Appendix D - Data Used in the Examples
The examples in this specification are based on the following patient story:
Peter Packton comes in to see his primary care provider, Dr. Anthony Allen, for an annual check-up. Dr. Allen sees Mr. Packton on September 2nd. The patient has a BMI of 30, no history of smoking, occasional chest pain with exertion, no physical signs of respiratory and cardiac problems, and a family history of coronary artery disease where his dad died of a heart attack at age 53. Dr. Allen diagnoses Mr. Packton with hypertension and an elevated LDL and decides to refer him to a cardiologist, requesting a consultation within a month. Dr. Allen sends a referral to a cardiologist, Dr. Charles Carlyle, but since Dr. Carlyle is unable to accept Mr. Packton's insurance, the referral is returned the next day to Dr. Allen's office with a reason of "Insurance out of network". Dr. Allen then sends the referral to another cardiologist, Dr. Beatrice Brown, who accepts the referral, and her practice schedules an appointment with Mr. Packton for September 8th. After seeing the patient, Dr. Brown sends her consultation report to Dr. Allen, sharing her findings, and letting him know that a CT Angiography is scheduled. The procedure is performed on September 21st, and the diagnosis of coronary artery disease is confirmed. Dr. Brown has a follow-up appointment with Mr. Packton on September 28th and sends the CTA report, including a summary of care with a proposed plan of care, which closes the referral loop.
Administrative information includes demographics, various identifiers, and other administrative data which are used in the examples above.
Patient
| First name | Peter |
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| Middle Name | Prince |
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| Family Name | Packton |
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| DOB | August 17, 1958 |
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| Address | 8823 Harmon Avenue, Apartment 3C |
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| CIty | Anytown |
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| State | New Jersey |
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| Zip | 66666 |
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Patient ID
with provider A | ID: T7190334
CX Data Type: T7190334^^^&1.3.6.1.4.1.21367.2016.10.1.21.5&ISO^MRN
II Data Type: <id root="1.3.6.1.4.1.21367.2016.10.1.21.5" extension="T7190334"> |
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Patient ID
with provider B | ID: L53HG67
CX Data Type: L53HG67^^^&1.3.6.1.4.1.21367.2016.10.1.32.11&ISO^MRN
II Data Type: <id root="1.3.6.1.4.1.21367.2016.10.1.32.11" extension="L53HG67"> |
|---|
Provider A
| First Name | Anthony |
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| Family Name | Allen |
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| Title | MD |
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| NPI | 5556667777 |
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| Organization name | Neighborhood Health Clinic |
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| Organization OID | 1.3.6.1.4.1.21367.2016.10.1.21 |
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| OID for patient ID assignment | 1.3.6.1.4.1.21367.2016.10.1.21.5 |
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| OID for provider ID assignment | 1.3.6.1.4.1.21367.2016.10.1.21.10 |
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| OID for referral orders assignment | 1.3.6.1.4.1.21367.2016.10.1.21.15 |
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Provider ID within
the organization | 34225PC |
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| Direct address | aallen@direct.nhc.example.org |
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Provider B
| First Name | Beatrice |
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| Family Name | Brown |
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| Title | MD |
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| NPI | 2223334444 |
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| Organization name | Cardiology Partners |
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| Organization OID | 1.3.6.1.4.1.21367.2016.10.1.32 |
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| OID for patient ID Assignment | 1.3.6.1.4.1.21367.2016.10.1.32.11 |
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| OID for provider ID assignment | 1.3.6.1.4.1.21367.2016.10.1.32.13 |
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| OID for appointment ID assignment | 1.3.6.1.4.1.21367.2016.10.1.32.17 |
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Provider ID within
the organization | 42334DG |
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| Direct address | bbrown@direct.cpart.example.org |
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Provider C
| First Name | Charles |
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| Family Name | Carlyle |
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| Title | MD |
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| NPI | 8889990000 |
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| Organization name | Cardiology Associates |
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| Organization OID | 1.3.6.1.4.1.21367.2016.10.1.62 |
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| OID for patient ID Assignment | 1.3.6.1.4.1.21367.2016.10.1.62.12 |
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| OID for provider ID assignment | 1.3.6.1.4.1.21367.2016.10.1.62.14 |
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| OID for appointment ID assignment | 1.3.6.1.4.1.21367.2016.10.1.62.18 |
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Provider ID within
the organization | 94893CC |
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| Direct address | ccarlyle@direct.cpart.example.org |
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D.2 Clinical Data
| Height | 5' 9" |
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| Weight | 205 lbs |
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| BMI | 30.3 |
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| Blood Pressure | 195/122 |
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| LDL | 200 |
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| CT Angiograph Impression | 40% stenosis of left anterior descending artery |
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