Consolidated CDA
3.0.0-ballot - ballot
Consolidated CDA
3.0.0-ballot - ballot
This page is part of the CCDA: Consolidated CDA Release (v3.0.0-ballot: CCDA 3.0 Ballot 1) based on FHIR (HL7® FHIR® Standard) v5.0.0. . For a full list of available versions, see the Directory of published versions
| Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/ProblemConcernAct | Version: 3.0.0-ballot | |||
| Draft as of 2023-12-21 | Computable Name: ProblemConcernAct | |||
| Other Identifiers: id: urn:hl7ii:2.16.840.1.113883.10.20.22.4.3:2024-05-01 | ||||
This template reflects an ongoing concern on behalf of the provider that placed the concern on a patient’s problem list. So long as the underlying condition is of concern to the provider (i.e., as long as the condition, whether active or resolved, is of ongoing concern and interest to the provider), the statusCode is “active”. Only when the underlying condition is no longer of concern is the statusCode set to “completed”. The effectiveTime reflects the time that the underlying condition was felt to be a concern; it may or may not correspond to the effectiveTime of the condition (e.g., even five years later, the clinician may remain concerned about a prior heart attack).
The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved.
The effectiveTime/low of the Problem Concern Act asserts when the concern became active. The effectiveTime/high asserts when the concern was completed (e.g., when the clinician deemed there is no longer any need to track the underlying condition).
A Problem Concern Act can contain one Problem Observation (templateId 2.16.840.1.113883.10.20.22.4.4). The Problem Observation is a discrete observation of a condition, and therefore will have a statusCode of “completed”. For instance, a Concern may contain a Problem Observation of “chest pain” that is still ongoing:
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from Act
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Act | C | 1..1 | Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author |
  Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root, value:extension | |
   templateId:problem-concern-act | 1..1 | II | ||
  @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.3 | |
  @extension | 1..1 | st | Required Pattern: 2024-05-01 | |
 @classCode | 1..1 | cs | Fixed Value: ACT | |
| @moodCode | 1..1 | cs | Fixed Value: EVN | |
| id | 1..* | II | ||
| code | 1..1 | CD | ||
| @code | 1..1 | cs | Required Pattern: CONC | |
 @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.5.6 | |
| text | 0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
| reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
| statusCode | 1..1 | CS | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. | |
| @code | 1..1 | cs | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. Binding: ProblemAct statusCode (required) | |
| effectiveTime | 1..1 | IVL_TS | ||
| low | 1..1 | IVXB_TS | The effectiveTime/low of the Problem Concern Act asserts when the concern became active. | |
| high | 0..1 | IVXB_TS | The effectiveTime/high asserts when the concern was completed (e.g., when the clinician deemed there is no longer any need to track the underlying condition). | |
 author | 0..* | AuthorParticipation | Base for all types and resources | |
 Slices for entryRelationship | 1..* | EntryRelationship | The following entryRelationship represents the importance of the concern to a provider. Slice: Unordered, Open by profile:observation | |
 entryRelationship:problem | 1..1 | EntryRelationship | ||
 @typeCode | 1..1 | cs | Fixed Value: SUBJ | |
| observation | 1..1 | ProblemObservation | Base for all types and resources | |
| entryRelationship:priority | 0..* | EntryRelationship | ||
| @typeCode | 1..1 | cs | Fixed Value: REFR | |
| observation | 1..1 | PriorityPreference | Base for all types and resources | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| Act.statusCode.code | required | ProblemActStatusCode |
| Id | Grade | Path(s) | Details | Requirements |
| should-author | warning | Act | SHOULD contain author : author.exists() | |
| should-text-ref-value | warning | Act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| value-starts-octothorpe | error | Act.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') |
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Act | C | 1..1 | Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author |
| Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root, value:extension | |
| templateId:problem-concern-act | 1..1 | II | ||
 @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.3 | |
| @extension | 1..1 | st | Required Pattern: 2024-05-01 | |
| @classCode | 1..1 | cs | Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT | |
| @moodCode | 1..1 | cs | Binding: XDocumentActMood (2.0.0) (required) Fixed Value: EVN | |
| id | 1..* | II | ||
| code | 1..1 | CD | Binding: v3 Code System ActCode (example) | |
| @code | 1..1 | cs | Required Pattern: CONC | |
| @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.5.6 | |
| text | 0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
| reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
| statusCode | 1..1 | CS | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. Binding: ActStatus (required) | |
| @code | 1..1 | cs | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. Binding: ProblemAct statusCode (required) | |
| effectiveTime | 1..1 | IVL_TS | ||
| low | 1..1 | IVXB_TS | The effectiveTime/low of the Problem Concern Act asserts when the concern became active. | |
| high | 0..1 | IVXB_TS | The effectiveTime/high asserts when the concern was completed (e.g., when the clinician deemed there is no longer any need to track the underlying condition). | |
| author | 0..* | AuthorParticipation | Base for all types and resources | |
| Slices for entryRelationship | 1..* | EntryRelationship | The following entryRelationship represents the importance of the concern to a provider. Slice: Unordered, Open by profile:observation | |
| entryRelationship:problem | 1..1 | EntryRelationship | ||
| @typeCode | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SUBJ | |
| observation | C | 1..1 | ProblemObservation | Base for all types and resources |
| entryRelationship:priority | 0..* | EntryRelationship | ||
| @typeCode | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR | |
| observation | C | 1..1 | PriorityPreference | Base for all types and resources |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code |
| Act.classCode | required | Fixed Value: ACT |
| Act.moodCode | required | Fixed Value: EVN |
| Act.code | example | ActCode |
| Act.statusCode | required | ActStatus |
| Act.statusCode.code | required | ProblemActStatusCode |
| Act.entryRelationship:problem.typeCode | required | Fixed Value: SUBJ |
| Act.entryRelationship:priority.typeCode | required | Fixed Value: REFR |
| Id | Grade | Path(s) | Details | Requirements |
| should-author | warning | Act | SHOULD contain author : author.exists() | |
| should-author | warning | Act.entryRelationship:problem.observation, Act.entryRelationship:priority.observation | SHOULD contain author : author.exists() | |
| should-effectiveTime | warning | Act.entryRelationship:priority.observation | SHOULD contain effectiveTime : effectiveTime.exists() | |
| should-text-ref-value | warning | Act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| should-text-ref-value | warning | Act.entryRelationship:problem.observation, Act.entryRelationship:priority.observation | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| value-starts-octothorpe | error | Act.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') |
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Act | C | 1..1 | Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author |
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| realmCode | 0..* | CS | ||
| typeId | 0..1 | II | ||
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| @assigningAuthorityName | 0..1 | st | ||
| @displayable | 0..1 | bl | ||
| @root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
| @extension | 1..1 | st | ||
| Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root, value:extension | |
| templateId:problem-concern-act | 1..1 | II | ||
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| @assigningAuthorityName | 0..1 | st | ||
| @displayable | 0..1 | bl | ||
| @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.3 | |
| @extension | 1..1 | st | Required Pattern: 2024-05-01 | |
| @classCode | 1..1 | cs | Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT | |
| @moodCode | 1..1 | cs | Binding: XDocumentActMood (2.0.0) (required) Fixed Value: EVN | |
| @negationInd | 0..1 | bl | ||
| id | 1..* | II | ||
| code | 1..1 | CD | Binding: v3 Code System ActCode (example) | |
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| @code | 1..1 | cs | Required Pattern: CONC | |
| @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.5.6 | |
| @codeSystemName | 0..1 | st | ||
| @codeSystemVersion | 0..1 | st | ||
| @displayName | 0..1 | st | ||
| @sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
| @sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
| originalText | 0..1 | ED | ||
| qualifier | 0..* | CR | ||
| translation | 0..* | CD | ||
| text | 0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| @compression | 0..1 | cs | Binding: CompressionAlgorithm (required) | |
| @integrityCheck | 0..1 | bin | ||
| @integrityCheckAlgorithm | 0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required) | |
| @language | 0..1 | cs | ||
| @mediaType | 0..1 | cs | Binding: MediaType (example) | |
| @representation | 0..1 | cs | Binding: Binary Data Encoding Value Set (required) | |
| xmlText | 0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string. | |
| reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
| thumbnail | 0..1 | ED | ||
| statusCode | 1..1 | CS | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. Binding: ActStatus (required) | |
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| @code | 1..1 | cs | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. Binding: ProblemAct statusCode (required) | |
| @sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
| @sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
| effectiveTime | 1..1 | IVL_TS | ||
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| @value | 0..1 | ts | Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz] | |
| @operator | 0..1 | cs | Binding: SetOperator (required) | |
| low | 1..1 | IVXB_TS | The effectiveTime/low of the Problem Concern Act asserts when the concern became active. | |
| center | 0..1 | TS | ||
| width | 0..1 | PQ | ||
| high | 0..1 | IVXB_TS | The effectiveTime/high asserts when the concern was completed (e.g., when the clinician deemed there is no longer any need to track the underlying condition). | |
| priorityCode | 0..1 | CE | Binding: ActPriority (example) | |
| languageCode | 0..1 | CS | Binding: AllLanguages (required) | |
| subject | 0..1 | Subject | ||
| specimen | 0..* | Specimen | ||
| performer | 0..* | Performer2 | ||
| author | 0..* | AuthorParticipation | Base for all types and resources | |
| informant | 0..* | Informant | ||
| participant | 0..* | Participant2 | ||
| Slices for entryRelationship | 1..* | EntryRelationship | The following entryRelationship represents the importance of the concern to a provider. Slice: Unordered, Open by profile:observation | |
| entryRelationship:problem | 1..1 | EntryRelationship | ||
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| realmCode | 0..* | CS | ||
 typeId | 0..1 | II | ||
 @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| @assigningAuthorityName | 0..1 | st | ||
| @displayable | 0..1 | bl | ||
| @root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
| @extension | 1..1 | st | ||
| templateId | 0..* | II | ||
| @typeCode | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SUBJ | |
| @inversionInd | 0..1 | bl | ||
| @contextConductionInd | 0..1 | bl | ||
| @negationInd | 0..1 | bl | ||
| sequenceNumber | 0..1 | INT | ||
| seperatableInd | 0..1 | BL | ||
| act | 0..1 | Act | ||
| encounter | 0..1 | Encounter | ||
| observation | C | 1..1 | ProblemObservation | Base for all types and resources |
| observationMedia | 0..1 | ObservationMedia | ||
| organizer | 0..1 | Organizer | ||
| procedure | 0..1 | Procedure | ||
| regionOfInterest | 0..1 | RegionOfInterest | ||
| substanceAdministration | 0..1 | SubstanceAdministration | ||
| supply | 0..1 | Supply | ||
| entryRelationship:priority | 0..* | EntryRelationship | ||
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| realmCode | 0..* | CS | ||
| typeId | 0..1 | II | ||
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| @assigningAuthorityName | 0..1 | st | ||
| @displayable | 0..1 | bl | ||
| @root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
| @extension | 1..1 | st | ||
| templateId | 0..* | II | ||
| @typeCode | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR | |
| @inversionInd | 0..1 | bl | ||
| @contextConductionInd | 0..1 | bl | ||
| @negationInd | 0..1 | bl | ||
| sequenceNumber | 0..1 | INT | ||
| seperatableInd | 0..1 | BL | ||
| act | 0..1 | Act | ||
| encounter | 0..1 | Encounter | ||
| observation | C | 1..1 | PriorityPreference | Base for all types and resources |
| observationMedia | 0..1 | ObservationMedia | ||
| organizer | 0..1 | Organizer | ||
| procedure | 0..1 | Procedure | ||
| regionOfInterest | 0..1 | RegionOfInterest | ||
| substanceAdministration | 0..1 | SubstanceAdministration | ||
| supply | 0..1 | Supply | ||
| reference | 0..* | Reference | ||
| precondition | 0..* | Precondition | ||
| sdtcPrecondition2 | 0..* | Precondition2 | XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc) | |
| sdtcInFulfillmentOf1 | 0..* | InFulfillmentOf1 | XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc) | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code |
| Act.nullFlavor | required | CDANullFlavor |
| Act.typeId.nullFlavor | required | CDANullFlavor |
| Act.templateId:problem-concern-act.nullFlavor | required | CDANullFlavor |
| Act.classCode | required | Fixed Value: ACT |
| Act.moodCode | required | Fixed Value: EVN |
| Act.code | example | ActCode |
| Act.code.nullFlavor | required | CDANullFlavor |
| Act.text.nullFlavor | required | CDANullFlavor |
| Act.text.compression | required | CDACompressionAlgorithm |
| Act.text.integrityCheckAlgorithm | required | IntegrityCheckAlgorithm |
| Act.text.mediaType | example | MediaType |
| Act.text.representation | required | BinaryDataEncoding |
| Act.statusCode | required | ActStatus |
| Act.statusCode.nullFlavor | required | CDANullFlavor |
| Act.statusCode.code | required | ProblemActStatusCode |
| Act.effectiveTime.nullFlavor | required | CDANullFlavor |
| Act.effectiveTime.operator | required | SetOperator |
| Act.priorityCode | example | ActPriority |
| Act.languageCode | required | AllLanguages |
| Act.entryRelationship:problem.nullFlavor | required | CDANullFlavor |
| Act.entryRelationship:problem.typeId.nullFlavor | required | CDANullFlavor |
| Act.entryRelationship:problem.typeCode | required | Fixed Value: SUBJ |
| Act.entryRelationship:priority.nullFlavor | required | CDANullFlavor |
| Act.entryRelationship:priority.typeId.nullFlavor | required | CDANullFlavor |
| Act.entryRelationship:priority.typeCode | required | Fixed Value: REFR |
| Id | Grade | Path(s) | Details | Requirements |
| should-author | warning | Act | SHOULD contain author : author.exists() | |
| should-author | warning | Act.entryRelationship:problem.observation, Act.entryRelationship:priority.observation | SHOULD contain author : author.exists() | |
| should-effectiveTime | warning | Act.entryRelationship:priority.observation | SHOULD contain effectiveTime : effectiveTime.exists() | |
| should-text-ref-value | warning | Act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| should-text-ref-value | warning | Act.entryRelationship:problem.observation, Act.entryRelationship:priority.observation | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| value-starts-octothorpe | error | Act.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') |
This structure is derived from Act
Summary
Mandatory: 14 elements (1 nested mandatory element)
Fixed Value: 4 elements
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Differential View
This structure is derived from Act
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Act | C | 1..1 | Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author |
| Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root, value:extension | |
| templateId:problem-concern-act | 1..1 | II | ||
| @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.3 | |
| @extension | 1..1 | st | Required Pattern: 2024-05-01 | |
| @classCode | 1..1 | cs | Fixed Value: ACT | |
| @moodCode | 1..1 | cs | Fixed Value: EVN | |
| id | 1..* | II | ||
| code | 1..1 | CD | ||
| @code | 1..1 | cs | Required Pattern: CONC | |
| @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.5.6 | |
| text | 0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
| reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
| statusCode | 1..1 | CS | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. | |
| @code | 1..1 | cs | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. Binding: ProblemAct statusCode (required) | |
| effectiveTime | 1..1 | IVL_TS | ||
| low | 1..1 | IVXB_TS | The effectiveTime/low of the Problem Concern Act asserts when the concern became active. | |
| high | 0..1 | IVXB_TS | The effectiveTime/high asserts when the concern was completed (e.g., when the clinician deemed there is no longer any need to track the underlying condition). | |
| author | 0..* | AuthorParticipation | Base for all types and resources | |
| Slices for entryRelationship | 1..* | EntryRelationship | The following entryRelationship represents the importance of the concern to a provider. Slice: Unordered, Open by profile:observation | |
| entryRelationship:problem | 1..1 | EntryRelationship | ||
| @typeCode | 1..1 | cs | Fixed Value: SUBJ | |
| observation | 1..1 | ProblemObservation | Base for all types and resources | |
| entryRelationship:priority | 0..* | EntryRelationship | ||
| @typeCode | 1..1 | cs | Fixed Value: REFR | |
| observation | 1..1 | PriorityPreference | Base for all types and resources | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| Act.statusCode.code | required | ProblemActStatusCode |
| Id | Grade | Path(s) | Details | Requirements |
| should-author | warning | Act | SHOULD contain author : author.exists() | |
| should-text-ref-value | warning | Act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| value-starts-octothorpe | error | Act.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') |
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Act | C | 1..1 | Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author |
| Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root, value:extension | |
| templateId:problem-concern-act | 1..1 | II | ||
| @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.3 | |
| @extension | 1..1 | st | Required Pattern: 2024-05-01 | |
| @classCode | 1..1 | cs | Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT | |
| @moodCode | 1..1 | cs | Binding: XDocumentActMood (2.0.0) (required) Fixed Value: EVN | |
| id | 1..* | II | ||
| code | 1..1 | CD | Binding: v3 Code System ActCode (example) | |
| @code | 1..1 | cs | Required Pattern: CONC | |
| @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.5.6 | |
| text | 0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
| reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
| statusCode | 1..1 | CS | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. Binding: ActStatus (required) | |
| @code | 1..1 | cs | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. Binding: ProblemAct statusCode (required) | |
| effectiveTime | 1..1 | IVL_TS | ||
| low | 1..1 | IVXB_TS | The effectiveTime/low of the Problem Concern Act asserts when the concern became active. | |
| high | 0..1 | IVXB_TS | The effectiveTime/high asserts when the concern was completed (e.g., when the clinician deemed there is no longer any need to track the underlying condition). | |
| author | 0..* | AuthorParticipation | Base for all types and resources | |
| Slices for entryRelationship | 1..* | EntryRelationship | The following entryRelationship represents the importance of the concern to a provider. Slice: Unordered, Open by profile:observation | |
| entryRelationship:problem | 1..1 | EntryRelationship | ||
| @typeCode | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SUBJ | |
| observation | C | 1..1 | ProblemObservation | Base for all types and resources |
| entryRelationship:priority | 0..* | EntryRelationship | ||
| @typeCode | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR | |
| observation | C | 1..1 | PriorityPreference | Base for all types and resources |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code |
| Act.classCode | required | Fixed Value: ACT |
| Act.moodCode | required | Fixed Value: EVN |
| Act.code | example | ActCode |
| Act.statusCode | required | ActStatus |
| Act.statusCode.code | required | ProblemActStatusCode |
| Act.entryRelationship:problem.typeCode | required | Fixed Value: SUBJ |
| Act.entryRelationship:priority.typeCode | required | Fixed Value: REFR |
| Id | Grade | Path(s) | Details | Requirements |
| should-author | warning | Act | SHOULD contain author : author.exists() | |
| should-author | warning | Act.entryRelationship:problem.observation, Act.entryRelationship:priority.observation | SHOULD contain author : author.exists() | |
| should-effectiveTime | warning | Act.entryRelationship:priority.observation | SHOULD contain effectiveTime : effectiveTime.exists() | |
| should-text-ref-value | warning | Act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| should-text-ref-value | warning | Act.entryRelationship:problem.observation, Act.entryRelationship:priority.observation | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| value-starts-octothorpe | error | Act.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Act | C | 1..1 | Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author |
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| realmCode | 0..* | CS | ||
| typeId | 0..1 | II | ||
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| @assigningAuthorityName | 0..1 | st | ||
| @displayable | 0..1 | bl | ||
| @root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
| @extension | 1..1 | st | ||
| Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root, value:extension | |
| templateId:problem-concern-act | 1..1 | II | ||
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| @assigningAuthorityName | 0..1 | st | ||
| @displayable | 0..1 | bl | ||
| @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.3 | |
| @extension | 1..1 | st | Required Pattern: 2024-05-01 | |
| @classCode | 1..1 | cs | Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT | |
| @moodCode | 1..1 | cs | Binding: XDocumentActMood (2.0.0) (required) Fixed Value: EVN | |
| @negationInd | 0..1 | bl | ||
| id | 1..* | II | ||
| code | 1..1 | CD | Binding: v3 Code System ActCode (example) | |
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| @code | 1..1 | cs | Required Pattern: CONC | |
| @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.5.6 | |
| @codeSystemName | 0..1 | st | ||
| @codeSystemVersion | 0..1 | st | ||
| @displayName | 0..1 | st | ||
| @sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
| @sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
| originalText | 0..1 | ED | ||
| qualifier | 0..* | CR | ||
| translation | 0..* | CD | ||
| text | 0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| @compression | 0..1 | cs | Binding: CompressionAlgorithm (required) | |
| @integrityCheck | 0..1 | bin | ||
| @integrityCheckAlgorithm | 0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required) | |
| @language | 0..1 | cs | ||
| @mediaType | 0..1 | cs | Binding: MediaType (example) | |
| @representation | 0..1 | cs | Binding: Binary Data Encoding Value Set (required) | |
| xmlText | 0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string. | |
| reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
| thumbnail | 0..1 | ED | ||
| statusCode | 1..1 | CS | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. Binding: ActStatus (required) | |
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| @code | 1..1 | cs | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. Binding: ProblemAct statusCode (required) | |
| @sdtcValueSet | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
| @sdtcValueSetVersion | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
| effectiveTime | 1..1 | IVL_TS | ||
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| @value | 0..1 | ts | Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz] | |
| @operator | 0..1 | cs | Binding: SetOperator (required) | |
| low | 1..1 | IVXB_TS | The effectiveTime/low of the Problem Concern Act asserts when the concern became active. | |
| center | 0..1 | TS | ||
| width | 0..1 | PQ | ||
| high | 0..1 | IVXB_TS | The effectiveTime/high asserts when the concern was completed (e.g., when the clinician deemed there is no longer any need to track the underlying condition). | |
| priorityCode | 0..1 | CE | Binding: ActPriority (example) | |
| languageCode | 0..1 | CS | Binding: AllLanguages (required) | |
| subject | 0..1 | Subject | ||
| specimen | 0..* | Specimen | ||
| performer | 0..* | Performer2 | ||
| author | 0..* | AuthorParticipation | Base for all types and resources | |
| informant | 0..* | Informant | ||
| participant | 0..* | Participant2 | ||
| Slices for entryRelationship | 1..* | EntryRelationship | The following entryRelationship represents the importance of the concern to a provider. Slice: Unordered, Open by profile:observation | |
| entryRelationship:problem | 1..1 | EntryRelationship | ||
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| realmCode | 0..* | CS | ||
| typeId | 0..1 | II | ||
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| @assigningAuthorityName | 0..1 | st | ||
| @displayable | 0..1 | bl | ||
| @root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
| @extension | 1..1 | st | ||
| templateId | 0..* | II | ||
| @typeCode | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SUBJ | |
| @inversionInd | 0..1 | bl | ||
| @contextConductionInd | 0..1 | bl | ||
| @negationInd | 0..1 | bl | ||
| sequenceNumber | 0..1 | INT | ||
| seperatableInd | 0..1 | BL | ||
| act | 0..1 | Act | ||
| encounter | 0..1 | Encounter | ||
| observation | C | 1..1 | ProblemObservation | Base for all types and resources |
| observationMedia | 0..1 | ObservationMedia | ||
| organizer | 0..1 | Organizer | ||
| procedure | 0..1 | Procedure | ||
| regionOfInterest | 0..1 | RegionOfInterest | ||
| substanceAdministration | 0..1 | SubstanceAdministration | ||
| supply | 0..1 | Supply | ||
| entryRelationship:priority | 0..* | EntryRelationship | ||
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| realmCode | 0..* | CS | ||
| typeId | 0..1 | II | ||
| @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |
| @assigningAuthorityName | 0..1 | st | ||
| @displayable | 0..1 | bl | ||
| @root | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
| @extension | 1..1 | st | ||
| templateId | 0..* | II | ||
| @typeCode | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR | |
| @inversionInd | 0..1 | bl | ||
| @contextConductionInd | 0..1 | bl | ||
| @negationInd | 0..1 | bl | ||
| sequenceNumber | 0..1 | INT | ||
| seperatableInd | 0..1 | BL | ||
| act | 0..1 | Act | ||
| encounter | 0..1 | Encounter | ||
| observation | C | 1..1 | PriorityPreference | Base for all types and resources |
| observationMedia | 0..1 | ObservationMedia | ||
| organizer | 0..1 | Organizer | ||
| procedure | 0..1 | Procedure | ||
| regionOfInterest | 0..1 | RegionOfInterest | ||
| substanceAdministration | 0..1 | SubstanceAdministration | ||
| supply | 0..1 | Supply | ||
| reference | 0..* | Reference | ||
| precondition | 0..* | Precondition | ||
| sdtcPrecondition2 | 0..* | Precondition2 | XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc) | |
| sdtcInFulfillmentOf1 | 0..* | InFulfillmentOf1 | XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc) | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code |
| Act.nullFlavor | required | CDANullFlavor |
| Act.typeId.nullFlavor | required | CDANullFlavor |
| Act.templateId:problem-concern-act.nullFlavor | required | CDANullFlavor |
| Act.classCode | required | Fixed Value: ACT |
| Act.moodCode | required | Fixed Value: EVN |
| Act.code | example | ActCode |
| Act.code.nullFlavor | required | CDANullFlavor |
| Act.text.nullFlavor | required | CDANullFlavor |
| Act.text.compression | required | CDACompressionAlgorithm |
| Act.text.integrityCheckAlgorithm | required | IntegrityCheckAlgorithm |
| Act.text.mediaType | example | MediaType |
| Act.text.representation | required | BinaryDataEncoding |
| Act.statusCode | required | ActStatus |
| Act.statusCode.nullFlavor | required | CDANullFlavor |
| Act.statusCode.code | required | ProblemActStatusCode |
| Act.effectiveTime.nullFlavor | required | CDANullFlavor |
| Act.effectiveTime.operator | required | SetOperator |
| Act.priorityCode | example | ActPriority |
| Act.languageCode | required | AllLanguages |
| Act.entryRelationship:problem.nullFlavor | required | CDANullFlavor |
| Act.entryRelationship:problem.typeId.nullFlavor | required | CDANullFlavor |
| Act.entryRelationship:problem.typeCode | required | Fixed Value: SUBJ |
| Act.entryRelationship:priority.nullFlavor | required | CDANullFlavor |
| Act.entryRelationship:priority.typeId.nullFlavor | required | CDANullFlavor |
| Act.entryRelationship:priority.typeCode | required | Fixed Value: REFR |
| Id | Grade | Path(s) | Details | Requirements |
| should-author | warning | Act | SHOULD contain author : author.exists() | |
| should-author | warning | Act.entryRelationship:problem.observation, Act.entryRelationship:priority.observation | SHOULD contain author : author.exists() | |
| should-effectiveTime | warning | Act.entryRelationship:priority.observation | SHOULD contain effectiveTime : effectiveTime.exists() | |
| should-text-ref-value | warning | Act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| should-text-ref-value | warning | Act.entryRelationship:problem.observation, Act.entryRelationship:priority.observation | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| value-starts-octothorpe | error | Act.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') |
This structure is derived from Act
Summary
Mandatory: 14 elements (1 nested mandatory element)
Fixed Value: 4 elements
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
IG © 2019+ Health Level Seven. Package hl7.cda.us.ccda#3.0.0-ballot based on FHIR 5.0.0. Generated 2023-12-21
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