LOINC
Version 2.67

51855-5Patient NoteActive

Term Description

A patient authored note is generated by a patient, or a patient agent (proxy), acting in a non-clinical role to provide clinically relevant information. The information within the note is used to support planned or unplanned health care services.

This document gives healthcare providers and others involved in a person's care information which the patient considers essential input during care delivery and coordination. This document enables patients and their agents to contribute to the continuity of care. The patient agent may not have a legally defined relationship with the patient (e.g. a close friend).

Because a patient authored note is generated by a person acting as a non-clinician, this document may not be a complete medical summary and should be considered in context with other information routinely collected by clinicians during care delivery and coordination.

This general class of patient authored notes includes information that is interoperable with data defined for clinician-generated documents. Other more specific classes of patient authored notes may include more tightly defined content.

This document may be generated from a patient-, clinician-, or payer-controlled source system.
Source: Regenstrief LOINC

Part Description

LP66710-2   Patient
Clinical information generated by a patient, or a patient agent (proxy), acting in a non-clinical role to provide clinically relevant information. The patient agent may not have a legally defined relationship with the patient (e.g. a close friend). Source: Regenstrief LOINC

Fully-Specified Name

Component
Note
Property
Find
Time
Pt
System
{Setting}
Scale
Doc
Method
Patient

Additional Names

Short Name
Patient Note

Basic Attributes

Class
DOC.ONTOLOGY
Type
Clinical
First Released
Version 2.24
Last Updated
Version 2.50
Order vs. Observation
Both

Member of these Groups

LG41826-5 {Setting}|ANYTypeofService|ANYKindofDocument|ANYRole|ANYSubjectMatterDomain
LG38748-6 Note|ANYRole|ANYSetting
LG39005-0 Patient|ANYTypeOfService|ANYKindOfNote|ANYSetting

Language Variants Get Info

zh-CNChinese (CHINA)
记录:发现:时间点:{环境}:文档型:患者
it-ITItalian (ITALY)
Nota:Osservazione:Pt:{Setting}:Doc:Paziente

LOINC FHIR® API Example - CodeSystem Request Get Info

https://fhir.loinc.org/CodeSystem/$lookup?system=http://loinc.org&code=51855-5