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Example Contract/C-2121 (XML)

Financial Management Work Group Maturity Level : N/A Standards Status : Informative Compartments : Patient

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

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42 CFR Part 2 Consent Directive (id = "C-2121") 

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

<Contract xmlns="http://hl7.org/fhir">
  <id value="C-2121"/> 
  <meta> 
    <versionId value="1"/> 
    <lastUpdated value="2016-07-19T18:18:42.108-04:00"/> 
  </meta> 
  display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border:
       1px solid #8da1b4; border-radius: 5px; line-height: 60%Resource Contract &quot;C-2121&quot; Version &quot;1&quot; Updated &quot;2016-07-19T18:18:42.
          108-04:00&quot; : SELF (Details: http://mdhhs.org/fhir/consent-signer-type code SELF = 'SELF',
           stated as 'null')Author's Signature (Details: urn:iso-astm:E1762-95:2013 code 1.2.840.10065.1.12.1.1
               = 'Author's Signature', stated as 'null')

  <status value="executed"/> 
  <contentDerivative> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/contract-content-derivative"/> 
      <code value="registration"/> 
    </coding> 
  </contentDerivative> 
  <issued value="2013-11-01T21:18:27-04:00"/> 
  <applies> 
    <start value="2013-11-01T21:18:27-04:00"/> 
  </applies> 
  <subject> 
    <reference value="Patient/f201"/> 
  </subject> 
  <type> 
    <coding> 
      <system value="http://mdhhs.org/fhir/consentdirective-type"/> 
      <code value="OPTIN"/> 
    </coding> 
    <text value="Opt-in consent directive"/> 
  </type> 
  <subType> 
    <!--        <code value="MDHHS-5515"/>
      <display
        value="Michigan MDHHS-5515 Consent to Share Behavioral Health Information
     for Care Coordination Purposes"
      />   -->

    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/consentcategorycodes"/> 
      <code value="hcd"/> 
    <!--         <code value="MDHHS-5515"/>
      <display
        value="Michigan MDHHS-5515 Consent to Share Behavioral Health Information
       for Care Coordination Purposes"
      />    -->

    </coding> 
  </subType> 
  <term> 
    <offer> 
      <type> 
        <coding> 
          <system value="http://terminology.hl7.org/CodeSystem/contracttermtypecodes"/> 
          <code value="statutory"/> 
        </coding> 
      </type> 
      <decision> 
        <coding> 
          <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/> 
          <code value="OPTIN"/> 
        </coding> 
      </decision> 
      <text value="Can't refuse"/> 
    </offer> 
    
    
      
        
        
      
          <!--   

    <!--  
      <securityLabel>
        <system value="http://terminology.hl7.org/CodeSystem/v3-Confidentiality"/>
        <code value="R"/>
        <display value="Restricted"/>
      </securityLabel>
      <securityLabel>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
        <code value="ETH"/>
        <display value="substance abuse information sensitivity"/>
      </securityLabel>
      <securityLabel>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
        <code value="42CFRPart2"/>
      </securityLabel>
      <securityLabel>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
        <code value="TREAT"/>
        <display value="treatment"/>
      </securityLabel>
      <securityLabel>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
        <code value="HPAYMT"/>
        <display value="healthcare payment"/>
      </securityLabel>
      <securityLabel>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
        <code value="HOPERAT"/>
        <display value="healthcare operations"/>
      </securityLabel>
      <securityLabel>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
        <code value="PERSISTLABEL"/>
        <display value="persist security label"/>
      </securityLabel>
      <securityLabel>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
        <code value="PRIVMARK"/>
        <display value="privacy mark"/>
      </securityLabel>
      <securityLabel>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
        <code value="NORDSCLCD"/>
        <display value="no redisclosure without consent directive"/>
      </securityLabel>
       -->

      -->
    <asset>       <period>         <start value="2013-11-01T21:18:27-04:00"/>         <end value="2019-11-01T21:18:27-04:00"/>       </period> 
    </asset> 
    <action> 
      <type> 
        <coding> 
          <system value="http://terminology.hl7.org/CodeSystem/contractaction"/> 
          <code value="action-a"/> 
        </coding> 
      </type> 
      <subject> 
        <reference> 
          <reference value="Organization/f001"/> 
          <display value="VA Ann Arbor Healthcare System"/> 
        </reference> 
        <role> 
          <coding> 
            <system value="http://mdhhs.org/fhir/consent-actor-type"/> 
            <code value="IR"/> 
            <display value="Recipient"/> 
          </coding> 
          <text value="Recipient of restricted health information"/> 
        </role> 
      </subject> 
      <subject> 
        <reference> 
          <reference value="Organization/2"/> 
          <display value="Community Mental Health Clinic"/> 
        </reference> 
        <role> 
          <coding> 
            <system value="http://mdhhs.org/fhir/consent-actor-type"/> 
            <code value="IS"/> 
            <display value="Sender"/> 
          </coding> 
          <text value="Sender of restricted health information"/> 
        </role> 
      </subject> 
      <intent> 
        <coding> 
          <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/> 
          <code value="HPRGRP"/> 
        </coding> 
      </intent> 
      <status> 
        <text value="Sample"/> 
      </status> 
    </action> 
    

  </term> 
  <signer> 
    <type> 
      <system value="http://mdhhs.org/fhir/consent-signer-type"/> 
      <code value="SELF"/> 
    </type> 
    <party> 
      <reference value="Patient/f201"/> 
      <display value="Alice Recruit"/> 
    </party> 
    <signature> 
      <type> 
        <system value="urn:iso-astm:E1762-95:2013"/> 
        <code value="1.2.840.10065.1.12.1.1"/> 
      </type> 
      <when value="2017-02-08T10:57:34+01:00"/> 
    

      <who> 
        <reference value="Patient/f201"/> 
    

      </who> 
    </signature> 
  </signer> 
  <legal> 
    <contentAttachment> 
      <contentType value="application/pdf"/> 
      <language value="en-US"/> 
      <url value="http://org.mihin.ecms/ConsentDirective-2121"/> 
      <title value="MDHHS-5515 Consent To Share Your Health Information"/> 
    </contentAttachment> 
  </legal> 


</

Contract

>

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.