Consolidated CDA
3.0.0-ballot - ballot United States of America flag

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

Logical Model: Advance Directive Observation

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:

  • Personal advance care plan
  • Living Will
  • Durable Healthcare (Medical) Power of Attorney

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:

  • Healthcare agent consent
  • Antibiotics administration preference
  • Artificial nutrition and hydration administration preference
  • Intubation and Ventilation procedure preference
  • Resuscitation procedure preference
  • Diagnostic Testing procedure preference
  • Preferences relating to palliative care
  • Preferences relating to hospice care at the end of life
  • Organ donation preference
  • Autopsy procedure preference
  • Burial preference
  • Care preference that is general in nature which the patient wants care providers to take into consideration
  • Information about a personal goal, such as seeing a grandchild born, attending a child’s wedding, finding care for a beloved pet, or dying in a certain place.

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:

Formal Views of Profile Content

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

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C1..1ObservationXML 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..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:advance-directive-obs 1..1II
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.48
..... @extension 1..1stRequired Pattern: 2022-02-14
... @classCode 1..1csFixed Value: OBS
... @moodCode 1..1csFixed Value: EVN
... code 1..1CDBinding: Advance Directives Categories (preferred)
.... Slices for translation 1..*CDSlice: Unordered, Open by value:code, value:codeSystem
..... translation:advanceDirective 1..1CDAdvance directive
...... @code 1..1csRequired Pattern: 75320-2
...... @codeSystem 1..1oid, uuid, ruidLOINC
Required Pattern: 2.16.840.1.113883.6.1
... text 1..1EDSHOULD reference the portion of section narrative text corresponding to this entry
.... reference C0..1TELvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
... statusCode 1..1CS
.... @code 1..1csFixed Value: completed
... effectiveTime 1..1IVL_TS
.... low 1..1IVXB_TS
.... high C1..1IVXB_TS1198-32449: 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..1CD
.... @code 0..1csBinding: Advance Directive Content Type SCT (required)
.... @codeSystem 0..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.6.96
... author 0..*AuthorParticipationBase for all types and resources
... informant 0..*InformantSHOULD contain informant
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:participantRole, value:typeCode
.... participant:participant1 C0..*Participant2The participant "VRF" represents the clinician(s) who verified the patient advance directive.
should-time: SHOULD contain time
..... Slices for templateId 1..*IISlice: Unordered, Open by value:root
...... templateId:primary 1..1II
....... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.1.58
....... @extension 0..0
..... @typeCode 1..1csFixed Value: VRF
..... time C0..1IVL_TSvalue-only: Interval fields SHALL not be present
...... @value 0..1tsvalue should be used instead of low/high
..... participantRole C1..1ParticipantRoleshould-code: SHOULD contain code
...... code 0..1CEBinding: Healthcare Provider Taxonomy (preferred)
...... addr 0..*USRealmAddressBase for all types and resources
...... playingEntity 1..1PlayingEntity
....... name 1..1USRealmPersonNamePNUSFIELDEDBase for all types and resources
.... participant:participant2 0..*Participant2This 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..1csFixed Value: CST
..... participantRole C1..1ParticipantRoleshould-code: SHOULD contain code
should-addr: SHOULD contain addr
should-telecom: SHOULD contain telecom
...... @classCode 1..1csFixed Value: AGNT
...... code 0..1CEBinding: Healthcare Agent or Proxy Choices (preferred)
...... addr 0..1USRealmAddressBase for all types and resources
...... telecom 0..*TEL
...... playingEntity C1..1PlayingEntityshould-code: SHOULD contain code
....... code 0..1CEBinding: Healthcare Agent Qualifier (preferred)
....... name 1..1PNThe name of the healthcare agent.
... Slices for reference 1..*ReferenceSlice: Unordered, Open by value:externalDocument, value:typeCode
.... reference:reference1 1..*Reference
..... @typeCode 1..1csFixed Value: REFR
..... externalDocument 1..1ExternalDocument
...... id 1..*II
...... text 0..1ED
....... reference C0..1TELThe 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).

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Observation.codepreferredAdvanceDirectivesCategories
Observation.value.coderequiredAdvanceDirectiveContentTypeSCT
Observation.participant:participant1.participantRole.codepreferredHealthcareProviderTaxonomy (a valid code from http://nucc.org/provider-taxonomy)
Observation.participant:participant2.participantRole.codepreferredHealthcareAgentOrProxyChoices
Observation.participant:participant2.participantRole.playingEntity.codepreferredHealthcareAgentQualifier

Constraints

IdGradePath(s)DetailsRequirements
1198-8699warningObservation.reference:reference1.externalDocument.text.referenceIf a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699).
:
1198-32449errorObservation.effectiveTime.highIf 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-addrwarningObservation.participant:participant2.participantRoleSHOULD contain addr
: addr.exists()
should-authorwarningObservationSHOULD contain author
: author.exists()
should-codewarningObservation.participant:participant1.participantRole, Observation.participant:participant2.participantRole, Observation.participant:participant2.participantRole.playingEntitySHOULD contain code
: code.exists()
should-informantwarningObservationSHOULD contain informant
: informant.exists()
should-telecomwarningObservation.participant:participant2.participantRoleSHOULD contain telecom
: telecom.exists()
should-text-ref-valuewarningObservationSHOULD contain text/reference/@value
: text.reference.value.exists()
should-timewarningObservation.participant:participant1SHOULD contain time
: time.exists()
value-onlyerrorObservation.participant:participant1.timeInterval fields SHALL not be present
: (low | high | width | center).empty()
value-starts-octothorpeerrorObservation.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C1..1ObservationXML 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..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:advance-directive-obs 1..1II
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.48
..... @extension 1..1stRequired Pattern: 2022-02-14
... @classCode 1..1csBinding: ActClassObservation (2.0.0) (required)
Fixed Value: OBS
... @moodCode 1..1csBinding: XActMoodDocumentObservation (2.0.0) (required)
Fixed Value: EVN
... code 1..1CDBinding: Advance Directives Categories (preferred)
.... Slices for translation 1..*CDSlice: Unordered, Open by value:code, value:codeSystem
..... translation:advanceDirective 1..1CDAdvance directive
...... @code 1..1csRequired Pattern: 75320-2
...... @codeSystem 1..1oid, uuid, ruidLOINC
Required Pattern: 2.16.840.1.113883.6.1
... text 1..1EDSHOULD reference the portion of section narrative text corresponding to this entry
.... reference C0..1TELvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
... statusCode 1..1CSBinding: ActStatus (required)
.... @code 1..1csFixed Value: completed
... effectiveTime 1..1IVL_TS
.... low 1..1IVXB_TS
.... high C1..1IVXB_TS1198-32449: 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..1CD
.... @code 0..1csBinding: Advance Directive Content Type SCT (required)
.... @codeSystem 0..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.6.96
... author 0..*AuthorParticipationBase for all types and resources
... informant 0..*InformantSHOULD contain informant
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:participantRole, value:typeCode
.... participant:participant1 C0..*Participant2The participant "VRF" represents the clinician(s) who verified the patient advance directive.
should-time: SHOULD contain time
..... Slices for templateId 1..*IISlice: Unordered, Open by value:root
...... templateId:primary 1..1II
....... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.1.58
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: VRF
..... time C0..1IVL_TSvalue-only: Interval fields SHALL not be present
...... @value 0..1tsvalue should be used instead of low/high
Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
..... participantRole C1..1ParticipantRoleshould-code: SHOULD contain code
...... @classCode 1..1csBinding: RoleClassRoot (required)
...... code 0..1CEBinding: Healthcare Provider Taxonomy (preferred)
...... addr C0..*USRealmAddressBase for all types and resources
...... playingEntity 1..1PlayingEntity
....... @classCode 1..1csBinding: EntityClassRoot (required)
....... name C1..1USRealmPersonNamePNUSFIELDEDBase for all types and resources
.... participant:participant2 0..*Participant2This 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..1csBinding: ParticipationType (required)
Fixed Value: CST
..... participantRole C1..1ParticipantRoleshould-code: SHOULD contain code
should-addr: SHOULD contain addr
should-telecom: SHOULD contain telecom
...... @classCode 1..1csBinding: RoleClassRoot (required)
Fixed Value: AGNT
...... code 0..1CEBinding: Healthcare Agent or Proxy Choices (preferred)
...... addr C0..1USRealmAddressBase for all types and resources
...... telecom 0..*TEL
...... playingEntity C1..1PlayingEntityshould-code: SHOULD contain code
....... @classCode 1..1csBinding: EntityClassRoot (required)
....... code 0..1CEBinding: Healthcare Agent Qualifier (preferred)
....... name 1..1PNThe name of the healthcare agent.
... Slices for reference 1..*ReferenceSlice: Unordered, Open by value:externalDocument, value:typeCode
.... reference:reference1 1..*Reference
..... @typeCode 1..1csBinding: x_ActRelationshipExternalReference (required)
Fixed Value: REFR
..... externalDocument 1..1ExternalDocument
...... id 1..*II
...... text 0..1ED
....... reference C0..1TELThe 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).

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Observation.classCoderequiredFixed Value: OBS
Observation.moodCoderequiredFixed Value: EVN
Observation.codepreferredAdvanceDirectivesCategories
Observation.statusCoderequiredActStatus
Observation.value.coderequiredAdvanceDirectiveContentTypeSCT
Observation.participant:participant1.typeCoderequiredFixed Value: VRF
Observation.participant:participant1.participantRole.classCoderequiredRoleClassRoot
Observation.participant:participant1.participantRole.codepreferredHealthcareProviderTaxonomy (a valid code from http://nucc.org/provider-taxonomy)
Observation.participant:participant1.participantRole.playingEntity.classCoderequiredEntityClassRoot
Observation.participant:participant2.typeCoderequiredFixed Value: CST
Observation.participant:participant2.participantRole.classCoderequiredFixed Value: AGNT
Observation.participant:participant2.participantRole.codepreferredHealthcareAgentOrProxyChoices
Observation.participant:participant2.participantRole.playingEntity.classCoderequiredEntityClassRoot
Observation.participant:participant2.participantRole.playingEntity.codepreferredHealthcareAgentQualifier
Observation.reference:reference1.typeCoderequiredFixed Value: REFR

Constraints

IdGradePath(s)DetailsRequirements
1198-8699warningObservation.reference:reference1.externalDocument.text.referenceIf a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699).
:
1198-32449errorObservation.effectiveTime.highIf 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'
81-7296errorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr**SHALL NOT** have mixed content except for white space (CONF:81-7296)
: item.xmlText.empty()
81-9371errorObservation.participant:participant1.participantRole.playingEntity.nameThe 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()
81-9372errorObservation.participant:participant1.participantRole.playingEntity.nameThe string **SHALL NOT** contain name parts (CONF:81-9372).
: item.xmlText.exists() implies (item.delimiter | item.family | item.given | item.prefix | item.suffix).empty()
81-10024errorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrIf 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'))
81-10025errorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrIf 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-lserrorObservation.participant:participant1.participantRole.playingEntity.nameNo 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-cityerrorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHALL contain exactly one [1..1] city (CONF:81-7292).
: nullFlavor.exists() or item.city.count() = 1
shall-max-ad-partserrorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHALL 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-streetAddressLineerrorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHALL 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-addrwarningObservation.participant:participant2.participantRoleSHOULD contain addr
: addr.exists()
should-authorwarningObservationSHOULD contain author
: author.exists()
should-codewarningObservation.participant:participant1.participantRole, Observation.participant:participant2.participantRole, Observation.participant:participant2.participantRole.playingEntitySHOULD contain code
: code.exists()
should-countrywarningObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHOULD contain country
: nullFlavor.exists() or item.country.exists()
should-informantwarningObservationSHOULD contain informant
: informant.exists()
should-telecomwarningObservation.participant:participant2.participantRoleSHOULD contain telecom
: telecom.exists()
should-text-ref-valuewarningObservationSHOULD contain text/reference/@value
: text.reference.value.exists()
should-timewarningObservation.participant:participant1SHOULD contain time
: time.exists()
should-usewarningObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHOULD contain @use
: nullFlavor.exists() or use.exists()
value-onlyerrorObservation.participant:participant1.timeInterval fields SHALL not be present
: (low | high | width | center).empty()
value-starts-octothorpeerrorObservation.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C1..1ObservationXML 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..1csBinding: CDANullFlavor (required)
... realmCode 0..*CS
... typeId 0..1II
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @assigningAuthorityName 0..1st
.... @displayable 0..1bl
.... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
.... @extension 1..1st
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:advance-directive-obs 1..1II
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... @assigningAuthorityName 0..1st
..... @displayable 0..1bl
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.48
..... @extension 1..1stRequired Pattern: 2022-02-14
... @classCode 1..1csBinding: ActClassObservation (2.0.0) (required)
Fixed Value: OBS
... @moodCode 1..1csBinding: XActMoodDocumentObservation (2.0.0) (required)
Fixed Value: EVN
... @negationInd 0..1bl
... id 1..*II
... code 1..1CDBinding: Advance Directives Categories (preferred)
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @code 0..1cs
.... @codeSystem 0..1oid, uuid, ruid
.... @codeSystemName 0..1st
.... @codeSystemVersion 0..1st
.... @displayName 0..1st
.... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1ED
.... qualifier 0..*CR
.... Slices for translation 1..*CDSlice: Unordered, Open by value:code, value:codeSystem
..... translation:advanceDirective 1..1CDAdvance directive
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @code 1..1csRequired Pattern: 75320-2
...... @codeSystem 1..1oid, uuid, ruidLOINC
Required Pattern: 2.16.840.1.113883.6.1
...... @codeSystemName 0..1st
...... @codeSystemVersion 0..1st
...... @displayName 0..1st
...... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
...... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
...... originalText 0..1ED
...... qualifier 0..*CR
...... translation 0..*CD
... derivationExpr 0..1ST
... text 1..1EDSHOULD reference the portion of section narrative text corresponding to this entry
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @compression 0..1csBinding: CompressionAlgorithm (required)
.... @integrityCheck 0..1bin
.... @integrityCheckAlgorithm 0..1csBinding: IntegrityCheckAlgorithm (2.0.0) (required)
.... @language 0..1cs
.... @mediaType 0..1csBinding: MediaType (example)
.... @representation 0..1csBinding: Binary Data Encoding Value Set (required)
.... xmlText 0..1stAllows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
.... reference C0..1TELvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
.... thumbnail 0..1ED
... statusCode 1..1CSBinding: ActStatus (required)
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @code 1..1csFixed Value: completed
.... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 1..1IVL_TS
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @value 0..1tsDate Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
.... @operator 0..1csBinding: SetOperator (required)
.... low 1..1IVXB_TS
.... center 0..1TS
.... width 0..1PQ
.... high C1..1IVXB_TS1198-32449: 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..1CEBinding: ActPriority (example)
... repeatNumber 0..1IVL_INT
... languageCode 0..1CSBinding: AllLanguages (required)
... value 1..1CD
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @code 0..1csBinding: Advance Directive Content Type SCT (required)
.... @codeSystem 0..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.6.96
.... @codeSystemName 0..1st
.... @codeSystemVersion 0..1st
.... @displayName 0..1st
.... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1ED
.... qualifier 0..*CR
.... translation 0..*CD
... interpretationCode 0..*CEBinding: ObservationInterpretation (required)
... methodCode 0..*CEBinding: ObservationMethod (example)
... targetSiteCode 0..*CD
... subject 0..1Subject
... specimen 0..*Specimen
... performer 0..*Performer2
... author 0..*AuthorParticipationBase for all types and resources
... informant 0..*InformantSHOULD contain informant
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:participantRole, value:typeCode
.... participant:participant1 C0..*Participant2The participant "VRF" represents the clinician(s) who verified the patient advance directive.
should-time: SHOULD contain time
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... Slices for templateId 1..*IISlice: Unordered, Open by value:root
...... templateId:primary 1..1II
....... @nullFlavor 0..1csBinding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1st
....... @displayable 0..1bl
....... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.1.58
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: VRF
..... @contextControlCode 0..1csBinding: ContextControl (required)
Fixed Value: OP
..... sdtcFunctionCode 0..1CEXML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time C0..1IVL_TSvalue-only: Interval fields SHALL not be present
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @value 0..1tsvalue should be used instead of low/high
Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
...... @operator 0..1csBinding: SetOperator (required)
...... low 0..1IVXB_TS
...... center 0..1TS
...... width 0..1PQ
...... high 0..1IVXB_TS
..... awarenessCode 0..1CE
..... participantRole C1..1ParticipantRoleshould-code: SHOULD contain code
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... realmCode 0..*CS
...... typeId 0..1II
....... @nullFlavor 0..1csBinding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1st
....... @displayable 0..1bl
....... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1st
...... templateId 0..*II
...... @classCode 1..1csBinding: RoleClassRoot (required)
...... id 0..*II
...... sdtcIdentifiedBy 0..*IdentifiedByXML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1CEBinding: Healthcare Provider Taxonomy (preferred)
...... addr C0..*USRealmAddressBase for all types and resources
...... telecom 0..*TEL
...... playingDevice 0..1Device
...... playingEntity 1..1PlayingEntity
....... @nullFlavor 0..1csBinding: CDANullFlavor (required)
....... realmCode 0..*CS
....... typeId 0..1II
........ @nullFlavor 0..1csBinding: CDANullFlavor (required)
........ @assigningAuthorityName 0..1st
........ @displayable 0..1bl
........ @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
........ @extension 1..1st
....... templateId 0..*II
....... @classCode 1..1csBinding: EntityClassRoot (required)
....... @determinerCode 0..1csBinding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... code 0..1CEBinding: EntityCode (example)
....... quantity 0..*PQ
....... name C1..1USRealmPersonNamePNUSFIELDEDBase for all types and resources
....... sdtcBirthTime 0..1TSXML Namespace: urn:hl7-org:sdtc
XML: birthTime (urn:hl7-org:sdtc)
....... desc 0..1ED
...... scopingEntity 0..1Entity
.... participant:participant2 0..*Participant2This 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..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: CST
..... @contextControlCode 0..1csBinding: ContextControl (required)
Fixed Value: OP
..... sdtcFunctionCode 0..1CEXML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1IVL_TS
..... awarenessCode 0..1CE
..... participantRole C1..1ParticipantRoleshould-code: SHOULD contain code
should-addr: SHOULD contain addr
should-telecom: SHOULD contain telecom
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... realmCode 0..*CS
...... typeId 0..1II
....... @nullFlavor 0..1csBinding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1st
....... @displayable 0..1bl
....... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1st
...... templateId 0..*II
...... @classCode 1..1csBinding: RoleClassRoot (required)
Fixed Value: AGNT
...... id 0..*II
...... sdtcIdentifiedBy 0..*IdentifiedByXML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1CEBinding: Healthcare Agent or Proxy Choices (preferred)
...... addr C0..1USRealmAddressBase for all types and resources
...... telecom 0..*TEL
...... playingDevice 0..1Device
...... playingEntity C1..1PlayingEntityshould-code: SHOULD contain code
....... @nullFlavor 0..1csBinding: CDANullFlavor (required)
....... realmCode 0..*CS
....... typeId 0..1II
........ @nullFlavor 0..1csBinding: CDANullFlavor (required)
........ @assigningAuthorityName 0..1st
........ @displayable 0..1bl
........ @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
........ @extension 1..1st
....... templateId 0..*II
....... @classCode 1..1csBinding: EntityClassRoot (required)
....... @determinerCode 0..1csBinding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... code 0..1CEBinding: Healthcare Agent Qualifier (preferred)
....... quantity 0..*PQ
....... name 1..1PNThe name of the healthcare agent.
....... sdtcBirthTime 0..1TSXML Namespace: urn:hl7-org:sdtc
XML: birthTime (urn:hl7-org:sdtc)
....... desc 0..1ED
...... scopingEntity 0..1Entity
... entryRelationship 0..*EntryRelationship
... Slices for reference 1..*ReferenceSlice: Unordered, Open by value:externalDocument, value:typeCode
.... reference:reference1 1..*Reference
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipExternalReference (required)
Fixed Value: REFR
..... seperatableInd 0..1BL
..... externalAct 0..1ExternalAct
..... externalObservation 0..1ExternalObservation
..... externalProcedure 0..1ExternalProcedure
..... externalDocument 1..1ExternalDocument
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... realmCode 0..*CS
...... typeId 0..1II
....... @nullFlavor 0..1csBinding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1st
....... @displayable 0..1bl
....... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1st
...... templateId 0..*II
...... @classCode 0..1csBinding: ActClassDocument (required)
...... @moodCode 0..1csBinding: ActMood (required)
Fixed Value: EVN
...... id 1..*II
...... code 0..1CDBinding: FHIRDocumentTypeCodes (example)
...... text 0..1ED
....... @nullFlavor 0..1csBinding: CDANullFlavor (required)
....... @compression 0..1csBinding: CompressionAlgorithm (required)
....... @integrityCheck 0..1bin
....... @integrityCheckAlgorithm 0..1csBinding: IntegrityCheckAlgorithm (2.0.0) (required)
....... @language 0..1cs
....... @mediaType 0..1csBinding: MediaType (example)
....... @representation 0..1csBinding: Binary Data Encoding Value Set (required)
....... xmlText 0..1stAllows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
....... reference C0..1TELThe 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..1ED
...... setId 0..1II
...... versionNumber 0..1INT
... precondition 0..*Precondition
... sdtcPrecondition2 0..*Precondition2XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
... referenceRange 0..*InfrastructureRoot
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... realmCode 0..*CS
.... typeId 0..1II
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... @assigningAuthorityName 0..1st
..... @displayable 0..1bl
..... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
..... @extension 1..1st
.... templateId 0..*II
.... @typeCode 0..1csBinding: ActRelationshipType (2.0.0) (required)
Fixed Value: REFV
.... observationRange 1..1ObservationRange
... sdtcInFulfillmentOf1 0..*InFulfillmentOf1XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Observation.nullFlavorrequiredCDANullFlavor
Observation.typeId.nullFlavorrequiredCDANullFlavor
Observation.templateId:advance-directive-obs.nullFlavorrequiredCDANullFlavor
Observation.classCoderequiredFixed Value: OBS
Observation.moodCoderequiredFixed Value: EVN
Observation.codepreferredAdvanceDirectivesCategories
Observation.code.nullFlavorrequiredCDANullFlavor
Observation.code.translation:advanceDirective.nullFlavorrequiredCDANullFlavor
Observation.text.nullFlavorrequiredCDANullFlavor
Observation.text.compressionrequiredCDACompressionAlgorithm
Observation.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
Observation.text.mediaTypeexampleMediaType
Observation.text.representationrequiredBinaryDataEncoding
Observation.statusCoderequiredActStatus
Observation.statusCode.nullFlavorrequiredCDANullFlavor
Observation.effectiveTime.nullFlavorrequiredCDANullFlavor
Observation.effectiveTime.operatorrequiredSetOperator
Observation.priorityCodeexampleActPriority
Observation.languageCoderequiredAllLanguages
Observation.value.nullFlavorrequiredCDANullFlavor
Observation.value.coderequiredAdvanceDirectiveContentTypeSCT
Observation.interpretationCoderequiredObservationInterpretation
Observation.methodCodeexampleObservationMethod
Observation.participant:participant1.nullFlavorrequiredCDANullFlavor
Observation.participant:participant1.typeId.nullFlavorrequiredCDANullFlavor
Observation.participant:participant1.templateId:primary.nullFlavorrequiredCDANullFlavor
Observation.participant:participant1.typeCoderequiredFixed Value: VRF
Observation.participant:participant1.contextControlCoderequiredFixed Value: OP
Observation.participant:participant1.time.nullFlavorrequiredCDANullFlavor
Observation.participant:participant1.time.operatorrequiredSetOperator
Observation.participant:participant1.participantRole.nullFlavorrequiredCDANullFlavor
Observation.participant:participant1.participantRole.typeId.nullFlavorrequiredCDANullFlavor
Observation.participant:participant1.participantRole.classCoderequiredRoleClassRoot
Observation.participant:participant1.participantRole.codepreferredHealthcareProviderTaxonomy (a valid code from http://nucc.org/provider-taxonomy)
Observation.participant:participant1.participantRole.playingEntity.nullFlavorrequiredCDANullFlavor
Observation.participant:participant1.participantRole.playingEntity.typeId.nullFlavorrequiredCDANullFlavor
Observation.participant:participant1.participantRole.playingEntity.classCoderequiredEntityClassRoot
Observation.participant:participant1.participantRole.playingEntity.determinerCoderequiredFixed Value: INSTANCE
Observation.participant:participant1.participantRole.playingEntity.codeexampleEntityCode
Observation.participant:participant2.nullFlavorrequiredCDANullFlavor
Observation.participant:participant2.typeId.nullFlavorrequiredCDANullFlavor
Observation.participant:participant2.typeCoderequiredFixed Value: CST
Observation.participant:participant2.contextControlCoderequiredFixed Value: OP
Observation.participant:participant2.participantRole.nullFlavorrequiredCDANullFlavor
Observation.participant:participant2.participantRole.typeId.nullFlavorrequiredCDANullFlavor
Observation.participant:participant2.participantRole.classCoderequiredFixed Value: AGNT
Observation.participant:participant2.participantRole.codepreferredHealthcareAgentOrProxyChoices
Observation.participant:participant2.participantRole.playingEntity.nullFlavorrequiredCDANullFlavor
Observation.participant:participant2.participantRole.playingEntity.typeId.nullFlavorrequiredCDANullFlavor
Observation.participant:participant2.participantRole.playingEntity.classCoderequiredEntityClassRoot
Observation.participant:participant2.participantRole.playingEntity.determinerCoderequiredFixed Value: INSTANCE
Observation.participant:participant2.participantRole.playingEntity.codepreferredHealthcareAgentQualifier
Observation.reference:reference1.nullFlavorrequiredCDANullFlavor
Observation.reference:reference1.typeId.nullFlavorrequiredCDANullFlavor
Observation.reference:reference1.typeCoderequiredFixed Value: REFR
Observation.reference:reference1.externalDocument.nullFlavorrequiredCDANullFlavor
Observation.reference:reference1.externalDocument.typeId.nullFlavorrequiredCDANullFlavor
Observation.reference:reference1.externalDocument.classCoderequiredActClassDocument
Observation.reference:reference1.externalDocument.moodCoderequiredFixed Value: EVN
Observation.reference:reference1.externalDocument.codeexampleFHIRDocumentTypeCodes
Observation.reference:reference1.externalDocument.text.nullFlavorrequiredCDANullFlavor
Observation.reference:reference1.externalDocument.text.compressionrequiredCDACompressionAlgorithm
Observation.reference:reference1.externalDocument.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
Observation.reference:reference1.externalDocument.text.mediaTypeexampleMediaType
Observation.reference:reference1.externalDocument.text.representationrequiredBinaryDataEncoding
Observation.referenceRange.nullFlavorrequiredCDANullFlavor
Observation.referenceRange.typeId.nullFlavorrequiredCDANullFlavor
Observation.referenceRange.typeCoderequiredFixed Value: REFV

Constraints

IdGradePath(s)DetailsRequirements
1198-8699warningObservation.reference:reference1.externalDocument.text.referenceIf a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699).
:
1198-32449errorObservation.effectiveTime.highIf 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'
81-7296errorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr**SHALL NOT** have mixed content except for white space (CONF:81-7296)
: item.xmlText.empty()
81-9371errorObservation.participant:participant1.participantRole.playingEntity.nameThe 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()
81-9372errorObservation.participant:participant1.participantRole.playingEntity.nameThe string **SHALL NOT** contain name parts (CONF:81-9372).
: item.xmlText.exists() implies (item.delimiter | item.family | item.given | item.prefix | item.suffix).empty()
81-10024errorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrIf 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'))
81-10025errorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrIf 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-lserrorObservation.participant:participant1.participantRole.playingEntity.nameNo 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-cityerrorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHALL contain exactly one [1..1] city (CONF:81-7292).
: nullFlavor.exists() or item.city.count() = 1
shall-max-ad-partserrorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHALL 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-streetAddressLineerrorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHALL 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-addrwarningObservation.participant:participant2.participantRoleSHOULD contain addr
: addr.exists()
should-authorwarningObservationSHOULD contain author
: author.exists()
should-codewarningObservation.participant:participant1.participantRole, Observation.participant:participant2.participantRole, Observation.participant:participant2.participantRole.playingEntitySHOULD contain code
: code.exists()
should-countrywarningObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHOULD contain country
: nullFlavor.exists() or item.country.exists()
should-informantwarningObservationSHOULD contain informant
: informant.exists()
should-telecomwarningObservation.participant:participant2.participantRoleSHOULD contain telecom
: telecom.exists()
should-text-ref-valuewarningObservationSHOULD contain text/reference/@value
: text.reference.value.exists()
should-timewarningObservation.participant:participant1SHOULD contain time
: time.exists()
should-usewarningObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHOULD contain @use
: nullFlavor.exists() or use.exists()
value-onlyerrorObservation.participant:participant1.timeInterval fields SHALL not be present
: (low | high | width | center).empty()
value-starts-octothorpeerrorObservation.text.referenceIf 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:

  • The element Observation.templateId is sliced based on the values of value:root, value:extension
  • The element Observation.code.translation is sliced based on the values of value:code, value:codeSystem
  • The element Observation.participant is sliced based on the values of value:participantRole, value:typeCode
  • The element Observation.participant.templateId is sliced based on the value of value:root
  • The element Observation.reference is sliced based on the values of value:externalDocument, value:typeCode

Differential View

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C1..1ObservationXML 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..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:advance-directive-obs 1..1II
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.48
..... @extension 1..1stRequired Pattern: 2022-02-14
... @classCode 1..1csFixed Value: OBS
... @moodCode 1..1csFixed Value: EVN
... code 1..1CDBinding: Advance Directives Categories (preferred)
.... Slices for translation 1..*CDSlice: Unordered, Open by value:code, value:codeSystem
..... translation:advanceDirective 1..1CDAdvance directive
...... @code 1..1csRequired Pattern: 75320-2
...... @codeSystem 1..1oid, uuid, ruidLOINC
Required Pattern: 2.16.840.1.113883.6.1
... text 1..1EDSHOULD reference the portion of section narrative text corresponding to this entry
.... reference C0..1TELvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
... statusCode 1..1CS
.... @code 1..1csFixed Value: completed
... effectiveTime 1..1IVL_TS
.... low 1..1IVXB_TS
.... high C1..1IVXB_TS1198-32449: 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..1CD
.... @code 0..1csBinding: Advance Directive Content Type SCT (required)
.... @codeSystem 0..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.6.96
... author 0..*AuthorParticipationBase for all types and resources
... informant 0..*InformantSHOULD contain informant
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:participantRole, value:typeCode
.... participant:participant1 C0..*Participant2The participant "VRF" represents the clinician(s) who verified the patient advance directive.
should-time: SHOULD contain time
..... Slices for templateId 1..*IISlice: Unordered, Open by value:root
...... templateId:primary 1..1II
....... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.1.58
....... @extension 0..0
..... @typeCode 1..1csFixed Value: VRF
..... time C0..1IVL_TSvalue-only: Interval fields SHALL not be present
...... @value 0..1tsvalue should be used instead of low/high
..... participantRole C1..1ParticipantRoleshould-code: SHOULD contain code
...... code 0..1CEBinding: Healthcare Provider Taxonomy (preferred)
...... addr 0..*USRealmAddressBase for all types and resources
...... playingEntity 1..1PlayingEntity
....... name 1..1USRealmPersonNamePNUSFIELDEDBase for all types and resources
.... participant:participant2 0..*Participant2This 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..1csFixed Value: CST
..... participantRole C1..1ParticipantRoleshould-code: SHOULD contain code
should-addr: SHOULD contain addr
should-telecom: SHOULD contain telecom
...... @classCode 1..1csFixed Value: AGNT
...... code 0..1CEBinding: Healthcare Agent or Proxy Choices (preferred)
...... addr 0..1USRealmAddressBase for all types and resources
...... telecom 0..*TEL
...... playingEntity C1..1PlayingEntityshould-code: SHOULD contain code
....... code 0..1CEBinding: Healthcare Agent Qualifier (preferred)
....... name 1..1PNThe name of the healthcare agent.
... Slices for reference 1..*ReferenceSlice: Unordered, Open by value:externalDocument, value:typeCode
.... reference:reference1 1..*Reference
..... @typeCode 1..1csFixed Value: REFR
..... externalDocument 1..1ExternalDocument
...... id 1..*II
...... text 0..1ED
....... reference C0..1TELThe 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).

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Observation.codepreferredAdvanceDirectivesCategories
Observation.value.coderequiredAdvanceDirectiveContentTypeSCT
Observation.participant:participant1.participantRole.codepreferredHealthcareProviderTaxonomy (a valid code from http://nucc.org/provider-taxonomy)
Observation.participant:participant2.participantRole.codepreferredHealthcareAgentOrProxyChoices
Observation.participant:participant2.participantRole.playingEntity.codepreferredHealthcareAgentQualifier

Constraints

IdGradePath(s)DetailsRequirements
1198-8699warningObservation.reference:reference1.externalDocument.text.referenceIf a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699).
:
1198-32449errorObservation.effectiveTime.highIf 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-addrwarningObservation.participant:participant2.participantRoleSHOULD contain addr
: addr.exists()
should-authorwarningObservationSHOULD contain author
: author.exists()
should-codewarningObservation.participant:participant1.participantRole, Observation.participant:participant2.participantRole, Observation.participant:participant2.participantRole.playingEntitySHOULD contain code
: code.exists()
should-informantwarningObservationSHOULD contain informant
: informant.exists()
should-telecomwarningObservation.participant:participant2.participantRoleSHOULD contain telecom
: telecom.exists()
should-text-ref-valuewarningObservationSHOULD contain text/reference/@value
: text.reference.value.exists()
should-timewarningObservation.participant:participant1SHOULD contain time
: time.exists()
value-onlyerrorObservation.participant:participant1.timeInterval fields SHALL not be present
: (low | high | width | center).empty()
value-starts-octothorpeerrorObservation.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C1..1ObservationXML 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..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:advance-directive-obs 1..1II
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.48
..... @extension 1..1stRequired Pattern: 2022-02-14
... @classCode 1..1csBinding: ActClassObservation (2.0.0) (required)
Fixed Value: OBS
... @moodCode 1..1csBinding: XActMoodDocumentObservation (2.0.0) (required)
Fixed Value: EVN
... code 1..1CDBinding: Advance Directives Categories (preferred)
.... Slices for translation 1..*CDSlice: Unordered, Open by value:code, value:codeSystem
..... translation:advanceDirective 1..1CDAdvance directive
...... @code 1..1csRequired Pattern: 75320-2
...... @codeSystem 1..1oid, uuid, ruidLOINC
Required Pattern: 2.16.840.1.113883.6.1
... text 1..1EDSHOULD reference the portion of section narrative text corresponding to this entry
.... reference C0..1TELvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
... statusCode 1..1CSBinding: ActStatus (required)
.... @code 1..1csFixed Value: completed
... effectiveTime 1..1IVL_TS
.... low 1..1IVXB_TS
.... high C1..1IVXB_TS1198-32449: 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..1CD
.... @code 0..1csBinding: Advance Directive Content Type SCT (required)
.... @codeSystem 0..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.6.96
... author 0..*AuthorParticipationBase for all types and resources
... informant 0..*InformantSHOULD contain informant
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:participantRole, value:typeCode
.... participant:participant1 C0..*Participant2The participant "VRF" represents the clinician(s) who verified the patient advance directive.
should-time: SHOULD contain time
..... Slices for templateId 1..*IISlice: Unordered, Open by value:root
...... templateId:primary 1..1II
....... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.1.58
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: VRF
..... time C0..1IVL_TSvalue-only: Interval fields SHALL not be present
...... @value 0..1tsvalue should be used instead of low/high
Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
..... participantRole C1..1ParticipantRoleshould-code: SHOULD contain code
...... @classCode 1..1csBinding: RoleClassRoot (required)
...... code 0..1CEBinding: Healthcare Provider Taxonomy (preferred)
...... addr C0..*USRealmAddressBase for all types and resources
...... playingEntity 1..1PlayingEntity
....... @classCode 1..1csBinding: EntityClassRoot (required)
....... name C1..1USRealmPersonNamePNUSFIELDEDBase for all types and resources
.... participant:participant2 0..*Participant2This 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..1csBinding: ParticipationType (required)
Fixed Value: CST
..... participantRole C1..1ParticipantRoleshould-code: SHOULD contain code
should-addr: SHOULD contain addr
should-telecom: SHOULD contain telecom
...... @classCode 1..1csBinding: RoleClassRoot (required)
Fixed Value: AGNT
...... code 0..1CEBinding: Healthcare Agent or Proxy Choices (preferred)
...... addr C0..1USRealmAddressBase for all types and resources
...... telecom 0..*TEL
...... playingEntity C1..1PlayingEntityshould-code: SHOULD contain code
....... @classCode 1..1csBinding: EntityClassRoot (required)
....... code 0..1CEBinding: Healthcare Agent Qualifier (preferred)
....... name 1..1PNThe name of the healthcare agent.
... Slices for reference 1..*ReferenceSlice: Unordered, Open by value:externalDocument, value:typeCode
.... reference:reference1 1..*Reference
..... @typeCode 1..1csBinding: x_ActRelationshipExternalReference (required)
Fixed Value: REFR
..... externalDocument 1..1ExternalDocument
...... id 1..*II
...... text 0..1ED
....... reference C0..1TELThe 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).

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Observation.classCoderequiredFixed Value: OBS
Observation.moodCoderequiredFixed Value: EVN
Observation.codepreferredAdvanceDirectivesCategories
Observation.statusCoderequiredActStatus
Observation.value.coderequiredAdvanceDirectiveContentTypeSCT
Observation.participant:participant1.typeCoderequiredFixed Value: VRF
Observation.participant:participant1.participantRole.classCoderequiredRoleClassRoot
Observation.participant:participant1.participantRole.codepreferredHealthcareProviderTaxonomy (a valid code from http://nucc.org/provider-taxonomy)
Observation.participant:participant1.participantRole.playingEntity.classCoderequiredEntityClassRoot
Observation.participant:participant2.typeCoderequiredFixed Value: CST
Observation.participant:participant2.participantRole.classCoderequiredFixed Value: AGNT
Observation.participant:participant2.participantRole.codepreferredHealthcareAgentOrProxyChoices
Observation.participant:participant2.participantRole.playingEntity.classCoderequiredEntityClassRoot
Observation.participant:participant2.participantRole.playingEntity.codepreferredHealthcareAgentQualifier
Observation.reference:reference1.typeCoderequiredFixed Value: REFR

Constraints

IdGradePath(s)DetailsRequirements
1198-8699warningObservation.reference:reference1.externalDocument.text.referenceIf a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699).
:
1198-32449errorObservation.effectiveTime.highIf 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'
81-7296errorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr**SHALL NOT** have mixed content except for white space (CONF:81-7296)
: item.xmlText.empty()
81-9371errorObservation.participant:participant1.participantRole.playingEntity.nameThe 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()
81-9372errorObservation.participant:participant1.participantRole.playingEntity.nameThe string **SHALL NOT** contain name parts (CONF:81-9372).
: item.xmlText.exists() implies (item.delimiter | item.family | item.given | item.prefix | item.suffix).empty()
81-10024errorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrIf 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'))
81-10025errorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrIf 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-lserrorObservation.participant:participant1.participantRole.playingEntity.nameNo 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-cityerrorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHALL contain exactly one [1..1] city (CONF:81-7292).
: nullFlavor.exists() or item.city.count() = 1
shall-max-ad-partserrorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHALL 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-streetAddressLineerrorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHALL 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-addrwarningObservation.participant:participant2.participantRoleSHOULD contain addr
: addr.exists()
should-authorwarningObservationSHOULD contain author
: author.exists()
should-codewarningObservation.participant:participant1.participantRole, Observation.participant:participant2.participantRole, Observation.participant:participant2.participantRole.playingEntitySHOULD contain code
: code.exists()
should-countrywarningObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHOULD contain country
: nullFlavor.exists() or item.country.exists()
should-informantwarningObservationSHOULD contain informant
: informant.exists()
should-telecomwarningObservation.participant:participant2.participantRoleSHOULD contain telecom
: telecom.exists()
should-text-ref-valuewarningObservationSHOULD contain text/reference/@value
: text.reference.value.exists()
should-timewarningObservation.participant:participant1SHOULD contain time
: time.exists()
should-usewarningObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHOULD contain @use
: nullFlavor.exists() or use.exists()
value-onlyerrorObservation.participant:participant1.timeInterval fields SHALL not be present
: (low | high | width | center).empty()
value-starts-octothorpeerrorObservation.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C1..1ObservationXML 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..1csBinding: CDANullFlavor (required)
... realmCode 0..*CS
... typeId 0..1II
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @assigningAuthorityName 0..1st
.... @displayable 0..1bl
.... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
.... @extension 1..1st
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:advance-directive-obs 1..1II
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... @assigningAuthorityName 0..1st
..... @displayable 0..1bl
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.48
..... @extension 1..1stRequired Pattern: 2022-02-14
... @classCode 1..1csBinding: ActClassObservation (2.0.0) (required)
Fixed Value: OBS
... @moodCode 1..1csBinding: XActMoodDocumentObservation (2.0.0) (required)
Fixed Value: EVN
... @negationInd 0..1bl
... id 1..*II
... code 1..1CDBinding: Advance Directives Categories (preferred)
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @code 0..1cs
.... @codeSystem 0..1oid, uuid, ruid
.... @codeSystemName 0..1st
.... @codeSystemVersion 0..1st
.... @displayName 0..1st
.... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1ED
.... qualifier 0..*CR
.... Slices for translation 1..*CDSlice: Unordered, Open by value:code, value:codeSystem
..... translation:advanceDirective 1..1CDAdvance directive
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @code 1..1csRequired Pattern: 75320-2
...... @codeSystem 1..1oid, uuid, ruidLOINC
Required Pattern: 2.16.840.1.113883.6.1
...... @codeSystemName 0..1st
...... @codeSystemVersion 0..1st
...... @displayName 0..1st
...... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
...... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
...... originalText 0..1ED
...... qualifier 0..*CR
...... translation 0..*CD
... derivationExpr 0..1ST
... text 1..1EDSHOULD reference the portion of section narrative text corresponding to this entry
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @compression 0..1csBinding: CompressionAlgorithm (required)
.... @integrityCheck 0..1bin
.... @integrityCheckAlgorithm 0..1csBinding: IntegrityCheckAlgorithm (2.0.0) (required)
.... @language 0..1cs
.... @mediaType 0..1csBinding: MediaType (example)
.... @representation 0..1csBinding: Binary Data Encoding Value Set (required)
.... xmlText 0..1stAllows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
.... reference C0..1TELvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
.... thumbnail 0..1ED
... statusCode 1..1CSBinding: ActStatus (required)
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @code 1..1csFixed Value: completed
.... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 1..1IVL_TS
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @value 0..1tsDate Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
.... @operator 0..1csBinding: SetOperator (required)
.... low 1..1IVXB_TS
.... center 0..1TS
.... width 0..1PQ
.... high C1..1IVXB_TS1198-32449: 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..1CEBinding: ActPriority (example)
... repeatNumber 0..1IVL_INT
... languageCode 0..1CSBinding: AllLanguages (required)
... value 1..1CD
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @code 0..1csBinding: Advance Directive Content Type SCT (required)
.... @codeSystem 0..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.6.96
.... @codeSystemName 0..1st
.... @codeSystemVersion 0..1st
.... @displayName 0..1st
.... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1ED
.... qualifier 0..*CR
.... translation 0..*CD
... interpretationCode 0..*CEBinding: ObservationInterpretation (required)
... methodCode 0..*CEBinding: ObservationMethod (example)
... targetSiteCode 0..*CD
... subject 0..1Subject
... specimen 0..*Specimen
... performer 0..*Performer2
... author 0..*AuthorParticipationBase for all types and resources
... informant 0..*InformantSHOULD contain informant
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:participantRole, value:typeCode
.... participant:participant1 C0..*Participant2The participant "VRF" represents the clinician(s) who verified the patient advance directive.
should-time: SHOULD contain time
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... Slices for templateId 1..*IISlice: Unordered, Open by value:root
...... templateId:primary 1..1II
....... @nullFlavor 0..1csBinding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1st
....... @displayable 0..1bl
....... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.1.58
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: VRF
..... @contextControlCode 0..1csBinding: ContextControl (required)
Fixed Value: OP
..... sdtcFunctionCode 0..1CEXML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time C0..1IVL_TSvalue-only: Interval fields SHALL not be present
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @value 0..1tsvalue should be used instead of low/high
Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
...... @operator 0..1csBinding: SetOperator (required)
...... low 0..1IVXB_TS
...... center 0..1TS
...... width 0..1PQ
...... high 0..1IVXB_TS
..... awarenessCode 0..1CE
..... participantRole C1..1ParticipantRoleshould-code: SHOULD contain code
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... realmCode 0..*CS
...... typeId 0..1II
....... @nullFlavor 0..1csBinding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1st
....... @displayable 0..1bl
....... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1st
...... templateId 0..*II
...... @classCode 1..1csBinding: RoleClassRoot (required)
...... id 0..*II
...... sdtcIdentifiedBy 0..*IdentifiedByXML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1CEBinding: Healthcare Provider Taxonomy (preferred)
...... addr C0..*USRealmAddressBase for all types and resources
...... telecom 0..*TEL
...... playingDevice 0..1Device
...... playingEntity 1..1PlayingEntity
....... @nullFlavor 0..1csBinding: CDANullFlavor (required)
....... realmCode 0..*CS
....... typeId 0..1II
........ @nullFlavor 0..1csBinding: CDANullFlavor (required)
........ @assigningAuthorityName 0..1st
........ @displayable 0..1bl
........ @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
........ @extension 1..1st
....... templateId 0..*II
....... @classCode 1..1csBinding: EntityClassRoot (required)
....... @determinerCode 0..1csBinding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... code 0..1CEBinding: EntityCode (example)
....... quantity 0..*PQ
....... name C1..1USRealmPersonNamePNUSFIELDEDBase for all types and resources
....... sdtcBirthTime 0..1TSXML Namespace: urn:hl7-org:sdtc
XML: birthTime (urn:hl7-org:sdtc)
....... desc 0..1ED
...... scopingEntity 0..1Entity
.... participant:participant2 0..*Participant2This 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..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: CST
..... @contextControlCode 0..1csBinding: ContextControl (required)
Fixed Value: OP
..... sdtcFunctionCode 0..1CEXML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1IVL_TS
..... awarenessCode 0..1CE
..... participantRole C1..1ParticipantRoleshould-code: SHOULD contain code
should-addr: SHOULD contain addr
should-telecom: SHOULD contain telecom
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... realmCode 0..*CS
...... typeId 0..1II
....... @nullFlavor 0..1csBinding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1st
....... @displayable 0..1bl
....... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1st
...... templateId 0..*II
...... @classCode 1..1csBinding: RoleClassRoot (required)
Fixed Value: AGNT
...... id 0..*II
...... sdtcIdentifiedBy 0..*IdentifiedByXML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1CEBinding: Healthcare Agent or Proxy Choices (preferred)
...... addr C0..1USRealmAddressBase for all types and resources
...... telecom 0..*TEL
...... playingDevice 0..1Device
...... playingEntity C1..1PlayingEntityshould-code: SHOULD contain code
....... @nullFlavor 0..1csBinding: CDANullFlavor (required)
....... realmCode 0..*CS
....... typeId 0..1II
........ @nullFlavor 0..1csBinding: CDANullFlavor (required)
........ @assigningAuthorityName 0..1st
........ @displayable 0..1bl
........ @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
........ @extension 1..1st
....... templateId 0..*II
....... @classCode 1..1csBinding: EntityClassRoot (required)
....... @determinerCode 0..1csBinding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... code 0..1CEBinding: Healthcare Agent Qualifier (preferred)
....... quantity 0..*PQ
....... name 1..1PNThe name of the healthcare agent.
....... sdtcBirthTime 0..1TSXML Namespace: urn:hl7-org:sdtc
XML: birthTime (urn:hl7-org:sdtc)
....... desc 0..1ED
...... scopingEntity 0..1Entity
... entryRelationship 0..*EntryRelationship
... Slices for reference 1..*ReferenceSlice: Unordered, Open by value:externalDocument, value:typeCode
.... reference:reference1 1..*Reference
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipExternalReference (required)
Fixed Value: REFR
..... seperatableInd 0..1BL
..... externalAct 0..1ExternalAct
..... externalObservation 0..1ExternalObservation
..... externalProcedure 0..1ExternalProcedure
..... externalDocument 1..1ExternalDocument
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... realmCode 0..*CS
...... typeId 0..1II
....... @nullFlavor 0..1csBinding: CDANullFlavor (required)
....... @assigningAuthorityName 0..1st
....... @displayable 0..1bl
....... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
....... @extension 1..1st
...... templateId 0..*II
...... @classCode 0..1csBinding: ActClassDocument (required)
...... @moodCode 0..1csBinding: ActMood (required)
Fixed Value: EVN
...... id 1..*II
...... code 0..1CDBinding: FHIRDocumentTypeCodes (example)
...... text 0..1ED
....... @nullFlavor 0..1csBinding: CDANullFlavor (required)
....... @compression 0..1csBinding: CompressionAlgorithm (required)
....... @integrityCheck 0..1bin
....... @integrityCheckAlgorithm 0..1csBinding: IntegrityCheckAlgorithm (2.0.0) (required)
....... @language 0..1cs
....... @mediaType 0..1csBinding: MediaType (example)
....... @representation 0..1csBinding: Binary Data Encoding Value Set (required)
....... xmlText 0..1stAllows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
....... reference C0..1TELThe 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..1ED
...... setId 0..1II
...... versionNumber 0..1INT
... precondition 0..*Precondition
... sdtcPrecondition2 0..*Precondition2XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
... referenceRange 0..*InfrastructureRoot
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... realmCode 0..*CS
.... typeId 0..1II
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... @assigningAuthorityName 0..1st
..... @displayable 0..1bl
..... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
..... @extension 1..1st
.... templateId 0..*II
.... @typeCode 0..1csBinding: ActRelationshipType (2.0.0) (required)
Fixed Value: REFV
.... observationRange 1..1ObservationRange
... sdtcInFulfillmentOf1 0..*InFulfillmentOf1XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Observation.nullFlavorrequiredCDANullFlavor
Observation.typeId.nullFlavorrequiredCDANullFlavor
Observation.templateId:advance-directive-obs.nullFlavorrequiredCDANullFlavor
Observation.classCoderequiredFixed Value: OBS
Observation.moodCoderequiredFixed Value: EVN
Observation.codepreferredAdvanceDirectivesCategories
Observation.code.nullFlavorrequiredCDANullFlavor
Observation.code.translation:advanceDirective.nullFlavorrequiredCDANullFlavor
Observation.text.nullFlavorrequiredCDANullFlavor
Observation.text.compressionrequiredCDACompressionAlgorithm
Observation.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
Observation.text.mediaTypeexampleMediaType
Observation.text.representationrequiredBinaryDataEncoding
Observation.statusCoderequiredActStatus
Observation.statusCode.nullFlavorrequiredCDANullFlavor
Observation.effectiveTime.nullFlavorrequiredCDANullFlavor
Observation.effectiveTime.operatorrequiredSetOperator
Observation.priorityCodeexampleActPriority
Observation.languageCoderequiredAllLanguages
Observation.value.nullFlavorrequiredCDANullFlavor
Observation.value.coderequiredAdvanceDirectiveContentTypeSCT
Observation.interpretationCoderequiredObservationInterpretation
Observation.methodCodeexampleObservationMethod
Observation.participant:participant1.nullFlavorrequiredCDANullFlavor
Observation.participant:participant1.typeId.nullFlavorrequiredCDANullFlavor
Observation.participant:participant1.templateId:primary.nullFlavorrequiredCDANullFlavor
Observation.participant:participant1.typeCoderequiredFixed Value: VRF
Observation.participant:participant1.contextControlCoderequiredFixed Value: OP
Observation.participant:participant1.time.nullFlavorrequiredCDANullFlavor
Observation.participant:participant1.time.operatorrequiredSetOperator
Observation.participant:participant1.participantRole.nullFlavorrequiredCDANullFlavor
Observation.participant:participant1.participantRole.typeId.nullFlavorrequiredCDANullFlavor
Observation.participant:participant1.participantRole.classCoderequiredRoleClassRoot
Observation.participant:participant1.participantRole.codepreferredHealthcareProviderTaxonomy (a valid code from http://nucc.org/provider-taxonomy)
Observation.participant:participant1.participantRole.playingEntity.nullFlavorrequiredCDANullFlavor
Observation.participant:participant1.participantRole.playingEntity.typeId.nullFlavorrequiredCDANullFlavor
Observation.participant:participant1.participantRole.playingEntity.classCoderequiredEntityClassRoot
Observation.participant:participant1.participantRole.playingEntity.determinerCoderequiredFixed Value: INSTANCE
Observation.participant:participant1.participantRole.playingEntity.codeexampleEntityCode
Observation.participant:participant2.nullFlavorrequiredCDANullFlavor
Observation.participant:participant2.typeId.nullFlavorrequiredCDANullFlavor
Observation.participant:participant2.typeCoderequiredFixed Value: CST
Observation.participant:participant2.contextControlCoderequiredFixed Value: OP
Observation.participant:participant2.participantRole.nullFlavorrequiredCDANullFlavor
Observation.participant:participant2.participantRole.typeId.nullFlavorrequiredCDANullFlavor
Observation.participant:participant2.participantRole.classCoderequiredFixed Value: AGNT
Observation.participant:participant2.participantRole.codepreferredHealthcareAgentOrProxyChoices
Observation.participant:participant2.participantRole.playingEntity.nullFlavorrequiredCDANullFlavor
Observation.participant:participant2.participantRole.playingEntity.typeId.nullFlavorrequiredCDANullFlavor
Observation.participant:participant2.participantRole.playingEntity.classCoderequiredEntityClassRoot
Observation.participant:participant2.participantRole.playingEntity.determinerCoderequiredFixed Value: INSTANCE
Observation.participant:participant2.participantRole.playingEntity.codepreferredHealthcareAgentQualifier
Observation.reference:reference1.nullFlavorrequiredCDANullFlavor
Observation.reference:reference1.typeId.nullFlavorrequiredCDANullFlavor
Observation.reference:reference1.typeCoderequiredFixed Value: REFR
Observation.reference:reference1.externalDocument.nullFlavorrequiredCDANullFlavor
Observation.reference:reference1.externalDocument.typeId.nullFlavorrequiredCDANullFlavor
Observation.reference:reference1.externalDocument.classCoderequiredActClassDocument
Observation.reference:reference1.externalDocument.moodCoderequiredFixed Value: EVN
Observation.reference:reference1.externalDocument.codeexampleFHIRDocumentTypeCodes
Observation.reference:reference1.externalDocument.text.nullFlavorrequiredCDANullFlavor
Observation.reference:reference1.externalDocument.text.compressionrequiredCDACompressionAlgorithm
Observation.reference:reference1.externalDocument.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
Observation.reference:reference1.externalDocument.text.mediaTypeexampleMediaType
Observation.reference:reference1.externalDocument.text.representationrequiredBinaryDataEncoding
Observation.referenceRange.nullFlavorrequiredCDANullFlavor
Observation.referenceRange.typeId.nullFlavorrequiredCDANullFlavor
Observation.referenceRange.typeCoderequiredFixed Value: REFV

Constraints

IdGradePath(s)DetailsRequirements
1198-8699warningObservation.reference:reference1.externalDocument.text.referenceIf a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699).
:
1198-32449errorObservation.effectiveTime.highIf 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'
81-7296errorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addr**SHALL NOT** have mixed content except for white space (CONF:81-7296)
: item.xmlText.empty()
81-9371errorObservation.participant:participant1.participantRole.playingEntity.nameThe 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()
81-9372errorObservation.participant:participant1.participantRole.playingEntity.nameThe string **SHALL NOT** contain name parts (CONF:81-9372).
: item.xmlText.exists() implies (item.delimiter | item.family | item.given | item.prefix | item.suffix).empty()
81-10024errorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrIf 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'))
81-10025errorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrIf 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-lserrorObservation.participant:participant1.participantRole.playingEntity.nameNo 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-cityerrorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHALL contain exactly one [1..1] city (CONF:81-7292).
: nullFlavor.exists() or item.city.count() = 1
shall-max-ad-partserrorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHALL 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-streetAddressLineerrorObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHALL 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-addrwarningObservation.participant:participant2.participantRoleSHOULD contain addr
: addr.exists()
should-authorwarningObservationSHOULD contain author
: author.exists()
should-codewarningObservation.participant:participant1.participantRole, Observation.participant:participant2.participantRole, Observation.participant:participant2.participantRole.playingEntitySHOULD contain code
: code.exists()
should-countrywarningObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHOULD contain country
: nullFlavor.exists() or item.country.exists()
should-informantwarningObservationSHOULD contain informant
: informant.exists()
should-telecomwarningObservation.participant:participant2.participantRoleSHOULD contain telecom
: telecom.exists()
should-text-ref-valuewarningObservationSHOULD contain text/reference/@value
: text.reference.value.exists()
should-timewarningObservation.participant:participant1SHOULD contain time
: time.exists()
should-usewarningObservation.participant:participant1.participantRole.addr, Observation.participant:participant2.participantRole.addrSHOULD contain @use
: nullFlavor.exists() or use.exists()
value-onlyerrorObservation.participant:participant1.timeInterval fields SHALL not be present
: (low | high | width | center).empty()
value-starts-octothorpeerrorObservation.text.referenceIf 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:

  • The element Observation.templateId is sliced based on the values of value:root, value:extension
  • The element Observation.code.translation is sliced based on the values of value:code, value:codeSystem
  • The element Observation.participant is sliced based on the values of value:participantRole, value:typeCode
  • The element Observation.participant.templateId is sliced based on the value of value:root
  • The element Observation.reference is sliced based on the values of value:externalDocument, value:typeCode

 

Other representations of profile: CSV, Excel