<CarePlan xmlns="http://hl7.org/fhir">
  <id value="esempio-CarePlan-Progetto-Individuale" />
  <meta>
    <versionId value="1" />
    <lastUpdated value="2023-01-11T08:32:56+01:00" />
    <profile value="https://fhir.siss.regione.lombardia.it/StructureDefinition/RLCarePlanProgettoIndividuale" />
  </meta>
  <extension url="https://fhir.siss.regione.lombardia.it/StructureDefinition/RLCarePlanVersionePAI">
    <valueUnsignedInt value="1" />
  </extension>
  <identifier>
    <system value="https://fhir.siss.regione.lombardia.it/sid/identificativoUnivocoPI" />
    <value value="PI-2023000000001" />
  </identifier>
  <status value="active" />
  <intent value="order" />
  <subject>
    <reference value="Patient/b7807e00-9745-11ed-a8fc-0242ac120002" />
    <display value="Mario Rossi" />
  </subject>
  <encounter>
    <reference value="Encounter/c559333c-974f-11ed-a8fc-0242ac120002" />
    <display value="Accesso" />
  </encounter>
  <period>
    <start value="2023-01-15T08:32:56+01:00" />
  </period>
  <created value="2023-01-11T08:32:56+01:00" />
  <author>
    <reference value="Organization/c8f77b34-974f-11ed-a8fc-0242ac120002" />
    <display value="ASST DELLA BRIANZA" />
  </author>
  <contributor>
    <reference value="PractitionerRole/d711fc58-974f-11ed-a8fc-0242ac120002" />
    <display value="Infermiere" />
  </contributor>
  <addresses>
    <reference value="Condition/e243606c-974f-11ed-a8fc-0242ac120002" />
    <display value="Patologia Primaria" />
  </addresses>
  <addresses>
    <reference value="Condition/e028bc4c-b134-11ed-afa1-0242ac120002" />
    <display value="Patologia Secondara" />
  </addresses>
  <supportingInfo>
    <reference value="Observation/bnm18194-974f-11ed-a8fc-0242ac120002" />
    <display value="Esito Valutazione" />
  </supportingInfo>
  <goal>
    <reference value="Goal/eaa18194-974f-11ed-a8fc-0242ac120002" />
    <display value="Obiettivi Salute" />
  </goal>
  <activity>
    <reference>
      <reference value="MedicationRequest/088c489c-9750-11ed-a8fc-0242ac120002" />
      <display value="Terapia farmacologica" />
    </reference>
  </activity>
  <activity>
    <reference>
      <reference value="ServiceRequest/14aec1c2-9750-11ed-a8fc-0242ac120002" />
      <display value="Servizi Socio Assistenziali" />
    </reference>
  </activity>
  <note>
    <text value="Monitorare il soddisfacimento dell'obiettivo di salute almeno una volta al mese" />
  </note>
</CarePlan>