Polaris FHIR Implementation Guide
1.9.7 - ci-build

Polaris FHIR Implementation Guide - Local Development build (v1.9.7) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Polaris App Consent - GRANTED Example - XML Representation

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<Consent xmlns="http://hl7.org/fhir">
  <id value="polaris-core-app-consent-scribe-ai-example"/>
  <meta>
    <profile
             value="https://fhir.apps.health/StructureDefinition/polaris-core-app-consent"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>App Consent - GRANTED</b></p><p>Patient: <strong>Avery Linwood</strong> has <strong>CONSENTED</strong> to sign up with and share clinical data with <strong>SmartDocs AI Scribe</strong> application.</p><p>Date: April 8, 2025 at 10:30 AM</p><p>Status: Active consent using FHIR R4 grant pattern (no provision type in root).</p></div>
  </text>
  <identifier>
    <system
            value="https://fhir.apps.health/NamingSystem/cedarbrook-clinic-app-consent-identifier"/>
    <value value="app-consent-scribe-ai-avery-20250408"/>
  </identifier>
  <status value="active"/>
  <scope>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/consentscope"/>
      <code value="patient-privacy"/>
      <display value="Privacy Consent"/>
    </coding>
  </scope>
  <category>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/consentcategorycodes"/>
      <code value="infa"/>
      <display value="Information Access"/>
    </coding>
  </category>
  <patient>
    <identifier>
      <system
              value="https://fhir.apps.health/NamingSystem/cedarbrook-clinic-patient-identifier"/>
      <value value="patient-avery-linwood"/>
    </identifier>
    <display value="Avery Linwood"/>
  </patient>
  <dateTime value="2025-04-08T10:30:00-06:00"/>
  <sourceAttachment>
    <contentType value="application/pdf"/>
    <data
          value="JVBERi0xLjQKJeLjz9MKMSAwIG9iago8PAovVHlwZSAvQ2F0YWxvZwovUGFnZXMgMiAwIFIKPj4KZW5kb2JqCjIgMCBvYmoKPDwKL1R5cGUgL1BhZ2VzCi9LaWRzIFszIDAgUl0KL0NvdW50IDEKPD4KZW5kb2JqCjMgMCBvYmoKPDwKL1R5cGUgL1BhZ2UKL1BhcmVudCAyIDAgUgovTWVkaWFCb3ggWzAgMCA2MTIgNzkyXQovUmVzb3VyY2VzIDw8L0ZvbnQgPDwvRjEgNCAwIFI+Pj4+Ci9Db250ZW50cyA1IDAgUgo+PgplbmRvYmoK"/>
    <size value="12345"/>
    <hash value="ZGEwNTQwYTM5YTMwMGM5ZjYzZGI4YzJjYTI2ZWFmYzE="/>
    <title value="SmartDocs AI Scribe Consent Form - Signed"/>
    <creation value="2025-04-08T10:30:00-06:00"/>
  </sourceAttachment>
  <policyRule>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/consentpolicycodes"/>
      <code value="cric"/>
      <display value="Common Rule Informed Consent"/>
    </coding>
  </policyRule>
  <provision>
    <actor>
      <role>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/v3-ParticipationType"/>
          <code value="IRCP"/>
          <display value="information recipient"/>
        </coding>
      </role>
      <reference>
        <identifier>
          <system
                  value="https://fhir.apps.health/NamingSystem/polaris-app-identifier"/>
          <value value="smartdocs-ai-scribe"/>
        </identifier>
        <display value="SmartDocs AI Scribe"/>
      </reference>
    </actor>
  </provision>
</Consent>