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: HealthConcernAct - Detailed Descriptions

Draft as of 2023-12-21

Definitions for the HealthConcernAct logical model.

Guidance on how to interpret the contents of this table can be found here

0. Act
Logical ContainerClinicalDocument (CDA Class)
ValidationInstances of this type are validated by templateId
XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
should-author: SHOULD contain author (author.exists())
2. Act.templateId
Control1..?
SlicingThis element introduces a set of slices on Act.templateId. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ root
  • value @ extension
4. Act.templateId:health-concern-act
Slice Namehealth-concern-act
Control1..1
6. Act.templateId:health-concern-act.root
Control1..?
Pattern Value2.16.840.1.113883.10.20.22.4.132
8. Act.templateId:health-concern-act.extension
Control1..?
Pattern Value2022-06-01
10. Act.classCode
Comments

SHALL contain exactly one [1..1] @classCode="ACT" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:4515-30750).

Fixed ValueACT
12. Act.moodCode
Comments

SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001) (CONF:4515-30751).

Fixed ValueEVN
14. Act.id
Comments

SHALL contain at least one [1..*] id (CONF:4515-30754).

Control1..?
16. Act.code
ShortFunctional Status
Comments

SHALL contain exactly one [1..1] code (CONF:4515-32310).

18. Act.code.code
Control1..?
Pattern Value75310-3
20. Act.code.codeSystem
ShortLOINC
Control1..?
Pattern Value2.16.840.1.113883.6.1
22. Act.text
ShortSHOULD reference the portion of section narrative text corresponding to this entry
24. Act.text.reference
Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
26. Act.statusCode
Comments

SHALL contain exactly one [1..1] statusCode (CONF:4515-30758).

Control1..?
28. Act.statusCode.code
Comments

This statusCode SHALL contain exactly one [1..1] @code, which SHALL be selected from ValueSet ProblemAct statusCode urn:oid:2.16.840.1.113883.11.20.9.19 STATIC (CONF:4515-32313).

Control1..?
BindingThe codes SHALL be taken from ProblemAct statusCode
30. Act.effectiveTime
Comments

MAY contain zero or one [0..1] effectiveTime (CONF:4515-30759).

32. Act.author
ShortA health concern may be a patient or provider concern. If the author is set to the recordTarget (patient), this is a patient concern. If the author is set to a provider, this is a provider concern. If both patient and provider are set as authors, this is a concern of both the patient and the provider.
Comments

SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:4515-31546).

Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
34. Act.entryRelationship
ShortWhen this Health Concern Act is a Social Determinant of Health Health Concern it **SHOULD** contain zero or more [0..*] entryRelationship subentries such that it contains an observation with an observation/value selected from ValueSet [Social Determinant of Health Conditions 2.16.840.1.113762.1.4.1196.788](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1196.788/expansion) **DYNAMIC** (CONF:4515-32962).
Comments

MAY contain zero or more [0..*] entryRelationship (CONF:4515-31549) such that it

SlicingThis element introduces a set of slices on Act.entryRelationship. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • profile @ act
  • profile @ observation
  • profile @ organizer
  • value @ typeCode
36. Act.entryRelationship:observations
Slice Nameobservations
Control0..*
38. Act.entryRelationship:observations.typeCode
Fixed ValueREFR
40. Act.entryRelationship:observations.observation
Control1..?
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Problem Observation, Allergy - Intolerance Observation, Assessment Scale Observation, Self-Care Activities (ADL and IADL), Mental Status Observation, Smoking Status - Meaningful Use, Functional Status Observation, Nutrition Assessment, Pregnancy Observation, Reaction Observation, Result Observation, Sensory Status, Social History Observation, Substance or Device Allergy - Intolerance Observation, Tobacco Use, Vital Sign Observation, Longitudinal Care Wound Observation, Problem Observation, Caregiver Characteristics, Cultural and Religious Observation, Characteristics of Home Environment, Nutritional Status Observation, Priority Preference)
42. Act.entryRelationship:acts
Slice Nameacts
Control0..*
44. Act.entryRelationship:acts.typeCode
Fixed ValueREFR
46. Act.entryRelationship:acts.act
Control1..?
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Encounter Diagnosis, Hospital Admission Diagnosis, Postprocedure Diagnosis, Preoperative Diagnosis, Entry Reference)
48. Act.entryRelationship:organizers
Slice Nameorganizers
Control0..*
50. Act.entryRelationship:organizers.typeCode
Fixed ValueREFR
52. Act.entryRelationship:organizers.organizer
Control1..?
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer(Family History Organizer, Result Organizer)
54. Act.entryRelationship:related-entries
Slice Namerelated-entries
ShortWhere a Health Concern needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry. This may also be used to refer to other Health Concern Acts where there is a general relationship between the source and the target (Health Concern REFERS TO Health Concern). For example, a patient has 2 health concerns identified in a CARE Plan: Failure to Thrive and Poor Feeding, while it could be that one may have caused the other, at the time of care planning and documentation it is not necessary, nor desirable to have to assert what caused what. The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
Comments

MAY contain zero or more [0..*] entryRelationship (CONF:4515-31157) such that it

Control0..*
56. Act.entryRelationship:related-entries.typeCode
Comments

SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-31158).

Fixed ValueREFR
58. Act.entryRelationship:related-entries.act
Comments

SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32106).

Control1..?
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
60. Act.entryRelationship:component-health-concern-acts
Slice Namecomponent-health-concern-acts
ShortThe following entryRelationship represents the relationship between two Health Concern Acts where the target is a component of the source (Health Concern HAS COMPONENT Health Concern). For example, a patient has an Impaired Mobility Health Concern. There may then be the need to document several component health concerns, such as "Unable to Transfer Bed to Chair","Unable to Rise from Commode", "Short of Breath Walking with Walker". The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
Comments

MAY contain zero or more [0..*] entryRelationship (CONF:4515-31160) such that it

Control0..*
Invariants4515-32745: The Entry Reference template **SHALL** contain an id that references a Health Concern Act (CONF:4515-32745). (%resource.descendants().ofType(CDA.Act).where(templateId.exists($this.root = '2.16.840.1.113883.10.20.22.4.132' and $this.extension = '2022-06-01') and id.exists($this.root = %context.act.id.first().root and $this.extension ~ %context.act.id.first().extension)))
62. Act.entryRelationship:component-health-concern-acts.typeCode
Comments

SHALL contain exactly one [1..1] @typeCode="COMP" Has component (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-31161).

Fixed ValueCOMP
64. Act.entryRelationship:component-health-concern-acts.act
Comments

SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32107).

Control1..?
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
66. Act.reference
ShortWhere it is necessary to reference an external clinical document such as a Referral document, Discharge Summary document etc., the External Document Reference template can be used to reference this document. However, if this Care Plan document is replacing or appending another Care Plan document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.
Comments

MAY contain zero or more [0..*] reference (CONF:4515-32757).

68. Act.reference.typeCode
Comments

The reference, if present, SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32758).

Fixed ValueREFR
70. Act.reference.externalDocument
Comments

The reference, if present, SHALL contain exactly one [1..1] External Document Reference (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.115:2014-06-09) (CONF:4515-32759).

Control1..?
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument(External Document Reference)

Guidance on how to interpret the contents of this table can be found here

0. Act
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.


Base definition for all types defined in FHIR type system.

ShortBase for all types and resources
Control10..1*
Is Modifierfalse
Logical ContainerClinicalDocument (CDA Class)
ValidationInstances of this type are validated by templateId
XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
should-author: SHOULD contain author (author.exists())
2. Act.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control1..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
SlicingThis element introduces a set of slices on Act.templateId. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ root
  • value @ extension
4. Act.templateId:health-concern-act
Slice Namehealth-concern-act
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
6. Act.templateId:health-concern-act.root
Definition

A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelRoot
Pattern Value2.16.840.1.113883.10.20.22.4.132
8. Act.templateId:health-concern-act.extension
Definition

A character string as a unique identifier within the scope of the identifier root.

Control1..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExtension
Pattern Value2022-06-01
10. Act.classCode
Comments

SHALL contain exactly one [1..1] @classCode="ACT" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:4515-30750).

Control1..1
BindingThe codes SHALL be taken from XActClassDocumentEntryAct (2.0.0)
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueACT
12. Act.moodCode
Comments

SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001) (CONF:4515-30751).

Control1..1
BindingThe codes SHALL be taken from XDocumentActMood (2.0.0)
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueEVN
14. Act.id
Comments

SHALL contain at least one [1..*] id (CONF:4515-30754).

Control1..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
16. Act.code
ShortFunctional Status
Comments

SHALL contain exactly one [1..1] code (CONF:4515-32310).

Control1..1
BindingFor example codes, see v3 Code System ActCode
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
18. Act.code.code
Definition

The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

Control1..1
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode
Pattern Value75310-3
20. Act.code.codeSystem
Definition

Specifies the code system that defines the code.

ShortLOINC
Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode System
Pattern Value2.16.840.1.113883.6.1
22. Act.text
ShortSHOULD reference the portion of section narrative text corresponding to this entry
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
24. Act.text.reference
Definition

A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
LabelReference
Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
26. Act.statusCode
Comments

SHALL contain exactly one [1..1] statusCode (CONF:4515-30758).

Control1..1
BindingThe codes SHALL be taken from ActStatus
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
28. Act.statusCode.code
Definition

The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

Comments

This statusCode SHALL contain exactly one [1..1] @code, which SHALL be selected from ValueSet ProblemAct statusCode urn:oid:2.16.840.1.113883.11.20.9.19 STATIC (CONF:4515-32313).

Control1..1
BindingThe codes SHALL be taken from ProblemAct statusCode
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode
30. Act.statusCode.codeSystem
Definition

Specifies the code system that defines the code.

Control0..0
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode System
32. Act.statusCode.codeSystemName
Definition

The common name of the coding system.

Control0..0
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode System Name
34. Act.statusCode.codeSystemVersion
Definition

If applicable, a version descriptor defined specifically for the given code system.

Control0..0
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode System Version
36. Act.statusCode.displayName
Definition

A name or title for the code, under which the sending system shows the code value to its users.

Control0..0
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelDisplay Name
38. Act.statusCode.originalText
Definition

The text or phrase used as the basis for the coding.

Control0..0
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
LabelOriginal Text
40. Act.statusCode.qualifier
Definition

Specifies additional codes that increase the specificity of the the primary code.

Control0..0
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
LabelQualifier
42. Act.statusCode.translation
Definition

A set of other concept descriptors that translate this concept descriptor into other code systems.

Control0..0
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
XML FormatThe type of this property is determined using the xsi:typeattribute.
LabelTranslation
44. Act.effectiveTime
Comments

MAY contain zero or one [0..1] effectiveTime (CONF:4515-30759).

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
46. Act.author
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

ShortA health concern may be a patient or provider concern. If the author is set to the recordTarget (patient), this is a patient concern. If the author is set to a provider, this is a provider concern. If both patient and provider are set as authors, this is a concern of both the patient and the provider.
Comments

SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:4515-31546).

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
Is Modifierfalse
48. Act.entryRelationship
ShortWhen this Health Concern Act is a Social Determinant of Health Health Concern it **SHOULD** contain zero or more [0..*] entryRelationship subentries such that it contains an observation with an observation/value selected from ValueSet [Social Determinant of Health Conditions 2.16.840.1.113762.1.4.1196.788](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1196.788/expansion) **DYNAMIC** (CONF:4515-32962).
Comments

MAY contain zero or more [0..*] entryRelationship (CONF:4515-31549) such that it

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
SlicingThis element introduces a set of slices on Act.entryRelationship. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • profile @ act
  • profile @ observation
  • profile @ organizer
  • value @ typeCode
50. Act.entryRelationship:observations
Slice Nameobservations
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
52. Act.entryRelationship:observations.typeCode
Control1..1
BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueREFR
54. Act.entryRelationship:observations.observation
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

ShortBase for all types and resources
Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Problem Observation, Allergy - Intolerance Observation, Assessment Scale Observation, Self-Care Activities (ADL and IADL), Mental Status Observation, Smoking Status - Meaningful Use, Functional Status Observation, Nutrition Assessment, Pregnancy Observation, Reaction Observation, Result Observation, Sensory Status, Social History Observation, Substance or Device Allergy - Intolerance Observation, Tobacco Use, Vital Sign Observation, Longitudinal Care Wound Observation, Problem Observation, Caregiver Characteristics, Cultural and Religious Observation, Characteristics of Home Environment, Nutritional Status Observation, Priority Preference)
Is Modifierfalse
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
should-author: SHOULD contain author (author.exists())
56. Act.entryRelationship:acts
Slice Nameacts
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
58. Act.entryRelationship:acts.typeCode
Control1..1
BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueREFR
60. Act.entryRelationship:acts.act
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

ShortBase for all types and resources
Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Encounter Diagnosis, Hospital Admission Diagnosis, Postprocedure Diagnosis, Preoperative Diagnosis, Entry Reference)
Is Modifierfalse
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
62. Act.entryRelationship:organizers
Slice Nameorganizers
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
64. Act.entryRelationship:organizers.typeCode
Control1..1
BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueREFR
66. Act.entryRelationship:organizers.organizer
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

ShortBase for all types and resources
Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer(Family History Organizer, Result Organizer)
Is Modifierfalse
Invariantsshould-sdtctext-ref-value: SHOULD contain text/reference/@value (sdtcText.reference.value.exists())
68. Act.entryRelationship:related-entries
Slice Namerelated-entries
ShortWhere a Health Concern needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry. This may also be used to refer to other Health Concern Acts where there is a general relationship between the source and the target (Health Concern REFERS TO Health Concern). For example, a patient has 2 health concerns identified in a CARE Plan: Failure to Thrive and Poor Feeding, while it could be that one may have caused the other, at the time of care planning and documentation it is not necessary, nor desirable to have to assert what caused what. The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
Comments

MAY contain zero or more [0..*] entryRelationship (CONF:4515-31157) such that it

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
70. Act.entryRelationship:related-entries.typeCode
Comments

SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-31158).

Control1..1
BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueREFR
72. Act.entryRelationship:related-entries.act
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

ShortBase for all types and resources
Comments

SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32106).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
Is Modifierfalse
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
74. Act.entryRelationship:component-health-concern-acts
Slice Namecomponent-health-concern-acts
ShortThe following entryRelationship represents the relationship between two Health Concern Acts where the target is a component of the source (Health Concern HAS COMPONENT Health Concern). For example, a patient has an Impaired Mobility Health Concern. There may then be the need to document several component health concerns, such as "Unable to Transfer Bed to Chair","Unable to Rise from Commode", "Short of Breath Walking with Walker". The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
Comments

MAY contain zero or more [0..*] entryRelationship (CONF:4515-31160) such that it

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
Invariants4515-32745: The Entry Reference template **SHALL** contain an id that references a Health Concern Act (CONF:4515-32745). (%resource.descendants().ofType(CDA.Act).where(templateId.exists($this.root = '2.16.840.1.113883.10.20.22.4.132' and $this.extension = '2022-06-01') and id.exists($this.root = %context.act.id.first().root and $this.extension ~ %context.act.id.first().extension)))
76. Act.entryRelationship:component-health-concern-acts.typeCode
Comments

SHALL contain exactly one [1..1] @typeCode="COMP" Has component (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-31161).

Control1..1
BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueCOMP
78. Act.entryRelationship:component-health-concern-acts.act
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

ShortBase for all types and resources
Comments

SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32107).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
Is Modifierfalse
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
80. Act.reference
ShortWhere it is necessary to reference an external clinical document such as a Referral document, Discharge Summary document etc., the External Document Reference template can be used to reference this document. However, if this Care Plan document is replacing or appending another Care Plan document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.
Comments

MAY contain zero or more [0..*] reference (CONF:4515-32757).

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
82. Act.reference.typeCode
Comments

The reference, if present, SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32758).

Control1..1
BindingThe codes SHALL be taken from x_ActRelationshipExternalReference
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueREFR
84. Act.reference.externalDocument
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

ShortBase for all types and resources
Comments

The reference, if present, SHALL contain exactly one [1..1] External Document Reference (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.115:2014-06-09) (CONF:4515-32759).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument(External Document Reference)
Is Modifierfalse
Invariantsshould-setId: SHOULD contain setId (setId.exists())
should-versionNumber: SHOULD contain versionNumber (versionNumber.exists())

Guidance on how to interpret the contents of this table can be found here

0. Act
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

ShortBase for all types and resources
Control1..1
Is Modifierfalse
Logical ContainerClinicalDocument (CDA Class)
ValidationInstances of this type are validated by templateId
XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
should-author: SHOULD contain author (author.exists())
2. Act.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
4. Act.realmCode
Definition

When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
6. Act.typeId
Definition

When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
8. Act.typeId.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
10. Act.typeId.assigningAuthorityName
Definition

A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelAssigning Authority Name
12. Act.typeId.displayable
Definition

Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelDisplayable
14. Act.typeId.root
Definition

Identifies the type as an HL7 Registered model

Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelRoot
Fixed Value2.16.840.1.113883.1.3
16. Act.typeId.extension
Definition

A character string as a unique identifier within the scope of the identifier root.

Control1..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExtension
18. Act.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control1..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
SlicingThis element introduces a set of slices on Act.templateId. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ root
  • value @ extension
20. Act.templateId:health-concern-act
Slice Namehealth-concern-act
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
22. Act.templateId:health-concern-act.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
24. Act.templateId:health-concern-act.assigningAuthorityName
Definition

A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelAssigning Authority Name
26. Act.templateId:health-concern-act.displayable
Definition

Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelDisplayable
28. Act.templateId:health-concern-act.root
Definition

A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelRoot
Pattern Value2.16.840.1.113883.10.20.22.4.132
30. Act.templateId:health-concern-act.extension
Definition

A character string as a unique identifier within the scope of the identifier root.

Control1..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExtension
Pattern Value2022-06-01
32. Act.classCode
Comments

SHALL contain exactly one [1..1] @classCode="ACT" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:4515-30750).

Control1..1
BindingThe codes SHALL be taken from XActClassDocumentEntryAct (2.0.0)
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueACT
34. Act.moodCode
Comments

SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001) (CONF:4515-30751).

Control1..1
BindingThe codes SHALL be taken from XDocumentActMood (2.0.0)
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueEVN
36. Act.negationInd
Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
38. Act.id
Comments

SHALL contain at least one [1..*] id (CONF:4515-30754).

Control1..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
40. Act.code
ShortFunctional Status
Comments

SHALL contain exactly one [1..1] code (CONF:4515-32310).

Control1..1
BindingFor example codes, see v3 Code System ActCode
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
42. Act.code.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
44. Act.code.code
Definition

The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

Control1..1
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode
Pattern Value75310-3
46. Act.code.codeSystem
Definition

Specifies the code system that defines the code.

ShortLOINC
Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode System
Pattern Value2.16.840.1.113883.6.1
48. Act.code.codeSystemName
Definition

The common name of the coding system.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode System Name
50. Act.code.codeSystemVersion
Definition

If applicable, a version descriptor defined specifically for the given code system.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode System Version
52. Act.code.displayName
Definition

A name or title for the code, under which the sending system shows the code value to its users.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelDisplay Name
54. Act.code.sdtcValueSet
Definition

The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

Control0..1
Typestring(oid: ISO Object Identifier)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
56. Act.code.sdtcValueSetVersion
Definition

The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
58. Act.code.originalText
Definition

The text or phrase used as the basis for the coding.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
LabelOriginal Text
60. Act.code.qualifier
Definition

Specifies additional codes that increase the specificity of the the primary code.

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
LabelQualifier
62. Act.code.translation
Definition

A set of other concept descriptors that translate this concept descriptor into other code systems.

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
XML FormatThe type of this property is determined using the xsi:typeattribute.
LabelTranslation
64. Act.text
ShortSHOULD reference the portion of section narrative text corresponding to this entry
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
66. Act.text.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
68. Act.text.compression
Definition

Indicates whether the raw byte data is compressed, and what compression algorithm was used.

Control0..1
BindingThe codes SHALL be taken from CompressionAlgorithm
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCompression
70. Act.text.integrityCheck
Definition

The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.

Control0..1
Typebase64Binary(bin: Binary Data)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelIntegrity Check
72. Act.text.integrityCheckAlgorithm
Definition

Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.

Control0..1
BindingThe codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0)
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelIntegrity Check Algorithm
74. Act.text.language
Definition

For character based information the language property specifies the human language of the text.

Control0..1
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelLanguage
76. Act.text.mediaType
Definition

Identifies the type of the encapsulated data and identifies a method to interpret or render the data.

Control0..1
BindingFor example codes, see MediaType
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelMedia Type
78. Act.text.representation
Control0..1
BindingThe codes SHALL be taken from Binary Data Encoding Value Set
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
80. Act.text.xmlText
Definition

Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)

ShortAllows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
Comments

This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as unadorned text.
82. Act.text.reference
Definition

A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
LabelReference
Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
84. Act.text.thumbnail
Definition

An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
LabelThumbnail
86. Act.statusCode
Comments

SHALL contain exactly one [1..1] statusCode (CONF:4515-30758).

Control1..1
BindingThe codes SHALL be taken from ActStatus
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
88. Act.statusCode.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
90. Act.statusCode.code
Definition

The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

Comments

This statusCode SHALL contain exactly one [1..1] @code, which SHALL be selected from ValueSet ProblemAct statusCode urn:oid:2.16.840.1.113883.11.20.9.19 STATIC (CONF:4515-32313).

Control1..1
BindingThe codes SHALL be taken from ProblemAct statusCode
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode
92. Act.statusCode.codeSystem
Definition

Specifies the code system that defines the code.

Control0..0
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode System
94. Act.statusCode.codeSystemName
Definition

The common name of the coding system.

Control0..0
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode System Name
96. Act.statusCode.codeSystemVersion
Definition

If applicable, a version descriptor defined specifically for the given code system.

Control0..0
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelCode System Version
98. Act.statusCode.displayName
Definition

A name or title for the code, under which the sending system shows the code value to its users.

Control0..0
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelDisplay Name
100. Act.statusCode.sdtcValueSet
Definition

The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

Control0..1
Typestring(oid: ISO Object Identifier)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
102. Act.statusCode.sdtcValueSetVersion
Definition

The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
104. Act.statusCode.originalText
Definition

The text or phrase used as the basis for the coding.

Control0..0
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
LabelOriginal Text
106. Act.statusCode.qualifier
Definition

Specifies additional codes that increase the specificity of the the primary code.

Control0..0
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
LabelQualifier
108. Act.statusCode.translation
Definition

A set of other concept descriptors that translate this concept descriptor into other code systems.

Control0..0
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
XML FormatThe type of this property is determined using the xsi:typeattribute.
LabelTranslation
110. Act.effectiveTime
Comments

MAY contain zero or one [0..1] effectiveTime (CONF:4515-30759).

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
112. Act.priorityCode
Control0..1
BindingFor example codes, see ActPriority
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
114. Act.languageCode
Control0..1
BindingThe codes SHALL be taken from AllLanguages
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
116. Act.subject
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Subject
118. Act.specimen
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
120. Act.performer
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
122. Act.author
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

ShortA health concern may be a patient or provider concern. If the author is set to the recordTarget (patient), this is a patient concern. If the author is set to a provider, this is a provider concern. If both patient and provider are set as authors, this is a concern of both the patient and the provider.
Comments

SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:4515-31546).

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
Is Modifierfalse
124. Act.informant
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
126. Act.participant
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
128. Act.entryRelationship
ShortWhen this Health Concern Act is a Social Determinant of Health Health Concern it **SHOULD** contain zero or more [0..*] entryRelationship subentries such that it contains an observation with an observation/value selected from ValueSet [Social Determinant of Health Conditions 2.16.840.1.113762.1.4.1196.788](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1196.788/expansion) **DYNAMIC** (CONF:4515-32962).
Comments

MAY contain zero or more [0..*] entryRelationship (CONF:4515-31549) such that it

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
SlicingThis element introduces a set of slices on Act.entryRelationship. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • profile @ act
  • profile @ observation
  • profile @ organizer
  • value @ typeCode
130. Act.entryRelationship:observations
Slice Nameobservations
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
132. Act.entryRelationship:observations.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
134. Act.entryRelationship:observations.realmCode
Definition

When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
136. Act.entryRelationship:observations.typeId
Definition

When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
138. Act.entryRelationship:observations.typeId.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
140. Act.entryRelationship:observations.typeId.assigningAuthorityName
Definition

A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelAssigning Authority Name
142. Act.entryRelationship:observations.typeId.displayable
Definition

Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelDisplayable
144. Act.entryRelationship:observations.typeId.root
Definition

Identifies the type as an HL7 Registered model

Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelRoot
Fixed Value2.16.840.1.113883.1.3
146. Act.entryRelationship:observations.typeId.extension
Definition

A character string as a unique identifier within the scope of the identifier root.

Control1..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExtension
148. Act.entryRelationship:observations.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
150. Act.entryRelationship:observations.typeCode
Control1..1
BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueREFR
152. Act.entryRelationship:observations.inversionInd
Definition

The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
154. Act.entryRelationship:observations.contextConductionInd
Definition

The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Default Valuetrue
156. Act.entryRelationship:observations.negationInd
Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
158. Act.entryRelationship:observations.sequenceNumber
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
160. Act.entryRelationship:observations.seperatableInd
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
162. Act.entryRelationship:observations.act
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
164. Act.entryRelationship:observations.encounter
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
166. Act.entryRelationship:observations.observation
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

ShortBase for all types and resources
Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Problem Observation, Allergy - Intolerance Observation, Assessment Scale Observation, Self-Care Activities (ADL and IADL), Mental Status Observation, Smoking Status - Meaningful Use, Functional Status Observation, Nutrition Assessment, Pregnancy Observation, Reaction Observation, Result Observation, Sensory Status, Social History Observation, Substance or Device Allergy - Intolerance Observation, Tobacco Use, Vital Sign Observation, Longitudinal Care Wound Observation, Problem Observation, Caregiver Characteristics, Cultural and Religious Observation, Characteristics of Home Environment, Nutritional Status Observation, Priority Preference)
Is Modifierfalse
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
should-author: SHOULD contain author (author.exists())
168. Act.entryRelationship:observations.observationMedia
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
170. Act.entryRelationship:observations.organizer
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
172. Act.entryRelationship:observations.procedure
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
174. Act.entryRelationship:observations.regionOfInterest
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
176. Act.entryRelationship:observations.substanceAdministration
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
178. Act.entryRelationship:observations.supply
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
180. Act.entryRelationship:acts
Slice Nameacts
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
182. Act.entryRelationship:acts.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
184. Act.entryRelationship:acts.realmCode
Definition

When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
186. Act.entryRelationship:acts.typeId
Definition

When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
188. Act.entryRelationship:acts.typeId.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
190. Act.entryRelationship:acts.typeId.assigningAuthorityName
Definition

A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelAssigning Authority Name
192. Act.entryRelationship:acts.typeId.displayable
Definition

Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelDisplayable
194. Act.entryRelationship:acts.typeId.root
Definition

Identifies the type as an HL7 Registered model

Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelRoot
Fixed Value2.16.840.1.113883.1.3
196. Act.entryRelationship:acts.typeId.extension
Definition

A character string as a unique identifier within the scope of the identifier root.

Control1..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExtension
198. Act.entryRelationship:acts.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
200. Act.entryRelationship:acts.typeCode
Control1..1
BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueREFR
202. Act.entryRelationship:acts.inversionInd
Definition

The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
204. Act.entryRelationship:acts.contextConductionInd
Definition

The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Default Valuetrue
206. Act.entryRelationship:acts.negationInd
Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
208. Act.entryRelationship:acts.sequenceNumber
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
210. Act.entryRelationship:acts.seperatableInd
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
212. Act.entryRelationship:acts.act
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

ShortBase for all types and resources
Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Encounter Diagnosis, Hospital Admission Diagnosis, Postprocedure Diagnosis, Preoperative Diagnosis, Entry Reference)
Is Modifierfalse
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
214. Act.entryRelationship:acts.encounter
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
216. Act.entryRelationship:acts.observation
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
218. Act.entryRelationship:acts.observationMedia
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
220. Act.entryRelationship:acts.organizer
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
222. Act.entryRelationship:acts.procedure
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
224. Act.entryRelationship:acts.regionOfInterest
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
226. Act.entryRelationship:acts.substanceAdministration
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
228. Act.entryRelationship:acts.supply
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
230. Act.entryRelationship:organizers
Slice Nameorganizers
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
232. Act.entryRelationship:organizers.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
234. Act.entryRelationship:organizers.realmCode
Definition

When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
236. Act.entryRelationship:organizers.typeId
Definition

When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
238. Act.entryRelationship:organizers.typeId.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
240. Act.entryRelationship:organizers.typeId.assigningAuthorityName
Definition

A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelAssigning Authority Name
242. Act.entryRelationship:organizers.typeId.displayable
Definition

Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelDisplayable
244. Act.entryRelationship:organizers.typeId.root
Definition

Identifies the type as an HL7 Registered model

Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelRoot
Fixed Value2.16.840.1.113883.1.3
246. Act.entryRelationship:organizers.typeId.extension
Definition

A character string as a unique identifier within the scope of the identifier root.

Control1..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExtension
248. Act.entryRelationship:organizers.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
250. Act.entryRelationship:organizers.typeCode
Control1..1
BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueREFR
252. Act.entryRelationship:organizers.inversionInd
Definition

The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
254. Act.entryRelationship:organizers.contextConductionInd
Definition

The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Default Valuetrue
256. Act.entryRelationship:organizers.negationInd
Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
258. Act.entryRelationship:organizers.sequenceNumber
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
260. Act.entryRelationship:organizers.seperatableInd
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
262. Act.entryRelationship:organizers.act
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
264. Act.entryRelationship:organizers.encounter
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
266. Act.entryRelationship:organizers.observation
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
268. Act.entryRelationship:organizers.observationMedia
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
270. Act.entryRelationship:organizers.organizer
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

ShortBase for all types and resources
Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer(Family History Organizer, Result Organizer)
Is Modifierfalse
Invariantsshould-sdtctext-ref-value: SHOULD contain text/reference/@value (sdtcText.reference.value.exists())
272. Act.entryRelationship:organizers.procedure
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
274. Act.entryRelationship:organizers.regionOfInterest
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
276. Act.entryRelationship:organizers.substanceAdministration
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
278. Act.entryRelationship:organizers.supply
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
280. Act.entryRelationship:related-entries
Slice Namerelated-entries
ShortWhere a Health Concern needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry. This may also be used to refer to other Health Concern Acts where there is a general relationship between the source and the target (Health Concern REFERS TO Health Concern). For example, a patient has 2 health concerns identified in a CARE Plan: Failure to Thrive and Poor Feeding, while it could be that one may have caused the other, at the time of care planning and documentation it is not necessary, nor desirable to have to assert what caused what. The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
Comments

MAY contain zero or more [0..*] entryRelationship (CONF:4515-31157) such that it

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
282. Act.entryRelationship:related-entries.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
284. Act.entryRelationship:related-entries.realmCode
Definition

When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
286. Act.entryRelationship:related-entries.typeId
Definition

When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
288. Act.entryRelationship:related-entries.typeId.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
290. Act.entryRelationship:related-entries.typeId.assigningAuthorityName
Definition

A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelAssigning Authority Name
292. Act.entryRelationship:related-entries.typeId.displayable
Definition

Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelDisplayable
294. Act.entryRelationship:related-entries.typeId.root
Definition

Identifies the type as an HL7 Registered model

Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelRoot
Fixed Value2.16.840.1.113883.1.3
296. Act.entryRelationship:related-entries.typeId.extension
Definition

A character string as a unique identifier within the scope of the identifier root.

Control1..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExtension
298. Act.entryRelationship:related-entries.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
300. Act.entryRelationship:related-entries.typeCode
Comments

SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-31158).

Control1..1
BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueREFR
302. Act.entryRelationship:related-entries.inversionInd
Definition

The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
304. Act.entryRelationship:related-entries.contextConductionInd
Definition

The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Default Valuetrue
306. Act.entryRelationship:related-entries.negationInd
Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
308. Act.entryRelationship:related-entries.sequenceNumber
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
310. Act.entryRelationship:related-entries.seperatableInd
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
312. Act.entryRelationship:related-entries.act
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

ShortBase for all types and resources
Comments

SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32106).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
Is Modifierfalse
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
314. Act.entryRelationship:related-entries.encounter
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
316. Act.entryRelationship:related-entries.observation
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
318. Act.entryRelationship:related-entries.observationMedia
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
320. Act.entryRelationship:related-entries.organizer
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
322. Act.entryRelationship:related-entries.procedure
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
324. Act.entryRelationship:related-entries.regionOfInterest
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
326. Act.entryRelationship:related-entries.substanceAdministration
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
328. Act.entryRelationship:related-entries.supply
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
330. Act.entryRelationship:component-health-concern-acts
Slice Namecomponent-health-concern-acts
ShortThe following entryRelationship represents the relationship between two Health Concern Acts where the target is a component of the source (Health Concern HAS COMPONENT Health Concern). For example, a patient has an Impaired Mobility Health Concern. There may then be the need to document several component health concerns, such as "Unable to Transfer Bed to Chair","Unable to Rise from Commode", "Short of Breath Walking with Walker". The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
Comments

MAY contain zero or more [0..*] entryRelationship (CONF:4515-31160) such that it

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
Invariants4515-32745: The Entry Reference template **SHALL** contain an id that references a Health Concern Act (CONF:4515-32745). (%resource.descendants().ofType(CDA.Act).where(templateId.exists($this.root = '2.16.840.1.113883.10.20.22.4.132' and $this.extension = '2022-06-01') and id.exists($this.root = %context.act.id.first().root and $this.extension ~ %context.act.id.first().extension)))
332. Act.entryRelationship:component-health-concern-acts.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
334. Act.entryRelationship:component-health-concern-acts.realmCode
Definition

When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
336. Act.entryRelationship:component-health-concern-acts.typeId
Definition

When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
338. Act.entryRelationship:component-health-concern-acts.typeId.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
340. Act.entryRelationship:component-health-concern-acts.typeId.assigningAuthorityName
Definition

A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelAssigning Authority Name
342. Act.entryRelationship:component-health-concern-acts.typeId.displayable
Definition

Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelDisplayable
344. Act.entryRelationship:component-health-concern-acts.typeId.root
Definition

Identifies the type as an HL7 Registered model

Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelRoot
Fixed Value2.16.840.1.113883.1.3
346. Act.entryRelationship:component-health-concern-acts.typeId.extension
Definition

A character string as a unique identifier within the scope of the identifier root.

Control1..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExtension
348. Act.entryRelationship:component-health-concern-acts.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
350. Act.entryRelationship:component-health-concern-acts.typeCode
Comments

SHALL contain exactly one [1..1] @typeCode="COMP" Has component (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-31161).

Control1..1
BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueCOMP
352. Act.entryRelationship:component-health-concern-acts.inversionInd
Definition

The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
354. Act.entryRelationship:component-health-concern-acts.contextConductionInd
Definition

The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Default Valuetrue
356. Act.entryRelationship:component-health-concern-acts.negationInd
Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
358. Act.entryRelationship:component-health-concern-acts.sequenceNumber
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
360. Act.entryRelationship:component-health-concern-acts.seperatableInd
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
362. Act.entryRelationship:component-health-concern-acts.act
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

ShortBase for all types and resources
Comments

SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32107).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
Is Modifierfalse
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
364. Act.entryRelationship:component-health-concern-acts.encounter
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
366. Act.entryRelationship:component-health-concern-acts.observation
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
368. Act.entryRelationship:component-health-concern-acts.observationMedia
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
370. Act.entryRelationship:component-health-concern-acts.organizer
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
372. Act.entryRelationship:component-health-concern-acts.procedure
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
374. Act.entryRelationship:component-health-concern-acts.regionOfInterest
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
376. Act.entryRelationship:component-health-concern-acts.substanceAdministration
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
378. Act.entryRelationship:component-health-concern-acts.supply
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
380. Act.reference
ShortWhere it is necessary to reference an external clinical document such as a Referral document, Discharge Summary document etc., the External Document Reference template can be used to reference this document. However, if this Care Plan document is replacing or appending another Care Plan document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.
Comments

MAY contain zero or more [0..*] reference (CONF:4515-32757).

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
382. Act.reference.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
384. Act.reference.realmCode
Definition

When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
386. Act.reference.typeId
Definition

When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
388. Act.reference.typeId.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
390. Act.reference.typeId.assigningAuthorityName
Definition

A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelAssigning Authority Name
392. Act.reference.typeId.displayable
Definition

Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelDisplayable
394. Act.reference.typeId.root
Definition

Identifies the type as an HL7 Registered model

Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelRoot
Fixed Value2.16.840.1.113883.1.3
396. Act.reference.typeId.extension
Definition

A character string as a unique identifier within the scope of the identifier root.

Control1..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExtension
398. Act.reference.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
400. Act.reference.typeCode
Comments

The reference, if present, SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32758).

Control1..1
BindingThe codes SHALL be taken from x_ActRelationshipExternalReference
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
Fixed ValueREFR
402. Act.reference.seperatableInd
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
404. Act.reference.externalAct
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalAct
406. Act.reference.externalObservation
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalObservation
408. Act.reference.externalProcedure
Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalProcedure
410. Act.reference.externalDocument
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

ShortBase for all types and resources
Comments

The reference, if present, SHALL contain exactly one [1..1] External Document Reference (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.115:2014-06-09) (CONF:4515-32759).

Control1..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument(External Document Reference)
Is Modifierfalse
Invariantsshould-setId: SHOULD contain setId (setId.exists())
should-versionNumber: SHOULD contain versionNumber (versionNumber.exists())
412. Act.precondition
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
414. Act.sdtcPrecondition2
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition2
XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameprecondition2.
416. Act.sdtcInFulfillmentOf1
Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameinFulfillmentOf1.