This page is part of the 同意書實作指引 (v0.1.0: Releases Ballot 1) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions 
: Consent-切結書 - XML Representation
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<Consent xmlns="http://hl7.org/fhir">
<id value="con-affidavit-example"/>
<meta>
<profile
value="http://hitstdio.ntunhs.edu.tw/consentForm/StructureDefinition/Consent-doltc-afft"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><h3><b>切結書</b></h3><p><b>同意書識別碼</b>：urn:uuid:90fe5d72-6b62-4f81-bce4-7ca60b0b0cd6 (https://www.tph.mohw.gov.tw/)</p><p><b>同意書的狀態</b>：active <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">(<a href="http://hl7.org/fhir/R4/valueset-consent-state-codes.html">ConsentState</a>#active)</span></p><p><b>同意書的規模</b>：Privacy Consent <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="https://terminology.hl7.org/5.0.0/CodeSystem-consentscope.html">Consent Scope Codes</a>#patient-privacy)</span></p><p><b>同意書的類別</b>：切結書 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="CodeSystem-consent-category.html">Consent Category</a>#AFFT)</span></p><p><b>病人</b>：<a href="Patient-pat-example.html">Patient/pat-example</a> "陳加玲"</p><p><b>日期</b>：2021-12-01</p><p><b>同意政策和規則的機構</b>：<a href="Organization-doltc-example.html">Organization/doltc-example</a> "長期照顧司籌備辦公室"</p><p><b>參照的文件</b>：<a href="DocumentReference-doc-example.html">DocumentReference/doc-example</a></p><p><b>政策規則</b>：失智症防治照護政策綱領暨行動方案2.0 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="CodeSystem-policy-rule.html">同意書政策依據</a>#dementia-plan)</span></p><h4>Provisions</h4><p><b>類型</b>：Opt In <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="http://hl7.org/fhir/R4/valueset-consent-provision-type.html">ConsentProvisionType</a>#permit)</span></p><p><b>Action</b>：Collect <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="https://terminology.hl7.org/5.0.0/CodeSystem-consentaction.html">Consent Action Codes</a>#collect)</span></p><p><b>SecurityLabel</b>：healthcare payment (Details: http://terminology.hl7.org/CodeSystem/v3-ActReason code HPAYMT = 'healthcare payment', stated as 'null')</p><p><b>Class</b>：ITI BPPC (Details: http://ihe.net/fhir/ihe.formatcode.fhir/CodeSystem/formatcode code urn:ihe:iti:bppc:2007 = 'urn:ihe:iti:bppc:2007', stated as 'ITI BPPC')</p><p><b>Code</b>：Consent Document <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki">( <a href="https://loinc.org/">LOINC</a>#59284-0)</span></p></div>
</text>
<identifier>
<system value="https://www.tph.mohw.gov.tw/"/>
<value value="urn:uuid:90fe5d72-6b62-4f81-bce4-7ca60b0b0cd6"/>
</identifier>
<status value="active"/>
<scope>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/consentscope"/>
<code value="patient-privacy"/>
</coding>
</scope>
<category>
<coding>
<system
value="http://hitstdio.ntunhs.edu.tw/consentForm/CodeSystem/consent-category"/>
<code value="AFFT"/>
</coding>
</category>
<patient>
<reference value="Patient/pat-example"/>
</patient>
<dateTime value="2021-12-01"/>
<performer>
<reference value="Organization/doltc-example"/>
</performer>
<sourceReference>
<reference value="DocumentReference/doc-example"/>
</sourceReference>
<policyRule>
<coding>
<system
value="http://hitstdio.ntunhs.edu.tw/consentForm/CodeSystem/policy-rule"/>
<code value="dementia-plan"/>
</coding>
</policyRule>
<provision>
<type value="permit"/>
<action>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/consentaction"/>
<code value="collect"/>
</coding>
</action>
<securityLabel>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
<code value="HPAYMT"/>
</securityLabel>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="59284-0"/>
</coding>
</code>
</provision>
</Consent>
