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="978a95c6-248e-49d1-b5dd-7c13282bd938" /> <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="d7830f15-e2c8-4cee-aa2d-a24b36080d53" /> <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> <templateId root="2.16.840.1.113883.10.20.22.2.7.1" extension="2014-06-09" /> <code code="47519-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="HISTORY OF PROCEDURES" /> <title>Procedures</title> <text> <table> <thead> <tr> <th>Description</th> <th>Date and Time (Range)</th> <th>Status</th> </tr> </thead> <tbody> <tr ID="Procedure2"> <td ID="ProcedureDesc2">Electrocardiogram (12-Lead)</td> <td>29 Mar 2014 09:15am</td> <td>Completed</td> </tr> </tbody> </table> </text> <entry> <!-- Observations should be used for care that result in information about the patient (e.g. a diagnostic test & result) but do not alter physical state--> <observation classCode="OBS" moodCode="EVN"> <templateId root="2.16.840.1.113883.10.20.22.4.13" /> <templateId root="2.16.840.1.113883.10.20.22.4.13" extension="2014-06-09" /> <id root="c03e5445-af1b-4911-a419-e2782f21448c" /> <code code="268400002" codeSystem="2.16.840.1.113883.6.96" displayName="12 lead electrocardiogram" codeSystemName="SNOMED CT"> </code> <text> <reference value="#Procedure2" /> </text> <statusCode code="completed" /> <effectiveTime value="20140329091522-0500" /> <!-- When choosing an observation, value records relevant findings--> <value xsi:type="CD" code="251135002" codeSystem="2.16.840.1.113883.6.96" displayName="Borderline normal electrocardiogram" codeSystemName="SNOMED CT" /> </observation> </entry> </section> </component> </structuredBody> </component> </ClinicalDocument>