Release 4B 5

This page is part of the FHIR Specification (v4.3.0: R4B (v5.0.0: R5 - STU ). The This is the current published version which supercedes in it's permanent home (it will always be available at this version is 5.0.0 . URL). For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R5 R4B R4 R3

Contract-example-42cfr-part2.xml

Example Contract/C-2121 (XML)

Financial Management Work Group Maturity Level : N/A Standards Status : Informative Compartments : Not linked to any defined compartments Patient

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

Jump past Narrative

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

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


  
  
    
    
  
  
    
    
      
        
      
      display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px
       solid #8da1b4; border-radius: 5px; line-height: 60%
        Resource &quot;C-2121&quot; Version &quot;1&quot; Updated &quot;2016-07-19T18:18:42.108-04:00&quot;
           
      
      
        : executed
      
      
        : Content Registration 
         (
          #registration)
        
      
      
        : 2013-11-01T21:18:27-04:00
      
      
        : 2013-11-01T21:18:27-04:00 --&gt; (ongoing)
      
      
        : 
         &quot;Roel&quot;
      
      
        : Opt-in consent directive 
        
      
      
        : Health Care Directive 
         (
          #hcd)
        
      
      
        
          
        
        
        
          
            
            
              
            
            
              
            
            
              
            
          
          
            
            Statutory 
               (
                #statutory)
              
            
            opt-in 
               (
                #OPTIN)
              
            
            
          
        
        
        
          
            
            
              
            
          
          
            
            
          
        
        
          
            
          
          
            : Action A 
             (
              #action-a)
            
          
          
            
              
            
            
              : 
               &quot;Burgers University Medical Center&quot;
            
            
              : Recipient of restricted health information 
              
            
          
          
            
              
            
            
              : 
               &quot;XYZ Insurance&quot;
            
            
              : Sender of restricted health information 
              
            
          
          
            : health program reporting 
             (
              #HPRGRP)
            
          
          
            : Sample 
            
          
        
      
      
        
          
        
        
          : SELF (Details: http://mdhhs.org/fhir/consent-signer-type code SELF = 'SELF', stated
           as 'null')
        
        
          : 
           &quot;Roel&quot;
        
      
      
      
        
          
          
            
          
        
        
          
          
        
      
    
  
  
  
    
      
      
    
  
  
  
    
  
  
    
  
  
    
      
      
    
    
  
  
    
      
      
    
  
  
    
      
        
          
          
        
      
      
        
          
          
        
      
      
    
    
      
        
        
      
    
    
      
        
          
          
        
      
      
        
          
          
        
        
          
            
            
            
          
          
        
      
      
        
          
          
        
        
          
            
            
            
          
          
        
      
      
        
          
          
        
      
      
        
      
    
  
  
    
      
      
    
    
      
      
    
    
      
        
        
      
      
      
        
      
    
  
  
    
      
      
      
      
    
  

<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> 
  <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative: Contract</b> <a name="C-2121"> </a> </p> <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">Resource Contract &quot;C-2121&quot; Version &quot;1&quot; Updated &quot;2016-07-19T18:18:42.
          108-04:00&quot; </p> </div> <p> <b> status</b> : executed</p> <p> <b> contentDerivative</b> : Content Registration <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-contract-content-derivative.html">Contract Content Derivation Codes</a> #registration)</span> </p> <p> <b> issued</b> : 2013-11-01T21:18:27-04:00</p> <p> <b> applies</b> : 2013-11-01T21:18:27-04:00 --&gt; (ongoing)</p> <p> <b> subject</b> : <a href="patient-example-f201-roel.html">Patient/f201</a>  &quot;Roel&quot;</p> <p> <b> type</b> : Opt-in consent directive <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (consentdirective-type#OPTIN)</span> </p> <p> <b> subType</b> : Health Care Directive <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-consentcategorycodes.html">Consent Category Codes</a> #hcd)</span> </p> <blockquote> <p> <b> term</b> </p> <h3> Offers</h3> <table class="grid"><tr> <td> -</td> <td> <b> Type</b> </td> <td> <b> Decision</b> </td> <td> <b> Text</b> </td> </tr> <tr> <td> *</td> <td> Statutory <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-contracttermtypecodes.html">Contract Term Type Codes</a> #statutory)</span> </td> <td> opt-in <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-v3-ActCode.html">ActCode</a> #OPTIN)</span> </td> <td> Can't refuse</td> </tr> </table> <h3> Assets</h3> <table class="grid"><tr> <td> -</td> <td> <b> Period</b> </td> </tr> <tr> <td> *</td> <td> 2013-11-01T21:18:27-04:00 --&gt; 2019-11-01T21:18:27-04:00</td> </tr> </table> <blockquote> <p> <b> action</b> </p> <p> <b> type</b> : Action A <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-contractaction.html">Contract Action Codes</a> #action-a)</span> </p> <blockquote> <p> <b> subject</b> </p> <p> <b> reference</b> : <a href="organization-example-f001-burgers.html">Organization/f001: VA Ann Arbor Healthcare System</a>  &quot;Burgers University Medical Center&quot;</p> <p> <b> role</b> : Recipient of restricted health information <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (consent-actor-type#IR &quot;Recipient&quot;)</span> </p> </blockquote> <blockquote> <p> <b> subject</b> </p> <p> <b> reference</b> : <a href="organization-example-insurer.html">Organization/2: Community Mental Health Clinic</a>  &quot;XYZ Insurance&quot;</p> <p> <b> role</b> : Sender of restricted health information <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (consent-actor-type#IS &quot;Sender&quot;)</span> </p> </blockquote> <p> <b> intent</b> : health program reporting <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-v3-ActReason.html">ActReason</a> #HPRGRP)</span> </p> <p> <b> status</b> : Sample <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span> </p> </blockquote> </blockquote> <blockquote> <p> <b> signer</b> </p> <p> <b> type</b> : SELF (Details: http://mdhhs.org/fhir/consent-signer-type code SELF = 'SELF',
           stated as 'null')</p> <p> <b> party</b> : <a href="patient-example-f201-roel.html">Patient/f201: Alice Recruit</a>  &quot;Roel&quot;</p> <h3> Signatures</h3> <table class="grid"><tr> <td> -</td> <td> <b> Type</b> </td> <td> <b> When</b> </td> <td> <b> Who</b> </td> </tr> <tr> <td> *</td> <td> 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')</td> <td> 8 Feb 2017, 8:57:34 pm</td> <td> <a href="patient-example-f201-roel.html">Patient/f201</a>  &quot;Roel&quot;</td> </tr> </table> </blockquote> <h3> Legals</h3> <table class="grid"><tr> <td> -</td> <td> <b> Content[x]</b> </td> </tr> <tr> <td> *</td> <td/>  </tr> </table> </div> </text> <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>     <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> 
    
    <asset>       <period>         <start value="2013-11-01T21:18:27-04:00"/>         <end value="2019-11-01T21:18:27-04:00"/>       </period>           <!--   
      <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>     <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.