Polaris FHIR Implementation Guide
1.9.5 - ci-build

Polaris FHIR Implementation Guide - Local Development build (v1.9.5) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Polaris App Consent - DENIED Example - JSON Representation

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{
  "resourceType" : "Consent",
  "id" : "avery-wellness-consent-denied",
  "meta" : {
    "profile" : [
      🔗 "https://fhir.apps.health/StructureDefinition/polaris-core-app-consent"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>App Consent - DENIED</b></p><p>Patient: <strong>Avery Linwood</strong> has <strong>DECLINED</strong> to share clinical data with <strong>WellnessTracker Pro</strong> application.</p><p>Date: April 8, 2025 at 3:45 PM</p><p>Status: Active consent using FHIR R4 deny pattern (nested provision with type='deny').</p></div>"
  },
  "identifier" : [
    {
      "system" : "https://fhir.apps.health/NamingSystem/cedarbrook-clinic-app-consent-identifier",
      "value" : "app-consent-wellness-avery-denied-20250408"
    }
  ],
  "status" : "active",
  "scope" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/consentscope",
        "code" : "patient-privacy",
        "display" : "Privacy Consent"
      }
    ]
  },
  "category" : [
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/consentcategorycodes",
          "code" : "infa",
          "display" : "Information Access"
        }
      ]
    }
  ],
  "patient" : {
    "identifier" : {
      "system" : "https://fhir.apps.health/NamingSystem/cedarbrook-clinic-patient-identifier",
      "value" : "1234567890"
    },
    "display" : "Avery Linwood"
  },
  "dateTime" : "2025-04-08T15:45:00-06:00",
  "sourceAttachment" : {
    "contentType" : "application/pdf",
    "data" : "JVBERi0xLjQKJeLjz9MKMSAwIG9iago8PAovVHlwZSAvQ2F0YWxvZwovUGFnZXMgMiAwIFIKPj4KZW5kb2JqCjIgMCBvYmoKPDwKL1R5cGUgL1BhZ2VzCi9LaWRzIFszIDAgUl0KL0NvdW50IDEKPD4KZW5kb2JqCjMgMCBvYmoKPDwKL1R5cGUgL1BhZ2UKL1BhcmVudCAyIDAgUgovTWVkaWFCb3ggWzAgMCA2MTIgNzkyXQovUmVzb3VyY2VzIDw8L0ZvbnQgPDwvRjEgNCAwIFI+Pj4+Ci9Db250ZW50cyA1IDAgUgo+PgplbmRvYmoK",
    "size" : 8456,
    "hash" : "YTQwNTQwYTM5YTMwMGM5ZjYzZGI4YzJjYTI2ZWFmYzE=",
    "title" : "WellnessTracker Pro Consent Refusal Form - Signed",
    "creation" : "2025-04-08T15:45:00-06:00"
  },
  "policyRule" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/consentpolicycodes",
        "code" : "cric",
        "display" : "Common Rule Informed Consent"
      }
    ]
  },
  "provision" : {
    "actor" : [
      {
        "role" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
              "code" : "IRCP",
              "display" : "information recipient"
            }
          ]
        },
        "reference" : {
          "identifier" : {
            "system" : "https://fhir.apps.health/NamingSystem/polaris-appdevice-identifier",
            "value" : "wellness-tracker-pro"
          },
          "display" : "WellnessTracker Pro"
        }
      }
    ],
    "provision" : [
      {
        "type" : "deny",
        "actor" : [
          {
            "role" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                  "code" : "IRCP",
                  "display" : "information recipient"
                }
              ]
            },
            "reference" : {
              "identifier" : {
                "system" : "https://fhir.apps.health/NamingSystem/polaris-appdevice-identifier",
                "value" : "wellness-tracker-pro"
              },
              "display" : "WellnessTracker Pro"
            }
          }
        ]
      }
    ]
  }
}