De-Identification Handbook
2.0.0-comment - ballot

De-Identification Handbook - Downloaded Version 2.0.0-comment See the Directory of published versions

## Example Bundle: ex-Bundle-DeathCert-pandemicIPS-VRDR-stage-1

Document Details

Profile: Death Certificate Document

Final Document at 2024-07-01 00:00:00+0000 by Practitioner Jim Black (official) for PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

Document Subject

Profiles: Decedent, Patient - Vital Records, Patient

PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

Marital Status: | Never Married
Contact Detail | ph: 07 850 9900(Mobile) Grenzstraße Oberhausen 46045 GM (home)
Unknown: | Joe Smith
Links: | General Practitioner: Yaser, Joseph
NVSS SexAtDeath | Female
Spouse Is Alive | Yes
Patient Birth Place | Roanoke VA US

Document Content

## Decedent Demographics

## Death Investigation

## Death Certification

## Decedent Disposition

## Coded Content

## Additional Resources Included in Document

Entry 2 - fullUrl = http://example.org/Patient/ex-Decedent-pandemicIPS-VRDR-stage-1

Resource Patient:

> Profiles: Decedent, Patient - Vital Records, Patient

> PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> Marital Status: | Never Married
> Contact Detail | ph: 07 850 9900(Mobile) Grenzstraße Oberhausen 46045 GM (home)
> Unknown: | Joe Smith
> Links: | General Practitioner: Yaser, Joseph
> NVSS SexAtDeath | Female
> Spouse Is Alive | Yes
> Patient Birth Place | Roanoke VA US

Entry 3 - fullUrl = http://example.org/Practitioner/ex-Practitioner-pandemicIPS-VRDR-stage-1

Resource Practitioner:

> Profile: Practitioner (IPS)

> name: Joseph Yaser

Entry 4 - fullUrl = http://example.org/RelatedPerson/ex-DecedentFather-pandemicIPS-VRDR-stage-1

Resource RelatedPerson:

> Profile: Decedent Father

> active: true

> patient: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> relationship: father

> name: Pseudo Dad(Anonymous)

Entry 5 - fullUrl = http://example.org/RelatedPerson/ex-DecedentMother-pandemicIPS-VRDR-stage-1

Resource RelatedPerson:

> Profile: Decedent Mother

> active: true

> patient: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> relationship: mother

> name: Pseudo Mom(Anonymous)

Entry 6 - fullUrl = http://example.org/RelatedPerson/ex-DecedentSpouse-pandemicIPS-VRDR-stage-1

Resource RelatedPerson:

> Profile: Decedent Spouse

> active: true

> patient: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> relationship: spouse

> name: Pseudo Spouse(Anonymous)

Entry 7 - fullUrl = http://example.org/Observation/ex-DecedentAge-pandemicIPS-VRDR-stage-1

Resource Observation:

> Profile: Decedent Age

> status: Final

> code: Age at death

> subject: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> effective: 2024-06-30 16:39:40-0500

> performer: Practitioner Jane Purple (official)

> value: 29 years (Details: UCUM codea = 'a')

Entry 8 - fullUrl = http://example.org/Observation/ex-DecedentUsualWork-pandemicIPS-VRDR-stage-1

Resource Observation:

> Profile: Decedent Usual Work

> status: Final

> code: History of Usual occupation

> subject: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> effective: 2024-06-30 16:39:40-0500

> performer: Practitioner Jane Purple (official)

> value: Health Care Assistants

> ### Components

> - | Code | Value[x]
> * | History of Usual industry | Residential nursing care facilities

Entry 9 - fullUrl = http://example.org/Observation/ex-DecedentPregStat-pandemicIPS-VRDR-stage-1

Resource Observation:

> Profile: Decedent Pregnancy

> status: Final

> code: Timing of recent pregnancy in relation to death

> subject: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> effective: 2024-06-30 16:39:40-0500

> performer: Practitioner Jane Purple (official)

> value: Pregnant at time of death

Entry 10 - fullUrl = http://example.org/Observation/ex-DeathDate-pandemicIPS-VRDR-stage-1

Resource Observation:

> Profile: Death Date

> status: Final

> code: Date and time of death [TimeStamp]

> subject: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> effective: 2024-06-30 16:39:40-0500

> performer: Practitioner Jane Purple (official)

> value: `Partial Date Time Vital Records:`

> > component

> > code: Date and time pronounced dead [US Standard Certificate of Death]

> > value: 2024-06-30 16:39:40-0500

> > component

> > code: Location of death

> > value: Other

Entry 11 - fullUrl = http://example.org/Practitioner/ex-Practitioner2-pandemicIPS-VRDR-stage-1

Resource Practitioner:

> Profile: US Core Practitioner Profile

> identifier: NPI/9941339101

> name: Jane Purple (Official)

> address: 44 South Street Rockville MD 20854 US

Entry 12 - fullUrl = http://example.org/Observation/ex-MannerOfDeath-pandemicIPS-VRDR-stage-1

Resource Observation:

> Profile: Manner of Death

> status: Final

> code: Manner of death

> subject: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> effective: 2024-06-30 16:39:40-0500

> performer: Practitioner Jim Black (official)

> value: Natural death

Entry 13 - fullUrl = http://example.org/Practitioner/ex-Certifier-pandemicIPS-VRDR-stage-1

Resource Practitioner:

> Profile: Death Certifier

> Practitioner Role: Certifier

> identifier: NPI/9941339100

> name: Jim Black (Official)

> address: 44 South Street Bird in Hand PA 17505 US

Entry 14 - fullUrl = http://example.org/Procedure/ex-DeathCertification-pandemicIPS-VRDR-stage-1

Resource Procedure:

> Profile: Death Certification Procedure

> identifier: 180

> status: Completed

> code: Death certification

> subject: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> ### Performers

> - | Function | Actor
> * | Nurse Practitioner | Practitioner Jim Black (official)

Entry 15 - fullUrl = http://example.org/Observation/ex-CauseOfDeathPart1-pandemicIPS-VRDR-stage-1

Resource Observation:

> Profile: Cause Of Death Part 1

> status: Final

> code: Cause of death [US Standard Certificate of Death]

> subject: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> effective: 2024-06-30 16:39:40-0500

> performer: Practitioner Jim Black (official)

> value: Covid-19

> > component

> > code: line number

> > value: 1

> > component

> > code: Disease onset to death interval

> > value: 4 hours

Entry 16 - fullUrl = http://example.org/Observation/ex-CauseOfDeathPart1-ex2-pandemicIPS-VRDR-stage-1

Resource Observation:

> Profile: Cause Of Death Part 1

> status: Final

> code: Cause of death [US Standard Certificate of Death]

> subject: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> effective: 2024-06-30 16:39:40-0500

> performer: Practitioner Jim Black (official)

> value: Eclampsia

> > component

> > code: line number

> > value: 2

> > component

> > code: Disease onset to death interval

> > value: 3 months

Entry 17 - fullUrl = http://example.org/Observation/ex-CauseOfDeathPart2-pandemicIPS-VRDR-stage-1

Resource Observation:

> Profile: Cause of Death Part 2

> status: Final

> code: Other significant causes or conditions of death

> subject: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> effective: 2024-06-30 16:39:40-0500

> performer: Practitioner Jim Black (official)

> value: hypertensive heart disease

Entry 18 - fullUrl = http://example.org/Location/ex-DispLocation-pandemicIPS-VRDR-stage-1

Resource Location:

> Profile: Disposition Location

> name: Rosewood Cemetary

> type: Disposition Location

> address: 303 Rosewood Ave Danville VA 24541 US

Entry 19 - fullUrl = http://example.org/Observation/ex-RecordAxisCauseOfDeath-pandemicIPS-VRDR-stage-1

Resource Observation:

> Profile: Record Axis Cause Of Death

> status: Final

> code: Cause of death record axis code [Automated]

> subject: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> effective: 2024-06-30 16:39:40-0500

> performer: Practitioner Jane Purple (official)

> value: COVID-19, virus identified

> ### Components

> - | Code | Value[x]
> * | position | 1

Entry 20 - fullUrl = http://example.org/Observation/ex-EntityAxisCauseOfDeath-pandemicIPS-VRDR-stage-1

Resource Observation:

> Profile: Entity Axis Cause Of Death

> status: Final

> code: Cause of death entity axis code [Automated]

> subject: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> effective: 2024-06-30 16:39:40-0500

> performer: Practitioner Jane Purple (official)

> value: COVID-19, virus identified

> > component

> > code: line number

> > value: 1

> > component

> > code: position

> > value: 1

Entry 21 - fullUrl = http://example.org/Practitioner/ex-Mortician-pandemicIPS-VRDR-stage-1

Resource Practitioner:

> Profile: Mortician

> Practitioner Role: Mortician

> identifier: NPI/212222AB

> name: Ronald Q Smith(Official)

Entry 22 - fullUrl = http://example.org/Observation/ex-ActivityAtTimeOfDeath-pandemicIPS-VRDR-stage-1

Resource Observation:

> Profile: Activity at Time of Death

> status: Final

> code: Activity at time of death [CDC]

> subject: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> effective: 2024-06-30 16:39:40-0500

> performer: Practitioner Jane Purple (official)

> value: While engaged in leisure activities.

Entry 23 - fullUrl = http://example.org/Observation/ex-CodedRaceAndEthnicity-pandemicIPS-VRDR-stage-1

Resource Observation:

> Profile: Observation - Coded Race and Ethnicity Vital Records

> status: Final

> code: Coded Race and Ethnicity

> subject: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> effective: 2024-06-30 16:39:40-0500

> performer: Practitioner Jane Purple (official)

> > component

> > code: First Edited Race Code

> > value: White

> > component

> > code: Second Edited Race Code

> > value: Israeli

> > component

> > code: First Edited American Indian Race Code

> > value: Arikara

> > component

> > code: Race Recode 40

> > value: AIAN and Asian

> > component

> > code: Hispanic Code

> > value: Chilean

Entry 24 - fullUrl = http://example.org/Observation/ex-ManualUnderlyingCauseOfDeath-pandemicIPS-VRDR-stage-1

Resource Observation:

> Profile: Manual Underlying Cause Of Death

> status: Final

> code: Cause of death.underlying [Manual]

> subject: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> effective: 2024-06-30 16:39:40-0500

> performer: Practitioner Jane Purple (official)

> value: Acute respiratory failure

Entry 25 - fullUrl = http://example.org/Observation/ex-AutomatedUnderlyingCauseOfDeath-pandemicIPS-VRDR-stage-1

Resource Observation:

> Profile: Automated Underlying Cause Of Death

> status: Final

> code: Cause of death.underlying [Automated]

> subject: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> effective: 2024-06-30 16:39:40-0500

> performer: Practitioner Jane Purple (official)

> value: Acute respiratory failure

Entry 26 - fullUrl = http://example.org/Organization/ex-FuneralHome-pandemicIPS-VRDR-stage-1

Resource Organization:

> Profile: Funeral Home

> active: true

> type: Funeral Home

> name: Lancaster Funeral Home and Crematory

> ### Contacts

> - | Address
> * | 211 High Street Lancaster PA 17573 US

Entry 27 - fullUrl = http://example.org/Observation/ex-DecedentDispositionMethod-pandemicIPS-VRDR-stage-1

Resource Observation:

> Profile: Decedent Disposition Method

> status: Final

> code: Body disposition method

> subject: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> effective: 2024-06-30 16:39:40-0500

> performer: Practitioner Ronald Q Smith(official)

> value: Other

Entry 28 - fullUrl = http://example.org/Observation/ex-PlaceOfInjury-pandemicIPS-VRDR-stage-1

Resource Observation:

> Profile: Place Of Injury

> status: Final

> code: Injury location

> subject: PseudoFamily(anonymous) Female, DoB: 1996-05-01 ( Social Beneficiary Identifier: SSN#123456789)

> effective: 2024-06-30 16:39:40-0500

> performer: Practitioner Jane Purple (official)

> value: Home

Entry 29 - fullUrl = http://example.org/Parameters/ex-CodingStatusValues-pandemicIPS-VRDR-stage-1

Resource Parameters:

> Profile: Coding Status Values

> ## Parameters

> shipmentNumber | A2B2
> receiptDate | 2021-12-12
> coderStatus | 5
> intentionalReject | Reject1
> acmeSystemReject | Not Rejected
> transaxConversion | Conversion using non-ambivalent table entries