This page is part of the CCDA: Consolidated CDA Release (v3.0.0-ballot: CCDA 3.0 Ballot 1) based on FHIR (HL7® FHIR® Standard) 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/AdvanceDirectiveObservation | Version: 3.0.0-ballot | |||
Draft as of 2023-12-21 | Computable Name: AdvanceDirectiveObservation | |||
Other Identifiers: id: urn:hl7ii:2.16.840.1.113883.10.20.22.4.48:2022-02-14 |
An Advance Directive Observation template is used to record information about a document authored by the person and containing goals, preferences, and priorities for care. The observation records that the document was available and may have been reviewed (verified). It records the kind (category) of advance directive document, where the document can be accessed, who verified it, and the type of content that was determined to be present. When a person has more than one advance directive document, each document is recorded using an Advance Directive Observation template. A set of Advance Directive Observations are grouped together using an Advance Directive Organizer.
An Advance Directive Observation template is not used to record information about portable medical orders, such as Medical Orders for Life Sustaining Treatments (MOLST), Physician Orders for Life Sustaining Treatments (POLST), or out-of-hospital Do Not Resuscitate (DNR) Orders. Portable medical order documents are authored by physicians, not patients. They document medical treatment intervention decisions that have been made rather than goals, preferences and priorities that a patient intends to be used as guidance when making care decisions.
The Advance Directive Observation template differs from the Advance Care Planning Intervention template. The Advance Directive Observation template is used to record that a person’s advance directive document has been accessed and reviewed. The Advance Care Planning Intervention template is used to document interactions, such as discussions or education, with the patient about advance care planning and personal advance care plans.
The categories of advance directives source documents could include, but are not limited to, the following:
Note: Under common law, a “power of attorney” was automatically revoked by the incompetency or incapacity of the principal, so the common law power of attorney was not useful as a planning for incapacity. Accordingly, states adopted “durable” power of attorney statutes allowing an agent to continue to act as empowered by a power of attorney even after the principal became disabled, incompetent or incapacitated.
The types of content in an advance directive could include, but are not limited to:
Examples: A person may have a durable healthcare power of attorney that appoints a Healthcare Power of Attorney. It may indicate that the person’s spouse has been established as the primary healthcare agent, and the person’s daughter as the first alternative healthcare agent. If the spouse was deceased, or was unavailable at the time, or unwilling to act as healthcare agent during the encounter being documented, then the person’s daughter would be identified as the acting healthcare agent at that time. In this example, “personal advance care plan” is the category of advance directive and “Healthcare Agent” is the type of advance directive content that is present. In this example, “durable healthcare power of attorney” is the category of advance directive and “Healthcare agent” is the type of advance directive content that is present.
A personal advance care plan may contain information about a person’s treatment preferences regarding resuscitation. In this example, “personal advance care plan” is the category of advance directive and “Resuscitation” is the type of advance directive content that is present.
The author of the Advance Directive Observation is the person documenting that the directives were reviewed and verified. The verifier is the person who read the document and verified the advance directive information. The role of verifier and the role of author need not be fulfilled by the same person, so each role is documented separately. However, the author and the verifier often will be the same person. This template supports Context Conduction. The author of the organizer can be assumed to be the author of the Advance Directive Observations within the organizer unless explicitly overridden an observation. When author identity confidence is high, implementers should explicitly assert conformance to the Provenance Author Participation template.
When an Advance Directive Observation template indicates that the advance directives include healthcare agent appointment information, each healthcare agent can be included in a participation with @typeCode=”CST”. If the participation context (e.g. provenance) for an Advance Directive Observation is not established for the observation, then the participations for the encompassing Advance Directive Organizer apply to the observation.
Advance directives are effective over a range of time. The effectiveTime/low tells when they went into effect (or will go into effect) and the high tells when they ceased or will cease to be in effect. If the starting effective time is not known, effectiveTime/low is UNK, but this would still be considered “Active”. If effectiveTime/high contains a value of “NA” or it is not valued, the advance directive remains active until some action is taken to make it inactive. (Explicit use of nullFlavor=”NA” is the preferred approach for indicating an Advance Directive that is not time bounded.) That action may update the existing information with an effectiveTime/high or it may replace the open-ended entry with a new entry that includes the effectiveTime/high information. An advance directive is active so long as the effectiveTime/high has not been passed.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from Observation
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Observation | C | 1..1 | Observation | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author should-informant: SHOULD contain informant |
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root, value:extension | |
templateId:advance-directive-obs | 1..1 | II | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.48 | |
@extension | 1..1 | st | Required Pattern: 2022-02-14 | |
@classCode | 1..1 | cs | Fixed Value: OBS | |
@moodCode | 1..1 | cs | Fixed Value: EVN | |
id | 1..* | II | ||
code | 1..1 | CD | Binding: Advance Directives Categories (preferred) | |
Slices for translation | 1..* | CD | Slice: Unordered, Open by value:code, value:codeSystem | |
translation:advanceDirective | 1..1 | CD | Advance directive | |
@code | 1..1 | cs | Required Pattern: 75320-2 | |
@codeSystem | 1..1 | oid, uuid, ruid | LOINC Required Pattern: 2.16.840.1.113883.6.1 | |
text | 1..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
statusCode | 1..1 | CS | ||
@code | 1..1 | cs | Fixed Value: completed | |
effectiveTime | 1..1 | IVL_TS | ||
low | 1..1 | IVXB_TS | ||
high | C | 1..1 | IVXB_TS | 1198-32449: If the Advance Directive does not have a specified ending time, the <high> element **SHALL** have the nullFlavor attribute set to *NA* (CONF:1198-32449). |
value | 1..1 | CD | ||
@code | 0..1 | cs | Binding: Advance Directive Content Type SCT (required) | |
@codeSystem | 0..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.96 | |
author | 0..* | AuthorParticipation | Base for all types and resources | |
informant | 0..* | Informant | SHOULD contain informant | |
Slices for participant | 0..* | Participant2 | Slice: Unordered, Open by value:participantRole, value:typeCode | |
participant:participant1 | C | 0..* | Participant2 | The participant "VRF" represents the clinician(s) who verified the patient advance directive. should-time: SHOULD contain time |
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root | |
templateId:primary | 1..1 | II | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.1.58 | |
@extension | 0..0 | |||
@typeCode | 1..1 | cs | Fixed Value: VRF | |
time | C | 0..1 | IVL_TS | value-only: Interval fields SHALL not be present |
@value | 0..1 | ts | value should be used instead of low/high | |
participantRole | C | 1..1 | ParticipantRole | should-code: SHOULD contain code |
code | 0..1 | CE | Binding: Healthcare Provider Taxonomy (preferred) | |
addr | 0..* | USRealmAddress | Base for all types and resources | |
playingEntity | 1..1 | PlayingEntity | ||
name | 1..1 | USRealmPersonNamePNUSFIELDED | Base for all types and resources | |
participant:participant2 | 0..* | Participant2 | This custodian (CST) participant identifies a legal representative for healthcare decision-making. Examples of such individuals are called health care agents, substitute decision makers and/or health care proxies. Only record a healthcare agent who is acting in that capacitiy and participating in carae decision-making during the documented care encounter. | |
@typeCode | 1..1 | cs | Fixed Value: CST | |
participantRole | C | 1..1 | ParticipantRole | should-code: SHOULD contain code should-addr: SHOULD contain addr should-telecom: SHOULD contain telecom |
@classCode | 1..1 | cs | Fixed Value: AGNT | |
code | 0..1 | CE | Binding: Healthcare Agent or Proxy Choices (preferred) | |
addr | 0..1 | USRealmAddress | Base for all types and resources | |
telecom | 0..* | TEL | ||
playingEntity | C | 1..1 | PlayingEntity | should-code: SHOULD contain code |
code | 0..1 | CE | Binding: Healthcare Agent Qualifier (preferred) | |
name | 1..1 | PN | The name of the healthcare agent. | |
Slices for reference | 1..* | Reference | Slice: Unordered, Open by value:externalDocument, value:typeCode | |
reference:reference1 | 1..* | Reference | ||
@typeCode | 1..1 | cs | Fixed Value: REFR | |
externalDocument | 1..1 | ExternalDocument | ||
id | 1..* | II | ||
text | 0..1 | ED | ||
reference | C | 0..1 | TEL | The URL of a referenced advance directive document **MAY** be present, and **SHALL** be represented in Observation/reference/ExternalDocument/text/reference (CONF:1198-8698). 1198-8699: If a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699). |
Documentation for this format |
Path | Conformance | ValueSet |
Observation.code | preferred | AdvanceDirectivesCategories |
Observation.value.code | required | AdvanceDirectiveContentTypeSCT |
Observation.participant:participant1.participantRole.code | preferred | HealthcareProviderTaxonomy (a valid code from http://nucc.org/provider-taxonomy ) |
Observation.participant:participant2.participantRole.code | preferred | HealthcareAgentOrProxyChoices |
Observation.participant:participant2.participantRole.playingEntity.code | preferred | HealthcareAgentQualifier |
Id | Grade | Path(s) | Details | Requirements |
1198-8699 | warning | Observation.reference:reference1.externalDocument.text.reference | If a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699). : | |
1198-32449 | error | Observation.effectiveTime.high | If the Advance Directive does not have a specified ending time, the <high> element **SHALL** have the nullFlavor attribute set to *NA* (CONF:1198-32449). : value.exists() or nullFlavor = 'NA' | |
should-addr | warning | Observation.participant:participant2.participantRole | SHOULD contain addr : addr.exists() | |
should-author | warning | Observation | SHOULD contain author : author.exists() | |
should-code | warning | Observation.participant:participant1.participantRole, Observation.participant:participant2.participantRole, Observation.participant:participant2.participantRole.playingEntity | SHOULD contain code : code.exists() | |
should-informant | warning | Observation | SHOULD contain informant : informant.exists() | |
should-telecom | warning | Observation.participant:participant2.participantRole | SHOULD contain telecom : telecom.exists() | |
should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value : text.reference.value.exists() | |
should-time | warning | Observation.participant:participant1 | SHOULD contain time : time.exists() | |
value-only | error | Observation.participant:participant1.time | Interval fields SHALL not be present : (low | high | width | center).empty() | |
value-starts-octothorpe | error | Observation.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Observation | C | 1..1 | Observation | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author should-informant: SHOULD contain informant |
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root, value:extension | |
templateId:advance-directive-obs | 1..1 | II | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.48 | |
@extension | 1..1 | st | Required Pattern: 2022-02-14 | |
@classCode | 1..1 | cs | Binding: ActClassObservation (2.0.0) (required) Fixed Value: OBS | |
@moodCode | 1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN | |
id | 1..* | II | ||
code | 1..1 | CD | Binding: Advance Directives Categories (preferred) | |
Slices for translation | 1..* | CD | Slice: Unordered, Open by value:code, value:codeSystem | |
translation:advanceDirective | 1..1 | CD | Advance directive | |
@code | 1..1 | cs | Required Pattern: 75320-2 | |
@codeSystem | 1..1 | oid, uuid, ruid | LOINC Required Pattern: 2.16.840.1.113883.6.1 | |
text | 1..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
statusCode | 1..1 | CS | Binding: ActStatus (required) | |
@code | 1..1 | cs | Fixed Value: completed | |
effectiveTime | 1..1 | IVL_TS | ||
low | 1..1 | IVXB_TS | ||
high | C | 1..1 | IVXB_TS | 1198-32449: If the Advance Directive does not have a specified ending time, the <high> element **SHALL** have the nullFlavor attribute set to *NA* (CONF:1198-32449). |
value | 1..1 | CD | ||
@code | 0..1 | cs | Binding: Advance Directive Content Type SCT (required) | |
@codeSystem | 0..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.96 | |
author | 0..* | AuthorParticipation | Base for all types and resources | |
informant | 0..* | Informant | SHOULD contain informant | |
Slices for participant | 0..* | Participant2 | Slice: Unordered, Open by value:participantRole, value:typeCode | |
participant:participant1 | C | 0..* | Participant2 | The participant "VRF" represents the clinician(s) who verified the patient advance directive. should-time: SHOULD contain time |
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root | |
templateId:primary | 1..1 | II | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.1.58 | |
@typeCode | 1..1 | cs | Binding: ParticipationType (required) Fixed Value: VRF | |
time | C | 0..1 | IVL_TS | value-only: Interval fields SHALL not be present |
@value | 0..1 | ts | value should be used instead of low/high Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz] | |
participantRole | C | 1..1 | ParticipantRole | should-code: SHOULD contain code |
@classCode | 1..1 | cs | Binding: RoleClassRoot (required) | |
code | 0..1 | CE | Binding: Healthcare Provider Taxonomy (preferred) | |
addr | C | 0..* | USRealmAddress | Base for all types and resources |
playingEntity | 1..1 | PlayingEntity | ||
@classCode | 1..1 | cs | Binding: EntityClassRoot (required) | |
name | C | 1..1 | USRealmPersonNamePNUSFIELDED | Base for all types and resources |
participant:participant2 | 0..* | Participant2 | This custodian (CST) participant identifies a legal representative for healthcare decision-making. Examples of such individuals are called health care agents, substitute decision makers and/or health care proxies. Only record a healthcare agent who is acting in that capacitiy and participating in carae decision-making during the documented care encounter. | |
@typeCode | 1..1 | cs | Binding: ParticipationType (required) Fixed Value: CST | |
participantRole | C | 1..1 | ParticipantRole | should-code: SHOULD contain code should-addr: SHOULD contain addr should-telecom: SHOULD contain telecom |
@classCode | 1..1 | cs | Binding: RoleClassRoot (required) Fixed Value: AGNT | |
code | 0..1 | CE | Binding: Healthcare Agent or Proxy Choices (preferred) | |
addr | C | 0..1 | USRealmAddress | Base for all types and resources |
telecom | 0..* | TEL | ||
playingEntity | C | 1..1 | PlayingEntity | should-code: SHOULD contain code |
@classCode | 1..1 | cs | Binding: EntityClassRoot (required) | |
code | 0..1 | CE | Binding: Healthcare Agent Qualifier (preferred) | |
name | 1..1 | PN | The name of the healthcare agent. | |
Slices for reference | 1..* | Reference | Slice: Unordered, Open by value:externalDocument, value:typeCode | |
reference:reference1 | 1..* | Reference | ||
@typeCode | 1..1 | cs | Binding: x_ActRelationshipExternalReference (required) Fixed Value: REFR | |
externalDocument | 1..1 | ExternalDocument | ||
id | 1..* | II | ||
text | 0..1 | ED | ||
reference | C | 0..1 | TEL | The URL of a referenced advance directive document **MAY** be present, and **SHALL** be represented in Observation/reference/ExternalDocument/text/reference (CONF:1198-8698). 1198-8699: If a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699). |
Documentation for this format |
Path | Conformance | ValueSet / Code |
Observation.classCode | required | Fixed Value: OBS |
Observation.moodCode | required | Fixed Value: EVN |
Observation.code | preferred | AdvanceDirectivesCategories |
Observation.statusCode | required | ActStatus |
Observation.value.code | required | AdvanceDirectiveContentTypeSCT |
Observation.participant:participant1.typeCode | required | Fixed Value: VRF |
Observation.participant:participant1.participantRole.classCode | required | RoleClassRoot |
Observation.participant:participant1.participantRole.code | preferred | HealthcareProviderTaxonomy (a valid code from http://nucc.org/provider-taxonomy ) |
Observation.participant:participant1.participantRole.playingEntity.classCode | required | EntityClassRoot |
Observation.participant:participant2.typeCode | required | Fixed Value: CST |
Observation.participant:participant2.participantRole.classCode | required | Fixed Value: AGNT |
Observation.participant:participant2.participantRole.code | preferred | HealthcareAgentOrProxyChoices |
Observation.participant:participant2.participantRole.playingEntity.classCode | required | EntityClassRoot |
Observation.participant:participant2.participantRole.playingEntity.code | preferred | HealthcareAgentQualifier |
Observation.reference:reference1.typeCode | required | Fixed Value: REFR |
Id | Grade | Path(s) | Details | Requirements |
1198-8699 | warning | Observation.reference:reference1.externalDocument.text.reference | If a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699). : | |
1198-32449 | error | Observation.effectiveTime.high | If the Advance Directive does not have a specified ending time, the <high> element **SHALL** have the nullFlavor attribute set to *NA* (CONF:1198-32449). : value.exists() or nullFlavor = 'NA' | |
81-7296 | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | **SHALL NOT** have mixed content except for white space (CONF:81-7296) : item.xmlText.empty() | |
81-9371 | error | Observation.participant:participant1.participantRole.playingEntity.name | The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). : conformsTo('http://hl7.org/cda/us/ccda/StructureDefinition/USRealmPatientNamePTNUSFIELDED') or item.xmlText.exists() | |
81-9372 | error | Observation.participant:participant1.participantRole.playingEntity.name | The string **SHALL NOT** contain name parts (CONF:81-9372). : item.xmlText.exists() implies (item.delimiter | item.family | item.given | item.prefix | item.suffix).empty() | |
81-10024 | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). : nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.state.exists(nullFlavor.exists() or xmlText.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state')) | |
81-10025 | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). : nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.postalCode.exists(nullFlavor.exists() or xmlText.matches('[0-9]{5}(-[0-9]{4})?')) | |
pn-no-ls | error | Observation.participant:participant1.participantRole.playingEntity.name | No PN name part may have a qualifier of LS. : (item.delimiter | item.family | item.given | item.prefix | item.suffix).where(qualifier.where($this = 'LS').exists()).empty() | |
shall-city | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHALL contain exactly one [1..1] city (CONF:81-7292). : nullFlavor.exists() or item.city.count() = 1 | |
shall-max-ad-parts | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHALL have at most one of each: state, city, postalCode, and country : (item.state.empty() or item.state.count() = 1) and (item.city.empty() or item.city.count() = 1) and (item.postalCode.empty() or item.postalCode.count() = 1) and (item.country.empty() or item.country.count() = 1) | |
shall-streetAddressLine | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). : nullFlavor.exists() or (item.streetAddressLine.count() >= 1 and item.streetAddressLine.count() <= 4) | |
should-addr | warning | Observation.participant:participant2.participantRole | SHOULD contain addr : addr.exists() | |
should-author | warning | Observation | SHOULD contain author : author.exists() | |
should-code | warning | Observation.participant:participant1.participantRole, Observation.participant:participant2.participantRole, Observation.participant:participant2.participantRole.playingEntity | SHOULD contain code : code.exists() | |
should-country | warning | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHOULD contain country : nullFlavor.exists() or item.country.exists() | |
should-informant | warning | Observation | SHOULD contain informant : informant.exists() | |
should-telecom | warning | Observation.participant:participant2.participantRole | SHOULD contain telecom : telecom.exists() | |
should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value : text.reference.value.exists() | |
should-time | warning | Observation.participant:participant1 | SHOULD contain time : time.exists() | |
should-use | warning | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHOULD contain @use : nullFlavor.exists() or use.exists() | |
value-only | error | Observation.participant:participant1.time | Interval fields SHALL not be present : (low | high | width | center).empty() | |
value-starts-octothorpe | error | Observation.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Observation | C | 1..1 | Observation | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author should-informant: SHOULD contain informant |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root, value:extension | |
templateId:advance-directive-obs | 1..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.48 | |
@extension | 1..1 | st | Required Pattern: 2022-02-14 | |
@classCode | 1..1 | cs | Binding: ActClassObservation (2.0.0) (required) Fixed Value: OBS | |
@moodCode | 1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN | |
@negationInd | 0..1 | bl | ||
id | 1..* | II | ||
code | 1..1 | CD | Binding: Advance Directives Categories (preferred) | |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@code | 0..1 | cs | ||
@codeSystem | 0..1 | oid, uuid, ruid | ||
@codeSystemName | 0..1 | st | ||
@codeSystemVersion | 0..1 | st | ||
@displayName | 0..1 | st | ||
@sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
@sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
originalText | 0..1 | ED | ||
qualifier | 0..* | CR | ||
Slices for translation | 1..* | CD | Slice: Unordered, Open by value:code, value:codeSystem | |
translation:advanceDirective | 1..1 | CD | Advance directive | |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@code | 1..1 | cs | Required Pattern: 75320-2 | |
@codeSystem | 1..1 | oid, uuid, ruid | LOINC Required Pattern: 2.16.840.1.113883.6.1 | |
@codeSystemName | 0..1 | st | ||
@codeSystemVersion | 0..1 | st | ||
@displayName | 0..1 | st | ||
@sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
@sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
originalText | 0..1 | ED | ||
qualifier | 0..* | CR | ||
translation | 0..* | CD | ||
derivationExpr | 0..1 | ST | ||
text | 1..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@compression | 0..1 | cs | Binding: CompressionAlgorithm (required) | |
@integrityCheck | 0..1 | bin | ||
@integrityCheckAlgorithm | 0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required) | |
@language | 0..1 | cs | ||
@mediaType | 0..1 | cs | Binding: MediaType (example) | |
@representation | 0..1 | cs | Binding: Binary Data Encoding Value Set (required) | |
xmlText | 0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string. | |
reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
thumbnail | 0..1 | ED | ||
statusCode | 1..1 | CS | Binding: ActStatus (required) | |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@code | 1..1 | cs | Fixed Value: completed | |
@sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
@sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
effectiveTime | 1..1 | IVL_TS | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@value | 0..1 | ts | Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz] | |
@operator | 0..1 | cs | Binding: SetOperator (required) | |
low | 1..1 | IVXB_TS | ||
center | 0..1 | TS | ||
width | 0..1 | PQ | ||
high | C | 1..1 | IVXB_TS | 1198-32449: If the Advance Directive does not have a specified ending time, the <high> element **SHALL** have the nullFlavor attribute set to *NA* (CONF:1198-32449). |
priorityCode | 0..1 | CE | Binding: ActPriority (example) | |
repeatNumber | 0..1 | IVL_INT | ||
languageCode | 0..1 | CS | Binding: AllLanguages (required) | |
value | 1..1 | CD | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@code | 0..1 | cs | Binding: Advance Directive Content Type SCT (required) | |
@codeSystem | 0..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.96 | |
@codeSystemName | 0..1 | st | ||
@codeSystemVersion | 0..1 | st | ||
@displayName | 0..1 | st | ||
@sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
@sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
originalText | 0..1 | ED | ||
qualifier | 0..* | CR | ||
translation | 0..* | CD | ||
interpretationCode | 0..* | CE | Binding: ObservationInterpretation (required) | |
methodCode | 0..* | CE | Binding: ObservationMethod (example) | |
targetSiteCode | 0..* | CD | ||
subject | 0..1 | Subject | ||
specimen | 0..* | Specimen | ||
performer | 0..* | Performer2 | ||
author | 0..* | AuthorParticipation | Base for all types and resources | |
informant | 0..* | Informant | SHOULD contain informant | |
Slices for participant | 0..* | Participant2 | Slice: Unordered, Open by value:participantRole, value:typeCode | |
participant:participant1 | C | 0..* | Participant2 | The participant "VRF" represents the clinician(s) who verified the patient advance directive. should-time: SHOULD contain time |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root | |
templateId:primary | 1..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.1.58 | |
@typeCode | 1..1 | cs | Binding: ParticipationType (required) Fixed Value: VRF | |
@contextControlCode | 0..1 | cs | Binding: ContextControl (required) Fixed Value: OP | |
sdtcFunctionCode | 0..1 | CE | XML Namespace: urn:hl7-org:sdtc XML: functionCode (urn:hl7-org:sdtc) | |
time | C | 0..1 | IVL_TS | value-only: Interval fields SHALL not be present |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@value | 0..1 | ts | value should be used instead of low/high Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz] | |
@operator | 0..1 | cs | Binding: SetOperator (required) | |
low | 0..1 | IVXB_TS | ||
center | 0..1 | TS | ||
width | 0..1 | PQ | ||
high | 0..1 | IVXB_TS | ||
awarenessCode | 0..1 | CE | ||
participantRole | C | 1..1 | ParticipantRole | should-code: SHOULD contain code |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
templateId | 0..* | II | ||
@classCode | 1..1 | cs | Binding: RoleClassRoot (required) | |
id | 0..* | II | ||
sdtcIdentifiedBy | 0..* | IdentifiedBy | XML Namespace: urn:hl7-org:sdtc XML: identifiedBy (urn:hl7-org:sdtc) | |
code | 0..1 | CE | Binding: Healthcare Provider Taxonomy (preferred) | |
addr | C | 0..* | USRealmAddress | Base for all types and resources |
telecom | 0..* | TEL | ||
playingDevice | 0..1 | Device | ||
playingEntity | 1..1 | PlayingEntity | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
templateId | 0..* | II | ||
@classCode | 1..1 | cs | Binding: EntityClassRoot (required) | |
@determinerCode | 0..1 | cs | Binding: EntityDeterminer (required) Fixed Value: INSTANCE | |
code | 0..1 | CE | Binding: EntityCode (example) | |
quantity | 0..* | PQ | ||
name | C | 1..1 | USRealmPersonNamePNUSFIELDED | Base for all types and resources |
sdtcBirthTime | 0..1 | TS | XML Namespace: urn:hl7-org:sdtc XML: birthTime (urn:hl7-org:sdtc) | |
desc | 0..1 | ED | ||
scopingEntity | 0..1 | Entity | ||
participant:participant2 | 0..* | Participant2 | This custodian (CST) participant identifies a legal representative for healthcare decision-making. Examples of such individuals are called health care agents, substitute decision makers and/or health care proxies. Only record a healthcare agent who is acting in that capacitiy and participating in carae decision-making during the documented care encounter. | |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
templateId | 0..* | II | ||
@typeCode | 1..1 | cs | Binding: ParticipationType (required) Fixed Value: CST | |
@contextControlCode | 0..1 | cs | Binding: ContextControl (required) Fixed Value: OP | |
sdtcFunctionCode | 0..1 | CE | XML Namespace: urn:hl7-org:sdtc XML: functionCode (urn:hl7-org:sdtc) | |
time | 0..1 | IVL_TS | ||
awarenessCode | 0..1 | CE | ||
participantRole | C | 1..1 | ParticipantRole | should-code: SHOULD contain code should-addr: SHOULD contain addr should-telecom: SHOULD contain telecom |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
templateId | 0..* | II | ||
@classCode | 1..1 | cs | Binding: RoleClassRoot (required) Fixed Value: AGNT | |
id | 0..* | II | ||
sdtcIdentifiedBy | 0..* | IdentifiedBy | XML Namespace: urn:hl7-org:sdtc XML: identifiedBy (urn:hl7-org:sdtc) | |
code | 0..1 | CE | Binding: Healthcare Agent or Proxy Choices (preferred) | |
addr | C | 0..1 | USRealmAddress | Base for all types and resources |
telecom | 0..* | TEL | ||
playingDevice | 0..1 | Device | ||
playingEntity | C | 1..1 | PlayingEntity | should-code: SHOULD contain code |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
templateId | 0..* | II | ||
@classCode | 1..1 | cs | Binding: EntityClassRoot (required) | |
@determinerCode | 0..1 | cs | Binding: EntityDeterminer (required) Fixed Value: INSTANCE | |
code | 0..1 | CE | Binding: Healthcare Agent Qualifier (preferred) | |
quantity | 0..* | PQ | ||
name | 1..1 | PN | The name of the healthcare agent. | |
sdtcBirthTime | 0..1 | TS | XML Namespace: urn:hl7-org:sdtc XML: birthTime (urn:hl7-org:sdtc) | |
desc | 0..1 | ED | ||
scopingEntity | 0..1 | Entity | ||
entryRelationship | 0..* | EntryRelationship | ||
Slices for reference | 1..* | Reference | Slice: Unordered, Open by value:externalDocument, value:typeCode | |
reference:reference1 | 1..* | Reference | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
templateId | 0..* | II | ||
@typeCode | 1..1 | cs | Binding: x_ActRelationshipExternalReference (required) Fixed Value: REFR | |
seperatableInd | 0..1 | BL | ||
externalAct | 0..1 | ExternalAct | ||
externalObservation | 0..1 | ExternalObservation | ||
externalProcedure | 0..1 | ExternalProcedure | ||
externalDocument | 1..1 | ExternalDocument | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
templateId | 0..* | II | ||
@classCode | 0..1 | cs | Binding: ActClassDocument (required) | |
@moodCode | 0..1 | cs | Binding: ActMood (required) Fixed Value: EVN | |
id | 1..* | II | ||
code | 0..1 | CD | Binding: FHIRDocumentTypeCodes (example) | |
text | 0..1 | ED | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@compression | 0..1 | cs | Binding: CompressionAlgorithm (required) | |
@integrityCheck | 0..1 | bin | ||
@integrityCheckAlgorithm | 0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required) | |
@language | 0..1 | cs | ||
@mediaType | 0..1 | cs | Binding: MediaType (example) | |
@representation | 0..1 | cs | Binding: Binary Data Encoding Value Set (required) | |
xmlText | 0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string. | |
reference | C | 0..1 | TEL | The URL of a referenced advance directive document **MAY** be present, and **SHALL** be represented in Observation/reference/ExternalDocument/text/reference (CONF:1198-8698). 1198-8699: If a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699). |
thumbnail | 0..1 | ED | ||
setId | 0..1 | II | ||
versionNumber | 0..1 | INT | ||
precondition | 0..* | Precondition | ||
sdtcPrecondition2 | 0..* | Precondition2 | XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc) | |
referenceRange | 0..* | InfrastructureRoot | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
templateId | 0..* | II | ||
@typeCode | 0..1 | cs | Binding: ActRelationshipType (2.0.0) (required) Fixed Value: REFV | |
observationRange | 1..1 | ObservationRange | ||
sdtcInFulfillmentOf1 | 0..* | InFulfillmentOf1 | XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc) | |
Documentation for this format |
Path | Conformance | ValueSet / Code |
Observation.nullFlavor | required | CDANullFlavor |
Observation.typeId.nullFlavor | required | CDANullFlavor |
Observation.templateId:advance-directive-obs.nullFlavor | required | CDANullFlavor |
Observation.classCode | required | Fixed Value: OBS |
Observation.moodCode | required | Fixed Value: EVN |
Observation.code | preferred | AdvanceDirectivesCategories |
Observation.code.nullFlavor | required | CDANullFlavor |
Observation.code.translation:advanceDirective.nullFlavor | required | CDANullFlavor |
Observation.text.nullFlavor | required | CDANullFlavor |
Observation.text.compression | required | CDACompressionAlgorithm |
Observation.text.integrityCheckAlgorithm | required | IntegrityCheckAlgorithm |
Observation.text.mediaType | example | MediaType |
Observation.text.representation | required | BinaryDataEncoding |
Observation.statusCode | required | ActStatus |
Observation.statusCode.nullFlavor | required | CDANullFlavor |
Observation.effectiveTime.nullFlavor | required | CDANullFlavor |
Observation.effectiveTime.operator | required | SetOperator |
Observation.priorityCode | example | ActPriority |
Observation.languageCode | required | AllLanguages |
Observation.value.nullFlavor | required | CDANullFlavor |
Observation.value.code | required | AdvanceDirectiveContentTypeSCT |
Observation.interpretationCode | required | ObservationInterpretation |
Observation.methodCode | example | ObservationMethod |
Observation.participant:participant1.nullFlavor | required | CDANullFlavor |
Observation.participant:participant1.typeId.nullFlavor | required | CDANullFlavor |
Observation.participant:participant1.templateId:primary.nullFlavor | required | CDANullFlavor |
Observation.participant:participant1.typeCode | required | Fixed Value: VRF |
Observation.participant:participant1.contextControlCode | required | Fixed Value: OP |
Observation.participant:participant1.time.nullFlavor | required | CDANullFlavor |
Observation.participant:participant1.time.operator | required | SetOperator |
Observation.participant:participant1.participantRole.nullFlavor | required | CDANullFlavor |
Observation.participant:participant1.participantRole.typeId.nullFlavor | required | CDANullFlavor |
Observation.participant:participant1.participantRole.classCode | required | RoleClassRoot |
Observation.participant:participant1.participantRole.code | preferred | HealthcareProviderTaxonomy (a valid code from http://nucc.org/provider-taxonomy ) |
Observation.participant:participant1.participantRole.playingEntity.nullFlavor | required | CDANullFlavor |
Observation.participant:participant1.participantRole.playingEntity.typeId.nullFlavor | required | CDANullFlavor |
Observation.participant:participant1.participantRole.playingEntity.classCode | required | EntityClassRoot |
Observation.participant:participant1.participantRole.playingEntity.determinerCode | required | Fixed Value: INSTANCE |
Observation.participant:participant1.participantRole.playingEntity.code | example | EntityCode |
Observation.participant:participant2.nullFlavor | required | CDANullFlavor |
Observation.participant:participant2.typeId.nullFlavor | required | CDANullFlavor |
Observation.participant:participant2.typeCode | required | Fixed Value: CST |
Observation.participant:participant2.contextControlCode | required | Fixed Value: OP |
Observation.participant:participant2.participantRole.nullFlavor | required | CDANullFlavor |
Observation.participant:participant2.participantRole.typeId.nullFlavor | required | CDANullFlavor |
Observation.participant:participant2.participantRole.classCode | required | Fixed Value: AGNT |
Observation.participant:participant2.participantRole.code | preferred | HealthcareAgentOrProxyChoices |
Observation.participant:participant2.participantRole.playingEntity.nullFlavor | required | CDANullFlavor |
Observation.participant:participant2.participantRole.playingEntity.typeId.nullFlavor | required | CDANullFlavor |
Observation.participant:participant2.participantRole.playingEntity.classCode | required | EntityClassRoot |
Observation.participant:participant2.participantRole.playingEntity.determinerCode | required | Fixed Value: INSTANCE |
Observation.participant:participant2.participantRole.playingEntity.code | preferred | HealthcareAgentQualifier |
Observation.reference:reference1.nullFlavor | required | CDANullFlavor |
Observation.reference:reference1.typeId.nullFlavor | required | CDANullFlavor |
Observation.reference:reference1.typeCode | required | Fixed Value: REFR |
Observation.reference:reference1.externalDocument.nullFlavor | required | CDANullFlavor |
Observation.reference:reference1.externalDocument.typeId.nullFlavor | required | CDANullFlavor |
Observation.reference:reference1.externalDocument.classCode | required | ActClassDocument |
Observation.reference:reference1.externalDocument.moodCode | required | Fixed Value: EVN |
Observation.reference:reference1.externalDocument.code | example | FHIRDocumentTypeCodes |
Observation.reference:reference1.externalDocument.text.nullFlavor | required | CDANullFlavor |
Observation.reference:reference1.externalDocument.text.compression | required | CDACompressionAlgorithm |
Observation.reference:reference1.externalDocument.text.integrityCheckAlgorithm | required | IntegrityCheckAlgorithm |
Observation.reference:reference1.externalDocument.text.mediaType | example | MediaType |
Observation.reference:reference1.externalDocument.text.representation | required | BinaryDataEncoding |
Observation.referenceRange.nullFlavor | required | CDANullFlavor |
Observation.referenceRange.typeId.nullFlavor | required | CDANullFlavor |
Observation.referenceRange.typeCode | required | Fixed Value: REFV |
Id | Grade | Path(s) | Details | Requirements |
1198-8699 | warning | Observation.reference:reference1.externalDocument.text.reference | If a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699). : | |
1198-32449 | error | Observation.effectiveTime.high | If the Advance Directive does not have a specified ending time, the <high> element **SHALL** have the nullFlavor attribute set to *NA* (CONF:1198-32449). : value.exists() or nullFlavor = 'NA' | |
81-7296 | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | **SHALL NOT** have mixed content except for white space (CONF:81-7296) : item.xmlText.empty() | |
81-9371 | error | Observation.participant:participant1.participantRole.playingEntity.name | The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). : conformsTo('http://hl7.org/cda/us/ccda/StructureDefinition/USRealmPatientNamePTNUSFIELDED') or item.xmlText.exists() | |
81-9372 | error | Observation.participant:participant1.participantRole.playingEntity.name | The string **SHALL NOT** contain name parts (CONF:81-9372). : item.xmlText.exists() implies (item.delimiter | item.family | item.given | item.prefix | item.suffix).empty() | |
81-10024 | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). : nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.state.exists(nullFlavor.exists() or xmlText.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state')) | |
81-10025 | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). : nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.postalCode.exists(nullFlavor.exists() or xmlText.matches('[0-9]{5}(-[0-9]{4})?')) | |
pn-no-ls | error | Observation.participant:participant1.participantRole.playingEntity.name | No PN name part may have a qualifier of LS. : (item.delimiter | item.family | item.given | item.prefix | item.suffix).where(qualifier.where($this = 'LS').exists()).empty() | |
shall-city | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHALL contain exactly one [1..1] city (CONF:81-7292). : nullFlavor.exists() or item.city.count() = 1 | |
shall-max-ad-parts | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHALL have at most one of each: state, city, postalCode, and country : (item.state.empty() or item.state.count() = 1) and (item.city.empty() or item.city.count() = 1) and (item.postalCode.empty() or item.postalCode.count() = 1) and (item.country.empty() or item.country.count() = 1) | |
shall-streetAddressLine | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). : nullFlavor.exists() or (item.streetAddressLine.count() >= 1 and item.streetAddressLine.count() <= 4) | |
should-addr | warning | Observation.participant:participant2.participantRole | SHOULD contain addr : addr.exists() | |
should-author | warning | Observation | SHOULD contain author : author.exists() | |
should-code | warning | Observation.participant:participant1.participantRole, Observation.participant:participant2.participantRole, Observation.participant:participant2.participantRole.playingEntity | SHOULD contain code : code.exists() | |
should-country | warning | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHOULD contain country : nullFlavor.exists() or item.country.exists() | |
should-informant | warning | Observation | SHOULD contain informant : informant.exists() | |
should-telecom | warning | Observation.participant:participant2.participantRole | SHOULD contain telecom : telecom.exists() | |
should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value : text.reference.value.exists() | |
should-time | warning | Observation.participant:participant1 | SHOULD contain time : time.exists() | |
should-use | warning | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHOULD contain @use : nullFlavor.exists() or use.exists() | |
value-only | error | Observation.participant:participant1.time | Interval fields SHALL not be present : (low | high | width | center).empty() | |
value-starts-octothorpe | error | Observation.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') |
This structure is derived from Observation
Summary
Mandatory: 20 elements (7 nested mandatory elements)
Fixed Value: 7 elements
Prohibited: 1 element
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Differential View
This structure is derived from Observation
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Observation | C | 1..1 | Observation | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author should-informant: SHOULD contain informant |
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root, value:extension | |
templateId:advance-directive-obs | 1..1 | II | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.48 | |
@extension | 1..1 | st | Required Pattern: 2022-02-14 | |
@classCode | 1..1 | cs | Fixed Value: OBS | |
@moodCode | 1..1 | cs | Fixed Value: EVN | |
id | 1..* | II | ||
code | 1..1 | CD | Binding: Advance Directives Categories (preferred) | |
Slices for translation | 1..* | CD | Slice: Unordered, Open by value:code, value:codeSystem | |
translation:advanceDirective | 1..1 | CD | Advance directive | |
@code | 1..1 | cs | Required Pattern: 75320-2 | |
@codeSystem | 1..1 | oid, uuid, ruid | LOINC Required Pattern: 2.16.840.1.113883.6.1 | |
text | 1..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
statusCode | 1..1 | CS | ||
@code | 1..1 | cs | Fixed Value: completed | |
effectiveTime | 1..1 | IVL_TS | ||
low | 1..1 | IVXB_TS | ||
high | C | 1..1 | IVXB_TS | 1198-32449: If the Advance Directive does not have a specified ending time, the <high> element **SHALL** have the nullFlavor attribute set to *NA* (CONF:1198-32449). |
value | 1..1 | CD | ||
@code | 0..1 | cs | Binding: Advance Directive Content Type SCT (required) | |
@codeSystem | 0..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.96 | |
author | 0..* | AuthorParticipation | Base for all types and resources | |
informant | 0..* | Informant | SHOULD contain informant | |
Slices for participant | 0..* | Participant2 | Slice: Unordered, Open by value:participantRole, value:typeCode | |
participant:participant1 | C | 0..* | Participant2 | The participant "VRF" represents the clinician(s) who verified the patient advance directive. should-time: SHOULD contain time |
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root | |
templateId:primary | 1..1 | II | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.1.58 | |
@extension | 0..0 | |||
@typeCode | 1..1 | cs | Fixed Value: VRF | |
time | C | 0..1 | IVL_TS | value-only: Interval fields SHALL not be present |
@value | 0..1 | ts | value should be used instead of low/high | |
participantRole | C | 1..1 | ParticipantRole | should-code: SHOULD contain code |
code | 0..1 | CE | Binding: Healthcare Provider Taxonomy (preferred) | |
addr | 0..* | USRealmAddress | Base for all types and resources | |
playingEntity | 1..1 | PlayingEntity | ||
name | 1..1 | USRealmPersonNamePNUSFIELDED | Base for all types and resources | |
participant:participant2 | 0..* | Participant2 | This custodian (CST) participant identifies a legal representative for healthcare decision-making. Examples of such individuals are called health care agents, substitute decision makers and/or health care proxies. Only record a healthcare agent who is acting in that capacitiy and participating in carae decision-making during the documented care encounter. | |
@typeCode | 1..1 | cs | Fixed Value: CST | |
participantRole | C | 1..1 | ParticipantRole | should-code: SHOULD contain code should-addr: SHOULD contain addr should-telecom: SHOULD contain telecom |
@classCode | 1..1 | cs | Fixed Value: AGNT | |
code | 0..1 | CE | Binding: Healthcare Agent or Proxy Choices (preferred) | |
addr | 0..1 | USRealmAddress | Base for all types and resources | |
telecom | 0..* | TEL | ||
playingEntity | C | 1..1 | PlayingEntity | should-code: SHOULD contain code |
code | 0..1 | CE | Binding: Healthcare Agent Qualifier (preferred) | |
name | 1..1 | PN | The name of the healthcare agent. | |
Slices for reference | 1..* | Reference | Slice: Unordered, Open by value:externalDocument, value:typeCode | |
reference:reference1 | 1..* | Reference | ||
@typeCode | 1..1 | cs | Fixed Value: REFR | |
externalDocument | 1..1 | ExternalDocument | ||
id | 1..* | II | ||
text | 0..1 | ED | ||
reference | C | 0..1 | TEL | The URL of a referenced advance directive document **MAY** be present, and **SHALL** be represented in Observation/reference/ExternalDocument/text/reference (CONF:1198-8698). 1198-8699: If a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699). |
Documentation for this format |
Path | Conformance | ValueSet |
Observation.code | preferred | AdvanceDirectivesCategories |
Observation.value.code | required | AdvanceDirectiveContentTypeSCT |
Observation.participant:participant1.participantRole.code | preferred | HealthcareProviderTaxonomy (a valid code from http://nucc.org/provider-taxonomy ) |
Observation.participant:participant2.participantRole.code | preferred | HealthcareAgentOrProxyChoices |
Observation.participant:participant2.participantRole.playingEntity.code | preferred | HealthcareAgentQualifier |
Id | Grade | Path(s) | Details | Requirements |
1198-8699 | warning | Observation.reference:reference1.externalDocument.text.reference | If a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699). : | |
1198-32449 | error | Observation.effectiveTime.high | If the Advance Directive does not have a specified ending time, the <high> element **SHALL** have the nullFlavor attribute set to *NA* (CONF:1198-32449). : value.exists() or nullFlavor = 'NA' | |
should-addr | warning | Observation.participant:participant2.participantRole | SHOULD contain addr : addr.exists() | |
should-author | warning | Observation | SHOULD contain author : author.exists() | |
should-code | warning | Observation.participant:participant1.participantRole, Observation.participant:participant2.participantRole, Observation.participant:participant2.participantRole.playingEntity | SHOULD contain code : code.exists() | |
should-informant | warning | Observation | SHOULD contain informant : informant.exists() | |
should-telecom | warning | Observation.participant:participant2.participantRole | SHOULD contain telecom : telecom.exists() | |
should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value : text.reference.value.exists() | |
should-time | warning | Observation.participant:participant1 | SHOULD contain time : time.exists() | |
value-only | error | Observation.participant:participant1.time | Interval fields SHALL not be present : (low | high | width | center).empty() | |
value-starts-octothorpe | error | Observation.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') |
Key Elements View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Observation | C | 1..1 | Observation | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author should-informant: SHOULD contain informant |
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root, value:extension | |
templateId:advance-directive-obs | 1..1 | II | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.48 | |
@extension | 1..1 | st | Required Pattern: 2022-02-14 | |
@classCode | 1..1 | cs | Binding: ActClassObservation (2.0.0) (required) Fixed Value: OBS | |
@moodCode | 1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN | |
id | 1..* | II | ||
code | 1..1 | CD | Binding: Advance Directives Categories (preferred) | |
Slices for translation | 1..* | CD | Slice: Unordered, Open by value:code, value:codeSystem | |
translation:advanceDirective | 1..1 | CD | Advance directive | |
@code | 1..1 | cs | Required Pattern: 75320-2 | |
@codeSystem | 1..1 | oid, uuid, ruid | LOINC Required Pattern: 2.16.840.1.113883.6.1 | |
text | 1..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
statusCode | 1..1 | CS | Binding: ActStatus (required) | |
@code | 1..1 | cs | Fixed Value: completed | |
effectiveTime | 1..1 | IVL_TS | ||
low | 1..1 | IVXB_TS | ||
high | C | 1..1 | IVXB_TS | 1198-32449: If the Advance Directive does not have a specified ending time, the <high> element **SHALL** have the nullFlavor attribute set to *NA* (CONF:1198-32449). |
value | 1..1 | CD | ||
@code | 0..1 | cs | Binding: Advance Directive Content Type SCT (required) | |
@codeSystem | 0..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.96 | |
author | 0..* | AuthorParticipation | Base for all types and resources | |
informant | 0..* | Informant | SHOULD contain informant | |
Slices for participant | 0..* | Participant2 | Slice: Unordered, Open by value:participantRole, value:typeCode | |
participant:participant1 | C | 0..* | Participant2 | The participant "VRF" represents the clinician(s) who verified the patient advance directive. should-time: SHOULD contain time |
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root | |
templateId:primary | 1..1 | II | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.1.58 | |
@typeCode | 1..1 | cs | Binding: ParticipationType (required) Fixed Value: VRF | |
time | C | 0..1 | IVL_TS | value-only: Interval fields SHALL not be present |
@value | 0..1 | ts | value should be used instead of low/high Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz] | |
participantRole | C | 1..1 | ParticipantRole | should-code: SHOULD contain code |
@classCode | 1..1 | cs | Binding: RoleClassRoot (required) | |
code | 0..1 | CE | Binding: Healthcare Provider Taxonomy (preferred) | |
addr | C | 0..* | USRealmAddress | Base for all types and resources |
playingEntity | 1..1 | PlayingEntity | ||
@classCode | 1..1 | cs | Binding: EntityClassRoot (required) | |
name | C | 1..1 | USRealmPersonNamePNUSFIELDED | Base for all types and resources |
participant:participant2 | 0..* | Participant2 | This custodian (CST) participant identifies a legal representative for healthcare decision-making. Examples of such individuals are called health care agents, substitute decision makers and/or health care proxies. Only record a healthcare agent who is acting in that capacitiy and participating in carae decision-making during the documented care encounter. | |
@typeCode | 1..1 | cs | Binding: ParticipationType (required) Fixed Value: CST | |
participantRole | C | 1..1 | ParticipantRole | should-code: SHOULD contain code should-addr: SHOULD contain addr should-telecom: SHOULD contain telecom |
@classCode | 1..1 | cs | Binding: RoleClassRoot (required) Fixed Value: AGNT | |
code | 0..1 | CE | Binding: Healthcare Agent or Proxy Choices (preferred) | |
addr | C | 0..1 | USRealmAddress | Base for all types and resources |
telecom | 0..* | TEL | ||
playingEntity | C | 1..1 | PlayingEntity | should-code: SHOULD contain code |
@classCode | 1..1 | cs | Binding: EntityClassRoot (required) | |
code | 0..1 | CE | Binding: Healthcare Agent Qualifier (preferred) | |
name | 1..1 | PN | The name of the healthcare agent. | |
Slices for reference | 1..* | Reference | Slice: Unordered, Open by value:externalDocument, value:typeCode | |
reference:reference1 | 1..* | Reference | ||
@typeCode | 1..1 | cs | Binding: x_ActRelationshipExternalReference (required) Fixed Value: REFR | |
externalDocument | 1..1 | ExternalDocument | ||
id | 1..* | II | ||
text | 0..1 | ED | ||
reference | C | 0..1 | TEL | The URL of a referenced advance directive document **MAY** be present, and **SHALL** be represented in Observation/reference/ExternalDocument/text/reference (CONF:1198-8698). 1198-8699: If a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699). |
Documentation for this format |
Path | Conformance | ValueSet / Code |
Observation.classCode | required | Fixed Value: OBS |
Observation.moodCode | required | Fixed Value: EVN |
Observation.code | preferred | AdvanceDirectivesCategories |
Observation.statusCode | required | ActStatus |
Observation.value.code | required | AdvanceDirectiveContentTypeSCT |
Observation.participant:participant1.typeCode | required | Fixed Value: VRF |
Observation.participant:participant1.participantRole.classCode | required | RoleClassRoot |
Observation.participant:participant1.participantRole.code | preferred | HealthcareProviderTaxonomy (a valid code from http://nucc.org/provider-taxonomy ) |
Observation.participant:participant1.participantRole.playingEntity.classCode | required | EntityClassRoot |
Observation.participant:participant2.typeCode | required | Fixed Value: CST |
Observation.participant:participant2.participantRole.classCode | required | Fixed Value: AGNT |
Observation.participant:participant2.participantRole.code | preferred | HealthcareAgentOrProxyChoices |
Observation.participant:participant2.participantRole.playingEntity.classCode | required | EntityClassRoot |
Observation.participant:participant2.participantRole.playingEntity.code | preferred | HealthcareAgentQualifier |
Observation.reference:reference1.typeCode | required | Fixed Value: REFR |
Id | Grade | Path(s) | Details | Requirements |
1198-8699 | warning | Observation.reference:reference1.externalDocument.text.reference | If a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699). : | |
1198-32449 | error | Observation.effectiveTime.high | If the Advance Directive does not have a specified ending time, the <high> element **SHALL** have the nullFlavor attribute set to *NA* (CONF:1198-32449). : value.exists() or nullFlavor = 'NA' | |
81-7296 | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | **SHALL NOT** have mixed content except for white space (CONF:81-7296) : item.xmlText.empty() | |
81-9371 | error | Observation.participant:participant1.participantRole.playingEntity.name | The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). : conformsTo('http://hl7.org/cda/us/ccda/StructureDefinition/USRealmPatientNamePTNUSFIELDED') or item.xmlText.exists() | |
81-9372 | error | Observation.participant:participant1.participantRole.playingEntity.name | The string **SHALL NOT** contain name parts (CONF:81-9372). : item.xmlText.exists() implies (item.delimiter | item.family | item.given | item.prefix | item.suffix).empty() | |
81-10024 | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). : nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.state.exists(nullFlavor.exists() or xmlText.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state')) | |
81-10025 | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). : nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.postalCode.exists(nullFlavor.exists() or xmlText.matches('[0-9]{5}(-[0-9]{4})?')) | |
pn-no-ls | error | Observation.participant:participant1.participantRole.playingEntity.name | No PN name part may have a qualifier of LS. : (item.delimiter | item.family | item.given | item.prefix | item.suffix).where(qualifier.where($this = 'LS').exists()).empty() | |
shall-city | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHALL contain exactly one [1..1] city (CONF:81-7292). : nullFlavor.exists() or item.city.count() = 1 | |
shall-max-ad-parts | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHALL have at most one of each: state, city, postalCode, and country : (item.state.empty() or item.state.count() = 1) and (item.city.empty() or item.city.count() = 1) and (item.postalCode.empty() or item.postalCode.count() = 1) and (item.country.empty() or item.country.count() = 1) | |
shall-streetAddressLine | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). : nullFlavor.exists() or (item.streetAddressLine.count() >= 1 and item.streetAddressLine.count() <= 4) | |
should-addr | warning | Observation.participant:participant2.participantRole | SHOULD contain addr : addr.exists() | |
should-author | warning | Observation | SHOULD contain author : author.exists() | |
should-code | warning | Observation.participant:participant1.participantRole, Observation.participant:participant2.participantRole, Observation.participant:participant2.participantRole.playingEntity | SHOULD contain code : code.exists() | |
should-country | warning | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHOULD contain country : nullFlavor.exists() or item.country.exists() | |
should-informant | warning | Observation | SHOULD contain informant : informant.exists() | |
should-telecom | warning | Observation.participant:participant2.participantRole | SHOULD contain telecom : telecom.exists() | |
should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value : text.reference.value.exists() | |
should-time | warning | Observation.participant:participant1 | SHOULD contain time : time.exists() | |
should-use | warning | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHOULD contain @use : nullFlavor.exists() or use.exists() | |
value-only | error | Observation.participant:participant1.time | Interval fields SHALL not be present : (low | high | width | center).empty() | |
value-starts-octothorpe | error | Observation.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Observation | C | 1..1 | Observation | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author should-informant: SHOULD contain informant |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root, value:extension | |
templateId:advance-directive-obs | 1..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.48 | |
@extension | 1..1 | st | Required Pattern: 2022-02-14 | |
@classCode | 1..1 | cs | Binding: ActClassObservation (2.0.0) (required) Fixed Value: OBS | |
@moodCode | 1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN | |
@negationInd | 0..1 | bl | ||
id | 1..* | II | ||
code | 1..1 | CD | Binding: Advance Directives Categories (preferred) | |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@code | 0..1 | cs | ||
@codeSystem | 0..1 | oid, uuid, ruid | ||
@codeSystemName | 0..1 | st | ||
@codeSystemVersion | 0..1 | st | ||
@displayName | 0..1 | st | ||
@sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
@sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
originalText | 0..1 | ED | ||
qualifier | 0..* | CR | ||
Slices for translation | 1..* | CD | Slice: Unordered, Open by value:code, value:codeSystem | |
translation:advanceDirective | 1..1 | CD | Advance directive | |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@code | 1..1 | cs | Required Pattern: 75320-2 | |
@codeSystem | 1..1 | oid, uuid, ruid | LOINC Required Pattern: 2.16.840.1.113883.6.1 | |
@codeSystemName | 0..1 | st | ||
@codeSystemVersion | 0..1 | st | ||
@displayName | 0..1 | st | ||
@sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
@sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
originalText | 0..1 | ED | ||
qualifier | 0..* | CR | ||
translation | 0..* | CD | ||
derivationExpr | 0..1 | ST | ||
text | 1..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@compression | 0..1 | cs | Binding: CompressionAlgorithm (required) | |
@integrityCheck | 0..1 | bin | ||
@integrityCheckAlgorithm | 0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required) | |
@language | 0..1 | cs | ||
@mediaType | 0..1 | cs | Binding: MediaType (example) | |
@representation | 0..1 | cs | Binding: Binary Data Encoding Value Set (required) | |
xmlText | 0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string. | |
reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
thumbnail | 0..1 | ED | ||
statusCode | 1..1 | CS | Binding: ActStatus (required) | |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@code | 1..1 | cs | Fixed Value: completed | |
@sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
@sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
effectiveTime | 1..1 | IVL_TS | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@value | 0..1 | ts | Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz] | |
@operator | 0..1 | cs | Binding: SetOperator (required) | |
low | 1..1 | IVXB_TS | ||
center | 0..1 | TS | ||
width | 0..1 | PQ | ||
high | C | 1..1 | IVXB_TS | 1198-32449: If the Advance Directive does not have a specified ending time, the <high> element **SHALL** have the nullFlavor attribute set to *NA* (CONF:1198-32449). |
priorityCode | 0..1 | CE | Binding: ActPriority (example) | |
repeatNumber | 0..1 | IVL_INT | ||
languageCode | 0..1 | CS | Binding: AllLanguages (required) | |
value | 1..1 | CD | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@code | 0..1 | cs | Binding: Advance Directive Content Type SCT (required) | |
@codeSystem | 0..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.96 | |
@codeSystemName | 0..1 | st | ||
@codeSystemVersion | 0..1 | st | ||
@displayName | 0..1 | st | ||
@sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
@sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
originalText | 0..1 | ED | ||
qualifier | 0..* | CR | ||
translation | 0..* | CD | ||
interpretationCode | 0..* | CE | Binding: ObservationInterpretation (required) | |
methodCode | 0..* | CE | Binding: ObservationMethod (example) | |
targetSiteCode | 0..* | CD | ||
subject | 0..1 | Subject | ||
specimen | 0..* | Specimen | ||
performer | 0..* | Performer2 | ||
author | 0..* | AuthorParticipation | Base for all types and resources | |
informant | 0..* | Informant | SHOULD contain informant | |
Slices for participant | 0..* | Participant2 | Slice: Unordered, Open by value:participantRole, value:typeCode | |
participant:participant1 | C | 0..* | Participant2 | The participant "VRF" represents the clinician(s) who verified the patient advance directive. should-time: SHOULD contain time |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root | |
templateId:primary | 1..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.1.58 | |
@typeCode | 1..1 | cs | Binding: ParticipationType (required) Fixed Value: VRF | |
@contextControlCode | 0..1 | cs | Binding: ContextControl (required) Fixed Value: OP | |
sdtcFunctionCode | 0..1 | CE | XML Namespace: urn:hl7-org:sdtc XML: functionCode (urn:hl7-org:sdtc) | |
time | C | 0..1 | IVL_TS | value-only: Interval fields SHALL not be present |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@value | 0..1 | ts | value should be used instead of low/high Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz] | |
@operator | 0..1 | cs | Binding: SetOperator (required) | |
low | 0..1 | IVXB_TS | ||
center | 0..1 | TS | ||
width | 0..1 | PQ | ||
high | 0..1 | IVXB_TS | ||
awarenessCode | 0..1 | CE | ||
participantRole | C | 1..1 | ParticipantRole | should-code: SHOULD contain code |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
templateId | 0..* | II | ||
@classCode | 1..1 | cs | Binding: RoleClassRoot (required) | |
id | 0..* | II | ||
sdtcIdentifiedBy | 0..* | IdentifiedBy | XML Namespace: urn:hl7-org:sdtc XML: identifiedBy (urn:hl7-org:sdtc) | |
code | 0..1 | CE | Binding: Healthcare Provider Taxonomy (preferred) | |
addr | C | 0..* | USRealmAddress | Base for all types and resources |
telecom | 0..* | TEL | ||
playingDevice | 0..1 | Device | ||
playingEntity | 1..1 | PlayingEntity | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
templateId | 0..* | II | ||
@classCode | 1..1 | cs | Binding: EntityClassRoot (required) | |
@determinerCode | 0..1 | cs | Binding: EntityDeterminer (required) Fixed Value: INSTANCE | |
code | 0..1 | CE | Binding: EntityCode (example) | |
quantity | 0..* | PQ | ||
name | C | 1..1 | USRealmPersonNamePNUSFIELDED | Base for all types and resources |
sdtcBirthTime | 0..1 | TS | XML Namespace: urn:hl7-org:sdtc XML: birthTime (urn:hl7-org:sdtc) | |
desc | 0..1 | ED | ||
scopingEntity | 0..1 | Entity | ||
participant:participant2 | 0..* | Participant2 | This custodian (CST) participant identifies a legal representative for healthcare decision-making. Examples of such individuals are called health care agents, substitute decision makers and/or health care proxies. Only record a healthcare agent who is acting in that capacitiy and participating in carae decision-making during the documented care encounter. | |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
templateId | 0..* | II | ||
@typeCode | 1..1 | cs | Binding: ParticipationType (required) Fixed Value: CST | |
@contextControlCode | 0..1 | cs | Binding: ContextControl (required) Fixed Value: OP | |
sdtcFunctionCode | 0..1 | CE | XML Namespace: urn:hl7-org:sdtc XML: functionCode (urn:hl7-org:sdtc) | |
time | 0..1 | IVL_TS | ||
awarenessCode | 0..1 | CE | ||
participantRole | C | 1..1 | ParticipantRole | should-code: SHOULD contain code should-addr: SHOULD contain addr should-telecom: SHOULD contain telecom |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
templateId | 0..* | II | ||
@classCode | 1..1 | cs | Binding: RoleClassRoot (required) Fixed Value: AGNT | |
id | 0..* | II | ||
sdtcIdentifiedBy | 0..* | IdentifiedBy | XML Namespace: urn:hl7-org:sdtc XML: identifiedBy (urn:hl7-org:sdtc) | |
code | 0..1 | CE | Binding: Healthcare Agent or Proxy Choices (preferred) | |
addr | C | 0..1 | USRealmAddress | Base for all types and resources |
telecom | 0..* | TEL | ||
playingDevice | 0..1 | Device | ||
playingEntity | C | 1..1 | PlayingEntity | should-code: SHOULD contain code |
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
templateId | 0..* | II | ||
@classCode | 1..1 | cs | Binding: EntityClassRoot (required) | |
@determinerCode | 0..1 | cs | Binding: EntityDeterminer (required) Fixed Value: INSTANCE | |
code | 0..1 | CE | Binding: Healthcare Agent Qualifier (preferred) | |
quantity | 0..* | PQ | ||
name | 1..1 | PN | The name of the healthcare agent. | |
sdtcBirthTime | 0..1 | TS | XML Namespace: urn:hl7-org:sdtc XML: birthTime (urn:hl7-org:sdtc) | |
desc | 0..1 | ED | ||
scopingEntity | 0..1 | Entity | ||
entryRelationship | 0..* | EntryRelationship | ||
Slices for reference | 1..* | Reference | Slice: Unordered, Open by value:externalDocument, value:typeCode | |
reference:reference1 | 1..* | Reference | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
templateId | 0..* | II | ||
@typeCode | 1..1 | cs | Binding: x_ActRelationshipExternalReference (required) Fixed Value: REFR | |
seperatableInd | 0..1 | BL | ||
externalAct | 0..1 | ExternalAct | ||
externalObservation | 0..1 | ExternalObservation | ||
externalProcedure | 0..1 | ExternalProcedure | ||
externalDocument | 1..1 | ExternalDocument | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
templateId | 0..* | II | ||
@classCode | 0..1 | cs | Binding: ActClassDocument (required) | |
@moodCode | 0..1 | cs | Binding: ActMood (required) Fixed Value: EVN | |
id | 1..* | II | ||
code | 0..1 | CD | Binding: FHIRDocumentTypeCodes (example) | |
text | 0..1 | ED | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@compression | 0..1 | cs | Binding: CompressionAlgorithm (required) | |
@integrityCheck | 0..1 | bin | ||
@integrityCheckAlgorithm | 0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required) | |
@language | 0..1 | cs | ||
@mediaType | 0..1 | cs | Binding: MediaType (example) | |
@representation | 0..1 | cs | Binding: Binary Data Encoding Value Set (required) | |
xmlText | 0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string. | |
reference | C | 0..1 | TEL | The URL of a referenced advance directive document **MAY** be present, and **SHALL** be represented in Observation/reference/ExternalDocument/text/reference (CONF:1198-8698). 1198-8699: If a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699). |
thumbnail | 0..1 | ED | ||
setId | 0..1 | II | ||
versionNumber | 0..1 | INT | ||
precondition | 0..* | Precondition | ||
sdtcPrecondition2 | 0..* | Precondition2 | XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc) | |
referenceRange | 0..* | InfrastructureRoot | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
@nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
@assigningAuthorityName | 0..1 | st | ||
@displayable | 0..1 | bl | ||
@root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
@extension | 1..1 | st | ||
templateId | 0..* | II | ||
@typeCode | 0..1 | cs | Binding: ActRelationshipType (2.0.0) (required) Fixed Value: REFV | |
observationRange | 1..1 | ObservationRange | ||
sdtcInFulfillmentOf1 | 0..* | InFulfillmentOf1 | XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc) | |
Documentation for this format |
Path | Conformance | ValueSet / Code |
Observation.nullFlavor | required | CDANullFlavor |
Observation.typeId.nullFlavor | required | CDANullFlavor |
Observation.templateId:advance-directive-obs.nullFlavor | required | CDANullFlavor |
Observation.classCode | required | Fixed Value: OBS |
Observation.moodCode | required | Fixed Value: EVN |
Observation.code | preferred | AdvanceDirectivesCategories |
Observation.code.nullFlavor | required | CDANullFlavor |
Observation.code.translation:advanceDirective.nullFlavor | required | CDANullFlavor |
Observation.text.nullFlavor | required | CDANullFlavor |
Observation.text.compression | required | CDACompressionAlgorithm |
Observation.text.integrityCheckAlgorithm | required | IntegrityCheckAlgorithm |
Observation.text.mediaType | example | MediaType |
Observation.text.representation | required | BinaryDataEncoding |
Observation.statusCode | required | ActStatus |
Observation.statusCode.nullFlavor | required | CDANullFlavor |
Observation.effectiveTime.nullFlavor | required | CDANullFlavor |
Observation.effectiveTime.operator | required | SetOperator |
Observation.priorityCode | example | ActPriority |
Observation.languageCode | required | AllLanguages |
Observation.value.nullFlavor | required | CDANullFlavor |
Observation.value.code | required | AdvanceDirectiveContentTypeSCT |
Observation.interpretationCode | required | ObservationInterpretation |
Observation.methodCode | example | ObservationMethod |
Observation.participant:participant1.nullFlavor | required | CDANullFlavor |
Observation.participant:participant1.typeId.nullFlavor | required | CDANullFlavor |
Observation.participant:participant1.templateId:primary.nullFlavor | required | CDANullFlavor |
Observation.participant:participant1.typeCode | required | Fixed Value: VRF |
Observation.participant:participant1.contextControlCode | required | Fixed Value: OP |
Observation.participant:participant1.time.nullFlavor | required | CDANullFlavor |
Observation.participant:participant1.time.operator | required | SetOperator |
Observation.participant:participant1.participantRole.nullFlavor | required | CDANullFlavor |
Observation.participant:participant1.participantRole.typeId.nullFlavor | required | CDANullFlavor |
Observation.participant:participant1.participantRole.classCode | required | RoleClassRoot |
Observation.participant:participant1.participantRole.code | preferred | HealthcareProviderTaxonomy (a valid code from http://nucc.org/provider-taxonomy ) |
Observation.participant:participant1.participantRole.playingEntity.nullFlavor | required | CDANullFlavor |
Observation.participant:participant1.participantRole.playingEntity.typeId.nullFlavor | required | CDANullFlavor |
Observation.participant:participant1.participantRole.playingEntity.classCode | required | EntityClassRoot |
Observation.participant:participant1.participantRole.playingEntity.determinerCode | required | Fixed Value: INSTANCE |
Observation.participant:participant1.participantRole.playingEntity.code | example | EntityCode |
Observation.participant:participant2.nullFlavor | required | CDANullFlavor |
Observation.participant:participant2.typeId.nullFlavor | required | CDANullFlavor |
Observation.participant:participant2.typeCode | required | Fixed Value: CST |
Observation.participant:participant2.contextControlCode | required | Fixed Value: OP |
Observation.participant:participant2.participantRole.nullFlavor | required | CDANullFlavor |
Observation.participant:participant2.participantRole.typeId.nullFlavor | required | CDANullFlavor |
Observation.participant:participant2.participantRole.classCode | required | Fixed Value: AGNT |
Observation.participant:participant2.participantRole.code | preferred | HealthcareAgentOrProxyChoices |
Observation.participant:participant2.participantRole.playingEntity.nullFlavor | required | CDANullFlavor |
Observation.participant:participant2.participantRole.playingEntity.typeId.nullFlavor | required | CDANullFlavor |
Observation.participant:participant2.participantRole.playingEntity.classCode | required | EntityClassRoot |
Observation.participant:participant2.participantRole.playingEntity.determinerCode | required | Fixed Value: INSTANCE |
Observation.participant:participant2.participantRole.playingEntity.code | preferred | HealthcareAgentQualifier |
Observation.reference:reference1.nullFlavor | required | CDANullFlavor |
Observation.reference:reference1.typeId.nullFlavor | required | CDANullFlavor |
Observation.reference:reference1.typeCode | required | Fixed Value: REFR |
Observation.reference:reference1.externalDocument.nullFlavor | required | CDANullFlavor |
Observation.reference:reference1.externalDocument.typeId.nullFlavor | required | CDANullFlavor |
Observation.reference:reference1.externalDocument.classCode | required | ActClassDocument |
Observation.reference:reference1.externalDocument.moodCode | required | Fixed Value: EVN |
Observation.reference:reference1.externalDocument.code | example | FHIRDocumentTypeCodes |
Observation.reference:reference1.externalDocument.text.nullFlavor | required | CDANullFlavor |
Observation.reference:reference1.externalDocument.text.compression | required | CDACompressionAlgorithm |
Observation.reference:reference1.externalDocument.text.integrityCheckAlgorithm | required | IntegrityCheckAlgorithm |
Observation.reference:reference1.externalDocument.text.mediaType | example | MediaType |
Observation.reference:reference1.externalDocument.text.representation | required | BinaryDataEncoding |
Observation.referenceRange.nullFlavor | required | CDANullFlavor |
Observation.referenceRange.typeId.nullFlavor | required | CDANullFlavor |
Observation.referenceRange.typeCode | required | Fixed Value: REFV |
Id | Grade | Path(s) | Details | Requirements |
1198-8699 | warning | Observation.reference:reference1.externalDocument.text.reference | If a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699). : | |
1198-32449 | error | Observation.effectiveTime.high | If the Advance Directive does not have a specified ending time, the <high> element **SHALL** have the nullFlavor attribute set to *NA* (CONF:1198-32449). : value.exists() or nullFlavor = 'NA' | |
81-7296 | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | **SHALL NOT** have mixed content except for white space (CONF:81-7296) : item.xmlText.empty() | |
81-9371 | error | Observation.participant:participant1.participantRole.playingEntity.name | The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). : conformsTo('http://hl7.org/cda/us/ccda/StructureDefinition/USRealmPatientNamePTNUSFIELDED') or item.xmlText.exists() | |
81-9372 | error | Observation.participant:participant1.participantRole.playingEntity.name | The string **SHALL NOT** contain name parts (CONF:81-9372). : item.xmlText.exists() implies (item.delimiter | item.family | item.given | item.prefix | item.suffix).empty() | |
81-10024 | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | If the country is US, the state element is required and SHALL be selected from ValueSet StateValueSet but SHOULD have @nullFlavor if the state is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies (CONF:81-10024). : nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.state.exists(nullFlavor.exists() or xmlText.memberOf('http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state')) | |
81-10025 | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | If the country is US, the postalCode element is required but SHOULD have @nullFlavor if the postalCode is unknown. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies (CONF:81-10025). : nullFlavor.exists() or (item.country.exists() and item.country.xmlText != 'US' and item.country.xmlText != 'USA') or item.postalCode.exists(nullFlavor.exists() or xmlText.matches('[0-9]{5}(-[0-9]{4})?')) | |
pn-no-ls | error | Observation.participant:participant1.participantRole.playingEntity.name | No PN name part may have a qualifier of LS. : (item.delimiter | item.family | item.given | item.prefix | item.suffix).where(qualifier.where($this = 'LS').exists()).empty() | |
shall-city | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHALL contain exactly one [1..1] city (CONF:81-7292). : nullFlavor.exists() or item.city.count() = 1 | |
shall-max-ad-parts | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHALL have at most one of each: state, city, postalCode, and country : (item.state.empty() or item.state.count() = 1) and (item.city.empty() or item.city.count() = 1) and (item.postalCode.empty() or item.postalCode.count() = 1) and (item.country.empty() or item.country.count() = 1) | |
shall-streetAddressLine | error | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHALL contain at least one and not more than 4 streetAddressLine (CONF:81-7291). : nullFlavor.exists() or (item.streetAddressLine.count() >= 1 and item.streetAddressLine.count() <= 4) | |
should-addr | warning | Observation.participant:participant2.participantRole | SHOULD contain addr : addr.exists() | |
should-author | warning | Observation | SHOULD contain author : author.exists() | |
should-code | warning | Observation.participant:participant1.participantRole, Observation.participant:participant2.participantRole, Observation.participant:participant2.participantRole.playingEntity | SHOULD contain code : code.exists() | |
should-country | warning | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHOULD contain country : nullFlavor.exists() or item.country.exists() | |
should-informant | warning | Observation | SHOULD contain informant : informant.exists() | |
should-telecom | warning | Observation.participant:participant2.participantRole | SHOULD contain telecom : telecom.exists() | |
should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value : text.reference.value.exists() | |
should-time | warning | Observation.participant:participant1 | SHOULD contain time : time.exists() | |
should-use | warning | Observation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr | SHOULD contain @use : nullFlavor.exists() or use.exists() | |
value-only | error | Observation.participant:participant1.time | Interval fields SHALL not be present : (low | high | width | center).empty() | |
value-starts-octothorpe | error | Observation.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') |
This structure is derived from Observation
Summary
Mandatory: 20 elements (7 nested mandatory elements)
Fixed Value: 7 elements
Prohibited: 1 element
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices: