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DEMO_Race_Additional_Specificity.xml
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DEMO_Race_Additional_Specificity.xml
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<recordTarget>
<patientRole>
<!-- The id would likely be the patient's medical record number. This root identifies Partners Healthcare as an example -->
<id extension="98765432" root="1.3.6.1.4.1.16517.1"/>
<!-- Additional ids can capture other MRNs or identifiers, such as social security number shown below -->
<id extension="12345679" root="2.16.840.1.113883.4.1"/>
<!-- HP is "primary home" from valueSet 2.16.840.1.113883.1.11.10637 -->
<addr use="HP">
<!-- You can have multiple [1..4] streetAddressLine elements. Single shown below -->
<streetAddressLine>4567 Residence Rd</streetAddressLine>
<city>Beaverton</city>
<!-- 5 or 9 digit zip codes from valueSet 2.16.840.1.113883.3.88.12.80.2-->
<!-- PostalCode is required if the country is US. If country is not specified, it's assumed to be US. If country
is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies -->
<postalCode>97867</postalCode>
<!-- State is required if the country is US. If country is not specified, it's assumed to be US.
If country is something other than US, the state MAY be present but MAY be bound to different vocabularies -->
<!-- OR is "Oregon" from valueSet 2.16.840.1.113883.3.88.12.80.1 -->
<state>OR</state>
<!-- US is "United States" from valueSet 2.16.840.1.113883.3.88.12.80.63 -->
<country>US</country>
</addr>
<!-- MC is "mobile contact" from HL7 AddressUse 2.16.840.1.113883.5.1119 -->
<telecom value="tel:+1(444)444-4444" use="MC"/>
<!-- Multiple telecoms are possible -->
<telecom value="mailto://[email protected]"/>
<patient>
<name use="L">
<given>Isabella</given>
<family qualifier="SP">Jones</family>
</name>
<administrativeGenderCode code="F" displayName="Female" codeSystem="2.16.840.1.113883.5.1" codeSystemName="AdministrativeGender"/>
<!-- Date of birth need only be precise to the day -->
<birthTime value="19501219"/>
<maritalStatusCode code="M" displayName="Married" codeSystem="2.16.840.1.113883.5.2" codeSystemName="MaritalStatusCode"/>
<religiousAffiliationCode code="1013" displayName="Christian (non-Catholic, non-specific)" codeSystem="2.16.840.1.113883.5.1076" codeSystemName="HL7 Religious Affiliation"/>
<!-- CDC Race and Ethnicity code set contains the five minimum race and ethnicity categories defined by OMB Standards -->
<raceCode code="2106-3" displayName="White" codeSystem="2.16.840.1.113883.6.238" codeSystemName="Race & Ethnicity - CDC"/>
<!-- The raceCode extension is only used if raceCode is valued -->
<sdtc:raceCode code="2114-7" displayName="Italian" codeSystem="2.16.840.1.113883.6.238" codeSystemName="Race & Ethnicity - CDC"/>
<ethnicGroupCode code="2186-5" displayName="Not Hispanic or Latino" codeSystem="2.16.840.1.113883.6.238" codeSystemName="Race & Ethnicity - CDC"/>
<guardian>
<code code="POWATT" displayName="Power of Attorney" codeSystem="2.16.840.1.113883.1.11.19830" codeSystemName="ResponsibleParty"/>
<addr use="HP">
<streetAddressLine>4567 Residence Rd</streetAddressLine>
<city>Beaverton</city>
<state>OR</state>
<postalCode>97867</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1(444)444-4444" use="MC"/>
<guardianPerson>
<name>
<given>Boris</given>
<given qualifier="CL">Bo</given>
<family>Jones</family>
</name>
</guardianPerson>
</guardian>
<birthplace>
<place>
<addr>
<streetAddressLine>4444 Home Street</streetAddressLine>
<city>Beaverton</city>
<state>OR</state>
<postalCode>97867</postalCode>
<country>US</country>
</addr>
</place>
</birthplace>
<languageCommunication>
<languageCode code="ita"/>
<!-- "ita" is ISO 639-2 alpha-3 code for "Italian" -->
<modeCode code="ESP" displayName="Expressed spoken" codeSystem="2.16.840.1.113883.5.60" codeSystemName="LanguageAbilityMode"/>
<proficiencyLevelCode code="G" displayName="Good" codeSystem="2.16.840.1.113883.5.61" codeSystemName="LanguageAbilityProficiency"/>
<!-- Patient's preferred language -->
<preferenceInd value="true"/>
</languageCommunication>
<languageCommunication>
<languageCode code="eng"/>
<!-- "eng" is ISO 639-2 alpha-3 code for "English" -->
<modeCode code="ESP" displayName="Expressed spoken" codeSystem="2.16.840.1.113883.5.60" codeSystemName="LanguageAbilityMode"/>
<proficiencyLevelCode code="P" displayName="Poor" codeSystem="2.16.840.1.113883.5.61" codeSystemName="LanguageAbilityProficiency"/>
<!-- Patient's preferred language -->
<preferenceInd value="false"/>
</languageCommunication>
</patient>
<providerOrganization>
<id extension="219BX" root="1.1.1.1.1.1.1.1.2"/>
<name>The Doctors Together Physician Group</name>
<telecom use="WP" value="tel: +1(555)555-5000"/>
<addr>
<streetAddressLine>1007 Health Drive</streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>99123</postalCode>
<country>US</country>
</addr>
</providerOrganization>
</patientRole>
</recordTarget>