Nexus EMR Item Consent Profile Core Profile

Canonical	../StructureDefinition/nexus-emr-core-item-consent
Status	draft · 1.26.0
Base	Consent (constraint)
Source	FSH · JSON

Patient-level consent for one catalogue item — whether the clinic may email the patient, text the patient, or use an AI scribe during their visit. Recorded manually by clinic staff from what the patient tells them, not captured through a patient-facing flow.

Examples

AI Scribe DECLINED With Evidence · Email PROVIDED · SMS DECLINED

AI Scribe DECLINED With Evidence

Item consent withdrawn by the patient for the AI Scribe item, with a status reason and a sourceReference to the signed withdrawal form

Consent/nexus-emr-item-consent-ai-scribe-declined-evidence — claims conformance to Nexus EMR Item Consent Profile Core

{
  "resourceType": "Consent",
  "id": "nexus-emr-item-consent-ai-scribe-declined-evidence",
  "meta": {
    "profile": [
      "../StructureDefinition/nexus-emr-core-item-consent"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Item Consent - AI Scribe - DECLINED (withdrawn)</b></p><p>Patient: <strong>Avery Linwood</strong> has <strong>DECLINED</strong> the <strong>AI Scribe</strong> item, withdrawing the consent she provided at her April visit. No AI scribe may listen to, transcribe, or summarize her visits.</p><p>Reason given: <em>Patient no longer comfortable with the visit being transcribed; signed a withdrawal form at reception</em></p><p>Decision made by: <strong>Avery Linwood</strong> (the patient) on June 12, 2025 at 9:15 AM</p><p>Evidence: signed AI Scribe consent withdrawal form (DocumentReference/nexus-emr-consent-evidence-document)</p><p>Status: rejected (Declined). The earlier 'active' answer remains readable in this resource's version history, along with the reason and evidence recorded with it.</p><p><strong>The decision is <code>provision.type = deny</code>, not <code>status</code>.</strong> Status is <code>active</code> because the record is operative; it says nothing about the answer. Earlier releases carried a declined item as <code>status = rejected</code>, which made one element mean opposite things across the Consent families sharing this store.</p></div>"
  },
  "extension": [
    {
      "url": "../StructureDefinition/nexus-consent-status-reason",
      "valueString": "Patient no longer comfortable with the visit being transcribed; signed a withdrawal form at reception"
    }
  ],
  "status": "active",
  "scope": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/consentscope",
        "code": "patient-privacy",
        "display": "Privacy Consent"
      }
    ]
  },
  "category": [
    {
      "coding": [
        {
          "system": "../CodeSystem/nexus-consent-item",
          "code": "ai-scribe",
          "display": "AI Scribe"
        }
      ]
    },
    {
      "coding": [
        {
          "system": "../CodeSystem/nexus-consent-family",
          "code": "item",
          "display": "Item consent"
        }
      ]
    }
  ],
  "patient": {
    "reference": "Patient/avery-linwood",
    "display": "Avery Linwood"
  },
  "dateTime": "2025-06-12T09:15:00-06:00",
  "performer": [
    {
      "reference": "Patient/avery-linwood",
      "display": "Avery Linwood"
    }
  ],
  "sourceReference": {
    "reference": "DocumentReference/nexus-emr-consent-evidence-document",
    "display": "Signed AI Scribe consent withdrawal form - June 12, 2025"
  },
  "policy": [
    {
      "uri": "../policy/nexus-privacy-policy"
    }
  ],
  "provision": {
    "type": "deny"
  }
}