diff --git a/containers/ecr-viewer/seed-scripts/create-seed-data.py b/containers/ecr-viewer/seed-scripts/create-seed-data.py index f3c859bf13..041ccb5e20 100644 --- a/containers/ecr-viewer/seed-scripts/create-seed-data.py +++ b/containers/ecr-viewer/seed-scripts/create-seed-data.py @@ -93,18 +93,18 @@ def convert_files(): print(f"Converted {folder} successfully.") else: print(f"Failed to convert {folder}. Response: {response.text}") - if os.environ.get("NEXT_PUBLIC_STANDALONE_VIEWER") == "true": + if os.environ.get("NEXT_PUBLIC_NON_INTEGRATED_VIEWER") == "true": return fhir_bundles, metadata else: return fhir_bundles -if os.environ.get("NEXT_PUBLIC_STANDALONE_VIEWER") == "true": - print("Running standalone viewer") +if os.environ.get("NEXT_PUBLIC_NON_INTEGRATED_VIEWER") == "true": + print("Running non integrated viewer") bundle_arr, metadata = convert_files() save_sql_insert_fhir(bundle_arr) save_sql_insert_metadata(metadata) else: - print("Running non standalone viewer") + print("Running viewer") bundle_arr = convert_files() save_sql_insert_fhir(bundle_arr) diff --git a/containers/ecr-viewer/seed-scripts/sql/data.sql b/containers/ecr-viewer/seed-scripts/sql/data.sql index b3af831fe8..71cfd3aaa7 100644 --- a/containers/ecr-viewer/seed-scripts/sql/data.sql +++ b/containers/ecr-viewer/seed-scripts/sql/data.sql @@ -1,16 +1,16 @@ -INSERT INTO fhir (ecr_id, data) VALUES ('1.2.840.114350.1.13.202.3.7.8.688883.486', '{"resourceType": "Bundle", "type": "batch", "entry": [{"fullUrl": "urn:uuid:1.2.840.114350.1.13.202.3.7.8.688883.486", "resource": {"resourceType": "Composition", "id": "1.2.840.114350.1.13.202.3.7.8.688883.486", "meta": {"profile": ["http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-composition"], "source": ["ecr"]}, "identifier": [{"use": "official", "type": {"coding": [{"code": "55751-2", "display": "Initial Public Health Case Report", "system": "http://loinc.org"}]}, "value": "28beb5ae-3f68-11ed-8bdc-005056a7fb21", "assigner": {"display": "EPC"}}], "extension": [{"url": "http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber", "valueString": "30"}], "status": "final", "type": {"coding": [{"code": "55751-2", "display": "Initial Public Health Case Report", "system": "http://loinc.org"}]}, "date": "2022-10-04T17:04:37-07:00", "title": "Initial Public Health Case Report", "confidentiality": "N", "section": [{"id": "c80f67bb-6876-6ad5-ea57-46aea1afa973", "title": "Miscellaneous Notes", "text": {"status": "generated", "div": "documented in this encounter"}, "code": {"coding": [{"code": "10164-2", "display": "HISTORY OF PRESENT ILLNESS", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "4D3493EE-4441-11ED-B2C1-005056A7FB21", "title": "Immunizations", "text": {"status": "generated", "div": "Not on file documented as of this encounter"}, "code": {"coding": [{"code": "11369-6", "display": "History of Immunization Narrative", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "4D38E8F4-4441-11ED-B2C1-005056A7FB21", "title": "Administered Medications", "text": {"status": "generated", "div": "
Inactive Administered Medications - up to 3 most recent administrations
Medication OrderMAR ActionAction DateDoseRateSite
alum-mag hydroxide-simeth (MAALOX) 200-200-20 mg/5 mL oral suspension 15 mL15 mL, Oral, ONCE (IN CLINIC), On Wed 9/28/22 at 2100, For 1 dose, Order WILL be automatically substituted with P&T Approved equivalent per protocol. SHAKE WELL prior to use.Given09/28/2022 8:37 PM PDT15 mL
aspirin tablet 325 mg325 mg, Oral, ONCE, On Wed 9/28/22 at 2100, For 1 doseGiven09/28/2022 8:37 PM PDT325 mg
lidocaine (XYLOCAINE) 2% viscous oral solution5 mL, Swish and Spit, ONCE (IN CLINIC), On Wed 9/28/22 at 2100, For 1 doseGiven09/28/2022 8:37 PM PDT5 mL
documented in this encounter"}, "code": {"coding": [{"code": "29549-3", "display": "MEDICATIONS ADMINISTERED", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"reference": "MedicationAdministration/367be6b3-75f2-2053-63e4-f0a6f1d6bff1"}, {"reference": "MedicationAdministration/3d9ad81e-9518-1b14-44a8-cc86725ed68c"}, {"reference": "MedicationAdministration/b3a81224-d404-4fd4-3134-5c54815acd0f"}]}, {"id": "ca51a58e-d5d5-8f6d-28be-f526ca11481f", "title": "Plan of Treatment", "text": {"status": "generated", "div": "Not on filedocumented as of this encounter"}, "code": {"coding": [{"code": "18776-5", "display": "Plan of care note", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"reference": "CarePlan/5ddcb7d6-d32c-e91c-f715-cf239eb4aee6"}]}, {"id": "4D3C57C8-4441-11ED-B2C1-005056A7FB21", "title": "Problems", "text": {"status": "generated", "div": "
Active ProblemsNoted Date
Coronavirus infection9/28/22
Close exposure to COVID-19 virus9/28/22
Seasonal allergies9/24/22
PregnantEstimated Date of DeliveryComments
Yes5/6/23Based on Est. Date of Conception
documented as of this encounter (statuses as of 10/04/2022)"}, "code": {"coding": [{"code": "11450-4", "display": "Problem list - Reported", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"display": "Problem - Seasonal allergies", "reference": "Condition/1c2932d2-ae86-4b76-fafa-b0a12b17a027"}, {"display": "Problem - Coronavirus infection", "reference": "Condition/1e7e7161-de05-f41e-f064-c227e43edd3e"}, {"display": "Problem - Close exposure to COVID-19 virus", "reference": "Condition/6cb5bd36-5db9-68d4-ec94-afc3f96f6392"}]}, {"id": "578e38a5-2cc7-00e0-1769-ea74746c5fe8", "title": "Reason for Visit", "text": {"status": "generated", "div": "Not on file"}, "code": {"coding": [{"code": "29299-5", "display": "REASON FOR VISIT", "system": "http://loinc.org"}]}, "mode": "snapshot", "extension": [{"url": "http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.2.12", "valueString": "Not on file"}]}, {"id": "4D3F4866-4441-11ED-B2C1-005056A7FB21", "title": "Results", "text": {"status": "generated", "div": "documented in this encounter"}, "code": {"coding": [{"code": "30954-2", "display": "Relevant diagnostic tests/laboratory data Narrative", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"display": "SARS-CoV-2, RNA", "reference": "Observation/3a45daf2-6872-fd2a-6ede-606810d52bb2"}, {"display": "Lab Interpretation", "reference": "Observation/e9c8e4b3-3fec-4f29-a5c5-e45f96680a4c"}]}, {"id": "8a900c7f-2adf-c43c-4fde-16f9696944df", "title": "Social History", "text": {"status": "generated", "div": "
Tobacco UseTypesPacks/DayYears UsedDate
Smoking Tobacco: Never
Smokeless Tobacco: Never
Alcohol UseStandard Drinks/WeekComments
Never0 (1 standard drink = 0.6 oz pure alcohol)
EducationAnswerDate Recorded
What is the highest level of school you have completed or the highest degree you have received?Bachelor''s degree (e.g., BA, AB, BS)09/24/2022
Sex Assigned at BirthDate Recorded
Female09/24/2022 12:34 PM PDT
documented as of this encounter"}, "code": {"coding": [{"code": "29762-2", "display": "Social history Narrative", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "8cfa32e2-c143-2ba9-dc72-266a3ba673c6", "title": "Encounter Details", "text": {"status": "generated", "div": "
DateTypeDepartmentCare TeamDescription
9/28/22Office VisitCSMG Internal Medicine8767 Wilshire Blvd2nd FloorBEVERLY HILLS, CA 90211310-385-6031Canavan, Allison H, MD8631 W. THIRD STREETSTE 510ELOS ANGELES, CA 90048310-385-3380 (Work)310-385-3224 (Fax)allison.canavan@cshs.org
Close exposure to COVID-19 virusCoronavirus infection (Primary Dx);
"}, "code": {"coding": [{"code": "46240-8", "display": "History of Hospitalizations+Outpatient visits Narrative", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "47663d83-626c-c5f7-50e9-73dc719baaee", "title": "Reportability Response Information Section", "text": {"status": "generated", "div": "
Reportability Response Information Section
"}, "extension": [{"url": "http://hl7.org/fhir/us/ecr/StructureDefinition/rr-composition", "valueIdentifier": {"use": "official", "type": {"coding": [{"code": "88085-6", "display": "Reportability response report Document Public health", "system": "http://loinc.org"}]}, "value": "f4c902d9-1d5f-45d4-ab98-c4c1c0844c1b"}}, {"url": "http://hl7.org/fhir/us/ecr/StructureDefinition/rr-eicr-processing-status-extension", "valueCodeableConcept": {"coding": [{"code": "RRVS19", "display": "eICR processed", "system": "urn:oid:2.16.840.1.114222.4.5.274"}]}}], "code": {"coding": [{"code": "88085-6", "display": "Reportability response report Document Public health", "system": "http://loinc.org"}]}, "entry": [{"display": "Relevant Reportable Condition Observation - Disease caused by severe acute respiratory syndrome coronavirus 2 (disorder)", "reference": "Observation/7036e22a-8b10-44de-92aa-1265753a1fa6"}, {"display": "Relevant Reportable Condition Observation - Disease caused by severe acute respiratory syndrome coronavirus 2 (disorder)", "reference": "Observation/650f0023-21cf-4dc4-ae9d-54e0bdf2f013"}]}], "subject": {"reference": "Patient/b62ffdd7-8175-4180-b6ff-451b17b50b63"}, "relatesTo": [{"code": "replaces", "targetReference": {"reference": "Composition/1.2.840.114350.1.13.202.3.7.8.688883.485"}, "extension": [{"url": "http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber", "valueString": "29"}]}], "encounter": {"reference": "Encounter/ad0fdf94-43bd-c07e-67dd-55274fda1880"}, "custodian": {"reference": "Organization/7a0fa8f7-d4a1-61ce-4335-518aa22fcfbb"}, "author": [{"reference": "Practitioner/03576c78-adb1-ff57-dd84-d8bc1ba0f861"}, {"reference": "Device/5133672a-39c9-6145-51b2-34054fe50eaa"}]}, "request": {"method": "PUT", "url": "Composition/1.2.840.114350.1.13.202.3.7.8.688883.486"}}, {"fullUrl": "urn:uuid:ad0fdf94-43bd-c07e-67dd-55274fda1880", "resource": {"resourceType": "Encounter", "id": "ad0fdf94-43bd-c07e-67dd-55274fda1880", "status": "unknown", "class": {"code": "AMB", "display": "Ambulatory", "system": "urn:oid:2.16.840.1.113883.5.4"}, "identifier": [{"system": "urn:oid:1.2.840.114350.1.13.202.3.7.3.698084.8", "value": "49154645347"}], "period": {"start": "2022-09-28T12:00:00-07:00", "end": "2022-09-28T12:30:00-07:00"}, "subject": {"reference": "Patient/b62ffdd7-8175-4180-b6ff-451b17b50b63"}, "location": [{"id": "1.2.840.114350.1.13.202.3.7.2.686980", "location": {"reference": "Location/fe72934a-15d3-8df5-b580-ee21c16b39c9", "display": "CSMG Internal Medicine"}, "extension": [{"url": "http://build.fhir.org/ig/HL7/case-reporting/StructureDefinition-us-ph-location-definitions.html#Location.type", "valueCodeableConcept": {"coding": [{"code": "257622000", "display": "Healthcare Facility", "system": "http://snomed.info/sct"}]}}]}], "participant": [{"type": [{"coding": [{"system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType", "code": "ATND"}]}], "individual": {"reference": "Practitioner/54aef910-c31a-d466-11e5-960b7c417f32"}}], "meta": {"source": ["ecr"]}}, "request": {"method": "PUT", "url": "Encounter/ad0fdf94-43bd-c07e-67dd-55274fda1880"}}, {"fullUrl": "urn:uuid:fe72934a-15d3-8df5-b580-ee21c16b39c9", "resource": {"resourceType": "Location", "id": "fe72934a-15d3-8df5-b580-ee21c16b39c9", "identifier": [{"value": "1.2.840.114350.1.13.202.3.7.2.686980"}], "name": "CSMG Internal Medicine", "address": {"use": "work", "line": ["8767 Wilshire Blvd", "2nd Floor"], "city": "BEVERLY HILLS", "state": "CA", "country": "US", "postalCode": "90211", "district": "LOS ANGELE"}, "type": [{"coding": [{"code": "257622000", "display": "Healthcare Facility", "system": "http://snomed.info/sct"}]}], "meta": {"source": ["ecr"]}}, "request": {"method": "PUT", "url": "Location/fe72934a-15d3-8df5-b580-ee21c16b39c9"}}, {"fullUrl": "urn:uuid:54aef910-c31a-d466-11e5-960b7c417f32", "resource": {"resourceType": "Practitioner", "id": "54aef910-c31a-d466-11e5-960b7c417f32", "meta": 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"California Department of Public Health", "address": [{"use": "work", "city": "Sacramento", "state": "CA"}], "telecom": [{"system": "email", "value": "CalREDIEeCR@cdph.ca.gov", "use": "work"}]}, "request": {"method": "PUT", "url": "Organization/d6930155-009b-92a0-d2b9-007761c45ad2"}}, {"fullUrl": "urn:uuid:7036e22a-8b10-44de-92aa-1265753a1fa6", "resource": {"resourceType": "Observation", "id": "7036e22a-8b10-44de-92aa-1265753a1fa6", "meta": {"profile": ["http://hl7.org/fhir/us/ecr/StructureDefinition/rr-reportability-information-observation"], "source": ["ecr"]}, "identifier": [{"system": "urn:ietf:rfc:3986", "value": "urn:uuid:7036e22a-8b10-44de-92aa-1265753a1fa6"}], "status": "final", "code": {"coding": [{"code": "64572001", "display": "Condition", "system": "http://snomed.info/sct"}, {"code": "75323-6", "display": "Condition", "system": "http://loinc.org"}]}, "valueCodeableConcept": {"coding": [{"code": "840539006", "display": "Disease caused by severe acute respiratory syndrome 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"urn:oid:1.2.840.114350.1.13.202.3.7.2.697780", "value": "TANGCX"}], "name": [{"family": "Tang", "given": ["Chris"]}, {"use": "usual", "text": "Cedars-Sinai"}], "address": [{"use": "work", "line": ["8700 Beverly Blvd"], "city": "Los Angeles", "state": "CA", "postalCode": "90048-1803"}]}, "request": {"method": "PUT", "url": "Practitioner/03576c78-adb1-ff57-dd84-d8bc1ba0f861"}}, {"fullUrl": "urn:uuid:5133672a-39c9-6145-51b2-34054fe50eaa", "resource": {"resourceType": "Device", "id": "5133672a-39c9-6145-51b2-34054fe50eaa", "identifier": [{"system": "urn:oid:1.2.840.114350.1.1", "value": "10.2"}], "type": {"coding": [{"display": "Epic - Version 10.2"}]}, "manufacturer": "Epic - Version 10.2", "version": [{"value": "Epic - Version 10.2"}], "category": {"coding": [{"system": "http://hl7.org/fhir/device-category", "code": "software", "display": "software"}]}, "owner": {"reference": "Organization/7a0fa8f7-d4a1-61ce-4335-518aa22fcfbb"}, "meta": {"source": ["ecr"]}}, "request": {"method": "PUT", 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"title": "Initial Public Health Case Report", "confidentiality": "N", "section": [{"id": "6d477942-5761-6b2c-f5fc-bdf036a1fe7e", "title": "Miscellaneous Notes", "text": {"status": "generated", "div": "Not on file documented in this encounter"}, "code": {"coding": [{"code": "10164-2", "display": "HISTORY OF PRESENT ILLNESS", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "A84C7F7E-3F70-11ED-9549-C301D81100B2", "title": "Immunizations", "text": {"status": "generated", "div": "
NameAdministration DatesNext Due
DTAP-HIB-IPV (PENTACEL)04/16/2010
HEP A (ADULT) 2 DOSE11/11/2011
HEP B (PED,ADOLESCENT) 3 DOSE03/21/1974
MENINGOCOCCAL CONJUGATE,MENACTRA (PED/ADOL/ADULT)11/16/2020
TDAP, (ADOL/ADULT)11/10/2020
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Active ProblemsNoted Date
Bipolar I disorder11/19/20
Reactive depression11/19/20
Rheumatoid arthritis with negative rheumatoid factor11/16/20
Arthralgia of both ankles11/16/20
Anxiety11/10/20
Asthma11/10/20
Knee pain4/29/19
Sprain of calcaneofibular ligament of right ankle4/16/19
Last Assessment & Plan:Formatting of this note might be different from the original.
This is my note about this problem.
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Smoking Tobacco: Never
Smokeless Tobacco: Never
Alcohol UseStandard Drinks/WeekComments
Yes0 (1 standard drink = 0.6 oz pure alcohol)
Sex Assigned at BirthDate Recorded
Not on file
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DateTypeDepartmentCare TeamDescription
9/28/22Lab RequisitionPROVIDENCE ST JOSEPH MED CTR LABORATORY501 S Buena Vista StBurbank, CA 91505-4809818-847-6060Test, Ambhp1, MD2001 LIND AVERENTON, WA 98059
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MemberRoleStatusDates
Adam Sheradmitting physicianActive
Start: March 12th, 2022
MCUTLERattending physicianActive
Start: March 12th, 2022
DR MEDITECHprimary care physicianActive
Start: March 12th, 2022
AMANDA NOELREFERRINGActive
Start: March 12th, 2022
AMANDA PARLATOFAMILYActive
Start: March 12th, 2022
Rickey RobertsOTHERActive
Start: March 12th, 2022
Stephen NewtonCONSULTINGActive
Start: March 12th, 2022
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Date patient received Moderna COVID-19 vaccine?
Date patient received Anthrax vaccine?
Date patient received Rabies vaccine?
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RIGRAPID HEART BEAT
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Height65 [in_i]March 14th, 2022 1:48pm
Height165.1 cmMarch 14th, 2022 1:48pm
Weight150.00 [lb_av]March 14th, 2022 1:48pm
Weight68.039 kgMarch 14th, 2022 1:48pm
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Anthrax

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Medication NameStart DateInstructions
Dapsone (Topical) - RXCUI C1741905 (DAPSONE7.5 %) 7.5 % GEL OINTMENTMarch 24th, 2022 9:38am
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"request": {"method": "PUT", "url": "Immunization/cbe1a949-774b-cb06-580b-a895f676d118"}}, {"fullUrl": "urn:uuid:81335318-8424-a5e6-822b-3f53ce03b63f", "resource": {"resourceType": "Organization", "id": "81335318-8424-a5e6-822b-3f53ce03b63f", "meta": {"source": ["ecr"]}}, "request": {"method": "PUT", "url": "Organization/81335318-8424-a5e6-822b-3f53ce03b63f"}}, {"fullUrl": "urn:uuid:3916538e-3ada-2731-6b75-d6951498a58e", "resource": {"resourceType": "Immunization", "id": "3916538e-3ada-2731-6b75-d6951498a58e", "identifier": [{"system": "urn:ietf:rfc:3986", "value": "urn:uuid:f388d4f7-a451-11ec-81e0-9e7eef92c510"}], "occurrenceString": "Unknown", "note": {"text": "Date patient received Anthrax vaccine?"}, "vaccineCode": {"coding": [{"display": "Date patient received Anthrax vaccine?"}]}, "manufacturer": {"reference": "Organization/81335318-8424-a5e6-822b-3f53ce03b63f"}, "status": "completed", "primarySource": true, "meta": {"source": ["ecr"]}}, "request": {"method": "PUT", "url": 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NameAdministration DatesNext Due
DTaP, 5 pertussis antigens vaccine (DAPTACEL)06/15/2021
Hep B, adult vaccine (Engerix/Recombivax)09/08/2020
SARS-COV-2 (COVID-19) Spikevax Vaccine, Moderna01/22/2021
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Pending Results
NameTypePriorityAssociated DiagnosesDate/Time
PCR SARS-CoV-2 and Influenza A/BLabRoutine07/27/2022 3:49 PM CDT
PCR SARS-CoV-2 and Influenza A/BLabRoutine07/27/2022 3:49 PM CDT
PCR SARS-CoV-2 and Influenza A/BLabRoutine07/27/2022 3:49 PM CDT
PCR SARS-CoV-2 and Influenza A/BLabRoutine07/27/2022 3:49 PM CDT
PCR SARS-CoV-2 and Influenza A/BLabRoutine07/27/2022 3:49 PM CDT
Scheduled Orders
NameTypePriorityAssociated DiagnosesOrder Schedule
PCR Hepatitis C Virus QtLabRoutineOrdered: 5/12/22
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Active ProblemsNoted Date
COVID toes7/13/22
Chest pain on breathing5/26/22
Type 1 diabetes2/28/22
Overview:Formatting of this note might be different from the original.
08/30/21 28.69 kg/m\u00b2BMI Readings from Last 1 Encounters:
Plague pneumonia6/16/21
Absence of menstruation6/12/18
Foot callus8/11/17
Overview:Formatting of this note might be different from the original.
Ouch.
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Tobacco UseTypesPacks/DayYears UsedDate
Smoking Tobacco: Never Assessed
Sex Assigned at BirthDate Recorded
Not on file
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DateTypeDepartmentCare TeamDescription
2/18/22Transcribe OrdersVanderbilt University Adult Hospital1211 Medical Center DrNashville, TN 37232615-322-5000Tech, Lab, MLT
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Reportability Response Information Section
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Request#:CG-22-0000003
Service date:3/11/2022 13:05


FISH IMPRESSION:

Abnormal for homozygous deletion of CDKN2A locus at 9p21 in __% of cells.

FISH KARYOTYPE:



nuc ish (DXZ1x1,DYZ3x1,D18Z1x2)[200]

\u00a0
\u00a0
\u00a0



COMMENTS:



Results of the FISH studies with the 21 DNA probes described above were analyzed in at least 200 cells per probe and no abnormal signal patterns were detected for the target regions of chromosomes 1, 4, 7, 9, 10, 11, 12, 14, 17, 19, 21, and 22.

Normal cut off values for probes:

1.0% for t(1;19) PBX1/TCF3
1.0% for t(9;22) BCR/ABL1
1.0% for KMT2A (11q23)
1.0% for t(12;21) ETV6/RUNX1
1.0% for IKZF1/CEP7
3.0% for CEP 4
2.0% for CEP 10
2.0% for CEP 17
1.0% for CDKN2A/CEP9 (9p21)
1.0% for IGH breakapart
1.0% for ABL2 breakapart
1.0% for ABL1 breakapart

These probes were developed by Vysis and their performance characteristics determined by VUMC as required by the CLIA ''88 regulations. \u00a0These probes have not been cleared or approved by the U.S. Food and Drug administration.


Ferrin Courtney Wheeler, PhD, FACMG
reviewed and approved

Electronically signed out by:
Mavrak, Geoffrey A

on 03/11/2022

Clinical History: \u00a0ALL
Specimen List: Blood
Date In Lab: 3/11/2022 13:09
Date Collected: 3/11/2022 13:05

Testing performed at Vanderbilt Cytogenetics One Hundred Oaks Laboratory, Suite 21100, 719 Thompson Ln,
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VPLS clients: \u00a0 See separate report sent to client.", "note": [{"text": "This test was performed at: Quest Laboratory,Location Varies,,,,,,"}], "extension": [{"url": "http://hl7.org/fhir/R4/specimen.html", "extension": [{"url": "specimen source", "valueString": "Oral"}, {"url": "specimen collection time", "valueDateTime": "2022-03-29T18:53:00Z"}, {"url": "specimen receive time", "valueDateTime": "2022-03-29T19:07:00Z"}, {"url": "observation entry reference value", "valueString": "#Result.1.2.840.114350.1.13.478.3.7.2.798268.2061344.Comp1"}]}], "subject": {"reference": "Patient/80c929f9-ded7-422f-a40e-ff327878eaaf"}, "performer": [{"display": "VUMC CERNER LAB", "reference": "Organization/e3ece69c-0968-59c9-47dd-f16db731621a"}]}, "request": {"method": "PUT", "url": "Observation/6fc06f11-d0f4-9553-2798-e8dd822678fe"}}, {"fullUrl": "urn:uuid:db8797cb-3129-eff4-9d78-a04b2326f0a2", "resource": {"resourceType": "Observation", "id": "db8797cb-3129-eff4-9d78-a04b2326f0a2", "meta": {"profile": ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults"], "source": ["ecr"]}, "identifier": [{"system": "urn:oid:1.2.840.114350.1.13.478.3.7.2.798268", "value": "2061344"}], "category": [{"coding": [{"system": "http://terminology.hl7.org/CodeSystem/observation-category", "code": "laboratory"}]}], "status": "final", "effectiveDateTime": "2022-03-29T20:10:54Z", "valueCodeableConcept": {"coding": [{"code": "16", "system": "urn:oid:1.2.840.114350.1.72.1.5007"}]}, "extension": [{"url": "http://hl7.org/fhir/R4/specimen.html", "extension": [{"url": "specimen source", "valueString": "Oral"}, {"url": "specimen collection time", "valueDateTime": "2022-03-29T18:53:00Z"}, {"url": "specimen receive time", "valueDateTime": "2022-03-29T19:07:00Z"}]}], "subject": {"reference": "Patient/80c929f9-ded7-422f-a40e-ff327878eaaf"}}, "request": {"method": "PUT", "url": "Observation/db8797cb-3129-eff4-9d78-a04b2326f0a2"}}, {"fullUrl": "urn:uuid:c86958f4-4bd2-7450-15ff-4c490820f58f", "resource": {"resourceType": "DiagnosticReport", "id": "c86958f4-4bd2-7450-15ff-4c490820f58f", "identifier": [{"system": "urn:oid:1.2.840.114350.1.13.478.3.7.2.798268", "value": "2061345"}], "status": "final", "code": {"coding": [{"code": "201700", "display": "Pharmacogenomics", "system": "urn:oid:1.2.840.114350.1.13.478.3.7.2.696580"}]}, "effectivePeriod": {"start": "2022-03-31T22:36:00Z", "end": "2022-03-31T22:36:00Z"}, "subject": {"reference": "Patient/80c929f9-ded7-422f-a40e-ff327878eaaf"}, "performer": [{"reference": "Organization/22c6cdd0-bde1-e220-9ba4-2c2802f795ad"}], "result": [{"reference": "Observation/2e9477e8-412b-905c-270f-16ca12bff791"}, {"reference": "Observation/ed66ccf7-584a-1142-b9a4-8fe01b6f21fb"}], "meta": {"source": ["ecr"]}}, "request": {"method": "PUT", "url": "DiagnosticReport/c86958f4-4bd2-7450-15ff-4c490820f58f"}}, {"fullUrl": "urn:uuid:2e9477e8-412b-905c-270f-16ca12bff791", "resource": {"resourceType": "Observation", "id": "2e9477e8-412b-905c-270f-16ca12bff791", "meta": {"profile": ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults"], "source": ["ecr"]}, "identifier": [{"system": "urn:oid:1.2.840.114350.1.13.478.3.7.7.798268.1000", "value": "2061345"}], "category": [{"coding": [{"system": "http://terminology.hl7.org/CodeSystem/observation-category", "code": "laboratory"}]}], "status": "final", "code": {"coding": [{"code": "NAR", "system": "urn:oid:1.2.840.114350.1.72.1.5220"}]}, "effectiveDateTime": "2022-03-31T22:51:17Z", "valueString": "Pharmacogenomics: Final Report

Request #: MD-22-0000041

Service Date: 3/31/2022 17:36

Reason for Request: Genotyping for Determination of Drug Efficacy, Dosage and Safety

Type of Specimen: DNA

Date Received: 3/31/2022 17:44

Date Reported: 3/31/2022 17:51

Interpretation:
Results from this assay may indicate dosage adjustments or medication alternatives that should be considered for this patient. Additional information regarding the implications of these results is available at www.mydruggenome.org.

For VUMC patients, clinical decision support regarding the management of this patient with respect to specific drugs based upon the patient''s genotype as listed below is available in the patient''s electronic medical record under Genomic Indicators. Clinical decision support may also be provided for some drugs through order entry and medication prescribing tools utilized within the VUMC system.



Comments:

Results:

CYP2C19 - \u00a0Cancelled

CYP2C9 - \u00a0 Cancelled

CYP2D6 - \u00a0 Cancelled \u00a0

CYP3A5 - \u00a0 Cancelled

CYP4F2 - \u00a0 Cancelled

DPYD - \u00a0 \u00a0 Cancelled

NUDT15 - \u00a0 Cancelled

SLCO1B1 - \u00a0Cancelled \u00a0 \u00a0 \u00a0

TPMT - \u00a0 \u00a0 Cancelled

VKORC1 - \u00a0 Cancelled \u00a0 \u00a0
\u00a0
These results should be correlated with other laboratory and clinical findings and additional testing should be considered if clinically indicated.
\u00a0 \u00a0

Methodology:

DNA was extracted from this specimen and screened for 37 variants in 10 genes that are associated with drug absorption, distribution, metabolism, excretion or response. The reported genotypes were determined using PCR amplification and oligonucleotide primers specific for each interrogated region of the genes listed within this panel. Fluorophore labeled probes were used to identify each variant.

Variants analyzed in this assay include: CYP2C19 *2, *3, *4, *6, *8, *17; CYP2C9 *2, *3, *6, *8; CYP3A5 *3, *6, *7; CYP4F2 *3; DPYD *2A, *13, c.557A>G, c.1236G>A (HapB3), c.2846A>T; \u00a0NUDT15 *2 or *3; SLCO1B1 *5; TPMT *2, *3B, *3C, *4; VKORC1 promoter variant c.-1639G>A; and CYP2D6 copy number and variants *2, *2A, *3, *4, *6, *7, *9, *10, *17, *29 and *41. A *1 allele is considered the reference (normal) sequence and is reported if none of the variants analyzed for a particular gene is detected. This assay is specific for the variants listed above and cannot exclude the presence of other variants within these genes that may affect the pharmacologic function of the protein product encoded by these genes. In most cases, variants for a particular gene exist on separate alleles; however, for individuals in which multiple variants in the same gene are detected, this assay cannot determine if the variants are on the same allele or on different alleles. Further, due to the highly polymorphic
nature of these regions, rare variants may exist that could affect the sensitivity or specificity of this assay and lead to a false-negative or a false-positive result.


Electronically signed out by:
Barba, Elizabeth

on 03/31/2022

This assay has not been cleared or approved by the US Food and Drug Administration. The performance of this assay was tested and validated prior to use for patient testing. This test is used for clinical purposes and should not be regarded as investigational or research. This laboratory is regulated by the Clinical Laboratory Improvement Act of 1988.", "extension": [{"url": "http://hl7.org/fhir/R4/specimen.html", "extension": [{"url": "specimen source", "valueString": "DNA"}, {"url": "specimen collection time", "valueDateTime": "2022-03-31T22:36:00Z"}, {"url": "specimen receive time", "valueDateTime": "2022-03-31T22:44:00Z"}, {"url": "observation entry reference value", "valueString": "#Result.1.2.840.114350.1.13.478.3.7.2.798268.2061345.Narrative"}]}], "subject": {"reference": "Patient/80c929f9-ded7-422f-a40e-ff327878eaaf"}, "performer": [{"display": "VUMC CERNER LAB", "reference": "Organization/e3ece69c-0968-59c9-47dd-f16db731621a"}]}, "request": {"method": "PUT", "url": "Observation/2e9477e8-412b-905c-270f-16ca12bff791"}}, {"fullUrl": "urn:uuid:ed66ccf7-584a-1142-b9a4-8fe01b6f21fb", "resource": {"resourceType": "Observation", "id": "ed66ccf7-584a-1142-b9a4-8fe01b6f21fb", "meta": {"profile": ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults"], "source": ["ecr"]}, "identifier": [{"system": "urn:oid:1.2.840.114350.1.13.478.3.7.2.798268", "value": "2061345"}], "category": [{"coding": [{"system": "http://terminology.hl7.org/CodeSystem/observation-category", "code": "laboratory"}]}], "status": "final", "effectiveDateTime": "2022-03-31T22:51:17Z", "valueCodeableConcept": {"coding": [{"code": "16", "system": "urn:oid:1.2.840.114350.1.72.1.5007"}]}, "extension": [{"url": "http://hl7.org/fhir/R4/specimen.html", "extension": [{"url": "specimen source", "valueString": "DNA"}, {"url": "specimen collection time", "valueDateTime": "2022-03-31T22:36:00Z"}, {"url": "specimen receive time", "valueDateTime": "2022-03-31T22:44:00Z"}]}], "subject": {"reference": "Patient/80c929f9-ded7-422f-a40e-ff327878eaaf"}}, "request": {"method": "PUT", "url": "Observation/ed66ccf7-584a-1142-b9a4-8fe01b6f21fb"}}, {"fullUrl": "urn:uuid:b0f590a6-4bf5-7add-9716-2bd3ba6defb2", "resource": {"resourceType": "DiagnosticReport", "id": "b0f590a6-4bf5-7add-9716-2bd3ba6defb2", "identifier": [{"system": "urn:oid:1.2.840.114350.1.13.478.3.7.2.798268", "value": "2061347"}], "status": "final", "code": {"coding": [{"code": "118330", "display": "Cytogenomic SNP microarray", "system": "urn:oid:1.2.840.114350.1.13.478.3.7.2.696580"}]}, "effectivePeriod": {"start": "2022-04-04T16:55:00Z", "end": "2022-04-04T16:55:00Z"}, "subject": {"reference": "Patient/80c929f9-ded7-422f-a40e-ff327878eaaf"}, "performer": [{"reference": "Organization/22c6cdd0-bde1-e220-9ba4-2c2802f795ad"}], "result": [{"reference": "Observation/2a4f8fb5-f957-3c30-1353-a30aa441a12b"}, {"reference": "Observation/2e70be1d-fa6c-0256-cf67-f695f5bba1ac"}, {"reference": "Observation/97b316f7-bb96-051f-adba-72ddc4ae5825"}], "meta": {"source": ["ecr"]}}, "request": {"method": "PUT", "url": "DiagnosticReport/b0f590a6-4bf5-7add-9716-2bd3ba6defb2"}}, {"fullUrl": "urn:uuid:2a4f8fb5-f957-3c30-1353-a30aa441a12b", "resource": {"resourceType": "Observation", "id": "2a4f8fb5-f957-3c30-1353-a30aa441a12b", "meta": {"profile": ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults"], "source": ["ecr"]}, "identifier": [{"system": "urn:oid:1.2.840.114350.1.13.478.3.7.7.798268.1000", "value": "2061347"}], "category": [{"coding": [{"system": "http://terminology.hl7.org/CodeSystem/observation-category", "code": "laboratory"}]}], "status": "final", "code": {"coding": [{"code": "NAR", "system": "urn:oid:1.2.840.114350.1.72.1.5220"}]}, "effectiveDateTime": "2022-04-18T19:57:02Z", "valueString": "MICROARRAY REPORT- Corrected

Request#: CG-22-0000006
Service date: 4/4/2022 11:55

Microarray Result:
Normal female

Microarray Interpretation:
SNP chromosomal microarray analysis (CMA) of a blood sample from this patient demonstrated no copy number changes of known clinical significance. No large regions of homozygosity (ROH) were detected. The ISCN nomenclature describing this result is: arr(X,1-22)x2.
Electronically signed out by:
Benfield, Luis A

on 04/18/2022
___________________________________________________________________

Clinical indication:
Specimen List: Blood
Date in Lab: 4/18/2022 14:46
Date Collected: 4/4/2022 11:55
___________________________________________________________________

Disclaimer:

Copy number gains less than 400 kb in size and copy number losses less than 200 kb in size will not be reported unless they represent a known or suspected clinically relevant imbalance. The reporting of copy number variants less than 100 kb in size is at the discretion of the laboratory and some clinically relevant copy number changes under 50 kb may not be reported due to limitations in probe coverage in certain genomic regions. Copy number changes of any size with no apparent clinical significance (likely benign or benign) have not been discussed in this report but may be available upon request. Regions of homozygosity (ROH) less than 10 Mb in size will not be reported unless the ROH is clinically relevant for potential uniparental disomy. Genome-wide ROH under 2% will not be reported. Copy number variants less than 200 kb associated with a carrier status for autosomal recessive conditions will not be reported unless specifically indicated in the reason for referral.

This microarray was designed and manufactured by Affymetrix for the sole purpose of identifying DNA copy number gains and losses associated with chromosomal imbalances and regions of homozygosity (ROH) associated with uniparental isodisomy (isoUPD).This microarray will detect aneuploidy, deletions and duplications of loci represented on the microarray. \u00a0It will not detect balanced alterations including: reciprocal translocations, inversions and balanced insertions. It will not detect point mutations and imbalances less than 10 kb. \u00a0Failure to detect an alteration at any locus does not exclude the diagnosis of any of the disorders represented on the microarray. This assay is not designed to detect mosaic gains and losses and its performance in detecting mosaicism has not been established. This test was developed and its performance characteristics determined by Affymetrix as required by CLIA \u00c2\u201988 regulations. This test is used for clinical purposes and the accuracy and precision has
been established and verified by this laboratory. This test has not been cleared or approved by the U.S. Food and Drug Administration.

Interpretation of copy number variants is performed using VUMC-laboratory maintained databases as well as the following resources:
Database of Genomic Variants (http://dgv.tcag.ca/dgv/app/home)
Online Mendelian Inheritance in Man (http://www.omim.org/)
UCSC Genome Bioinformatics (http://genome.ucsc.edu/cgi-bin/hgGateway)
ClinGen Clinical Genome Resource (http://www.ncbi.nlm.nih.gov/projects/dbvar/clingen)
DECIPHER Database (https://decipher.sanger.ac.uk/browser)
PubMed-NCBI (http://www.ncbi.nlm.nih.gov/pubmed)
Technical standards for the interpretation and reporting of constitutional copy-number variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics (ACMG) and the Clinical Genome Resource (ClinGen). PMID: 31690835

Method:
Microarray platform: ThermoFisher Scientific CytoScanTM HD Cytogenetics Solution
Version: 1.1 (Based on UCSC hg19 assembly)
Number of loci analyzed: 2,696,550
Mean probe spacing: <700 bp






Testing performed at Vanderbilt Cytogenetics One Hundred Oaks Laboratory, Suite 21100, 719 Thompson Ln,
Nashville, TN 37204 \u00a0phone 615-875-0228, fax 615-875-0234", "extension": [{"url": "http://hl7.org/fhir/R4/specimen.html", "extension": [{"url": "specimen source", "valueString": "Blood"}, {"url": "specimen collection time", "valueDateTime": "2022-04-04T16:55:00Z"}, {"url": "specimen receive time", "valueDateTime": "2022-04-18T19:46:00Z"}, {"url": "observation entry reference value", "valueString": "#Result.1.2.840.114350.1.13.478.3.7.2.798268.2061347.Narrative"}]}], "subject": {"reference": "Patient/80c929f9-ded7-422f-a40e-ff327878eaaf"}, "performer": [{"display": "VUMC CERNER LAB", "reference": "Organization/e3ece69c-0968-59c9-47dd-f16db731621a"}]}, "request": {"method": "PUT", "url": "Observation/2a4f8fb5-f957-3c30-1353-a30aa441a12b"}}, {"fullUrl": "urn:uuid:2e70be1d-fa6c-0256-cf67-f695f5bba1ac", "resource": {"resourceType": "Observation", "id": "2e70be1d-fa6c-0256-cf67-f695f5bba1ac", "meta": {"profile": 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Equivocal: Antibodies to HCV may or may not be present; repeat serologic testing in approximately 8 weeks or nucleic acid testing is recommended to assess possible infection. 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ProblemNoted Date
Malignant neoplasm of lower-inner quadrant of left breast in female, estrogen receptor positive12/14/22
Headache8/19/22
Backache8/19/22
Malignant neoplasm of urinary bladder neck11/5/21
Malignant neoplasm of overlapping sites of pancreas9/18/17
Cancer Staging:Stage IIB Stage III
(pT1, pN2, cM0) - Signed by Ocmd Phsbeacon, MD on 9/30/2022Pathologic: (cT1, cN1, cM0) - Signed by Ocmd Phsbeacon, MD on 1/13/2022Clinical stage from 1/13/2022:
Bilateral malignant neoplasm of lower outer quadrant of breast in female2/27/17
Cancer Staging:Stage IIA Stage IV
(rpT2, pN1a(f), pM1, G3, ER: Negative, PR: Negative, HER2: Negative) - Signed by Ocmd Phsbeacon, MD on 1/10/2018Pathologic stage from 12/10/2017: (T1, N1, M0) - Signed by Ocmd Phsbeacon, MD on 2/27/2017Clinical stage from 2/27/2017:
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"http://terminology.hl7.org/CodeSystem/observation-category", "code": "social-history"}]}], "status": "final", "code": {"coding": [{"code": "11341-5", "display": "History of Occupation", "system": "http://loinc.org"}]}, "effectivePeriod": {"start": "2017-12-16"}, "valueCodeableConcept": {"coding": [{"code": "3600", "display": "Nursing, psychiatric, and home health aides", "system": "urn:oid:2.16.840.1.113883.6.240"}]}, "component": [{"code": {"coding": [{"code": "74159-5", "display": "Work Schedule", "system": "http://loinc.org"}]}, "valueCodeableConcept": {"coding": [{"code": "NS", "display": "Night Shift", "system": "urn:oid:2.16.840.1.113883.5.1063"}]}}, {"code": {"coding": [{"code": "63761-1", "display": "What were your main activities or duties for this job", "system": "http://loinc.org"}]}, "valueString": "Patient care"}, {"code": {"coding": [{"code": "87729-0", "display": "History of Occupational Hazard", "system": "http://loinc.org"}]}, "valueString": "Infectious Disease"}, {"code": {"coding": [{"code": "87707-6", "display": "Job supervisory level or pay grade", "system": "http://loinc.org"}]}, "valueCodeableConcept": {"coding": [{"code": "C-6", "display": "C6 - Manager", "system": "urn:oid:2.16.840.1.114222.4.5.327"}]}}, {"code": {"coding": [{"code": "86188-0", "display": "History of Occupation Industry", "system": "http://loinc.org"}]}, "valueCodeableConcept": {"coding": [{"code": "8270", "display": "Nursing care facilities", "system": "http://snomed.info/sct"}]}}, {"code": {"coding": [{"code": "85104-8", "display": "Compensation and Sector Employment Type", "system": "http://loinc.org"}]}, "valueCodeableConcept": {"coding": [{"code": "PWNSE", "display": "Paid non-governmental work, not self-employed", "system": "urn:oid:2.16.840.1.113883.5.1139"}]}}], "subject": {"reference": "Patient/e50b75a5-9643-4b2e-84be-79aaee0f4ff3"}}, "request": {"method": "PUT", "url": "Observation/965db622-e821-a004-71b9-f6959814516f"}}, {"fullUrl": "urn:uuid:51487854-3257-0685-a4cf-f191347b317e", "resource": {"resourceType": "Observation", "id": "51487854-3257-0685-a4cf-f191347b317e", "meta": {"profile": ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults"], "source": ["ecr"]}, "identifier": [{"system": "urn:ietf:rfc:3986", "value": "urn:uuid:7916c040-f9a4-447d-95e7-3e4877582959"}], "category": [{"coding": [{"system": "http://terminology.hl7.org/CodeSystem/observation-category", "code": "social-history"}]}], "status": "final", "code": {"coding": [{"code": "87510-4", "display": "Date of Retirement", "system": "http://loinc.org"}]}, "valueQuantity": {"value": 20171216}, "subject": {"reference": "Patient/e50b75a5-9643-4b2e-84be-79aaee0f4ff3"}}, "request": {"method": "PUT", "url": "Observation/51487854-3257-0685-a4cf-f191347b317e"}}, {"fullUrl": "urn:uuid:", "resource": {"resourceType": "Observation", "meta": {"profile": ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults"], "source": ["ecr"]}}, "request": {"method": "PUT", "url": "Observation/"}}]}') ON CONFLICT (ecr_id) DO NOTHING; -INSERT INTO fhir (ecr_id, data) VALUES ('df33f075-83a1-4d28-ba63-05bcc3339c21', '{"resourceType": "Bundle", "type": "batch", "entry": [{"fullUrl": "urn:uuid:df33f075-83a1-4d28-ba63-05bcc3339c21", "resource": {"resourceType": "Composition", "id": "df33f075-83a1-4d28-ba63-05bcc3339c21", "meta": {"profile": ["http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-composition"], "source": ["ecr"]}, "identifier": [{"use": "official", "type": {"coding": [{"code": "55751-2", "display": "Initial Public Health Case Report", "system": "http://loinc.org"}]}, "value": "34682681|64851396"}], "extension": [{"url": "http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber", "valueString": "2"}], "status": "final", "type": {"coding": [{"code": "55751-2", "display": "Initial Public Health Case Report", "system": "http://loinc.org"}]}, "date": "2022-04-15T05:24:59Z", "title": "Initial Public Health Case Report", "confidentiality": "N", "section": [{"id": "3e5d0a34-2c60-8934-a031-bf45982d4640", "title": "PROBLEMS - DIAGNOSES", "text": {"status": "generated", "div": "
Problem or DiagnosisProblem Status
Closed injury of head (disorder)Active
COVID-19Active
Hypertensive disorder, systemic arterial (disorder)Active
Neoplasm of pituitary gland (disorder)Active
Cerebrovascular accident (disorder)Active
Low back strainActive
Motor vehicle crash, injuryActive
Chronic male pelvic painActive
Strain of neckActive
Cervicogenic headacheActive
"}, "code": {"coding": [{"code": "11450-4", "display": "PROBLEM LIST", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"display": "Problem - Closed injury of head (disorder)", "reference": "Condition/47c4eafe-d230-03e3-a449-f3d4e8a570bb"}, {"display": "Problem - Disease caused by 2019-nCoV", "reference": "Condition/7bcd701e-5d28-f178-a33f-64aa74239d54"}, {"reference": "Condition/bc63883a-ebd9-370f-0d9f-ad35c8fe7f52"}, {"display": "Problem - Hypertensive disorder, systemic arterial (disorder)", "reference": "Condition/07559a5f-52d6-186f-25fd-123dd7950656"}, {"display": "Problem - Neoplasm of pituitary gland (disorder)", "reference": "Condition/063ada0c-960f-8557-e828-76ea3ed99aba"}, {"display": "Problem - Cerebrovascular accident (disorder)", "reference": "Condition/2b0e32d9-1c75-b38e-c628-165e8fb18782"}, {"display": "Problem - Low back strain (disorder)", "reference": "Condition/eef12569-0e57-b962-463d-8c74f3f211eb"}, {"display": "Problem - Motor vehicle injury (disorder)", "reference": "Condition/8fabb65c-a7bc-d78a-ee66-87bc0f6f8f23"}, {"display": "Problem - Chronic pain in male pelvis (finding)", "reference": "Condition/65565a5f-5d97-9656-fc4f-c3fac1b55e3d"}, {"display": "Problem - Strain of neck muscle (disorder)", "reference": "Condition/2c4295cc-bde8-63b2-7f48-081683140235"}, {"display": "Problem - Cervicogenic headache (finding)", "reference": "Condition/6e0fec6b-8384-ad29-0f00-a6c9e11d0a29"}]}, {"id": "c559c907-9f5c-028a-07d7-1fd82fc505e8", "title": "ENCOUNTERS", "text": {"status": "generated", "div": "
Encounter ReasonDate of Encounter
observation encounter20220413083600+0000
"}, "code": {"coding": [{"code": "46240-8", "display": "History of Encounters", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "a7c180db-0fa9-6f2b-4d30-bc7884e7e212", "title": "RESULTS", "text": {"status": "generated", "div": "
Lab Test NameLab Test Result ValueLab Test Result Date
Chol/HDL RiskUnknown
Phosphorus4.1|http://unitsofmeasure.org|mg/dL
VLDL Chol Calc34.00|http://unitsofmeasure.org|mg/dL
LDL Direct81|http://unitsofmeasure.org|mg/dL
Trig168|http://unitsofmeasure.org|mg/dL
PTT31|http://unitsofmeasure.org|Seconds
PT10.6|http://unitsofmeasure.org|Seconds
Mg Lvl1.9|http://unitsofmeasure.org|mg/dL
HDL36|http://unitsofmeasure.org|mg/dL
Cholesterol129|http://unitsofmeasure.org|mg/dL
INRUnknown
Estimated Creatinine Clearance104.42|http://unitsofmeasure.org|mL/min
eGFR PediatricNot Reported
Calc Osmo277|http://unitsofmeasure.org|mOsmol/kg
A/G RatioUnknown
eGFR Non-African American88|http://unitsofmeasure.org|mL/min/1.73m2
eGFR African American102|http://unitsofmeasure.org|mL/min/1.73m2
NRBC #0.02|http://unitsofmeasure.org|x10e3/mcL
Sodium137|http://unitsofmeasure.org|mmol/L
Potassium4.1|http://unitsofmeasure.org|mmol/L
Baso # Auto0.05|http://unitsofmeasure.org|x10e3/mcL
Albumin. Level3.6|http://unitsofmeasure.org|gm/dL
Mono # Auto1.15|http://unitsofmeasure.org|x10e3/mcL
Neut # Auto7.67|http://unitsofmeasure.org|x10e3/mcL
Baso % Auto0.4|http://unitsofmeasure.org|%
Eos % Auto0.8|http://unitsofmeasure.org|%
Lymph % Auto34.1|http://unitsofmeasure.org|%
Neut % Auto56.1|http://unitsofmeasure.org|%
Calcium9.6|http://unitsofmeasure.org|mg/dL
RDW-SD45.6|http://unitsofmeasure.org|Femtoliters
Immature Grans # Auto0.03|http://unitsofmeasure.org|x10e3/mcL
Lymph # Auto4.67|http://unitsofmeasure.org|x10e3/mcL
Mono % Auto8.4|http://unitsofmeasure.org|%
RDW-CV17.5|http://unitsofmeasure.org|%
Immature Grans %0.2|http://unitsofmeasure.org|%
Eos # Auto0.11|http://unitsofmeasure.org|x10e3/mcL
Chloride105|http://unitsofmeasure.org|mmol/L
BUN23|http://unitsofmeasure.org|mg/dL
Plt315|http://unitsofmeasure.org|x10e3/mcL
WBC13.68|http://unitsofmeasure.org|x10e3/mcL
TP7.5|http://unitsofmeasure.org|gm/dL
RBC5.41|http://unitsofmeasure.org|x10e6/mcL
PTT30|http://unitsofmeasure.org|Seconds
PT10.8|http://unitsofmeasure.org|Seconds
MPV8.3|http://unitsofmeasure.org|Femtoliters
MCV72.3|http://unitsofmeasure.org|Femtoliters
MCHC30.4|http://unitsofmeasure.org|gm/dL
MCH22.0|http://unitsofmeasure.org|pg
Hgb11.9|http://unitsofmeasure.org|gm/dL
Hct39.1|http://unitsofmeasure.org|%
Glucose Level95|http://unitsofmeasure.org|mg/dL
CO229|http://unitsofmeasure.org|mmol/L
T Bili0.2|http://unitsofmeasure.org|mg/dL
AST20|http://unitsofmeasure.org|units/L
ALT26|http://unitsofmeasure.org|units/L
Alk Phos74|http://unitsofmeasure.org|units/L
NRBC %0.1|http://unitsofmeasure.org|/100 WBC
BUN/Creat RatioUnknown
INRUnknown
Anion Gap3|http://unitsofmeasure.org|mmol/L
Creatinine1.010|http://unitsofmeasure.org|mg/dL
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Medication NameMedication Start Date
docusate (Colace)20220413132200+0000
acetaminophen (Tylenol)20220413132200+0000
hydrocodone-acetaminophen (Norco 5 mg-325 mg oral tablet)20220413132200+0000
ipratropium-albuterol (DuoNeb)20220413132200+0000
hydrALAZINE20220413132200+0000
labetalol20220413132200+0000
levETIRAcetam (Keppra)Unknown
meclizine20220413113800+0000
melatonin (melatonin 3 mg oral tablet)20220413132200+0000
morphine20220413132200+0000
ondansetron (Zofran)20220413132200+0000
simethicone (Mylicon)20220413132200+0000
heparin20220413170000+0000
famotidine (Pepcid)Unknown
Sodium Chloride 0.9% intravenous solution 1,000 mL20220413110600+0000
acetaminophen (Tylenol)20220413110600+0000
heparin20220413130000+0000
morphine20220413113700+0000
ondansetron (Zofran)20220413110600+0000
morphine20220413105900+0000
prochlorperazine (Compazine)20220413120000+0000
diphenhydrAMINE (Benadryl)20220413105900+0000
ketorolac (Toradol)20220413105900+0000
"}, "code": {"coding": [{"code": "29549-3", "display": "Medications Administered", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"reference": "MedicationAdministration/d79bfe31-f85f-4d2a-5eb9-6183842bd415"}, {"reference": "MedicationAdministration/a76d84ff-d244-13ff-54a1-b7da3861df8b"}, {"reference": "MedicationAdministration/978dd261-ced7-606c-94cb-d9a9ee079d69"}, {"reference": "MedicationAdministration/f8736fd2-4ec9-f119-f83d-dc5f902fbb39"}, {"reference": "MedicationAdministration/3fc944e1-612d-f09a-607a-2dcfdc31e067"}, {"reference": "MedicationAdministration/8a9c0b16-62f6-b3df-44ac-a4e3a3568025"}, {"reference": "MedicationAdministration/68ced031-e2b8-bb07-96df-263c4f62ee78"}, {"reference": "MedicationAdministration/09fe790a-08bb-15b5-ad51-b986c592c815"}, {"reference": "MedicationAdministration/680b158c-a138-eb05-a948-fc1b7a48fc95"}, {"reference": "MedicationAdministration/41947ef8-4fd7-3717-ccd7-59a5ed151bdb"}, {"reference": "MedicationAdministration/0af4fb75-7649-8b1e-3ac2-4ccf6ca8ddb5"}, {"reference": "MedicationAdministration/9256df52-4aae-21c8-0bdd-fd30f3d226ba"}, {"reference": "MedicationAdministration/0ef906a6-598a-f208-701f-407d7a89c539"}, {"reference": "MedicationAdministration/7ebdc457-3f17-7cfb-4976-fd2b2a353b39"}, {"reference": "MedicationAdministration/72f91cdf-07a2-b899-22b5-e838620e987b"}, {"reference": "MedicationAdministration/d0528813-3060-32f0-ef54-0cdd807e6b9c"}, {"reference": "MedicationAdministration/47489478-127e-2205-3016-77f4c552cb12"}, {"reference": "MedicationAdministration/b4b560b3-a232-865d-3dca-daac79ba0d40"}, {"reference": "MedicationAdministration/eec8a692-2b39-d7e7-a0d8-0a120c2b810b"}, {"reference": "MedicationAdministration/87241dd2-4d29-3445-74e9-361a3b263dd2"}, {"reference": "MedicationAdministration/1230d359-3d2b-b52a-3984-7a7dd860b2f0"}, {"reference": "MedicationAdministration/47a56c19-9de2-94ca-14c8-245c0f5bfa1e"}, {"reference": "MedicationAdministration/c6238475-81cb-a9ed-1535-aa716292a7d7"}]}, {"id": "dd08df91-869b-46df-dd36-c5c0f2ad2eae", "title": "IMMUNIZATIONS", "text": {"status": "generated", "div": "No ImmunizationInformation"}, "code": {"coding": [{"code": "11369-6", "display": "History of immunizations", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "c74504df-1bdc-137f-3790-44f6cea7fa89", "title": "SOCIAL HISTORY", "text": {"status": "generated", "div": "
Social History ObservationSocial History Observation Result
Birth SexM
Travel HistoryPregnancy Status-Not applicable (qualifier value)
Travel HistoryCOVID-19 Previously tested-No (qualifier value)
Travel HistoryTB Risk Score-
Travel HistorySymptoms of TB-No symptoms of TB
Travel HistoryHistory of tuberculosis (situation)-No known history of exposure to TB
Travel HistoryC.diff Screening-No (qualifier value)
Travel HistoryMRSA Screen Hx MRSA-No (qualifier value)
Travel HistoryRecent Exposure to Communicable Disease-No (qualifier value)
Travel HistoryPregnancy Status-Not applicable (qualifier value)
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Smokes tobacco daily (finding)March 25th, 2021 4:57pm
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Full body hivesResolved
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DTaPJanuary 31st, 2019232323232
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Hepatitis B, Recombinant- EngerixFebruary 8th, 20196
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Hib, PRP-T ConjugateFebruary 8th, 20193546544
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Pneumococcal Conjugate Vaccine, 13 valentJanuary 31st, 20194564654
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Prevnar 13February 8th, 201964654654
RotaTeqFebruary 8th, 201953465464
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Height67.00 [in_i]January 29th, 2019 1:14pm
Weight160.00 [lb_av]January 29th, 2019 1:14pm
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Departed ClinicalMEDITECH General Hospital-Day Hospital - MTGHJanuary 29th, 2019 1:09pmJanuary 29th, 2019 1:10pmAnthony Brown
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Arterial Blood GlucoseJanuary 25th, 2021 9:39amMarch 14th, 2021 5:08pm
AmmoniaJanuary 25th, 2021 9:39amJanuary 25th, 2021 9:38am
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"primarySource": true, "patient": {"reference": "Patient/b4bb6e48-6f2d-49da-ace5-d45d49c7bb29"}, "meta": {"source": ["ecr"]}}, "request": {"method": "PUT", "url": "Immunization/b3125f05-6d79-ef56-7374-88b6e9e29d2e"}}, {"fullUrl": "urn:uuid:cde7445e-8a4b-239a-bf9c-25dbd5e5543b", "resource": {"resourceType": "Immunization", "id": "cde7445e-8a4b-239a-bf9c-25dbd5e5543b", "identifier": [{"system": "urn:ietf:rfc:3986", "value": "urn:uuid:f0047bd9-0817-47ad-0ba8-cee34a47086e"}], "occurrenceDateTime": "2019-02-08", "note": {"text": "Pentacel"}, "vaccineCode": {"coding": [{"code": "110", "display": "Pentacel", "system": "urn:oid:2.16.840.1.113883.12.292"}]}, "lotNumber": "32131324313", "manufacturer": {"reference": "Organization/81335318-8424-a5e6-822b-3f53ce03b63f"}, "status": "completed", "primarySource": true, "patient": {"reference": "Patient/b4bb6e48-6f2d-49da-ace5-d45d49c7bb29"}, "meta": {"source": ["ecr"]}}, "request": {"method": "PUT", "url": "Immunization/cde7445e-8a4b-239a-bf9c-25dbd5e5543b"}}, {"fullUrl": "urn:uuid:f1ed7d55-28df-4e16-4ee3-9bab48b0ba7c", "resource": {"resourceType": "Immunization", "id": "f1ed7d55-28df-4e16-4ee3-9bab48b0ba7c", "identifier": [{"system": "urn:ietf:rfc:3986", "value": "urn:uuid:a7a9942e-70a9-4530-869d-ebfe78e92c27"}], "occurrenceDateTime": "2019-02-08", "note": {"text": "Pentacel"}, "vaccineCode": {"coding": [{"code": "110", "display": "Pentacel", "system": "urn:oid:2.16.840.1.113883.12.292"}]}, "lotNumber": "35454364", "manufacturer": {"reference": "Organization/81335318-8424-a5e6-822b-3f53ce03b63f"}, "status": "completed", "primarySource": true, "patient": {"reference": "Patient/b4bb6e48-6f2d-49da-ace5-d45d49c7bb29"}, "meta": {"source": ["ecr"]}}, "request": {"method": "PUT", "url": "Immunization/f1ed7d55-28df-4e16-4ee3-9bab48b0ba7c"}}, {"fullUrl": "urn:uuid:4cb2dcdf-3470-94a0-6941-68f3acbc2dfc", "resource": {"resourceType": "Immunization", "id": "4cb2dcdf-3470-94a0-6941-68f3acbc2dfc", 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Problem or DiagnosisProblem Status
UnknownActive
"}, "code": {"coding": [{"code": "11450-4", "display": "PROBLEM LIST", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"reference": "Condition/f6192ee0-0f5e-de9c-e1f5-b3733e98f39b"}]}, {"id": "7660061e-2891-3532-b8db-63fca133bca6", "title": "ENCOUNTERS", "text": {"status": "generated", "div": "
Encounter ReasonDate of Encounter
Emergency20220513072500+0000
"}, "code": {"coding": [{"code": "46240-8", "display": "History of Encounters", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "a7d62592-7456-6cc1-b9eb-ed2ffe81780a", "title": "RESULTS", "text": {"status": "generated", "div": "
Lab Test NameLab Test Result ValueLab Test Result Date
Ur MucousNONE /LPF
Ur Squam Epithelial1|http://unitsofmeasure.org|/HPF
Ur WBC1|http://unitsofmeasure.org|/HPF
Ur RBC2|http://unitsofmeasure.org|/HPF
Ur BacteriaNone Seen /HPF
Symptomatic as defined by CDC?No
In ICU?No
Group care resident?No
First test?UNK
Employed in healthcare?No
Date of onset?UNK
SARS-CoV-2 Interp:Unknown
SARS-CoV-2 PCRNegative
Flu B PCRNot Detected
Flu A PCRNot Detected
Ur pH6.0
Ur Spec Grav1.020 mg/dL
Ur Urobilinogen0.2 EU/dL
Ur BloodTrace-lysed
Ur BiliNegative
Ur Leuk EstNegative
Ur ProteinNegative mg/dL
Ur NitriteNegative
Ur KetonesNegative mg/dL
UR GlucoseNegative mg/dL
"}, "code": {"coding": [{"code": "30954-2", "display": "RESULTS", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"reference": "Observation/449f4d35-ede1-d54a-ee8b-85247ab0b6e6"}, {"reference": "Observation/6ae97d71-62a8-ebc2-fc80-b4a67e742ecb"}, {"reference": "Observation/69f90668-7f73-3170-bfb2-049587dfcd9e"}, {"reference": "Observation/378e9d76-db69-45bb-06df-d63f96e10619"}, {"reference": "Observation/a7b1cb64-7121-3dfe-8605-889d1ff3511d"}, {"reference": "Observation/81503091-497e-5d02-4115-a9b94e3f3c87"}, {"reference": "Observation/ac4992a1-cbfe-dfcf-5f6b-ca49aa06cddd"}, {"reference": "Observation/aeeb7e8a-7b73-55f7-148e-4fdfc078285b"}, {"reference": "Observation/3d8742ee-44b7-2bc3-1515-d1c4771e6fb2"}, {"reference": "Observation/c5c046e4-b0eb-3210-114c-7be495e24a3f"}, {"reference": "Observation/546deab4-bca2-d056-24e3-d5bcde20d975"}, {"reference": "Observation/2e39b82b-8663-164f-11a6-31fdbba093b7"}, {"reference": "Observation/ed81d103-56dc-f9b9-ccc6-315503cb75b8"}, {"reference": "Observation/b055bbba-9778-0f5d-1ed4-0415c127aeec"}, {"reference": "Observation/9f30a6e1-c3d8-bef3-df89-b7c64b9bada4"}, {"reference": "Observation/8347a4a4-68d7-c939-a39a-1c83ade11da9"}, {"reference": "Observation/247c7366-60be-2ba4-1667-dc4a2cffdcdf"}, {"reference": "Observation/5d87c713-c202-2486-c0c2-5d6d691af42f"}, {"reference": "Observation/a1993689-9c3a-6986-9d21-e7515972f8c2"}, {"reference": "Observation/0909ed94-9369-57cb-60a3-353c08947a8a"}, {"reference": "Observation/304a0b98-17f1-b855-6f0f-bb507f3045ad"}, {"reference": "Observation/b7f26954-ec35-0dbd-da80-48b380621693"}, {"reference": "Observation/83a07fb4-b3c1-118a-ac11-a3232785ac3b"}, {"reference": "Observation/f73f0c43-7283-9ace-b129-68555b0eef89"}, {"reference": "Observation/eb888a57-1652-152f-705c-6014061a43e0"}]}, {"id": "b4994b93-a4e6-b688-1327-a65a269c568d", "title": "Medications Administered", "text": {"status": "generated", "div": "
Medication NameMedication Start Date
acetaminophen (Tylenol Infant''s 160 mg/5 mL oral suspension)20220513094400+0000
ibuprofen (ibuprofen 100 mg/5 mL oral suspension)20220513094400+0000
azithromycin (azithromycin 200 mg/5 mL oral liquid)20220513094200+0000
prednisoLONE (Orapred 15 mg/5 mL oral liquid)20220513094300+0000
acetaminophen (Tylenol)20220513090400+0000
azithromycin20220513090200+0000
ibuprofen20220513100000+0000
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Social History ObservationSocial History Observation Result
Birth SexM
Travel HistoryCOVID- 19 Testing Reason-Screening
Travel HistoryPregnancy Status-Not applicable (qualifier value)
"}, "code": {"coding": [{"code": "29762-2", "display": "Social History", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"reference": "Observation/334a7b0b-e775-63c1-3461-49e6c5e1e3c1"}, {"reference": "Observation/c368a59d-afcf-2b68-0ed6-164deb6eddfd"}]}, {"id": "7dbd51e8-1c15-8cfa-cbce-f6f4b9a1ed5d", "title": "Plan of Treatment", "text": {"status": "generated", "div": "No Plan Of Treatment Information"}, "code": {"coding": [{"code": "18776-5", "display": "Treatment Plan", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"reference": "CarePlan/ec77d178-de8a-915a-311a-1f11f2838946"}]}, {"id": "1f7f0fb5-56ac-daea-0962-3334f085966f", "title": "History of Present Illness", "text": {"status": "generated", "div": "
Narrative Text
Fever
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NameAdministration DatesNext Due
DTaP, 5 pertussis antigens vaccine (DAPTACEL)06/15/2021
Hep B, adult vaccine (Engerix/Recombivax)09/08/2020
SARS-COV-2 (COVID-19) RED CAP +BLUE LABEL VACCINE, MODERNA 12+YO01/22/2021
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Pending Results
NameTypePriorityAssociated DiagnosesDate/Time
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
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Active ProblemsNoted Date
COVID toes7/13/22
Chest pain on breathing5/26/22
Type 1 diabetes2/28/22
Overview:Formatting of this note might be different from the original.
08/30/21 28.69 kg/m\u00b2BMI Readings from Last 1 Encounters:
Plague pneumonia6/16/21
Absence of menstruation6/12/18
Foot callus8/11/17
Overview:Formatting of this note might be different from the original.
Ouch.
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Problem or DiagnosisProblem Status
TTP (thrombotic thrombocytopenic purpura)Active
"}, "code": {"coding": [{"code": "11450-4", "display": "PROBLEM LIST", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"display": "Problem - Thrombotic thrombocytopenic purpura (disorder)", "reference": "Condition/3907477b-3eba-59c4-6622-d3c3a81a39f4"}]}, {"id": "58ebd6f7-9c63-dac4-1f3f-c4a55907bb39", "title": "ENCOUNTERS", "text": {"status": "generated", "div": "
Encounter ReasonDate of Encounter
observation encounter20220415161500+0000
"}, "code": {"coding": [{"code": "46240-8", "display": "History of Encounters", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "dc32a83b-bbcc-85fe-5240-91c405175be5", "title": "RESULTS", "text": {"status": "generated", "div": "
Lab Test NameLab Test Result ValueLab Test Result Date
Troponin TNIH8.2|http://unitsofmeasure.org|ng/L
Troponin TNIH8.1|http://unitsofmeasure.org|ng/L
Troponin TNIH9.5|http://unitsofmeasure.org|ng/L
NT-ProBNP84|http://unitsofmeasure.org|pg/mL
Estimated Creatinine Clearance52.76|http://unitsofmeasure.org|mL/min
Symptomatic as defined by CDC?Yes
In ICU?No
Group care resident?No
Employed in healthcare?No
SARS-CoV-2 Interp:Unknown
SARS-CoV-2 PCRNegative
eGFR PediatricNot Reported
Flu B PCRNot Detected
Flu A PCRNot Detected
Calc Osmo270|http://unitsofmeasure.org|mOsmol/kg
A/G RatioUnknown
eGFR Non-African American70|http://unitsofmeasure.org|mL/min/1.73m2
eGFR African American81|http://unitsofmeasure.org|mL/min/1.73m2
Sodium135|http://unitsofmeasure.org|mmol/L
Potassium4.0|http://unitsofmeasure.org|mmol/L
Baso # Auto0.02|http://unitsofmeasure.org|x10e3/mcL
Albumin. Level3.6|http://unitsofmeasure.org|gm/dL
Mono # Auto0.60|http://unitsofmeasure.org|x10e3/mcL
Neut # Auto4.73|http://unitsofmeasure.org|x10e3/mcL
Baso % Auto0.3|http://unitsofmeasure.org|%
Eos % Auto0.7|http://unitsofmeasure.org|%
Lymph % Auto21.3|http://unitsofmeasure.org|%
Neut % Auto68.9|http://unitsofmeasure.org|%
Calcium9.1|http://unitsofmeasure.org|mg/dL
RDW-SD49.7|http://unitsofmeasure.org|Femtoliters
Immature Grans # Auto0.01|http://unitsofmeasure.org|x10e3/mcL
Lymph # Auto1.46|http://unitsofmeasure.org|x10e3/mcL
Mono % Auto8.7|http://unitsofmeasure.org|%
RDW-CV14.9|http://unitsofmeasure.org|%
Immature Grans %0.1|http://unitsofmeasure.org|%
Eos # Auto0.05|http://unitsofmeasure.org|x10e3/mcL
Chloride101|http://unitsofmeasure.org|mmol/L
BUN9|http://unitsofmeasure.org|mg/dL
Plt195|http://unitsofmeasure.org|x10e3/mcL
WBC6.87|http://unitsofmeasure.org|x10e3/mcL
TP8.9|http://unitsofmeasure.org|gm/dL
RBC4.92|http://unitsofmeasure.org|x10e6/mcL
MPV11.6|http://unitsofmeasure.org|Femtoliters
MCV90.7|http://unitsofmeasure.org|Femtoliters
MCHC33.0|http://unitsofmeasure.org|gm/dL
MCH29.9|http://unitsofmeasure.org|pg
Hgb14.7|http://unitsofmeasure.org|gm/dL
Hct44.6|http://unitsofmeasure.org|%
Glucose Level115|http://unitsofmeasure.org|mg/dL
D Dimer0.34|http://unitsofmeasure.org|mcg/mL FEU
CO228|http://unitsofmeasure.org|mmol/L
T Bili0.8|http://unitsofmeasure.org|mg/dL
AST25|http://unitsofmeasure.org|units/L
ALT19|http://unitsofmeasure.org|units/L
Alk Phos67|http://unitsofmeasure.org|units/L
BUN/Creat RatioUnknown
Anion Gap6|http://unitsofmeasure.org|mmol/L
Creatinine0.856|http://unitsofmeasure.org|mg/dL
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VALUES ('cf9e1db8-fcc5-4cbc-96cd-043d3fd65bac', '{"resourceType": "Bundle", "type": "batch", "entry": [{"fullUrl": "urn:uuid:cf9e1db8-fcc5-4cbc-96cd-043d3fd65bac", "resource": {"resourceType": "Composition", "id": "cf9e1db8-fcc5-4cbc-96cd-043d3fd65bac", "meta": {"profile": ["http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-composition"], "source": ["ecr"]}, "identifier": [{"use": "official", "type": {"coding": [{"code": "55751-2", "display": "Initial Public Health Case Report", "system": "http://loinc.org"}]}, "value": "32943241|64979134"}], "extension": [{"url": "http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber", "valueString": "2"}], "status": "final", "type": {"coding": [{"code": "55751-2", "display": "Initial Public Health Case Report", "system": "http://loinc.org"}]}, "date": "2022-04-30T16:55:43Z", "title": "Initial Public Health Case Report", "confidentiality": "N", "section": [{"id": "4830b790-114f-0e08-8f3b-f30cfac2e55c", "title": "PROBLEMS - DIAGNOSES", "text": {"status": "generated", "div": "
Problem or DiagnosisProblem Status
Disease caused by 2019-nCoVActive
Abdominal pain (finding)Active
Abdominal pain (finding)Active
Patient encounter status (finding)Active
Patient encounter status (finding)Active
Lupus erythematosus (disorder)Active
Abdominal painActive
Lupus erythematosusActive
Malaise (finding)Active
Low back painActive
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Encounter ReasonDate of Encounter
Emergency20220428011000+0000
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Lab Test NameLab Test Result ValueLab Test Result Date
Ur pHUnknown
Ur Spec GravUnknown
Ur Urobilinogen<2.0 mg/dL
Ur Blood1+ mg/dL
Ur BiliNegative mg/dL
Ur Leuk Est1+
Ur ColorYellow
Ur MucousRare /LPF
Ur Squam Epithelial5|http://unitsofmeasure.org|/HPF
Ur WBC18|http://unitsofmeasure.org|/HPF
Ur RBC2|http://unitsofmeasure.org|/HPF
Ur ProteinNegative mg/dL
Ur NitriteNegative
Ur KetonesNegative mg/dL
UR GlucoseNegative mg/dL
Ur BacteriaNone Seen /HPF
Ur ClarityClear
U Beta hCG QlNegative
Ur pH5.5
Ur Spec Grav1.020 mg/dL
Ur Urobilinogen0.2 EU/dL
Ur BloodTrace-lysed
Ur BiliNegative
Ur Leuk EstTrace
Ur ProteinNegative mg/dL
Ur NitriteNegative
Ur KetonesNegative mg/dL
UR GlucoseNegative mg/dL
Estimated Creatinine Clearance55.01|http://unitsofmeasure.org|mL/min
Troponin TNIH4.2|http://unitsofmeasure.org|ng/L
eGFR PediatricNot Reported
Calc Osmo284|http://unitsofmeasure.org|mOsmol/L
A/G Ratio1.1|http://unitsofmeasure.org|Ratio
eGFR Non-African American64.68 mL/min/1.73m2
eGFR African American74.97 mL/min/1.73m2
Sodium141|http://unitsofmeasure.org|mmol/L
Potassium3.6|http://unitsofmeasure.org|mmol/L
NT-ProBNP44|http://unitsofmeasure.org|pg/mL
Baso # Auto0.05|http://unitsofmeasure.org|x10e3/mcL
Albumin. Level4.1|http://unitsofmeasure.org|gm/dL
Mono # Auto0.6|http://unitsofmeasure.org|x10e3/mcL
Neut # Auto3.3|http://unitsofmeasure.org|x10e3/mcL
Baso % Auto0.8|http://unitsofmeasure.org|%
Eos % Auto1.9|http://unitsofmeasure.org|%
Lymph % Auto32.3|http://unitsofmeasure.org|%
Neut % Auto55.5|http://unitsofmeasure.org|%
Calcium8.8|http://unitsofmeasure.org|mg/dL
Immature Grans # Auto0.01|http://unitsofmeasure.org|x10e3/mcL
Lymph # Auto1.9|http://unitsofmeasure.org|x10e3/mcL
Mono % Auto9.3|http://unitsofmeasure.org|%
RDW-CV13.9|http://unitsofmeasure.org|%
Immature Grans %0.2|http://unitsofmeasure.org|%
Eos # Auto0.1|http://unitsofmeasure.org|x10e3/mcL
Chloride106|http://unitsofmeasure.org|mmol/L
BUN20|http://unitsofmeasure.org|mg/dL
Plt231|http://unitsofmeasure.org|x10e3/mcL
WBC5.9|http://unitsofmeasure.org|x10e3/mcL
TP7.8|http://unitsofmeasure.org|gm/dL
RBC4.01|http://unitsofmeasure.org|x10e6/mcL
PT11.3|http://unitsofmeasure.org|Seconds
MPV11.7|http://unitsofmeasure.org|Femtoliters
MCV93.8|http://unitsofmeasure.org|Femtoliters
MCHC31.9|http://unitsofmeasure.org|gm/dL
MCH29.9|http://unitsofmeasure.org|pg
Hgb12.0|http://unitsofmeasure.org|gm/dL
Hct37.6|http://unitsofmeasure.org|%
Glucose Level97|http://unitsofmeasure.org|mg/dL
CO224.8|http://unitsofmeasure.org|mmol/L
T BiliTNP see comment mg/dL
AST22|http://unitsofmeasure.org|Intl_units/L
ALT27|http://unitsofmeasure.org|Intl_units/L
Alk Phos72|http://unitsofmeasure.org|Intl_units/L
BUN/Creat Ratio20.0|http://unitsofmeasure.org|Ratio
INRUnknown
Anion GapUnknown
HCG Bld QLNegative
Creatinine1.0|http://unitsofmeasure.org|mg/dL
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{"reference": "Observation/33e33359-906b-32f0-b37d-c3158227e983"}, {"reference": "Observation/f585f4ee-42d5-8f2f-56f0-7e0da7a03abd"}, {"reference": "Observation/2277e890-f5ea-3a88-c352-ed3f4954f1ce"}, {"reference": "Observation/befcee9f-ad47-45df-3312-363b6ddf2b9b"}, {"reference": "Observation/a4f9de6e-c44e-e616-438a-5791551dcbb1"}, {"reference": "Observation/e4c97705-3c2a-e926-ec4f-5f30e85388b2"}]}, {"id": "36583a63-dfcd-7388-88d4-873cc3872f08", "title": "Medications Administered", "text": {"status": "generated", "div": "
Medication NameMedication Start Date
ibuprofen (ibuprofen 400 mg oral tablet)20220428100300+0000
predniSONE (predniSONE 20 mg oral tablet)20220428100300+0000
ketorolac (Toradol)20220428100200+0000
dexamethasone20220428100200+0000
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Social History ObservationSocial History Observation Result
Birth SexF
"}, "code": {"coding": [{"code": "29762-2", "display": "Social History", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "7dbd51e8-1c15-8cfa-cbce-f6f4b9a1ed5d", "title": "Plan of Treatment", "text": {"status": "generated", "div": "No Plan Of Treatment Information"}, "code": {"coding": [{"code": "18776-5", "display": "Treatment Plan", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"reference": "CarePlan/ec77d178-de8a-915a-311a-1f11f2838946"}]}, {"id": "35ea10af-dd39-40cf-113d-22418b1902a7", "title": "History of Present Illness", "text": {"status": "generated", "div": "
Narrative Text
Medical screening exam
Chest pain
Chest wall pain
"}, "code": {"coding": [{"code": "10164-2", "display": "History of Present Illness", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "1d6b8d13-b182-2153-661c-65533f2caa82", "title": "Reason For Visit", "text": {"status": "generated", "div": "
text
CP
"}, "code": {"coding": [{"code": "29299-5", "display": "Reason For Visit", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "c705cd57-3d58-4001-33d0-5063dd68bd54", "title": "Reportability Response Information Section", "text": {"status": "generated", "div": "
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Drugs Of Abuse Comprehensive Screen, UrLabSTAT12/23/2022 11:13 AM PST
Scheduled Orders
NameTypePriorityAssociated DiagnosesOrder Schedule
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Unconfirmed screening results must not be used for non-medical purposes (e.g., employment testing).
Only positive maternal and neonatal screening results reflex for confirmation and are reported separately.
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+INSERT INTO fhir (ecr_id, data) VALUES ('1.2.840.114350.1.13.202.3.7.8.688883.486', '{"resourceType": "Bundle", "type": "batch", "entry": [{"fullUrl": "urn:uuid:1.2.840.114350.1.13.202.3.7.8.688883.486", "resource": {"resourceType": "Composition", "id": "1.2.840.114350.1.13.202.3.7.8.688883.486", "meta": {"profile": ["http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-composition"], "source": ["ecr"]}, "identifier": [{"use": "official", "type": {"coding": [{"code": "55751-2", "display": "Initial Public Health Case Report", "system": "http://loinc.org"}]}, "value": "28beb5ae-3f68-11ed-8bdc-005056a7fb21", "assigner": {"display": "EPC"}}], "extension": [{"url": "http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber", "valueString": "30"}], "status": "final", "type": {"coding": [{"code": "55751-2", "display": "Initial Public Health Case Report", "system": "http://loinc.org"}]}, "date": "2022-10-04T17:04:37-07:00", "title": "Initial Public Health Case Report", "confidentiality": "N", "section": [{"id": "c80f67bb-6876-6ad5-ea57-46aea1afa973", "title": "Miscellaneous Notes", "text": {"status": "generated", "div": "documented in this encounter"}, "code": {"coding": [{"code": "10164-2", "display": "HISTORY OF PRESENT ILLNESS", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "4D3493EE-4441-11ED-B2C1-005056A7FB21", "title": "Immunizations", "text": {"status": "generated", "div": "Not on file documented as of this encounter"}, "code": {"coding": [{"code": "11369-6", "display": "History of Immunization Narrative", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "4D38E8F4-4441-11ED-B2C1-005056A7FB21", "title": "Administered Medications", "text": {"status": "generated", "div": "
Inactive Administered Medications - up to 3 most recent administrations
Medication OrderMAR ActionAction DateDoseRateSite
alum-mag hydroxide-simeth (MAALOX) 200-200-20 mg/5 mL oral suspension 15 mL15 mL, Oral, ONCE (IN CLINIC), On Wed 9/28/22 at 2100, For 1 dose, Order WILL be automatically substituted with P&T Approved equivalent per protocol. SHAKE WELL prior to use.Given09/28/2022 8:37 PM PDT15 mL
aspirin tablet 325 mg325 mg, Oral, ONCE, On Wed 9/28/22 at 2100, For 1 doseGiven09/28/2022 8:37 PM PDT325 mg
lidocaine (XYLOCAINE) 2% viscous oral solution5 mL, Swish and Spit, ONCE (IN CLINIC), On Wed 9/28/22 at 2100, For 1 doseGiven09/28/2022 8:37 PM PDT5 mL
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Active ProblemsNoted Date
Coronavirus infection9/28/22
Close exposure to COVID-19 virus9/28/22
Seasonal allergies9/24/22
PregnantEstimated Date of DeliveryComments
Yes5/6/23Based on Est. Date of Conception
documented as of this encounter (statuses as of 10/04/2022)"}, "code": {"coding": [{"code": "11450-4", "display": "Problem list - Reported", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"display": "Problem - Seasonal allergies", "reference": "Condition/1c2932d2-ae86-4b76-fafa-b0a12b17a027"}, {"display": "Problem - Coronavirus infection", "reference": "Condition/1e7e7161-de05-f41e-f064-c227e43edd3e"}, {"display": "Problem - Close exposure to COVID-19 virus", "reference": "Condition/6cb5bd36-5db9-68d4-ec94-afc3f96f6392"}]}, {"id": "578e38a5-2cc7-00e0-1769-ea74746c5fe8", "title": "Reason for Visit", "text": {"status": "generated", "div": "Not on file"}, "code": {"coding": [{"code": "29299-5", "display": "REASON FOR VISIT", "system": "http://loinc.org"}]}, "mode": "snapshot", "extension": [{"url": "http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.2.12", "valueString": "Not on file"}]}, {"id": "4D3F4866-4441-11ED-B2C1-005056A7FB21", "title": "Results", "text": {"status": "generated", "div": "documented in this encounter"}, "code": {"coding": [{"code": "30954-2", "display": "Relevant diagnostic tests/laboratory data Narrative", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"display": "SARS-CoV-2, RNA", "reference": "Observation/3a45daf2-6872-fd2a-6ede-606810d52bb2"}, {"display": "Lab Interpretation", "reference": "Observation/e9c8e4b3-3fec-4f29-a5c5-e45f96680a4c"}]}, {"id": "8a900c7f-2adf-c43c-4fde-16f9696944df", "title": "Social History", "text": {"status": "generated", "div": "
Tobacco UseTypesPacks/DayYears UsedDate
Smoking Tobacco: Never
Smokeless Tobacco: Never
Alcohol UseStandard Drinks/WeekComments
Never0 (1 standard drink = 0.6 oz pure alcohol)
EducationAnswerDate Recorded
What is the highest level of school you have completed or the highest degree you have received?Bachelor''s degree (e.g., BA, AB, BS)09/24/2022
Sex Assigned at BirthDate Recorded
Female09/24/2022 12:34 PM PDT
documented as of this encounter"}, "code": {"coding": [{"code": "29762-2", "display": "Social history Narrative", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "8cfa32e2-c143-2ba9-dc72-266a3ba673c6", "title": "Encounter Details", "text": {"status": "generated", "div": "
DateTypeDepartmentCare TeamDescription
9/28/22Office VisitCSMG Internal Medicine8767 Wilshire Blvd2nd FloorBEVERLY HILLS, CA 90211310-385-6031Canavan, Allison H, MD8631 W. THIRD STREETSTE 510ELOS ANGELES, CA 90048310-385-3380 (Work)310-385-3224 (Fax)allison.canavan@cshs.org
Close exposure to COVID-19 virusCoronavirus infection (Primary Dx);
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Reportability Response Information Section
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U.S.C. 360bbb-3(b)(1), unless the authorization is terminated or
diagnosis of COVID-19 infection under section 564(b)(1) of the Act, 21
of in vitro diagnostic tests for detection of SARS-CoV-2 virus and/or
circumstances exist justifying the authorization of the emergency use
only authorized for the duration of time the declaration that
FDA independent review of this validation is pending. This test is
during the Public Health Emergency) issued on February 29th, 2020.
prior to Emergency Use Authorization for Coronavirus Disease-2019
Laboratories Certified to Perform High Complexity Testing under CLIA
the FDA''s Guidance Document (Policy for Diagnostics Testing in
Authorization (EUA). This test has been validated in accordance with
approved. This test has been authorized by FDA under an Emergency Use
by LabCorp Laboratories. This test has not been FDA cleared or
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CONFLICT (ecr_id) DO NOTHING; +INSERT INTO fhir (ecr_id, data) VALUES ('1.2.840.114350.1.13.297.3.7.8.688883.538441', '{"resourceType": "Bundle", "type": "batch", "entry": [{"fullUrl": "urn:uuid:1.2.840.114350.1.13.297.3.7.8.688883.538441", "resource": {"resourceType": "Composition", "id": "1.2.840.114350.1.13.297.3.7.8.688883.538441", "meta": {"profile": ["http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-composition"], "source": ["ecr"]}, "identifier": [{"use": "official", "type": {"coding": [{"code": "55751-2", "display": "Initial Public Health Case Report", "system": "http://loinc.org"}]}, "value": "7a89f990-3f70-11ed-9549-c301d81100b2", "assigner": {"display": "EPC"}}], "extension": [{"url": "http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber", "valueString": "15"}], "status": "final", "type": {"coding": [{"code": "55751-2", "display": "Initial Public Health Case Report", "system": "http://loinc.org"}]}, "date": "2022-09-28T14:01:01-07:00", "title": "Initial Public Health Case Report", "confidentiality": "N", "section": [{"id": "6d477942-5761-6b2c-f5fc-bdf036a1fe7e", "title": "Miscellaneous Notes", "text": {"status": "generated", "div": "Not on file documented in this encounter"}, "code": {"coding": [{"code": "10164-2", "display": "HISTORY OF PRESENT ILLNESS", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "A84C7F7E-3F70-11ED-9549-C301D81100B2", "title": "Immunizations", "text": {"status": "generated", "div": "
NameAdministration DatesNext Due
DTAP-HIB-IPV (PENTACEL)04/16/2010
HEP A (ADULT) 2 DOSE11/11/2011
HEP B (PED,ADOLESCENT) 3 DOSE03/21/1974
MENINGOCOCCAL CONJUGATE,MENACTRA (PED/ADOL/ADULT)11/16/2020
TDAP, (ADOL/ADULT)11/10/2020
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Active ProblemsNoted Date
Bipolar I disorder11/19/20
Reactive depression11/19/20
Rheumatoid arthritis with negative rheumatoid factor11/16/20
Arthralgia of both ankles11/16/20
Anxiety11/10/20
Asthma11/10/20
Knee pain4/29/19
Sprain of calcaneofibular ligament of right ankle4/16/19
Last Assessment & Plan:Formatting of this note might be different from the original.
This is my note about this problem.
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Smoking Tobacco: Never
Smokeless Tobacco: Never
Alcohol UseStandard Drinks/WeekComments
Yes0 (1 standard drink = 0.6 oz pure alcohol)
Sex Assigned at BirthDate Recorded
Not on file
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DateTypeDepartmentCare TeamDescription
9/28/22Lab RequisitionPROVIDENCE ST JOSEPH MED CTR LABORATORY501 S Buena Vista StBurbank, CA 91505-4809818-847-6060Test, Ambhp1, MD2001 LIND AVERENTON, WA 98059
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MemberRoleStatusDates
Adam Sheradmitting physicianActive
Start: March 12th, 2022
MCUTLERattending physicianActive
Start: March 12th, 2022
DR MEDITECHprimary care physicianActive
Start: March 12th, 2022
AMANDA NOELREFERRINGActive
Start: March 12th, 2022
AMANDA PARLATOFAMILYActive
Start: March 12th, 2022
Rickey RobertsOTHERActive
Start: March 12th, 2022
Stephen NewtonCONSULTINGActive
Start: March 12th, 2022
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Date patient received Moderna COVID-19 vaccine?
Date patient received Anthrax vaccine?
Date patient received Rabies vaccine?
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RIGRAPID HEART BEAT
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Height65 [in_i]March 14th, 2022 1:48pm
Height165.1 cmMarch 14th, 2022 1:48pm
Weight150.00 [lb_av]March 14th, 2022 1:48pm
Weight68.039 kgMarch 14th, 2022 1:48pm
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Anthrax

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Dapsone (Topical) - RXCUI C1741905 (DAPSONE7.5 %) 7.5 % GEL OINTMENTMarch 24th, 2022 9:38am
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NameAdministration DatesNext Due
DTaP, 5 pertussis antigens vaccine (DAPTACEL)06/15/2021
Hep B, adult vaccine (Engerix/Recombivax)09/08/2020
SARS-COV-2 (COVID-19) Spikevax Vaccine, Moderna01/22/2021
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Pending Results
NameTypePriorityAssociated DiagnosesDate/Time
PCR SARS-CoV-2 and Influenza A/BLabRoutine07/27/2022 3:49 PM CDT
PCR SARS-CoV-2 and Influenza A/BLabRoutine07/27/2022 3:49 PM CDT
PCR SARS-CoV-2 and Influenza A/BLabRoutine07/27/2022 3:49 PM CDT
PCR SARS-CoV-2 and Influenza A/BLabRoutine07/27/2022 3:49 PM CDT
PCR SARS-CoV-2 and Influenza A/BLabRoutine07/27/2022 3:49 PM CDT
Scheduled Orders
NameTypePriorityAssociated DiagnosesOrder Schedule
PCR Hepatitis C Virus QtLabRoutineOrdered: 5/12/22
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Active ProblemsNoted Date
COVID toes7/13/22
Chest pain on breathing5/26/22
Type 1 diabetes2/28/22
Overview:Formatting of this note might be different from the original.
08/30/21 28.69 kg/m\u00b2BMI Readings from Last 1 Encounters:
Plague pneumonia6/16/21
Absence of menstruation6/12/18
Foot callus8/11/17
Overview:Formatting of this note might be different from the original.
Ouch.
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Smoking Tobacco: Never Assessed
Sex Assigned at BirthDate Recorded
Not on file
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Request#:CG-22-0000003
Service date:3/11/2022 13:05


FISH IMPRESSION:

Abnormal for homozygous deletion of CDKN2A locus at 9p21 in __% of cells.

FISH KARYOTYPE:



nuc ish (DXZ1x1,DYZ3x1,D18Z1x2)[200]

\u00a0
\u00a0
\u00a0



COMMENTS:



Results of the FISH studies with the 21 DNA probes described above were analyzed in at least 200 cells per probe and no abnormal signal patterns were detected for the target regions of chromosomes 1, 4, 7, 9, 10, 11, 12, 14, 17, 19, 21, and 22.

Normal cut off values for probes:

1.0% for t(1;19) PBX1/TCF3
1.0% for t(9;22) BCR/ABL1
1.0% for KMT2A (11q23)
1.0% for t(12;21) ETV6/RUNX1
1.0% for IKZF1/CEP7
3.0% for CEP 4
2.0% for CEP 10
2.0% for CEP 17
1.0% for CDKN2A/CEP9 (9p21)
1.0% for IGH breakapart
1.0% for ABL2 breakapart
1.0% for ABL1 breakapart

These probes were developed by Vysis and their performance characteristics determined by VUMC as required by the CLIA ''88 regulations. \u00a0These probes have not been cleared or approved by the U.S. Food and Drug administration.


Ferrin Courtney Wheeler, PhD, FACMG
reviewed and approved

Electronically signed out by:
Mavrak, Geoffrey A

on 03/11/2022

Clinical History: \u00a0ALL
Specimen List: Blood
Date In Lab: 3/11/2022 13:09
Date Collected: 3/11/2022 13:05

Testing performed at Vanderbilt Cytogenetics One Hundred Oaks Laboratory, Suite 21100, 719 Thompson Ln,
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A detected result is positive and indicates the presence of the virus in the sample. A not detected result indicates that the test did not detect the virus in the sample."}], "extension": [{"url": "http://hl7.org/fhir/R4/specimen.html", "extension": [{"url": "specimen source", "valueString": "Nares"}, {"url": "specimen collection time", "valueDateTime": "2022-03-11T19:05:00Z"}, {"url": "specimen receive time", "valueDateTime": "2022-03-11T19:46:00Z"}, {"url": "observation entry reference value", "valueString": "#Result.1.2.840.114350.1.13.478.3.7.2.798268.2061339.Comp1"}]}, {"url": "https://reportstream.cdc.gov/fhir/StructureDefinition/condition-code", "coding": [{"code": "840539006", "system": "http://snomed.info/sct"}]}], "subject": {"reference": "Patient/f3622006-f41c-4317-99b9-46eb36852a2e"}, "performer": [{"display": "VUMC CERNER LAB", "reference": "Organization/e3ece69c-0968-59c9-47dd-f16db731621a"}]}, "request": {"method": "PUT", "url": "Observation/b1ba1ccd-e2cd-3261-7460-be0abb6508cb"}}, {"fullUrl": "urn:uuid:b4965bf2-9a65-df39-676b-acc5151db64b", "resource": {"resourceType": "Observation", "id": "b4965bf2-9a65-df39-676b-acc5151db64b", "meta": {"profile": ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults"], "source": ["ecr"]}, "identifier": [{"system": "urn:oid:1.2.840.114350.1.13.478.3.7.6.798268.2000", "value": "2061339.2"}], "category": [{"coding": [{"system": "http://terminology.hl7.org/CodeSystem/observation-category", "code": "laboratory"}]}], "status": "final", "code": {"coding": [{"code": "16535", "display": "SARS-CoV-2 Nucleic Acid Method (Comment)", "system": "urn:oid:1.2.840.114350.1.13.478.3.7.2.768282"}]}, "effectiveDateTime": "2022-03-11T19:49:19Z", "valueString": "Nares
This test was performed using the Hologic Panther COVID-19 test. 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VPLS clients: \u00a0 See separate report sent to client.", "note": [{"elems": [{"elemText": "test"}], "text": "This test was performed at: Quest Laboratory,Location Varies,,,,,,"}], "extension": [{"url": "http://hl7.org/fhir/R4/specimen.html", "extension": [{"url": "specimen source", "valueString": "Oral"}, {"url": "specimen collection time", "valueDateTime": "2022-03-29T18:53:00Z"}, {"url": "specimen receive time", "valueDateTime": "2022-03-29T19:07:00Z"}, {"url": "observation entry reference value", "valueString": "#Result.1.2.840.114350.1.13.478.3.7.2.798268.2061344.Comp1"}]}], "subject": {"reference": "Patient/f3622006-f41c-4317-99b9-46eb36852a2e"}, "performer": [{"display": "VUMC CERNER LAB", "reference": "Organization/e3ece69c-0968-59c9-47dd-f16db731621a"}]}, "request": {"method": "PUT", "url": "Observation/6fc06f11-d0f4-9553-2798-e8dd822678fe"}}, {"fullUrl": "urn:uuid:db8797cb-3129-eff4-9d78-a04b2326f0a2", "resource": {"resourceType": "Observation", "id": "db8797cb-3129-eff4-9d78-a04b2326f0a2", "meta": {"profile": ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults"], "source": ["ecr"]}, "identifier": [{"system": "urn:oid:1.2.840.114350.1.13.478.3.7.2.798268", "value": "2061344"}], "category": [{"coding": [{"system": "http://terminology.hl7.org/CodeSystem/observation-category", "code": "laboratory"}]}], "status": "final", "effectiveDateTime": "2022-03-29T20:10:54Z", "valueCodeableConcept": {"coding": [{"code": "16", "system": "urn:oid:1.2.840.114350.1.72.1.5007"}]}, "extension": [{"url": "http://hl7.org/fhir/R4/specimen.html", "extension": [{"url": "specimen source", "valueString": "Oral"}, {"url": "specimen collection time", "valueDateTime": "2022-03-29T18:53:00Z"}, {"url": "specimen receive time", "valueDateTime": "2022-03-29T19:07:00Z"}]}], "subject": {"reference": "Patient/f3622006-f41c-4317-99b9-46eb36852a2e"}}, "request": {"method": "PUT", "url": "Observation/db8797cb-3129-eff4-9d78-a04b2326f0a2"}}, {"fullUrl": "urn:uuid:c86958f4-4bd2-7450-15ff-4c490820f58f", "resource": {"resourceType": "DiagnosticReport", "id": "c86958f4-4bd2-7450-15ff-4c490820f58f", "identifier": [{"system": "urn:oid:1.2.840.114350.1.13.478.3.7.2.798268", "value": "2061345"}], "status": "final", "code": {"coding": [{"code": "201700", "display": "Pharmacogenomics", "system": "urn:oid:1.2.840.114350.1.13.478.3.7.2.696580"}]}, "effectivePeriod": {"start": "2022-03-31T22:36:00Z", "end": "2022-03-31T22:36:00Z"}, "subject": {"reference": "Patient/f3622006-f41c-4317-99b9-46eb36852a2e"}, "performer": [{"reference": "Organization/22c6cdd0-bde1-e220-9ba4-2c2802f795ad"}], "result": [{"reference": "Observation/2e9477e8-412b-905c-270f-16ca12bff791"}, {"reference": "Observation/ed66ccf7-584a-1142-b9a4-8fe01b6f21fb"}], "meta": {"source": ["ecr"]}}, "request": {"method": "PUT", "url": "DiagnosticReport/c86958f4-4bd2-7450-15ff-4c490820f58f"}}, {"fullUrl": "urn:uuid:2e9477e8-412b-905c-270f-16ca12bff791", "resource": {"resourceType": "Observation", "id": "2e9477e8-412b-905c-270f-16ca12bff791", "meta": {"profile": ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults"], "source": ["ecr"]}, "identifier": [{"system": "urn:oid:1.2.840.114350.1.13.478.3.7.7.798268.1000", "value": "2061345"}], "category": [{"coding": [{"system": "http://terminology.hl7.org/CodeSystem/observation-category", "code": "laboratory"}]}], "status": "final", "code": {"coding": [{"code": "NAR", "system": "urn:oid:1.2.840.114350.1.72.1.5220"}]}, "effectiveDateTime": "2022-03-31T22:51:17Z", "valueString": "Pharmacogenomics: Final Report

Request #: MD-22-0000041

Service Date: 3/31/2022 17:36

Reason for Request: Genotyping for Determination of Drug Efficacy, Dosage and Safety

Type of Specimen: DNA

Date Received: 3/31/2022 17:44

Date Reported: 3/31/2022 17:51

Interpretation:
Results from this assay may indicate dosage adjustments or medication alternatives that should be considered for this patient. Additional information regarding the implications of these results is available at www.mydruggenome.org.

For VUMC patients, clinical decision support regarding the management of this patient with respect to specific drugs based upon the patient''s genotype as listed below is available in the patient''s electronic medical record under Genomic Indicators. Clinical decision support may also be provided for some drugs through order entry and medication prescribing tools utilized within the VUMC system.



Comments:

Results:

CYP2C19 - \u00a0Cancelled

CYP2C9 - \u00a0 Cancelled

CYP2D6 - \u00a0 Cancelled \u00a0

CYP3A5 - \u00a0 Cancelled

CYP4F2 - \u00a0 Cancelled

DPYD - \u00a0 \u00a0 Cancelled

NUDT15 - \u00a0 Cancelled

SLCO1B1 - \u00a0Cancelled \u00a0 \u00a0 \u00a0

TPMT - \u00a0 \u00a0 Cancelled

VKORC1 - \u00a0 Cancelled \u00a0 \u00a0
\u00a0
These results should be correlated with other laboratory and clinical findings and additional testing should be considered if clinically indicated.
\u00a0 \u00a0

Methodology:

DNA was extracted from this specimen and screened for 37 variants in 10 genes that are associated with drug absorption, distribution, metabolism, excretion or response. The reported genotypes were determined using PCR amplification and oligonucleotide primers specific for each interrogated region of the genes listed within this panel. Fluorophore labeled probes were used to identify each variant.

Variants analyzed in this assay include: CYP2C19 *2, *3, *4, *6, *8, *17; CYP2C9 *2, *3, *6, *8; CYP3A5 *3, *6, *7; CYP4F2 *3; DPYD *2A, *13, c.557A>G, c.1236G>A (HapB3), c.2846A>T; \u00a0NUDT15 *2 or *3; SLCO1B1 *5; TPMT *2, *3B, *3C, *4; VKORC1 promoter variant c.-1639G>A; and CYP2D6 copy number and variants *2, *2A, *3, *4, *6, *7, *9, *10, *17, *29 and *41. A *1 allele is considered the reference (normal) sequence and is reported if none of the variants analyzed for a particular gene is detected. This assay is specific for the variants listed above and cannot exclude the presence of other variants within these genes that may affect the pharmacologic function of the protein product encoded by these genes. In most cases, variants for a particular gene exist on separate alleles; however, for individuals in which multiple variants in the same gene are detected, this assay cannot determine if the variants are on the same allele or on different alleles. Further, due to the highly polymorphic
nature of these regions, rare variants may exist that could affect the sensitivity or specificity of this assay and lead to a false-negative or a false-positive result.


Electronically signed out by:
Barba, Elizabeth

on 03/31/2022

This assay has not been cleared or approved by the US Food and Drug Administration. The performance of this assay was tested and validated prior to use for patient testing. This test is used for clinical purposes and should not be regarded as investigational or research. This laboratory is regulated by the Clinical Laboratory Improvement Act of 1988.", "extension": [{"url": "http://hl7.org/fhir/R4/specimen.html", "extension": [{"url": "specimen source", "valueString": "DNA"}, {"url": "specimen collection time", "valueDateTime": "2022-03-31T22:36:00Z"}, {"url": "specimen receive time", "valueDateTime": "2022-03-31T22:44:00Z"}, {"url": "observation entry reference value", "valueString": "#Result.1.2.840.114350.1.13.478.3.7.2.798268.2061345.Narrative"}]}], "subject": {"reference": "Patient/f3622006-f41c-4317-99b9-46eb36852a2e"}, "performer": [{"display": "VUMC CERNER LAB", "reference": "Organization/e3ece69c-0968-59c9-47dd-f16db731621a"}]}, "request": {"method": "PUT", "url": "Observation/2e9477e8-412b-905c-270f-16ca12bff791"}}, {"fullUrl": "urn:uuid:ed66ccf7-584a-1142-b9a4-8fe01b6f21fb", "resource": {"resourceType": "Observation", "id": "ed66ccf7-584a-1142-b9a4-8fe01b6f21fb", "meta": {"profile": ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults"], "source": ["ecr"]}, "identifier": [{"system": "urn:oid:1.2.840.114350.1.13.478.3.7.2.798268", "value": "2061345"}], "category": [{"coding": [{"system": "http://terminology.hl7.org/CodeSystem/observation-category", "code": "laboratory"}]}], "status": "final", "effectiveDateTime": "2022-03-31T22:51:17Z", "valueCodeableConcept": {"coding": [{"code": "16", "system": "urn:oid:1.2.840.114350.1.72.1.5007"}]}, "extension": [{"url": "http://hl7.org/fhir/R4/specimen.html", "extension": [{"url": "specimen source", "valueString": "DNA"}, {"url": "specimen collection time", "valueDateTime": "2022-03-31T22:36:00Z"}, {"url": "specimen receive time", "valueDateTime": "2022-03-31T22:44:00Z"}]}], "subject": {"reference": "Patient/f3622006-f41c-4317-99b9-46eb36852a2e"}}, "request": {"method": "PUT", "url": "Observation/ed66ccf7-584a-1142-b9a4-8fe01b6f21fb"}}, {"fullUrl": "urn:uuid:b0f590a6-4bf5-7add-9716-2bd3ba6defb2", "resource": {"resourceType": "DiagnosticReport", "id": "b0f590a6-4bf5-7add-9716-2bd3ba6defb2", "identifier": [{"system": "urn:oid:1.2.840.114350.1.13.478.3.7.2.798268", "value": "2061347"}], "status": "final", "code": {"coding": [{"code": "118330", "display": "Cytogenomic SNP microarray", "system": "urn:oid:1.2.840.114350.1.13.478.3.7.2.696580"}]}, "effectivePeriod": {"start": "2022-04-04T16:55:00Z", "end": "2022-04-04T16:55:00Z"}, "subject": {"reference": "Patient/f3622006-f41c-4317-99b9-46eb36852a2e"}, "performer": [{"reference": "Organization/22c6cdd0-bde1-e220-9ba4-2c2802f795ad"}], "result": [{"reference": "Observation/2a4f8fb5-f957-3c30-1353-a30aa441a12b"}, {"reference": "Observation/2e70be1d-fa6c-0256-cf67-f695f5bba1ac"}, {"reference": "Observation/97b316f7-bb96-051f-adba-72ddc4ae5825"}], "meta": {"source": ["ecr"]}}, "request": {"method": "PUT", "url": "DiagnosticReport/b0f590a6-4bf5-7add-9716-2bd3ba6defb2"}}, {"fullUrl": "urn:uuid:2a4f8fb5-f957-3c30-1353-a30aa441a12b", "resource": {"resourceType": "Observation", "id": "2a4f8fb5-f957-3c30-1353-a30aa441a12b", "meta": {"profile": ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults"], "source": ["ecr"]}, "identifier": [{"system": "urn:oid:1.2.840.114350.1.13.478.3.7.7.798268.1000", "value": "2061347"}], "category": [{"coding": [{"system": "http://terminology.hl7.org/CodeSystem/observation-category", "code": "laboratory"}]}], "status": "final", "code": {"coding": [{"code": "NAR", "system": "urn:oid:1.2.840.114350.1.72.1.5220"}]}, "effectiveDateTime": "2022-04-18T19:57:02Z", "valueString": "MICROARRAY REPORT- Corrected

Request#: CG-22-0000006
Service date: 4/4/2022 11:55

Microarray Result:
Normal female

Microarray Interpretation:
SNP chromosomal microarray analysis (CMA) of a blood sample from this patient demonstrated no copy number changes of known clinical significance. No large regions of homozygosity (ROH) were detected. The ISCN nomenclature describing this result is: arr(X,1-22)x2.
Electronically signed out by:
Benfield, Luis A

on 04/18/2022
___________________________________________________________________

Clinical indication:
Specimen List: Blood
Date in Lab: 4/18/2022 14:46
Date Collected: 4/4/2022 11:55
___________________________________________________________________

Disclaimer:

Copy number gains less than 400 kb in size and copy number losses less than 200 kb in size will not be reported unless they represent a known or suspected clinically relevant imbalance. The reporting of copy number variants less than 100 kb in size is at the discretion of the laboratory and some clinically relevant copy number changes under 50 kb may not be reported due to limitations in probe coverage in certain genomic regions. Copy number changes of any size with no apparent clinical significance (likely benign or benign) have not been discussed in this report but may be available upon request. Regions of homozygosity (ROH) less than 10 Mb in size will not be reported unless the ROH is clinically relevant for potential uniparental disomy. Genome-wide ROH under 2% will not be reported. Copy number variants less than 200 kb associated with a carrier status for autosomal recessive conditions will not be reported unless specifically indicated in the reason for referral.

This microarray was designed and manufactured by Affymetrix for the sole purpose of identifying DNA copy number gains and losses associated with chromosomal imbalances and regions of homozygosity (ROH) associated with uniparental isodisomy (isoUPD).This microarray will detect aneuploidy, deletions and duplications of loci represented on the microarray. \u00a0It will not detect balanced alterations including: reciprocal translocations, inversions and balanced insertions. It will not detect point mutations and imbalances less than 10 kb. \u00a0Failure to detect an alteration at any locus does not exclude the diagnosis of any of the disorders represented on the microarray. This assay is not designed to detect mosaic gains and losses and its performance in detecting mosaicism has not been established. This test was developed and its performance characteristics determined by Affymetrix as required by CLIA \u00c2\u201988 regulations. This test is used for clinical purposes and the accuracy and precision has
been established and verified by this laboratory. This test has not been cleared or approved by the U.S. Food and Drug Administration.

Interpretation of copy number variants is performed using VUMC-laboratory maintained databases as well as the following resources:
Database of Genomic Variants (http://dgv.tcag.ca/dgv/app/home)
Online Mendelian Inheritance in Man (http://www.omim.org/)
UCSC Genome Bioinformatics (http://genome.ucsc.edu/cgi-bin/hgGateway)
ClinGen Clinical Genome Resource (http://www.ncbi.nlm.nih.gov/projects/dbvar/clingen)
DECIPHER Database (https://decipher.sanger.ac.uk/browser)
PubMed-NCBI (http://www.ncbi.nlm.nih.gov/pubmed)
Technical standards for the interpretation and reporting of constitutional copy-number variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics (ACMG) and the Clinical Genome Resource (ClinGen). PMID: 31690835

Method:
Microarray platform: ThermoFisher Scientific CytoScanTM HD Cytogenetics Solution
Version: 1.1 (Based on UCSC hg19 assembly)
Number of loci analyzed: 2,696,550
Mean probe spacing: <700 bp






Testing performed at Vanderbilt Cytogenetics One Hundred Oaks Laboratory, Suite 21100, 719 Thompson Ln,
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ProblemNoted Date
Malignant neoplasm of lower-inner quadrant of left breast in female, estrogen receptor positive12/14/22
Headache8/19/22
Backache8/19/22
Malignant neoplasm of urinary bladder neck11/5/21
Malignant neoplasm of overlapping sites of pancreas9/18/17
Cancer Staging:Stage IIB Stage III
(pT1, pN2, cM0) - Signed by Ocmd Phsbeacon, MD on 9/30/2022Pathologic: (cT1, cN1, cM0) - Signed by Ocmd Phsbeacon, MD on 1/13/2022Clinical stage from 1/13/2022:
Bilateral malignant neoplasm of lower outer quadrant of breast in female2/27/17
Cancer Staging:Stage IIA Stage IV
(rpT2, pN1a(f), pM1, G3, ER: Negative, PR: Negative, HER2: Negative) - Signed by Ocmd Phsbeacon, MD on 1/10/2018Pathologic stage from 12/10/2017: (T1, N1, M0) - Signed by Ocmd Phsbeacon, MD on 2/27/2017Clinical stage from 2/27/2017:
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"http://terminology.hl7.org/CodeSystem/observation-category", "code": "social-history"}]}], "status": "final", "code": {"coding": [{"code": "11341-5", "display": "History of Occupation", "system": "http://loinc.org"}]}, "effectivePeriod": {"start": "2017-12-16"}, "valueCodeableConcept": {"coding": [{"code": "3600", "display": "Nursing, psychiatric, and home health aides", "system": "urn:oid:2.16.840.1.113883.6.240"}]}, "component": [{"code": {"coding": [{"code": "74159-5", "display": "Work Schedule", "system": "http://loinc.org"}]}, "valueCodeableConcept": {"coding": [{"code": "NS", "display": "Night Shift", "system": "urn:oid:2.16.840.1.113883.5.1063"}]}}, {"code": {"coding": [{"code": "63761-1", "display": "What were your main activities or duties for this job", "system": "http://loinc.org"}]}, "valueString": "Patient care"}, {"code": {"coding": [{"code": "87729-0", "display": "History of Occupational Hazard", "system": "http://loinc.org"}]}, "valueString": "Infectious Disease"}, {"code": {"coding": [{"code": "87707-6", "display": "Job supervisory level or pay grade", "system": "http://loinc.org"}]}, "valueCodeableConcept": {"coding": [{"code": "C-6", "display": "C6 - Manager", "system": "urn:oid:2.16.840.1.114222.4.5.327"}]}}, {"code": {"coding": [{"code": "86188-0", "display": "History of Occupation Industry", "system": "http://loinc.org"}]}, "valueCodeableConcept": {"coding": [{"code": "8270", "display": "Nursing care facilities", "system": "http://snomed.info/sct"}]}}, {"code": {"coding": [{"code": "85104-8", "display": "Compensation and Sector Employment Type", "system": "http://loinc.org"}]}, "valueCodeableConcept": {"coding": [{"code": "PWNSE", "display": "Paid non-governmental work, not self-employed", "system": "urn:oid:2.16.840.1.113883.5.1139"}]}}], "subject": {"reference": "Patient/e583072e-b04d-4150-9632-b518ac62a09f"}}, "request": {"method": "PUT", "url": "Observation/965db622-e821-a004-71b9-f6959814516f"}}, {"fullUrl": "urn:uuid:51487854-3257-0685-a4cf-f191347b317e", "resource": {"resourceType": "Observation", "id": "51487854-3257-0685-a4cf-f191347b317e", "meta": {"profile": ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults"], "source": ["ecr"]}, "identifier": [{"system": "urn:ietf:rfc:3986", "value": "urn:uuid:7916c040-f9a4-447d-95e7-3e4877582959"}], "category": [{"coding": [{"system": "http://terminology.hl7.org/CodeSystem/observation-category", "code": "social-history"}]}], "status": "final", "code": {"coding": [{"code": "87510-4", "display": "Date of Retirement", "system": "http://loinc.org"}]}, "valueQuantity": {"value": 20171216}, "subject": {"reference": "Patient/e583072e-b04d-4150-9632-b518ac62a09f"}}, "request": {"method": "PUT", "url": "Observation/51487854-3257-0685-a4cf-f191347b317e"}}, {"fullUrl": "urn:uuid:", "resource": {"resourceType": "Observation", "meta": {"profile": ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults"], "source": ["ecr"]}}, "request": {"method": "PUT", "url": "Observation/"}}]}') ON CONFLICT (ecr_id) DO NOTHING; +INSERT INTO fhir (ecr_id, data) VALUES ('df33f075-83a1-4d28-ba63-05bcc3339c21', '{"resourceType": "Bundle", "type": "batch", "entry": [{"fullUrl": "urn:uuid:df33f075-83a1-4d28-ba63-05bcc3339c21", "resource": {"resourceType": "Composition", "id": "df33f075-83a1-4d28-ba63-05bcc3339c21", "meta": {"profile": ["http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-composition"], "source": ["ecr"]}, "identifier": [{"use": "official", "type": {"coding": [{"code": "55751-2", "display": "Initial Public Health Case Report", "system": "http://loinc.org"}]}, "value": "34682681|64851396"}], "extension": [{"url": "http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber", "valueString": "2"}], "status": "final", "type": {"coding": [{"code": "55751-2", "display": "Initial Public Health Case Report", "system": "http://loinc.org"}]}, "date": "2022-04-15T05:24:59Z", "title": "Initial Public Health Case Report", "confidentiality": "N", "section": [{"id": "3e5d0a34-2c60-8934-a031-bf45982d4640", "title": "PROBLEMS - DIAGNOSES", "text": {"status": "generated", "div": "
Problem or DiagnosisProblem Status
Closed injury of head (disorder)Active
COVID-19Active
Hypertensive disorder, systemic arterial (disorder)Active
Neoplasm of pituitary gland (disorder)Active
Cerebrovascular accident (disorder)Active
Low back strainActive
Motor vehicle crash, injuryActive
Chronic male pelvic painActive
Strain of neckActive
Cervicogenic headacheActive
"}, "code": {"coding": [{"code": "11450-4", "display": "PROBLEM LIST", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"display": "Problem - Closed injury of head (disorder)", "reference": "Condition/47c4eafe-d230-03e3-a449-f3d4e8a570bb"}, {"display": "Problem - Disease caused by 2019-nCoV", "reference": "Condition/7bcd701e-5d28-f178-a33f-64aa74239d54"}, {"reference": "Condition/bc63883a-ebd9-370f-0d9f-ad35c8fe7f52"}, {"display": "Problem - Hypertensive disorder, systemic arterial (disorder)", "reference": "Condition/07559a5f-52d6-186f-25fd-123dd7950656"}, {"display": "Problem - Neoplasm of pituitary gland (disorder)", "reference": "Condition/063ada0c-960f-8557-e828-76ea3ed99aba"}, {"display": "Problem - Cerebrovascular accident (disorder)", "reference": "Condition/2b0e32d9-1c75-b38e-c628-165e8fb18782"}, {"display": "Problem - Low back strain (disorder)", "reference": "Condition/eef12569-0e57-b962-463d-8c74f3f211eb"}, {"display": "Problem - Motor vehicle injury (disorder)", "reference": "Condition/8fabb65c-a7bc-d78a-ee66-87bc0f6f8f23"}, {"display": "Problem - Chronic pain in male pelvis (finding)", "reference": "Condition/65565a5f-5d97-9656-fc4f-c3fac1b55e3d"}, {"display": "Problem - Strain of neck muscle (disorder)", "reference": "Condition/2c4295cc-bde8-63b2-7f48-081683140235"}, {"display": "Problem - Cervicogenic headache (finding)", "reference": "Condition/6e0fec6b-8384-ad29-0f00-a6c9e11d0a29"}]}, {"id": "c559c907-9f5c-028a-07d7-1fd82fc505e8", "title": "ENCOUNTERS", "text": {"status": "generated", "div": "
Encounter ReasonDate of Encounter
observation encounter20220413083600+0000
"}, "code": {"coding": [{"code": "46240-8", "display": "History of Encounters", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "a7c180db-0fa9-6f2b-4d30-bc7884e7e212", "title": "RESULTS", "text": {"status": "generated", "div": "
Lab Test NameLab Test Result ValueLab Test Result Date
Chol/HDL RiskUnknown
Phosphorus4.1|http://unitsofmeasure.org|mg/dL
VLDL Chol Calc34.00|http://unitsofmeasure.org|mg/dL
LDL Direct81|http://unitsofmeasure.org|mg/dL
Trig168|http://unitsofmeasure.org|mg/dL
PTT31|http://unitsofmeasure.org|Seconds
PT10.6|http://unitsofmeasure.org|Seconds
Mg Lvl1.9|http://unitsofmeasure.org|mg/dL
HDL36|http://unitsofmeasure.org|mg/dL
Cholesterol129|http://unitsofmeasure.org|mg/dL
INRUnknown
Estimated Creatinine Clearance104.42|http://unitsofmeasure.org|mL/min
eGFR PediatricNot Reported
Calc Osmo277|http://unitsofmeasure.org|mOsmol/kg
A/G RatioUnknown
eGFR Non-African American88|http://unitsofmeasure.org|mL/min/1.73m2
eGFR African American102|http://unitsofmeasure.org|mL/min/1.73m2
NRBC #0.02|http://unitsofmeasure.org|x10e3/mcL
Sodium137|http://unitsofmeasure.org|mmol/L
Potassium4.1|http://unitsofmeasure.org|mmol/L
Baso # Auto0.05|http://unitsofmeasure.org|x10e3/mcL
Albumin. Level3.6|http://unitsofmeasure.org|gm/dL
Mono # Auto1.15|http://unitsofmeasure.org|x10e3/mcL
Neut # Auto7.67|http://unitsofmeasure.org|x10e3/mcL
Baso % Auto0.4|http://unitsofmeasure.org|%
Eos % Auto0.8|http://unitsofmeasure.org|%
Lymph % Auto34.1|http://unitsofmeasure.org|%
Neut % Auto56.1|http://unitsofmeasure.org|%
Calcium9.6|http://unitsofmeasure.org|mg/dL
RDW-SD45.6|http://unitsofmeasure.org|Femtoliters
Immature Grans # Auto0.03|http://unitsofmeasure.org|x10e3/mcL
Lymph # Auto4.67|http://unitsofmeasure.org|x10e3/mcL
Mono % Auto8.4|http://unitsofmeasure.org|%
RDW-CV17.5|http://unitsofmeasure.org|%
Immature Grans %0.2|http://unitsofmeasure.org|%
Eos # Auto0.11|http://unitsofmeasure.org|x10e3/mcL
Chloride105|http://unitsofmeasure.org|mmol/L
BUN23|http://unitsofmeasure.org|mg/dL
Plt315|http://unitsofmeasure.org|x10e3/mcL
WBC13.68|http://unitsofmeasure.org|x10e3/mcL
TP7.5|http://unitsofmeasure.org|gm/dL
RBC5.41|http://unitsofmeasure.org|x10e6/mcL
PTT30|http://unitsofmeasure.org|Seconds
PT10.8|http://unitsofmeasure.org|Seconds
MPV8.3|http://unitsofmeasure.org|Femtoliters
MCV72.3|http://unitsofmeasure.org|Femtoliters
MCHC30.4|http://unitsofmeasure.org|gm/dL
MCH22.0|http://unitsofmeasure.org|pg
Hgb11.9|http://unitsofmeasure.org|gm/dL
Hct39.1|http://unitsofmeasure.org|%
Glucose Level95|http://unitsofmeasure.org|mg/dL
CO229|http://unitsofmeasure.org|mmol/L
T Bili0.2|http://unitsofmeasure.org|mg/dL
AST20|http://unitsofmeasure.org|units/L
ALT26|http://unitsofmeasure.org|units/L
Alk Phos74|http://unitsofmeasure.org|units/L
NRBC %0.1|http://unitsofmeasure.org|/100 WBC
BUN/Creat RatioUnknown
INRUnknown
Anion Gap3|http://unitsofmeasure.org|mmol/L
Creatinine1.010|http://unitsofmeasure.org|mg/dL
"}, "code": {"coding": [{"code": "30954-2", "display": "RESULTS", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"reference": "Observation/669afe70-d46a-6c5a-bfaa-0462d90ba971"}, {"reference": "Observation/72cffbc2-4943-2898-0594-ee8d47b84782"}, {"reference": "Observation/25b26309-ce1b-541b-2ad0-b4037f1c2ed2"}, {"reference": "Observation/d500db57-e204-1544-45d3-5807c1f361da"}, {"reference": "Observation/24667cf4-bccd-7cb6-c513-1757c3d3df56"}, {"reference": "Observation/5659d25c-4bc9-f555-dea4-9d3b30666798"}, {"reference": "Observation/b7ef76fe-e4e3-198b-2f9a-d794724e2409"}, {"reference": "Observation/aec5ef09-b2e9-f0d2-6c16-a68dfce76c33"}, {"reference": "Observation/d6b3d327-931e-9310-be54-6e5c0ac9369c"}, {"reference": "Observation/a944fa13-5e3c-f119-b12e-f15d1c8ec410"}, {"reference": "Observation/9933511b-0922-5c70-fede-3fcb109c0b5d"}, {"reference": "Observation/e0aa51dc-77f9-41b2-e379-d0dd6d532e37"}, {"reference": "Observation/2995211e-b63a-04e0-291b-8b03d6e7209a"}, {"reference": "Observation/041d93a8-0ae4-7b9c-e1a6-15f8c7c6abdd"}, {"reference": "Observation/c8cd2349-1637-810c-2bb6-2a1997019295"}, {"reference": "Observation/264a6633-15a4-ffe9-a878-bfb37039c654"}, {"reference": "Observation/fcf12021-cb7c-e1d8-b42a-5bca54402469"}, {"reference": "Observation/3c2e98a4-fd49-f6db-d8d2-8aa7eb96ee5f"}, {"reference": "Observation/bb2380e8-f0e2-2280-ea12-5ff8ad038e59"}, {"reference": "Observation/505e9087-9721-c2a2-844d-99133b9fe974"}, {"reference": "Observation/2f178a8f-6e74-bb84-5619-0418924c6a7e"}, {"reference": "Observation/cfc53f36-abef-d177-e089-957c73c2fc07"}, {"reference": "Observation/f0d9b1a9-5706-8f53-b267-d05e692a19c6"}, {"reference": "Observation/ea70cb27-85f0-b205-d658-cf9ebdf40802"}, {"reference": "Observation/607685f7-0b3f-e484-0766-80dd6d4a5842"}, {"reference": "Observation/b35693d0-16d6-31d1-3fa9-e7691d7dc924"}, {"reference": "Observation/8c4061ab-74df-5093-6808-7ad07235e7e6"}, {"reference": "Observation/d2719f59-27ca-6226-f3bd-586ef734eef5"}, {"reference": "Observation/66a38bce-d5b3-fb1c-7e04-46069d2cdce4"}, {"reference": "Observation/3ca70793-400f-6caa-a25b-3a7ae07c5e39"}, {"reference": "Observation/7899eb53-1762-5452-2c01-1e89e87ecd75"}, {"reference": "Observation/e5978ea1-fec6-e6e8-5475-4c31c3c8abd7"}, {"reference": "Observation/eae839eb-9d6e-c9a8-1ac4-3dfbc3fac67d"}, {"reference": "Observation/7bbbf1a2-c4b2-c3ad-1832-788db7fa92fd"}, {"reference": "Observation/f17a85de-82fa-d809-2c99-6068baa126b4"}, {"reference": "Observation/d4b48186-6821-f30d-991d-1bd6f3b6691a"}, {"reference": "Observation/a1b7f8a7-7536-d96d-b436-74817230c55c"}, {"reference": "Observation/b242c5d7-74a7-6595-1783-7f6ee197f901"}, {"reference": "Observation/4ced71d6-ad9e-c3b4-9142-4ee295fc2e17"}, {"reference": "Observation/cd894b93-2504-2748-b955-f5ff523887ba"}, {"reference": "Observation/70d289aa-7f9b-bf1e-ecdf-c4d09e4a5093"}, {"reference": "Observation/05ba4e77-2ddf-8ab6-d92c-8e53fa1d55ed"}, {"reference": "Observation/a7d3def7-6bec-a8f8-d328-04c40aadecc9"}, {"reference": "Observation/244ddfa2-dd36-d911-97a9-7b3f8365b190"}, {"reference": "Observation/e5aa0a6b-9119-af83-bbc9-d4eca6c9b313"}, {"reference": "Observation/1850e9fa-7ef5-6507-e975-b99aa75a098f"}, {"reference": "Observation/7e081ec9-af06-a434-a0ca-f823aff8bae4"}, {"reference": "Observation/4fe4411e-4b85-1cf4-b1b2-5f53555963ed"}, {"reference": "Observation/858a2450-e45d-5df7-afb5-ac38115a7487"}, {"reference": "Observation/3b80b0f0-da03-a615-f69c-57b4591b96ea"}, {"reference": "Observation/dd63811b-60e3-605b-95b1-79b1305bd70e"}, {"reference": "Observation/7a4e1aac-b8b1-2179-a80c-e8c40934fff2"}, {"reference": "Observation/e86f39d7-4e90-9fca-677f-db58aeeca42e"}, {"reference": "Observation/539d5565-69b3-91fd-0744-f4e3c054e510"}, {"reference": "Observation/4605c412-3f46-1c67-e8d8-267f8974d192"}, {"reference": "Observation/ccb14b90-044c-fc57-6fc7-7cee67f06222"}, {"reference": "Observation/15b3d8a9-8ae7-0ab9-7ffe-57dff7a9cffd"}, {"reference": "Observation/7d9bc710-a31d-4047-df2f-2cafd97cb02e"}, {"reference": "Observation/aa0825c8-2cd8-f610-178b-16de6aafe423"}, {"reference": "Observation/e97c82cc-56f0-2980-85b1-e983dac30917"}, {"reference": "Observation/1c9600bc-b586-f001-25fc-13be72f7f296"}]}, {"id": "3bb3aac3-d469-3fba-d196-ba5e7a2c2801", "title": "Medications Administered", "text": {"status": "generated", "div": "
Medication NameMedication Start Date
docusate (Colace)20220413132200+0000
acetaminophen (Tylenol)20220413132200+0000
hydrocodone-acetaminophen (Norco 5 mg-325 mg oral tablet)20220413132200+0000
ipratropium-albuterol (DuoNeb)20220413132200+0000
hydrALAZINE20220413132200+0000
labetalol20220413132200+0000
levETIRAcetam (Keppra)Unknown
meclizine20220413113800+0000
melatonin (melatonin 3 mg oral tablet)20220413132200+0000
morphine20220413132200+0000
ondansetron (Zofran)20220413132200+0000
simethicone (Mylicon)20220413132200+0000
heparin20220413170000+0000
famotidine (Pepcid)Unknown
Sodium Chloride 0.9% intravenous solution 1,000 mL20220413110600+0000
acetaminophen (Tylenol)20220413110600+0000
heparin20220413130000+0000
morphine20220413113700+0000
ondansetron (Zofran)20220413110600+0000
morphine20220413105900+0000
prochlorperazine (Compazine)20220413120000+0000
diphenhydrAMINE (Benadryl)20220413105900+0000
ketorolac (Toradol)20220413105900+0000
"}, "code": {"coding": [{"code": "29549-3", "display": "Medications Administered", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"reference": "MedicationAdministration/d79bfe31-f85f-4d2a-5eb9-6183842bd415"}, {"reference": "MedicationAdministration/a76d84ff-d244-13ff-54a1-b7da3861df8b"}, {"reference": "MedicationAdministration/978dd261-ced7-606c-94cb-d9a9ee079d69"}, {"reference": "MedicationAdministration/f8736fd2-4ec9-f119-f83d-dc5f902fbb39"}, {"reference": "MedicationAdministration/3fc944e1-612d-f09a-607a-2dcfdc31e067"}, {"reference": "MedicationAdministration/8a9c0b16-62f6-b3df-44ac-a4e3a3568025"}, {"reference": "MedicationAdministration/68ced031-e2b8-bb07-96df-263c4f62ee78"}, {"reference": "MedicationAdministration/09fe790a-08bb-15b5-ad51-b986c592c815"}, {"reference": "MedicationAdministration/680b158c-a138-eb05-a948-fc1b7a48fc95"}, {"reference": "MedicationAdministration/41947ef8-4fd7-3717-ccd7-59a5ed151bdb"}, {"reference": "MedicationAdministration/0af4fb75-7649-8b1e-3ac2-4ccf6ca8ddb5"}, {"reference": "MedicationAdministration/9256df52-4aae-21c8-0bdd-fd30f3d226ba"}, {"reference": "MedicationAdministration/0ef906a6-598a-f208-701f-407d7a89c539"}, {"reference": "MedicationAdministration/7ebdc457-3f17-7cfb-4976-fd2b2a353b39"}, {"reference": "MedicationAdministration/72f91cdf-07a2-b899-22b5-e838620e987b"}, {"reference": "MedicationAdministration/d0528813-3060-32f0-ef54-0cdd807e6b9c"}, {"reference": "MedicationAdministration/47489478-127e-2205-3016-77f4c552cb12"}, {"reference": "MedicationAdministration/b4b560b3-a232-865d-3dca-daac79ba0d40"}, {"reference": "MedicationAdministration/eec8a692-2b39-d7e7-a0d8-0a120c2b810b"}, {"reference": "MedicationAdministration/87241dd2-4d29-3445-74e9-361a3b263dd2"}, {"reference": "MedicationAdministration/1230d359-3d2b-b52a-3984-7a7dd860b2f0"}, {"reference": "MedicationAdministration/47a56c19-9de2-94ca-14c8-245c0f5bfa1e"}, {"reference": "MedicationAdministration/c6238475-81cb-a9ed-1535-aa716292a7d7"}]}, {"id": "dd08df91-869b-46df-dd36-c5c0f2ad2eae", "title": "IMMUNIZATIONS", "text": {"status": "generated", "div": "No ImmunizationInformation"}, "code": {"coding": [{"code": "11369-6", "display": "History of immunizations", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "c74504df-1bdc-137f-3790-44f6cea7fa89", "title": "SOCIAL HISTORY", "text": {"status": "generated", "div": "
Social History ObservationSocial History Observation Result
Birth SexM
Travel HistoryPregnancy Status-Not applicable (qualifier value)
Travel HistoryCOVID-19 Previously tested-No (qualifier value)
Travel HistoryTB Risk Score-
Travel HistorySymptoms of TB-No symptoms of TB
Travel HistoryHistory of tuberculosis (situation)-No known history of exposure to TB
Travel HistoryC.diff Screening-No (qualifier value)
Travel HistoryMRSA Screen Hx MRSA-No (qualifier value)
Travel HistoryRecent Exposure to Communicable Disease-No (qualifier value)
Travel HistoryPregnancy Status-Not applicable (qualifier value)
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DTaPJanuary 31st, 2019232323232
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Hepatitis B, Recombinant- EngerixFebruary 8th, 20196
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Prevnar 13February 8th, 201964654654
RotaTeqFebruary 8th, 201953465464
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Height67.00 [in_i]January 29th, 2019 1:14pm
Weight160.00 [lb_av]January 29th, 2019 1:14pm
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Departed ClinicalMEDITECH General Hospital-Day Hospital - MTGHJanuary 29th, 2019 1:09pmJanuary 29th, 2019 1:10pmAnthony Brown
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Arterial Blood GlucoseJanuary 25th, 2021 9:39amMarch 14th, 2021 5:08pm
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UnknownActive
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Encounter ReasonDate of Encounter
Emergency20220513072500+0000
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Ur MucousNONE /LPF
Ur Squam Epithelial1|http://unitsofmeasure.org|/HPF
Ur WBC1|http://unitsofmeasure.org|/HPF
Ur RBC2|http://unitsofmeasure.org|/HPF
Ur BacteriaNone Seen /HPF
Symptomatic as defined by CDC?No
In ICU?No
Group care resident?No
First test?UNK
Employed in healthcare?No
Date of onset?UNK
SARS-CoV-2 Interp:Unknown
SARS-CoV-2 PCRNegative
Flu B PCRNot Detected
Flu A PCRNot Detected
Ur pH6.0
Ur Spec Grav1.020 mg/dL
Ur Urobilinogen0.2 EU/dL
Ur BloodTrace-lysed
Ur BiliNegative
Ur Leuk EstNegative
Ur ProteinNegative mg/dL
Ur NitriteNegative
Ur KetonesNegative mg/dL
UR GlucoseNegative mg/dL
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prednisoLONE (Orapred 15 mg/5 mL oral liquid)20220513094300+0000
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Social History ObservationSocial History Observation Result
Birth SexM
Travel HistoryCOVID- 19 Testing Reason-Screening
Travel HistoryPregnancy Status-Not applicable (qualifier value)
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Narrative Text
Fever
Cough
Encounter for medical screening examination
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text
FEVER
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NameAdministration DatesNext Due
DTaP, 5 pertussis antigens vaccine (DAPTACEL)06/15/2021
Hep B, adult vaccine (Engerix/Recombivax)09/08/2020
SARS-COV-2 (COVID-19) RED CAP +BLUE LABEL VACCINE, MODERNA 12+YO01/22/2021
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Pending Results
NameTypePriorityAssociated DiagnosesDate/Time
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
PCR SARS-CoV-2 and Influenza A/BLabRoutine12/07/2021 4:16 PM CST
documented as of this encounter"}, "code": {"coding": [{"code": "18776-5", "display": "Plan of care note", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"reference": "CarePlan/581a29d4-5295-5382-5460-cf0582ee5bca"}]}, {"id": "656AD662-8ABE-11ED-8CA0-0050561597B4", "title": "Problems", "text": {"status": "generated", "div": "
Active ProblemsNoted Date
COVID toes7/13/22
Chest pain on breathing5/26/22
Type 1 diabetes2/28/22
Overview:Formatting of this note might be different from the original.
08/30/21 28.69 kg/m\u00b2BMI Readings from Last 1 Encounters:
Plague pneumonia6/16/21
Absence of menstruation6/12/18
Foot callus8/11/17
Overview:Formatting of this note might be different from the original.
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Problem or DiagnosisProblem Status
TTP (thrombotic thrombocytopenic purpura)Active
"}, "code": {"coding": [{"code": "11450-4", "display": "PROBLEM LIST", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"display": "Problem - Thrombotic thrombocytopenic purpura (disorder)", "reference": "Condition/3907477b-3eba-59c4-6622-d3c3a81a39f4"}]}, {"id": "58ebd6f7-9c63-dac4-1f3f-c4a55907bb39", "title": "ENCOUNTERS", "text": {"status": "generated", "div": "
Encounter ReasonDate of Encounter
observation encounter20220415161500+0000
"}, "code": {"coding": [{"code": "46240-8", "display": "History of Encounters", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "dc32a83b-bbcc-85fe-5240-91c405175be5", "title": "RESULTS", "text": {"status": "generated", "div": "
Lab Test NameLab Test Result ValueLab Test Result Date
Troponin TNIH8.2|http://unitsofmeasure.org|ng/L
Troponin TNIH8.1|http://unitsofmeasure.org|ng/L
Troponin TNIH9.5|http://unitsofmeasure.org|ng/L
NT-ProBNP84|http://unitsofmeasure.org|pg/mL
Estimated Creatinine Clearance52.76|http://unitsofmeasure.org|mL/min
Symptomatic as defined by CDC?Yes
In ICU?No
Group care resident?No
Employed in healthcare?No
SARS-CoV-2 Interp:Unknown
SARS-CoV-2 PCRNegative
eGFR PediatricNot Reported
Flu B PCRNot Detected
Flu A PCRNot Detected
Calc Osmo270|http://unitsofmeasure.org|mOsmol/kg
A/G RatioUnknown
eGFR Non-African American70|http://unitsofmeasure.org|mL/min/1.73m2
eGFR African American81|http://unitsofmeasure.org|mL/min/1.73m2
Sodium135|http://unitsofmeasure.org|mmol/L
Potassium4.0|http://unitsofmeasure.org|mmol/L
Baso # Auto0.02|http://unitsofmeasure.org|x10e3/mcL
Albumin. Level3.6|http://unitsofmeasure.org|gm/dL
Mono # Auto0.60|http://unitsofmeasure.org|x10e3/mcL
Neut # Auto4.73|http://unitsofmeasure.org|x10e3/mcL
Baso % Auto0.3|http://unitsofmeasure.org|%
Eos % Auto0.7|http://unitsofmeasure.org|%
Lymph % Auto21.3|http://unitsofmeasure.org|%
Neut % Auto68.9|http://unitsofmeasure.org|%
Calcium9.1|http://unitsofmeasure.org|mg/dL
RDW-SD49.7|http://unitsofmeasure.org|Femtoliters
Immature Grans # Auto0.01|http://unitsofmeasure.org|x10e3/mcL
Lymph # Auto1.46|http://unitsofmeasure.org|x10e3/mcL
Mono % Auto8.7|http://unitsofmeasure.org|%
RDW-CV14.9|http://unitsofmeasure.org|%
Immature Grans %0.1|http://unitsofmeasure.org|%
Eos # Auto0.05|http://unitsofmeasure.org|x10e3/mcL
Chloride101|http://unitsofmeasure.org|mmol/L
BUN9|http://unitsofmeasure.org|mg/dL
Plt195|http://unitsofmeasure.org|x10e3/mcL
WBC6.87|http://unitsofmeasure.org|x10e3/mcL
TP8.9|http://unitsofmeasure.org|gm/dL
RBC4.92|http://unitsofmeasure.org|x10e6/mcL
MPV11.6|http://unitsofmeasure.org|Femtoliters
MCV90.7|http://unitsofmeasure.org|Femtoliters
MCHC33.0|http://unitsofmeasure.org|gm/dL
MCH29.9|http://unitsofmeasure.org|pg
Hgb14.7|http://unitsofmeasure.org|gm/dL
Hct44.6|http://unitsofmeasure.org|%
Glucose Level115|http://unitsofmeasure.org|mg/dL
D Dimer0.34|http://unitsofmeasure.org|mcg/mL FEU
CO228|http://unitsofmeasure.org|mmol/L
T Bili0.8|http://unitsofmeasure.org|mg/dL
AST25|http://unitsofmeasure.org|units/L
ALT19|http://unitsofmeasure.org|units/L
Alk Phos67|http://unitsofmeasure.org|units/L
BUN/Creat RatioUnknown
Anion Gap6|http://unitsofmeasure.org|mmol/L
Creatinine0.856|http://unitsofmeasure.org|mg/dL
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VALUES ('cf9e1db8-fcc5-4cbc-96cd-043d3fd65bac', '{"resourceType": "Bundle", "type": "batch", "entry": [{"fullUrl": "urn:uuid:cf9e1db8-fcc5-4cbc-96cd-043d3fd65bac", "resource": {"resourceType": "Composition", "id": "cf9e1db8-fcc5-4cbc-96cd-043d3fd65bac", "meta": {"profile": ["http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-composition"], "source": ["ecr"]}, "identifier": [{"use": "official", "type": {"coding": [{"code": "55751-2", "display": "Initial Public Health Case Report", "system": "http://loinc.org"}]}, "value": "32943241|64979134"}], "extension": [{"url": "http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber", "valueString": "2"}], "status": "final", "type": {"coding": [{"code": "55751-2", "display": "Initial Public Health Case Report", "system": "http://loinc.org"}]}, "date": "2022-04-30T16:55:43Z", "title": "Initial Public Health Case Report", "confidentiality": "N", "section": [{"id": "4830b790-114f-0e08-8f3b-f30cfac2e55c", "title": "PROBLEMS - DIAGNOSES", "text": {"status": "generated", "div": "
Problem or DiagnosisProblem Status
Disease caused by 2019-nCoVActive
Abdominal pain (finding)Active
Abdominal pain (finding)Active
Patient encounter status (finding)Active
Patient encounter status (finding)Active
Lupus erythematosus (disorder)Active
Abdominal painActive
Lupus erythematosusActive
Malaise (finding)Active
Low back painActive
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Encounter ReasonDate of Encounter
Emergency20220428011000+0000
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Lab Test NameLab Test Result ValueLab Test Result Date
Ur pHUnknown
Ur Spec GravUnknown
Ur Urobilinogen<2.0 mg/dL
Ur Blood1+ mg/dL
Ur BiliNegative mg/dL
Ur Leuk Est1+
Ur ColorYellow
Ur MucousRare /LPF
Ur Squam Epithelial5|http://unitsofmeasure.org|/HPF
Ur WBC18|http://unitsofmeasure.org|/HPF
Ur RBC2|http://unitsofmeasure.org|/HPF
Ur ProteinNegative mg/dL
Ur NitriteNegative
Ur KetonesNegative mg/dL
UR GlucoseNegative mg/dL
Ur BacteriaNone Seen /HPF
Ur ClarityClear
U Beta hCG QlNegative
Ur pH5.5
Ur Spec Grav1.020 mg/dL
Ur Urobilinogen0.2 EU/dL
Ur BloodTrace-lysed
Ur BiliNegative
Ur Leuk EstTrace
Ur ProteinNegative mg/dL
Ur NitriteNegative
Ur KetonesNegative mg/dL
UR GlucoseNegative mg/dL
Estimated Creatinine Clearance55.01|http://unitsofmeasure.org|mL/min
Troponin TNIH4.2|http://unitsofmeasure.org|ng/L
eGFR PediatricNot Reported
Calc Osmo284|http://unitsofmeasure.org|mOsmol/L
A/G Ratio1.1|http://unitsofmeasure.org|Ratio
eGFR Non-African American64.68 mL/min/1.73m2
eGFR African American74.97 mL/min/1.73m2
Sodium141|http://unitsofmeasure.org|mmol/L
Potassium3.6|http://unitsofmeasure.org|mmol/L
NT-ProBNP44|http://unitsofmeasure.org|pg/mL
Baso # Auto0.05|http://unitsofmeasure.org|x10e3/mcL
Albumin. Level4.1|http://unitsofmeasure.org|gm/dL
Mono # Auto0.6|http://unitsofmeasure.org|x10e3/mcL
Neut # Auto3.3|http://unitsofmeasure.org|x10e3/mcL
Baso % Auto0.8|http://unitsofmeasure.org|%
Eos % Auto1.9|http://unitsofmeasure.org|%
Lymph % Auto32.3|http://unitsofmeasure.org|%
Neut % Auto55.5|http://unitsofmeasure.org|%
Calcium8.8|http://unitsofmeasure.org|mg/dL
Immature Grans # Auto0.01|http://unitsofmeasure.org|x10e3/mcL
Lymph # Auto1.9|http://unitsofmeasure.org|x10e3/mcL
Mono % Auto9.3|http://unitsofmeasure.org|%
RDW-CV13.9|http://unitsofmeasure.org|%
Immature Grans %0.2|http://unitsofmeasure.org|%
Eos # Auto0.1|http://unitsofmeasure.org|x10e3/mcL
Chloride106|http://unitsofmeasure.org|mmol/L
BUN20|http://unitsofmeasure.org|mg/dL
Plt231|http://unitsofmeasure.org|x10e3/mcL
WBC5.9|http://unitsofmeasure.org|x10e3/mcL
TP7.8|http://unitsofmeasure.org|gm/dL
RBC4.01|http://unitsofmeasure.org|x10e6/mcL
PT11.3|http://unitsofmeasure.org|Seconds
MPV11.7|http://unitsofmeasure.org|Femtoliters
MCV93.8|http://unitsofmeasure.org|Femtoliters
MCHC31.9|http://unitsofmeasure.org|gm/dL
MCH29.9|http://unitsofmeasure.org|pg
Hgb12.0|http://unitsofmeasure.org|gm/dL
Hct37.6|http://unitsofmeasure.org|%
Glucose Level97|http://unitsofmeasure.org|mg/dL
CO224.8|http://unitsofmeasure.org|mmol/L
T BiliTNP see comment mg/dL
AST22|http://unitsofmeasure.org|Intl_units/L
ALT27|http://unitsofmeasure.org|Intl_units/L
Alk Phos72|http://unitsofmeasure.org|Intl_units/L
BUN/Creat Ratio20.0|http://unitsofmeasure.org|Ratio
INRUnknown
Anion GapUnknown
HCG Bld QLNegative
Creatinine1.0|http://unitsofmeasure.org|mg/dL
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{"reference": "Observation/33e33359-906b-32f0-b37d-c3158227e983"}, {"reference": "Observation/f585f4ee-42d5-8f2f-56f0-7e0da7a03abd"}, {"reference": "Observation/2277e890-f5ea-3a88-c352-ed3f4954f1ce"}, {"reference": "Observation/befcee9f-ad47-45df-3312-363b6ddf2b9b"}, {"reference": "Observation/a4f9de6e-c44e-e616-438a-5791551dcbb1"}, {"reference": "Observation/e4c97705-3c2a-e926-ec4f-5f30e85388b2"}]}, {"id": "36583a63-dfcd-7388-88d4-873cc3872f08", "title": "Medications Administered", "text": {"status": "generated", "div": "
Medication NameMedication Start Date
ibuprofen (ibuprofen 400 mg oral tablet)20220428100300+0000
predniSONE (predniSONE 20 mg oral tablet)20220428100300+0000
ketorolac (Toradol)20220428100200+0000
dexamethasone20220428100200+0000
"}, "code": {"coding": [{"code": "29549-3", "display": "Medications Administered", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"reference": "MedicationAdministration/b4f23db8-3dd4-128a-9e9a-8950aba90765"}, {"reference": "MedicationAdministration/d6ad2f63-41ac-6780-3095-b098fa30e66a"}, {"reference": "MedicationAdministration/086c88c7-8a99-492a-4a9b-2554975ee335"}, {"reference": "MedicationAdministration/7ef1176a-afc7-60fc-039d-5e3685d27410"}]}, {"id": "dd08df91-869b-46df-dd36-c5c0f2ad2eae", "title": "IMMUNIZATIONS", "text": {"status": "generated", "div": "No ImmunizationInformation"}, "code": {"coding": [{"code": "11369-6", "display": "History of immunizations", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "946ec7ff-8f6e-41b4-8609-dc72d0dd97a6", "title": "SOCIAL HISTORY", "text": {"status": "generated", "div": "
Social History ObservationSocial History Observation Result
Birth SexF
"}, "code": {"coding": [{"code": "29762-2", "display": "Social History", "system": "http://loinc.org"}]}, "mode": "snapshot"}, {"id": "7dbd51e8-1c15-8cfa-cbce-f6f4b9a1ed5d", "title": "Plan of Treatment", "text": {"status": "generated", "div": "No Plan Of Treatment Information"}, "code": {"coding": [{"code": "18776-5", "display": "Treatment Plan", "system": "http://loinc.org"}]}, "mode": "snapshot", "entry": [{"reference": "CarePlan/ec77d178-de8a-915a-311a-1f11f2838946"}]}, {"id": "35ea10af-dd39-40cf-113d-22418b1902a7", "title": "History of Present Illness", "text": {"status": "generated", "div": "
Narrative Text
Medical screening exam
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Pending Results
NameTypePriorityAssociated DiagnosesDate/Time
Drugs Of Abuse Comprehensive Screen, UrLabSTAT12/23/2022 11:13 AM PST
Scheduled Orders
NameTypePriorityAssociated DiagnosesOrder Schedule
Drugs Of Abuse Comprehensive Screen, UrLabRoutineOne Time for 1 Occurrences starting 12/23/22 until 12/23/22
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Tobacco UseTypesPacks/DayYears UsedDate
Smoking Tobacco: Never Assessed
Sex Assigned at BirthDate Recorded
Not on file
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DateTypeDepartmentCare TeamDescription
10/11/22EmergencyHOAG MEMORIAL HOSPITAL NEWPORT EMERGENCY CENTER1 HOAG DRNEWPORT BEACH, CA 92663-4162949-764-8372
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Unconfirmed screening results must not be used for non-medical purposes (e.g., employment testing).
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INSERT INTO fhir_metadata ( ecr_id,patient_name_last,patient_name_first,patient_birth_date,data_source,reportable_condition,rule_summary,report_date ) VALUES ( diff --git a/containers/fhir-converter/Templates/eCR/Resource/_Practitioner.liquid b/containers/fhir-converter/Templates/eCR/Resource/_Practitioner.liquid index ede27ddc21..9b8890a43f 100644 --- a/containers/fhir-converter/Templates/eCR/Resource/_Practitioner.liquid +++ b/containers/fhir-converter/Templates/eCR/Resource/_Practitioner.liquid @@ -3,7 +3,7 @@ "resource":{ "resourceType": "Practitioner", "id":"{{ ID }}", - {% if practitioner.assignedPerson and practitioner.assignedPerson.name and practitioner.assignedPerson.name.given.first._ -%} + {% if practitioner.assignedPerson and practitioner.assignedPerson.name -%} {% assign personNames = practitioner.assignedPerson.name | to_array -%} {% assign personType = "PERSON" -%} {% endif -%}