A profile on the FHIR R4 Basic resource for representing a referral, with the code element constrained to the LOINC valid HL7 attachment requests value set.

​The US Core ADI DocumentReference Profile inherits from the FHIR DocumentReference resource; refer to it for scope and usage definitions. This profile and the US Core Observation ADI Documentation Profile meet the U.S. Core Data for Interoperability (USCDI) Advance Directive Observation Data Element requirements. It sets minimum expectations for searching and fetching patient Advance Directive Information (ADI) documents using the DocumentReference resource. Examples of advance healthcare directive documents include physician order for life sustaining treatment (POLST), do not resuscitate order (DNR), and medical power of attorney. In addition to the document contents, it communicates the type of advance directive document, the author, the verifier, and other properties. To represent whether advance directive documents exist for a patient, see the US Core Observation ADI Documentation Profile. This profile sets minimum expectations for searching and fetching patient ADI documents using the DocumentReference resource. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.

The US Core PMO ServiceRequest Profile inherits from the FHIR ServiceRequest resource; refer to it for scope and usage definitions. This profile represents an order based on a PMO document and references the US Core ADI DocumentReference Profile to communicate the contents of the PMO document, such as POLST, MOLST, or other state-specific forms. PMO documents follow the patient across care settings and are typically stored as scanned images in EMRs/EHRs. Together, these two profiles satisfy the USCDI's PMO Order Data Element's intent to represent orders based on an individual's PMO. The US Core PMO ServiceRequest Profile establishes minimum expectations for recording, searching, and fetching PMO-related ServiceRequest information, specifying core elements, extensions, vocabularies, and value sets that SHALL be present to promote interoperability.

Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The ethnicity codes used to represent these concepts are based upon the Race & Ethnicity - CDC (CDCREC) which includes over 900 concepts for representing race and ethnicity of which 43 reference ethnicity. The ethnicity concepts are grouped by and pre-mapped to the 2 OMB ethnicity categories:

• Hispanic or Latino
• Not Hispanic or Latino.

Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the Race & Ethnicity - CDC (CDCREC) which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:

• American Indian or Alaska Native
• Asian
• Black or African American
• Native Hawaiian or Other Pacific Islander
• White.

A value set of LOINC codes for portable medical orders.

Digital signature example showing how it is used to sign a FHIR Document. The CDEX use case would be the target resource in response to a Task-based request where a digital signature was required. If no signature was required, the response would typically be in the form of an individual resource.

This is a an example of POLST (PDF) for the US Core ADI DocumentReference Profile

This is an example hospital location for the US Core Location Profile using three coding type, showing SNOMED CT, HSLOC, and v3-RoleCode concepts.

This is a patient example for the US Core Patient Profile.

This is an example DNR request using the US Core PMO ServiceRequest Profile.