Medplum

<?xml version="1.0" encoding="UTF-8"?> <?xml-stylesheet type="text/xsl" href="CDA.xsl"?> <ClinicalDocument xmlns = "urn:hl7-org:v3" xmlns:xsi = "http://www.w3.org/2001/XMLSchema-instance" xmlns:voc = "urn:hl7-org:v3/voc" xmlns:sdtc = "urn:hl7-org:sdtc"> <realmCode code = "US"/> <typeId extension = "POCD_HD000040" root = "2.16.840.1.113883.1.3"/> <templateId root = "2.16.840.1.113883.10.20.22.1.1" extension = "2015-08-01"/> <templateId root = "2.16.840.1.113883.10.20.22.1.1"/> <templateId root = "2.16.840.1.113883.10.20.22.1.2" extension = "2015-08-01"/> <templateId root="2.16.840.1.113883.10.20.22.1.2" /> <id root="3db70aff-83f5-4caf-91dc-d23fcc5e03bb" /> <code code="34133-9" displayName="Summarization of Episode Note" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" /> <title>Medical Summary</title> <effectiveTime value="20250101000000-0500" /> <languageCode code="en-US" /> <recordTarget> <patientRole> <id root="ce862cfe-6559-411e-92e9-e8d005b1c226" /> <id extension="111223333" root="2.16.840.1.113883.4.1" /> <telecom nullFlavor="UNK" /> <addr nullFlavor="UNK" /> <patient> <name use="L"> <given>Katherine</given> <family>Madison</family> </name> <raceCode nullFlavor="UNK"/> <ethnicGroupCode nullFlavor="UNK"/> </patient> </patientRole> </recordTarget> <component> <structuredBody> <component> <section> <!-- conforms to Immunizations section with entries optional --> <templateId root="2.16.840.1.113883.10.20.22.2.2" /> <templateId root="2.16.840.1.113883.10.20.22.2.2" extension="2015-08-01" /> <!-- Immunizations section with entries required --> <templateId root="2.16.840.1.113883.10.20.22.2.2.1" /> <templateId root="2.16.840.1.113883.10.20.22.2.2.1" extension="2015-08-01" /> <code code="11369-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="History of immunizations" /> <title>IMMUNIZATIONS</title> <text> <content ID="immunSect" /> <table border="1" width="100%"> <thead> <tr> <th>Vaccine</th> <th>Lot Number</th> <th>Date</th> <th>Status</th> </tr> </thead> <tbody> <tr ID="immun1"> <td ID="ImmunizationProduct_100">Influenza Virus Vaccine</td> <td>1</td> <td>8/15/2010</td> <td>Completed</td> </tr> </tbody> </table> </text> <entry> <substanceAdministration classCode="SBADM" moodCode="EVN" negationInd="false"> <!-- ** Immunization activity ** --> <templateId root="2.16.840.1.113883.10.20.22.4.52" /> <templateId root="2.16.840.1.113883.10.20.22.4.52" extension="2015-08-01" /> <id root="e6f1ba43-c0ed-4b9b-9f12-f435d8ad8f92" /> <text> <reference value="#immun1" /> </text> <!-- Indicates the status of the substanceAdministartion --> <statusCode code="completed" /> <effectiveTime value="20100815" /> <consumable> <manufacturedProduct classCode="MANU"> <!-- ** Immunization medication information ** --> <templateId root="2.16.840.1.113883.10.20.22.4.54" /> <templateId root="2.16.840.1.113883.10.20.22.4.54" extension="2014-06-09" /> <manufacturedMaterial> <code code="88" codeSystem="2.16.840.1.113883.12.292" displayName="influenza virus vaccine, unspecified formulation" codeSystemName="CVX"> </code> <lotNumberText>1</lotNumberText> </manufacturedMaterial> <manufacturerOrganization> <name>Health LS - Immuno Inc.</name> </manufacturerOrganization> </manufacturedProduct> </consumable> <!-- Optional Performer --> <performer> <assignedEntity> <id root="7ae96c77-6b8f-4e5a-9938-2f6392857789" /> <addr> <streetAddressLine>1021 Health Drive</streetAddressLine> <city>Ann Arbor</city> <state>MI</state> <postalCode>99099</postalCode> <country>US</country> </addr> <telecom nullFlavor="UNK" /> <assignedPerson> <id root="7ae96c77-6b8f-4e5a-9938-2f6392857789" /> <name> <given>Amanda</given> <family>Assigned</family> </name> </assignedPerson> <representedOrganization> <id root="7ae96c77-6b8f-4e5a-9938-2f6392857789" /> <name>Good Health Clinic</name> <telecom nullFlavor="UNK" /> <addr nullFlavor="UNK" /> </representedOrganization> </assignedEntity> </performer> <!-- Optional Author --> <!-- <author> <templateId root="2.16.840.1.113883.10.20.22.4.119" /> <time value="20100815" /> <assignedAuthor> <id extension="99999999" root="2.16.840.1.113883.4.6" /> <code code="207Q00000X" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Health Care Provider Taxonomy" displayName="Allopathic &amp; Osteopathic Physicians; Family Medicine" /> <telecom value="tel:555-555-1002" /> <assignedPerson> <name> <given>Henry</given> <family>Seven</family> </name> </assignedPerson> </assignedAuthor> </author> --> </substanceAdministration> </entry> </section> </component> </structuredBody> </component> </ClinicalDocument>