The decrypted payload is a FHIR Bundle. This profile aligns with the KTC specification for a Patient Shared Bundle at https://ktc-spec.github.io/#fhir-bundle-profile-patientsharedbundle

This profile aligns with https://ktc-spec.github.io/#documentreference-profile-patientshareddocumentreference that is part of the CMS Health Tech Ecosystem Kill the Clipboard use case.

Example of a payor organization with a required type

An allergy or intolerance recorded about a care recipient. Where the source system supplied no code for the allergen, the delivered code restates the substance the record's own reaction detail names — or states the value is unknown when nothing on the record names it. Nothing is invented.

A plan of care recorded about a care recipient. The required assessment-and-plan category is present on every delivered record - added by haau3 when the source system did not state one, always keeping any category the source did state - and activities are described inline, commonly with an unknown status, exactly as the source stated them.

The one care team haau3 keeps for a care recipient, listing the people involved in their care: the caregiver using haau3, anyone a source system named on a care team, and every practitioner appearing in the person's retrieved records. A participant's role - or occasionally the participant themselves - may state that the value is unknown rather than carrying an invented label. The team is added to over time and participants are never removed.

A record that information was communicated about a care recipient. Delivered exactly as it arrived, and current sources send very little: the records seen so far carry only a status and a subject, with no message content, sender, recipient or time. Treat the presence of a record as the fact, not as a message to read.

A clinical summary document delivered for a care recipient — a continuity-of-care document or a progress note, as the practice that produced it wrote it up. Every delivered record says who it is about, what kind of document it is, when it was written and by whom. Its sections state what they contain; the records they list are delivered as ordinary records of their own type, and a section lists only those haau3 holds.

A health problem recorded about a care recipient — a diagnosis, a concern, an item on a problem list. Every delivered record states which list it belongs to in a recognized vocabulary; anything the source system stated is always preserved alongside. Where no code for the problem could be read from the source, the record states the code is unknown rather than carrying an invented one.

A consent or advance directive as the source system recorded it. Delivered as it arrived: current sources state the consent category as unknown rather than naming one, and send no provision detail. Nothing here is derived by haau3.

An insurance plan delivered for a care recipient. Every delivered record names the person it covers, says how they relate to the subscriber or states plainly that the relationship is unknown, and names a payer. Where a source system named more than one payer, the additional payers are delivered on the same record rather than dropped.

A diagnostic report delivered about a care recipient — laboratory results, imaging, cardiology, pathology — grouping the individual results it is based on, or carrying the written report itself. Every delivered record says what kind of report it is, or states plainly that the kind is unknown; every delivered record names the person it belongs to.

A clinical document or note about a care recipient. The document's content is delivered as an address naming a file held on the same server, and haau3 delivers that file with it; a document commonly carries several renderings of one note, one per attachment.

A visit recorded about a care recipient, delivered exactly as the source system stated it: the visit class carries the source's own vocabulary rather than a translated one, the visit type may state that the value is unknown when the source never gave one, and the practitioners the source recorded on the visit are preserved.

An insurance claim delivered for a care recipient — what was billed against a plan and what the plan said about it. Every delivered record names the person it belongs to, the plan it was billed against, and the provider who billed it.

A relative's health history as the source system recorded it — which relative, and what they were diagnosed with. Delivered exactly as it arrived: relationships are properly coded, conditions carry coded diagnoses, and no age or birth date for the relative is sent. Nothing here is derived by haau3.

A goal recorded about a care recipient, delivered as the source system stated it. The goal itself is commonly carried in the description's text rather than a code, and haau3 delivers both exactly as they arrived.

A vaccination recorded about a care recipient. Delivered exactly as the source system stated it, including dose-protocol details; the occurrence may arrive as a date or as the source's own free-text form.

A medication — the drug that prescriptions, statements and dispenses reference. Delivered exactly as the source system stated it: every vocabulary's coding is preserved, and a readable name is always present in the code's text even where individual codings carry no display.

A dose of medication actually administered to a care recipient. Delivered exactly as the source system stated it; an organization-performed administration names a PractitionerRole carrying that organization, which is how R4 expresses the shape.

A pharmacy dispense recorded about a care recipient — a fill or refill handed over. Delivered exactly as the source system stated it, naming both the medication and the prescription it filled; hand-over time and quantity are present, preparation time and days-supply are not sent by current sources.

A prescription or medication order recorded about a care recipient. Delivered exactly as the source system stated it: the medication may be a reference to a delivered Medication or an inline code, the order date is frequently absent because the source never stated one, and the requester is most often an organization.

A medication a care recipient is or was taking, as the source system recorded it. Delivered exactly as it arrived: assertion dates are never sent by current sources, effective dates rarely, and dosage is predominantly the source's own free text. Read together with haau3 MedicationRequests when assembling a medication list.

Something measured or recorded about a care recipient — a lab result, a vital sign, a survey answer, an exam finding. Delivered records always state who they are about and what kind of record they are; where the kind could not be determined it is stated as unknown rather than invented. Categories the source system supplied are always preserved.

The organization for a care recipient.

A care recipient.

A patient's self-reported answer to one of the three haau3 'My Story' prompts. Each Observation represents a single (patient, prompt) pair, identifiable by a stable haau3 namespace key for deterministic upsert via conditional update on Identifier. Mirrors PACIO ADI's ADI-CareExperiencePreference constraints; instances additionally claim PACIO conformance via meta.profile.

A practitioner involved in a care recipient's care. Conforms to US Core 6.1.0 Practitioner; NPI is the anchor for haau3 practitioner identity resolution.

A procedure recorded about a care recipient, delivered exactly as the source system stated it: the procedure code may state that the value is unknown when the source never gave one, and the performed date is absent when the source never stated it.

A questionnaire or form

An individual's response to a questionnaire/form.

Individuals related to the patient like caregivers, family members, or guardians. Records created by haau3 carry no source identifier; records delivered from a source system carry the identifier naming the record they came from. The active flag may state that the value is unknown, since source systems do not send it.

An order or referral recorded about a care recipient, delivered exactly as the source system stated it: the timing may be a date, a period, a schedule, or absent, and the order code may state that the value is unknown when the source never gave one.

A sample collected from a care recipient that a test was performed on. Where the source system did not state what kind of sample it was, the record says the value is unknown rather than carrying an invented one.

A payer named by the source system beyond the first. US Core allows a Coverage to name one payer; where a source named several, the first is delivered in Coverage.payor and every other is delivered here, exactly as the source expressed it, so that no payer the source named is lost.

ValueSet for DocumentReference.type for patient-shared documents in the KTC use

Value set for payor identifier types.

The three LOINC codes corresponding to the MVP haau3 'My Story' questions. Strict subset of the PACIO Care Experience Preferences Grouping value set (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1115.11).

LOINC panel codes for the questionnaires haau3 can administer.

Code system for payor identifier types.

Stable haau3 patient id. Used on Patient.identifier only.

The 6-item Transportation Security Index is an abbreviated version of the 16-item Transportation Security Index. It captures the lived experiences of people experiencing transportation insecurity, and it has been validated using a nationally representative survey. The index can be used to assign respondents a continuous score representing their level of transportation insecurity or to categorize respondents as experiencing no insecurity or insecurity that is marginal, low, moderate, or high.

Example of a QuestionnaireResponse for the 6-item Transportation Security Index questionnaire (LOINC code 106423-7).

Example haau3 Coverage instance representing a commercial insurance plan.

Example organization that conforms to C4BB Commercial Organization.

Example organization that conforms to C4BB Organization, representing a Medicaid HMO payer.

Example LOINC 60591-5 for a FHIR-rendered PDF.

Example patient that conforms to Haau3 Patient.

Example practitioner that conforms to Haau3 Practitioner (US Core 6.1.0 Practitioner) with additional fields to align with CMS National Provider Directory.

Example caregiver that conforms to Haau3 RelatedPerson, with the relationship and communication fields the haau3 app writes.

Example LOINC 51855-5 patient story PDF.

Example patient-reported AllergyIntolerance demonstrating an additional clinical content entry in a Patient-Shared Bundle.

Example Condition demonstrating an additional clinical content entry alongside the patient-shared DocumentReferences.

Example patient-reported Immunization demonstrating an additional clinical content entry in a Patient-Shared Bundle.

Example US Core Lab Result Observation — Hemoglobin A1c result of 7.1% for the example patient.

Example patient-reported MedicationRequest demonstrating an additional clinical content entry in a Patient-Shared Bundle.

Example patient that conforms to US Core 6.1.0 Patient.

Example US Core Vital Signs Observation — blood pressure panel 120/78 mmHg for the example patient.

Worked example of a patient-shared Bundle containing the patient subject and one self-reported Patient Story observation. Demonstrates the 2..* entry minimum and the patient slice. Note: this rendered example shows meta.profile on its entries because IG tooling stamps it on examples; bundles haau3 issues do not carry meta.profile, and receivers must not require it.

Example haau3 Coverage instance representing a Medicaid HMO plan.

Example haau3 Patient Story Observation answering 'Are there things that are important to you about how you receive care?'

Example haau3 Patient Story Observation answering 'If it were possible to choose, where would you like to spend your final days?'

Example haau3 Patient Story Observation answering 'What do you want caregivers to know about your religious beliefs?'

The eHealth Literacy Scale (eHEALS) is an 8-item measure developed to measure consumers' combined knowledge, comfort, and perceived skills at finding, evaluating, and applying electronic health information to health problems. The objective of the study was to psychometrically evaluate the properties of the eHEALS within a population context.

Example of a QuestionnaireResponse for the eHealth Literacy Scale questionnaire (LOINC code 107619-9).

An allergy whose source system supplied no code for the allergen. The delivered code restates the substance the record's own reaction detail names, with a tag recording the completion; the reaction detail is preserved unchanged.

An active plan of care carrying the required assessment-and-plan category, which the source system did not state, with its activity described inline and that activity's status stated as unknown.

The one care team kept for a care recipient, with one participant whose role a source system stated and one practitioner added from the person's records whose role is stated as unknown.

A completed communication about the care recipient, delivered exactly as it arrived: no content, sender, recipient or time accompanies it. Treat the record as the fact that a communication occurred rather than as a message to read.

A clinical summary document as it is commonly delivered: the practice that produced it, the clinician who attested to it, the span of care it covers, and its headings — with entries delivered only for the records haau3 also holds.

A health problem whose source system stated its kind only in its own vocabularies. The delivered record carries the recognized problem-list value ahead of the source's own codings, which are preserved unchanged, and a tag recording the completion.

An active advance-directive consent delivered as it arrived. The category states that the kind of consent is unknown, which is what the source system sent rather than anything haau3 derived, and no provision detail accompanies it.

An insurance plan as it is commonly delivered: a primary payer identified by a reference, a second payer the source named in words alone and which is carried on the record rather than dropped, and a relationship stated in the source system's own terms.

A laboratory report as it is commonly delivered: the kind stated in the source system's own terms, a period rather than a single time, no issued time, the individual results named as separate records, and the report itself carried inside the record for a person to read.

A report whose source system did not say what kind of report it is. The delivered record states that the kind is unknown, in the standard shape for a value that is expected but not known, and carries a tag recording that the statement was supplied rather than sent.

A clinical note delivered as two renderings of one document, each naming a file held on the same server, with the custodian stated by name as the source sent it.

An office visit whose class carries the CPT code the source system sent rather than a translated standard code, and whose status the source left as unknown. Delivered exactly as stated.

An insurance claim as it is commonly delivered: the source system's own CARIN profile left in place, the billing provider carried inside the claim, the payer named by an identifier, and the plan it was billed against named as a delivered record.

A completed family history for the care recipient's mother, carrying two coded conditions. Delivered as it arrived, with no age or birth date for the relative, because current sources send neither.

An active goal whose meaning the source system carried in the description's text, with a coding that states only that no code was available.

A vaccination delivered exactly as the source stated it, including dose-protocol detail. The occurrence is the machine-usable date; the tag records that a duplicative source text form was set aside.

A medication whose RxNorm coding arrived without display text, as most production codings do. The code's text carries the readable name a consumer can always rely on.

A completed medication administration: the drug by reference, the care recipient, and the administration time, exactly as the source stated them.

A completed pharmacy refill: hand-over time and quantity present, preparation time and days-supply absent as current sources send them, referencing both the delivered Medication and the delivered MedicationRequest it filled.

A completed medication order delivered without an authoredOn date, because the source system never stated one. The medication is a reference to a delivered haau3 Medication, as every current production record's is.

An active medication-use statement delivered without an assertion date or effective dates, because the source system stated neither. The dosage is the source's own free text, delivered as it arrived.

A measurement whose kind the source system stated only in its own private vocabulary. The record states that its standard kind is unknown rather than carrying an invented one, and the source's own category is preserved unchanged.

A completed procedure where the source system never said what was done. The code states that the value is unknown rather than carrying an invented one; the performed date and the order it fulfilled are delivered as stated.

An in-progress set of questionnaire answers delivered as they arrived. The authoring date states that it is unknown rather than carrying a value, because the source system sent none and haau3 invents nothing. The questionnaire it answers is named by a URL on the source system.

An active referral order with the date the source stated and the order described in the source's own words.

A sample a lab result was run on, where the source system did not say what kind of sample it was. The type states that the value is unknown rather than carrying an invented one.