Primary Problem: Roberta is a normally well-controlled Type 2 diabetic with well-managed hypertension. She experiences occassional gout attacks. Significant Clinical Event Requiring Patient Summary: Roberta has been been experiencing some neuropathy she is assuming is caused by her diabetes, and her gout is flaring up. She needs to see a GP in Yellowknife and may need a referral. Dr Allan GP (Prac ID 9600), Roberta's most responsible GP in Ontario, is wanting to communicate Roberta's clinical information to Dr Smith (Prac ID 2222) a GP in Alberta where Roberta is working.
 <confidentiality value="R" /> <custodian> <reference value="urn:uuid:d931f072-38f9-46ac-98b5-d470404e5aa0" /> </custodian> <section id="1"> <extension url="http://hl7.org/fhir/StructureDefinition/note"> <valueAnnotation> <text value="Patient does not have drug coverage (Medication Section)" /> </valueAnnotation> </extension> <title value="Medication Summary" /> <code> <coding> <system value="http://loinc.org" /> <code value="10160-0" /> <display value="Hx of Medication use" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml">Medications</div> </text> <entry> <reference value="urn:uuid:03cd9a05-597b-4d34-a203-ac5d8134eabd" /> </entry> <entry> <reference value="urn:uuid:407c998a-d316-4172-a01f-21f5849113ee" /> </entry> <entry> <reference value="urn:uuid:39799944-a74a-4ea0-8722-8a5f3102e96a" /> </entry> </section> <section id="2"> <extension url="http://hl7.org/fhir/StructureDefinition/note"> <valueAnnotation> <text value="Patient does not have drug coverage (Allergies Section)" /> </valueAnnotation> </extension> <title value="Allergies and Intolerances" /> <code> <coding> <system value="http://loinc.org" /> <code value="48765-2" /> <display value="Allergies &or adverse reactions Doc" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml">Allergies and Intolerances</div> </text> <entry> <reference value="urn:uuid:ceea9c48-759d-4636-a11e-0a067b32973a" /> </entry> </section> <section id="3"> <extension url="http://hl7.org/fhir/StructureDefinition/note"> <valueAnnotation> <text value="Patient does not have drug coverage (Problem List Section)" /> </valueAnnotation> </extension> <title value="Problem List" /> <code> <coding> <system value="http://loinc.org" /> <code value="11450-4" /> <display value="Problem list Reported" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml">Current list of problems</div> </text> <entry> <reference value="urn:uuid:3ea95c2b-cd7d-4ad4-b5f7-10c6563180e7" /> </entry> <entry> <reference value="urn:uuid:d538db9e-8562-4bff-9d18-89643589ad5e" /> </entry> </section> <section id="4"> <extension url="http://hl7.org/fhir/StructureDefinition/note"> <valueAnnotation> <text value="2019-07 Appendectomy" /> </valueAnnotation> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/note"> <valueAnnotation> <text value="1987 Eye surgery, correction of astigmatism" /> </valueAnnotation> </extension> <title value="History of Procedures" /> <code> <coding> <system value="http://loinc.org" /> <code value="47519-4" /> <display value="Procedures Hx Doc" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml">Procedure History</div> </text> <emptyReason> <text value="text-only" /> </emptyReason> </section> <section id="5"> <title value="Vital Signs" /> <code> <coding> <system value="http://loinc.org" /> <code value="8716-3" /> <display value="Vital signs note" /> </coding> </code> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml"> <p>Vital Signs</p> </div> </text> <entry> <reference value="urn:uuid:6c4b6a3e-2c64-4de3-b23e-e435347052e6" /> </entry> <entry> <reference value="urn:uuid:77537ea0-85a1-40d0-88e7-9f488a3ba174" /> </entry> <entry> <reference value="urn:uuid:9a9891a6-aaa8-4c66-88d2-bb67800d36d0" /> </entry> <entry> <reference value="urn:uuid:5d882fe0-dcdd-47ca-85f2-ccfc90159bde" /> </entry> </section> <section id="6"> <extension url="http://hl7.org/fhir/StructureDefinition/note"> <valueAnnotation> <text value="Patient attending smoking cessation sessions" /> </valueAnnotation> </extension> <title value="Social History" /> <code> <coding> <system value="http://loinc.org" /> <code value="29762-2" /> <display value="Social History Note" /> </coding> </code> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml"> <p>Social History</p> </div> </text> <entry> <reference value="urn:uuid:2df99df4-465e-4bab-9313-fbe9117f1d37" /> </entry> <entry> <reference value="urn:uuid:9da812e0-d4d5-445e-9eb4-2c9f3563b3fd" /> </entry> <entry> <reference value="urn:uuid:33acf3e5-7f39-4d03-a4e9-6933833e2df1" /> </entry> </section> <section id="7"> <title value="Family History" /> <code> <coding> <system value="http://loinc.org" /> <code value="10157-6" /> <display value="History of family member diseases note" /> </coding> </code> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml"> <p>Family History</p> </div> </text> <entry> <reference value="urn:uuid:6be80d8c-4c63-41f1-b9b2-b06cb144afb1" /> </entry> <entry> <reference value="urn:uuid:d3d24ba7-f425-4c63-8444-cd7d6453bbb2" /> </entry> </section> </Composition> </resource> </entry> <entry> <fullUrl value="urn:uuid:a3cf9ac3-c323-490e-87e4-88fbf65b9600" /> <resource> <Practitioner> <id value="a3cf9ac3-c323-490e-87e4-88fbf65b9600" /> <meta> <profile value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/practitioner" /> </meta> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml"> <a name="Practitioner_a3cf9ac3-c323-490e-87e4-88fbf65b9600"></a>Practitioner a3cf9ac3-c323-490e-87e4-88fbf65b9600</div> </text> <identifier> <type> <coding> <system value="http://terminology.hl7.org/CodeSystem/v2-0203" /> <code value="LN" /> </coding> </type> <system value="https://fhir.infoway-inforoute.ca/NamingSystem/ca-ab-license-physician" /> <value value="practitioner-id" /> <assigner> <display value="College of Physicians and Surgeons of Alberta" /> </assigner> </identifier> <name> <family value="Velcro" /> <given value="A" /> <prefix value="Dr." /> </name> </Practitioner> </resource> </entry> <entry> <fullUrl value="urn:uuid:b5cf9ac3-c323-490e-87e4-88fbf65b9888" /> <resource> <PractitionerRole> <id value="b5cf9ac3-c323-490e-87e4-88fbf65b9888" /> <meta> <profile value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/practitioner-role" /> </meta> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml"> <a name="PractitionerRole_b5cf9ac3-c323-490e-87e4-88fbf65b9888"></a>PractitionerRole b5cf9ac3-c323-490e-87e4-88fbf65b9888</div> </text> <practitioner> <reference value="urn:uuid:a3cf9ac3-c323-490e-87e4-88fbf65b9600" /> </practitioner> <specialty> <coding> <system value="http://snomed.info/sct" /> <code value="408443003" /> </coding> <text value="General medical practice" /> </specialty> <location> <reference value="urn:uuid:a3138b3c-ff74-42e2-ad17-6ee17b3a078a" /> </location> </PractitionerRole> </resource> </entry> <entry> <fullUrl value="urn:uuid:d520ecd1-76a0-4894-b895-b8a5a971954e" /> <resource> <Patient> <id value="d520ecd1-76a0-4894-b895-b8a5a971954e" /> <meta> <profile value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/patient" /> </meta> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml"> <a name="Patient_d520ecd1-76a0-4894-b895-b8a5a971954e"></a> <p class="res-header-id"> <b>Generated Narrative: Patient d520ecd1-76a0-4894-b895-b8a5a971954e</b> </p> <a name="d520ecd1-76a0-4894-b895-b8a5a971954e"></a> <a name="hcd520ecd1-76a0-4894-b895-b8a5a971954e"></a> <div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"> <p style="margin-bottom: 0px" /> <p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-patient.html">P-Care Patient</a></p> </div> <p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Patrick Test Other, DoB: 1979-10-28 ( Jurisdictional health number: 123456789)</p> <hr /> <table class="grid"> <tr> <td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Detail</td> <td colspan="3"> <ul> <li>ph: 123-456-7900</li> <li>fax: 123-111-2222</li> </ul> </td> </tr> <tr> <td style="background-color: #f3f5da" title="Nominated Contact: wife">wife:</td> <td colspan="3"> <ul> <li>Maria Test </li> </ul> </td> </tr> <tr> <td style="background-color: #f3f5da" title="Recorded sex or gender (RSG) information includes the various sex and gender concepts that are often used in existing systems but are known NOT to represent a gender identity, sex parameter for clinical use, or attributes related to sexuality, such as sexual orientation, sexual activity, or sexual attraction. Examples of recorded sex or gender concepts include administrative gender, administrative sex, and sex assigned at birth. When exchanging this concept, refer to the guidance in the [Gender Harmony Implementation Guide](http://hl7.org/xprod/ig/uv/gender-harmony/).">Person Recorded Sex Or Gender:</td> <td colspan="3"> <ul> <li>value: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0001 M}">Male</span></li> <li>type: <span title="Codes:{http://loinc.org 99502-7}">Recorded sex or gender</span></li> </ul> </td> </tr> </table> </div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender"> <extension url="value"> <valueCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/v2-0001" /> <code value="M" /> </coding> </valueCodeableConcept> </extension> <extension url="type"> <valueCodeableConcept> <coding> <system value="http://loinc.org" /> <code value="99502-7" /> <display value="Recorded sex or gender" /> </coding> </valueCodeableConcept> </extension> </extension> <identifier> <type> <coding> <system value="http://terminology.hl7.org/CodeSystem/v2-0203" /> <code value="JHN" /> </coding> </type> <system value="https://fhir.infoway-inforoute.ca/NamingSystem/ca-ab-patient-healthcare-id" /> <value value="123456789" /> </identifier> <name> <text value="Patrick Test" /> <family value="Patrick" /> <given value="Test" /> </name> <telecom> <system value="phone" /> <value value="123-456-7900" /> </telecom> <telecom> <system value="fax" /> <value value="123-111-2222" /> </telecom> <gender value="other" /> <birthDate value="1979-10-28" /> <contact> <relationship> <coding> <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode" /> <code value="WIFE" /> </coding> </relationship> <name> <family value="Test" /> <given value="Maria" /> </name> </contact> </Patient> </resource> </entry> <entry> <fullUrl value="urn:uuid:d931f072-38f9-46ac-98b5-d470404e5aa0" /> <resource> <Organization> <id value="d931f072-38f9-46ac-98b5-d470404e5aa0" /> <meta> <profile value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/organization" /> </meta> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml"> <a name="Organization_d931f072-38f9-46ac-98b5-d470404e5aa0"></a>Narrative goes here</div> </text> <name value="Fictional Custodian Organization" /> </Organization> </resource> </entry> <entry> <fullUrl value="urn:uuid:a3138b3c-ff74-42e2-ad17-6ee17b3a078a" /> <resource> <Location> <id value="a3138b3c-ff74-42e2-ad17-6ee17b3a078a" /> <meta> <profile value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/location" /> </meta> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml"> <a name="Location_a3138b3c-ff74-42e2-ad17-6ee17b3a078a"></a> <p class="res-header-id"> <b>Generated Narrative: Location a3138b3c-ff74-42e2-ad17-6ee17b3a078a</b> </p> <a name="a3138b3c-ff74-42e2-ad17-6ee17b3a078a"></a> <a name="hca3138b3c-ff74-42e2-ad17-6ee17b3a078a"></a> <div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"> <p style="margin-bottom: 0px" /> <p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-location.html">P-Care Location</a></p> </div> <p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Happy Family Medicine (Facility ID: location-billing-id)</p> <hr /> <table class="grid"> <tr> <td style="background-color: #f3f5da" title="The status of the location">Status:</td> <td colspan="3">Active</td> </tr> <tr> <td style="background-color: #f3f5da" title="Physical location">Address:</td> <td colspan="3">123 Sunny Lane Smallville AB T5K 2B6 CA </td> </tr> <tr> <td style="background-color: #f3f5da" title="Ways to make contact with the location">Contact Detail</td> <td colspan="3"> <ul> <li>ph: 555-555-5555</li> <li>fax: 555-123-4567</li> </ul> </td> </tr> </table> </div> </text> <identifier> <type> <coding> <system value="http://terminology.hl7.org/CodeSystem/v2-0203" /> <code value="FI" /> </coding> </type> <system value="https://fhir.infoway-inforoute.ca/NamingSystem/ca-ab-health-site-id-wdfa" /> <value value="location-billing-id" /> <assigner> <display value="Some value from AHWFACID" /> </assigner> </identifier> <status value="active" /> <name value="Happy Family Medicine" /> <telecom> <system value="phone" /> <value value="555-555-5555" /> </telecom> <telecom> <system value="fax" /> <value value="555-123-4567" /> </telecom> <address> <line value="123 Sunny Lane" /> <city value="Smallville" /> <state value="AB" /> <postalCode value="T5K 2B6" /> <country value="CA" /> </address> </Location> </resource> </entry> <entry> <fullUrl value="urn:uuid:03cd9a05-597b-4d34-a203-ac5d8134eabd" /> <resource> <MedicationStatement> <id value="03cd9a05-597b-4d34-a203-ac5d8134eabd" /> <meta> <profile value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/medication-statement" /> </meta> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml"> <a name="MedicationStatement_03cd9a05-597b-4d34-a203-ac5d8134eabd"></a>MedicationStatement 03cd9a05-597b-4d34-a203-ac5d8134eabd</div> </text> <status value="unknown" /> <medicationReference> <reference value="urn:uuid:5d1928a7-947e-416d-a121-0005f8a2887a" /> </medicationReference> <subject> <reference value="urn:uuid:d520ecd1-76a0-4894-b895-b8a5a971954e" /> </subject> <effectiveDateTime value="2021-04-29" /> <note> <text value="Prozac not tolerated" /> </note> <dosage> <text value="300mg, 1 Tablet PO Daily, 3 months" /> <patientInstruction value="Some patient instruction..." /> <route> <coding> <system value="http://snomed.info/sct" /> <code value="26643006" /> <display value="Oral route" /> </coding> </route> <doseAndRate> <doseQuantity> <value value="300" /> <unit value="mg" /> <system value="http://unitsofmeasure.org" /> <code value="mg" /> </doseQuantity> </doseAndRate> </dosage> </MedicationStatement> </resource> </entry> <entry> <fullUrl value="urn:uuid:407c998a-d316-4172-a01f-21f5849113ee" /> <resource> <MedicationStatement> <id value="407c998a-d316-4172-a01f-21f5849113ee" /> <meta> <profile value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/medication-statement" /> </meta> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml"> <a name="MedicationStatement_407c998a-d316-4172-a01f-21f5849113ee"></a>MedicationStatement 407c998a-d316-4172-a01f-21f5849113ee</div> </text> <extension url="http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage"> <valueString value="(This is the rendered dosage): 500mg, 1 Tablet PO Daily, 3 months" /> </extension> <status value="unknown" /> <medicationReference> <reference value="urn:uuid:85930c06-5bf4-4335-8128-7025003d10b1" /> </medicationReference> <subject> <reference value="urn:uuid:d520ecd1-76a0-4894-b895-b8a5a971954e" /> </subject> <effectiveDateTime value="2020-11-21" /> <dosage> <text value="500mg, 1 Tablet PO Daily, 3 months" /> </dosage> </MedicationStatement> </resource> </entry> <entry> <fullUrl value="urn:uuid:39799944-a74a-4ea0-8722-8a5f3102e96a" /> <resource> <MedicationStatement> <id value="39799944-a74a-4ea0-8722-8a5f3102e96a" /> <meta> <profile value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/medication-statement" /> </meta> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml"> <a name="MedicationStatement_39799944-a74a-4ea0-8722-8a5f3102e96a"></a>MedicationStatement 407c998a-d316-4172-a01f-21f5849113ee</div> </text> <status value="unknown" /> <medicationReference> <reference value="urn:uuid:41b2269a-7c8a-464e-9cf6-de84ef77fdce" /> </medicationReference> <subject> <reference value="urn:uuid:d520ecd1-76a0-4894-b895-b8a5a971954e" /> </subject> <effectiveDateTime value="2020-02-29" /> <dosage> <text value="5mg, 1 Tablet PO BID, 1 week" /> </dosage> </MedicationStatement> </resource> </entry> <entry> <fullUrl value="urn:uuid:5d1928a7-947e-416d-a121-0005f8a2887a" /> <resource> <Medication> <id value="5d1928a7-947e-416d-a121-0005f8a2887a" /> <meta> <profile value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/medication" /> </meta> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml"> <a name="Medication_5d1928a7-947e-416d-a121-0005f8a2887a"></a>Medication 5d1928a7-947e-416d-a121-0005f8a2887a</div> </text> <extension url="http://prescribeit.ca/fhir/StructureDefinition/ext-medication-strength-description"> <valueString value="50 mg" /> </extension> <code> <text value="Bupropion/ Wellbutrin XL" /> </code> <form> <text value="Oral Tablet" /> </form> </Medication> </resource> </entry> <entry> <fullUrl value="urn:uuid:85930c06-5bf4-4335-8128-7025003d10b1" /> <resource> <Medication> <id value="85930c06-5bf4-4335-8128-7025003d10b1" /> <meta> <profile value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/medication" /> </meta> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml"> <a name="Medication_85930c06-5bf4-4335-8128-7025003d10b1"></a>Medication 5d1928a7-947e-416d-a121-0005f8a2887a</div> </text> <code> <text value="Metformin/ Glucophage" /> </code> <form> <text value="Oral Tablet" /> </form> </Medication> </resource> </entry> <entry> <fullUrl value="urn:uuid:41b2269a-7c8a-464e-9cf6-de84ef77fdce" /> <resource> <Medication> <id value="41b2269a-7c8a-464e-9cf6-de84ef77fdce" /> <meta> <profile value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/medication" /> </meta> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml"> <a name="Medication_41b2269a-7c8a-464e-9cf6-de84ef77fdce"></a>Medication 5d1928a7-947e-416d-a121-0005f8a2887a</div> </text> <code> <text value="Prednisone" /> </code> <form> <text value="Oral Tablet" /> </form> </Medication> </resource> </entry> <entry> <fullUrl value="urn:uuid:ceea9c48-759d-4636-a11e-0a067b32973a" /> <resource> 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</category> <code> <coding> <system value="http://loinc.org" /> <code value="29463-7" /> </coding> <text value="Body weight" /> </code> <subject> <reference value="urn:uuid:d520ecd1-76a0-4894-b895-b8a5a971954e" /> </subject> <effectiveDateTime value="2019-12-02" /> <valueQuantity> <value value="180" /> <unit value="[lb_av]" /> <system value="http://unitsofmeasure.org" /> <code value="[lb_av]" /> </valueQuantity> </Observation> </resource> </entry> <entry> <fullUrl value="urn:uuid:5d882fe0-dcdd-47ca-85f2-ccfc90159bde" /> <resource> <Observation> <id value="5d882fe0-dcdd-47ca-85f2-ccfc90159bde" /> <meta> <profile value="http://fhir.infoway-inforoute.ca/p-care/StructureDefinition/observation-head-circum" /> </meta> <text> <status value="generated" /> <div xmlns="http://www.w3.org/1999/xhtml"> <a name="Observation_5d882fe0-dcdd-47ca-85f2-ccfc90159bde"></a>Observation (Head Circumference) 5d882fe0-dcdd-47ca-85f2-ccfc90159bde</div> </text> <status value="final" /> <category> <coding> <system 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