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

Resource Profile: Encounter Activity

Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.49 Version: 2.1.0-draft1
Active as of 2023-01-16 Computable Name: EncounterActivity
Other Identifiers: id: urn:hl7ii:2.16.840.1.113883.10.20.22.4.49:2015-08-01

This clinical statement describes an interaction between a patient and clinician. Interactions may include in-person encounters, telephone conversations, and email exchanges.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from CDAR2.Encounter

NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 1..1CDAR2.EncounterBase for all types and resources
... classCode 1..1codeRequired Pattern: ENC
... moodCode 1..1codeRequired Pattern: EVN
... Slices for templateId 0..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:primary 1..1II
..... root 1..1stringRequired Pattern: 2.16.840.1.113883.10.20.22.4.49
..... extension 1..1stringRequired Pattern: 2015-08-01
... code 1..1CDBinding: EncounterTypeCode (preferred)
.... originalText 0..1ED
..... reference 0..1TEL
...... value C0..1uri1198-15972: This reference/@value **SHALL** begin with a '#' and **SHALL** point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:1198-15972).
.... translation 0..1CDThe translation may exist to map the code of EncounterTypeCode (2.16.840.1.113883.3.88.12.80.32) value set to the code of Encounter Planned (2.16.840.1.113883.11.20.9.52) value set.
... effectiveTime 1..1IVL_TS
... dischargeDispositionCode C0..1CEThe prefix sdtc: SHALL be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the dischargeDispositionCode element
XML Namespace: urn:hl7-org:sdtc
1198-32177: This sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *code*, which **SHOULD** be selected from ValueSet 2.16.840.1.113883.3.88.12.80.33 NUBC UB-04 FL17-Patient Status (code system 2.16.840.1.113883.6.301.5) *DYNAMIC* or, if access to NUBC is unavailable, from CodeSystem 2.16.840.1.113883.12.112 HL7 Discharge Disposition (CONF:1198-32177).
1198-32377: This sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *codeSystem*, which **SHOULD** be either CodeSystem: NUBC 2.16.840.1.113883.6.301.5 *OR* CodeSystem: HL7 Discharge Disposition 2.16.840.1.113883.12.112 (CONF:1198-32377).
... performer 0..*Performer2
.... assignedEntity 1..1AssignedEntity
..... code 0..1CEBinding: Healthcare Provider Taxonomy (preferred)
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:participantRole, value:typeCode
.... participant:location 0..*Participant2
..... typeCode 1..1codeRequired Pattern: LOC
..... participantRole 1..1ServiceDeliveryLocationBase for all types and resources
... Slices for entryRelationship 0..*ElementSlice: Unordered, Open by value:act
.... entryRelationship:indication 0..*Element
..... typeCode 1..1codeRequired Pattern: RSON
..... observation 1..1IndicationBase for all types and resources
.... entryRelationship:diagnosis 0..*Element
..... act 1..1EncounterDiagnosisBase for all types and resources

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Encounter.codepreferredEncounterTypeCode
Encounter.performer.assignedEntity.codepreferredHealthcare Provider Taxonomy (a valid code from http://nucc.org/provider-taxonomy)

Constraints

IdGradePath(s)DetailsRequirements
1198-15972errorEncounter.code.originalText.reference.valueThis reference/@value **SHALL** begin with a '#' and **SHALL** point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:1198-15972).
:
1198-32177warningEncounter.dischargeDispositionCodeThis sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *code*, which **SHOULD** be selected from ValueSet 2.16.840.1.113883.3.88.12.80.33 NUBC UB-04 FL17-Patient Status (code system 2.16.840.1.113883.6.301.5) *DYNAMIC* or, if access to NUBC is unavailable, from CodeSystem 2.16.840.1.113883.12.112 HL7 Discharge Disposition (CONF:1198-32177).
:
1198-32377warningEncounter.dischargeDispositionCodeThis sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *codeSystem*, which **SHOULD** be either CodeSystem: NUBC 2.16.840.1.113883.6.301.5 *OR* CodeSystem: HL7 Discharge Disposition 2.16.840.1.113883.12.112 (CONF:1198-32377).
:
NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 1..1CDAR2.EncounterBase for all types and resources
... classCode 1..1codeBinding: ActClass (required)
Fixed Value: ENC
... moodCode 1..1codeRequired Pattern: EVN
... Slices for templateId 0..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:primary 1..1II
..... root 1..1stringRequired Pattern: 2.16.840.1.113883.10.20.22.4.49
..... extension 1..1stringRequired Pattern: 2015-08-01
... code 1..1CDBinding: EncounterTypeCode (preferred)
.... originalText 0..1ED
..... reference 0..1TEL
...... value C0..1uri1198-15972: This reference/@value **SHALL** begin with a '#' and **SHALL** point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:1198-15972).
.... translation 0..1CDThe translation may exist to map the code of EncounterTypeCode (2.16.840.1.113883.3.88.12.80.32) value set to the code of Encounter Planned (2.16.840.1.113883.11.20.9.52) value set.
... effectiveTime 1..1IVL_TS
... dischargeDispositionCode C0..1CEThe prefix sdtc: SHALL be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the dischargeDispositionCode element
XML Namespace: urn:hl7-org:sdtc
1198-32177: This sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *code*, which **SHOULD** be selected from ValueSet 2.16.840.1.113883.3.88.12.80.33 NUBC UB-04 FL17-Patient Status (code system 2.16.840.1.113883.6.301.5) *DYNAMIC* or, if access to NUBC is unavailable, from CodeSystem 2.16.840.1.113883.12.112 HL7 Discharge Disposition (CONF:1198-32177).
1198-32377: This sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *codeSystem*, which **SHOULD** be either CodeSystem: NUBC 2.16.840.1.113883.6.301.5 *OR* CodeSystem: HL7 Discharge Disposition 2.16.840.1.113883.12.112 (CONF:1198-32377).
... performer 0..*Performer2
.... assignedEntity 1..1AssignedEntity
..... classCode 1..1codeBinding: RoleClassAssignedEntity (required)
Fixed Value: ASSIGNED
..... id 1..*II
..... code 0..1CEBinding: Healthcare Provider Taxonomy (preferred)
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:participantRole, value:typeCode
.... participant:location 0..*Participant2
..... typeCode 1..1codeBinding: ParticipationType (required)
Required Pattern: LOC
..... participantRole 1..1ServiceDeliveryLocationBase for all types and resources
... Slices for entryRelationship C0..*ElementSlice: Unordered, Open by value:act
.... entryRelationship:All Slices Content/Rules for all slices
..... typeCode 1..1code
..... contextConductionInd 1..1boolean
.... entryRelationship:indication C0..*Element
..... typeCode 1..1codeRequired Pattern: RSON
..... contextConductionInd 1..1boolean
..... observation 1..1IndicationBase for all types and resources
.... entryRelationship:diagnosis C0..*Element
..... typeCode 1..1code
..... contextConductionInd 1..1boolean
..... act 1..1EncounterDiagnosisBase for all types and resources

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Encounter.classCoderequiredFixed Value: ENC
Encounter.codepreferredEncounterTypeCode
Encounter.performer.assignedEntity.classCoderequiredFixed Value: ASSIGNED
Encounter.performer.assignedEntity.codepreferredHealthcare Provider Taxonomy (a valid code from http://nucc.org/provider-taxonomy)
Encounter.participant:location.typeCoderequiredPattern: LOC

Constraints

IdGradePath(s)DetailsRequirements
1198-15972errorEncounter.code.originalText.reference.valueThis reference/@value **SHALL** begin with a '#' and **SHALL** point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:1198-15972).
:
1198-32177warningEncounter.dischargeDispositionCodeThis sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *code*, which **SHOULD** be selected from ValueSet 2.16.840.1.113883.3.88.12.80.33 NUBC UB-04 FL17-Patient Status (code system 2.16.840.1.113883.6.301.5) *DYNAMIC* or, if access to NUBC is unavailable, from CodeSystem 2.16.840.1.113883.12.112 HL7 Discharge Disposition (CONF:1198-32177).
:
1198-32377warningEncounter.dischargeDispositionCodeThis sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *codeSystem*, which **SHOULD** be either CodeSystem: NUBC 2.16.840.1.113883.6.301.5 *OR* CodeSystem: HL7 Discharge Disposition 2.16.840.1.113883.12.112 (CONF:1198-32377).
:
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
enc-er-1errorEncounter.entryRelationship, Encounter.entryRelationship:indication, Encounter.entryRelationship:diagnosisOnly one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act
: (observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1
NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 1..1CDAR2.EncounterBase for all types and resources
... classCode 1..1codeBinding: ActClass (required)
Fixed Value: ENC
... moodCode 1..1codeRequired Pattern: EVN
... realmCode 0..*CS
... Slices for templateId 0..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:primary 1..1II
..... nullFlavor 0..1codeBinding: NullFlavor (required)
..... assigningAuthorityName 0..1string
..... displayable 0..1boolean
..... root 1..1stringRequired Pattern: 2.16.840.1.113883.10.20.22.4.49
..... extension 1..1stringRequired Pattern: 2015-08-01
... id 1..*II
... code 1..1CDBinding: EncounterTypeCode (preferred)
.... nullFlavor 0..1codeBinding: NullFlavor (required)
.... code 0..1string
.... codeSystem 0..1string
.... codeSystemName 0..1string
.... codeSystemVersion 0..1string
.... displayName 0..1string
.... sdtcValueSet 0..1stringXML: valueSet (urn:hl7-org:sdtc)
.... sdtcValueSetVersion 0..1stringXML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1ED
..... nullFlavor 0..1codeBinding: NullFlavor (required)
..... charset 0..1code
..... compression 0..1codeBinding: CompressionAlgorithm (required)
..... integrityCheck 0..1base64Binary
..... integrityCheckAlgorithm 0..1codeBinding: IntegrityCheckAlgorithm (required)
..... language 0..1code
..... mediaType 0..1code
..... representation 0..1code
..... data[x] 0..1
...... dataStringstring
...... dataBase64Binarybase64Binary
..... reference 0..1TEL
...... nullFlavor 0..1codeBinding: NullFlavor (required)
...... value C0..1uri1198-15972: This reference/@value **SHALL** begin with a '#' and **SHALL** point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:1198-15972).
...... useablePeriod 0..*
....... useablePeriodIVL_TS
....... useablePeriodEIVL_TS
....... useablePeriodPIVL_TS
....... useablePeriodSXPR_TS
...... use 0..*codeBinding: AddressUse (required)
..... thumbnail 0..1ED
.... qualifier 0..*CR
.... translation 0..1CDThe translation may exist to map the code of EncounterTypeCode (2.16.840.1.113883.3.88.12.80.32) value set to the code of Encounter Planned (2.16.840.1.113883.11.20.9.52) value set.
... text 0..1ED
... statusCode 0..1CSBinding: ActStatus (required)
... effectiveTime 1..1IVL_TS
... dischargeDispositionCode C0..1CEThe prefix sdtc: SHALL be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the dischargeDispositionCode element
XML Namespace: urn:hl7-org:sdtc
1198-32177: This sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *code*, which **SHOULD** be selected from ValueSet 2.16.840.1.113883.3.88.12.80.33 NUBC UB-04 FL17-Patient Status (code system 2.16.840.1.113883.6.301.5) *DYNAMIC* or, if access to NUBC is unavailable, from CodeSystem 2.16.840.1.113883.12.112 HL7 Discharge Disposition (CONF:1198-32177).
1198-32377: This sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *codeSystem*, which **SHOULD** be either CodeSystem: NUBC 2.16.840.1.113883.6.301.5 *OR* CodeSystem: HL7 Discharge Disposition 2.16.840.1.113883.12.112 (CONF:1198-32377).
... priorityCode 0..1CEBinding: ActPriority (extensible)
... subject 0..1Element
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... typeCode 1..1codeBinding: ParticipationTargetSubject (required)
Fixed Value: SBJ
.... contextControlCode 1..1codeBinding: ContextControl (required)
Fixed Value: OP
.... awarenessCode 0..1CEBinding: TargetAwareness (extensible)
.... relatedSubject 1..1RelatedSubject
... specimen 0..*Specimen
... performer 0..*Performer2
.... nullFlavor 0..1codeBinding: NullFlavor (required)
.... typeCode 0..1csBinding: ParticipationPhysicalPerformer (required)
Fixed Value: PRF
.... realmCode 0..*CS
.... typeId 0..1II
.... templateId 0..*II
.... functionCode 0..1CEXML Namespace: urn:hl7-org:sdtc
.... time 0..1IVL_TS
.... modeCode 0..1CE
.... assignedEntity 1..1AssignedEntity
..... classCode 1..1codeBinding: RoleClassAssignedEntity (required)
Fixed Value: ASSIGNED
..... templateId 0..*II
..... id 1..*II
..... sdtcIdentifiedBy 0..*IdentifiedByXML: identifiedBy (urn:hl7-org:sdtc)
..... code 0..1CEBinding: Healthcare Provider Taxonomy (preferred)
..... addr 0..*AD
..... telecom 0..*TEL
..... assignedPerson 0..1Person
..... representedOrganization 0..1Organization
... author 0..*Author
... informant 0..*Element
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... typeCode 1..1codeBinding: ParticipationInformationGenerator (required)
Fixed Value: INF
.... contextControlCode 1..1codeBinding: ContextControl (required)
Fixed Value: OP
.... assignedEntity 0..1AssignedEntity
.... relatedEntity 0..1RelatedEntity
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:participantRole, value:typeCode
.... participant:location 0..*Participant2
..... nullFlavor 0..1codeBinding: NullFlavor (required)
..... typeCode 1..1codeBinding: ParticipationType (required)
Required Pattern: LOC
..... contextControlCode 0..1codeBinding: ContextControl (required)
Fixed Value: OP
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 0..*II
..... sdtcFunctionCode 0..1CEXML: functionCode (urn:hl7-org:sdtc)
..... time 0..1IVL_TS
..... awarenessCode 0..1CE
..... participantRole 1..1ServiceDeliveryLocationBase for all types and resources
... Slices for entryRelationship C0..*ElementSlice: Unordered, Open by value:act
.... entryRelationship:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... typeCode 1..1code
..... inversionInd 0..1boolean
..... contextConductionInd 1..1boolean
..... sequenceNumber 0..1INT
..... negationInd 0..1boolean
..... seperatableInd 0..1BL
..... (Choice of one) 1..1
...... observation 0..1Observation
...... regionOfInterest 0..1RegionOfInterest
...... observationMedia 0..1ObservationMedia
...... substanceAdministration 0..1SubstanceAdministration
...... supply 0..1Supply
...... procedure 0..1Procedure
...... encounter 0..1Encounter
...... organizer 0..1Organizer
...... act 0..1Act
.... entryRelationship:indication C0..*Element
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... typeCode 1..1codeRequired Pattern: RSON
..... inversionInd 0..1boolean
..... contextConductionInd 1..1boolean
..... sequenceNumber 0..1INT
..... negationInd 0..1boolean
..... seperatableInd 0..1BL
..... observation 1..1IndicationBase for all types and resources
.... entryRelationship:diagnosis C0..*Element
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... typeCode 1..1code
..... inversionInd 0..1boolean
..... contextConductionInd 1..1boolean
..... sequenceNumber 0..1INT
..... negationInd 0..1boolean
..... seperatableInd 0..1BL
..... act 1..1EncounterDiagnosisBase for all types and resources
... reference 0..*Element
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... typeCode 1..1code
.... seperatableInd 0..1BL
.... externalAct 0..1ExternalAct
.... externalObservation 0..1ExternalObservation
.... externalProcedure 0..1ExternalProcedure
.... externalDocument 0..1ExternalDocument
... precondition 0..*Precondition

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Encounter.classCoderequiredFixed Value: ENC
Encounter.templateId:primary.nullFlavorrequiredNullFlavor
Encounter.codepreferredEncounterTypeCode
Encounter.code.nullFlavorrequiredNullFlavor
Encounter.code.originalText.nullFlavorrequiredNullFlavor
Encounter.code.originalText.compressionrequiredCompressionAlgorithm
Encounter.code.originalText.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
Encounter.code.originalText.reference.nullFlavorrequiredNullFlavor
Encounter.code.originalText.reference.userequiredAddressUse
Encounter.statusCoderequiredActStatus
Encounter.priorityCodeextensibleActPriority
Encounter.subject.typeCoderequiredFixed Value: SBJ
Encounter.subject.contextControlCoderequiredFixed Value: OP
Encounter.subject.awarenessCodeextensibleTargetAwareness
Encounter.performer.nullFlavorrequiredNullFlavor
Encounter.performer.typeCoderequiredFixed Value: PRF
Encounter.performer.assignedEntity.classCoderequiredFixed Value: ASSIGNED
Encounter.performer.assignedEntity.codepreferredHealthcare Provider Taxonomy (a valid code from http://nucc.org/provider-taxonomy)
Encounter.informant.typeCoderequiredFixed Value: INF
Encounter.informant.contextControlCoderequiredFixed Value: OP
Encounter.participant:location.nullFlavorrequiredNullFlavor
Encounter.participant:location.typeCoderequiredPattern: LOC
Encounter.participant:location.contextControlCoderequiredFixed Value: OP

Constraints

IdGradePath(s)DetailsRequirements
1198-15972errorEncounter.code.originalText.reference.valueThis reference/@value **SHALL** begin with a '#' and **SHALL** point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:1198-15972).
:
1198-32177warningEncounter.dischargeDispositionCodeThis sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *code*, which **SHOULD** be selected from ValueSet 2.16.840.1.113883.3.88.12.80.33 NUBC UB-04 FL17-Patient Status (code system 2.16.840.1.113883.6.301.5) *DYNAMIC* or, if access to NUBC is unavailable, from CodeSystem 2.16.840.1.113883.12.112 HL7 Discharge Disposition (CONF:1198-32177).
:
1198-32377warningEncounter.dischargeDispositionCodeThis sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *codeSystem*, which **SHOULD** be either CodeSystem: NUBC 2.16.840.1.113883.6.301.5 *OR* CodeSystem: HL7 Discharge Disposition 2.16.840.1.113883.12.112 (CONF:1198-32377).
:
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
enc-er-1errorEncounter.entryRelationship, Encounter.entryRelationship:indication, Encounter.entryRelationship:diagnosisOnly one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act
: (observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from CDAR2.Encounter

Summary

Mandatory: 8 elements (6 nested mandatory elements)

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element Encounter.templateId is sliced based on the values of value:root, value:extension
  • The element Encounter.participant is sliced based on the values of value:participantRole, value:typeCode
  • The element Encounter.entryRelationship is sliced based on the value of value:act

Differential View

This structure is derived from CDAR2.Encounter

NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 1..1CDAR2.EncounterBase for all types and resources
... classCode 1..1codeRequired Pattern: ENC
... moodCode 1..1codeRequired Pattern: EVN
... Slices for templateId 0..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:primary 1..1II
..... root 1..1stringRequired Pattern: 2.16.840.1.113883.10.20.22.4.49
..... extension 1..1stringRequired Pattern: 2015-08-01
... code 1..1CDBinding: EncounterTypeCode (preferred)
.... originalText 0..1ED
..... reference 0..1TEL
...... value C0..1uri1198-15972: This reference/@value **SHALL** begin with a '#' and **SHALL** point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:1198-15972).
.... translation 0..1CDThe translation may exist to map the code of EncounterTypeCode (2.16.840.1.113883.3.88.12.80.32) value set to the code of Encounter Planned (2.16.840.1.113883.11.20.9.52) value set.
... effectiveTime 1..1IVL_TS
... dischargeDispositionCode C0..1CEThe prefix sdtc: SHALL be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the dischargeDispositionCode element
XML Namespace: urn:hl7-org:sdtc
1198-32177: This sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *code*, which **SHOULD** be selected from ValueSet 2.16.840.1.113883.3.88.12.80.33 NUBC UB-04 FL17-Patient Status (code system 2.16.840.1.113883.6.301.5) *DYNAMIC* or, if access to NUBC is unavailable, from CodeSystem 2.16.840.1.113883.12.112 HL7 Discharge Disposition (CONF:1198-32177).
1198-32377: This sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *codeSystem*, which **SHOULD** be either CodeSystem: NUBC 2.16.840.1.113883.6.301.5 *OR* CodeSystem: HL7 Discharge Disposition 2.16.840.1.113883.12.112 (CONF:1198-32377).
... performer 0..*Performer2
.... assignedEntity 1..1AssignedEntity
..... code 0..1CEBinding: Healthcare Provider Taxonomy (preferred)
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:participantRole, value:typeCode
.... participant:location 0..*Participant2
..... typeCode 1..1codeRequired Pattern: LOC
..... participantRole 1..1ServiceDeliveryLocationBase for all types and resources
... Slices for entryRelationship 0..*ElementSlice: Unordered, Open by value:act
.... entryRelationship:indication 0..*Element
..... typeCode 1..1codeRequired Pattern: RSON
..... observation 1..1IndicationBase for all types and resources
.... entryRelationship:diagnosis 0..*Element
..... act 1..1EncounterDiagnosisBase for all types and resources

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Encounter.codepreferredEncounterTypeCode
Encounter.performer.assignedEntity.codepreferredHealthcare Provider Taxonomy (a valid code from http://nucc.org/provider-taxonomy)

Constraints

IdGradePath(s)DetailsRequirements
1198-15972errorEncounter.code.originalText.reference.valueThis reference/@value **SHALL** begin with a '#' and **SHALL** point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:1198-15972).
:
1198-32177warningEncounter.dischargeDispositionCodeThis sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *code*, which **SHOULD** be selected from ValueSet 2.16.840.1.113883.3.88.12.80.33 NUBC UB-04 FL17-Patient Status (code system 2.16.840.1.113883.6.301.5) *DYNAMIC* or, if access to NUBC is unavailable, from CodeSystem 2.16.840.1.113883.12.112 HL7 Discharge Disposition (CONF:1198-32177).
:
1198-32377warningEncounter.dischargeDispositionCodeThis sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *codeSystem*, which **SHOULD** be either CodeSystem: NUBC 2.16.840.1.113883.6.301.5 *OR* CodeSystem: HL7 Discharge Disposition 2.16.840.1.113883.12.112 (CONF:1198-32377).
:

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 1..1CDAR2.EncounterBase for all types and resources
... classCode 1..1codeBinding: ActClass (required)
Fixed Value: ENC
... moodCode 1..1codeRequired Pattern: EVN
... Slices for templateId 0..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:primary 1..1II
..... root 1..1stringRequired Pattern: 2.16.840.1.113883.10.20.22.4.49
..... extension 1..1stringRequired Pattern: 2015-08-01
... code 1..1CDBinding: EncounterTypeCode (preferred)
.... originalText 0..1ED
..... reference 0..1TEL
...... value C0..1uri1198-15972: This reference/@value **SHALL** begin with a '#' and **SHALL** point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:1198-15972).
.... translation 0..1CDThe translation may exist to map the code of EncounterTypeCode (2.16.840.1.113883.3.88.12.80.32) value set to the code of Encounter Planned (2.16.840.1.113883.11.20.9.52) value set.
... effectiveTime 1..1IVL_TS
... dischargeDispositionCode C0..1CEThe prefix sdtc: SHALL be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the dischargeDispositionCode element
XML Namespace: urn:hl7-org:sdtc
1198-32177: This sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *code*, which **SHOULD** be selected from ValueSet 2.16.840.1.113883.3.88.12.80.33 NUBC UB-04 FL17-Patient Status (code system 2.16.840.1.113883.6.301.5) *DYNAMIC* or, if access to NUBC is unavailable, from CodeSystem 2.16.840.1.113883.12.112 HL7 Discharge Disposition (CONF:1198-32177).
1198-32377: This sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *codeSystem*, which **SHOULD** be either CodeSystem: NUBC 2.16.840.1.113883.6.301.5 *OR* CodeSystem: HL7 Discharge Disposition 2.16.840.1.113883.12.112 (CONF:1198-32377).
... performer 0..*Performer2
.... assignedEntity 1..1AssignedEntity
..... classCode 1..1codeBinding: RoleClassAssignedEntity (required)
Fixed Value: ASSIGNED
..... id 1..*II
..... code 0..1CEBinding: Healthcare Provider Taxonomy (preferred)
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:participantRole, value:typeCode
.... participant:location 0..*Participant2
..... typeCode 1..1codeBinding: ParticipationType (required)
Required Pattern: LOC
..... participantRole 1..1ServiceDeliveryLocationBase for all types and resources
... Slices for entryRelationship C0..*ElementSlice: Unordered, Open by value:act
.... entryRelationship:All Slices Content/Rules for all slices
..... typeCode 1..1code
..... contextConductionInd 1..1boolean
.... entryRelationship:indication C0..*Element
..... typeCode 1..1codeRequired Pattern: RSON
..... contextConductionInd 1..1boolean
..... observation 1..1IndicationBase for all types and resources
.... entryRelationship:diagnosis C0..*Element
..... typeCode 1..1code
..... contextConductionInd 1..1boolean
..... act 1..1EncounterDiagnosisBase for all types and resources

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Encounter.classCoderequiredFixed Value: ENC
Encounter.codepreferredEncounterTypeCode
Encounter.performer.assignedEntity.classCoderequiredFixed Value: ASSIGNED
Encounter.performer.assignedEntity.codepreferredHealthcare Provider Taxonomy (a valid code from http://nucc.org/provider-taxonomy)
Encounter.participant:location.typeCoderequiredPattern: LOC

Constraints

IdGradePath(s)DetailsRequirements
1198-15972errorEncounter.code.originalText.reference.valueThis reference/@value **SHALL** begin with a '#' and **SHALL** point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:1198-15972).
:
1198-32177warningEncounter.dischargeDispositionCodeThis sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *code*, which **SHOULD** be selected from ValueSet 2.16.840.1.113883.3.88.12.80.33 NUBC UB-04 FL17-Patient Status (code system 2.16.840.1.113883.6.301.5) *DYNAMIC* or, if access to NUBC is unavailable, from CodeSystem 2.16.840.1.113883.12.112 HL7 Discharge Disposition (CONF:1198-32177).
:
1198-32377warningEncounter.dischargeDispositionCodeThis sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *codeSystem*, which **SHOULD** be either CodeSystem: NUBC 2.16.840.1.113883.6.301.5 *OR* CodeSystem: HL7 Discharge Disposition 2.16.840.1.113883.12.112 (CONF:1198-32377).
:
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
enc-er-1errorEncounter.entryRelationship, Encounter.entryRelationship:indication, Encounter.entryRelationship:diagnosisOnly one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act
: (observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 1..1CDAR2.EncounterBase for all types and resources
... classCode 1..1codeBinding: ActClass (required)
Fixed Value: ENC
... moodCode 1..1codeRequired Pattern: EVN
... realmCode 0..*CS
... Slices for templateId 0..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:primary 1..1II
..... nullFlavor 0..1codeBinding: NullFlavor (required)
..... assigningAuthorityName 0..1string
..... displayable 0..1boolean
..... root 1..1stringRequired Pattern: 2.16.840.1.113883.10.20.22.4.49
..... extension 1..1stringRequired Pattern: 2015-08-01
... id 1..*II
... code 1..1CDBinding: EncounterTypeCode (preferred)
.... nullFlavor 0..1codeBinding: NullFlavor (required)
.... code 0..1string
.... codeSystem 0..1string
.... codeSystemName 0..1string
.... codeSystemVersion 0..1string
.... displayName 0..1string
.... sdtcValueSet 0..1stringXML: valueSet (urn:hl7-org:sdtc)
.... sdtcValueSetVersion 0..1stringXML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1ED
..... nullFlavor 0..1codeBinding: NullFlavor (required)
..... charset 0..1code
..... compression 0..1codeBinding: CompressionAlgorithm (required)
..... integrityCheck 0..1base64Binary
..... integrityCheckAlgorithm 0..1codeBinding: IntegrityCheckAlgorithm (required)
..... language 0..1code
..... mediaType 0..1code
..... representation 0..1code
..... data[x] 0..1
...... dataStringstring
...... dataBase64Binarybase64Binary
..... reference 0..1TEL
...... nullFlavor 0..1codeBinding: NullFlavor (required)
...... value C0..1uri1198-15972: This reference/@value **SHALL** begin with a '#' and **SHALL** point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:1198-15972).
...... useablePeriod 0..*
....... useablePeriodIVL_TS
....... useablePeriodEIVL_TS
....... useablePeriodPIVL_TS
....... useablePeriodSXPR_TS
...... use 0..*codeBinding: AddressUse (required)
..... thumbnail 0..1ED
.... qualifier 0..*CR
.... translation 0..1CDThe translation may exist to map the code of EncounterTypeCode (2.16.840.1.113883.3.88.12.80.32) value set to the code of Encounter Planned (2.16.840.1.113883.11.20.9.52) value set.
... text 0..1ED
... statusCode 0..1CSBinding: ActStatus (required)
... effectiveTime 1..1IVL_TS
... dischargeDispositionCode C0..1CEThe prefix sdtc: SHALL be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the dischargeDispositionCode element
XML Namespace: urn:hl7-org:sdtc
1198-32177: This sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *code*, which **SHOULD** be selected from ValueSet 2.16.840.1.113883.3.88.12.80.33 NUBC UB-04 FL17-Patient Status (code system 2.16.840.1.113883.6.301.5) *DYNAMIC* or, if access to NUBC is unavailable, from CodeSystem 2.16.840.1.113883.12.112 HL7 Discharge Disposition (CONF:1198-32177).
1198-32377: This sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *codeSystem*, which **SHOULD** be either CodeSystem: NUBC 2.16.840.1.113883.6.301.5 *OR* CodeSystem: HL7 Discharge Disposition 2.16.840.1.113883.12.112 (CONF:1198-32377).
... priorityCode 0..1CEBinding: ActPriority (extensible)
... subject 0..1Element
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... typeCode 1..1codeBinding: ParticipationTargetSubject (required)
Fixed Value: SBJ
.... contextControlCode 1..1codeBinding: ContextControl (required)
Fixed Value: OP
.... awarenessCode 0..1CEBinding: TargetAwareness (extensible)
.... relatedSubject 1..1RelatedSubject
... specimen 0..*Specimen
... performer 0..*Performer2
.... nullFlavor 0..1codeBinding: NullFlavor (required)
.... typeCode 0..1csBinding: ParticipationPhysicalPerformer (required)
Fixed Value: PRF
.... realmCode 0..*CS
.... typeId 0..1II
.... templateId 0..*II
.... functionCode 0..1CEXML Namespace: urn:hl7-org:sdtc
.... time 0..1IVL_TS
.... modeCode 0..1CE
.... assignedEntity 1..1AssignedEntity
..... classCode 1..1codeBinding: RoleClassAssignedEntity (required)
Fixed Value: ASSIGNED
..... templateId 0..*II
..... id 1..*II
..... sdtcIdentifiedBy 0..*IdentifiedByXML: identifiedBy (urn:hl7-org:sdtc)
..... code 0..1CEBinding: Healthcare Provider Taxonomy (preferred)
..... addr 0..*AD
..... telecom 0..*TEL
..... assignedPerson 0..1Person
..... representedOrganization 0..1Organization
... author 0..*Author
... informant 0..*Element
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... typeCode 1..1codeBinding: ParticipationInformationGenerator (required)
Fixed Value: INF
.... contextControlCode 1..1codeBinding: ContextControl (required)
Fixed Value: OP
.... assignedEntity 0..1AssignedEntity
.... relatedEntity 0..1RelatedEntity
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:participantRole, value:typeCode
.... participant:location 0..*Participant2
..... nullFlavor 0..1codeBinding: NullFlavor (required)
..... typeCode 1..1codeBinding: ParticipationType (required)
Required Pattern: LOC
..... contextControlCode 0..1codeBinding: ContextControl (required)
Fixed Value: OP
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 0..*II
..... sdtcFunctionCode 0..1CEXML: functionCode (urn:hl7-org:sdtc)
..... time 0..1IVL_TS
..... awarenessCode 0..1CE
..... participantRole 1..1ServiceDeliveryLocationBase for all types and resources
... Slices for entryRelationship C0..*ElementSlice: Unordered, Open by value:act
.... entryRelationship:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... typeCode 1..1code
..... inversionInd 0..1boolean
..... contextConductionInd 1..1boolean
..... sequenceNumber 0..1INT
..... negationInd 0..1boolean
..... seperatableInd 0..1BL
..... (Choice of one) 1..1
...... observation 0..1Observation
...... regionOfInterest 0..1RegionOfInterest
...... observationMedia 0..1ObservationMedia
...... substanceAdministration 0..1SubstanceAdministration
...... supply 0..1Supply
...... procedure 0..1Procedure
...... encounter 0..1Encounter
...... organizer 0..1Organizer
...... act 0..1Act
.... entryRelationship:indication C0..*Element
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... typeCode 1..1codeRequired Pattern: RSON
..... inversionInd 0..1boolean
..... contextConductionInd 1..1boolean
..... sequenceNumber 0..1INT
..... negationInd 0..1boolean
..... seperatableInd 0..1BL
..... observation 1..1IndicationBase for all types and resources
.... entryRelationship:diagnosis C0..*Element
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... typeCode 1..1code
..... inversionInd 0..1boolean
..... contextConductionInd 1..1boolean
..... sequenceNumber 0..1INT
..... negationInd 0..1boolean
..... seperatableInd 0..1BL
..... act 1..1EncounterDiagnosisBase for all types and resources
... reference 0..*Element
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... typeCode 1..1code
.... seperatableInd 0..1BL
.... externalAct 0..1ExternalAct
.... externalObservation 0..1ExternalObservation
.... externalProcedure 0..1ExternalProcedure
.... externalDocument 0..1ExternalDocument
... precondition 0..*Precondition

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Encounter.classCoderequiredFixed Value: ENC
Encounter.templateId:primary.nullFlavorrequiredNullFlavor
Encounter.codepreferredEncounterTypeCode
Encounter.code.nullFlavorrequiredNullFlavor
Encounter.code.originalText.nullFlavorrequiredNullFlavor
Encounter.code.originalText.compressionrequiredCompressionAlgorithm
Encounter.code.originalText.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
Encounter.code.originalText.reference.nullFlavorrequiredNullFlavor
Encounter.code.originalText.reference.userequiredAddressUse
Encounter.statusCoderequiredActStatus
Encounter.priorityCodeextensibleActPriority
Encounter.subject.typeCoderequiredFixed Value: SBJ
Encounter.subject.contextControlCoderequiredFixed Value: OP
Encounter.subject.awarenessCodeextensibleTargetAwareness
Encounter.performer.nullFlavorrequiredNullFlavor
Encounter.performer.typeCoderequiredFixed Value: PRF
Encounter.performer.assignedEntity.classCoderequiredFixed Value: ASSIGNED
Encounter.performer.assignedEntity.codepreferredHealthcare Provider Taxonomy (a valid code from http://nucc.org/provider-taxonomy)
Encounter.informant.typeCoderequiredFixed Value: INF
Encounter.informant.contextControlCoderequiredFixed Value: OP
Encounter.participant:location.nullFlavorrequiredNullFlavor
Encounter.participant:location.typeCoderequiredPattern: LOC
Encounter.participant:location.contextControlCoderequiredFixed Value: OP

Constraints

IdGradePath(s)DetailsRequirements
1198-15972errorEncounter.code.originalText.reference.valueThis reference/@value **SHALL** begin with a '#' and **SHALL** point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:1198-15972).
:
1198-32177warningEncounter.dischargeDispositionCodeThis sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *code*, which **SHOULD** be selected from ValueSet 2.16.840.1.113883.3.88.12.80.33 NUBC UB-04 FL17-Patient Status (code system 2.16.840.1.113883.6.301.5) *DYNAMIC* or, if access to NUBC is unavailable, from CodeSystem 2.16.840.1.113883.12.112 HL7 Discharge Disposition (CONF:1198-32177).
:
1198-32377warningEncounter.dischargeDispositionCodeThis sdtc:dischargeDispositionCode **SHOULD** contain exactly [0..1] *codeSystem*, which **SHOULD** be either CodeSystem: NUBC 2.16.840.1.113883.6.301.5 *OR* CodeSystem: HL7 Discharge Disposition 2.16.840.1.113883.12.112 (CONF:1198-32377).
:
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
enc-er-1errorEncounter.entryRelationship, Encounter.entryRelationship:indication, Encounter.entryRelationship:diagnosisOnly one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act
: (observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from CDAR2.Encounter

Summary

Mandatory: 8 elements (6 nested mandatory elements)

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element Encounter.templateId is sliced based on the values of value:root, value:extension
  • The element Encounter.participant is sliced based on the values of value:participantRole, value:typeCode
  • The element Encounter.entryRelationship is sliced based on the value of value:act

 

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