FHIR Implementation Guide for the Norwegian Municipal Sector - Local Development build (v0.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

• Narrative Content
• XML
• JSON
• TTL

: Example municipal follow-up plan - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:CarePlan ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "example-careplan"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://kommune.conteir.no/StructureDefinition/kommune-careplan"^^xsd:anyURI ;
fhir:link <https://kommune.conteir.no/StructureDefinition/kommune-careplan>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CarePlan example-careplan</b></p><a name=\"example-careplan\"> </a><a name=\"hcexample-careplan\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-kommune-careplan.html\">no-kommune-CarePlan</a></p></div><p><b>status</b>: Active</p><p><b>intent</b>: Plan</p><p><b>category</b>: <span title=\"Codes:\">Municipal follow-up</span></p><p><b>title</b>: Follow-up plan after discharge - Grünerløkka district</p><p><b>subject</b>: <a href=\"Patient-example-patient.html\">Kari Hansen  Female, DoB: 1948-09-12 ( urn:oid:2.16.578.1.12.4.1.4.1#Foedselsnummer#12094812345)</a></p><p><b>period</b>: 2026-01-13 --&gt; 2026-03-31</p><p><b>author</b>: <a href=\"PractitionerRole-example-practitionerrole.html\">PractitionerRole</a></p><p><b>careTeam</b>: <a href=\"CareTeam-example-careteam.html\">CareTeam Multidisciplinary follow-up team, Grünerløkka district</a></p><p><b>addresses</b>: <a href=\"Condition-example-health-concern.html\">Health concern after hip fracture</a></p><p><b>supportingInfo</b>: </p><ul><li><a href=\"Condition-example-health-concern.html\">Health concern after hip fracture</a></li><li><a href=\"Observation-example-observation.html\">Observation </a></li><li><a href=\"DocumentReference-example-documentreference.html\">DocumentReference: status = current; type = Clinical note; date = 2026-01-12 09:00:00+0100; description = Decision on home nursing and practical assistance after discharge</a></li><li><a href=\"Goal-example-goal.html\">Goal: lifecycleStatus = active; description = ; start[x] = 2026-01-20</a></li></ul><p><b>goal</b>: <a href=\"Goal-example-goal.html\">Goal: lifecycleStatus = active; description = ; start[x] = 2026-01-20</a></p><blockquote><p><b>activity</b></p><p><b>outcomeReference</b>: </p><ul><li><a href=\"Encounter-example-encounter.html\">Encounter: status = finished; class = ambulatory (ActCode#AMB); type = ; serviceType = ; period = 2026-01-15 10:00:00+0100 --&gt; 2026-01-15 10:45:00+0100</a></li><li><a href=\"Encounter-example-encounter-followup.html\">Encounter: status = finished; class = virtual (ActCode#VR); type = ; serviceType = ; period = 2026-01-22 11:00:00+0100 --&gt; 2026-01-22 11:20:00+0100</a></li><li><a href=\"Encounter-example-encounter-phone.html\">Encounter: status = finished; class = virtual (ActCode#VR); type = ; serviceType = ; period = 2026-01-29 09:00:00+0100 --&gt; 2026-01-29 09:10:00+0100</a></li><li><a href=\"Encounter-example-encounter-evaluation.html\">Encounter: status = finished; class = ambulatory (ActCode#AMB); type = ; serviceType = ; period = 2026-02-05 13:00:00+0100 --&gt; 2026-02-05 13:40:00+0100</a></li><li><a href=\"Encounter-example-short-term-stay.html\">Encounter: status = finished; class = inpatient encounter (ActCode#IMP); type = ; serviceType = ; period = 2026-01-13 15:00:00+0100 --&gt; 2026-01-15 09:30:00+0100</a></li></ul><p><b>reference</b>: <a href=\"ServiceRequest-example-servicerequest.html\">ServiceRequest </a></p></blockquote><blockquote><p><b>activity</b></p><p><b>reference</b>: <a href=\"Appointment-example-appointment.html\">Appointment: status = booked; serviceType = ; appointmentType = ; description = Planned home visit for medication follow-up and function assessment; start = 2026-01-22 11:00:00+0100; end = 2026-01-22 11:30:00+0100; created = 2026-01-13 12:00:00+0100</a></p></blockquote><blockquote><p><b>activity</b></p><p><b>outcomeReference</b>: <a href=\"Encounter-example-encounter-evaluation.html\">Encounter: status = finished; class = ambulatory (ActCode#AMB); type = ; serviceType = ; period = 2026-02-05 13:00:00+0100 --&gt; 2026-02-05 13:40:00+0100</a></p><p><b>reference</b>: <a href=\"ServiceRequest-example-rehabilitation-servicerequest.html\">ServiceRequest </a></p></blockquote></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:intent [ fhir:v "plan"] ; # 
  fhir:category ( [
fhir:text [ fhir:v "Municipal follow-up" ]
  ] ) ; # 
  fhir:title [ fhir:v "Follow-up plan after discharge - Grünerløkka district"] ; # 
  fhir:subject [
fhir:reference [ fhir:v "Patient/example-patient" ]
  ] ; # 
  fhir:period [
fhir:start [ fhir:v "2026-01-13"^^xsd:date ] ;
fhir:end [ fhir:v "2026-03-31"^^xsd:date ]
  ] ; # 
  fhir:author [
fhir:reference [ fhir:v "PractitionerRole/example-practitionerrole" ]
  ] ; # 
  fhir:careTeam ( [
fhir:reference [ fhir:v "CareTeam/example-careteam" ]
  ] ) ; # 
  fhir:addresses ( [
fhir:reference [ fhir:v "Condition/example-health-concern" ] ;
fhir:display [ fhir:v "Health concern after hip fracture" ]
  ] ) ; # 
  fhir:supportingInfo ( [
fhir:reference [ fhir:v "Condition/example-health-concern" ] ;
fhir:display [ fhir:v "Health concern after hip fracture" ]
  ] [
fhir:reference [ fhir:v "Observation/example-observation" ]
  ] [
fhir:reference [ fhir:v "DocumentReference/example-documentreference" ]
  ] [
fhir:reference [ fhir:v "Goal/example-goal" ]
  ] ) ; # 
  fhir:goal ( [
fhir:reference [ fhir:v "Goal/example-goal" ]
  ] ) ; # 
  fhir:activity ( [
    ( fhir:outcomeReference [
fhir:reference [ fhir:v "Encounter/example-encounter" ]     ] [
fhir:reference [ fhir:v "Encounter/example-encounter-followup" ]     ] [
fhir:reference [ fhir:v "Encounter/example-encounter-phone" ]     ] [
fhir:reference [ fhir:v "Encounter/example-encounter-evaluation" ]     ] [
fhir:reference [ fhir:v "Encounter/example-short-term-stay" ]     ] ) ;
fhir:reference [
fhir:reference [ fhir:v "ServiceRequest/example-servicerequest" ]     ]
  ] [
fhir:reference [
fhir:reference [ fhir:v "Appointment/example-appointment" ]     ]
  ] [
    ( fhir:outcomeReference [
fhir:reference [ fhir:v "Encounter/example-encounter-evaluation" ]     ] ) ;
fhir:reference [
fhir:reference [ fhir:v "ServiceRequest/example-rehabilitation-servicerequest" ]     ]
  ] ) . #