Consolidated CDA Release 2.1 StructureDefinition Prototype Publication
2.1.0-draft1 - CI Build
United States of America
Consolidated CDA Release 2.1 StructureDefinition Prototype Publication
2.1.0-draft1 - CI Build
United States of America
This page is part of the CCDA: Consolidated CDA Release (v2.1.0-draft1: CCDA 2.1 Draft) based on FHIR v5.0.0. . For a full list of available versions, see the Directory of published versions 
| Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.131 | Version: 2.1.0-draft1 | |||
| Active as of 2023-01-16 | Computable Name: InterventionAct | |||
| Other Identifiers: id: urn:hl7ii:2.16.840.1.113883.10.20.22.4.131:2015-08-01 | ||||
This template represents an Intervention Act. It is a wrapper for intervention-type activities considered to be parts of the same intervention. For example, an activity such as “elevate head of bed” combined with “provide humidified O2 per nasal cannula” may be the interventions performed for a health concern of “respiratory insufficiency” to achieve a goal of “pulse oximetry greater than 92%”. These intervention activities may be newly described or derived from a variety of sources within an EHR.
Interventions are actions taken to increase the likelihood of achieving the patient’s or providers’ goals. An Intervention Act should contain a reference to a Goal Observation representing the reason for the intervention.
Intervention Acts can be related to each other, or to Planned Intervention Acts. (E.g., a Planned Intervention Act with moodCode of INT could be related to a series of Intervention Acts with moodCode of EVN, each having an effectiveTime containing the time of the intervention.)
All interventions referenced in an Intervention Act must have a moodCode of EVN, indicating that they have occurred.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from CDAR2.Act
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Act | 1..1 | CDAR2.Act | Base for all types and resources | |
 classCode | 1..1 | code | Required Pattern: ACT | |
| moodCode | 1..1 | code | Required Pattern: EVN | |
  Slices for templateId | 0..* | II | Slice: Unordered, Open by value:root, value:extension | |
   templateId:primary | 1..1 | II | ||
  root | 1..1 | string | Required Pattern: 2.16.840.1.113883.10.20.22.4.131 | |
  extension | 1..1 | string | Required Pattern: 2015-08-01 | |
| id | 1..* | II | ||
| code | 1..1 | CD | ||
| code | 1..1 | string | Required Pattern: 362956003 | |
 codeSystem | 1..1 | string | Required Pattern: 2.16.840.1.113883.6.96 | |
| statusCode | 1..1 | CS | ||
| code | 1..1 | string | Required Pattern: completed | |
| effectiveTime | 0..1 | IVL_TS | ||
 author | 0..* | AuthorParticipation | Base for all types and resources | |
| Slices for entryRelationship | 0..* | Element | Slice: Unordered, Open by profile:observation, profile:substanceAdministration, profile:act, profile:procedure, profile:encounter, profile:supply | |
 entryRelationship:advanceDirectiveObservation | 0..* | Element | ||
 typeCode | 1..1 | code | Required Pattern: REFR | |
| observation | 1..1 | AdvanceDirectiveObservation | Base for all types and resources | |
| entryRelationship:immunizationActivity | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| substanceAdministration | 1..1 | ImmunizationActivity | Base for all types and resources | |
| entryRelationship:medicationActivity | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| substanceAdministration | 1..1 | MedicationActivity | Base for all types and resources | |
| entryRelationship:procedureActivityAct | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| act | 1..1 | ProcedureActivityAct | Base for all types and resources | |
| entryRelationship:interventionAct | 0..* | Element | The following entryRelationship represents the relationship between two Intervention Acts (Intervention RELATES TO Intervention). | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| act | 1..1 | InterventionAct | Base for all types and resources | |
| entryRelationship:procedureActivityObservation | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| observation | 1..1 | ProcedureActivityObservation | Base for all types and resources | |
| entryRelationship:procedureActivityProcedure | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| procedure | 1..1 | ProcedureActivityProcedure | Base for all types and resources | |
| entryRelationship:encounterActivity | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| encounter | 1..1 | EncounterActivity | Base for all types and resources | |
| entryRelationship:instruction | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| act | 1..1 | Instruction | Base for all types and resources | |
| entryRelationship:nonMedSupply | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| supply | 1..1 | NonMedicinalSupplyActivity | Base for all types and resources | |
| entryRelationship:nutritionRecommendation | 0..* | Element | ||
| act | 1..1 | NutritionRecommendation | Base for all types and resources | |
| entryRelationship:entryReference | 0..* | Element | Where an Intervention needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry. | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| act | 1..1 | EntryReference | Base for all types and resources | |
| entryRelationship:entryReference | C | 0..* | Element | An Intervention Act should reference a Goal Observation. Because the Goal Observation is already described in the CDA document instance's Goals section, rather than repeating the full content of the Goal Observation, the Entry Reference template can be used to reference this entry. The following entryRelationship represents an Entry Reference to Goal Observation. 1198-32459: This entryReference template **SHALL** reference an instance of a Goal Observation template (CONF:1198-32459). |
| typeCode | 1..1 | code | Required Pattern: RSON | |
| act | 1..1 | EntryReference | Base for all types and resources | |
| entryRelationship:handoffCommunicationParticipants | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| act | 1..1 | HandoffCommunicationParticipants | Base for all types and resources | |
| entryRelationship:plannedInterventionAct | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| act | 1..1 | PlannedInterventionAct | Base for all types and resources | |
 reference | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| externalDocument | 1..1 | ExternalDocumentReference | Base for all types and resources | |
| Documentation for this format | ||||
| Id | Grade | Path(s) | Details | Requirements |
| 1198-32459 | error | Act.entryRelationship:entryReference | This entryReference template **SHALL** reference an instance of a Goal Observation template (CONF:1198-32459). : |
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Act | 1..1 | CDAR2.Act | Base for all types and resources | |
 classCode | 1..1 | code | Required Pattern: ACT | |
| moodCode | 1..1 | code | Required Pattern: EVN | |
| Slices for templateId | 0..* | II | Slice: Unordered, Open by value:root, value:extension | |
| templateId:primary | 1..1 | II | ||
| root | 1..1 | string | Required Pattern: 2.16.840.1.113883.10.20.22.4.131 | |
| extension | 1..1 | string | Required Pattern: 2015-08-01 | |
| id | 1..* | II | ||
| code | 1..1 | CD | Binding: v3 Code System ActCode (extensible) | |
| code | 1..1 | string | Required Pattern: 362956003 | |
| codeSystem | 1..1 | string | Required Pattern: 2.16.840.1.113883.6.96 | |
| statusCode | 1..1 | CS | Binding: ActStatus (required) | |
| code | 1..1 | string | Required Pattern: completed | |
| effectiveTime | 0..1 | IVL_TS | ||
| author | 0..* | AuthorParticipation | Base for all types and resources | |
| Slices for entryRelationship | C | 0..* | Element | Slice: Unordered, Open by profile:observation, profile:substanceAdministration, profile:act, profile:procedure, profile:encounter, profile:supply |
| entryRelationship:All Slices | Content/Rules for all slices | |||
 typeCode | 1..1 | code | ||
 contextConductionInd | 1..1 | boolean | ||
| entryRelationship:advanceDirectiveObservation | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| observation | 1..1 | AdvanceDirectiveObservation | Base for all types and resources | |
| entryRelationship:immunizationActivity | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| substanceAdministration | 1..1 | ImmunizationActivity | Base for all types and resources | |
| entryRelationship:medicationActivity | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| substanceAdministration | C | 1..1 | MedicationActivity | Base for all types and resources |
| entryRelationship:procedureActivityAct | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| act | 1..1 | ProcedureActivityAct | Base for all types and resources | |
| entryRelationship:interventionAct | C | 0..* | Element | The following entryRelationship represents the relationship between two Intervention Acts (Intervention RELATES TO Intervention). |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| act | 1..1 | InterventionAct | Base for all types and resources | |
| entryRelationship:procedureActivityObservation | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| observation | 1..1 | ProcedureActivityObservation | Base for all types and resources | |
| entryRelationship:procedureActivityProcedure | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| procedure | 1..1 | ProcedureActivityProcedure | Base for all types and resources | |
| entryRelationship:encounterActivity | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| encounter | 1..1 | EncounterActivity | Base for all types and resources | |
| entryRelationship:instruction | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| act | 1..1 | Instruction | Base for all types and resources | |
| entryRelationship:nonMedSupply | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| supply | 1..1 | NonMedicinalSupplyActivity | Base for all types and resources | |
| entryRelationship:nutritionRecommendation | C | 0..* | Element | |
| typeCode | 1..1 | code | ||
| contextConductionInd | 1..1 | boolean | ||
| act | 1..1 | NutritionRecommendation | Base for all types and resources | |
| entryRelationship:entryReference | C | 0..* | Element | Where an Intervention needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry. |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| act | 1..1 | EntryReference | Base for all types and resources | |
| entryRelationship:entryReference | C | 0..* | Element | An Intervention Act should reference a Goal Observation. Because the Goal Observation is already described in the CDA document instance's Goals section, rather than repeating the full content of the Goal Observation, the Entry Reference template can be used to reference this entry. The following entryRelationship represents an Entry Reference to Goal Observation. 1198-32459: This entryReference template **SHALL** reference an instance of a Goal Observation template (CONF:1198-32459). |
| typeCode | 1..1 | code | Required Pattern: RSON | |
| contextConductionInd | 1..1 | boolean | ||
| act | 1..1 | EntryReference | Base for all types and resources | |
| entryRelationship:handoffCommunicationParticipants | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| act | 1..1 | HandoffCommunicationParticipants | Base for all types and resources | |
| entryRelationship:plannedInterventionAct | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| act | 1..1 | PlannedInterventionAct | Base for all types and resources | |
 reference | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| externalDocument | 1..1 | ExternalDocumentReference | Base for all types and resources | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| Act.code | extensible | ActCode |
| Act.statusCode | required | ActStatus |
| Id | Grade | Path(s) | Details | Requirements |
| 1098-30800 | warning | Act.entryRelationship:medicationActivity.substanceAdministration | Medication Activity **SHOULD** include doseQuantity **OR** rateQuantity (CONF:1098-30800). : | |
| 1198-32459 | error | Act.entryRelationship:entryReference | This entryReference template **SHALL** reference an instance of a Goal Observation template (CONF:1198-32459). : | |
| act-er-1 | error | Act.entryRelationship, Act.entryRelationship:advanceDirectiveObservation, Act.entryRelationship:immunizationActivity, Act.entryRelationship:medicationActivity, Act.entryRelationship:procedureActivityAct, Act.entryRelationship:interventionAct, Act.entryRelationship:procedureActivityObservation, Act.entryRelationship:procedureActivityProcedure, Act.entryRelationship:encounterActivity, Act.entryRelationship:instruction, Act.entryRelationship:nonMedSupply, Act.entryRelationship:nutritionRecommendation, Act.entryRelationship:entryReference, Act.entryRelationship:entryReference, Act.entryRelationship:handoffCommunicationParticipants, Act.entryRelationship:plannedInterventionAct | Only one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act : (observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1 | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Act | 1..1 | CDAR2.Act | Base for all types and resources | |
| classCode | 1..1 | code | Required Pattern: ACT | |
| moodCode | 1..1 | code | Required Pattern: EVN | |
| realmCode | 0..* | CS | ||
| typeId | 0..1 | II | ||
| Slices for templateId | 0..* | II | Slice: Unordered, Open by value:root, value:extension | |
| templateId:primary | 1..1 | II | ||
| nullFlavor | 0..1 | code | Binding: NullFlavor (required) | |
| assigningAuthorityName | 0..1 | string | ||
| displayable | 0..1 | boolean | ||
| root | 1..1 | string | Required Pattern: 2.16.840.1.113883.10.20.22.4.131 | |
| extension | 1..1 | string | Required Pattern: 2015-08-01 | |
| id | 1..* | II | ||
| code | 1..1 | CD | Binding: v3 Code System ActCode (extensible) | |
| nullFlavor | 0..1 | code | Binding: NullFlavor (required) | |
| code | 1..1 | string | Required Pattern: 362956003 | |
| codeSystem | 1..1 | string | Required Pattern: 2.16.840.1.113883.6.96 | |
| codeSystemName | 0..1 | string | ||
| codeSystemVersion | 0..1 | string | ||
| displayName | 0..1 | string | ||
| sdtcValueSet | 0..1 | string | XML: valueSet (urn:hl7-org:sdtc) | |
| sdtcValueSetVersion | 0..1 | string | XML: valueSetVersion (urn:hl7-org:sdtc) | |
| originalText | 0..1 | ED | ||
| qualifier | 0..* | CR | ||
| translation | 0..* | CD | ||
| negationInd | 0..1 | boolean | ||
| text | 0..1 | ED | ||
| statusCode | 1..1 | CS | Binding: ActStatus (required) | |
| nullFlavor | 0..1 | code | Binding: NullFlavor (required) | |
| code | 1..1 | string | Required Pattern: completed | |
| sdtcValueSet | 0..1 | string | XML: valueSet (urn:hl7-org:sdtc) | |
| sdtcValueSetVersion | 0..1 | string | XML: valueSetVersion (urn:hl7-org:sdtc) | |
| effectiveTime | 0..1 | IVL_TS | ||
| priorityCode | 0..1 | CE | Binding: ActPriority (extensible) | |
| languageCode | 0..1 | CS | Binding: HumanLanguage (required) | |
| subject | 0..1 | Element | ||
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Binding: ParticipationTargetSubject (required) Fixed Value: SBJ | |
| contextControlCode | 1..1 | code | Binding: ContextControl (required) Fixed Value: OP | |
| awarenessCode | 0..1 | CE | Binding: TargetAwareness (extensible) | |
| relatedSubject | 1..1 | RelatedSubject | ||
| specimen | 0..* | Specimen | ||
| performer | 0..* | Performer2 | ||
| author | 0..* | AuthorParticipation | Base for all types and resources | |
| informant | 0..* | Element | ||
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Binding: ParticipationInformationGenerator (required) Fixed Value: INF | |
| contextControlCode | 1..1 | code | Binding: ContextControl (required) Fixed Value: OP | |
| assignedEntity | 0..1 | AssignedEntity | ||
| relatedEntity | 0..1 | RelatedEntity | ||
| participant | 0..* | Participant2 | ||
| Slices for entryRelationship | C | 0..* | Element | Slice: Unordered, Open by profile:observation, profile:substanceAdministration, profile:act, profile:procedure, profile:encounter, profile:supply |
| entryRelationship:All Slices | Content/Rules for all slices | |||
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | ||
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
 (Choice of one) | 1..1 | |||
| observation | 0..1 | Observation | ||
| regionOfInterest | 0..1 | RegionOfInterest | ||
| observationMedia | 0..1 | ObservationMedia | ||
| substanceAdministration | 0..1 | SubstanceAdministration | ||
| supply | 0..1 | Supply | ||
| procedure | 0..1 | Procedure | ||
| encounter | 0..1 | Encounter | ||
| organizer | 0..1 | Organizer | ||
| act | 0..1 | Act | ||
| entryRelationship:advanceDirectiveObservation | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| observation | 1..1 | AdvanceDirectiveObservation | Base for all types and resources | |
| entryRelationship:immunizationActivity | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| substanceAdministration | 1..1 | ImmunizationActivity | Base for all types and resources | |
| entryRelationship:medicationActivity | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| substanceAdministration | C | 1..1 | MedicationActivity | Base for all types and resources |
| entryRelationship:procedureActivityAct | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| act | 1..1 | ProcedureActivityAct | Base for all types and resources | |
| entryRelationship:interventionAct | C | 0..* | Element | The following entryRelationship represents the relationship between two Intervention Acts (Intervention RELATES TO Intervention). |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| act | 1..1 | InterventionAct | Base for all types and resources | |
| entryRelationship:procedureActivityObservation | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| observation | 1..1 | ProcedureActivityObservation | Base for all types and resources | |
| entryRelationship:procedureActivityProcedure | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| procedure | 1..1 | ProcedureActivityProcedure | Base for all types and resources | |
| entryRelationship:encounterActivity | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| encounter | 1..1 | EncounterActivity | Base for all types and resources | |
| entryRelationship:instruction | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| act | 1..1 | Instruction | Base for all types and resources | |
| entryRelationship:nonMedSupply | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| supply | 1..1 | NonMedicinalSupplyActivity | Base for all types and resources | |
| entryRelationship:nutritionRecommendation | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | ||
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| act | 1..1 | NutritionRecommendation | Base for all types and resources | |
| entryRelationship:entryReference | C | 0..* | Element | Where an Intervention needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry. |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| act | 1..1 | EntryReference | Base for all types and resources | |
| entryRelationship:entryReference | C | 0..* | Element | An Intervention Act should reference a Goal Observation. Because the Goal Observation is already described in the CDA document instance's Goals section, rather than repeating the full content of the Goal Observation, the Entry Reference template can be used to reference this entry. The following entryRelationship represents an Entry Reference to Goal Observation. 1198-32459: This entryReference template **SHALL** reference an instance of a Goal Observation template (CONF:1198-32459). |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: RSON | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| act | 1..1 | EntryReference | Base for all types and resources | |
| entryRelationship:handoffCommunicationParticipants | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| act | 1..1 | HandoffCommunicationParticipants | Base for all types and resources | |
| entryRelationship:plannedInterventionAct | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| act | 1..1 | PlannedInterventionAct | Base for all types and resources | |
| reference | 0..* | Element | ||
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| seperatableInd | 0..1 | BL | ||
| externalAct | 0..1 | ExternalAct | ||
| externalObservation | 0..1 | ExternalObservation | ||
| externalProcedure | 0..1 | ExternalProcedure | ||
| externalDocument | 1..1 | ExternalDocumentReference | Base for all types and resources | |
| precondition | 0..* | Precondition | ||
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code |
| Act.templateId:primary.nullFlavor | required | NullFlavor |
| Act.code | extensible | ActCode |
| Act.code.nullFlavor | required | NullFlavor |
| Act.statusCode | required | ActStatus |
| Act.statusCode.nullFlavor | required | NullFlavor |
| Act.priorityCode | extensible | ActPriority |
| Act.languageCode | required | HumanLanguage (a valid code from http://terminology.hl7.org/CodeSystem/ietf3066) |
| Act.subject.typeCode | required | Fixed Value: SBJ |
| Act.subject.contextControlCode | required | Fixed Value: OP |
| Act.subject.awarenessCode | extensible | TargetAwareness |
| Act.informant.typeCode | required | Fixed Value: INF |
| Act.informant.contextControlCode | required | Fixed Value: OP |
| Id | Grade | Path(s) | Details | Requirements |
| 1098-30800 | warning | Act.entryRelationship:medicationActivity.substanceAdministration | Medication Activity **SHOULD** include doseQuantity **OR** rateQuantity (CONF:1098-30800). : | |
| 1198-32459 | error | Act.entryRelationship:entryReference | This entryReference template **SHALL** reference an instance of a Goal Observation template (CONF:1198-32459). : | |
| act-er-1 | error | Act.entryRelationship, Act.entryRelationship:advanceDirectiveObservation, Act.entryRelationship:immunizationActivity, Act.entryRelationship:medicationActivity, Act.entryRelationship:procedureActivityAct, Act.entryRelationship:interventionAct, Act.entryRelationship:procedureActivityObservation, Act.entryRelationship:procedureActivityProcedure, Act.entryRelationship:encounterActivity, Act.entryRelationship:instruction, Act.entryRelationship:nonMedSupply, Act.entryRelationship:nutritionRecommendation, Act.entryRelationship:entryReference, Act.entryRelationship:entryReference, Act.entryRelationship:handoffCommunicationParticipants, Act.entryRelationship:plannedInterventionAct | Only one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act : (observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1 | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from CDAR2.Act
Summary
Mandatory: 11 elements (31 nested mandatory elements)
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Differential View
This structure is derived from CDAR2.Act
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Act | 1..1 | CDAR2.Act | Base for all types and resources | |
| classCode | 1..1 | code | Required Pattern: ACT | |
| moodCode | 1..1 | code | Required Pattern: EVN | |
| Slices for templateId | 0..* | II | Slice: Unordered, Open by value:root, value:extension | |
| templateId:primary | 1..1 | II | ||
| root | 1..1 | string | Required Pattern: 2.16.840.1.113883.10.20.22.4.131 | |
| extension | 1..1 | string | Required Pattern: 2015-08-01 | |
| id | 1..* | II | ||
| code | 1..1 | CD | ||
| code | 1..1 | string | Required Pattern: 362956003 | |
| codeSystem | 1..1 | string | Required Pattern: 2.16.840.1.113883.6.96 | |
| statusCode | 1..1 | CS | ||
| code | 1..1 | string | Required Pattern: completed | |
| effectiveTime | 0..1 | IVL_TS | ||
| author | 0..* | AuthorParticipation | Base for all types and resources | |
| Slices for entryRelationship | 0..* | Element | Slice: Unordered, Open by profile:observation, profile:substanceAdministration, profile:act, profile:procedure, profile:encounter, profile:supply | |
| entryRelationship:advanceDirectiveObservation | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| observation | 1..1 | AdvanceDirectiveObservation | Base for all types and resources | |
| entryRelationship:immunizationActivity | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| substanceAdministration | 1..1 | ImmunizationActivity | Base for all types and resources | |
| entryRelationship:medicationActivity | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| substanceAdministration | 1..1 | MedicationActivity | Base for all types and resources | |
| entryRelationship:procedureActivityAct | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| act | 1..1 | ProcedureActivityAct | Base for all types and resources | |
| entryRelationship:interventionAct | 0..* | Element | The following entryRelationship represents the relationship between two Intervention Acts (Intervention RELATES TO Intervention). | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| act | 1..1 | InterventionAct | Base for all types and resources | |
| entryRelationship:procedureActivityObservation | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| observation | 1..1 | ProcedureActivityObservation | Base for all types and resources | |
| entryRelationship:procedureActivityProcedure | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| procedure | 1..1 | ProcedureActivityProcedure | Base for all types and resources | |
| entryRelationship:encounterActivity | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| encounter | 1..1 | EncounterActivity | Base for all types and resources | |
| entryRelationship:instruction | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| act | 1..1 | Instruction | Base for all types and resources | |
| entryRelationship:nonMedSupply | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| supply | 1..1 | NonMedicinalSupplyActivity | Base for all types and resources | |
| entryRelationship:nutritionRecommendation | 0..* | Element | ||
| act | 1..1 | NutritionRecommendation | Base for all types and resources | |
| entryRelationship:entryReference | 0..* | Element | Where an Intervention needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry. | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| act | 1..1 | EntryReference | Base for all types and resources | |
| entryRelationship:entryReference | C | 0..* | Element | An Intervention Act should reference a Goal Observation. Because the Goal Observation is already described in the CDA document instance's Goals section, rather than repeating the full content of the Goal Observation, the Entry Reference template can be used to reference this entry. The following entryRelationship represents an Entry Reference to Goal Observation. 1198-32459: This entryReference template **SHALL** reference an instance of a Goal Observation template (CONF:1198-32459). |
| typeCode | 1..1 | code | Required Pattern: RSON | |
| act | 1..1 | EntryReference | Base for all types and resources | |
| entryRelationship:handoffCommunicationParticipants | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| act | 1..1 | HandoffCommunicationParticipants | Base for all types and resources | |
| entryRelationship:plannedInterventionAct | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| act | 1..1 | PlannedInterventionAct | Base for all types and resources | |
| reference | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| externalDocument | 1..1 | ExternalDocumentReference | Base for all types and resources | |
| Documentation for this format | ||||
| Id | Grade | Path(s) | Details | Requirements |
| 1198-32459 | error | Act.entryRelationship:entryReference | This entryReference template **SHALL** reference an instance of a Goal Observation template (CONF:1198-32459). : |
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Act | 1..1 | CDAR2.Act | Base for all types and resources | |
| classCode | 1..1 | code | Required Pattern: ACT | |
| moodCode | 1..1 | code | Required Pattern: EVN | |
| Slices for templateId | 0..* | II | Slice: Unordered, Open by value:root, value:extension | |
| templateId:primary | 1..1 | II | ||
| root | 1..1 | string | Required Pattern: 2.16.840.1.113883.10.20.22.4.131 | |
| extension | 1..1 | string | Required Pattern: 2015-08-01 | |
| id | 1..* | II | ||
| code | 1..1 | CD | Binding: v3 Code System ActCode (extensible) | |
| code | 1..1 | string | Required Pattern: 362956003 | |
| codeSystem | 1..1 | string | Required Pattern: 2.16.840.1.113883.6.96 | |
| statusCode | 1..1 | CS | Binding: ActStatus (required) | |
| code | 1..1 | string | Required Pattern: completed | |
| effectiveTime | 0..1 | IVL_TS | ||
| author | 0..* | AuthorParticipation | Base for all types and resources | |
| Slices for entryRelationship | C | 0..* | Element | Slice: Unordered, Open by profile:observation, profile:substanceAdministration, profile:act, profile:procedure, profile:encounter, profile:supply |
| entryRelationship:All Slices | Content/Rules for all slices | |||
| typeCode | 1..1 | code | ||
| contextConductionInd | 1..1 | boolean | ||
| entryRelationship:advanceDirectiveObservation | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| observation | 1..1 | AdvanceDirectiveObservation | Base for all types and resources | |
| entryRelationship:immunizationActivity | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| substanceAdministration | 1..1 | ImmunizationActivity | Base for all types and resources | |
| entryRelationship:medicationActivity | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| substanceAdministration | C | 1..1 | MedicationActivity | Base for all types and resources |
| entryRelationship:procedureActivityAct | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| act | 1..1 | ProcedureActivityAct | Base for all types and resources | |
| entryRelationship:interventionAct | C | 0..* | Element | The following entryRelationship represents the relationship between two Intervention Acts (Intervention RELATES TO Intervention). |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| act | 1..1 | InterventionAct | Base for all types and resources | |
| entryRelationship:procedureActivityObservation | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| observation | 1..1 | ProcedureActivityObservation | Base for all types and resources | |
| entryRelationship:procedureActivityProcedure | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| procedure | 1..1 | ProcedureActivityProcedure | Base for all types and resources | |
| entryRelationship:encounterActivity | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| encounter | 1..1 | EncounterActivity | Base for all types and resources | |
| entryRelationship:instruction | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| act | 1..1 | Instruction | Base for all types and resources | |
| entryRelationship:nonMedSupply | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| supply | 1..1 | NonMedicinalSupplyActivity | Base for all types and resources | |
| entryRelationship:nutritionRecommendation | C | 0..* | Element | |
| typeCode | 1..1 | code | ||
| contextConductionInd | 1..1 | boolean | ||
| act | 1..1 | NutritionRecommendation | Base for all types and resources | |
| entryRelationship:entryReference | C | 0..* | Element | Where an Intervention needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry. |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| act | 1..1 | EntryReference | Base for all types and resources | |
| entryRelationship:entryReference | C | 0..* | Element | An Intervention Act should reference a Goal Observation. Because the Goal Observation is already described in the CDA document instance's Goals section, rather than repeating the full content of the Goal Observation, the Entry Reference template can be used to reference this entry. The following entryRelationship represents an Entry Reference to Goal Observation. 1198-32459: This entryReference template **SHALL** reference an instance of a Goal Observation template (CONF:1198-32459). |
| typeCode | 1..1 | code | Required Pattern: RSON | |
| contextConductionInd | 1..1 | boolean | ||
| act | 1..1 | EntryReference | Base for all types and resources | |
| entryRelationship:handoffCommunicationParticipants | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| act | 1..1 | HandoffCommunicationParticipants | Base for all types and resources | |
| entryRelationship:plannedInterventionAct | C | 0..* | Element | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| contextConductionInd | 1..1 | boolean | ||
| act | 1..1 | PlannedInterventionAct | Base for all types and resources | |
| reference | 0..* | Element | ||
| typeCode | 1..1 | code | Required Pattern: REFR | |
| externalDocument | 1..1 | ExternalDocumentReference | Base for all types and resources | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| Act.code | extensible | ActCode |
| Act.statusCode | required | ActStatus |
| Id | Grade | Path(s) | Details | Requirements |
| 1098-30800 | warning | Act.entryRelationship:medicationActivity.substanceAdministration | Medication Activity **SHOULD** include doseQuantity **OR** rateQuantity (CONF:1098-30800). : | |
| 1198-32459 | error | Act.entryRelationship:entryReference | This entryReference template **SHALL** reference an instance of a Goal Observation template (CONF:1198-32459). : | |
| act-er-1 | error | Act.entryRelationship, Act.entryRelationship:advanceDirectiveObservation, Act.entryRelationship:immunizationActivity, Act.entryRelationship:medicationActivity, Act.entryRelationship:procedureActivityAct, Act.entryRelationship:interventionAct, Act.entryRelationship:procedureActivityObservation, Act.entryRelationship:procedureActivityProcedure, Act.entryRelationship:encounterActivity, Act.entryRelationship:instruction, Act.entryRelationship:nonMedSupply, Act.entryRelationship:nutritionRecommendation, Act.entryRelationship:entryReference, Act.entryRelationship:entryReference, Act.entryRelationship:handoffCommunicationParticipants, Act.entryRelationship:plannedInterventionAct | Only one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act : (observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1 | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Act | 1..1 | CDAR2.Act | Base for all types and resources | |
| classCode | 1..1 | code | Required Pattern: ACT | |
| moodCode | 1..1 | code | Required Pattern: EVN | |
| realmCode | 0..* | CS | ||
| typeId | 0..1 | II | ||
| Slices for templateId | 0..* | II | Slice: Unordered, Open by value:root, value:extension | |
| templateId:primary | 1..1 | II | ||
| nullFlavor | 0..1 | code | Binding: NullFlavor (required) | |
| assigningAuthorityName | 0..1 | string | ||
| displayable | 0..1 | boolean | ||
| root | 1..1 | string | Required Pattern: 2.16.840.1.113883.10.20.22.4.131 | |
| extension | 1..1 | string | Required Pattern: 2015-08-01 | |
| id | 1..* | II | ||
| code | 1..1 | CD | Binding: v3 Code System ActCode (extensible) | |
| nullFlavor | 0..1 | code | Binding: NullFlavor (required) | |
| code | 1..1 | string | Required Pattern: 362956003 | |
| codeSystem | 1..1 | string | Required Pattern: 2.16.840.1.113883.6.96 | |
| codeSystemName | 0..1 | string | ||
| codeSystemVersion | 0..1 | string | ||
| displayName | 0..1 | string | ||
| sdtcValueSet | 0..1 | string | XML: valueSet (urn:hl7-org:sdtc) | |
| sdtcValueSetVersion | 0..1 | string | XML: valueSetVersion (urn:hl7-org:sdtc) | |
| originalText | 0..1 | ED | ||
| qualifier | 0..* | CR | ||
| translation | 0..* | CD | ||
| negationInd | 0..1 | boolean | ||
| text | 0..1 | ED | ||
| statusCode | 1..1 | CS | Binding: ActStatus (required) | |
| nullFlavor | 0..1 | code | Binding: NullFlavor (required) | |
| code | 1..1 | string | Required Pattern: completed | |
| sdtcValueSet | 0..1 | string | XML: valueSet (urn:hl7-org:sdtc) | |
| sdtcValueSetVersion | 0..1 | string | XML: valueSetVersion (urn:hl7-org:sdtc) | |
| effectiveTime | 0..1 | IVL_TS | ||
| priorityCode | 0..1 | CE | Binding: ActPriority (extensible) | |
| languageCode | 0..1 | CS | Binding: HumanLanguage (required) | |
| subject | 0..1 | Element | ||
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Binding: ParticipationTargetSubject (required) Fixed Value: SBJ | |
| contextControlCode | 1..1 | code | Binding: ContextControl (required) Fixed Value: OP | |
| awarenessCode | 0..1 | CE | Binding: TargetAwareness (extensible) | |
| relatedSubject | 1..1 | RelatedSubject | ||
| specimen | 0..* | Specimen | ||
| performer | 0..* | Performer2 | ||
| author | 0..* | AuthorParticipation | Base for all types and resources | |
| informant | 0..* | Element | ||
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Binding: ParticipationInformationGenerator (required) Fixed Value: INF | |
| contextControlCode | 1..1 | code | Binding: ContextControl (required) Fixed Value: OP | |
| assignedEntity | 0..1 | AssignedEntity | ||
| relatedEntity | 0..1 | RelatedEntity | ||
| participant | 0..* | Participant2 | ||
| Slices for entryRelationship | C | 0..* | Element | Slice: Unordered, Open by profile:observation, profile:substanceAdministration, profile:act, profile:procedure, profile:encounter, profile:supply |
| entryRelationship:All Slices | Content/Rules for all slices | |||
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | ||
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| (Choice of one) | 1..1 | |||
| observation | 0..1 | Observation | ||
| regionOfInterest | 0..1 | RegionOfInterest | ||
| observationMedia | 0..1 | ObservationMedia | ||
| substanceAdministration | 0..1 | SubstanceAdministration | ||
| supply | 0..1 | Supply | ||
| procedure | 0..1 | Procedure | ||
| encounter | 0..1 | Encounter | ||
| organizer | 0..1 | Organizer | ||
| act | 0..1 | Act | ||
| entryRelationship:advanceDirectiveObservation | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| observation | 1..1 | AdvanceDirectiveObservation | Base for all types and resources | |
| entryRelationship:immunizationActivity | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| substanceAdministration | 1..1 | ImmunizationActivity | Base for all types and resources | |
| entryRelationship:medicationActivity | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| substanceAdministration | C | 1..1 | MedicationActivity | Base for all types and resources |
| entryRelationship:procedureActivityAct | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| act | 1..1 | ProcedureActivityAct | Base for all types and resources | |
| entryRelationship:interventionAct | C | 0..* | Element | The following entryRelationship represents the relationship between two Intervention Acts (Intervention RELATES TO Intervention). |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| act | 1..1 | InterventionAct | Base for all types and resources | |
| entryRelationship:procedureActivityObservation | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| observation | 1..1 | ProcedureActivityObservation | Base for all types and resources | |
| entryRelationship:procedureActivityProcedure | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| procedure | 1..1 | ProcedureActivityProcedure | Base for all types and resources | |
| entryRelationship:encounterActivity | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| encounter | 1..1 | EncounterActivity | Base for all types and resources | |
| entryRelationship:instruction | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| act | 1..1 | Instruction | Base for all types and resources | |
| entryRelationship:nonMedSupply | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| supply | 1..1 | NonMedicinalSupplyActivity | Base for all types and resources | |
| entryRelationship:nutritionRecommendation | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | ||
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| act | 1..1 | NutritionRecommendation | Base for all types and resources | |
| entryRelationship:entryReference | C | 0..* | Element | Where an Intervention needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry. |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| act | 1..1 | EntryReference | Base for all types and resources | |
| entryRelationship:entryReference | C | 0..* | Element | An Intervention Act should reference a Goal Observation. Because the Goal Observation is already described in the CDA document instance's Goals section, rather than repeating the full content of the Goal Observation, the Entry Reference template can be used to reference this entry. The following entryRelationship represents an Entry Reference to Goal Observation. 1198-32459: This entryReference template **SHALL** reference an instance of a Goal Observation template (CONF:1198-32459). |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: RSON | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| act | 1..1 | EntryReference | Base for all types and resources | |
| entryRelationship:handoffCommunicationParticipants | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| act | 1..1 | HandoffCommunicationParticipants | Base for all types and resources | |
| entryRelationship:plannedInterventionAct | C | 0..* | Element | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| inversionInd | 0..1 | boolean | ||
| contextConductionInd | 1..1 | boolean | ||
| sequenceNumber | 0..1 | INT | ||
| negationInd | 0..1 | boolean | ||
| seperatableInd | 0..1 | BL | ||
| act | 1..1 | PlannedInterventionAct | Base for all types and resources | |
| reference | 0..* | Element | ||
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| typeCode | 1..1 | code | Required Pattern: REFR | |
| seperatableInd | 0..1 | BL | ||
| externalAct | 0..1 | ExternalAct | ||
| externalObservation | 0..1 | ExternalObservation | ||
| externalProcedure | 0..1 | ExternalProcedure | ||
| externalDocument | 1..1 | ExternalDocumentReference | Base for all types and resources | |
| precondition | 0..* | Precondition | ||
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code |
| Act.templateId:primary.nullFlavor | required | NullFlavor |
| Act.code | extensible | ActCode |
| Act.code.nullFlavor | required | NullFlavor |
| Act.statusCode | required | ActStatus |
| Act.statusCode.nullFlavor | required | NullFlavor |
| Act.priorityCode | extensible | ActPriority |
| Act.languageCode | required | HumanLanguage (a valid code from http://terminology.hl7.org/CodeSystem/ietf3066) |
| Act.subject.typeCode | required | Fixed Value: SBJ |
| Act.subject.contextControlCode | required | Fixed Value: OP |
| Act.subject.awarenessCode | extensible | TargetAwareness |
| Act.informant.typeCode | required | Fixed Value: INF |
| Act.informant.contextControlCode | required | Fixed Value: OP |
| Id | Grade | Path(s) | Details | Requirements |
| 1098-30800 | warning | Act.entryRelationship:medicationActivity.substanceAdministration | Medication Activity **SHOULD** include doseQuantity **OR** rateQuantity (CONF:1098-30800). : | |
| 1198-32459 | error | Act.entryRelationship:entryReference | This entryReference template **SHALL** reference an instance of a Goal Observation template (CONF:1198-32459). : | |
| act-er-1 | error | Act.entryRelationship, Act.entryRelationship:advanceDirectiveObservation, Act.entryRelationship:immunizationActivity, Act.entryRelationship:medicationActivity, Act.entryRelationship:procedureActivityAct, Act.entryRelationship:interventionAct, Act.entryRelationship:procedureActivityObservation, Act.entryRelationship:procedureActivityProcedure, Act.entryRelationship:encounterActivity, Act.entryRelationship:instruction, Act.entryRelationship:nonMedSupply, Act.entryRelationship:nutritionRecommendation, Act.entryRelationship:entryReference, Act.entryRelationship:entryReference, Act.entryRelationship:handoffCommunicationParticipants, Act.entryRelationship:plannedInterventionAct | Only one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act : (observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1 | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from CDAR2.Act
Summary
Mandatory: 11 elements (31 nested mandatory elements)
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Other representations of profile: CSV, Excel, Schematron
IG © 2019+ Health Level Seven. Package hl7.cda.us.ccda#2.1.0-draft1 based on FHIR 5.0.0-snapshot3. Generated 2023-01-16
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