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Publication Request

Publication Request

1. Published Name of the Standard for which request is being made

HL7 IG for CDA® Release 2: Personal Advance Care Plan (PACP) Document (US Realm) STU Release 2

2. Standards Material/Document


3. Date of Request

Jul 21, 2020

4. Use Period

2 years (24 months)

5. Reason for extension, timeline, and actions

6. Original Publication Date

7. End date of the current STU period

8. Length of the requested extension

9. Review Process

10. HL7 Work Group making this request and date

Structured Documents

10a. Requesting WG Date

Jul 30, 2020

11. URL of approval minutes

12. HL7 Product Management Group

CDA Management Group

12a. Management Group Date of Approval

Aug 07, 2020

13. URL of approval minutes

14. Is the artifact ready for final publication?


15. If not ready, please describe remaining steps.

16. Tool name used to produce the machine processable artifacts in the IG

Trifolia Workbench

17. The name of the “IG artifact” within the context of the above mentioned tool.

Personal Advance Care Plan V2

18. Balloted Name of the standard for which request is being made

HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan Document, Release 1 - US Realm

19. Requested name for published standard

HL7 IG for CDA® Release 2: Personal Advance Care Plan (PACP) Document (US Realm) STU Release 2

20. If CMET, list IDs balloted

21. Project Insight Number


22. Document Realm


23. Ballot cycle in which the document was successfully balloted


24. Results of that ballot (following reconciliation activities):

24. Results of that ballot (following reconciliation activities):

(not needed for errata, STU extension, or unballoted STU update)

25. Affirmative


26. Negative


27. Abstentions


28. Not Returned


29. Total in ballot pool


30. Date on which final document/standards material was supplied to HQ

Jul 30, 2020

31. URL of publication material/ SVN repository

32. Publishing Facilitator

Lisa Nelson

33. Special Publication Instructions

Consensus Group needs to be notified that this IG is being published as a STU to give implementers access to a published version with changes resulting from ballot reconciliation. A normative ballot will be pursued once sufficient testing and use confirms the IG content is ready to seek normative status. Refer to TSC minutes from 9/30/2019 and SDWG minutes from 10/3/2019 for prior decisions to allow this path forward to STU publication for the ballot.

34. URL of ballot reconciliation document

35. Has the Work Group posted its consideration of all comments received in its reconciliation document on the ballot desktop?


36. Substantive Changes Since Last Ballot?


37. Product Brief Reviewed By

Lisa Nelson, Scott Brown; Structured Documents WG (July 30, 2020)

38. Date Product Brief Reviewed

Jul 02, 2020

39. Has the Product Brief changed?

Product Brief

Product Brief

40. Family


41. Section

Implementation Guides

42. Topic

Care Provision Clinical Quality Decision Support Medical Records Patient Care

43. Please Describe the Topic

The Personal Advance Care Plan document is a CDA document template designed to share information created by an individual to express his or her care and medical treatment goals, preferences, and priorities for some future point in time, under certain circumstances when the individual cannot make medical treatment decisions or communicate his or her goals, preferences, and priorities with the care team.

44. Product Type

Implementation Guide

45. Parent standard


46. Parent Standard Status


47. Update/replace standard

HL7 IG for CDA® Release 2: Personal Advance Care Plan (PACP) Document (US Realm) STU Release 1

48. Common name/search keyword

PACP, Advance Care Plan

49. Description

The purpose of the PACP document is to ensure that the information created by the individual is available and considered in clinical care planning, and the focus of the standard is sharing patient generated information. It should not matter if the source information is documented on a piece of paper, in a video recording, or in a consumer-controlled application that exists for this purpose. The standard provides a means to share this information in a standard way with a system that maintains a clinical record for the person. It is not intended to be a legal document or a digitization of a legal document. However, a PACP can reference a legal document, and it can represent information contained in a legal document such as the appointment of healthcare agents and the identity of witnesses or a notary.



These are categories of potential users, implementers, or other interested parties such as those that are indicated on the Project Scope Statement under “Stakeholders/Vendors/Providers”. Select those that are applicable, or suggest others:

50. Stakeholders

Other (specify in text box below)

51. Vendors


52. Providers

Emergency Services Healthcare Institutions (hospitals, long term care, home care, mental health) Other (specify in text box below)

53. Benefits

 Improves the guidance available on how to include advance care plan and advance care planning information in a C-CDA document.
 Creates additional supplemental templates for representing decisions made by the patient or the patient’s surrogate decision-maker (e.g., a healthcare agent) at the time of service (obligation instructions or prohibition instructions).
 Creates a supplemental template for representing advance care planning services delivered to provide advance care planning education and assistance, and to review advance care plans with the patient.

54. Implementations/Case Studies

 ADVault, Inc. (

55. Development Background

Advance directives and advance care plans are documents that people have traditionally used to express their medical treatment wishes. Advance directives typically consist of two documents – the “living will,” and the “medical power of attorney.” A living will documents whether a person wants “life-sustaining treatments” (e.g., artificial nutrition or hydration, dialysis or the use of a ventilator to help with breathing) should that person suffer a medical emergency and be unable to communicate with the care team. A person uses a medical power of attorney to appoint one or more people to serve as advocates or “healthcare agents” empowered to make medical treatment decisions on behalf of the person if he or she is incapacitated and cannot communicate with medical personnel. The living will provides information that helps the healthcare agent make treatment decisions on the person’s behalf. Advance care plans cover the same subjects as living wills and medical powers of attorney; however, they are broader in scope and often include an individual’s thoughts on religion, hospice and palliative care options, and the person’s desired care experience more generally.

A new CDA R2 schema extension has be released by SDWG to support the extensions used in this implementation guides.

The July 2016 CDA_SDTC schema extension release package is available at: