr> <tr> <th>NHS number</th> <td>1352465790</td> </tr> <tr> <th>Patient address</th> <td> <p>Address Line: 21, Grove Street, Overtown</p> <p>City: Leeds</p> <p>Post Code: LS21 1PF</p> </td> </tr> <tr> <th>Relevant contacts</th> <td> Name: Joy Smith <p>Relationship: Next of kin</p><p>Contact details: Tel. 0712345678 Email. mrssmith@mymail.com</p></td> </tr> </tbody> </table> </div> </text> <entry> <reference value="urn:uuid:31686b67-9f20-4644-9a54-193d2f91de57" /> </entry> </section> <section> <title value="Person completing record" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="887231000000104" /> <display value="Person completing record" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table width="100%"> <tbody> <tr> <th>Name</th> <td> <p>Prefix: Dr</p> <p>Given Name: Paul</p> <p>Family Name: Rastall</p> </td> </tr> <tr> <th>Role</th> <td>Consultant</td> </tr> <tr> <th>Specialty</th> <td>Cardiology</td> </tr> <tr> <th>Professional identifier</th> <td>GMC: 6122477</td> </tr> <tr> <th>Date and time completed</th> <td>17 Feb 2015 10:00</td> </tr> <tr> <th>Contact details</th> <td>Phone: 0113 6323200 (Work)</td> </tr> <tr> <th>Organisation</th> <td> <p>Name: Leeds Teaching Hospitals NHS Trust,</p> <p>Address Line: St James's University Hospital, Beckett Street</p> <p>City: Leeds</p> <p>Post Code: LS9 7TF</p> </td> </tr> </tbody> </table> </div> </text> <entry> <reference value="urn:uuid:6239b7a7-380d-46ff-a1c5-7abc4e68f8bc" /> </entry> <entry> <reference value="urn:uuid:12bba528-a08a-448b-946b-7e8008044025" /> </entry> </section> <section> <title value="Plan and requested actions" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="887201000000105" /> <display value="Plan and requested actions" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table width="100%"> <tbody> <tr> <th>Actions for healthcare professionals</th> <td> GP please continue secondary preventative medication. <p>Status: Requested</p><p>Doses will be uptitrated by Cardiac Rehab team.</p><p>Status: Requested</p></td> </tr> <tr> <th>Actions for patient or their carer</th> <td>Patient to attend community follow up after discharge.</td> </tr> <tr> <th>Agreed with patient or legitimate patient representative</th> <td>Patient agreed to avoid driving for one week on discharge.</td> </tr> </tbody> </table> </div> </text> </section> <section> <title value="Procedures" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="887171000000109" /> <display value="Procedures" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table width="100%"> <tbody> <tr> <th>Procedure name</th> <td> Percutaneous coronary intervention <p>Anatomical site: Right coronary artery structure</p><p>Comment: Patient successfully underwent angioplasty procedure to place a drug eluting stent.</p></td> </tr> <tr> <th>Procedure name</th> <td> Electrocardiographic monitoring <p>Comment: ECGs showed inferior ischaemic changes and diseased RCA.</p></td> </tr> </tbody> </table> </div> </text> <entry> <reference value="urn:uuid:1e04ce96-6e52-4f82-bc26-93c89c5836a1" /> </entry> </section> <section> <title value="Referrer details" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="1052891000000108" /> <display value="Referrer details" /> </coding> </code> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table width="100%"> <tbody> <tr> <th>Referrer details</th> <td> <p>Name:</p> <p>Prefix: Dr.</p> <p>Given name: Amanda</p> <p>Family name: Smith</p> <p>Role: Specialist Registrar</p> <p>Tel: 0113 6323222 (work)</p> <p>Organisation</p> <p>Name: St. James's University Hospital Accident and Emergency Department</p> <p>Address Line: St James's University Hospital, Beckett Street</p> <p>City: Leeds</p> <p>Post Code: LS9 7TF</p> </td> </tr> </tbody> </table> </div> </text> <entry> <reference value="urn:uuid:d791b058-2624-436a-bc02-db38d65325b8" /> </entry> <entry> <reference value="urn:uuid:5f76e146-3eaa-4f0e-aa3b-8d26b8b2febe" /> </entry> </section> <section> <title value="Social context" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="887051000000101" /> <display value="Social context" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml"> <table width="100%"> <tbody> <tr> <th>Household composition</th> <td>Lives with wife</td> </tr> <tr> <th>Occupational history</th> <td>Self employed electrician</td> </tr> </tbody> </table> </div> </text> </section> </Composition> </resource> </entry> <entry> <fullUrl value="urn:uuid:4f36b35a-ad18-4ea9-a3fb-c893f709e88a" /> <resource> <Encounter> <id value="4f36b35a-ad18-4ea9-a3fb-c893f709e88a" /> <meta> <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-ITK-Encounter-1" /> </meta> <extension url="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-AdmissionMethod-1"> <valueCodeableConcept> <coding> <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-AdmissionMethod-1" /> <code value="21" /> <display value="Accident and emergency or dental casualty department of the Health Care Provider" /> </coding> </valueCodeableConcept> </extension> <identifier> <system value="https://tools.ietf.org/html/rfc4122" /> <value value="13c73015-d8fa-4844-8d68-4f856883eca8" /> </identifier> <status value="finished" /> <class> <system value="http://hl7.org/fhir/v3-ActEncounterCode" /> <code value="IMP" /> <display value="inpatient encounter" /> </class> <type> <coding> <system value="http://snomed.info/sct" /> <code value="24882007" /> <display value="Medical consultation on hospital inpatient" /> </coding> </type> <subject> <reference value="urn:uuid:31686b67-9f20-4644-9a54-193d2f91de57" /> </subject> <participant> <type> <coding> <system value="http://hl7.org/fhir/v3/ParticipationType" /> <code value="DIS" /> <display value="discharger" /> </coding> </type> <individual> <reference value="urn:uuid:6239b7a7-380d-46ff-a1c5-7abc4e68f8bc" /> </individual> </participant> <period> <start value="2015-02-12T09:00:00+00:00" /> <end value="2015-02-16T15:00:00+00:00" /> </period> <reason> <coding> <system value="http://snomed.info/sct" /> <code value="425419005" /> <display value="ECG: inferior ischaemia" /> </coding> </reason> <hospitalization> <admitSource> <coding> <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-SourceOfAdmission-1" /> <code value="51" /> <display value="NHS other Hospital Provider - Ward for general Patients or the younger physically disabled or A and E department" /> </coding> </admitSource> <dischargeDisposition> <coding> <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-DischargeDestination-1" /> <code value="19" /> <display value="Usual place of residence unless listed below, for example, a private dwelling whether owner occupied or owned by Local Authority, housing association or other landlord. This includes wardened accommodation but not residential accommodation where health care is provided. It also includes Patients with no fixed abode." /> </coding> </dischargeDisposition> </hospitalization> <location> <location> <reference value="urn:uuid:01bb1ccc-577b-4a4a-9fb0-9c8fe9f21fa3" /> </location> <period> <end value="2015-02-16T15:00:00+00:00" /> </period> </location> </Encounter> </resource> </entry> <entry> <fullUrl value="urn:uuid:d0710501-2e32-4cbd-bd63-a14354bbcd0f" /> <resource> <List> <id value="d0710501-2e32-4cbd-bd63-a14354bbcd0f" /> <meta> <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-ITK-Medication-List-1" /> </meta> <identifier> <system value="https://tools.ietf.org/html/rfc4122" /> <value value="cb8e31b2-15d4-4fe6-a690-13934348fbf1" /> </identifier> <status value="current" /> <mode value="snapshot" /> <code> <coding> <system value="http://snomed.info/sct" /> <code value="933361000000108" /> <display value="Medications and medical devices" /> </coding> </code> <subject> <reference value="urn:uuid:31686b67-9f20-4644-9a54-193d2f91de57" /> 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value="urn:uuid:7016a1b0-9fa4-4f4f-9eef-0922f3b2aa48" /> <resource> <PractitionerRole> <id value="7016a1b0-9fa4-4f4f-9eef-0922f3b2aa48" /> <meta> <profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-PractitionerRole-1" /> </meta> <practitioner> <reference value="urn:uuid:6239b7a7-380d-46ff-a1c5-7abc4e68f8bc" /> </practitioner> <organization> <reference value="urn:uuid:12bba528-a08a-448b-946b-7e8008044025" /> </organization> <code> <coding> <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1" /> <code value="R0050" /> <display value="Consultant" /> </coding> </code> <specialty> <coding> <system value="http://snomed.info/sct" /> <code value="394579002" /> <display value="Cardiology" /> </coding> </specialty> </PractitionerRole> </resource> </entry> <entry> <fullUrl value="urn:uuid:a7922b56-d0da-4437-9c45-901b399e8cc5" /> <resource> <PractitionerRole> <id value="a7922b56-d0da-4437-9c45-901b399e8cc5" /> <meta> <profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-PractitionerRole-1" /> </meta> <practitioner> <reference value="urn:uuid:8ece9986-9af0-4882-b0cf-23a96ea7b509" /> </practitioner> <organization> <reference value="urn:uuid:acd640c9-5ff9-41ae-9ef3-07a1d5667140" /> </organization> <code> <coding> <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1" /> <code value="R0700" /> <display value="Community Nurse" /> </coding> </code> </PractitionerRole> </resource> </entry> <entry> <fullUrl value="urn:uuid:98828e88-b869-439d-8a64-10fd2cd7a4cd" /> <resource> <PractitionerRole> <id value="98828e88-b869-439d-8a64-10fd2cd7a4cd" /> <meta> <profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-PractitionerRole-1" /> </meta> <practitioner> <reference value="urn:uuid:5e414a77-d394-4248-a631-00e45ddb64a0" /> </practitioner> <organization> <reference value="urn:uuid:f9f24f89-646b-4a19-a6b1-cabfa3b612e1" /> </organization> <code> <coding> <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1" /> <code value="R0260" /> <display value="General Medical Practitioner" /> </coding> </code> </PractitionerRole> </resource> </entry> <entry> <fullUrl value="urn:uuid:3f4fc686-8796-4e68-b277-1970d7c9370f" /> <resource> <PractitionerRole> <id value="3f4fc686-8796-4e68-b277-1970d7c9370f" /> <meta> <profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-PractitionerRole-1" /> </meta> <practitioner> <reference value="urn:uuid:d791b058-2624-436a-bc02-db38d65325b8" /> </practitioner> <organization> <reference value="urn:uuid:5f76e146-3eaa-4f0e-aa3b-8d26b8b2febe" /> </organization> <code> <coding> <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1" /> <code value="R0110" /> <display value="Specialist Registrar" /> </coding> </code> </PractitionerRole> </resource> </entry> <entry> <fullUrl value="urn:uuid:f9f24f89-646b-4a19-a6b1-cabfa3b612e1" /> <resource> <Organization> <id value="f9f24f89-646b-4a19-a6b1-cabfa3b612e1" /> <meta> <profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1" /> </meta> <identifier> <system value="https://fhir.nhs.uk/Id/ods-organization-code" /> <value value="GP123456" /> </identifier> <name value="MGP Medical Centre" /> <address> <line value="1 MGP House, Overtown" /> <city value="Leeds" /> <postalCode value="LS21 7PA" /> </address> </Organization> </resource> </entry> <entry> <fullUrl value="urn:uuid:12bba528-a08a-448b-946b-7e8008044025" /> <resource> <Organization> <id value="12bba528-a08a-448b-946b-7e8008044025" /> <meta> <profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1" /> </meta> <identifier> <system value="https://fhir.nhs.uk/Id/ods-organization-code" /> <value value="RR8" /> </identifier> <name value="Leeds Teaching Hospitals NHS Trust" /> <address> <line value="St James's University Hospital, Beckett Street" /> <city value="Leeds" /> <postalCode value="LS9 7TF" /> </address> </Organization> </resource> </entry> <entry> <fullUrl value="urn:uuid:acd640c9-5ff9-41ae-9ef3-07a1d5667140" /> <resource> <Organization> <id value="acd640c9-5ff9-41ae-9ef3-07a1d5667140" /> <meta> <profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1" /> </meta> <identifier> <system value="https://fhir.nhs.uk/Id/ods-organization-code" /> <value value="RY6" /> </identifier> <name value="Leeds Community Healthcare NHS Trust" /> </Organization> </resource> </entry> <entry> <fullUrl value="urn:uuid:5f76e146-3eaa-4f0e-aa3b-8d26b8b2febe" /> <resource> <Organization> <id value="5f76e146-3eaa-4f0e-aa3b-8d26b8b2febe" /> <meta> <profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1" /> </meta> <name value="St. James's University Hospital Accident and Emergency Department" /> <address> <line value="St James's University Hospital, Beckett Street" /> <city value="Leeds" /> <postalCode value="LS9 7TF" /> </address> </Organization> </resource> </entry> <entry> <fullUrl value="urn:uuid:01bb1ccc-577b-4a4a-9fb0-9c8fe9f21fa3" /> <resource> <Location> <id value="01bb1ccc-577b-4a4a-9fb0-9c8fe9f21fa3" /> <meta> <profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Location-1" /> </meta> <identifier> <system value="https://fhir.nhs.uk/Id/local-location-identifier" /> <value value="RR8CRAM" /> </identifier> <name value="Cramer Ward" /> <managingOrganization> <reference value="urn:uuid:12bba528-a08a-448b-946b-7e8008044025" /> </managingOrganization> </Location> </resource> </entry> </Bundle>


        
          
          
        
        
        
          
            
            
            
          
        
        
          
        
        
          
        
        
        
          
        
        
        <custodian>
          <reference value="urn:uuid:12bba528-a08a-448b-946b-7e8008044025" />
        </custodian>
        <section>
          <title value="Admission details" />
          <code>
            <coding>
              <system value="http://snomed.info/sct" />
              <code value="886781000000108" />
              <display value="Admission details" />
            </coding>
          </code>
          <text>
            <status value="extensions" />
            <div xmlns="http://www.w3.org/1999/xhtml">
              <table width="100%">
                <tbody>
                  <tr>
                    <th>Reason for admission</th>
                    <td>ECG: inferior ischaemia</td>
                  </tr>
                  <tr>
                    <th>Admission method</th>
                    <td>Accident and emergency or dental casualty department of the Health Care Provider</td>
                  </tr>
                  <tr>
                    <th>Source of admission</th>
                    <td>NHS other Hospital Provider - Ward for general Patients or the younger physically 
disabled or A and E department</td>
                  </tr>
                  <tr>
                    <th>Date/time of admission</th>
                    <td>12-Feb-2015 09:00</td>
                  </tr>
                </tbody>
              </table>
            </div>
          </text>
          <entry>
            <reference value="urn:uuid:4f36b35a-ad18-4ea9-a3fb-c893f709e88a" />
          </entry>
        </section>
        <section>
          <title value="Allergies and adverse reactions" />
          <code>
            <coding>
              <system value="http://snomed.info/sct" />
              <code value="886921000000105" />
              <display value="Allergies and adverse reactions" />
            </coding>
          </code>
          <text>
            <status value="additional" />
            <div xmlns="http://www.w3.org/1999/xhtml">
              <table width="100%">
                <tbody>
                  <tr>
                    <th>Causative agent</th>
                    <td>Penicillin -class of antibiotic-</td>
                  </tr>
                  <tr>
                    <th>Reaction details</th>
                    <td>
                      <p>Description of reaction: Eruption due to drug</p>
                      <p>Date recorded: 12 February 2015</p>
                      <p>Severity: Mild</p>
                      <p>Certainty: Certain</p>
                      <p>Comment: No swelling</p>
                    </td>
                  </tr>
                </tbody>
              </table>
            </div>
          </text>
          <entry>
            <reference value="urn:uuid:95e8f8d0-dfc3-4c72-a9dc-7ba1ccd1fab4" />
          </entry>
        </section>
        <section>
          <title value="Assessment scales" />
          <code>
            <coding>
              <system value="http://snomed.info/sct" />
              <code value="887141000000103" />
              <display value="Assessment scales" />
            </coding>
          </code>
          <text>
            <status value="additional" />
            <div xmlns="http://www.w3.org/1999/xhtml">
              <table width="100%">
                <tbody>
                  <tr>
                    <th>Assessment scale</th>
                    <td>TIMI assessment</td>
                  </tr>
                </tbody>
              </table>
            </div>
          </text>
        </section>
        <section>
          <title value="Clinical summary" />
          <code>
            <coding>
              <system value="http://snomed.info/sct" />
              <code value="887181000000106" />
              <display value="Clinical summary" />
            </coding>
          </code>
          <text>
            <status value="additional" />
            <div xmlns="http://www.w3.org/1999/xhtml">
              <table width="100%">
                <tbody>
                  <tr>
                    <th>Clinical Summary</th>
                  </tr>
                  <tr>
                    <td>
                      <p>60 year old man complaining of chest pain lasting around 2 hours.</p>
                      <p>Examination unremarkable.</p>
                      <p>Inferior ischaemic changes on ECGs.</p>
                      <p>Coronary angiogram demonstrated diseased RCA, drug eluting stent successfully placed.</p>
                      <p>Appropriate secondary prevention medications prescribed for follow up with Cardiac Rehabilitation team.</p>
                    </td>
                  </tr>
                </tbody>
              </table>
            </div>
          </text>
        </section>
        <section>
          <title value="Diagnoses" />
          <code>
            <coding>
              <system value="http://snomed.info/sct" />
              <code value="887161000000102" />
              <display value="Diagnoses" />
            </coding>
          </code>
          <text>
            <status value="additional" />
            <div xmlns="http://www.w3.org/1999/xhtml">
              <table width="100%">
                <tbody>
                  <tr>
                    <th>Diagnosis name</th>
                    <td>Chest pain</td>
                  </tr>
                  <tr>
                    <th>Comment</th>
                    <td>Patient arrived in Accident and Emergency complaining of chest pain and admitted to 
ward for further tests.</td>
                  </tr>
                  <tr>
                    <th>Diagnosis name</th>
                    <td>Coronary arteriosclerosis</td>
                  </tr>
                  <tr>
                    <th>Comment</th>
                    <td>The coronary angiogram indicates a diseased RCA.</td>
                  </tr>
                  <tr>
                    <th>Diagnosis name</th>
                    <td>ECG: inferior ischaemia</td>
                  </tr>
                  <tr>
                    <th>Comment</th>
                    <td>ECG shows inferior ischaemic changes.</td>
                  </tr>
                </tbody>
              </table>
            </div>
          </text>
          <entry>
            <reference value="urn:uuid:caf5f17d-e73d-4aaa-a406-dab1717da0c4" />
          </entry>
        </section>
        <section>
          <title value="Discharge details" />
          <code>
            <coding>
              <system value="http://snomed.info/sct" />
              <code value="886811000000106" />
              <display value="Discharge details" />
            </coding>
          </code>
          <text>
            <status value="additional" />
            <div xmlns="http://www.w3.org/1999/xhtml">
              <table width="100%">
                <tbody>
                  <tr>
                    <th>Discharging consultant</th>
                    <td>
                      <p>Prefix: Dr</p>
                      <p>Given Name: Paul</p>
                      <p>Family Name: Rastall</p>
                    </td>
                  </tr>
                  <tr>
                    <th>Discharging specialty/department</th>
                    <td>Cardiology</td>
                  </tr>
                  <tr>
                    <th>Discharge location</th>
                    <td>
                      <p>Name: Cramer ward</p>
                      <p>Identifier: RR8CRAM</p>
                    </td>
                  </tr>
                  <tr>
                    <th>Date/time of discharge</th>
                    <td>16-Feb-2015 15:00</td>
                  </tr>
                  <tr>
                    <th>Discharge method</th>
                    <td>Patient discharged on clinical advice or with clinical consent</td>
                  </tr>
                  <tr>
                    <th>Discharge destination</th>
                    <td>Discharge type: Usual place of residence unless listed below, for example, 
a private dwelling whether owner occupied or owned by Local Authority, housing association 
or other landlord. This includes wardened accommodation but not residential accommodation 
where health care is provided. It also includes Patients with no fixed abode.</td>
                  </tr>
                </tbody>
              </table>
            </div>
          </text>
          <entry>
            <reference value="urn:uuid:4f36b35a-ad18-4ea9-a3fb-c893f709e88a" />
          </entry>
          <entry>
            <reference value="urn:uuid:6239b7a7-380d-46ff-a1c5-7abc4e68f8bc" />
          </entry>
        </section>
        <section>
          <title value="Distribution list" />
          <code>
            <coding>
              <system value="http://snomed.info/sct" />
              <code value="887261000000109" />
              <display value="Distribution list" />
            </coding>
          </code>
          <text>
            <status value="generated" />
            <div xmlns="http://www.w3.org/1999/xhtml">
              <table width="100%">
                <tbody>
                  <tr>
                    <th>Name</th>
                    <td>
                      <p>Prefix: Mrs</p>
                      <p>Given Name: Angela</p>
                      <p>Family Name: Jones</p>
                    </td>
                  </tr>
                  <tr>
                    <th>Role</th>
                    <td>Community Nurse</td>
                  </tr>
                  <tr>
                    <th>Organisation</th>
                    <td>Leeds Community Healthcare NHS Trust</td>
                  </tr>
                </tbody>
              </table>
              <table width="100%">
                <tbody>
                  <tr>
                    <th>Name</th>
                    <td>
                      <p>Prefix: Dr</p>
                      <p>Given Name: John</p>
                      <p>Family Name: Lorenzo</p>
                    </td>
                  </tr>
                  <tr>
                    <th>Role</th>
                    <td>General Medical Practitioner</td>
                  </tr>
                  <tr>
                    <th>Organisation</th>
                    <td>MGP Medical Centre</td>
                  </tr>
                </tbody>
              </table>
            </div>
          </text>
          <entry>
            <reference value="urn:uuid:8ece9986-9af0-4882-b0cf-23a96ea7b509" />
          </entry>
          <entry>
            <reference value="urn:uuid:5e414a77-d394-4248-a631-00e45ddb64a0" />
          </entry>
        </section>
        <section>
          <title value="GP practice" />
          <code>
            <coding>
              <system value="http://snomed.info/sct" />
              <code value="886711000000101" />
              <display value="GP practice" />
            </coding>
          </code>
          <text>
            <status value="additional" />
            <div xmlns="http://www.w3.org/1999/xhtml">
              <table width="100%">
                <tbody>
                  <tr>
                    <th>GP name</th>
                    <td>
                      <p>Prefix: Dr</p>
                      <p>Given Name: John</p>
                      <p>Family Name: Lorenzo</p>
                    </td>
                  </tr>
                  <tr>
                    <th>GP practice details</th>
                    <td>
                      <p>Name: MGP Medical Centre</p>
                      <p>Address:</p>
                      <p>Address Line: 1 MGP House, Overtown</p>
                      <p>City: Leeds</p>
                      <p>Post Code: LS21 7PA</p>
                    </td>
                  </tr>
                </tbody>
              </table>
            </div>
          </text>
          <entry>
            <reference value="urn:uuid:f9f24f89-646b-4a19-a6b1-cabfa3b612e1" />
          </entry>
        </section>
        <section>
          <title value="Individual requirements" />
          <code>
            <coding>
              <system value="http://snomed.info/sct" />
              <code value="1052901000000109" />
              <display value="Individual requirement" />
            </coding>
          </code>
          <text>
            <status value="additional" />
            <div xmlns="http://www.w3.org/1999/xhtml">
              <table width="100%">
                <tbody>
                  <tr>
                    <th>Individual requirements</th>
                    <td>Hospital needs to arrange for transportation to the patient's home.</td>
                  </tr>
                </tbody>
              </table>
            </div>
          </text>
        </section>
        <section>
          <title value="Information and advice given" />
          <code>
            <coding>
              <system value="http://snomed.info/sct" />
              <code value="1052951000000105" />
              <display value="Information and advice given" />
            </coding>
          </code>
          <text>
            <status value="additional" />
            <div xmlns="http://www.w3.org/1999/xhtml">
              <table width="100%">
                <tbody>
                  <tr>
                    <th>Information and advice given</th>
                    <td>
                      <p>Patient seen by Cardiac Rehab and information given regarding the diagnosis and 
possible life style changes when he is discharged.</p>
                      <p>Richard is concerned about whether he can drive and asks about this as he is a self employed electrician.</p>
                      <p>Dr Paul Rastall advised him that he should not to drive for at least a week, 
but reassured him that he should be able to drive once recovered and said 
he will arrange for a community follow-up.</p>
                    </td>
                  </tr>
                </tbody>
              </table>
            </div>
          </text>
        </section>
        <section>
          <title value="Investigation results" />
          <code>
            <coding>
              <system value="http://snomed.info/sct" />
              <code value="1082101000000102" />
              <display value="Investigation results" />
            </coding>
          </code>
          <text>
            <status value="additional" />
            <div xmlns="http://www.w3.org/1999/xhtml">
              <table>
                <tbody>
                  <tr>
                    <th>Investigation result</th>
                  </tr>
                  <tr>
                    <td>
                      <pre>Full Blood Count 
 
TestValueUnitsReference Range
White Cell Count11.1x10*9/L3.5 - 10.0
Red Cell Count5.0x10*12/L4.25 - 5.75 
Haemoglobin150g/L13.0 - 17.0
Haematocrit0.2300.400 - 0.500
Mean Cell Volume90fL84 - 98
Mean Cell Hb33.0pg27.5 - 32.0
Mean Cell Hb Con34.0pg31.0 - 35.0
RDW12.0%< 14.5
Platelet Count300x10*9/L150 - 400

Machine Differential 
 
Test ValueUnits Reference Range
Neutrophils7.0x10*9/L1.7 - 7.5
Lymphocytes3.5x10*9/L1.0 - 3.5 
Monocytes0.3x10*9/L< 0.6 
Eosinophils0.4x10*9/L< 0.4 
Basophils0.1x10*9/L< 0.1 
LUCs0.2x10*9/L< 0.4</pre>
                    </td>
                  </tr>
                </tbody>
              </table>
            </div>
          </text>
        </section>
        <section>
          <title value="Medications and medical devices" />
          <code>
            <coding>
              <system value="http://snomed.info/sct" />
              <code value="933361000000108" />
              <display value="Medications and medical devices" />
            </coding>
          </code>
          <text>
            <status value="extensions" />
            <div xmlns="http://www.w3.org/1999/xhtml">
              <table width="100%">
                <tbody>
                  <tr>
                    <th>Medication item</th>
                    <td>Medication name: Ramipril 2.5mg tablets</td>
                    <td>Form: Chewable tablet</td>
                    <td>Route: Oral</td>
                    <td>Dose directions description: One 2.5mg tablet once a day.</td>
                  </tr>
                  <tr>
                    <th>Medication change</th>
                    <td colspan="4">Status: Continued</td>
                  </tr>
                </tbody>
              </table>
              <table width="100%">
                <tbody>
                  <tr>
                    <th>Medication item</th>
                    <td>Medication name: Aspirin 75mg gastro-resistant tablets</td>
                    <td>Form: Chewable tablet</td>
                    <td>Route: Oral</td>
                    <td>Dose directions description: Take one 75mg tablet once a day.</td>
                  </tr>
                  <tr>
                    <th>Medication change</th>
                    <td colspan="4">Status: Continued</td>
                  </tr>
                </tbody>
              </table>
              <table width="100%">
                <tbody>
                  <tr>
                    <th>Medication item</th>
                    <td>Medication name: Clopidogrel 75mg tablets</td>
                    <td>Form: Chewable tablet</td>
                    <td>Route: Oral</td>
                    <td>Dose directions description: Take one 75mg tablet daily for one year then stop.</td>
                  </tr>
                  <tr>
                    <th>Medication change</th>
                    <td colspan="4">Status: Added</td>
                  </tr>
                </tbody>
              </table>
              <table width="100%">
                <tbody>
                  <tr>
                    <th>Medication item</th>
                    <td>Medication name: Simvastatin 40mg tablets</td>
                    <td>Form: Chewable tablet</td>
                    <td>Route: Oral</td>
                    <td>Dose directions description: Take one 40mg tablet once a day.</td>
                  </tr>
                  <tr>
                    <th>Medication change</th>
                    <td colspan="4">Status: Continued</td>
                  </tr>
                </tbody>
              </table>
              <table width="100%">
                <tbody>
                  <tr>
                    <th>Medication item</th>
                    <td>Medication name: Bisoprolol 5mg tablets</td>
                    <td>Form: Chewable tablet</td>
                    <td>Route: Oral</td>
                    <td>Dose directions description: Take one 5mg tablet daily.</td>
                  </tr>
                  <tr>
                    <th>Course details</th>
                    <td colspan="4">Comment/recommendation: Uptitrate according to BP and HR</td>
                  </tr>
                  <tr>
                    <th>Medication change</th>
                    <td colspan="4">Status: Continued</td>
                  </tr>
                </tbody>
              </table>
            </div>
          </text>
          <entry>
            <reference value="urn:uuid:d0710501-2e32-4cbd-bd63-a14354bbcd0f" />
          </entry>
        </section>
        <section>
          <title value="Patient and carer concerns, expectations and wishes" />
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            <coding>
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              <code value="1052941000000107" />
              <display value="Patient and carer concerns, expectations and wishes" />
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            <status value="additional" />
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                  <tr>
                    <th>Patient and carer concerns, expectations and wishes</th>
                    <td>The carer is concerned about the possibility of the patient suffering from a heart attack, 
 bearing a similarity to the illness of the mother of the patient. 
 The patient is worried about the impact of their illness on their ability to work and drive.</td>
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                </tbody>
              </table>
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          </text>
        </section>
        <section>
          <title value="Patient demographics" />
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            <coding>
              <system value="http://snomed.info/sct" />
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              <display value="Patient demographics" />
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            <status value="additional" />
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              <table width="100%">
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                    <th>Patient name</th>
                    <td>
                      <p>Prefix: Mr</p>
                      <p>Given Name: Richard</p>
                      <p>Family Name: Smith</p>
                    </td>
                  </tr>
                  <tr>
                    <th>Date of birth</th>
                    <td>1 January 1957</td>
                  </tr>
                  <tr>
                    <th>Gender</th>
                    <td>Male</td>
                  </tr>
                  <tr>
                    <th>NHS number</th>
                    <td>1352465790</td>
                  </tr>
                  <tr>
                    <th>Patient address</th>
                    <td>
                      <p>Address Line: 21, Grove Street, Overtown</p>
                      <p>City: Leeds</p>
                      <p>Post Code: LS21 1PF</p>
                    </td>
                  </tr>
                  <tr>
                    <th>Relevant contacts</th>
                    <td>
                                 Name: Joy Smith
                                 <p>Relationship: Next of kin</p><p>Contact details: Tel. 0712345678 Email. mrssmith@mymail.com</p></td>
                  </tr>
                </tbody>
              </table>
            </div>
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            <reference value="urn:uuid:31686b67-9f20-4644-9a54-193d2f91de57" />
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        <section>
          <title value="Person completing record" />
          <code>
            <coding>
              <system value="http://snomed.info/sct" />
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              <display value="Person completing record" />
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          <text>
            <status value="additional" />
            <div xmlns="http://www.w3.org/1999/xhtml">
              <table width="100%">
                <tbody>
                  <tr>
                    <th>Name</th>
                    <td>
                      <p>Prefix: Dr</p>
                      <p>Given Name: Paul</p>
                      <p>Family Name: Rastall</p>
                    </td>
                  </tr>
                  <tr>
                    <th>Role</th>
                    <td>Consultant</td>
                  </tr>
                  <tr>
                    <th>Specialty</th>
                    <td>Cardiology</td>
                  </tr>
                  <tr>
                    <th>Professional identifier</th>
                    <td>GMC: 6122477</td>
                  </tr>
                  <tr>
                    <th>Date and time completed</th>
                    <td>17 Feb 2015 10:00</td>
                  </tr>
                  <tr>
                    <th>Contact details</th>
                    <td>Phone: 0113 6323200 (Work)</td>
                  </tr>
                  <tr>
                    <th>Organisation</th>
                    <td>
                      <p>Name: Leeds Teaching Hospitals NHS Trust,</p>
                      <p>Address Line: St James's University Hospital, Beckett Street</p>
                      <p>City: Leeds</p>
                      <p>Post Code: LS9 7TF</p>
                    </td>
                  </tr>
                </tbody>
              </table>
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            <reference value="urn:uuid:6239b7a7-380d-46ff-a1c5-7abc4e68f8bc" />
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          <entry>
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        </section>
        <section>
          <title value="Plan and requested actions" />
          <code>
            <coding>
              <system value="http://snomed.info/sct" />
              <code value="887201000000105" />
              <display value="Plan and requested actions" />
            </coding>
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          <text>
            <status value="additional" />
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                <tbody>
                  <tr>
                    <th>Actions for healthcare professionals</th>
                    <td>
                                 GP please continue secondary preventative medication.
                                 <p>Status: Requested</p><p>Doses will be uptitrated by Cardiac Rehab team.</p><p>Status: Requested</p></td>
                  </tr>
                  <tr>
                    <th>Actions for patient or their carer</th>
                    <td>Patient to attend community follow up after discharge.</td>
                  </tr>
                  <tr>
                    <th>Agreed with patient or legitimate patient representative</th>
                    <td>Patient agreed to avoid driving for one week on discharge.</td>
                  </tr>
                </tbody>
              </table>
            </div>
          </text>
        </section>
        <section>
          <title value="Procedures" />
          <code>
            <coding>
              <system value="http://snomed.info/sct" />
              <code value="887171000000109" />
              <display value="Procedures" />
            </coding>
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            <status value="additional" />
            <div xmlns="http://www.w3.org/1999/xhtml">
              <table width="100%">
                <tbody>
                  <tr>
                    <th>Procedure name</th>
                    <td>
                                 Percutaneous coronary intervention
                                 <p>Anatomical site: Right coronary artery structure</p><p>Comment: Patient successfully underwent angioplasty procedure to place a drug eluting stent.</p></td>
                  </tr>
                  <tr>
                    <th>Procedure name</th>
                    <td>
                                 Electrocardiographic monitoring
                                 <p>Comment: ECGs showed inferior ischaemic changes and diseased RCA.</p></td>
                  </tr>
                </tbody>
              </table>
            </div>
          </text>
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            <reference value="urn:uuid:1e04ce96-6e52-4f82-bc26-93c89c5836a1" />
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        </section>
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          <title value="Referrer details" />
          <code>
            <coding>
              <system value="http://snomed.info/sct" />
              <code value="1052891000000108" />
              <display value="Referrer details" />
            </coding>
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          <text>
            <status value="generated" />
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              <table width="100%">
                <tbody>
                  <tr>
                    <th>Referrer details</th>
                    <td>
                      <p>Name:</p>
                      <p>Prefix: Dr.</p>
                      <p>Given name: Amanda</p>
                      <p>Family name: Smith</p>
                      <p>Role: Specialist Registrar</p>
                      <p>Tel: 0113 6323222 (work)</p>
                      <p>Organisation</p>
                      <p>Name: St. James's University Hospital Accident and Emergency Department</p>
                      <p>Address Line: St James's University Hospital, Beckett Street</p>
                      <p>City: Leeds</p>
                      <p>Post Code: LS9 7TF</p>
                    </td>
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                </tbody>
              </table>
            </div>
          </text>
          <entry>
            <reference value="urn:uuid:d791b058-2624-436a-bc02-db38d65325b8" />
          </entry>
          <entry>
            <reference value="urn:uuid:5f76e146-3eaa-4f0e-aa3b-8d26b8b2febe" />
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        <section>
          <title value="Social context" />
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            <coding>
              <system value="http://snomed.info/sct" />
              <code value="887051000000101" />
              <display value="Social context" />
            </coding>
          </code>
          <text>
            <status value="additional" />
            <div xmlns="http://www.w3.org/1999/xhtml">
              <table width="100%">
                <tbody>
                  <tr>
                    <th>Household composition</th>
                    <td>Lives with wife</td>
                  </tr>
                  <tr>
                    <th>Occupational history</th>
                    <td>Self employed electrician</td>
                  </tr>
                </tbody>
              </table>
            </div>
          </text>
        </section>
      </Composition>
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        </meta>
        <extension url="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-AdmissionMethod-1">
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            <coding>
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              <code value="21" />
              <display value="Accident and emergency or dental casualty department of the Health Care Provider" />
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        <identifier>
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          <value value="13c73015-d8fa-4844-8d68-4f856883eca8" />
        </identifier>
        <status value="finished" />
        <class>
          <system value="http://hl7.org/fhir/v3-ActEncounterCode" />
          <code value="IMP" />
          <display value="inpatient encounter" />
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        <type>
          <coding>
            <system value="http://snomed.info/sct" />
            <code value="24882007" />
            <display value="Medical consultation on hospital inpatient" />
          </coding>
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        <participant>
          <type>
            <coding>
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              <code value="DIS" />
              <display value="discharger" />
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          <individual>
            <reference value="urn:uuid:6239b7a7-380d-46ff-a1c5-7abc4e68f8bc" />
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        </participant>
        <period>
          <start value="2015-02-12T09:00:00+00:00" />
          <end value="2015-02-16T15:00:00+00:00" />
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          <coding>
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            <code value="425419005" />
            <display value="ECG: inferior ischaemia" />
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              <display value="NHS other Hospital Provider - Ward for general Patients or the  younger physically disabled or A and E department" />
            </coding>
          </admitSource>
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            <coding>
              <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-DischargeDestination-1" />
              <code value="19" />
              <display value="Usual place of residence unless listed below, for example, a private  dwelling whether owner occupied or owned by Local Authority, housing association or other landlord.  This includes wardened accommodation but not residential accommodation where health care is provided.  It also includes Patients with no fixed abode." />
            </coding>
          </dischargeDisposition>
        </hospitalization>
        <location>
          <location>
            <reference value="urn:uuid:01bb1ccc-577b-4a4a-9fb0-9c8fe9f21fa3" />
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          <period>
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        </location>
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        <identifier>
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          <value value="cb8e31b2-15d4-4fe6-a690-13934348fbf1" />
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        <status value="current" />
        <mode value="snapshot" />
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          <coding>
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            <display value="Medications and medical devices" />
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          </item>
        </entry>
        <entry>
          <item>
            <reference value="urn:uuid:934ac400-f197-4bbc-a307-5ce8d271d4dd" />
          </item>
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        <entry>
          <item>
            <reference value="urn:uuid:1092404d-00c9-4f9e-b7df-9abbc8762c91" />
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        <entry>
          <item>
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        <entry>
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    </resource>
  </entry>
  <entry>
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        </meta>
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        <status value="active" />
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        <taken value="y" />
        <dosage>
          <text value="One 2.5mg tablet once a day." />
          <route>
            <coding>
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              <code value="26643006" />
              <display value="Oral" />
            </coding>
          </route>
        </dosage>
      </MedicationStatement>
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        <extension url="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationChangeSummary-1">
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        <taken value="y" />
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        <code>
          <coding>
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        <form>
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        <code>
          <coding>
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            <code value="319781007" />
            <display value="Aspirin 75mg gastro-resistant tablets" />
          </coding>
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        <name value="MGP Medical Centre" />
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          <postalCode value="LS21 7PA" />
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          <value value="RR8" />
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        <name value="Leeds Teaching Hospitals NHS Trust" />
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          <city value="Leeds" />
          <postalCode value="LS9 7TF" />
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          <value value="RY6" />
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        <name value="Leeds Community Healthcare NHS Trust" />
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        <name value="St. James's University Hospital Accident and Emergency Department" />
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          <value value="RR8CRAM" />
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        <name value="Cramer Ward" />
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</Bundle>