Patient Care Coordination (PCC) Implementation Guide
0.1.1-current - ci-build
Patient Care Coordination (PCC) Implementation Guide
0.1.1-current - ci-build
Patient Care Coordination (PCC) Implementation Guide - Local Development build (v0.1.1-current) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
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{
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"resourceType" : "Composition",
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Composition_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Composition </b></p><p><b>status</b>: Final</p><p><b>type</b>: <span title=\"Codes:{http://loinc.org 60591-5}, {http://snomed.info/sct 824321000000109}\">Patient summary Document</span></p><p><b>category</b>: <span title=\"Codes:{http://snomed.info/sct 700232004}\">general medical service (qualifier value)</span></p><p><b>date</b>: 2025-07-24 06:34:33+0100</p><p><b>author</b>: <a href=\"Bundle-a820f27e-b626-4b89-88b1-7e759d0b9eb1.html#urn-uuid-44b7ff18-5c26-414e-8f53-d8a9515ea243\">Bundle: identifier = UUID:b5cef54c-e779-4c00-bbc2-ff8bdfaa8756; type = document; timestamp = 2025-07-24 05:34:33+0000</a></p><p><b>title</b>: GP Patient Summary</p><p><b>custodian</b>: <a href=\"Bundle-a820f27e-b626-4b89-88b1-7e759d0b9eb1.html#urn-uuid-83521388-6fd3-4e2f-bda6-6fb889190c61\">Bundle: identifier = UUID:b5cef54c-e779-4c00-bbc2-ff8bdfaa8756; type = document; timestamp = 2025-07-24 05:34:33+0000</a></p></div>"
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"status" : "final",
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"coding" : [
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"reference" : "urn:uuid:2da4ef7b-c18e-4d95-b91e-2406317d4477"
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"date" : "2025-07-24T06:34:33+01:00",
"author" : [
{
"reference" : "urn:uuid:44b7ff18-5c26-414e-8f53-d8a9515ea243"
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"title" : "GP Patient Summary",
"custodian" : {
"reference" : "urn:uuid:83521388-6fd3-4e2f-bda6-6fb889190c61"
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"section" : [
{
"title" : "Problems",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "11450-4"
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"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h1>Problems and Issues</h1><div><h2>Active Problems and Issues</h2><div class=\"date-banner\"><p>Date filter not applied</p></div><table id=\"prb-tab-act\"><thead><tr><th>Start Date</th><th>Entry</th><th>Significance</th><th>Details</th></tr></thead><tbody><tr><td class=\"date-column\">25-Apr-2018</td><td>Lower back pain</td><td>Minor</td><td/></tr><tr><td class=\"date-column\">01-May-2015</td><td>Type II Diabetes mellitus</td><td>Major</td><td>Diabetes type II blood glucose management</td></tr></tbody></table></div><div><h2>Major Inactive Problems and Issues</h2><div class=\"date-banner\"><p>For the period '24-Jul-2015' to '24-Jul-2025'</p></div><p>No 'Major Inactive Problems and Issues' data is recorded for this patient.</p></div><div><h2>Other Inactive Problems and Issues</h2><div class=\"date-banner\"><p>For the period '24-Jul-2015' to '24-Jul-2025'</p></div><p>No 'Other Inactive Problems and Issues' data is recorded for this patient.</p></div></div>"
}
},
{
"title" : "Allergy",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "48765-2"
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]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h1>Allergies and Adverse Reactions</h1><div><h2>Current Allergies and Adverse Reactions</h2><table id=\"all-tab-curr\"><thead><tr><th>Start Date</th><th>Details</th></tr></thead><tbody><tr><td class=\"date-column\">15-Mar-2016</td><td>Allergy to Penicillin, Patient experienced rash, nausea and vomiting</td></tr></tbody></table></div><div><h2>Historical Allergies and Adverse Reactions</h2><table id=\"all-tab-hist\"><thead><tr><th>Start Date</th><th>End Date</th><th>Details</th></tr></thead><tbody><tr><td class=\"date-column\">02-Jun-1963</td><td/><td>Hayfever, allergy to pollen</td></tr></tbody></table></div></div>"
}
},
{
"title" : "Medication",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "10160-0"
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"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h1>Medications</h1><div><h2>Acute Medication (Last 12 Months)</h2><div class=\"date-banner\"><p>Date filter not applied</p></div><table id=\"med-tab-acu-med\"><thead><tr><th>Type</th><th>Start Date</th><th>Medication Item</th><th>Dosage Instruction</th><th>Quantity</th><th>Scheduled End Date</th><th>Days Duration</th><th>Additional Information</th></tr></thead><tbody><tr><td>NHS Medication</td><td class=\"date-column\">25-Jan-2025</td><td>Tramadol 50mg capsules</td><td>one tablet every 4 to 6 hours</td><td>28 days</td><td/><td align=\"right\">28</td><td>Take 1 or 2 tablets as directed up to 4 times per day</td></tr></tbody></table></div><div><h2>Current Repeat Medication</h2><div class=\"date-banner\"><p>Date filter not applied</p></div><table id=\"med-tab-curr-rep\"><thead><tr><th>Type</th><th>Start Date</th><th>Medication Item</th><th>Dosage Instruction</th><th>Quantity</th><th>Last Issued Date</th><th>Number of Prescriptions Issued</th><th>Max Issues</th><th>Review Date</th><th>Additional Information</th></tr></thead><tbody><tr><td>Repeat</td><td class=\"date-column\">01-Feb-2022</td><td>Metformin 500mg tablets</td><td>one tablet 2 to 3 times daily</td><td>28 days</td><td class=\"date-column\">28-Dec-2024</td><td align=\"right\">3</td><td align=\"right\">6</td><td class=\"date-column\">15-Jul-2025</td><td>Take one tablet three times daily</td></tr><tr><td>Repeat</td><td class=\"date-column\">01-Dec-2012</td><td>Lercanidipine 20mg tablets</td><td>one tablet daily</td><td>28 days</td><td class=\"date-column\">20-Dec-2024</td><td align=\"right\">3</td><td align=\"right\">6</td><td class=\"date-column\">15-Jul-2025</td><td>Take one tablet daily</td></tr></tbody></table></div><div><h2>Discontinued Repeat Medication</h2><div class=\"content-banner\"><p>All repeat medication ended by a clinician action</p></div><div class=\"date-banner\"><p>Date filter not applied</p></div><table id=\"med-tab-dis-rep\"><thead><tr><th>Type</th><th>Last Issued Date</th><th>Medication Item</th><th>Dosage Instruction</th><th>Quantity</th><th>Discontinued Date</th><th>Discontinuation Reason</th><th>Additional Information</th></tr></thead><tbody><tr><td>Repeat</td><td class=\"date-column\">01-Feb-2012</td><td>Metformin 500mg tablets</td><td>one tablet 2 to 3 times per day</td><td>28 days</td><td class=\"date-column\">01-Feb-2012</td><td>60 tablet pack discontinued</td><td>Take with food and water</td></tr></tbody></table></div><div><h2>All Medication</h2><div class=\"date-banner\"><p>For the period '24-Jul-2015' to '24-Jul-2025'</p></div><table id=\"med-tab-all-sum\"><thead><tr><th>Type</th><th>Start Date</th><th>Medication Item</th><th>Dosage Instruction</th><th>Quantity</th><th>Last Issued Date</th><th>Number of Prescriptions Issued</th><th>Discontinuation Details</th><th>Additional Information</th></tr></thead><tbody><tr><td colspan=\"9\" class=\"med-item-column\"><b>Lercanidipine 20mg tablets</b></td></tr><tr><td>Repeat</td><td class=\"date-column\">01-Dec-2012</td><td>Lercanidipine 20mg tablets</td><td>one tablet daily</td><td>28 days</td><td class=\"date-column\">01-Dec-2012</td><td align=\"right\">1</td><td/><td>Take one tablet daily</td></tr><tr><td colspan=\"9\" class=\"med-item-column\"><b>Metformin 500mg tablets</b></td></tr><tr><td>Repeat</td><td class=\"date-column\">01-Feb-2022</td><td>Metformin 500mg tablets</td><td>one tablet 2 to 3 times daily</td><td>28 days</td><td class=\"date-column\">01-Feb-2022</td><td align=\"right\">1</td><td/><td>Take one tablet three times daily</td></tr><tr><td>Repeat</td><td class=\"date-column\">01-Feb-2012</td><td>Metformin 500mg tablets</td><td>one tablet 2 to 3 times per day</td><td>28 days</td><td class=\"date-column\">01-Feb-2012</td><td align=\"right\">1</td><td>DISCONTINUED:<br/>01-Feb-2012<br/>60 tablet pack discontinued</td><td>Take with food and water</td></tr><tr><td colspan=\"9\" class=\"med-item-column\"><b>Tramadol 50mg capsules</b></td></tr><tr><td>NHS Medication</td><td class=\"date-column\">25-Jan-2025</td><td>Tramadol 50mg capsules</td><td>one tablet every 4 to 6 hours</td><td>28 days</td><td class=\"date-column\">25-Jan-2025</td><td align=\"right\">1</td><td/><td>Take 1 or 2 tablets as directed up to 4 times per day</td></tr></tbody></table></div><div><h2>All Medication Issues</h2><div class=\"date-banner\"><p>For the period '24-Jul-2015' to '24-Jul-2025'</p></div><table id=\"med-tab-all-iss\"><thead><tr><th>Type</th><th>Issue Date</th><th>Medication Item</th><th>Dosage Instruction</th><th>Quantity</th><th>Days Duration</th><th>Additional Information</th></tr></thead><tbody><tr><td colspan=\"7\" class=\"med-item-column\"><b>Lercanidipine 20mg tablets</b></td></tr><tr><td>Repeat</td><td class=\"date-column\">01-Dec-2012</td><td>Lercanidipine 20mg tablets</td><td>one tablet daily</td><td>28 days</td><td/><td>Take one tablet daily</td></tr><tr><td colspan=\"7\" class=\"med-item-column\"><b>Metformin 500mg tablets</b></td></tr><tr><td>Repeat</td><td class=\"date-column\">01-Feb-2022</td><td>Metformin 500mg tablets</td><td>one tablet 2 to 3 times daily</td><td>28 days</td><td/><td>Take one tablet three times daily</td></tr><tr><td>Repeat</td><td class=\"date-column\">01-Feb-2012</td><td>Metformin 500mg tablets</td><td>one tablet 2 to 3 times per day</td><td>28 days</td><td align=\"right\">4</td><td>Take with food and water</td></tr><tr><td colspan=\"7\" class=\"med-item-column\"><b>Tramadol 50mg capsules</b></td></tr><tr><td>NHS Medication</td><td class=\"date-column\">25-Jan-2025</td><td>Tramadol 50mg capsules</td><td>one tablet every 4 to 6 hours</td><td>28 days</td><td align=\"right\">28</td><td>Take 1 or 2 tablets as directed up to 4 times per day</td></tr></tbody></table></div></div>"
}
},
{
"title" : "Immunisations",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "11369-6"
}
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h1>Immunisations</h1><table id=\"imm-tab\"><thead><tr><th>Date</th><th>Vaccination</th><th>Part</th><th>Contents</th><th>Details</th></tr></thead><tbody><tr><td class=\"date-column\">30-Aug-2015</td><td>Pneumovax II</td><td align=\"right\">1</td><td>Pneumoccocal</td><td/></tr><tr><td class=\"date-column\">18-Jan-2013</td><td>Influenza vaccine</td><td align=\"right\">1</td><td>Influenza</td><td/></tr><tr><td class=\"date-column\">04-Oct-2010</td><td>Influenza vaccine</td><td align=\"right\">1</td><td>Influenza</td><td/></tr></tbody></table></div>"
}
},
{
"title" : "Referral",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "47519-4"
}
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h1>Referrals</h1><div class=\"date-banner\"><p>For the period '24-Jul-2015' to '24-Jul-2025'</p></div><table id=\"ref-tab\"><thead><tr><th>Date</th><th>From</th><th>To</th><th>Priority</th><th>Details</th></tr></thead><tbody><tr><td class=\"date-column\">02-Jul-2016</td><td>Dr Johnson and Partners</td><td>Community Diabetic Clinic</td><td>Routine</td><td>Needs further support with dietary needs</td></tr></tbody></table></div>"
}
},
{
"title" : "History - Encounters",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "11329-0"
}
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h1>Encounters</h1><div class=\"date-banner\"><p>All relevant items</p></div><table id=\"enc-tab\"><thead><tr><th>Date</th><th>Title</th><th>Details</th></tr></thead><tbody><tr><td class=\"date-column\">01-Feb-2018</td><td>Care navigation</td><td>Reception signposting regarding exercise classes</td></tr></tbody></table></div>"
}
},
{
"title" : "Observation",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "61149-1"
}
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h1>Clinical Items</h1><div class=\"date-banner\"><p>For the period '24-Jul-2015' to '24-Jul-2025'</p></div><p>No 'Clinical Items' data is recorded for this patient.</p><h1>Observations</h1><div class=\"date-banner\"><p>For the period '24-Jul-2015' to '24-Jul-2025'</p></div><table id=\"obs-tab\"><thead><tr><th>Date</th><th>Entry</th><th>Value</th><th>Range</th><th>Details</th></tr></thead><tbody><tr><td class=\"date-column\">07-May-2017</td><td>Foot Risk Classification</td><td>Left diabetic foot at low risk</td><td>Low to High Risk</td><td>Annual review</td></tr><tr><td class=\"date-column\">07-May-2017</td><td>Foot Risk Classification</td><td>Right diabetic foot at low risk</td><td>Low to High Risk</td><td>Annual review</td></tr></tbody></table><h1>Administrative Items</h1><div class=\"date-banner\"><p>All relevant items</p></div><table id=\"adm-tab\"><thead><tr><th>Date</th><th>Entry</th><th>Details</th></tr></thead><tbody><tr><td class=\"date-column\">02-May-2015</td><td>Appointment Letter</td><td>Community diabetes clinic</td></tr></tbody></table></div>"
}
}
]
}
},
{
"fullUrl" : "urn:uuid:44b7ff18-5c26-414e-8f53-d8a9515ea243",
"resource" : {
"resourceType" : "Practitioner",
"id" : "1",
"meta" : {
"versionId" : "1469444400000",
"lastUpdated" : "2016-07-25T12:00:00.000+01:00"
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner 1</b></p><a name=\"1\"> </a><a name=\"hc1\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: 1469444400000; Last updated: 2016-07-25 12:00:00+0100</p></div><p><b>identifier</b>: <code>http://fhir.nhs.net/Id/sds-user-id</code>/G13579135, <code>http://fhir.nhs.net/Id/sds-role-profile-id</code>/PT1234</p><p><b>name</b>: Nichole Gilbert </p><p><b>gender</b>: Female</p><p><b>communication</b>: <span title=\"Codes:{http://fhir.nhs.net/ValueSet/human-language-1 en}\">English</span></p></div>"
},
"identifier" : [
{
"system" : "http://fhir.nhs.net/Id/sds-user-id",
"value" : "G13579135"
},
{
"system" : "http://fhir.nhs.net/Id/sds-role-profile-id",
"value" : "PT1234"
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],
"name" : [
{
"use" : "usual",
"family" : "Gilbert",
"given" : [
"Nichole"
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"prefix" : [
"Miss"
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],
"gender" : "female",
"communication" : [
{
"coding" : [
{
"system" : "http://fhir.nhs.net/ValueSet/human-language-1",
"code" : "en",
"display" : "English"
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}
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}
},
{
"fullUrl" : "urn:uuid:83521388-6fd3-4e2f-bda6-6fb889190c61",
"resource" : {
"resourceType" : "Organization",
"id" : "8",
"meta" : {
"versionId" : "1548849600000",
"lastUpdated" : "2019-01-30T12:00:00.000+00:00"
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_8\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization 8</b></p><a name=\"8\"> </a><a name=\"hc8\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: 1548849600000; Last updated: 2019-01-30 12:00:00+0000</p></div><p><b>identifier</b>: <code>http://fhir.nhs.net/Id/ods-organization-code</code>/A20047</p><p><b>name</b>: Dr Legg's Surgery</p><p><b>telecom</b>: ph: 12345678(Work)</p><p><b>address</b>: NHS NPFIT Test Data Manager Princes Exchange Leeds LS1 4HY (work)</p></div>"
},
"identifier" : [
{
"system" : "http://fhir.nhs.net/Id/ods-organization-code",
"value" : "A20047"
}
],
"name" : "Dr Legg's Surgery",
"telecom" : [
{
"system" : "phone",
"value" : "12345678",
"use" : "work"
}
],
"address" : [
{
"use" : "work",
"line" : [
"NHS NPFIT",
"Test Data Manager",
"Princes Exchange"
],
"city" : "Leeds",
"postalCode" : "LS1 4HY"
}
]
}
},
{
"fullUrl" : "urn:uuid:2da4ef7b-c18e-4d95-b91e-2406317d4477",
"resource" : {
"resourceType" : "Patient",
"id" : "2",
"meta" : {
"versionId" : "1521806400000",
"lastUpdated" : "2018-03-23T12:00:00.000+00:00"
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient 2</b></p><a name=\"2\"> </a><a name=\"hc2\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: 1521806400000; Last updated: 2018-03-23 12:00:00+0000</p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Mike MEAKIN Male, DoB: 1927-06-19 ( https://fhir.nhs.uk/Id/nhs-number#9658218873)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\"><ul><li>ph: 01454587554(Home)</li><li>1 KNIGHTS COURT, DN16 3PL(home)</li></ul></td></tr></table></div>"
},
"identifier" : [
{
"system" : "https://fhir.nhs.uk/Id/nhs-number",
"value" : "9658218873"
}
],
"name" : [
{
"use" : "usual",
"text" : "Mike MEAKIN",
"family" : "MEAKIN",
"given" : [
"Mike"
],
"prefix" : [
"MR"
]
}
],
"telecom" : [
{
"system" : "phone",
"value" : "01454587554",
"use" : "home"
}
],
"gender" : "male",
"birthDate" : "1927-06-19",
"address" : [
{
"use" : "home",
"type" : "physical",
"text" : "1 KNIGHTS COURT, DN16 3PL"
}
]
}
}
]
}