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: Immunization Activity

Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/ImmunizationActivity Version: 3.0.0-ballot
Draft as of 2023-12-21 Computable Name: ImmunizationActivity
Other Identifiers: id: urn:hl7ii:2.16.840.1.113883.10.20.22.4.52:2015-08-01

An Immunization Activity describes immunization substance administrations that have actually occurred or are intended to occur. Immunization Activities in “INT” mood are reflections of immunizations a clinician intends a patient to receive. Immunization Activities in “EVN” mood reflect immunizations actually received.

An Immunization Activity is very similar to a Medication Activity with some key differentiators. The drug code system is constrained to CVX codes. Administration timing is less complex. Patient refusal reasons should be captured. All vaccines administered should be fully documented in the patient’s permanent medical record. Healthcare providers who administer vaccines covered by the National Childhood Vaccine Injury Act are required to ensure that the permanent medical record of the recipient indicates:

  1. Date of administration
  2. Vaccine manufacturer
  3. Vaccine lot number
  4. Name and title of the person who administered the vaccine and the address of the clinic or facility where the permanent record will reside
  5. Vaccine information statement (VIS)

a. Date printed on the VIS b. Date VIS given to patient or parent/guardian.

This information should be included in an Immunization Activity when available. (Reference: [https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/c/vis-instruct.pdf])

Usage:

Formal Views of Profile Content

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

This structure is derived from SubstanceAdministration

NameFlagsCard.TypeDescription & Constraintsdoco
.. SubstanceAdministration C1..1SubstanceAdministrationXML Namespace: urn:hl7-org:v3
Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, repeatNumber, routeCode, approachSiteCode, doseQuantity, rateQuantity, maxDoseQuantity, administrationUnitCode, consumable, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcInFulfillmentOf1
Base for all types and resources
Instances of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
should-text-ref-value: SHOULD contain text/reference/@value
should-doseQuantity: SHOULD contain doseQuantity
dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present.
should-performer: SHOULD contain performer
should-author: SHOULD contain author
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:immunization-activity 1..1II
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.52
..... @extension 1..1stRequired Pattern: 2015-08-01
... @classCode 1..1cs
... @moodCode 1..1csBinding: MoodCodeEvnInt (required)
... code 0..1CDSubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used and there is no defined value set.
... @negationInd 1..1blUse negationInd="true" to indicate that the immunization was not given.
... text 0..1EDSHOULD reference the portion of section narrative text corresponding to this entry
.... reference C0..1TELvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
... statusCode 1..1CS
.... @code 1..1csBinding: ActStatus (required)
... effectiveTime 1..1SXCM_TS, IVL_TS, EIVL_TS, PIVL_TS, SXPR_TS
... repeatNumber C0..1IVL_INTIn "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
value-only: Interval fields SHALL not be present
.... @value 0..1intvalue should be used instead of low/high
... routeCode C0..1CEBinding: SPL Drug Route of Administration Terminology (required)
should-translation: SHOULD contain translation
.... translation 0..*CDBinding: Medication Route (required)
... approachSiteCode 0..1CDBinding: Body Site Value Set (required)
... doseQuantity C0..1IVL_PQshould-unit: SHOULD contain @unit
.... @unit 0..1csNOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units
Binding: UnitsOfMeasureCaseSensitive (required)
... administrationUnitCode 0..1CEBinding: AdministrationUnitDoseForm (required)
... consumable 1..1InfrastructureRoot
.... manufacturedProduct 1..1ImmunizationMedicationInformationBase for all types and resources
... performer 0..1Performer2
... author 0..*AuthorParticipationBase for all types and resources
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:typeCode
.... participant:drugVehicle 0..*Participant2
..... @typeCode 1..1csFixed Value: CSM
..... participantRole 1..1DrugVehicleBase for all types and resources
... Slices for entryRelationship 0..*EntryRelationshipSlice: Unordered, Open by profile:act, profile:observation, profile:supply
.... entryRelationship:indication 0..*EntryRelationship
..... @typeCode 1..1csFixed Value: RSON
..... observation 1..1IndicationBase for all types and resources
.... entryRelationship:instruction 0..1EntryRelationship
..... @typeCode 1..1csFixed Value: SUBJ
..... @inversionInd 1..1blFixed Value: true
..... act 1..1InstructionBase for all types and resources
.... entryRelationship:medSupplyOrder 0..1EntryRelationship
..... @typeCode 1..1csFixed Value: REFR
..... supply 1..1MedicationSupplyOrderBase for all types and resources
.... entryRelationship:medDispense 0..1EntryRelationship
..... @typeCode 1..1csFixed Value: REFR
..... supply 1..1MedicationDispenseBase for all types and resources
.... entryRelationship:reactionObs 0..1EntryRelationship
..... @typeCode 1..1csFixed Value: CAUS
..... observation 1..1ReactionObservationBase for all types and resources
.... entryRelationship:immunizationRefusal 0..1EntryRelationship
..... @typeCode 1..1csFixed Value: RSON
..... observation 1..1ImmunizationRefusalReasonBase for all types and resources
.... entryRelationship:substanceAdmin 0..*EntryRelationshipThe following entryRelationship is used to indicate a given immunization's order in a series. The nested Substance Administered Act identifies an administration in the series. The entryRelationship/sequenceNumber shows the order of this particular administration in that series.
..... @typeCode 1..1csFixed Value: COMP
..... @inversionInd 1..1blFixed Value: true
..... sequenceNumber 0..1INT
..... act 1..1SubstanceAdministeredActBase for all types and resources
... Slices for precondition 0..*PreconditionSlice: Unordered, Open by profile:criterion
.... precondition:substanceAdmin 0..*Precondition
..... @typeCode 1..1cs
..... criterion 1..1PreconditionforSubstanceAdministrationBase for all types and resources

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
SubstanceAdministration.moodCoderequiredMoodCodeEvnInt
SubstanceAdministration.statusCode.coderequiredActStatus
SubstanceAdministration.routeCoderequiredSPLDrugRouteOfAdministrationTerminology
SubstanceAdministration.routeCode.translationrequiredMedicationRoute
SubstanceAdministration.approachSiteCoderequiredBodySiteValueSet
SubstanceAdministration.doseQuantity.unitrequiredUnitsOfMeasureCaseSensitive (a valid code from UCUM)
SubstanceAdministration.administrationUnitCoderequiredAdministrationUnitDoseForm

Constraints

IdGradePath(s)DetailsRequirements
dose-unit-or-admin-uniterrorSubstanceAdministrationIf doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present.
: doseQuantity.unit.exists() implies administrationUnitCode.empty()
should-authorwarningSubstanceAdministrationSHOULD contain author
: author.exists()
should-doseQuantitywarningSubstanceAdministrationSHOULD contain doseQuantity
: doseQuantity.exists()
should-performerwarningSubstanceAdministrationSHOULD contain performer
: performer.exists()
should-text-ref-valuewarningSubstanceAdministrationSHOULD contain text/reference/@value
: text.reference.value.exists()
should-translationwarningSubstanceAdministration.routeCodeSHOULD contain translation
: translation.exists()
should-unitwarningSubstanceAdministration.doseQuantitySHOULD contain @unit
: nullFlavor.exists() or unit.exists()
value-onlyerrorSubstanceAdministration.repeatNumberInterval fields SHALL not be present
: (low | high | width | center).empty()
value-starts-octothorpeerrorSubstanceAdministration.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')
NameFlagsCard.TypeDescription & Constraintsdoco
.. SubstanceAdministration C1..1SubstanceAdministrationXML Namespace: urn:hl7-org:v3
Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, repeatNumber, routeCode, approachSiteCode, doseQuantity, rateQuantity, maxDoseQuantity, administrationUnitCode, consumable, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcInFulfillmentOf1
Base for all types and resources
Instances of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
should-text-ref-value: SHOULD contain text/reference/@value
should-doseQuantity: SHOULD contain doseQuantity
dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present.
should-performer: SHOULD contain performer
should-author: SHOULD contain author
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:immunization-activity 1..1II
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.52
..... @extension 1..1stRequired Pattern: 2015-08-01
... @classCode 1..1csBinding: ActClass (2.0.0) (required)
Fixed Value: SBADM
... @moodCode 1..1csBinding: MoodCodeEvnInt (required)
... code 0..1CDSubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used and there is no defined value set.
Binding: ActSubstanceAdministrationCode (example)
... @negationInd 1..1blUse negationInd="true" to indicate that the immunization was not given.
... text 0..1EDSHOULD reference the portion of section narrative text corresponding to this entry
.... reference C0..1TELvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
... statusCode 1..1CSBinding: ActStatus (required)
.... @code 1..1csBinding: ActStatus (required)
... effectiveTime 1..1
.... effectiveTimeSXCM_TS
.... effectiveTimeIVL_TS
.... effectiveTimeEIVL_TS
.... effectiveTimePIVL_TS
.... effectiveTimeSXPR_TS
... repeatNumber C0..1IVL_INTIn "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
value-only: Interval fields SHALL not be present
.... @value 0..1intvalue should be used instead of low/high
... routeCode C0..1CEBinding: SPL Drug Route of Administration Terminology (required)
should-translation: SHOULD contain translation
.... translation 0..*CDBinding: Medication Route (required)
... approachSiteCode 0..1CDBinding: Body Site Value Set (required)
... doseQuantity C0..1IVL_PQshould-unit: SHOULD contain @unit
.... @unit 0..1csNOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units
Binding: UnitsOfMeasureCaseSensitive (required)
... administrationUnitCode 0..1CEBinding: AdministrationUnitDoseForm (required)
... consumable 1..1InfrastructureRoot
.... manufacturedProduct C1..1ImmunizationMedicationInformationBase for all types and resources
... performer 0..1Performer2
... author 0..*AuthorParticipationBase for all types and resources
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:typeCode
.... participant:drugVehicle 0..*Participant2
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: CSM
..... participantRole C1..1DrugVehicleBase for all types and resources
... Slices for entryRelationship 0..*EntryRelationshipSlice: Unordered, Open by profile:act, profile:observation, profile:supply
.... entryRelationship:indication 0..*EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: RSON
..... observation C1..1IndicationBase for all types and resources
.... entryRelationship:instruction 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: SUBJ
..... @inversionInd 1..1blFixed Value: true
..... act C1..1InstructionBase for all types and resources
.... entryRelationship:medSupplyOrder 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... supply C1..1MedicationSupplyOrderBase for all types and resources
.... entryRelationship:medDispense 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... supply C1..1MedicationDispenseBase for all types and resources
.... entryRelationship:reactionObs 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: CAUS
..... observation C1..1ReactionObservationBase for all types and resources
.... entryRelationship:immunizationRefusal 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: RSON
..... observation C1..1ImmunizationRefusalReasonBase for all types and resources
.... entryRelationship:substanceAdmin 0..*EntryRelationshipThe following entryRelationship is used to indicate a given immunization's order in a series. The nested Substance Administered Act identifies an administration in the series. The entryRelationship/sequenceNumber shows the order of this particular administration in that series.
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: COMP
..... @inversionInd 1..1blFixed Value: true
..... sequenceNumber 0..1INT
..... act C1..1SubstanceAdministeredActBase for all types and resources
... Slices for precondition 0..*PreconditionSlice: Unordered, Open by profile:criterion
.... precondition:substanceAdmin 0..*Precondition
..... @typeCode 1..1csBinding: ActRelationshipType (required)
Fixed Value: PRCN
..... criterion 1..1PreconditionforSubstanceAdministrationBase for all types and resources

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
SubstanceAdministration.classCoderequiredFixed Value: SBADM
SubstanceAdministration.moodCoderequiredMoodCodeEvnInt
SubstanceAdministration.codeexampleActSubstanceAdministrationCode
SubstanceAdministration.statusCoderequiredActStatus
SubstanceAdministration.statusCode.coderequiredActStatus
SubstanceAdministration.routeCoderequiredSPLDrugRouteOfAdministrationTerminology
SubstanceAdministration.routeCode.translationrequiredMedicationRoute
SubstanceAdministration.approachSiteCoderequiredBodySiteValueSet
SubstanceAdministration.doseQuantity.unitrequiredUnitsOfMeasureCaseSensitive (a valid code from UCUM)
SubstanceAdministration.administrationUnitCoderequiredAdministrationUnitDoseForm
SubstanceAdministration.participant:drugVehicle.typeCoderequiredFixed Value: CSM
SubstanceAdministration.entryRelationship:indication.typeCoderequiredFixed Value: RSON
SubstanceAdministration.entryRelationship:instruction.typeCoderequiredFixed Value: SUBJ
SubstanceAdministration.entryRelationship:medSupplyOrder.typeCoderequiredFixed Value: REFR
SubstanceAdministration.entryRelationship:medDispense.typeCoderequiredFixed Value: REFR
SubstanceAdministration.entryRelationship:reactionObs.typeCoderequiredFixed Value: CAUS
SubstanceAdministration.entryRelationship:immunizationRefusal.typeCoderequiredFixed Value: RSON
SubstanceAdministration.entryRelationship:substanceAdmin.typeCoderequiredFixed Value: COMP
SubstanceAdministration.precondition:substanceAdmin.typeCoderequiredFixed Value: PRCN

Constraints

IdGradePath(s)DetailsRequirements
dose-unit-or-admin-uniterrorSubstanceAdministrationIf doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present.
: doseQuantity.unit.exists() implies administrationUnitCode.empty()
product-choiceerrorSubstanceAdministration.consumable.manufacturedProductmanufacturedLabeledDrug and manufacturedMaterial are mutually exclusive (one must be present)
: (manufacturedLabeledDrug | manufacturedMaterial).count() = 1
role-choiceerrorSubstanceAdministration.participant:drugVehicle.participantRoleplayingDevice and playingEntity are mutually exclusive
: (playingDevice | playingEntity).count() <= 1
should-authorwarningSubstanceAdministrationSHOULD contain author
: author.exists()
should-doseQuantitywarningSubstanceAdministrationSHOULD contain doseQuantity
: doseQuantity.exists()
should-effectiveTimewarningSubstanceAdministration.entryRelationship:indication.observation, SubstanceAdministration.entryRelationship:medDispense.supply, SubstanceAdministration.entryRelationship:reactionObs.observationSHOULD contain effectiveTime
: effectiveTime.exists()
should-manufacturerOrganizationwarningSubstanceAdministration.consumable.manufacturedProductSHOULD contain manufacturerOrganization
: manufacturerOrganization.exists()
should-performerwarningSubstanceAdministrationSHOULD contain performer
: performer.exists()
should-quantitywarningSubstanceAdministration.entryRelationship:medSupplyOrder.supply, SubstanceAdministration.entryRelationship:medDispense.supplySHOULD contain quantity
: quantity.exists()
should-repeatNumberwarningSubstanceAdministration.entryRelationship:medSupplyOrder.supply, SubstanceAdministration.entryRelationship:medDispense.supplySHOULD contain repeatNumber
: repeatNumber.exists()
should-text-ref-valuewarningSubstanceAdministrationSHOULD contain text/reference/@value
: text.reference.value.exists()
should-text-ref-valuewarningSubstanceAdministration.entryRelationship:indication.observation, SubstanceAdministration.entryRelationship:instruction.act, SubstanceAdministration.entryRelationship:medSupplyOrder.supply, SubstanceAdministration.entryRelationship:medDispense.supply, SubstanceAdministration.entryRelationship:reactionObs.observation, SubstanceAdministration.entryRelationship:immunizationRefusal.observation, SubstanceAdministration.entryRelationship:substanceAdmin.actSHOULD contain text/reference/@value
: text.reference.value.exists()
should-translationwarningSubstanceAdministration.routeCodeSHOULD contain translation
: translation.exists()
should-unitwarningSubstanceAdministration.doseQuantitySHOULD contain @unit
: nullFlavor.exists() or unit.exists()
value-onlyerrorSubstanceAdministration.repeatNumberInterval fields SHALL not be present
: (low | high | width | center).empty()
value-starts-octothorpeerrorSubstanceAdministration.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')
NameFlagsCard.TypeDescription & Constraintsdoco
.. SubstanceAdministration C1..1SubstanceAdministrationXML Namespace: urn:hl7-org:v3
Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, repeatNumber, routeCode, approachSiteCode, doseQuantity, rateQuantity, maxDoseQuantity, administrationUnitCode, consumable, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcInFulfillmentOf1
Base for all types and resources
Instances of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
should-text-ref-value: SHOULD contain text/reference/@value
should-doseQuantity: SHOULD contain doseQuantity
dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present.
should-performer: SHOULD contain performer
should-author: SHOULD contain author
... @nullFlavor 0..1csBinding: CDANullFlavor (required)
... realmCode 0..*CS
... typeId 0..1II
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @assigningAuthorityName 0..1st
.... @displayable 0..1bl
.... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
.... @extension 1..1st
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:immunization-activity 1..1II
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... @assigningAuthorityName 0..1st
..... @displayable 0..1bl
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.52
..... @extension 1..1stRequired Pattern: 2015-08-01
... @classCode 1..1csBinding: ActClass (2.0.0) (required)
Fixed Value: SBADM
... @moodCode 1..1csBinding: MoodCodeEvnInt (required)
... id 1..*II
... code 0..1CDSubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used and there is no defined value set.
Binding: ActSubstanceAdministrationCode (example)
... @negationInd 1..1blUse negationInd="true" to indicate that the immunization was not given.
... text 0..1EDSHOULD reference the portion of section narrative text corresponding to this entry
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @compression 0..1csBinding: CompressionAlgorithm (required)
.... @integrityCheck 0..1bin
.... @integrityCheckAlgorithm 0..1csBinding: IntegrityCheckAlgorithm (2.0.0) (required)
.... @language 0..1cs
.... @mediaType 0..1csBinding: MediaType (example)
.... @representation 0..1csBinding: Binary Data Encoding Value Set (required)
.... xmlText 0..1stAllows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
.... reference C0..1TELvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
.... thumbnail 0..1ED
... statusCode 1..1CSBinding: ActStatus (required)
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @code 1..1csBinding: ActStatus (required)
.... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 1..1
.... effectiveTimeSXCM_TS
.... effectiveTimeIVL_TS
.... effectiveTimeEIVL_TS
.... effectiveTimePIVL_TS
.... effectiveTimeSXPR_TS
... priorityCode 0..1CEBinding: ActPriority (example)
... repeatNumber C0..1IVL_INTIn "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
value-only: Interval fields SHALL not be present
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @value 0..1intvalue should be used instead of low/high
.... @operator 0..1csBinding: SetOperator (required)
.... low 0..1IVXB_INT
.... center 0..1INT
.... width 0..1INT
.... high 0..1IVXB_INT
... routeCode C0..1CEBinding: SPL Drug Route of Administration Terminology (required)
should-translation: SHOULD contain translation
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @code 0..1cs
.... @codeSystem 0..1oid, uuid, ruid
.... @codeSystemName 0..1st
.... @codeSystemVersion 0..1st
.... @displayName 0..1st
.... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1ED
.... translation 0..*CDBinding: Medication Route (required)
... approachSiteCode 0..1CDBinding: Body Site Value Set (required)
... doseQuantity C0..1IVL_PQshould-unit: SHOULD contain @unit
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @unit 0..1csNOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units
Binding: UnitsOfMeasureCaseSensitive (required)
.... @value 0..1real
.... translation 0..*PQR
.... @operator 0..1csBinding: SetOperator (required)
.... low 0..1IVXB_PQ
.... center 0..1PQ
.... width 0..1PQ
.... high 0..1IVXB_PQ
... rateQuantity 0..1IVL_PQ
... maxDoseQuantity 0..1RTO_PQ_PQ
... administrationUnitCode 0..1CEBinding: AdministrationUnitDoseForm (required)
... consumable 1..1InfrastructureRoot
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... realmCode 0..*CS
.... typeId 0..1II
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... @assigningAuthorityName 0..1st
..... @displayable 0..1bl
..... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
..... @extension 1..1st
.... templateId 0..*II
.... @typeCode 0..1csBinding: ParticipationType (required)
Fixed Value: CSM
.... manufacturedProduct C1..1ImmunizationMedicationInformationBase for all types and resources
... subject 0..1Subject
... specimen 0..*Specimen
... performer 0..1Performer2
... author 0..*AuthorParticipationBase for all types and resources
... informant 0..*Informant
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:typeCode
.... participant:drugVehicle 0..*Participant2
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: CSM
..... @contextControlCode 0..1csBinding: ContextControl (required)
Fixed Value: OP
..... sdtcFunctionCode 0..1CEXML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1IVL_TS
..... awarenessCode 0..1CE
..... participantRole C1..1DrugVehicleBase for all types and resources
... Slices for entryRelationship 0..*EntryRelationshipSlice: Unordered, Open by profile:act, profile:observation, profile:supply
.... entryRelationship:indication 0..*EntryRelationship
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: RSON
..... @inversionInd 0..1bl
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 0..1Act
..... encounter 0..1Encounter
..... observation C1..1IndicationBase for all types and resources
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
.... entryRelationship:instruction 0..1EntryRelationship
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: SUBJ
..... @inversionInd 1..1blFixed Value: true
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act C1..1InstructionBase for all types and resources
..... encounter 0..1Encounter
..... observation 0..1Observation
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
.... entryRelationship:medSupplyOrder 0..1EntryRelationship
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... @inversionInd 0..1bl
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 0..1Act
..... encounter 0..1Encounter
..... observation 0..1Observation
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply C1..1MedicationSupplyOrderBase for all types and resources
.... entryRelationship:medDispense 0..1EntryRelationship
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... @inversionInd 0..1bl
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 0..1Act
..... encounter 0..1Encounter
..... observation 0..1Observation
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply C1..1MedicationDispenseBase for all types and resources
.... entryRelationship:reactionObs 0..1EntryRelationship
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: CAUS
..... @inversionInd 0..1bl
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 0..1Act
..... encounter 0..1Encounter
..... observation C1..1ReactionObservationBase for all types and resources
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
.... entryRelationship:immunizationRefusal 0..1EntryRelationship
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: RSON
..... @inversionInd 0..1bl
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 0..1Act
..... encounter 0..1Encounter
..... observation C1..1ImmunizationRefusalReasonBase for all types and resources
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
.... entryRelationship:substanceAdmin 0..*EntryRelationshipThe following entryRelationship is used to indicate a given immunization's order in a series. The nested Substance Administered Act identifies an administration in the series. The entryRelationship/sequenceNumber shows the order of this particular administration in that series.
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: COMP
..... @inversionInd 1..1blFixed Value: true
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act C1..1SubstanceAdministeredActBase for all types and resources
..... encounter 0..1Encounter
..... observation 0..1Observation
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
... reference 0..*Reference
... Slices for precondition 0..*PreconditionSlice: Unordered, Open by profile:criterion
.... precondition:substanceAdmin 0..*Precondition
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: ActRelationshipType (required)
Fixed Value: PRCN
..... criterion 1..1PreconditionforSubstanceAdministrationBase for all types and resources
... sdtcInFulfillmentOf1 0..*InFulfillmentOf1XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
SubstanceAdministration.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.templateId:immunization-activity.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.classCoderequiredFixed Value: SBADM
SubstanceAdministration.moodCoderequiredMoodCodeEvnInt
SubstanceAdministration.codeexampleActSubstanceAdministrationCode
SubstanceAdministration.text.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.text.compressionrequiredCDACompressionAlgorithm
SubstanceAdministration.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
SubstanceAdministration.text.mediaTypeexampleMediaType
SubstanceAdministration.text.representationrequiredBinaryDataEncoding
SubstanceAdministration.statusCoderequiredActStatus
SubstanceAdministration.statusCode.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.statusCode.coderequiredActStatus
SubstanceAdministration.priorityCodeexampleActPriority
SubstanceAdministration.repeatNumber.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.repeatNumber.operatorrequiredSetOperator
SubstanceAdministration.routeCoderequiredSPLDrugRouteOfAdministrationTerminology
SubstanceAdministration.routeCode.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.routeCode.translationrequiredMedicationRoute
SubstanceAdministration.approachSiteCoderequiredBodySiteValueSet
SubstanceAdministration.doseQuantity.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.doseQuantity.unitrequiredUnitsOfMeasureCaseSensitive (a valid code from UCUM)
SubstanceAdministration.doseQuantity.operatorrequiredSetOperator
SubstanceAdministration.administrationUnitCoderequiredAdministrationUnitDoseForm
SubstanceAdministration.consumable.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.consumable.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.consumable.typeCoderequiredFixed Value: CSM
SubstanceAdministration.participant:drugVehicle.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.participant:drugVehicle.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.participant:drugVehicle.typeCoderequiredFixed Value: CSM
SubstanceAdministration.participant:drugVehicle.contextControlCoderequiredFixed Value: OP
SubstanceAdministration.entryRelationship:indication.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:indication.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:indication.typeCoderequiredFixed Value: RSON
SubstanceAdministration.entryRelationship:instruction.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:instruction.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:instruction.typeCoderequiredFixed Value: SUBJ
SubstanceAdministration.entryRelationship:medSupplyOrder.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:medSupplyOrder.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:medSupplyOrder.typeCoderequiredFixed Value: REFR
SubstanceAdministration.entryRelationship:medDispense.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:medDispense.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:medDispense.typeCoderequiredFixed Value: REFR
SubstanceAdministration.entryRelationship:reactionObs.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:reactionObs.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:reactionObs.typeCoderequiredFixed Value: CAUS
SubstanceAdministration.entryRelationship:immunizationRefusal.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:immunizationRefusal.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:immunizationRefusal.typeCoderequiredFixed Value: RSON
SubstanceAdministration.entryRelationship:substanceAdmin.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:substanceAdmin.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:substanceAdmin.typeCoderequiredFixed Value: COMP
SubstanceAdministration.precondition:substanceAdmin.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.precondition:substanceAdmin.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.precondition:substanceAdmin.typeCoderequiredFixed Value: PRCN

Constraints

IdGradePath(s)DetailsRequirements
dose-unit-or-admin-uniterrorSubstanceAdministrationIf doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present.
: doseQuantity.unit.exists() implies administrationUnitCode.empty()
product-choiceerrorSubstanceAdministration.consumable.manufacturedProductmanufacturedLabeledDrug and manufacturedMaterial are mutually exclusive (one must be present)
: (manufacturedLabeledDrug | manufacturedMaterial).count() = 1
role-choiceerrorSubstanceAdministration.participant:drugVehicle.participantRoleplayingDevice and playingEntity are mutually exclusive
: (playingDevice | playingEntity).count() <= 1
should-authorwarningSubstanceAdministrationSHOULD contain author
: author.exists()
should-doseQuantitywarningSubstanceAdministrationSHOULD contain doseQuantity
: doseQuantity.exists()
should-effectiveTimewarningSubstanceAdministration.entryRelationship:indication.observation, SubstanceAdministration.entryRelationship:medDispense.supply, SubstanceAdministration.entryRelationship:reactionObs.observationSHOULD contain effectiveTime
: effectiveTime.exists()
should-manufacturerOrganizationwarningSubstanceAdministration.consumable.manufacturedProductSHOULD contain manufacturerOrganization
: manufacturerOrganization.exists()
should-performerwarningSubstanceAdministrationSHOULD contain performer
: performer.exists()
should-quantitywarningSubstanceAdministration.entryRelationship:medSupplyOrder.supply, SubstanceAdministration.entryRelationship:medDispense.supplySHOULD contain quantity
: quantity.exists()
should-repeatNumberwarningSubstanceAdministration.entryRelationship:medSupplyOrder.supply, SubstanceAdministration.entryRelationship:medDispense.supplySHOULD contain repeatNumber
: repeatNumber.exists()
should-text-ref-valuewarningSubstanceAdministrationSHOULD contain text/reference/@value
: text.reference.value.exists()
should-text-ref-valuewarningSubstanceAdministration.entryRelationship:indication.observation, SubstanceAdministration.entryRelationship:instruction.act, SubstanceAdministration.entryRelationship:medSupplyOrder.supply, SubstanceAdministration.entryRelationship:medDispense.supply, SubstanceAdministration.entryRelationship:reactionObs.observation, SubstanceAdministration.entryRelationship:immunizationRefusal.observation, SubstanceAdministration.entryRelationship:substanceAdmin.actSHOULD contain text/reference/@value
: text.reference.value.exists()
should-translationwarningSubstanceAdministration.routeCodeSHOULD contain translation
: translation.exists()
should-unitwarningSubstanceAdministration.doseQuantitySHOULD contain @unit
: nullFlavor.exists() or unit.exists()
value-onlyerrorSubstanceAdministration.repeatNumberInterval fields SHALL not be present
: (low | high | width | center).empty()
value-starts-octothorpeerrorSubstanceAdministration.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')

This structure is derived from SubstanceAdministration

Summary

Mandatory: 9 elements (10 nested mandatory elements)
Fixed Value: 10 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element SubstanceAdministration.templateId is sliced based on the values of value:root, value:extension
  • The element SubstanceAdministration.participant is sliced based on the value of value:typeCode
  • The element SubstanceAdministration.entryRelationship is sliced based on the values of profile:act, profile:observation, profile:supply
  • The element SubstanceAdministration.precondition is sliced based on the value of profile:criterion

Differential View

This structure is derived from SubstanceAdministration

NameFlagsCard.TypeDescription & Constraintsdoco
.. SubstanceAdministration C1..1SubstanceAdministrationXML Namespace: urn:hl7-org:v3
Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, repeatNumber, routeCode, approachSiteCode, doseQuantity, rateQuantity, maxDoseQuantity, administrationUnitCode, consumable, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcInFulfillmentOf1
Base for all types and resources
Instances of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
should-text-ref-value: SHOULD contain text/reference/@value
should-doseQuantity: SHOULD contain doseQuantity
dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present.
should-performer: SHOULD contain performer
should-author: SHOULD contain author
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:immunization-activity 1..1II
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.52
..... @extension 1..1stRequired Pattern: 2015-08-01
... @classCode 1..1cs
... @moodCode 1..1csBinding: MoodCodeEvnInt (required)
... code 0..1CDSubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used and there is no defined value set.
... @negationInd 1..1blUse negationInd="true" to indicate that the immunization was not given.
... text 0..1EDSHOULD reference the portion of section narrative text corresponding to this entry
.... reference C0..1TELvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
... statusCode 1..1CS
.... @code 1..1csBinding: ActStatus (required)
... effectiveTime 1..1SXCM_TS, IVL_TS, EIVL_TS, PIVL_TS, SXPR_TS
... repeatNumber C0..1IVL_INTIn "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
value-only: Interval fields SHALL not be present
.... @value 0..1intvalue should be used instead of low/high
... routeCode C0..1CEBinding: SPL Drug Route of Administration Terminology (required)
should-translation: SHOULD contain translation
.... translation 0..*CDBinding: Medication Route (required)
... approachSiteCode 0..1CDBinding: Body Site Value Set (required)
... doseQuantity C0..1IVL_PQshould-unit: SHOULD contain @unit
.... @unit 0..1csNOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units
Binding: UnitsOfMeasureCaseSensitive (required)
... administrationUnitCode 0..1CEBinding: AdministrationUnitDoseForm (required)
... consumable 1..1InfrastructureRoot
.... manufacturedProduct 1..1ImmunizationMedicationInformationBase for all types and resources
... performer 0..1Performer2
... author 0..*AuthorParticipationBase for all types and resources
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:typeCode
.... participant:drugVehicle 0..*Participant2
..... @typeCode 1..1csFixed Value: CSM
..... participantRole 1..1DrugVehicleBase for all types and resources
... Slices for entryRelationship 0..*EntryRelationshipSlice: Unordered, Open by profile:act, profile:observation, profile:supply
.... entryRelationship:indication 0..*EntryRelationship
..... @typeCode 1..1csFixed Value: RSON
..... observation 1..1IndicationBase for all types and resources
.... entryRelationship:instruction 0..1EntryRelationship
..... @typeCode 1..1csFixed Value: SUBJ
..... @inversionInd 1..1blFixed Value: true
..... act 1..1InstructionBase for all types and resources
.... entryRelationship:medSupplyOrder 0..1EntryRelationship
..... @typeCode 1..1csFixed Value: REFR
..... supply 1..1MedicationSupplyOrderBase for all types and resources
.... entryRelationship:medDispense 0..1EntryRelationship
..... @typeCode 1..1csFixed Value: REFR
..... supply 1..1MedicationDispenseBase for all types and resources
.... entryRelationship:reactionObs 0..1EntryRelationship
..... @typeCode 1..1csFixed Value: CAUS
..... observation 1..1ReactionObservationBase for all types and resources
.... entryRelationship:immunizationRefusal 0..1EntryRelationship
..... @typeCode 1..1csFixed Value: RSON
..... observation 1..1ImmunizationRefusalReasonBase for all types and resources
.... entryRelationship:substanceAdmin 0..*EntryRelationshipThe following entryRelationship is used to indicate a given immunization's order in a series. The nested Substance Administered Act identifies an administration in the series. The entryRelationship/sequenceNumber shows the order of this particular administration in that series.
..... @typeCode 1..1csFixed Value: COMP
..... @inversionInd 1..1blFixed Value: true
..... sequenceNumber 0..1INT
..... act 1..1SubstanceAdministeredActBase for all types and resources
... Slices for precondition 0..*PreconditionSlice: Unordered, Open by profile:criterion
.... precondition:substanceAdmin 0..*Precondition
..... @typeCode 1..1cs
..... criterion 1..1PreconditionforSubstanceAdministrationBase for all types and resources

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
SubstanceAdministration.moodCoderequiredMoodCodeEvnInt
SubstanceAdministration.statusCode.coderequiredActStatus
SubstanceAdministration.routeCoderequiredSPLDrugRouteOfAdministrationTerminology
SubstanceAdministration.routeCode.translationrequiredMedicationRoute
SubstanceAdministration.approachSiteCoderequiredBodySiteValueSet
SubstanceAdministration.doseQuantity.unitrequiredUnitsOfMeasureCaseSensitive (a valid code from UCUM)
SubstanceAdministration.administrationUnitCoderequiredAdministrationUnitDoseForm

Constraints

IdGradePath(s)DetailsRequirements
dose-unit-or-admin-uniterrorSubstanceAdministrationIf doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present.
: doseQuantity.unit.exists() implies administrationUnitCode.empty()
should-authorwarningSubstanceAdministrationSHOULD contain author
: author.exists()
should-doseQuantitywarningSubstanceAdministrationSHOULD contain doseQuantity
: doseQuantity.exists()
should-performerwarningSubstanceAdministrationSHOULD contain performer
: performer.exists()
should-text-ref-valuewarningSubstanceAdministrationSHOULD contain text/reference/@value
: text.reference.value.exists()
should-translationwarningSubstanceAdministration.routeCodeSHOULD contain translation
: translation.exists()
should-unitwarningSubstanceAdministration.doseQuantitySHOULD contain @unit
: nullFlavor.exists() or unit.exists()
value-onlyerrorSubstanceAdministration.repeatNumberInterval fields SHALL not be present
: (low | high | width | center).empty()
value-starts-octothorpeerrorSubstanceAdministration.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. SubstanceAdministration C1..1SubstanceAdministrationXML Namespace: urn:hl7-org:v3
Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, repeatNumber, routeCode, approachSiteCode, doseQuantity, rateQuantity, maxDoseQuantity, administrationUnitCode, consumable, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcInFulfillmentOf1
Base for all types and resources
Instances of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
should-text-ref-value: SHOULD contain text/reference/@value
should-doseQuantity: SHOULD contain doseQuantity
dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present.
should-performer: SHOULD contain performer
should-author: SHOULD contain author
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:immunization-activity 1..1II
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.52
..... @extension 1..1stRequired Pattern: 2015-08-01
... @classCode 1..1csBinding: ActClass (2.0.0) (required)
Fixed Value: SBADM
... @moodCode 1..1csBinding: MoodCodeEvnInt (required)
... code 0..1CDSubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used and there is no defined value set.
Binding: ActSubstanceAdministrationCode (example)
... @negationInd 1..1blUse negationInd="true" to indicate that the immunization was not given.
... text 0..1EDSHOULD reference the portion of section narrative text corresponding to this entry
.... reference C0..1TELvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
... statusCode 1..1CSBinding: ActStatus (required)
.... @code 1..1csBinding: ActStatus (required)
... effectiveTime 1..1
.... effectiveTimeSXCM_TS
.... effectiveTimeIVL_TS
.... effectiveTimeEIVL_TS
.... effectiveTimePIVL_TS
.... effectiveTimeSXPR_TS
... repeatNumber C0..1IVL_INTIn "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
value-only: Interval fields SHALL not be present
.... @value 0..1intvalue should be used instead of low/high
... routeCode C0..1CEBinding: SPL Drug Route of Administration Terminology (required)
should-translation: SHOULD contain translation
.... translation 0..*CDBinding: Medication Route (required)
... approachSiteCode 0..1CDBinding: Body Site Value Set (required)
... doseQuantity C0..1IVL_PQshould-unit: SHOULD contain @unit
.... @unit 0..1csNOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units
Binding: UnitsOfMeasureCaseSensitive (required)
... administrationUnitCode 0..1CEBinding: AdministrationUnitDoseForm (required)
... consumable 1..1InfrastructureRoot
.... manufacturedProduct C1..1ImmunizationMedicationInformationBase for all types and resources
... performer 0..1Performer2
... author 0..*AuthorParticipationBase for all types and resources
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:typeCode
.... participant:drugVehicle 0..*Participant2
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: CSM
..... participantRole C1..1DrugVehicleBase for all types and resources
... Slices for entryRelationship 0..*EntryRelationshipSlice: Unordered, Open by profile:act, profile:observation, profile:supply
.... entryRelationship:indication 0..*EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: RSON
..... observation C1..1IndicationBase for all types and resources
.... entryRelationship:instruction 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: SUBJ
..... @inversionInd 1..1blFixed Value: true
..... act C1..1InstructionBase for all types and resources
.... entryRelationship:medSupplyOrder 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... supply C1..1MedicationSupplyOrderBase for all types and resources
.... entryRelationship:medDispense 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... supply C1..1MedicationDispenseBase for all types and resources
.... entryRelationship:reactionObs 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: CAUS
..... observation C1..1ReactionObservationBase for all types and resources
.... entryRelationship:immunizationRefusal 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: RSON
..... observation C1..1ImmunizationRefusalReasonBase for all types and resources
.... entryRelationship:substanceAdmin 0..*EntryRelationshipThe following entryRelationship is used to indicate a given immunization's order in a series. The nested Substance Administered Act identifies an administration in the series. The entryRelationship/sequenceNumber shows the order of this particular administration in that series.
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: COMP
..... @inversionInd 1..1blFixed Value: true
..... sequenceNumber 0..1INT
..... act C1..1SubstanceAdministeredActBase for all types and resources
... Slices for precondition 0..*PreconditionSlice: Unordered, Open by profile:criterion
.... precondition:substanceAdmin 0..*Precondition
..... @typeCode 1..1csBinding: ActRelationshipType (required)
Fixed Value: PRCN
..... criterion 1..1PreconditionforSubstanceAdministrationBase for all types and resources

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
SubstanceAdministration.classCoderequiredFixed Value: SBADM
SubstanceAdministration.moodCoderequiredMoodCodeEvnInt
SubstanceAdministration.codeexampleActSubstanceAdministrationCode
SubstanceAdministration.statusCoderequiredActStatus
SubstanceAdministration.statusCode.coderequiredActStatus
SubstanceAdministration.routeCoderequiredSPLDrugRouteOfAdministrationTerminology
SubstanceAdministration.routeCode.translationrequiredMedicationRoute
SubstanceAdministration.approachSiteCoderequiredBodySiteValueSet
SubstanceAdministration.doseQuantity.unitrequiredUnitsOfMeasureCaseSensitive (a valid code from UCUM)
SubstanceAdministration.administrationUnitCoderequiredAdministrationUnitDoseForm
SubstanceAdministration.participant:drugVehicle.typeCoderequiredFixed Value: CSM
SubstanceAdministration.entryRelationship:indication.typeCoderequiredFixed Value: RSON
SubstanceAdministration.entryRelationship:instruction.typeCoderequiredFixed Value: SUBJ
SubstanceAdministration.entryRelationship:medSupplyOrder.typeCoderequiredFixed Value: REFR
SubstanceAdministration.entryRelationship:medDispense.typeCoderequiredFixed Value: REFR
SubstanceAdministration.entryRelationship:reactionObs.typeCoderequiredFixed Value: CAUS
SubstanceAdministration.entryRelationship:immunizationRefusal.typeCoderequiredFixed Value: RSON
SubstanceAdministration.entryRelationship:substanceAdmin.typeCoderequiredFixed Value: COMP
SubstanceAdministration.precondition:substanceAdmin.typeCoderequiredFixed Value: PRCN

Constraints

IdGradePath(s)DetailsRequirements
dose-unit-or-admin-uniterrorSubstanceAdministrationIf doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present.
: doseQuantity.unit.exists() implies administrationUnitCode.empty()
product-choiceerrorSubstanceAdministration.consumable.manufacturedProductmanufacturedLabeledDrug and manufacturedMaterial are mutually exclusive (one must be present)
: (manufacturedLabeledDrug | manufacturedMaterial).count() = 1
role-choiceerrorSubstanceAdministration.participant:drugVehicle.participantRoleplayingDevice and playingEntity are mutually exclusive
: (playingDevice | playingEntity).count() <= 1
should-authorwarningSubstanceAdministrationSHOULD contain author
: author.exists()
should-doseQuantitywarningSubstanceAdministrationSHOULD contain doseQuantity
: doseQuantity.exists()
should-effectiveTimewarningSubstanceAdministration.entryRelationship:indication.observation, SubstanceAdministration.entryRelationship:medDispense.supply, SubstanceAdministration.entryRelationship:reactionObs.observationSHOULD contain effectiveTime
: effectiveTime.exists()
should-manufacturerOrganizationwarningSubstanceAdministration.consumable.manufacturedProductSHOULD contain manufacturerOrganization
: manufacturerOrganization.exists()
should-performerwarningSubstanceAdministrationSHOULD contain performer
: performer.exists()
should-quantitywarningSubstanceAdministration.entryRelationship:medSupplyOrder.supply, SubstanceAdministration.entryRelationship:medDispense.supplySHOULD contain quantity
: quantity.exists()
should-repeatNumberwarningSubstanceAdministration.entryRelationship:medSupplyOrder.supply, SubstanceAdministration.entryRelationship:medDispense.supplySHOULD contain repeatNumber
: repeatNumber.exists()
should-text-ref-valuewarningSubstanceAdministrationSHOULD contain text/reference/@value
: text.reference.value.exists()
should-text-ref-valuewarningSubstanceAdministration.entryRelationship:indication.observation, SubstanceAdministration.entryRelationship:instruction.act, SubstanceAdministration.entryRelationship:medSupplyOrder.supply, SubstanceAdministration.entryRelationship:medDispense.supply, SubstanceAdministration.entryRelationship:reactionObs.observation, SubstanceAdministration.entryRelationship:immunizationRefusal.observation, SubstanceAdministration.entryRelationship:substanceAdmin.actSHOULD contain text/reference/@value
: text.reference.value.exists()
should-translationwarningSubstanceAdministration.routeCodeSHOULD contain translation
: translation.exists()
should-unitwarningSubstanceAdministration.doseQuantitySHOULD contain @unit
: nullFlavor.exists() or unit.exists()
value-onlyerrorSubstanceAdministration.repeatNumberInterval fields SHALL not be present
: (low | high | width | center).empty()
value-starts-octothorpeerrorSubstanceAdministration.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. SubstanceAdministration C1..1SubstanceAdministrationXML Namespace: urn:hl7-org:v3
Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, repeatNumber, routeCode, approachSiteCode, doseQuantity, rateQuantity, maxDoseQuantity, administrationUnitCode, consumable, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcInFulfillmentOf1
Base for all types and resources
Instances of this type are validated by templateId
Logical Container: ClinicalDocument (CDA Class)
should-text-ref-value: SHOULD contain text/reference/@value
should-doseQuantity: SHOULD contain doseQuantity
dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present.
should-performer: SHOULD contain performer
should-author: SHOULD contain author
... @nullFlavor 0..1csBinding: CDANullFlavor (required)
... realmCode 0..*CS
... typeId 0..1II
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @assigningAuthorityName 0..1st
.... @displayable 0..1bl
.... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
.... @extension 1..1st
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:immunization-activity 1..1II
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... @assigningAuthorityName 0..1st
..... @displayable 0..1bl
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.52
..... @extension 1..1stRequired Pattern: 2015-08-01
... @classCode 1..1csBinding: ActClass (2.0.0) (required)
Fixed Value: SBADM
... @moodCode 1..1csBinding: MoodCodeEvnInt (required)
... id 1..*II
... code 0..1CDSubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used and there is no defined value set.
Binding: ActSubstanceAdministrationCode (example)
... @negationInd 1..1blUse negationInd="true" to indicate that the immunization was not given.
... text 0..1EDSHOULD reference the portion of section narrative text corresponding to this entry
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @compression 0..1csBinding: CompressionAlgorithm (required)
.... @integrityCheck 0..1bin
.... @integrityCheckAlgorithm 0..1csBinding: IntegrityCheckAlgorithm (2.0.0) (required)
.... @language 0..1cs
.... @mediaType 0..1csBinding: MediaType (example)
.... @representation 0..1csBinding: Binary Data Encoding Value Set (required)
.... xmlText 0..1stAllows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
.... reference C0..1TELvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
.... thumbnail 0..1ED
... statusCode 1..1CSBinding: ActStatus (required)
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @code 1..1csBinding: ActStatus (required)
.... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 1..1
.... effectiveTimeSXCM_TS
.... effectiveTimeIVL_TS
.... effectiveTimeEIVL_TS
.... effectiveTimePIVL_TS
.... effectiveTimeSXPR_TS
... priorityCode 0..1CEBinding: ActPriority (example)
... repeatNumber C0..1IVL_INTIn "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
value-only: Interval fields SHALL not be present
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @value 0..1intvalue should be used instead of low/high
.... @operator 0..1csBinding: SetOperator (required)
.... low 0..1IVXB_INT
.... center 0..1INT
.... width 0..1INT
.... high 0..1IVXB_INT
... routeCode C0..1CEBinding: SPL Drug Route of Administration Terminology (required)
should-translation: SHOULD contain translation
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @code 0..1cs
.... @codeSystem 0..1oid, uuid, ruid
.... @codeSystemName 0..1st
.... @codeSystemVersion 0..1st
.... @displayName 0..1st
.... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1ED
.... translation 0..*CDBinding: Medication Route (required)
... approachSiteCode 0..1CDBinding: Body Site Value Set (required)
... doseQuantity C0..1IVL_PQshould-unit: SHOULD contain @unit
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... @unit 0..1csNOTE: The base CDA R2.0 standard requires @unit to be drawn from UCUM, and best practice is to use case sensitive UCUM units
Binding: UnitsOfMeasureCaseSensitive (required)
.... @value 0..1real
.... translation 0..*PQR
.... @operator 0..1csBinding: SetOperator (required)
.... low 0..1IVXB_PQ
.... center 0..1PQ
.... width 0..1PQ
.... high 0..1IVXB_PQ
... rateQuantity 0..1IVL_PQ
... maxDoseQuantity 0..1RTO_PQ_PQ
... administrationUnitCode 0..1CEBinding: AdministrationUnitDoseForm (required)
... consumable 1..1InfrastructureRoot
.... @nullFlavor 0..1csBinding: CDANullFlavor (required)
.... realmCode 0..*CS
.... typeId 0..1II
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... @assigningAuthorityName 0..1st
..... @displayable 0..1bl
..... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
..... @extension 1..1st
.... templateId 0..*II
.... @typeCode 0..1csBinding: ParticipationType (required)
Fixed Value: CSM
.... manufacturedProduct C1..1ImmunizationMedicationInformationBase for all types and resources
... subject 0..1Subject
... specimen 0..*Specimen
... performer 0..1Performer2
... author 0..*AuthorParticipationBase for all types and resources
... informant 0..*Informant
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:typeCode
.... participant:drugVehicle 0..*Participant2
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: CSM
..... @contextControlCode 0..1csBinding: ContextControl (required)
Fixed Value: OP
..... sdtcFunctionCode 0..1CEXML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1IVL_TS
..... awarenessCode 0..1CE
..... participantRole C1..1DrugVehicleBase for all types and resources
... Slices for entryRelationship 0..*EntryRelationshipSlice: Unordered, Open by profile:act, profile:observation, profile:supply
.... entryRelationship:indication 0..*EntryRelationship
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: RSON
..... @inversionInd 0..1bl
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 0..1Act
..... encounter 0..1Encounter
..... observation C1..1IndicationBase for all types and resources
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
.... entryRelationship:instruction 0..1EntryRelationship
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: SUBJ
..... @inversionInd 1..1blFixed Value: true
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act C1..1InstructionBase for all types and resources
..... encounter 0..1Encounter
..... observation 0..1Observation
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
.... entryRelationship:medSupplyOrder 0..1EntryRelationship
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... @inversionInd 0..1bl
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 0..1Act
..... encounter 0..1Encounter
..... observation 0..1Observation
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply C1..1MedicationSupplyOrderBase for all types and resources
.... entryRelationship:medDispense 0..1EntryRelationship
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... @inversionInd 0..1bl
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 0..1Act
..... encounter 0..1Encounter
..... observation 0..1Observation
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply C1..1MedicationDispenseBase for all types and resources
.... entryRelationship:reactionObs 0..1EntryRelationship
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: CAUS
..... @inversionInd 0..1bl
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 0..1Act
..... encounter 0..1Encounter
..... observation C1..1ReactionObservationBase for all types and resources
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
.... entryRelationship:immunizationRefusal 0..1EntryRelationship
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: RSON
..... @inversionInd 0..1bl
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 0..1Act
..... encounter 0..1Encounter
..... observation C1..1ImmunizationRefusalReasonBase for all types and resources
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
.... entryRelationship:substanceAdmin 0..*EntryRelationshipThe following entryRelationship is used to indicate a given immunization's order in a series. The nested Substance Administered Act identifies an administration in the series. The entryRelationship/sequenceNumber shows the order of this particular administration in that series.
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: COMP
..... @inversionInd 1..1blFixed Value: true
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act C1..1SubstanceAdministeredActBase for all types and resources
..... encounter 0..1Encounter
..... observation 0..1Observation
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
... reference 0..*Reference
... Slices for precondition 0..*PreconditionSlice: Unordered, Open by profile:criterion
.... precondition:substanceAdmin 0..*Precondition
..... @nullFlavor 0..1csBinding: CDANullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
...... @nullFlavor 0..1csBinding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1st
...... @displayable 0..1bl
...... @root 1..1oid, uuid, ruidFixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1st
..... templateId 0..*II
..... @typeCode 1..1csBinding: ActRelationshipType (required)
Fixed Value: PRCN
..... criterion 1..1PreconditionforSubstanceAdministrationBase for all types and resources
... sdtcInFulfillmentOf1 0..*InFulfillmentOf1XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
SubstanceAdministration.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.templateId:immunization-activity.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.classCoderequiredFixed Value: SBADM
SubstanceAdministration.moodCoderequiredMoodCodeEvnInt
SubstanceAdministration.codeexampleActSubstanceAdministrationCode
SubstanceAdministration.text.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.text.compressionrequiredCDACompressionAlgorithm
SubstanceAdministration.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
SubstanceAdministration.text.mediaTypeexampleMediaType
SubstanceAdministration.text.representationrequiredBinaryDataEncoding
SubstanceAdministration.statusCoderequiredActStatus
SubstanceAdministration.statusCode.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.statusCode.coderequiredActStatus
SubstanceAdministration.priorityCodeexampleActPriority
SubstanceAdministration.repeatNumber.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.repeatNumber.operatorrequiredSetOperator
SubstanceAdministration.routeCoderequiredSPLDrugRouteOfAdministrationTerminology
SubstanceAdministration.routeCode.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.routeCode.translationrequiredMedicationRoute
SubstanceAdministration.approachSiteCoderequiredBodySiteValueSet
SubstanceAdministration.doseQuantity.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.doseQuantity.unitrequiredUnitsOfMeasureCaseSensitive (a valid code from UCUM)
SubstanceAdministration.doseQuantity.operatorrequiredSetOperator
SubstanceAdministration.administrationUnitCoderequiredAdministrationUnitDoseForm
SubstanceAdministration.consumable.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.consumable.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.consumable.typeCoderequiredFixed Value: CSM
SubstanceAdministration.participant:drugVehicle.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.participant:drugVehicle.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.participant:drugVehicle.typeCoderequiredFixed Value: CSM
SubstanceAdministration.participant:drugVehicle.contextControlCoderequiredFixed Value: OP
SubstanceAdministration.entryRelationship:indication.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:indication.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:indication.typeCoderequiredFixed Value: RSON
SubstanceAdministration.entryRelationship:instruction.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:instruction.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:instruction.typeCoderequiredFixed Value: SUBJ
SubstanceAdministration.entryRelationship:medSupplyOrder.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:medSupplyOrder.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:medSupplyOrder.typeCoderequiredFixed Value: REFR
SubstanceAdministration.entryRelationship:medDispense.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:medDispense.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:medDispense.typeCoderequiredFixed Value: REFR
SubstanceAdministration.entryRelationship:reactionObs.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:reactionObs.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:reactionObs.typeCoderequiredFixed Value: CAUS
SubstanceAdministration.entryRelationship:immunizationRefusal.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:immunizationRefusal.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:immunizationRefusal.typeCoderequiredFixed Value: RSON
SubstanceAdministration.entryRelationship:substanceAdmin.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:substanceAdmin.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.entryRelationship:substanceAdmin.typeCoderequiredFixed Value: COMP
SubstanceAdministration.precondition:substanceAdmin.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.precondition:substanceAdmin.typeId.nullFlavorrequiredCDANullFlavor
SubstanceAdministration.precondition:substanceAdmin.typeCoderequiredFixed Value: PRCN

Constraints

IdGradePath(s)DetailsRequirements
dose-unit-or-admin-uniterrorSubstanceAdministrationIf doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present.
: doseQuantity.unit.exists() implies administrationUnitCode.empty()
product-choiceerrorSubstanceAdministration.consumable.manufacturedProductmanufacturedLabeledDrug and manufacturedMaterial are mutually exclusive (one must be present)
: (manufacturedLabeledDrug | manufacturedMaterial).count() = 1
role-choiceerrorSubstanceAdministration.participant:drugVehicle.participantRoleplayingDevice and playingEntity are mutually exclusive
: (playingDevice | playingEntity).count() <= 1
should-authorwarningSubstanceAdministrationSHOULD contain author
: author.exists()
should-doseQuantitywarningSubstanceAdministrationSHOULD contain doseQuantity
: doseQuantity.exists()
should-effectiveTimewarningSubstanceAdministration.entryRelationship:indication.observation, SubstanceAdministration.entryRelationship:medDispense.supply, SubstanceAdministration.entryRelationship:reactionObs.observationSHOULD contain effectiveTime
: effectiveTime.exists()
should-manufacturerOrganizationwarningSubstanceAdministration.consumable.manufacturedProductSHOULD contain manufacturerOrganization
: manufacturerOrganization.exists()
should-performerwarningSubstanceAdministrationSHOULD contain performer
: performer.exists()
should-quantitywarningSubstanceAdministration.entryRelationship:medSupplyOrder.supply, SubstanceAdministration.entryRelationship:medDispense.supplySHOULD contain quantity
: quantity.exists()
should-repeatNumberwarningSubstanceAdministration.entryRelationship:medSupplyOrder.supply, SubstanceAdministration.entryRelationship:medDispense.supplySHOULD contain repeatNumber
: repeatNumber.exists()
should-text-ref-valuewarningSubstanceAdministrationSHOULD contain text/reference/@value
: text.reference.value.exists()
should-text-ref-valuewarningSubstanceAdministration.entryRelationship:indication.observation, SubstanceAdministration.entryRelationship:instruction.act, SubstanceAdministration.entryRelationship:medSupplyOrder.supply, SubstanceAdministration.entryRelationship:medDispense.supply, SubstanceAdministration.entryRelationship:reactionObs.observation, SubstanceAdministration.entryRelationship:immunizationRefusal.observation, SubstanceAdministration.entryRelationship:substanceAdmin.actSHOULD contain text/reference/@value
: text.reference.value.exists()
should-translationwarningSubstanceAdministration.routeCodeSHOULD contain translation
: translation.exists()
should-unitwarningSubstanceAdministration.doseQuantitySHOULD contain @unit
: nullFlavor.exists() or unit.exists()
value-onlyerrorSubstanceAdministration.repeatNumberInterval fields SHALL not be present
: (low | high | width | center).empty()
value-starts-octothorpeerrorSubstanceAdministration.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')

This structure is derived from SubstanceAdministration

Summary

Mandatory: 9 elements (10 nested mandatory elements)
Fixed Value: 10 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element SubstanceAdministration.templateId is sliced based on the values of value:root, value:extension
  • The element SubstanceAdministration.participant is sliced based on the value of value:typeCode
  • The element SubstanceAdministration.entryRelationship is sliced based on the values of profile:act, profile:observation, profile:supply
  • The element SubstanceAdministration.precondition is sliced based on the value of profile:criterion

 

Other representations of profile: CSV, Excel