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Composition "727220" Version "1"

Created by ANONYMOUS (Unknown) at 6/12/2018 2:31:23 PM(UTC) (Audit)

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Document Id db734647-fc99-424c-a864-7e3cda82e703
Document Created: December 1, 2016, 11:20, PST
Care provision Consultation for transition of care from November 1, 2016 to December 1, 2016
Performer Claude Pharmacist, CPh
Author Registered Pharmacist, RPh, The Pharmacy Alliance Health Group
Contact info 1004 Pharmacy Drive
Portland, OR 99123, US
Tel: +1(555)555-1004
Encounter Id 9937012 2.16.840.1.113883.19
Encounter Type Consultation
Encounter Date From December 1, 2016, 09:20 to December 1, 2016, 10:20
Encounter Location id: NPI-Example 2.16.840.1.113883.4.6
Responsible party Michael Coletta, M.D. of Mass Pharmacy
Contact info 2100 North Ave
Burlington, MA 02368, US
Tel: +1(555)555-1003
Assigned entity Review of Care Plan
Assigned entity {$code/@code='SELF'?} Review of Care Plan
Emergency contact Mrs. Martha Jones

Contact info 17 Daws Rd.
Ann Arbor, MI 97857, US
Tel: (999)555-1212
Care giver Mrs. Martha Jones
Contact info 17 Daws Rd.
Ann Arbor, MI 97857, US
Tel: (999)555-1212
Entered by Ellen Enter
Contact info 1007 Pharmacy Drive
Portland, OR 99123, US
Tel: +1(555)555-1050
Signed Eve Everywoman at December 1, 2016
Contact info Primary Home:
2222 Home Street
Beaverton, OR 97867, US
Tel: +1(555)555-2003
Informant Harold Pharma, CPh
Contact info 1007 Pharmacy Drive
Portland, OR 99123, US
Tel: +1(555)555-1003
Information recipient: Pharmacist Coordinator, CPh
Contact info 100 Better Health Rd.
Ann Arbor, MI 97857, US
Telecom information not available
Legal authenticator Pharmacist Registered, RPh of Greater Area Pharmacy signed at December 1, 2016
Contact info 1004 Pharmacy Drive
Portland, OR 99123, US
Tel: +1(555)555-1004
Document maintained by Greater Area Pharmacy HIE
Contact info Work Place:
1009 Pharmacy Drive
Portland, OR 99123, US
Tel: +1(555)555-1009

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        <tbody>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Document Id</span> </td>
            <td class="td_header_role_value">db734647-fc99-424c-a864-7e3cda82e703</td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Document Created:</span> </td>
            <td class="td_header_role_value">December 1, 2016, 11:20, PST </td> </tr> </tbody> </table>
      <table style="border: 1pt inset #00008b line-height: 10pt width: 100%" class="header_table">
        <tbody>
          <!--documentationOf/serviceEvent-->
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Care provision</span> </td>
            <td class="td_header_role_value">Consultation for transition of care from November 1, 2016 to December 1, 2016 </td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Performer </span> </td>
            <td class="td_header_role_value">Claude Pharmacist, CPh</td> </tr> </tbody> </table>
      <table style="border: 1pt inset #00008b line-height: 10pt width: 100%" class="header_table">
        <tbody>
          <!--Author-->
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Author</span> </td>
            <td class="td_header_role_value">Registered Pharmacist, RPh, The Pharmacy Alliance Health Group</td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">1004 Pharmacy Drive
              <br/>Portland, OR 99123, US
              <br/>Tel: +1(555)555-1004
              <br/> </td> </tr> </tbody> </table>
      <table style="border: 1pt inset #00008b line-height: 10pt width: 100%" class="header_table">
        <tbody>
          <!--encompassingEncounter-->
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Encounter Id</span> </td>
            <td class="td_header_role_value">9937012 2.16.840.1.113883.19</td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Encounter Type</span> </td>
            <td class="td_header_role_value">Consultation</td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Encounter Date</span> </td>
            <td class="td_header_role_value">From December 1, 2016, 09:20 to December 1, 2016, 10:20 </td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Encounter Location</span> </td>
            <td class="td_header_role_value">id: NPI-Example 2.16.840.1.113883.4.6</td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Responsible party</span> </td>
            <td class="td_header_role_value">Michael Coletta, M.D. of Mass Pharmacy</td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">2100 North Ave
              <br/>Burlington, MA 02368, US
              <br/>Tel: +1(555)555-1003
              <br/> </td> </tr> </tbody> </table>
      <table style="border: 1pt inset #00008b line-height: 10pt width: 100%" class="header_table">
        <tbody>
          <!--participant-->
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Assigned entity</span> </td>
            <td class="td_header_role_value">Review of Care Plan
              <br/> </td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Assigned entity {$code/@code='SELF'?}</span> </td>
            <td class="td_header_role_value">Review of Care Plan
              <br/> </td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Emergency contact</span> </td>
            <td class="td_header_role_value">Mrs. Martha Jones
              <br/>
              <br/> </td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">17 Daws Rd.
              <br/>Ann Arbor, MI 97857, US
              <br/>Tel: (999)555-1212
              <br/> </td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Care giver</span> </td>
            <td class="td_header_role_value">Mrs. Martha Jones
              <br/> </td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">17 Daws Rd.
              <br/>Ann Arbor, MI 97857, US
              <br/>Tel: (999)555-1212
              <br/> </td> </tr> </tbody> </table>
      <table style="border: 1pt inset #00008b line-height: 10pt width: 100%" class="header_table">
        <tbody>
          <tr>
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              <span class="td_label">Entered by</span> </td>
            <td class="td_header_role_value">Ellen Enter</td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">1007 Pharmacy Drive
              <br/>Portland, OR 99123, US
              <br/>Tel: +1(555)555-1050
              <br/> </td> </tr> </tbody> </table>
      <table style="border: 1pt inset #00008b line-height: 10pt width: 100%" class="header_table">
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          <!--Authenticator-->
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            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Signed </span> </td>
            <td class="td_header_role_value">Eve Everywoman at December 1, 2016 </td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">Primary Home:
              <br/>2222 Home Street
              <br/>Beaverton, OR 97867, US
              <br/>Tel: +1(555)555-2003
              <br/> </td> </tr> </tbody> </table>
      <table style="border: 1pt inset #00008b line-height: 10pt width: 100%" class="header_table">
        <tbody>
          <!--informant-->
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Informant</span> </td>
            <td class="td_header_role_value">Harold Pharma, CPh</td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">1007 Pharmacy Drive
              <br/>Portland, OR 99123, US
              <br/>Tel: +1(555)555-1003
              <br/> </td> </tr> </tbody> </table>
      <table style="border: 1pt inset #00008b line-height: 10pt width: 100%" class="header_table">
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          <!--informationRecipient-->
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            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Information recipient:</span> </td>
            <td class="td_header_role_value">Pharmacist Coordinator, CPh</td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">100 Better Health Rd.
              <br/>Ann Arbor, MI 97857, US
              <br/>Telecom information not available
              <br/> </td> </tr> </tbody> </table>
      <table style="border: 1pt inset #00008b line-height: 10pt width: 100%" class="header_table">
        <tbody>
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            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Legal authenticator</span> </td>
            <td class="td_header_role_value">Pharmacist Registered, RPh of Greater Area Pharmacy signed at December 1, 2016 </td> </tr>
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            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">1004 Pharmacy Drive
              <br/>Portland, OR 99123, US
              <br/>Tel: +1(555)555-1004
              <br/> </td> </tr> </tbody> </table>
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              <span class="td_label">Document maintained by</span> </td>
            <td class="td_header_role_value">Greater Area Pharmacy HIE</td> </tr>
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            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">Work Place:
              <br/>1009 Pharmacy Drive
              <br/>Portland, OR 99123, US
              <br/>Tel: +1(555)555-1009
              <br/> </td> </tr> </tbody> </table> </div>
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      <display value="Overall Plan of Care/Advance Care Directives"/>
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  <date value="2016-12-01T11:20:00-08:00"/>
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  <title value="Pharmacist Care Plan"/>
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        <table>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
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              <td colspan="20">
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                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
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                          <th>Problem</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Problem</td>
                          <td>Constipation</td>
                          <td>AUG 19, 2016</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
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              <td colspan="20">
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                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Problem Type</th>
                          <th>Problem</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Problem</td>
                          <td>Non-compliance of drug therapy ( Non-adherence because patient forgets to take medication) </td>
                          <td>AUG 19, 2016</td> </tr>
                        <tr>
                          <td colspan="20">
                            <ul>
                              <li>
                                <table>
                                  <thead>
                                    <tr>
                                      <th>Reference to</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>Prescription of "oxyCODONE Hydrochloride 10 MG Oral Tablet" in the Interventions Section</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
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          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
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                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Intolerance Type</th>
                          <th>Substance</th>
                          <th>Reaction</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>
                            <span class="Italics Bold">No known </span>Allergy to Substance</td>
                          <td>
                            <span class="Italics Bold">No known </span>Penicillin</td>
                          <td>Other ( Some text related to reaction to allergy) </td>
                          <td>AUG 20, 2016</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Intolerance Type</th>
                          <th>Substance</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>
                            <span class="Italics Bold">No known </span>Allergy to Substance</td>
                          <td>No Information</td>
                          <td>DEC 1, 2016</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Observation</th>
                          <th>Value</th>
                          <th>Date(s)</th>
                          <th>Author</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Cognitive Function</td>
                          <td>Difficulty processing information accurately</td>
                          <td>AUG 1, 2016</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Psychologist</span>: John Middle Psychologist</li>
                              <li>
                                <span class="Italics">Date: </span>AUG 1, 2016</li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>ADL Type</th>
                          <th>Ability</th>
                          <th>Author</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Bathing</td>
                          <td>Independent</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Adult Medicine</span> </li>
                              <li>
                                <span class="Italics">Date: </span>JUL 6, 2016 11:48</li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Functional Assessment</th>
                          <th>Result of Evaluation</th>
                          <th>Date(s)</th>
                          <th>Author</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Functional status</td>
                          <td>Independent walking</td>
                          <td>MAR 11, 2016</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Adult Medicine</span> </li>
                              <li>
                                <span class="Italics">Date: </span>JUL 6, 2016 11:45</li> </ul> </td> </tr>
                        <tr>
                          <td colspan="20">
                            <ul>
                              <li>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Device Supplied</th>
                                      <th>Status</th>
                                      <th>Duration</th>
                                      <th>Quantity</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>cane, device (physical object)</td>
                                      <td>completed</td>
                                      <td/>
                                      <td>2</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Observation</th>
                          <th>Value</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Nutrition status ( Nutritional Status) </td>
                          <td>well nourished</td>
                          <td>MAY 12, 2016</td> </tr>
                        <tr>
                          <td colspan="20">
                            <ul>
                              <li>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Observation</th>
                                      <th>Value</th>
                                      <th>Date(s)</th>
                                      <th>Author</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>Nutrition assessment</td>
                                      <td>low sodium diet (finding)</td>
                                      <td>MAY 12, 2016</td>
                                      <td>
                                        <ul>
                                          <li>
                                            <span class="Italics">Adult Medicine</span>: Patricia Patty Primary</li>
                                          <li>
                                            <span class="Italics">Date: </span>JUL 30, 2016</li> </ul> </td> </tr>
                                    <tr>
                                      <td>Nutrition assessment</td>
                                      <td>excessive dietary carbohydrate intake (finding)</td>
                                      <td>MAY 12, 2016</td>
                                      <td>
                                        <ul>
                                          <li>
                                            <span class="Italics">Adult Medicine</span>: Patricia Patty Primary</li>
                                          <li>
                                            <span class="Italics">Date: </span>JUL 30, 2016</li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Social History Observation Type</th>
                          <th>Value</th>
                          <th>Date(s)</th>
                          <th>Author</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Alcohol Intake</td>
                          <td>12</td>
                          <td>FEB 15, 2016</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Adult Medicine</span> </li>
                              <li>
                                <span class="Italics">Date: </span>SEP 10, 2016 11:45</li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Social History Observation Type</th>
                          <th>Value</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>History of tobacco use</td>
                          <td>Current every day smoker</td>
                          <td>FEB 14, 2016</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Vital Sign</th>
                          <th>Value</th>
                          <th>Date(s)</th>
                          <th>Author</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Patient Body Weight - Measured</td>
                          <td>88 kg</td>
                          <td>SEP 1, 2016</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Adult Medicine</span> </li>
                              <li>
                                <span class="Italics">Date: </span>SEP 1, 2016 09:15</li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Observation</th>
                          <th>Value</th>
                          <th>Date(s)</th>
                          <th>Participant</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>ASSERTION</td>
                          <td>caregiver difficulty providing physical care</td>
                          <td>MAR 12, 2016</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Mother</span> </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Social History Observation Type</th>
                          <th>Value</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Personal belief</td>
                          <td>Does not accept blood transfusions, or donates, or stores blood for transfusion.</td>
                          <td>MAR 12, 2016</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Functional Assessment</th>
                          <th>Result of Evaluation</th>
                          <th>Effective Date</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Brief Interview for Mental Status</td>
                          <td>7</td>
                          <td>FEB 14, 2016</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Problem Type</th>
                          <th>Problem</th>
                          <th>Date(s)</th>
                          <th>Author</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>ASSERTION</td>
                          <td>pressure ulcer stage 3</td>
                          <td>FEB 14, 2016</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics"/>Assigned Amanda</li>
                              <li>
                                <span class="Italics">Date: </span>[month number out of range]31, 2001 1:</li> </ul> </td> </tr>
                        <tr>
                          <td colspan="20">
                            <ul>
                              <li>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Observation</th>
                                      <th>Value</th>
                                      <th>Date(s)</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>Width of Wound</td>
                                      <td>1 [in_i]</td>
                                      <td>[month number out of range]3, 2001</td> </tr>
                                    <tr>
                                      <td>Length of Wound</td>
                                      <td>2 [in_i]</td>
                                      <td>[month number out of range]3, 2001</td> </tr> </tbody> </table>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Observation</th>
                                      <th>Value</th>
                                      <th>Date(s)</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>ASSERTION</td>
                                      <td>Offensive wound odor</td>
                                      <td>[month number out of range]3, 2001</td> </tr> </tbody> </table>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Observation</th>
                                      <th>Value</th>
                                      <th>Date(s)</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>Number of pressure ulcers</td>
                                      <td>3</td>
                                      <td>[month number out of range]3, 2001</td> </tr>
                                    <tr>
                                      <td colspan="20">
                                        <ul>
                                          <li>
                                            <table>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <thead>
                                                <tr>
                                                  <th>Observation</th>
                                                  <th>Value</th> </tr> </thead>
                                              <tbody>
                                                <tr>
                                                  <td>ASSERTION</td>
                                                  <td>Pressure ulcer stage 3</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Observation</th>
                                      <th>Value</th>
                                      <th>Date(s)</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>Highest Pressure Ulcer Stage</td>
                                      <td>necrotic eschar</td>
                                      <td/> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Observation</th>
                          <th>Value</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Hearing</td>
                          <td>Impaired</td>
                          <td>MAR 11, 2015</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Pregnancy Status</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>pregnant</td>
                          <td>SEP 10, 2016</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Encounter Diagnosis Type</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>DIAGNOSIS</td> </tr>
                        <tr>
                          <td colspan="20">
                            <ul>
                              <li>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Problem Type</th>
                                      <th>Problem</th>
                                      <th>Date(s)</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>Problem</td>
                                      <td>Migraine</td>
                                      <td>AUG 19, 2016</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Family History Subject</th>
                          <th>Administrative Gender</th>
                          <th>Birth Date</th>
                          <th>Deceased</th>
                          <th>Deceased Date</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Father</td>
                          <td>M / </td>
                          <td>1910</td>
                          <td>true</td>
                          <td>1967</td> </tr>
                        <tr>
                          <td colspan="20">
                            <ul>
                              <li>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Problem Type</th>
                                      <th>Problem</th>
                                      <th>Date(s)</th>
                                      <th>Age at Onset</th>
                                      <th>Cause of Death</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>Condition</td>
                                      <td>Myocardial infarction</td>
                                      <td>1967</td>
                                      <td>57 years</td>
                                      <td/> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Observation</th>
                          <th>Value</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Assertion</td>
                          <td>Food Allergy</td>
                          <td>JAN 9, 2016</td> </tr>
                        <tr>
                          <td colspan="20">
                            <ul>
                              <li>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Observation</th>
                                      <th>Value</th>
                                      <th>Date(s)</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>ASSERTION</td>
                                      <td>Hives</td>
                                      <td>JAN 9, 2016 08:05 to JAN 9, 2016 12:05</td> </tr>
                                    <tr>
                                      <td colspan="20">
                                        <ul>
                                          <li>
                                            <table>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <thead>
                                                <tr>
                                                  <th>Observation</th>
                                                  <th>Value</th> </tr> </thead>
                                              <tbody>
                                                <tr>
                                                  <td>Severity Observation</td>
                                                  <td>Mild</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Risk Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Social History Observation Type</th>
                          <th>Value</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Characteristics of residence</td>
                          <td>Motel</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Risk Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Problem Type</th>
                          <th>Problem</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Condition</td>
                          <td>Opiod abuse (disorder)</td>
                          <td>DEC 1, 2016</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Risk Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Problem Type</th>
                          <th>Problem</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>
                            <span class="Italics Bold">No known </span>Condition</td>
                          <td>
                            <span class="Italics Bold">No known </span>Problem</td>
                          <td>DEC 1, 2016 10:45</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Risk Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Intolerance Type</th>
                          <th>Substance</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>
                            <span class="Italics Bold">No known </span>Allergy to Substance</td>
                          <td>No Information</td>
                          <td>DEC 1, 2016</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </div>
    </text>
    <entry>
      <reference value="Observation/426627"/>
    </entry>
    <entry>
      <reference value="Observation/426628"/>
    </entry>
    <entry>
      <reference value="Condition/88"/>
    </entry>
    <entry>
      <reference value="Observation/426634"/>
    </entry>
    <entry>
      <reference value="Condition/89"/>
    </entry>
    <entry>
      <reference value="AllergyIntolerance/9"/>
    </entry>
    <entry>
      <reference value="AllergyIntolerance/10"/>
    </entry>
    <entry>
      <reference value="Observation/426635"/>
    </entry>
    <entry>
      <reference value="Observation/426636"/>
    </entry>
    <entry>
      <reference value="Observation/426637"/>
    </entry>
    <entry>
      <reference value="Observation/426639"/>
    </entry>
    <entry>
      <reference value="Observation/426642"/>
    </entry>
    <entry>
      <reference value="Observation/426643"/>
    </entry>
    <entry>
      <reference value="Observation/426644"/>
    </entry>
    <entry>
      <reference value="Observation/426645"/>
    </entry>
    <entry>
      <reference value="Observation/426646"/>
    </entry>
    <entry>
      <reference value="Observation/426647"/>
    </entry>
    <entry>
      <reference value="Condition/90"/>
    </entry>
    <entry>
      <reference value="Observation/426648"/>
    </entry>
    <entry>
      <reference value="Observation/426649"/>
    </entry>
    <entry>
      <reference value="Condition/91"/>
    </entry>
    <entry>
      <reference value="FamilyMemberHistory/40"/>
    </entry>
    <entry>
      <reference value="AllergyIntolerance/11"/>
    </entry>
    <entry>
      <reference value="Observation/426650"/>
    </entry>
    <entry>
      <reference value="Condition/92"/>
    </entry>
    <entry>
      <reference value="Condition/93"/>
    </entry>
    <entry>
      <reference value="AllergyIntolerance/12"/>
    </entry>
  </section>
  <section>
    <title value="Goals Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="61146-7"/>
        <display value="Goals"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table>
          <col width="30%"/>
          <thead>
            <tr>
              <th>Goal</th>
              <th>Date</th>
              <th>Author</th>
              <th>Reference to</th> </tr> </thead>
          <tbody>
            <tr>
              <td>Prevention of constipation</td>
              <td>DEC 1, 2016</td>
              <td>
                <ul>
                  <li>
                    <span class="Italics">Pharmacist</span>: Registered Pharmacist, The Pharmacy Alliance Health Group</li> </ul> </td>
              <td>Problem of "Constipation" in the Health Concerns Section</td> </tr>
            <tr>
              <td>Prevention of opioid abuse</td>
              <td>DEC 1, 2016</td>
              <td>
                <ul>
                  <li>
                    <span class="Italics">Pharmacist</span>: Registered Pharmacist, The Pharmacy Alliance Health Group</li> </ul> </td>
              <td>Risk for "Opioid Abuse" in the Health Concerns Section</td> </tr> </tbody> </table> </div>
    </text>
    <entry>
      <reference value="Goal/22"/>
    </entry>
    <entry>
      <reference value="Goal/23"/>
    </entry>
  </section>
  <section>
    <title value="Interventions Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="62387-6"/>
        <display value="Interventions Provided"/>
      </coding>
    </code>
    <text>
      <status value="additional"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Intervention</th>
              <th>Date(s)</th> </tr> </thead>
          <tbody>
            <tr>
              <td>Procedure/intervention</td>
              <td/> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Medication (Prescription)</th>
                          <th>Dose</th>
                          <th>Frequency</th>
                          <th>Duration</th>
                          <th>Repeat Number</th>
                          <th>Route</th>
                          <th>Rate</th>
                          <th>Author</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>oxyCODONE Hydrochloride 10 MG Oral Tablet</td>
                          <td>2</td>
                          <td>6 h</td>
                          <td>NOV 25, 2016 to NOV 28, 2016</td>
                          <td>1</td>
                          <td>ORAL</td>
                          <td>24 1</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">General Practice</span>: John Middle Doe</li>
                              <li>
                                <span class="Italics">Date: </span>NOV 25, 2016</li> </ul> </td> </tr>
                        <tr>
                          <td colspan="20">
                            <ul>
                              <li>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Reason for action</th>
                                      <th>Value</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>Complaint</td>
                                      <td>Chronic Low Back Pain</td> </tr> </tbody> </table>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Medication Supplied</th>
                                      <th>Status</th>
                                      <th>Other timing</th>
                                      <th>Repeat Number</th>
                                      <th>Quantity</th>
                                      <th>Performer</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>oxyCODONE Hydrochloride 10 MG Oral Tablet</td>
                                      <td>completed</td>
                                      <td>NOV 28, 2016</td>
                                      <td>1</td>
                                      <td>24 1</td>
                                      <td>
                                        <ul>
                                          <li>
                                            <span class="Italics">Pharmacy</span>: </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Intervention</th>
              <th>Date(s)</th> </tr> </thead>
          <tbody>
            <tr>
              <td>Procedure/intervention</td>
              <td/> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Medication (Prescription)</th>
                          <th>Dose</th>
                          <th>Frequency</th>
                          <th>Duration</th>
                          <th>Repeat Number</th>
                          <th>Route</th>
                          <th>Rate</th>
                          <th>Author</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>oxyCODONE Hydrochloride 10 MG Oral Tablet</td>
                          <td>2</td>
                          <td>6 h</td>
                          <td>NOV 25, 2016 to NOV 28, 2016</td>
                          <td>0</td>
                          <td>ORAL</td>
                          <td>24 1</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Nurse Practitioner</span>: Mary Middle Jane</li>
                              <li>
                                <span class="Italics">Date: </span>NOV 25, 2016</li> </ul> </td> </tr>
                        <tr>
                          <td colspan="20">
                            <ul>
                              <li>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Reason for action</th>
                                      <th>Value</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>Complaint</td>
                                      <td>Chronic Low Back Pain</td> </tr> </tbody> </table>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Medication Supplied</th>
                                      <th>Status</th>
                                      <th>Description</th>
                                      <th>Other timing</th>
                                      <th>Repeat Number</th>
                                      <th>Quantity</th>
                                      <th>Performer</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>oxyCODONE Hydrochloride 10 MG Oral Tablet</td>
                                      <td>aborted</td>
                                      <td>Refused to dispense - drug denied.</td>
                                      <td>NOV 25, 2016</td>
                                      <td>1</td>
                                      <td>0</td>
                                      <td>
                                        <ul>
                                          <li>
                                            <span class="Italics">Pharmacy</span>: </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Intervention</th>
              <th>Date(s)</th> </tr> </thead>
          <tbody>
            <tr>
              <td>Procedure/intervention</td>
              <td/> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Act</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Medication regimen compliance education </td>
                          <td>JAN 22, 2016</td> </tr> </tbody> </table>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Reference to</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Problem of "Non-compliance of drug therapy" in the Health Concern Section </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Planned Intervention</th> </tr> </thead>
          <tbody>
            <tr>
              <td>Intervention</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Reference to</th>
                          <th>Description</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Goal of "Prevention of opioid abuse" in the Goals Section</td> </tr> </tbody> </table>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Patient Referral</th>
                          <th>Date(s)</th>
                          <th>Priority</th>
                          <th>Author</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Referral to general practitioner</td>
                          <td>DEC 1, 2016</td>
                          <td/>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Pharmacist</span>: Registered Pharmacist, The Pharmacy Alliance Health Group</li>
                              <li>
                                <span class="Italics">Date: </span>DEC 1, 2016</li> </ul> </td> </tr>
                        <tr>
                          <td colspan="20">
                            <ul>
                              <li>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Reason for action</th>
                                      <th>Value</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>Problem</td>
                                      <td>Opioid abuse (disorder)</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Planned Encounter</th>
                          <th>Date(s)</th>
                          <th>Performer</th>
                          <th>Location</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Office outpatient visit 15 minutes</td>
                          <td>DEC 15, 2016 13:00</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Clinical Pharmacist</span>: Claude Pharma Pharmacist</li> </ul> </td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Urgent Care Center</span> </li> </ul> </td> </tr>
                        <tr>
                          <td>Office outpatient visit 15 minutes</td>
                          <td>DEC 25, 2016 13:00</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Clinical Pharmacist</span>: Claude Pharma Pharmacist</li> </ul> </td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Urgent Care Center</span> </li> </ul> </td> </tr> </tbody> </table>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Act</th>
                          <th>Description</th>
                          <th>Date(s)</th>
                          <th>Priority</th>
                          <th>Participant</th>
                          <th>Author</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>handoff communication (procedure)</td>
                          <td/>
                          <td>DEC 1, 2016</td>
                          <td/>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Registered Nurse</span>: Nightingale Nancy</li> </ul> </td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Registered nurse</span>: Nurse Florence</li>
                              <li>
                                <span class="Italics">Date: </span>DEC 1, 2016</li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </div>
    </text>
    <entry>
      <reference value="RequestGroup/8"/>
    </entry>
    <entry>
      <reference value="RequestGroup/9"/>
    </entry>
    <entry>
      <reference value="RequestGroup/10"/>
    </entry>
    <entry>
      <reference value="RequestGroup/11"/>
    </entry>
    <entry>
      <reference value="RequestGroup/12"/>
    </entry>
    <entry>
      <reference value="RequestGroup/13"/>
    </entry>
  </section>
  <section>
    <title value="Health Status Evaluations/Outcomes Section"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="11383-7"/>
        <display value="Patient Problem Outcome"/>
      </coding>
    </code>
    <text>
      <status value="additional"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table>
          <col width="30%"/>
          <thead>
            <tr>
              <th>Outcome Type</th>
              <th>Outcome Value</th>
              <th>Author</th> </tr> </thead>
          <tbody>
            <tr>
              <td>Nutrition and dietetics team consult</td>
              <td>Normal Bowel Habits</td>
              <td>
                <ul>
                  <li>
                    <span class="Italics">Pharmacist</span>: Registered Pharmacist, The Pharmacy Alliance Health Group</li>
                  <li>
                    <span class="Italics">Date: </span>JAN 1, 2016</li> </ul> </td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <thead>
                        <tr>
                          <th>Reference to</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Goal of "Prevention of constipation" in the Goals Section</td> </tr> </tbody> </table>
                    <table>
                      <thead>
                        <tr>
                          <th>Progress Toward Goal</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Goal achieved</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </div>
    </text>
    <entry>
      <reference value="Observation/426651"/>
    </entry>
  </section>
  <section>
    <title value="INSURANCE PROVIDERS"/>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="48768-6"/>
        <display value="Payer"/>
      </coding>
    </code>
    <text>
      <status value="generated"/>
      <div xmlns="http://www.w3.org/1999/xhtml">
        <table>
          <thead>
            <tr>
              <th>Coverage</th> </tr> </thead>
          <tbody>
            <tr>
              <td>Payment sources</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <thead>
                        <tr>
                          <th>Policy</th>
                          <th>Preference Order</th>
                          <th>Covered Party</th>
                          <th>Policy Holder</th>
                          <th>Performer</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Medicaid</td>
                          <td>1</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Self</span>: Eve Middle Betterhalf</li> </ul> </td>
                          <td>
                            <ul>
                              <li/> </ul> </td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Payor</span>: </li> </ul>
                            <ul>
                              <li>
                                <span class="Italics">Guarantor</span>: Boris Betterhalf</li>
                              <li>
                                <span class="Italics">Date: </span>Unknown</li> </ul> </td> </tr>
                        <tr>
                          <td colspan="20">
                            <ul>
                              <li>
                                <table>
                                  <thead>
                                    <tr>
                                      <th>Authorization For</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>Nutritionist education, guidance, and counseling</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </div>
    </text>
    <entry>
      <reference value="Coverage/3"/>
    </entry>
  </section>
</Composition>

Composition "727219" Version "1"

Created by ANONYMOUS (Unknown) at 6/12/2018 2:29:47 PM(UTC) (Audit)

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
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Document Id db734647-fc99-424c-a864-7e3cda82e703
Document Created: December 1, 2016, 11:20, PST
Care provision Consultation for transition of care from November 1, 2016 to December 1, 2016
Performer Claude Pharmacist, CPh
Author Registered Pharmacist, RPh, The Pharmacy Alliance Health Group
Contact info 1004 Pharmacy Drive
Portland, OR 99123, US
Tel: +1(555)555-1004
Encounter Id 9937012 2.16.840.1.113883.19
Encounter Type Consultation
Encounter Date From December 1, 2016, 09:20 to December 1, 2016, 10:20
Encounter Location id: NPI-Example 2.16.840.1.113883.4.6
Responsible party Michael Coletta, M.D. of Mass Pharmacy
Contact info 2100 North Ave
Burlington, MA 02368, US
Tel: +1(555)555-1003
Assigned entity Review of Care Plan
Assigned entity {$code/@code='SELF'?} Review of Care Plan
Emergency contact Mrs. Martha Jones

Contact info 17 Daws Rd.
Ann Arbor, MI 97857, US
Tel: (999)555-1212
Care giver Mrs. Martha Jones
Contact info 17 Daws Rd.
Ann Arbor, MI 97857, US
Tel: (999)555-1212
Entered by Ellen Enter
Contact info 1007 Pharmacy Drive
Portland, OR 99123, US
Tel: +1(555)555-1050
Signed Eve Everywoman at December 1, 2016
Contact info Primary Home:
2222 Home Street
Beaverton, OR 97867, US
Tel: +1(555)555-2003
Informant Harold Pharma, CPh
Contact info 1007 Pharmacy Drive
Portland, OR 99123, US
Tel: +1(555)555-1003
Information recipient: Pharmacist Coordinator, CPh
Contact info 100 Better Health Rd.
Ann Arbor, MI 97857, US
Telecom information not available
Legal authenticator Pharmacist Registered, RPh of Greater Area Pharmacy signed at December 1, 2016
Contact info 1004 Pharmacy Drive
Portland, OR 99123, US
Tel: +1(555)555-1004
Document maintained by Greater Area Pharmacy HIE
Contact info Work Place:
1009 Pharmacy Drive
Portland, OR 99123, US
Tel: +1(555)555-1009

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              <span class="td_label">Document Id</span> </td>
            <td class="td_header_role_value">db734647-fc99-424c-a864-7e3cda82e703</td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Document Created:</span> </td>
            <td class="td_header_role_value">December 1, 2016, 11:20, PST </td> </tr> </tbody> </table>
      <table style="border: 1pt inset #00008b line-height: 10pt width: 100%" class="header_table">
        <tbody>
          <!--documentationOf/serviceEvent-->
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Care provision</span> </td>
            <td class="td_header_role_value">Consultation for transition of care from November 1, 2016 to December 1, 2016 </td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Performer </span> </td>
            <td class="td_header_role_value">Claude Pharmacist, CPh</td> </tr> </tbody> </table>
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        <tbody>
          <!--Author-->
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Author</span> </td>
            <td class="td_header_role_value">Registered Pharmacist, RPh, The Pharmacy Alliance Health Group</td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">1004 Pharmacy Drive
              <br/>Portland, OR 99123, US
              <br/>Tel: +1(555)555-1004
              <br/> </td> </tr> </tbody> </table>
      <table style="border: 1pt inset #00008b line-height: 10pt width: 100%" class="header_table">
        <tbody>
          <!--encompassingEncounter-->
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            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Encounter Id</span> </td>
            <td class="td_header_role_value">9937012 2.16.840.1.113883.19</td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Encounter Type</span> </td>
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            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Encounter Date</span> </td>
            <td class="td_header_role_value">From December 1, 2016, 09:20 to December 1, 2016, 10:20 </td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Encounter Location</span> </td>
            <td class="td_header_role_value">id: NPI-Example 2.16.840.1.113883.4.6</td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Responsible party</span> </td>
            <td class="td_header_role_value">Michael Coletta, M.D. of Mass Pharmacy</td> </tr>
          <tr>
            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">2100 North Ave
              <br/>Burlington, MA 02368, US
              <br/>Tel: +1(555)555-1003
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          <!--participant-->
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              <span class="td_label">Assigned entity</span> </td>
            <td class="td_header_role_value">Review of Care Plan
              <br/> </td> </tr>
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              <span class="td_label">Assigned entity {$code/@code='SELF'?}</span> </td>
            <td class="td_header_role_value">Review of Care Plan
              <br/> </td> </tr>
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            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Emergency contact</span> </td>
            <td class="td_header_role_value">Mrs. Martha Jones
              <br/>
              <br/> </td> </tr>
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            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">17 Daws Rd.
              <br/>Ann Arbor, MI 97857, US
              <br/>Tel: (999)555-1212
              <br/> </td> </tr>
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            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Care giver</span> </td>
            <td class="td_header_role_value">Mrs. Martha Jones
              <br/> </td> </tr>
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              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">17 Daws Rd.
              <br/>Ann Arbor, MI 97857, US
              <br/>Tel: (999)555-1212
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              <span class="td_label">Entered by</span> </td>
            <td class="td_header_role_value">Ellen Enter</td> </tr>
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              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">1007 Pharmacy Drive
              <br/>Portland, OR 99123, US
              <br/>Tel: +1(555)555-1050
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          <!--Authenticator-->
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              <span class="td_label">Signed </span> </td>
            <td class="td_header_role_value">Eve Everywoman at December 1, 2016 </td> </tr>
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            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">Primary Home:
              <br/>2222 Home Street
              <br/>Beaverton, OR 97867, US
              <br/>Tel: +1(555)555-2003
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          <!--informant-->
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              <span class="td_label">Informant</span> </td>
            <td class="td_header_role_value">Harold Pharma, CPh</td> </tr>
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            <td class="td_header_role_value">1007 Pharmacy Drive
              <br/>Portland, OR 99123, US
              <br/>Tel: +1(555)555-1003
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          <!--informationRecipient-->
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              <span class="td_label">Information recipient:</span> </td>
            <td class="td_header_role_value">Pharmacist Coordinator, CPh</td> </tr>
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            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">100 Better Health Rd.
              <br/>Ann Arbor, MI 97857, US
              <br/>Telecom information not available
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              <span class="td_label">Legal authenticator</span> </td>
            <td class="td_header_role_value">Pharmacist Registered, RPh of Greater Area Pharmacy signed at December 1, 2016 </td> </tr>
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            <td style="width: 20% background-color: #3399ff padding: 0.1cm 0.2cm vertical-align: top background-color: #ffffcc" class="td_header_role_name">
              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">1004 Pharmacy Drive
              <br/>Portland, OR 99123, US
              <br/>Tel: +1(555)555-1004
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              <span class="td_label">Document maintained by</span> </td>
            <td class="td_header_role_value">Greater Area Pharmacy HIE</td> </tr>
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              <span class="td_label">Contact info</span> </td>
            <td class="td_header_role_value">Work Place:
              <br/>1009 Pharmacy Drive
              <br/>Portland, OR 99123, US
              <br/>Tel: +1(555)555-1009
              <br/> </td> </tr> </tbody> </table> </div>
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  <date value="2016-12-01T11:20:00-08:00"/>
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              <th>Health Concern</th> </tr> </thead>
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            <tr>
              <td>active</td> </tr>
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                          <th>Problem Type</th>
                          <th>Problem</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Problem</td>
                          <td>Constipation</td>
                          <td>AUG 19, 2016</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
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                          <th>Problem</th>
                          <th>Date(s)</th> </tr> </thead>
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                          <td>Problem</td>
                          <td>Non-compliance of drug therapy ( Non-adherence because patient forgets to take medication) </td>
                          <td>AUG 19, 2016</td> </tr>
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                                      <th>Reference to</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>Prescription of "oxyCODONE Hydrochloride 10 MG Oral Tablet" in the Interventions Section</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
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                        <tr>
                          <th>Intolerance Type</th>
                          <th>Substance</th>
                          <th>Reaction</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>
                            <span class="Italics Bold">No known </span>Allergy to Substance</td>
                          <td>
                            <span class="Italics Bold">No known </span>Penicillin</td>
                          <td>Other ( Some text related to reaction to allergy) </td>
                          <td>AUG 20, 2016</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
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              <td>active</td> </tr>
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                            <span class="Italics Bold">No known </span>Allergy to Substance</td>
                          <td>No Information</td>
                          <td>DEC 1, 2016</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
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                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Observation</th>
                          <th>Value</th>
                          <th>Date(s)</th>
                          <th>Author</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Cognitive Function</td>
                          <td>Difficulty processing information accurately</td>
                          <td>AUG 1, 2016</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Psychologist</span>: John Middle Psychologist</li>
                              <li>
                                <span class="Italics">Date: </span>AUG 1, 2016</li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>ADL Type</th>
                          <th>Ability</th>
                          <th>Author</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Bathing</td>
                          <td>Independent</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Adult Medicine</span> </li>
                              <li>
                                <span class="Italics">Date: </span>JUL 6, 2016 11:48</li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Functional Assessment</th>
                          <th>Result of Evaluation</th>
                          <th>Date(s)</th>
                          <th>Author</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Functional status</td>
                          <td>Independent walking</td>
                          <td>MAR 11, 2016</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Adult Medicine</span> </li>
                              <li>
                                <span class="Italics">Date: </span>JUL 6, 2016 11:45</li> </ul> </td> </tr>
                        <tr>
                          <td colspan="20">
                            <ul>
                              <li>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Device Supplied</th>
                                      <th>Status</th>
                                      <th>Duration</th>
                                      <th>Quantity</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>cane, device (physical object)</td>
                                      <td>completed</td>
                                      <td/>
                                      <td>2</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Observation</th>
                          <th>Value</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Nutrition status ( Nutritional Status) </td>
                          <td>well nourished</td>
                          <td>MAY 12, 2016</td> </tr>
                        <tr>
                          <td colspan="20">
                            <ul>
                              <li>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Observation</th>
                                      <th>Value</th>
                                      <th>Date(s)</th>
                                      <th>Author</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>Nutrition assessment</td>
                                      <td>low sodium diet (finding)</td>
                                      <td>MAY 12, 2016</td>
                                      <td>
                                        <ul>
                                          <li>
                                            <span class="Italics">Adult Medicine</span>: Patricia Patty Primary</li>
                                          <li>
                                            <span class="Italics">Date: </span>JUL 30, 2016</li> </ul> </td> </tr>
                                    <tr>
                                      <td>Nutrition assessment</td>
                                      <td>excessive dietary carbohydrate intake (finding)</td>
                                      <td>MAY 12, 2016</td>
                                      <td>
                                        <ul>
                                          <li>
                                            <span class="Italics">Adult Medicine</span>: Patricia Patty Primary</li>
                                          <li>
                                            <span class="Italics">Date: </span>JUL 30, 2016</li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Social History Observation Type</th>
                          <th>Value</th>
                          <th>Date(s)</th>
                          <th>Author</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Alcohol Intake</td>
                          <td>12</td>
                          <td>FEB 15, 2016</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Adult Medicine</span> </li>
                              <li>
                                <span class="Italics">Date: </span>SEP 10, 2016 11:45</li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Social History Observation Type</th>
                          <th>Value</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>History of tobacco use</td>
                          <td>Current every day smoker</td>
                          <td>FEB 14, 2016</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Vital Sign</th>
                          <th>Value</th>
                          <th>Date(s)</th>
                          <th>Author</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Patient Body Weight - Measured</td>
                          <td>88 kg</td>
                          <td>SEP 1, 2016</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Adult Medicine</span> </li>
                              <li>
                                <span class="Italics">Date: </span>SEP 1, 2016 09:15</li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Observation</th>
                          <th>Value</th>
                          <th>Date(s)</th>
                          <th>Participant</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>ASSERTION</td>
                          <td>caregiver difficulty providing physical care</td>
                          <td>MAR 12, 2016</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics">Mother</span> </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Social History Observation Type</th>
                          <th>Value</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Personal belief</td>
                          <td>Does not accept blood transfusions, or donates, or stores blood for transfusion.</td>
                          <td>MAR 12, 2016</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Functional Assessment</th>
                          <th>Result of Evaluation</th>
                          <th>Effective Date</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Brief Interview for Mental Status</td>
                          <td>7</td>
                          <td>FEB 14, 2016</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Problem Type</th>
                          <th>Problem</th>
                          <th>Date(s)</th>
                          <th>Author</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>ASSERTION</td>
                          <td>pressure ulcer stage 3</td>
                          <td>FEB 14, 2016</td>
                          <td>
                            <ul>
                              <li>
                                <span class="Italics"/>Assigned Amanda</li>
                              <li>
                                <span class="Italics">Date: </span>[month number out of range]31, 2001 1:</li> </ul> </td> </tr>
                        <tr>
                          <td colspan="20">
                            <ul>
                              <li>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Observation</th>
                                      <th>Value</th>
                                      <th>Date(s)</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>Width of Wound</td>
                                      <td>1 [in_i]</td>
                                      <td>[month number out of range]3, 2001</td> </tr>
                                    <tr>
                                      <td>Length of Wound</td>
                                      <td>2 [in_i]</td>
                                      <td>[month number out of range]3, 2001</td> </tr> </tbody> </table>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Observation</th>
                                      <th>Value</th>
                                      <th>Date(s)</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>ASSERTION</td>
                                      <td>Offensive wound odor</td>
                                      <td>[month number out of range]3, 2001</td> </tr> </tbody> </table>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Observation</th>
                                      <th>Value</th>
                                      <th>Date(s)</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>Number of pressure ulcers</td>
                                      <td>3</td>
                                      <td>[month number out of range]3, 2001</td> </tr>
                                    <tr>
                                      <td colspan="20">
                                        <ul>
                                          <li>
                                            <table>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <col width="10%"/>
                                              <thead>
                                                <tr>
                                                  <th>Observation</th>
                                                  <th>Value</th> </tr> </thead>
                                              <tbody>
                                                <tr>
                                                  <td>ASSERTION</td>
                                                  <td>Pressure ulcer stage 3</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
                                <table>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <col width="10%"/>
                                  <thead>
                                    <tr>
                                      <th>Observation</th>
                                      <th>Value</th>
                                      <th>Date(s)</th> </tr> </thead>
                                  <tbody>
                                    <tr>
                                      <td>Highest Pressure Ulcer Stage</td>
                                      <td>necrotic eschar</td>
                                      <td/> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>
                  <li>
                    <table>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <col width="10%"/>
                      <thead>
                        <tr>
                          <th>Observation</th>
                          <th>Value</th>
                          <th>Date(s)</th> </tr> </thead>
                      <tbody>
                        <tr>
                          <td>Hearing</td>
                          <td>Impaired</td>
                          <td>MAR 11, 2015</td> </tr> </tbody> </table> </li> </ul> </td> </tr> </tbody> </table>
        <table>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <col width="10%"/>
          <thead>
            <tr>
              <th>Health Concern</th> </tr> </thead>
          <tbody>
            <tr>
              <td>active</td> </tr>
            <tr>
              <td colspan="20">
                <ul>