Type: openEHR TEMPLATE
Purpose: Not Specified
Use: null
Misuse: null
| TEMPLATE ID | XX CL 7.8 Consent Report |
|---|---|
| Concept | XX CL 7.8 Consent Report |
| Description | Not Specified |
| Purpose | Not Specified |
| References | |
| Other Details (Language Independent) |
|
| Language used | en |
| Citeable Identifier | 1013.26.808 |
| Root archetype id | openEHR-EHR-COMPOSITION.report.v1 |
| Consent Report | Consent Report: Document to communicate information to others, commonly in response to a request from another party. |
| Other Context | |
| Report ID | Report ID: Identification information about the report. |
| Status | Status: The status of the entire report. Note: This is not the status of any of the report components. |
| Informed Consent Request | Informed Consent Request: Request or instruction to gain and record informed consent from a subject (or the subject's agent) for a proposed procedure, trial or other healthcare-related activity (including treatments and investigations), based upon a clear appreciation and understanding of the facts, implications, and possible future consequences by the subject (or the subject's agent). |
| Current Activity | Current Activity: Current Activity. |
| Description | |
| Activity | Activity: Identification of the index proposed procedure/trial/activity (including correct side/correct site, where appropriate). |
| Activity Description | Activity Description: Narrative description of the proposed procedure, clinical trial or healthcare-related activity. |
| Intent | Intent: Description of the intent of the proposed procedure, clinical trial or healthcare-related activity. |
| Consent Description | Consent Description: Narrative description of the informed consent required before performing the proposed procedure, clinical trial or healthcare-related activity. |
| Start Date | Start Date: Proposed start date, and optional time, for the proposed index procedure, clinical trial or healthcare-related activity. |
| Date Consent Required | Date Consent Required: Date, and optional time, by which the consent is required. |
| Protocol | |
| Proposed consent document | Proposed consent document: Identification of the consent form or document proposed for use. |
| Supporting information | Supporting information: Details about supporting information proposed to be made available to the subject or subject's agent to support or inform the consent process. |
| Information name | Information name: Identification of the information to be made available. |
| Information type | Information type: Type of information made available. |
| Description | Description: Narrative description of the information to be made available. |
| Informed Consent | Informed Consent: Record of status and details of informed consent from a patient (or patient's agent) for a proposed procedure, trial or other healthcare-related activity (including treatments and investigations), based upon a clear appreciation and understanding of the facts, implications, and possible future consequences by the patient or patient's agent. |
| Description | |
| Activity | Activity: Identification of the procedure, clinical trial or healthcare-related activity (including correct side/correct site, where appropriate) against which the consent status and details are recorded. |
| Description | Description: Narrative description of the procedure, clinical trial or healthcare-related activity. |
| Intent | Intent: Description of the intent of the procedure, clinical trial or healthcare-related activity. |
| Consent Description | Consent Description: Narrative description of the informed consent required or recorded prior to performing the proposed procedure, clinical trial or healthcare-related activity. |
| Form of Consent | Form of Consent: Form of the consent sought or provided.
|
| Start Date | Start Date: Date, and optional time, when validity of the informed consent becomes active. |
| End Date | End Date: Date, and optional time, when validity of the informed consent ceased. |
| Caveat | Caveat: Details of any qualifications or exemptions to the informed consent. |
| Evidence of Consent | Evidence of Consent: Evidence of consent status. For example, audio of consent being requested or image of written consent obtained. |
| Protocol | |
| Consent Document Used | Consent Document Used: Identification of the consent form or document used. |
| Review Date | Review Date: Date when consent status is due for review. |
| Patient Information | Patient Information: Details about Patient Information made available to the subject or subject's agent. |
| Name | Name: Identification of the information made available. For example, the name of the form. |
| Description | Description: Narrative description of the patient information made available. |
| Multimedia Representation | Multimedia Representation: Digital representation of the Patient Information made available. |