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The purpose of the document is to facilitate the exchange of a patient's medical treatment goals, preferences, and priorities to be used in care planning. This document will enable an individual to share his or her directives with members of the care team for consideration when developing or updating the person's care plan. The document will define a standard exchange format to support interoperability of this information.

The project will identify source documents for establishing information exchange requirements. The scope is limited to the document content and does not address transport requirements. Input will be gathered from participants in: the HL7 SDWG, the HL7 PC WG, and a team of interested parties from within the Healthcare Industry. The implementation guide will clarify how the information generated by the individual relates to the clinician's information in the EMR. Input on the creation of the implementation guide and the associated CDA templates will be gathered from participants in a team with technical CDA expertise.

Project Charter 

Project Summary for HL7 Implementation Guide for CDA® Release 2: Personal Advance Care Plan Document, Release 1

Project Insight ID 1204

Key Project Objectives

  • Supplement to a Current Standard, Implementation Guide
  • Systems used to created patient-centered care plans through a patient mediated process need a way for individuals to share information about their care goals, preferences, and priorities.

Detailed Project Requirements

  • Individuals need a way to generate information about their care goals, preferences and priorities so that their wishes will be considered when providers create and update their care plan.
  • Enabling interoperable exchange of this information makes it more possible for a person's care plan to be centered on the person's goals, preferences and priorities.

Ballot Reconciliation calls

PACP Ballot Reconciliation calls to start on Nov 12th

Occurs every 2 week(s) on Tuesday effective 11/12/2019 until 12/17/2019 from 11:00 AM to 12:00 PM ET

11/12/2019; 11/26/2019; 12/10/2019; 12/17/2019

You can also dial in using your phone.

United States (Toll Free): 1 877 568 4106

- One-touch: tel:+18775684106,,391224589#






Submit initial materials to HL7Completed

Submit final ballot package materials to HL7


Review initial materials with SDWGCompleted

2019-08-01Request vote to approve materials to be submitted for ballotCompleted

Ballot - Completed 

2019-10-01Request to TSC to downgrade Normative Ballot to STU

Permission from TSC to publish as STU following completion of ballot reconciliation

2020-04-16Vote to accept final ballot reconciliation spreadsheetCompleted

Co-Chair request to withdrawn negativesCompleted

2020-07-23Execute all changes according to approved definitionsCompleted

Change IG status to Published in Trifolia

Produce Publication Package and Fill out a Publication RequestHow to Create a Publication Request from Template

2020-07-30Vote to Publish as STUComplete at SDWG 22-0-0



  1. HL7 Implementation Guide which specifies a CDA document template for a type of Patient Generated Document called a Personal Advance Care Plan (PACP), sample documents and Schematron
  2. Reconciliation Package (resolutions and execution of changes).

Activities and Schedule

ActivityResponsibleDate ScheduledDate CompletedBallot Sheet for reviewComment Resolution Tracking
Ballot AnalysisStructured Documents workgroup

92 comments received
Ballot Reconciliation Block Voting and Discussion as neededStructured Documents workgroup



22 comments addressed

70 comments remaining

Ballot Reconciliation Block Voting and Discussion as neededStructured Documents workgroup




15 comments addressed



Ballot Reconciliation Block Voting and Discussion as neededStructured Documents workgroup




CDAR2_IG_PERSADVCAREPLAN_R1_N1_2019SEP_almalgamated_20200109 20200109.xls

16 comments addressed

39 comments remaining

Ballot Reconciliation Block Voting and Discussion as neededStructured Documents workgroup




CDAR2_IG_PERSADVCAREPLAN_R1_N1_2019SEP_almalgamated_20200116 20200116.xls

11 comments addressed

28 comments remaining

Ballot Reconciliation Block Voting and Discussion as neededStructured Documents workgroup




23 comments addressed

5 comments remaining

Ballot Reconciliation Block Voting and Discussion as neededStructured Documents workgroup




CDAR2_IG_PERSADVCAREPLAN_R1_N1_2019SEP_almalgamated_20200221 20200221.xls

3 comments addressed

2 comments remaining

Ballot Reconciliation Block Voting and Discussion as neededStructured Documents workgroup




2 comments addressed

0 comments remaining

Completed Ballot Reconciliation SheetStructured Documents workgroup




Scott Brown/Calvin Beebe

CDAR2_IG_PERSADVCAREPLAN_R1_N1_2019SEP_almalgamated_20200416_20200409 (1).xlsFinal
Reopen itemsStructured Documents workgroup2020.06.18



Lisa Nelson / Anne Smith

CDAR2_IG_PERSADVCAREPLAN_R1_N1_2019SEP_almalgamated_20200416_20200625.xlsComments 12, 44 reopened
Discuss and vote on Comment 12Structured Documents workgroup2020.07.02



Lisa Nelson / Scott Brown 


1 comments addressed

1 comments remaining

Discuss and vote on Comment 44Structured Documents workgroup2020.07.02



Lisa Nelson / Rob McClure 


1 comments addressed

0 comments remaining

Updated Completed Ballot Reconciliation SheetStructured Documents workgroup2020.07.09


Lisa Nelson / Scott Brown 



Ballot Reconciliation Execution Activities and Schedule

ActivityDateAction ItemsNotes
Reconciliation of Comments 1-472020-06-20

Comment 12 Needs to be reopened

Comment 44 Needs to be reopened


Request agenda item for 2020.06.25 to re-open two comments.

#12 Reopened (2020-06-25) Lisa/Ann Smith 28-0-0

#44 Reopened (2020-06-25) Lisa/Scott Brown 27-0-0

Re-dispose for Comment #122020-07-02

Proposed Disposition - Not Persuasive. Moving the MAY to a SHALL

would require each person to have a guardian. That is not the intended constraint behavior.

Re-dispose for Comment #442020-07-09
Impacted by Vocabulary changes2020-06-29

Comments 42, 44, 45, 46. 

Meeting scheduled for 2020-06-29


Confirm examples & samples update

Comments 15, 26, 28 need to verify changes are made in Examples/SamplesDONE
Lantana- recordTarget
Comments 49, 50: work with Lantana to create primitive constraint that author is constrained to be the recordTarget.DONE
Discuss with Rob McClure2020-06-29Comments 53, 54, 57: May need to be re-opened: Review first with Rob Mcclure. (RE: Should there be a binding strength when there is a fixed code binding?)

Complete: Direct Reference Codes do not include a Binding Strength.  In essence, there is not a “binding”, rather, there is a “direct reference”.


ValueSet Binding
Review all templates for value set binding strengthDONE
Follow up Stephen ChuTentative 2020.07.01 Comments 70, 71 
Extensions in Examples2020-06-28Update all applicable extensions to "2020-06-10"



Header Examples update2020-06-28

Device author - remove the Device Author and add new participant assembler

Author - update

Document Examples update2020-06-28

Level 2 (figure 9) : Code 81335-21 updated to 81335-2;  name of display "Patient Healthcare Agent" 

Header2020-06-28Confirm all headers in three sample files are updated from the header of approved.  DONE

Fix sample documents, fix entry templates, fix examples for entry templates

Update LOINC Copyright
Confirm wording for LOINC copyrighted material 

email sent to Lynn Lasko.


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