An abstract type that defines the basic properties common to all data values defined in this specification. Data Value is an abstract type, meaning that no proper value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type
An indicator of a data value's exceptional status, sometimes also denoting the manner and rationale for that status.
Coded data in its simplest form, where only the code is not predetermined. The code system and code system version are fixed by the context in which CS value occurs. CS is used for coded attributes that have a single HL7-defined value set
A binary value for use in boolean logic. A BL value can be either true or false, or, as any other value, MAY be NULL
Integer numbers (-1,0,1,2, 100, 3398129, etc.) are precise numbers that are results of counting and enumerating. Integer numbers are discrete, the set of integers is infinite but countable. No arbitrary limit is imposed on the range of integer numbers. Two NULL flavors are defined for the positive and negative infinity
A scalar magnitude. Typically used whenever quantities are measured, estimated, or computed from other real numbers. The typical representation is decimal, where the number of significant decimal digits is known as the precision.
A concept defined by text and/or references to concepts defined in a code system
A reference to a concept defined in a code system
The text as seen and/or selected by the user who entered the data which represents the intended meaning of the user
The plain code symbol defined by the code system, or an expression in a syntax defined by the code system which describes the concept
If applicable, a version descriptor defined specifically for the given code system
The value set that applied when this CD was created
The version of the value set that applied when this CD was created
A name, title, or representation for the code or expression as it exists in the code system identified by the value of codeSystem
The reason a particular CD has been provided
The CD from which this CD was translated, if it was translated from another CD
An identifier that uniquely identifies a thing or object. Examples are object identifier for HL7 RIM objects, medical record number, order id, service catalog item id, Vehicle Identification Number (VIN), etc.
A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier
A character string as a unique identifier within the scope of the identifier root.
This is a human-readable name for the namespace represented in the root. It is a descriptive name for the actual namespace; e.g. 'California, U.S. Driver's License Number, 1970-'.
Specifies the scope in which the identifier applies to the object with which it is associated
Specifies the reliability with which the identifier is known. This attribute MAY be used to assist with identifier matching algorithms
Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false)
An abstract super-type for all RIM classes, either directly or through inheritance
An indicator that the class instance is null, including the flavor of null that is intended
A physical thing, group of physical things or an organization capable of participating in Acts while in a role
The major class of Entities to which an Entity-instance belongs
A code specifying whether the Entity object represents a universal (KIND) vs. a particular (INSTANCE)
A value representing whether the information associated with an Entity is currently active or inactive for the purpose of participation in acts
The specific kind of Entity to which an Entity-instance belongs
A competency of the Entity that plays the Role as identified, defined, guaranteed, or acknowledged by the Entity that scopes the Role
The major class of Role to which a Role-instance belongs
The specific kind of Role to which an Role-instance belongs
A unique identifier for the player Entity in this Role
An indicator specifying that the Role is a competency that is specifically not attributed to the Entity playing the Role.
The state of this Role as defined in the state-transition mode
An integer specifying the relative preference for considering this role instance before other like-typed Roles (same classCode and code) having the same scoper. Roles with lower priorityNumber values are considered before and above those with higher values.
An association between an Act and a Role. The Entity playing the Role is the actor
The kind of Participation or involvement the Entity playing the Role associated with the Participation has with regard to the associated Act
Additional detail about the function that the Participation has in the Act, if such detail is not implied by the Participation.typeCode
An indicator stipulating that the specified participation did not, does not, or should not occur, depending on mood.
An integer specifying the relative order of occurrence of the Participation in relation to other Participations of the same Act of the same type (same typeCode)
A record of something that is being done, has been done, can be done, or is intended or requested to be done
The major class of Acts to which an Act-instance belongs.
The intended use of the Act statement: as a report of fact, a command, a possibility, a goal, etc
The particular kind of Act that the Act-instance represents within its class
An indicator specifying that the Act statement is a negation of the Act in Event mood as described by the descriptive attributes
The urgency under which the Act happened, can happen, is happening, is intended to happen, or is requested/demanded to happen.
An act that is intended to result in new information about a subject
Indicates that when the observation event occurred, the finding communicated by the value attribute was NOT found. This attribute should only be used when the terminology used for Observation.value is not itself capable of expressing negated findings. (E.g. ICD9).
A directed association between a source Act and a target Act
The meaning and purpose of the ActRelationship instance
An indicator specifying that the ActRelationship.typeCode should be interpreted as if the roles of the source and target Acts were reversed
An indicator that asserts that the meaning of the link is negated
An integer specifying the relative preference for considering this relationship before other like-typed relationships having the same source Act. Relationships with lower priorityNumber values are considered before and above those with higher values
The codes identify the conditions under which accept acknowledgements are required to be returned in response to this message. Note that accept acknowledgement address two different issues at the same time: reliable transport as well as syntactical correctness
Send an acknowledgement for error/reject conditions only.
Send an acknowledgement for successful completions only.
v3 Code System AcknowledgementDetailCode
Refelects rejections because elements of the communication are not supported in the current context.
The interaction (or: this version of the interaction) is not supported.
The receiver requires information in the attentionLine classes for routing purposes.
An internal software component (database, application, queue mechanism, etc.) has failed, leading to inability to process the message.
Rejection: The message can't be stored by the receiver due to an unspecified internal application issue. The message was neither processed nor stored by the receiving application.
Message routing error, destination unreachable.
Error: The destination of this message is known to the receiving application. Messages have been successfully routed to that destination in the past. The link to the destination application or an intermediate application is unavailable.
Error: Message routing error, unknown destination.
The destination of this message is unknown to the receiving application. The receiving application in the message does not match the application which received the message. The message was neither routed, processed nor stored by the receiving application.
Message routing warning, destination unreachable.
Warning: The destination of this message is known to the receiving application. Messages have been successfully routed to that destination in the past. The link to the destination application or an intermediate application is (temporarily) unavailable. The receiving application will forward the message as soon as the destination can be reached again.
Reflects errors in the syntax or structure of the communication.
The attribute contained data of the wrong data type, e.g. a numeric attribute contained "FOO".
Description: Required association or attribute missing in message; or the sequence of the classes is different than required by the standard or one of the conformance profiles identified in the message.
Required association missing in message; or the sequence of the classes is different than required by the standard or one of the conformance profiles identified in the message.
A required attribute is missing in a class.
Description: The number of repetitions of a group of association or attributes is less than the required minimum for the standard or of one of the conformance profiles or templates identified in the message.
Description: A coded attribute or datatype property violates one of the terminology constraints specified in the standard or one of the conformance profiles or templates declared by the instance.
An attribute value was compared against the corresponding code system, and no match was found.
An attribute value referenced a code system that is not valid for an attribute constrained to CNE.
Description: A coded attribute is referencing a code that has been deprecated by the owning code system.
Description: The number of repetitions of a (group of) association(s) or attribute(s) exceeds the limits of the standard or of one of the conformance profiles or templates identified in the message.
Number of association repetitions exceeds limit
The number of repetitions of a (group of) association(s) exceeds the limits of the standard or of one of the conformance profiles identified in the message.
Number of attribute repetitions exceeds limit
The number of repetitions of an attribute exceeds the limits of the standard or of one of the conformance profiles identified in the message.
Description: An attribute or association identified as mandatory in a specification or declared conformance profile or template has been specified with a null flavor.
Description: The value of an attribute or property differs from the fixed value asserted in the standard or one of the conformance profiles or templates declared in the message.
Description: A formal constraint asserted in the standard or one of the conformance profiles or templates declared in the message has been violated.
v3 Code System AcknowledgementDetailType
A code identifying the specific message to be provided. Discussion: A textual value may be specified as the print name, or for non-coded messages, as the original text. Examples: 'Required attribute xxx is missing', 'System will be unavailable March 19 from 0100 to 0300'
Definition:An issue which has prevented, or will prevent (unless a management is provided for the issue by the sender), the successful processing of an interaction. Response interactions which include an issue which is an Error are a 'rejection', indicating that the request was not successfully processed. Example:Unable to find specified patient.
Definition: The message relates to an issue which has no bearing on the successful processing of the request. Information issues cannot be overridden by specifying a management. Example: A Patient's coverage will expire in 5 days.
Definition: The message relates to an issue which cannot prevent the successful processing of a request, but which could result in the processing not having the ideal or intended effect. Managing a warning issue is not required for successful processing, but will suppress the warning from being raised. Example: Unexpected additional repetitions of phone number have been ignored.
This attribute contains an acknowledgement code as described in the HL7 message processing rules. OpenIssue: Description was copied from attribute and needs to be improved to be appropriate for a value set.
This attribute contains an acknowledgement code as described in the HL7 message processing rules. OpenIssue: Description was copied from attribute and needs to be improved to be appropriate for a code system.
Receiving application successfully processed message.
Receiving application found error in processing message. Sending error response with additional error detail information.
Receiving application failed to process message for reason unrelated to content or format. Original message sender must decide on whether to automatically send message again.
Receiving message handling service accepts responsibility for passing message onto receiving application.
Receiving message handling service cannot accept message for any other reason (e.g. message sequence number, etc.).
Receiving message handling service rejects message if interaction identifier, version or processing mode is incompatible with known receiving application role information.
A record of something that is being done, has been done, can be done, or is intended or requested to be done. Examples:The kinds of acts that are common in health care are (1) a clinical observation, (2) an assessment of health condition (such as problems and diagnoses), (3) healthcare goals, (4) treatment services (such as medication, surgery, physical and psychological therapy), (5) assisting, monitoring or attending, (6) training and education services to patients and their next of kin, (7) and notary services (such as advanced directives or living will), (8) editing and maintaining documents, and many others. Discussion and Rationale: Acts are the pivot of the RIM; all domain information and processes are represented primarily in Acts. Any profession or business, including healthcare, is primarily constituted of intentional and occasionally non-intentional actions, performed and recorded by responsible actors. An Act-instance is a record of such an action. Acts connect to Entities in their Roles through Participations and connect to other Acts through ActRelationships. Participations are the authors, performers and other responsible parties as well as subjects and beneficiaries (which includes tools and material used in the performance of the act, which are also subjects). The moodCode distinguishes between Acts that are meant as factual records, vs. records of intended or ordered services, and the other modalities in which act can appear. One of the Participations that all acts have (at least implicitly) is a primary author, who is responsible of the Act and who "owns" the act. Responsibility for the act means responsibility for what is being stated in the Act and as what it is stated. Ownership of the act is assumed in the sense of who may operationally modify the same act. Ownership and responsibility of the Act is not the same as ownership or responsibility of what the Act-object refers to in the real world. The same real world activity can be described by two people, each being the author of their Act, describing the same real world activity. Yet one can be a witness while the other can be a principal performer. The performer has responsibilities for the physical actions; the witness only has responsibility for making a true statement to the best of his or her ability. The two Act-instances may even disagree, but because each is properly attributed to its author, such disagreements can exist side by side and left to arbitration by a recipient of these Act-instances. In this sense, an Act-instance represents a "statement" according to Rector and Nowlan (1991) [Foundations for an electronic medical record. Methods Inf Med. 30.] Rector and Nowlan have emphasized the importance of understanding the medical record not as a collection of facts, but "a faithful record of what clinicians have heard, seen, thought, and done." Rector and Nowlan go on saying that "the other requirements for a medical record, e.g., that it be attributable and permanent, follow naturally from this view." Indeed the Act class is this attributable statement, and the rules of updating acts (discussed in the state-transition model, see Act.statusCode) versus generating new Act-instances are designed according to this principle of permanent attributable statements. Rector and Nolan focus on the electronic medical record as a collection of statements, while attributed statements, these are still mostly factual statements. However, the Act class goes beyond this limitation to attributed factual statements, representing what is known as "speech-acts" in linguistics and philosophy. The notion of speech-act includes that there is pragmatic meaning in language utterances, aside from just factual statements; and that these utterances interact with the real world to change the state of affairs, even directly cause physical activities to happen. For example, an order is a speech act that (provided it is issued adequately) will cause the ordered action to be physically performed. The speech act theory has culminated in the seminal work by Austin (1962) [How to do things with words. Oxford University Press]. An activity in the real world may progress from defined, through planned and ordered to executed, which is represented as the mood of the Act. Even though one might think of a single activity as progressing from planned to executed, this progression is reflected by multiple Act-instances, each having one and only one mood that will not change along the Act-instance life cycle. This is because the attribution and content of speech acts along this progression of an activity may be different, and it is often critical that a permanent and faithful record be maintained of this progression. The specification of orders or promises or plans must not be overwritten by the specification of what was actually done, so as to allow comparing actions with their earlier specifications. Act-instances that describe this progression of the same real world activity are linked through the ActRelationships (of the relationship category "sequel"). Act as statements or speech-acts are the only representation of real world facts or processes in the HL7 RIM. The truth about the real world is constructed through a combination (and arbitration) of such attributed statements only, and there is no class in the RIM whose objects represent "objective state of affairs" or "real processes" independent from attributed statements. As such, there is no distinction between an activity and its documentation. Every Act includes both to varying degrees. For example, a factual statement made about recent (but past) activities, authored (and signed) by the performer of such activities, is commonly known as a procedure report or original documentation (e.g., surgical procedure report, clinic note etc.). Conversely, a status update on an activity that is presently in progress, authored by the performer (or a close observer) is considered to capture that activity (and is later superceded by a full procedure report). However, both status update and procedure report are acts of the same kind, only distinguished by mood and state (see statusCode) and completeness of the information.
Used to group a set of acts sharing a common context. Organizer structures can nest within other context structures - such as where a document is contained within a folder, or a folder is contained within an EHR extract.
A context representing a grouped commitment of information to the EHR. It is considered the unit of modification of the record, the unit of transmission in record extracts, and the unit of attestation by authorizing clinicians. A composition represents part of a patient record originating from a single interaction between an authenticator and the record. Unless otherwise stated all statements within a composition have the same authenticator, apply to the same patient and were recorded in a single session of use of a single application. A composition contains organizers and entries.
The notion of a document comes particularly from the paper world, where it corresponds to the contents recorded on discrete pieces of paper. In the electronic world, a document is a kind of composition that bears resemblance to their paper world counter-parts. Documents typically are meant to be human-readable. HL7's notion of document differs from that described in the W3C XML Recommendation, in which a document refers specifically to the contents that fall between the root element's start-tag and end-tag. Not all XML documents are HL7 documents.
A clinical document is a documentation of clinical observations and services, with the following characteristics: Persistence - A clinical document continues to exist in an unaltered state, for a time period defined by local and regulatory requirements; Stewardship - A clinical document is maintained by a person or organization entrusted with its care; Potential for authentication - A clinical document is an assemblage of information that is intended to be legally authenticated; Wholeness - Authentication of a clinical document applies to the whole and does not apply to portions of the document without the full context of the document; Human readability - A clinical document is human readable.
A clinical document that conforms to Level One of the HL7 Clinical Document Architecture (CDA)
Description: Container of clinical statements. Navigational. No semantic content. Knowledge of the section code is not required to interpret contained observations. Represents a heading in a heading structure, or "container tree". The record entries relating to a single clinical session are usually grouped under headings that represent phases of the encounter, or assist with layout and navigation. Clinical headings usually reflect the clinical workflow during a care session, and might also reflect the main author's reasoning processes. Much research has demonstrated that headings are used differently by different professional groups and specialties, and that headings are not used consistently enough to support safe automatic processing of the E H R.
A group of entries within a composition or topic that have a common characteristic - for example, Examination, Diagnosis, Management OR Subjective, Objective, Analysis, Plan. The distinction from Topic relates to value sets. For Category there is a bounded list of things like "Examination", "Diagnosis" or SOAP categories. For Topic the list is wide open to any clinical condition or reason for a part of an encounter. A CATEGORY MAY CONTAIN ENTRIES.
A context that distinguishes the body of a document from the document header. This is seen, for instance, in HTML documents, which have discrete and elements.
A context that subdivides the body of a document. Document sections are typically used for human navigation, to give a reader a clue as to the expected content. Document sections are used to organize and provide consistency to the contents of a document body. Document sections can contain document sections and can contain entries.
A group of entries within a composition that are related to a common clinical theme - such as a specific disorder or problem, prevention, screening and provision of contraceptive services. A topic may contain categories and entries.
This context represents the part of a patient record conveyed in a single communication. It is drawn from a providing system for the purposes of communication to a requesting process (which might be another repository, a client application or a middleware service such as an electronic guideline engine), and supporting the faithful inclusion of the communicated data in the receiving system. An extract may be the entirety of the patient record as held by the sender or it may be a part of that record (e.g. changes since a specified date). An extract contains folders or compositions. An extract cannot contain another extract.
A context that comprises all compositions. The EHR is an extract that includes the entire chart. NOTE: In an exchange scenario, an EHR is a specialization of an extract.
A context representing the high-level organization of an extract e.g. to group parts of the record by episode, care team, clinical specialty, clinical condition, or source application. Internationally, this kind of organizing structure is used variably: in some centers and systems the folder is treated as an informal compartmentalization of the overall health record; in others it might represent a significant legal portion of the EHR relating to the originating enterprise or team. A folder contains compositions. Folders may be nested within folders.
Definition: An ACT that organizes a set of component acts into a semantic grouping that share a particular context such as timeframe, patient, etc. UsageNotes: The focus in a GROUPER act is the grouping of the contained acts. For example "a request to group" (RQO), "a type of grouping that is allowed to occur" (DEF), etc. Unlike WorkingList, which represents a dynamic, shared, continuously updated collection to provide a "view" of a set of objects, GROUPER collections tend to be static and simply indicate a shared set of semantics. Note that sharing of semantics can be achieved using ACT as well. However, with GROUPER, the sole semantic is of grouping.
Description:An ACT that organizes a set of component acts into a semantic grouping that have a shared subject. The subject may be either a subject participation (SBJ), subject act relationship (SUBJ), or child participation/act relationship types. Discussion: The focus in a CLUSTER act is the grouping of the contained acts. For example "a request to cluster" (RQO), "a type of cluster that is allowed to occur" (DEF), etc. Examples: Radiologic investigations that might include administration of a dye, followed by radiographic observations; "Isolate cluster" which includes all testing and specimen processing performed on a specific isolate; a set of actions to perform at a particular stage in a clinical trial.
An accommodation is a service provided for a Person or other LivingSubject in which a place is provided for the subject to reside for a period of time. Commonly used to track the provision of ward, private and semi-private accommodations for a patient.
A financial account established to track the net result of financial acts.
A unit of work, a grouper of work items as defined by the system performing that work. Typically some laboratory order fulfillers communicate references to accessions in their communications regarding laboratory orders. Often one or more specimens are related to an accession such that in some environments the accession number is taken as an identifier for a specimen (group).
A transformation process where a requested invoice is transformed into an agreed invoice. Represents the adjudication processing of an invoice (claim). Adjudication results can be adjudicated as submitted, with adjustments or refused. Adjudication results comprise 2 components: the adjudication processing results and a restated (or adjudicated) invoice or claim
An act representing a system action such as the change of state of another act or the initiation of a query. All control acts represent trigger events in the HL7 context. ControlActs may occur in different moods.
Sender asks addressee to do something depending on the focal Act of the payload. An example is "fulfill this order". Addressee has responsibilities to either reject the message or to act on it in an appropriate way (specified by the specific receiver responsibilities for the interaction).
Sender sends payload to addressee as information. Addressee does not have responsibilities beyond serving addressee's own interest (i.e., read and memorize if you see fit). This is equivalent to an FYI on a memo.
Description: Sender transmits a status change pertaining to the focal act of the payload. This status of the focal act is the final state of the state transition. This can be either a request or an event, according to the mood of the control act.
An agreement of obligation between two or more parties that is subject to contractual law and enforcement.
A contract whose value is measured in monetary terms.
When used in the EVN mood, this concept means with respect to a covered party: A health care insurance policy or plan that is contractually binding between two or more parties; or A health care program, usually administered by government entities, that provides coverage to persons determined eligible under the terms of the program. When used in the definition (DEF) mood, COV means potential coverage for a patient who may or may not be a covered party. The concept's meaning is fully specified by the choice of ActCoverageTypeCode (abstract) ActProgramCode or ActInsurancePolicyCode.
Definition: A worry that tends to persist over time and has as its subject a state or process. The subject of the worry has the potential to require intervention or management. Examples: an observation result, procedure, substance administration, equipment repair status, device recall status, a health risk, a financial risk, public health risk, pregnancy, health maintenance, allergy, and acute or chronic illness.
A public health case is a Concern about an observation or event that has a specific significance for public health. The creation of a PublicHealthCase initiates the tracking of the object of concern. The decision to track is related to but somewhat independent of the underlying event or observation. UsageNotes: Typically a Public Health Case involves an instance or instances of a reportable infectious disease or other condition. The public health case can include a health-related event concerning a single individual or it may refer to multiple health-related events that are occurrences of the same disease or condition of interest to public health. A public health case definition (Act.moodCode = "definition") includes the description of the clinical, laboratory, and epidemiologic indicators associated with a disease or condition of interest to public health. There are case definitions for conditions that are reportable, as well as for those that are not. A public health case definition is a construct used by public health for the purpose of counting cases, and should not be used as clinical indications for treatment. Examples include AIDS, toxic-shock syndrome, and salmonellosis and their associated indicators that are used to define a case.
An Outbreak is a concern resulting from a series of public health cases. UsageNotes: The date on which an outbreak starts is the earliest date of onset among the cases assigned to the outbreak and its ending date is the last date of onset among the cases assigned to the outbreak. The effectiveTime attribute is used to convey the relevant dates for the case. An outbreak definition (Act.moodCode = "definition" includes the criteria for the number, types and occurrence pattern of cases necessary to declare an outbreak and to judge the severity of an outbreak.
The Consent class represents informed consents and all similar medico-legal transactions between the patient (or his legal guardian) and the provider. Examples are informed consent for surgical procedures, informed consent for clinical trials, advanced beneficiary notice, against medical advice decline from service, release of information agreement, etc. The details of consents vary. Often an institution has a number of different consent forms for various purposes, including reminding the physician about the topics to mention. Such forms also include patient education material. In electronic medical record communication, consents thus are information-generating acts on their own and need to be managed similar to medical activities. Thus, Consent is modeled as a special class of Act. The "signatures" to the consent document are represented electronically through Participation instances to the consent object. Typically an informed consent has Participation.typeCode of "performer", the healthcare provider informing the patient, and "consenter", the patient or legal guardian. Some consent may associate a witness or a notary public (e.g., living wills, advanced directives). In consents where a healthcare provider is not required (e.g. living will), the performer may be the patient himself or a notary public. Some consent has a minimum required delay between the consent and the service, so as to allow the patient to rethink his decisions. This minimum delay can be expressed in the act definition by the ActRelationship.pauseQuantity attribute that delays the service until the pause time has elapsed after the consent has been completed.
An Act where a container is registered either via an automated sensor, such as a barcode reader, or by manual receipt
An identified point during a clinical trial at which one or more actions are scheduled to be performed (definition mood), or are actually performed (event mood). The actions may or may not involve an encounter between the subject and a healthcare professional.
An action taken with respect to a subject Entity by a regulatory or authoritative body with supervisory capacity over that entity. The action is taken in response to behavior by the subject Entity that body finds to be undesirable. Suspension, license restrictions, monetary fine, letter of reprimand, mandated training, mandated supervision, etc.Examples:
An interaction between entities that provides opportunity for transmission of a physical, chemical, or biological agent from an exposure source entity to an exposure target entity. Examples: The following examples are provided to indicate what interactions are considered exposures rather than other types of Acts: A patient accidentally receives three times the recommended dose of their medication due to a dosing error. This is a substance administration. Public health and/or safety authorities may also be interested in documenting this with an associated exposure. A patient accidentally is dispensed an incorrect medicine (e.g., clomiphene instead of clomipramine). They have taken several doses before the mistake is detected. They are therefore "exposed" to a medicine that there was no therapeutic indication for them to receive. There are several substance administrations in this example. Public health and/or safety authorities may also be interested in documenting this with associated exposures. In a busy medical ward, a patient is receiving chemotherapy for a lymphoma. Unfortunately, the IV infusion bag containing the medicine splits, spraying cytotoxic medication over the patient being treated and the patient in the adjacent bed. There are three substance administrations in this example. The first is the intended one (IV infusion) with its associated (implicit) exposure. There is an incident with an associated substance administration to the same patient involving the medication sprayed over the patient as well as an associated exposure. Additionally, the incident includes a substance administration involving the spraying of medication on the adjacent patient, also with an associated exposure. A patient who is a refugee from a war-torn African nation arrives in a busy inner city A&E department suffering from a cough with bloody sputum. Not understanding the registration and triage process, they sit in the waiting room for several hours before it is noticed that they have not booked in. As soon as they are being processed, it is suspected that they are suffering from TB. Vulnerable (immunosuppressed) patients who were sharing the waiting room with this patient may have been exposed to the tubercule bacillus, and must be traced for investigation. This is an exposure (or possibly multiple exposures) in the waiting room involving the refugee and everyone else in the waiting room during the period. There might also be a number of known or presumed substance administrations (coughing) via several possible routes. The substance administrations are only hypotheses until confirmed by further testing. A patient who has received an elective total hip replacement procedure suffers a prolonged stay in hospital, due to contracting an MRSA infection in the surgical wound site after the surgery. This is an exposure to MRSA. Although there was some sort of substance administration, it's possible the exact mechanism for introduction of the MRSA into the wound will not be identified. Routine maintenance of the X-ray machines at a local hospital reveals a serious breach of the shielding on one of the machines. Patients who have undergone investigations using that machine in the last month are likely to have been exposed to significantly higher doses of X-rays than was intended, and must be tracked for possible adverse effects. There has been an exposure of each patient who used the machine in the past 30 days. Some patients may have had substance administrations. A new member of staff is employed in the laundry processing room of a small cottage hospital, and a misreading of the instructions for adding detergents results in fifty times the usual concentration of cleaning materials being added to a batch of hospital bedding. As a result, several patients have been exposed to very high levels of detergents still present in the "clean" bedding, and have experienced dermatological reactions to this. There has been an incident with multiple exposures to several patients. Although there are substance administrations involving the application of the detergent to the skin of the patients, it is expected that the substance administrations would not be directly documented. Seven patients who are residents in a health care facility for the elderly mentally ill have developed respiratory problems. After several months of various tests having been performed and various medications prescribed to these patients, the problem is traced to their being "sensitive" to a new fungicide used in the wall plaster of the ward where these patients reside. The patients have been continuously exposed to the fungicide. Although there have been continuous substance administrations (via breathing) this would not normally be documented as a substance administration. A patient with osteoarthritis of the knees is treated symptomatically using analgesia, paracetamol (acetaminophen) 1g up to four times a day for pain relief. His GP does not realize that the patient has, 20 years previously (while at college) had severe alcohol addiction problems, and now, although this is completely under control, his liver has suffered significantly, leaving him more sensitive to hepatic toxicity from paracetamol use. Later that year, the patient returns with a noticeable level of jaundice. Paracetamol is immediately withdrawn and alternative solutions for the knee pain are sought. The jaundice gradually subsides with conservative management, but referral to the gastroenterologist is required for advice and monitoring. There is a substance administration with an associated exposure. The exposure component is based on the relative toxic level of the substance to a patient with a compromised liver function. A patient goes to their GP complaining of abdominal pain, having been discharged from the local hospital ten days' previously after an emergency appendectomy. The GP can find nothing particularly amiss, and presumes it is post operative surgical pain that will resolve. The patient returns a fortnight later, when the GP prescribes further analgesia, but does decide to request an outpatient surgical follow-up appointment. At this post-surgical outpatient review, the registrar decides to order an ultrasound, which, when performed three weeks later, shows a small faint inexplicable mass. A laparoscopy is then performed, as a day case procedure, and a piece of a surgical swab is removed from the patient's abdominal cavity. Thankfully, a full recovery then takes place. This is a procedural sequelae. There may be an Incident recorded for this also. A patient is slightly late for a regular pacemaker battery check in the Cardiology department of the local hospital. They are hurrying down the second floor corridor. A sudden summer squall has recently passed over the area, and rain has come in through an open corridor window leaving a small puddle on the corridor floor. In their haste, the patient slips in the puddle and falls so badly that they have to be taken to the A&E department, where it is discovered on investigation they have slightly torn the cruciate ligament in their left knee. This is not an exposure. There has been an incident. Usage Notes: This class deals only with opportunity and not the outcome of the exposure; i.e. not all exposed parties will necessarily experience actual harm or benefit. Exposure differs from Substance Administration by the absence of the participation of a performer in the act. The following participations SHOULD be used with the following participations to distinguish the specific entities: The exposed entity participates via the "exposure target" (EXPTRGT) participation. An entity that has carried the agent transmitted in the exposure participates via the "exposure source" (EXSRC) participation. For example: a person or animal who carried an infectious disease and interacts (EXSRC) with another person or animal (EXPTRGT) transmitting the disease agent; a place or other environment (EXSRC) and a person or animal (EXPTRGT) who is exposed in the presence of this environment. When it is unknown whether a participating entity is the source of the agent (EXSRC) or the target of the transmission (EXPTRGT), the "exposure participant" (EXPART) is used. The physical (including energy), chemical or biological substance which is participating in the exposure uses the "exposure agent" (EXPAGNT) participation. There are at least three scenarios: the player of the Role that participates as EXPAGNT is the chemical or biological substance mixed or carried by the scoper-entity of the Role (e.g., ingredient role); or the player of the Role that participates as EXPAGNT is a mixture known to contain the chemical, radiological or biological substance of interest; or the player of the Role that participates as a EXPAGNT is known to carry the agent (i.e., the player is a fomite, vector, etc.). The Exposure.statusCode attribute should be interpreted as the state of the Exposure business object (e.g., active, aborted, completed) and not the clinical status of the exposure (e.g., probable, confirmed). The clinical status of the exposure should be associated with the exposure via a subject observation. Design Comment: The usage notes require a clear criterion for determining whether an act is an exposure or substance administration-deleterious potential, uncertainty of actual transmission, or otherwise. SBADM states that the criterion is the presence of a performer-but there are examples above that call this criterion into question (e.g., the first one, concerning a dosing error).
Description: An acquisition exposure act describes the proximity (location and time) through which the participating entity was potentially exposed to a physical (including energy), chemical or biological agent from another entity. The acquisition exposure act is used in conjunction with transmission exposure acts as part of an analysis technique for contact tracing. Although an exposure can be decomposed into transmission and acquisition exposures, there is no requirement that all exposures be treated in this fashion. Constraints: The Acquisition Exposure inherits the participation constraints that apply to Exposure with the following exception. The EXPSRC (exposure source) participation must never be associated with the Transmission Exposure either directly or via context conduction.
Description: A transmission exposure act describes the proximity (time and location) over which the participating source entity was capable of transmitting a physical (including energy), chemical or biological substance agent to another entity. The transmission exposure act is used in conjunction with acquisition exposure acts as part of an analysis technique for contact tracing. Although an exposure can be decomposed into transmission and acquisition exposures, there is no requirement that all exposures be treated in this fashion. Constraints: The Transmission Exposure inherits the participation constraints that apply to Exposure with the following exception. The EXPTRGT (exposure target) participation must never be associated with the Transmission Exposure either directly or via context conduction.
An event that occurred outside of the control of one or more of the parties involved. Includes the concept of an accident.
The act of transmitting information and understanding about a topic to a subject where the participation association must be SBJ. Discussion: This act may be used to request that a patient or provider be informed about an Act, or to indicate that a person was informed about a particular act.
Represents concepts related to invoice processing in health care
Working list collects a dynamic list of individual instances of Act via ActRelationship which reflects the need of an individual worker, team of workers, or an organization to manage lists of acts for many different clinical and administrative reasons. Examples of working lists include problem lists, goal lists, allergy lists, and to-do lists.
An officially or unofficially instituted program to track acts of a particular type or categorization.
Description:An act that is intended to result in new information about a subject. The main difference between Observations and other Acts is that Observations have a value attribute. The code attribute of Observation and the value attribute of Observation must be considered in combination to determine the semantics of the observation. Discussion: Structurally, many observations are name-value-pairs, where the Observation.code (inherited from Act) is the name and the Observation.value is the value of the property. Such a construct is also known as a variable (a named feature that can assume a value) hence, the Observation class is always used to hold generic name-value-pairs or variables, even though the variable valuation may not be the result of an elaborate observation method. It may be a simple answer to a question or it may be an assertion or setting of a parameter. As with all Act statements, Observation statements describe what was done, and in the case of Observations, this includes a description of what was actually observed (results or answers); and those results or answers are part of the observation and not split off into other objects. The method of action is asserted by the Observation classCode or its subclasses at the least granular level, by the Observation.code attribute value at the medium level of granularity, and by the attribute value of observation.methodCode when a finer level of granularity is required. The method in whole or in part may also appear in the attribute value of Observation.value when using coded data types to express the value of the attribute. Relevant aspects of methodology may also be restated in value when the results themselves imply or state a methodology. An observation may consist of component observations each having their own Observation.code and Observation.value. In this case, the composite observation may not have an Observation.value for itself. For instance, a white blood cell count consists of the sub-observations for the counts of the various granulocytes, lymphocytes and other normal or abnormal blood cells (e.g., blasts). The overall white blood cell count Observation itself may therefore not have a value by itself (even though it could have one, e.g., the sum total of white blood cells). Thus, as long as an Act is essentially an Act of recognizing and noting information about a subject, it is an Observation, regardless of whether it has a simple value by itself or whether it has sub-observations. Even though observations are professional acts (see Act) and as such are intentional actions, this does not require that every possible outcome of an observation be pondered in advance of it being actually made. For instance, differential white blood cell counts (WBC) rarely show blasts, but if they do, this is part of the WBC observation even though blasts might not be predefined in the structure of a normal WBC. Clinical documents commonly have Subjective and Objective findings, both of which are kinds of Observations. In addition, clinical documents commonly contain Assessments, which are also kinds of Observations. Thus, the establishment of a diagnosis is an Observation. Examples: Recording the results of a Family History Assessment Laboratory test and associated result Physical exam test and associated result Device temperature Soil lead level
Regions of Interest (ROI) within a subject Act. Primarily used for making secondary observations on a subset of a subject observation. The relationship between a ROI and its referenced Act is specified through an ActRelationship of type "subject" (SUBJ), which must always be present.
A Region of Interest (ROI) specified for a multidimensional observation, such as an Observation Series (OBSSER). The ROI is specified using a set of observation criteria, each delineating the boundary of the region in one of the dimensions in the multidimensional observation. The relationship between a ROI and its referenced Act is specified through an ActRelationship of type subject (SUBJ), which must always be present. Each of the boundary criteria observations is connected with the ROI using ActRelationships of type "has component" (COMP). In each boundary criterion, the Act.code names the dimension and the Observation.value specifies the range of values inside the region. Typically the bounded dimension is continuous, and so the Observation.value will be an interval (IVL) data type. The Observation.value need not be specified if the respective dimension is only named but not constrained. For example, an ROI for the QT interval of a certain beat in ECG Lead II would contain 2 boundary criteria, one naming the interval in time (constrained), and the other naming the interval in ECG Lead II (only named, but not constrained).
A Region of Interest (ROI) specified for an image using an overlay shape. Typically used to make reference to specific regions in images, e.g., to specify the location of a radiologic finding in an image or to specify the site of a physical finding by "circling" a region in a schematic picture of a human body. The units of the coordinate values are in pixels. The origin is in the upper left hand corner, with positive X values going to the right and positive Y values going down. The relationship between a ROI and its referenced Act is specified through an ActRelationship of type "subject" (SUBJ), which must always be present.
The spatial relationship of a subject whether human, other animal, or plant, to a frame of reference such as gravity or a collection device.
Contains codes for defining the observed, physical position of a subject, such as during an observation, assessment, collection of a specimen, etc. ECG waveforms and vital signs, such as blood pressure, are two examples where a general, observed position typically needs to be noted. Deprecation Comment: This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.
Lying on the left side. Deprecation Comment: This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.
Lying with the front or ventral surface downward; lying face down. Deprecation Comment: This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.
Lying on the right side. Deprecation Comment: This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.
A semi-sitting position in bed with the head of the bed elevated approximately 45 degrees. Deprecation Comment: This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.
Resting the body on the buttocks, typically with upper torso erect or semi erect. Deprecation Comment: This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.
To be stationary, upright, vertical, on one's legs. Deprecation Comment: This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.
Deprecation Comment: This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.
Lying on the back, on an inclined plane, typically about 30-45 degrees with head raised and feet lowered. Deprecation Comment: This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.
Lying on the back, on an inclined plane, typically about 30-45 degrees, with head lowered and feet raised. Deprecation Comment: This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.
An observation identifying a potential adverse outcome as a result of an Act or combination of Acts. Examples: Detection of a drug-drug interaction; Identification of a late-submission for an invoice; Requesting discharge for a patient who does not meet hospital-defined discharge criteria. Discussion: This class is commonly used for identifying 'business rule' or 'process' problems that may result in a refusal to carry out a particular request. In some circumstances it may be possible to 'bypass' a problem by modifying the request to acknowledge the issue and/or by providing some form of mitigation. Constraints: the Act or Acts that may cause the the adverse outcome are the target of a subject ActRelationship. The subbtypes of this concept indicate the type of problem being detected (e.g. drug-drug interaction) while the Observation.value is used to repesent a specific problem code (e.g. specific drug-drug interaction id).
Definition: An observation that is composed of a set of observations. These observations typically have a logical or practical grouping for generally accepted clinical or functional purposes, such as observations that are run together because of automation. A battery can define required and optional component observations and, in some cases, will define complex rules that determine whether or not a particular observation is made. BATTERY is a constraint on the Observation class in that it is understood to always be composed of component observations. UsageNotes: The focus in a BATTERY is that it is composed of individual observations. In request (RQO) mood, a battery is a request to perform the component observations. In event (EVN) mood a battery is a reporting of associated set of observation events. In definition mood a battery is the definition of the associated set of observations. Examples: Vital signs, Full blood count, Chemistry panel.
The set of actions that define an experiment to assess the effectiveness and/or safety of a biopharmaceutical product (food, drug, device, etc.). In definition mood, this set of actions is often embodied in a clinical trial protocol; in event mood, this designates the aggregate act of applying the actions to one or more subjects.
An instance of Observation of a Condition at a point in time that includes any Observations or Procedures associated with that Condition as well as links to previous instances of Condition Node for the same Condition Deprecation Comment: This concept has been deprecated because an alternative structure for tracking the evolution of a problem has been presented and adopted by the Care Provision Work Group.
An observable finding or state that persists over time and tends to require intervention or management, and, therefore, distinguished from an Observation made at a point in time; may exist before an Observation of the Condition is made or after interventions to manage the Condition are undertaken. Examples: equipment repair status, device recall status, a health risk, a financial risk, public health risk, pregnancy, health maintenance, chronic illness
A public health case is an Observation representing a condition or event that has a specific significance for public health. Typically it involves an instance or instances of a reportable infectious disease or other condition. The public health case can include a health-related event concerning a single individual or it may refer to multiple health-related events that are occurrences of the same disease or condition of interest to public health. An outbreak involving multiple individuals may be considered as a type of public health case. A public health case definition (Act.moodCode = "definition") includes the description of the clinical, laboratory, and epidemiologic indicators associated with a disease or condition of interest to public health. There are case definitions for conditions that are reportable, as well as for those that are not. There are also case definitions for outbreaks. A public health case definition is a construct used by public health for the purpose of counting cases, and should not be used as clinical indications for treatment. Examples include AIDS, toxic-shock syndrome, and salmonellosis and their associated indicators that are used to define a case.
An outbreak represents a series of public health cases. The date on which an outbreak starts is the earliest date of onset among the cases assigned to the outbreak, and its ending date is the last date of onset among the cases assigned to the outbreak.
Class for holding attributes unique to diagnostic images.
Description:An observation of genomic phenomena.
Description:A determinant peptide in a polypeptide as described by polypeptide.
Description:An expression level of genes/proteins or other expressed genomic entities.
Description:The position of a gene (or other significant sequence) on the genome.
Description:A genomic phenomenon that is expressed externally in the organism.
Description:A polypeptide resulting from the translation of a gene.
Description:A sequence of biomolecule like the DNA, RNA, protein and the like.
Description:A variation in a sequence as described by BioSequence.
An formalized inquiry into the circumstances surrounding a particular unplanned event or potential event for the purposes of identifying possible causes and contributing factors for the event. This investigation could be conducted at a local institutional level or at the level of a local or national government.
Container for Correlated Observation Sequences sharing a common frame of reference. All Observations of the same cd must be comparable and relative to the common frame of reference. For example, a 3-channel ECG device records a 12-lead ECG in 4 steps (3 leads at a time). Each of the separate 3-channel recordings would be in their own "OBSCOR". And, all 4 OBSCOR would be contained in one OBSSER because all the times are relative to the same origin (beginning of the recording) and all the ECG signals were from a fixed set of electrodes.
Container for Observation Sequences (Observations whose values are contained in LIST<>'s) having values correlated with each other. Each contained Observation Sequence LIST<> must be the same length. Values in the LIST<>'s are correlated based on index. E.g. the values in position 2 in all the LIST<>'s are correlated. This is analogous to a table where each column is an Observation Sequence with a LIST<> of values, and each row in the table is a correlation between the columns. For example, a 12-lead ECG would contain 13 sequences: one sequence for time, and a sequence for each of the 12 leads.
An observation denoting the physical location of a person or thing based on a reference coordinate system.
Description:An observation representing the degree to which the assignment of the spatial coordinates, based on a matching algorithm by a geocoding engine against a reference spatial database, matches true or accepted values.
Description:An observation representing one of a set of numerical values used to determine the position of a place. The name of the coordinate value is determined by the reference coordinate system.
An observation on a specimen in a laboratory environment that may affect processing, analysis or result interpretation
An act which describes the process whereby a 'verifying party' validates either the existence of the Role attested to by some Credential or the actual Vetting act and its details.
An Act that of taking on whole or partial responsibility for, or attention to, safety and well-being of a subject of care. Discussion: A care provision event may exist without any other care actions taking place. For example, when a patient is assigned to the care of a particular health professional. In request (RQO) mood care provision communicates a referral, which is a request: from one party (linked as a participant of type author (AUT)), to another party (linked as a participant of type performer (PRF), to take responsibility for a scope specified by the code attribute, for an entity (linked as a participant of type subject (SBJ)). The scope of the care for which responsibility is taken is identified by code attribute. In event (EVN) mood care provision indicates the effective time interval of a specified scope of responsibility by a performer (PRF) or set of performers (PRF) for a subject (SBJ). Examples: Referral from GP to a specialist. Assignment of a patient or group of patients to the case list of a health professional. Assignment of inpatients to the care of particular nurses for a working shift.
An interaction between a patient and healthcare participant(s) for the purpose of providing patient service(s) or assessing the health status of a patient. For example, outpatient visit to multiple departments, home health support (including physical therapy), inpatient hospital stay, emergency room visit, field visit (e.g., traffic accident), office visit, occupational therapy, telephone call.
Description:A mandate, regulation, obligation, requirement, rule, or expectation unilaterally imposed by one party on: The activity of another party The behavior of another party The manner in which an act is executed
Description:A mandate, regulation, obligation, requirement, rule, or expectation unilaterally imposed by a jurisdiction on: The activity of another party The behavior of another party The manner in which an act is executed Examples:A jurisdictional mandate regarding the prescribing and dispensing of a particular medication. A jurisdictional privacy or security regulation dictating the manner in which personal health information is disclosed. A jurisdictional requirement that certain services or health conditions are reported to a monitoring program, e.g., immunizations, methadone treatment, or cancer registries.
Description:A mandate, obligation, requirement, rule, or expectation unilaterally imposed by an organization on: The activity of another party The behavior of another party The manner in which an act is executed Examples:A clinical or research protocols imposed by a payer, a malpractice insurer, or an institution to which a provider must adhere. A mandate imposed by a denominational institution for a provider to provide or withhold certain information from the patient about treatment options.
Description:An ethical or clinical obligation, requirement, rule, or expectation imposed or strongly encouraged by organizations that oversee particular clinical domains or provider certification which define the boundaries within which a provider may practice and which may have legal basis or ramifications on: The activity of another party The behavior of another party The manner in which an act is executed Examples:An ethical obligation for a provider to fully inform a patient about all treatment options. An ethical obligation for a provider not to disclose personal health information that meets certain criteria, e.g., where disclosure might result in harm to the patient or another person. The set of health care services which a provider is credentialed or privileged to provide.
Description:A requirement, rule, or expectation typically documented as guidelines, protocols, or formularies imposed or strongly encouraged by an organization that oversees or has authority over the practices within a domain, and which may have legal basis or ramifications on: The activity of another party The behavior of another party The manner in which an act is executed Examples:A payer may require a prescribing provider to adhere to formulary guidelines. An institution may adopt clinical guidelines and protocols and implement these within its electronic health record and decision support systems.
An Act whose immediate and primary outcome (post-condition) is the alteration of the physical condition of the subject. Examples: : Procedures may involve the disruption of some body surface (e.g. an incision in a surgical procedure), but they also include conservative procedures such as reduction of a luxated join, chiropractic treatment, massage, balneotherapy, acupuncture, shiatsu, etc. Outside of clinical medicine, procedures may be such things as alteration of environments (e.g. straightening rivers, draining swamps, building dams) or the repair or change of machinery etc.
The act of introducing or otherwise applying a substance to the subject. Discussion: The effect of the substance is typically established on a biochemical basis, however, that is not a requirement. For example, radiotherapy can largely be described in the same way, especially if it is a systemic therapy such as radio-iodine. This class also includes the application of chemical treatments to an area. Examples: Chemotherapy protocol; Drug prescription; Vaccination record
Description: The act of removing a substance from the subject.
A procedure for obtaining a specimen from a source entity.
Represents the act of maintaining information about the registration of its associated registered subject. The subject can be either an Act or a Role, and includes subjects such as lab exam definitions, drug protocol definitions, prescriptions, persons, patients, practitioners, and equipment. The registration may have a unique identifier - separate from the unique identification of the subject - as well as a core set of related participations and act relationships that characterize the registration event and aid in the disposition of the subject information by a receiving system.
The act of examining and evaluating the subject, usually another act. For example, "This prescription needs to be reviewed in 2 months."
A procedure or treatment performed on a specimen to prepare it for analysis
Supply orders and deliveries are simple Acts that focus on the delivered product. The product is associated with the Supply Act via Participation.typeCode="product". With general Supply Acts, the precise identification of the Material (manufacturer, serial numbers, etc.) is important. Most of the detailed information about the Supply should be represented using the Material class. If delivery needs to be scheduled, tracked, and billed separately, one can associate a Transportation Act with the Supply Act. Pharmacy dispense services are represented as Supply Acts, associated with a SubstanceAdministration Act. The SubstanceAdministration class represents the administration of medication, while dispensing is supply.
Diet services are supply services, with some aspects resembling Medication services: the detail of the diet is given as a description of the Material associated via Participation.typeCode="product". Medically relevant diet types may be communicated in the Diet.code attribute using domain ActDietCode, however, the detail of the food supplied and the various combinations of dishes should be communicated as Material instances. Deprecation Note Class: Use either the Supply class (if dealing with what should be given to the patient) or SubstanceAdministration class (if dealing with what the patient should consume) energyQuantity: This quantity can be conveyed by using a Content relationship with a quantity attribute expressing the calories carbohydrateQuantity:This quantity can be conveyed using a Content relationship to an Entity with a code of carbohydrate and a quantity attribute on the content relationship.
The act of putting something away for safe keeping. The "something" may be physical object such as a specimen, or information, such as observations regarding a specimen.
Definition: Indicates that the subject Act has undergone or should undergo substitution of a type indicated by Act.code. Rationale: Used to specify "allowed" substitution when creating orders, "actual" susbstitution when sending events, as well as the reason for the substitution and who was responsible for it.
Definition: The act of transferring information without the intent of imparting understanding about a topic to the subject that is the recipient or holder of the transferred information where the participation association must be RCV or HLD.
Transportation is the moving of a payload (people or material) from a location of origin to a destination location. Thus, any transport service has the three target instances of type payload, origin, and destination, besides the targets that are generally used for any service (i.e., performer, device, etc.)
A sub-class of Act representing any transaction between two accounts whose value is measured in monetary terms. In the "intent" mood, communicates a request for a transaction to be initiated, or communicates a transfer of value between two accounts. In the "event" mood, communicates the posting of a transaction to an account.
This context represents the information acquired and recorded for an observation, a clinical statement such as a portion of the patient's history or an inference or assertion, or an action that might be intended or has actually been performed. This class may represent both the actual data describing the observation, inference, or action, and optionally the details supporting the clinical reasoning process such as a reference to an electronic guideline, decision support system, or other knowledge reference.
Organizer of entries. Navigational. No semantic content. Knowledge of the section code is not required to interpret contained observations. Represents a heading in a heading structure, or "organizer tree". The record entries relating to a single clinical session are usually grouped under headings that represent phases of the encounter, or assist with layout and navigation. Clinical headings usually reflect the clinical workflow during a care session, and might also reflect the main author's reasoning processes. Much research has demonstrated that headings are used differently by different professional groups and specialties, and that headings are not used consistently enough to support safe automatic processing of the E H R.
A code specifying the particular kind of Act that the Act-instance represents within its class. Constraints: The kind of Act (e.g. physical examination, serum potassium, inpatient encounter, charge financial transaction, etc.) is specified with a code from one of several, typically external, coding systems. The coding system will depend on the class of Act, such as LOINC for observations, etc. Conceptually, the Act.code must be a specialization of the Act.classCode. This is why the structure of ActClass domain should be reflected in the superstructure of the ActCode domain and then individual codes or externally referenced vocabularies subordinated under these domains that reflect the ActClass structure. Act.classCode and Act.code are not modifiers of each other but the Act.code concept should really imply the Act.classCode concept. For a negative example, it is not appropriate to use an Act.code "potassium" together with and Act.classCode for "laboratory observation" to somehow mean "potassium laboratory observation" and then use the same Act.code for "potassium" together with Act.classCode for "medication" to mean "substitution of potassium". This mutually modifying use of Act.code and Act.classCode is not permitted.
An account represents a grouping of financial transactions that are tracked and reported together with a single balance. Examples of account codes (types) are Patient billing accounts (collection of charges), Cost centers; Cash.
An account for collecting charges, reversals, adjustments and payments, including deductibles, copayments, coinsurance (financial transactions) credited or debited to the account receivable account for a patient's encounter.
Description: Types of advance payment to be made on a plastic card usually issued by a financial institution used of purchasing services and/or products.
An account representing charges and credits (financial transactions) for a patient's encounter.
Includes coded responses that will occur as a result of the adjudication of an electronic invoice at a summary level and provides guidance on interpretation of the referenced adjudication results.
Catagorization of grouping criteria for the associated transactions and/or summary (totals, subtotals).
Transaction counts and value totals by Contract Identifier.
Transaction counts and value totals for each calendar day within the date range specified.
Transaction counts and value totals by service location (e.g clinic).
Transaction counts and value totals for each calendar month within the date range specified.
Transaction counts and value totals for the date range specified.
Transaction counts and value totals by Provider Identifier.
Transaction counts and value totals for each calendar week within the date range specified.
Transaction counts and value totals for each calendar year within the date range specified.
The invoice element has been accepted for payment but one or more adjustment(s) have been made to one or more invoice element line items (component charges). Also includes the concept 'Adjudicate as zero' and items not covered under a particular Policy. Invoice element can be reversed (nullified). Recommend that the invoice element is saved for DUR (Drug Utilization Reporting).
adjudicated with adjustments and no financial impact
The invoice element has been accepted for payment but one or more adjustment(s) have been made to one or more invoice element line items (component charges) without changing the amount. Invoice element can be reversed (nullified). Recommend that the invoice element is saved for DUR (Drug Utilization Reporting).
The invoice element has passed through the adjudication process but payment is refused due to one or more reasons. Includes items such as patient not covered, or invoice element is not constructed according to payer rules (e.g. 'invoice submitted too late'). If one invoice element line item in the invoice element structure is rejected, the remaining line items may not be adjudicated and the complete group is treated as rejected. A refused invoice element can be forwarded to the next payer (for Coordination of Benefits) or modified and resubmitted to refusing payer. Invoice element cannot be reversed (nullified) as there is nothing to reverse. Recommend that the invoice element is not saved for DUR (Drug Utilization Reporting).
The invoice element was/will be paid exactly as submitted, without financial adjustment(s). If the dollar amount stays the same, but the billing codes have been amended or financial adjustments have been applied through the adjudication process, the invoice element is treated as "Adjudicated with Adjustment". If information items are included in the adjudication results that do not affect the monetary amounts paid, then this is still Adjudicated as Submitted (e.g. 'reached Plan Maximum on this Claim'). Invoice element can be reversed (nullified). Recommend that the invoice element is saved for DUR (Drug Utilization Reporting).
Actions to be carried out by the recipient of the Adjudication Result information.
The adjudication result associated is to be displayed to the receiver of the adjudication result.
The adjudication result associated is to be printed on the specified form, which is then provided to the covered party.
Definition:An identifying modifier code for healthcare interventions or procedures.
Description:CPT modifier codes are found in Appendix A of CPT 2000 Standard Edition.
Description:HCPCS Level II (HCFA-assigned) and Carrier-assigned (Level III) modifiers are reported in Appendix A of CPT 2000 Standard Edition and in the Medicare Bulletin.
The type of provision(s) made for reimbursing for the deliver of healthcare services and/or goods provided by a Provider, over a specified period.
A billing arrangement where a Provider charges a lump sum to provide a prescribed group (volume) of services to a single patient which occur over a period of time. Services included in the block may vary. This billing arrangement is also known as Program of Care for some specific Payors and Program Fees for other Payors.
A billing arrangement where the payment made to a Provider is determined by analyzing one or more demographic attributes about the persons/patients who are enrolled with the Provider (in their practice).
A billing arrangement where a Provider charges a lump sum to provide a particular volume of one or more interventions/procedures or groups of interventions/procedures.
A billing arrangement where a Provider charges for non-clinical items. This includes interest in arrears, mileage, etc. Clinical content is not included in Invoices submitted with this type of billing arrangement.
A billing arrangement where funding is based on a list of individuals registered as patients of the Provider.
A billing arrangement where a Provider charges a sum to provide a group (volume) of interventions/procedures to one or more patients within a defined period of time, typically on the same date. Interventions/procedures included in the session may vary.
A billing arrangement where a Provider charges a separate fee for each intervention/procedure/event or product. Fee for Service is used when an individual intervention/procedure/event is used for billing purposes. In other words, fees are associated with the intervention/procedure/event. For example, a specific CCI (Canadian Classification of Interventions) code has an associated fee and is used for billing purposes.
A first fill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.) and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets)
A first fill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets) and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).
A fill where a small portion is provided to allow for determination of the therapy effectiveness and patient tolerance and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).
A fully specified bounded Region of Interest (ROI) delineates a ROI in which only those dimensions participate that are specified by boundary criteria, whereas all other dimensions are excluded. For example a ROI to mark an episode of "ST elevation" in a subset of the EKG leads V2, V3, and V4 would include 4 boundaries, one each for time, V2, V3, and V4.
A partially specified bounded Region of Interest (ROI) specifies a ROI in which at least all values in the dimensions specified by the boundary criteria participate. For example, if an episode of ventricular fibrillations (VFib) is observed, it usually doesn't make sense to exclude any EKG leads from the observation and the partially specified ROI would contain only one boundary for time indicating the time interval where VFib was observed.
Description:The type and scope of responsibility taken-on by the performer of the Act for a specific subject of care.
Description:The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by a credentialing agency, i.e. government or non-government agency. Failure in executing this Act may result in loss of credential to the person or organization who participates as performer of the Act. Excludes employment agreements. Example:Hospital license; physician license; clinic accreditation.
Description:The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by an agency for credentialing individuals.
certified anatomic pathology and clinical pathology care
Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.
certified clinical biochemical genetics care
certified clinical molecular genetics care
certified neurology with special qualifications in child neurology care
certified obstetrics and gynecology care
certified public health and general preventive medicine care
certified physical medicine and rehabilitation care
Description:Scope of responsibility taken-on for physician care of a patient as defined by a governmental licensing agency.
Description:The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by an agency for credentialing programs within organizations.
Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency.
accredited critical access hospital care
Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.
certified acute myocardial infarction care
certified digestive/gastrointestinal disorders care
certified orthopedic joint replacement care
certified chronic obstructive pulmonary disease care
certified stroke disease management care
Domain provides codes that qualify the ActEncounterClass (ENC)
A comprehensive term for health care provided in a healthcare facility (e.g. a practitioneraTMs office, clinic setting, or hospital) on a nonresident basis. The term ambulatory usually implies that the patient has come to the location and is not assigned to a bed. Sometimes referred to as an outpatient encounter.
A patient encounter that takes place at a dedicated healthcare service delivery location where the patient receives immediate evaluation and treatment, provided until the patient can be discharged or responsibility for the patient's care is transferred elsewhere (for example, the patient could be admitted as an inpatient or transferred to another facility.)
A patient encounter that takes place both outside a dedicated service delivery location and outside a patient's residence. Example locations might include an accident site and at a supermarket.
Healthcare encounter that takes place in the residence of the patient or a designee
A patient encounter where a patient is admitted by a hospital or equivalent facility, assigned to a location where patients generally stay at least overnight and provided with room, board, and continuous nursing service.
Any category of inpatient encounter except 'acute'
A patient encounter where patient is scheduled or planned to receive service delivery in the future, and the patient is given a pre-admission account number. When the patient comes back for subsequent service, the pre-admission encounter is selected and is encapsulated into the service registration, and a new account number is generated. Usage Note: This is intended to be used in advance of encounter types such as ambulatory, inpatient encounter, virtual, etc.
An encounter where the patient is admitted to a health care facility for a predetermined length of time, usually less than 24 hours.
A patient encounter where the patient and the practitioner(s) are not in the same physical location. Examples include telephone conference, email exchange, robotic surgery, and televideo conference.
General category of medical service provided to the patient during their encounter.
Provision of Alternate Level of Care to a patient in an acute bed. Patient is waiting for placement in a long-term care facility and is unable to return home.
Provision of diagnosis and treatment of diseases and disorders affecting the heart
Provision of recurring care for chronic illness.
Provision of treatment for oral health and/or dental surgery.
General care performed by a general practitioner or family doctor as a responsible provider for a patient.
Provision of diagnostic and/or therapeutic treatment.
Provision of care of women during pregnancy, childbirth and immediate postpartum period. Also known as Maternity.
Provision of treatment and/or diagnosis related to tumors and/or cancer.
Provision of care for patients who are living or dying from an advanced illness.
Provision of diagnosis and treatment of diseases and disorders affecting children.
Pharmaceutical care performed by a pharmacist.
Provision of treatment for physical injury.
Provision of treatment of psychiatric disorder relating to mental illness.
Description: Coded types of attachments included to support a healthcare claim.
Description: Automobile Information Attachment
Description: Work Injury related additional Information Attachment
Definition: The type of consent directive, e.g., to consent or dissent to collect, access, or use in specific ways within an EHRS or for health information exchange; or to disclose health information for purposes such as research.
Definition: Consent to have healthcare information collected in an electronic health record. This entails that the information may be used in analysis, modified, updated.
Definition: Consent to have collected healthcare information disclosed.
Definition: Consent to access healthcare information.
Definition: Consent to access or "read" only, which entails that the information is not to be copied, screen printed, saved, emailed, stored, re-disclosed or altered in any way. This level ensures that data which is masked or to which access is restricted will not be. Example: Opened and then emailed or screen printed for use outside of the consent directive purpose.
Definition: Consent to access and save only, which entails that access to the saved copy will remain locked.
Definition: Information re-disclosed without the patient's consent.
Definition: Consent to have healthcare information in an electronic health record accessed for research purposes.
Definition: Consent to have de-identified healthcare information in an electronic health record that is accessed for research purposes, but without consent to re-identify the information under any circumstance.
Definition: Consent to have de-identified healthcare information in an electronic health record that is accessed for research purposes re-identified under specific circumstances outlined in the consent. Example:: Where there is a need to inform the subject of potential health issues.
Constrains the ActCode to the domain of Container Registration
Used by one system to inform another that it has received a container.
Used by one system to inform another that the container is in position for specimen transfer (e.g., container removal from track, pipetting, etc.).
Used by one system to inform another that the container has been released from that system.
Used by one system to inform another that the container did not arrive at its next expected location.
Used by one system to inform another that the specific container is being processed by the equipment. It is useful as a response to a query about Container Status, when the specific step of the process is not relevant.
Status is used by one system to inform another that the processing has been completed, but the container has not been released from that system.
Used by one system to inform another that the container is no longer available within the scope of the system (e.g., tube broken or discarded).
An observation form that determines parameters or attributes of an Act. Examples are the settings of a ventilator machine as parameters of a ventilator treatment act; the controls on dillution factors of a chemical analyzer as a parameter of a laboratory observation act; the settings of a physiologic measurement assembly (e.g., time skew) or the position of the body while measuring blood pressure. Control variables are forms of observations because just as with clinical observations, the Observation.code determines the parameter and the Observation.value assigns the value. While control variables sometimes can be observed (by noting the control settings or an actually measured feedback loop) they are not primary observations, in the sense that a control variable without a primary act is of no use (e.g., it makes no sense to record a blood pressure position without recording a blood pressure, whereas it does make sense to record a systolic blood pressure without a diastolic blood pressure).
Specifies whether or not automatic repeat testing is to be initiated on specimens.
A baseline value for the measured test that is inherently contained in the diluent. In the calculation of the actual result for the measured test, this baseline value is normally considered.
Specifies whether or not further testing may be automatically or manually initiated on specimens.
Response to an insurance coverage eligibility query or authorization request.
Indication of authorization for healthcare service(s) and/or product(s). If authorization is approved, funds are set aside.
Authorization approved and funds have been set aside to pay for specified healthcare service(s) and/or product(s) within defined criteria for the authorization.
Authorization for specified healthcare service(s) and/or product(s) denied.
Indication of eligibility coverage for healthcare service(s) and/or product(s).
Insurance coverage is in effect for healthcare service(s) and/or product(s).
Insurance coverage is not in effect for healthcare service(s) and/or product(s). May optionally include reasons for the ineligibility.
Criteria that are applicable to the authorized coverage.
Maximum amount paid or maximum number of services/products covered; or maximum amount or number covered during a specified time period under the policy or program.
Codes representing the time period during which coverage is available; or financial participation requirements are in effect.
Definition: Maximum amount paid by payer or covered party; or maximum number of services or products covered under the policy or program during a covered party's lifetime.
Maximum net amount that will be covered for the product or service specified.
Definition: Maximum amount paid by payer or covered party; or maximum number of services/products covered under the policy or program by time period specified by the effective time on the act.
Maximum unit price that will be covered for the authorized product or service.
Maximum number of items that will be covered of the product or service specified.
Definition: Codes representing the maximum coverate or financial participation requirements.
Codes representing the types of covered parties that may receive covered benefits under a policy or program.
Definition: Set of codes indicating the type of insurance policy or program that pays for the cost of benefits provided to covered parties.
Set of codes indicating the type of insurance policy or other source of funds to cover healthcare costs.
Private insurance policy that provides coverage in addition to other policies (e.g. in addition to a Public Healthcare insurance policy).
Insurance policy that provides for an allotment of funds replenished on a periodic (e.g. annual) basis. The use of the funds under this policy is at the discretion of the covered party.
Insurance policy for injuries sustained in an automobile accident. Will also typically covered non-named parties to the policy, such as pedestrians and passengers.
Definition: An automobile insurance policy under which the insurance company will cover the cost of damages to an automobile owned by the named insured that are caused by accident or intentionally by another party.
Definition: An automobile insurance policy under which the insurance company will indemnify a loss for which another motorist is liable if that motorist is unable to pay because he or she is uninsured. Coverage under the policy applies to bodily injury damages only. Injuries to the covered party caused by a hit-and-run driver are also covered.
Insurance policy funded by a public health system such as a provincial or national health plan. Examples include BC MSP (British Columbia Medical Services Plan) OHIP (Ontario Health Insurance Plan), NHS (National Health Service).
Definition: A public or government health program that administers and funds coverage for dental care to assist program eligible who meet financial and health status criteria.
Definition: A public or government health program that administers and funds coverage for health and social services to assist program eligible who meet financial and health status criteria related to a particular disease. Example: Reproductive health, sexually transmitted disease, and end renal disease programs.
Definition: A program that provides low-income, uninsured, and underserved women access to timely, high-quality screening and diagnostic services, to detect breast and cervical cancer at the earliest stages. Example: To improve women's access to screening for breast and cervical cancers, Congress passed the Breast and Cervical Cancer Mortality Prevention Act of 1990, which guided CDC in creating the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which provides access to critical breast and cervical cancer screening services for underserved women in the United States. An estimated 7 to 10% of U.S. women of screening age are eligible to receive NBCCEDP services. Federal guidelines establish an eligibility baseline to direct services to uninsured and underinsured women at or below 250% of federal poverty level; ages 18 to 64 for cervical screening; ages 40 to 64 for breast screening.
Definition: A public or government program that administers publicly funded coverage of kidney dialysis and kidney transplant services. Example: In the U.S., the Medicare End-stage Renal Disease program (ESRD), the National Kidney Foundation (NKF) American Kidney Fund (AKF) The Organ Transplant Fund.
Definition: Government administered and funded HIV-AIDS program for beneficiaries meeting financial and health status criteria. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors. Example: In the U.S., the Ryan White program, which is administered by the Health Resources and Services Administration.
Definition: Government administered and funded mental health program for beneficiaries meeting financial and mental health status criteria. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors. Example: In the U.S., states receive funding for substance use programs from the Substance Abuse Mental Health Administration (SAMHSA).
Definition: Government administered and funded program to support provision of care to underserved populations through safety net clinics. Example: In the U.S., safety net providers such as federally qualified health centers (FQHC) receive funding under PHSA Section 330 grants administered by the Health Resources and Services Administration.
Definition: Government administered and funded substance use program for beneficiaries meeting financial, substance use behavior, and health status criteria. Beneficiaries may be required to enroll as a result of legal proceedings. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors. Example: In the U.S., states receive funding for substance use programs from the Substance Abuse Mental Health Administration (SAMHSA).
Definition: A government health program that provides coverage for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds.
Definition: A government health program that provides coverage through managed care contracts for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. Discussion: The structure and business processes for underwriting and administering a subsidized managed care program is further specified by the Underwriter and Payer Role.class and Role.code.
Definition: A government health program that provides coverage for health services to persons meeting eligibility criteria for a supplemental health policy or program such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. Example: Supplemental health coverage program may cover the cost of a health program or policy financial participations, such as the copays and the premiums, and may provide coverage for services in addition to those covered under the supplemented health program or policy. In the U.S., Medicaid programs may pay the premium for a covered party who is also covered under the Medicare program or a private health policy. Discussion: The structure and business processes for underwriting and administering a subsidized supplemental retiree health program is further specified by the Underwriter and Payer Role.class and Role.code.
Insurance policy for injuries sustained in the work place or in the course of employment.
Definition: Set of codes indicating the type of insurance policy. Insurance, in law and economics, is a form of risk management primarily used to hedge against the risk of potential financial loss. Insurance is defined as the equitable transfer of the risk of a potential loss, from one entity to another, in exchange for a premium and duty of care. A policy holder is an individual or an organization enters into a contract with an underwriter which stipulates that, in exchange for payment of a sum of money (a premium), one or more covered parties (insureds) is guaranteed compensation for losses resulting from certain perils under specified conditions. The underwriter analyzes the risk of loss, makes a decision as to whether the risk is insurable, and prices the premium accordingly. A policy provides benefits that indemnify or cover the cost of a loss incurred by a covered party, and may include coverage for services required to remediate a loss. An insurance policy contains pertinent facts about the policy holder, the insurance coverage, the covered parties, and the insurer. A policy may include exemptions and provisions specifying the extent to which the indemnification clause cannot be enforced for intentional tortious conduct of a covered party, e.g., whether the covered parties are jointly or severably insured. Discussion: In contrast to programs, an insurance policy has one or more policy holders, who own the policy. The policy holder may be the covered party, a relative of the covered party, a partnership, or a corporation, e.g., an employer. A subscriber of a self-insured health insurance policy is a policy holder. A subscriber of an employer sponsored health insurance policy is holds a certificate of coverage, but is not a policy holder; the policy holder is the employer. See CoveredRoleType.
Definition: Set of codes indicating the type of health insurance policy that covers health services provided to covered parties. A health insurance policy is a written contract for insurance between the insurance company and the policyholder, and contains pertinent facts about the policy owner (the policy holder), the health insurance coverage, the insured subscribers and dependents, and the insurer. Health insurance is typically administered in accordance with a plan, which specifies (1) the type of health services and health conditions that will be covered under what circumstances (e.g., exclusion of a pre-existing condition, service must be deemed medically necessary; service must not be experimental; service must provided in accordance with a protocol; drug must be on a formulary; service must be prior authorized; or be a referral from a primary care provider); (2) the type and affiliation of providers (e.g., only allopathic physicians, only in network, only providers employed by an HMO); (3) financial participations required of covered parties (e.g., co-pays, coinsurance, deductibles, out-of-pocket); and (4) the manner in which services will be paid (e.g., under indemnity or fee-for-service health plans, the covered party typically pays out-of-pocket and then file a claim for reimbursement, while health plans that have contractual relationships with providers, i.e., network providers, typically do not allow the providers to bill the covered party for the cost of the service until after filing a claim with the payer and receiving reimbursement).
Definition: A health insurance policy that that covers benefits for dental services.
Definition: A health insurance policy that covers benefits for healthcare services provided for named conditions under the policy, e.g., cancer, diabetes, or HIV-AIDS.
Definition: A health insurance policy that covers benefits for prescription drugs, pharmaceuticals, and supplies.
Definition: A health insurance policy that covers healthcare benefits by protecting covered parties from medical expenses arising from health conditions, sickness, or accidental injury as well as preventive care. Health insurance policies explicitly exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy. Discussion: Health insurance policies are offered by health insurance plans that typically reimburse providers for covered services on a fee-for-service basis, that is, a fee that is the allowable amount that a provider may charge. This is in contrast to managed care plans, which typically prepay providers a per-member/per-month amount or capitation as reimbursement for all covered services rendered. Health insurance plans include indemnity and healthcare services plans.
Definition: An insurance policy that covers benefits for long-term care services people need when they no longer can care for themselves. This may be due to an accident, disability, prolonged illness or the simple process of aging. Long-term care services assist with activities of daily living including: Help at home with day-to-day activities, such as cooking, cleaning, bathing and dressing Care in the community, such as in an adult day care facility Supervised care provided in an assisted living facility Skilled care provided in a nursing home
Definition: Government mandated program providing coverage, disability income, and vocational rehabilitation for injuries sustained in the work place or in the course of employment. Employers may either self-fund the program, purchase commercial coverage, or pay a premium to a government entity that administers the program. Employees may be required to pay premiums toward the cost of coverage as well. Managed care policies specifically exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy. Discussion: Managed care policies are offered by managed care plans that contract with selected providers or health care organizations to provide comprehensive health care at a discount to covered parties and coordinate the financing and delivery of health care. Managed care uses medical protocols and procedures agreed on by the medical profession to be cost effective, also known as medical practice guidelines. Providers are typically reimbursed for covered services by a capitated amount on a per member per month basis that may reflect difference in the health status and level of services anticipated to be needed by the member.
Definition: A policy for a health plan that has features of both an HMO and a FFS plan. Like an HMO, a POS plan encourages the use its HMO network to maintain discounted fees with participating providers, but recognizes that sometimes covered parties want to choose their own provider. The POS plan allows a covered party to use providers who are not part of the HMO network (non-participating providers). However, there is a greater cost associated with choosing these non-network providers. A covered party will usually pay deductibles and coinsurances that are substantially higher than the payments when he or she uses a plan provider. Use of non-participating providers often requires the covered party to pay the provider directly and then to file a claim for reimbursement, like in an FFS plan.
Definition: A policy for a health plan that provides coverage for health care only through contracted or employed physicians and hospitals located in particular geographic or service areas. HMOs emphasize prevention and early detection of illness. Eligibility to enroll in an HMO is determined by where a covered party lives or works.
Definition: A network-based, managed care plan that allows a covered party to choose any health care provider. However, if care is received from a "preferred" (participating in-network) provider, there are generally higher benefit coverage and lower deductibles.
Definition: A health insurance policy that covers benefits for mental health services and prescriptions.
Definition: A health insurance policy that covers benefits for substance use services.
Definition: Set of codes for a policy that provides coverage for health care expenses arising from vision services. A health insurance policy that covers benefits for vision care services, prescriptions, and products.
Definition: An insurance policy that provides a regular payment to compensate for income lost due to the covered party's inability to work because of illness or injury.
Definition: An insurance policy under a benefit plan run by an employer or employee organization for the purpose of providing benefits other than pension-related to employees and their families. Typically provides health-related benefits, benefits for disability, disease or unemployment, or day care and scholarship benefits, among others. An employer sponsored health policy includes coverage of health care expenses arising from sickness or accidental injury, coverage for on-site medical clinics or for dental or vision benefits, which are typically provided under a separate policy. Coverage excludes health care expenses covered by accident or disability, workers' compensation, liability or automobile insurance.
Definition: An insurance policy that covers qualified benefits under a Flexible Benefit plan such as group medical insurance, long and short term disability income insurance, group term life insurance for employees only up to $50,000 face amount, specified disease coverage such as a cancer policy, dental and/or vision insurance, hospital indemnity insurance, accidental death and dismemberment insurance, a medical expense reimbursement plan and a dependent care reimbursement plan. Discussion: See UnderwriterRoleTypeCode flexible benefit plan which is defined as a benefit plan that allows employees to choose from several life, health, disability, dental, and other insurance plans according to their individual needs. Also known as cafeteria plans. Authorized under Section 125 of the Revenue Act of 1978.
Definition: A policy under which the insurer agrees to pay a sum of money upon the occurrence of the covered partys death. In return, the policyholder agrees to pay a stipulated amount called a premium at regular intervals. Life insurance indemnifies the beneficiary for the loss of the insurable interest that a beneficiary has in the life of a covered party. For persons related by blood, a substantial interest established through love and affection, and for all other persons, a lawful and substantial economic interest in having the life of the insured continue. An insurable interest is required when purchasing life insurance on another person. Specific exclusions are often written into the contract to limit the liability of the insurer; for example claims resulting from suicide or relating to war, riot and civil commotion. Discussion:A life insurance policy may be used by the covered party as a source of health care coverage in the case of a viatical settlement, which is the sale of a life insurance policy by the policy owner, before the policy matures. Such a sale, at a price discounted from the face amount of the policy but usually in excess of the premiums paid or current cash surrender value, provides the seller an immediate cash settlement. Generally, viatical settlements involve insured individuals with a life expectancy of less than two years. In countries without state-subsidized healthcare and high healthcare costs (e.g. United States), this is a practical way to pay extremely high health insurance premiums that severely ill people face. Some people are also familiar with life settlements, which are similar transactions but involve insureds with longer life expectancies (two to fifteen years).
Definition: A policy that, after an initial premium or premiums, pays out a sum at pre-determined intervals. For example, a policy holder may pay $10,000, and in return receive $150 each month until he dies; or $1,000 for each of 14 years or death benefits if he dies before the full term of the annuity has elapsed.
Definition: Life insurance under which the benefit is payable only if the insured dies during a specified period. If an insured dies during that period, the beneficiary receives the death payments. If the insured survives, the policy ends and the beneficiary receives nothing.
Definition: Life insurance under which the benefit is payable upon the insuredaTMs death or diagnosis of a terminal illness. If an insured dies during that period, the beneficiary receives the death payments. If the insured survives, the policy ends and the beneficiary receives nothing
Definition: A type of insurance that covers damage to or loss of the policyholderaTMs property by providing payments for damages to property damage or the injury or death of living subjects. The terms "casualty" and "liability" insurance are often used interchangeably. Both cover the policyholder's legal liability for damages caused to other persons and/or their property.
Definition: An agreement between two or more insurance companies by which the risk of loss is proportioned. Thus the risk of loss is spread and a disproportionately large loss under a single policy does not fall on one insurance company. Acceptance by an insurer, called a reinsurer, of all or part of the risk of loss of another insurance company. Discussion: Reinsurance is a means by which an insurance company can protect itself against the risk of losses with other insurance companies. Individuals and corporations obtain insurance policies to provide protection for various risks (hurricanes, earthquakes, lawsuits, collisions, sickness and death, etc.). Reinsurers, in turn, provide insurance to insurance companies. For example, an HMO may purchase a reinsurance policy to protect itself from losing too much money from one insured's particularly expensive health care costs. An insurance company issuing an automobile liability policy, with a limit of $100,000 per accident may reinsure its liability in excess of $10,000. A fire insurance company which issues a large policy generally reinsures a portion of the risk with one or several other companies. Also called risk control insurance or stop-loss insurance.
Definition: A risk or part of a risk for which there is no normal insurance market available. Insurance written by unauthorized insurance companies. Surplus lines insurance is insurance placed with unauthorized insurance companies through licensed surplus lines agents or brokers.
Definition: A form of insurance protection that provides additional liability coverage after the limits of your underlying policy are reached. An umbrella liability policy also protects you (the insured) in many situations not covered by the usual liability policies.
Definition: A set of codes used to indicate coverage under a program. A program is an organized structure for administering and funding coverage of a benefit package for covered parties meeting eligibility criteria, typically related to employment, health, financial, and demographic status. Programs are typically established or permitted by legislation with provisions for ongoing government oversight. Regulations may mandate the structure of the program, the manner in which it is funded and administered, covered benefits, provider types, eligibility criteria and financial participation. A government agency may be charged with implementing the program in accordance to the regulation. Risk of loss under a program in most cases would not meet what an underwriter would consider an insurable risk, i.e., the risk is not random in nature, not financially measurable, and likely requires subsidization with government funds. Discussion: Programs do not have policy holders or subscribers. Program eligibles are enrolled based on health status, statutory eligibility, financial status, or age. Program eligibles who are covered parties under the program may be referred to as members, beneficiaries, eligibles, or recipients. Programs risk are underwritten by not for profit organizations such as governmental entities, and the beneficiaries typically do not pay for any or some portion of the cost of coverage. See CoveredPartyRoleType.
Definition: A program that covers the cost of services provided directly to a beneficiary who typically has no other source of coverage without charge.
Definition: A program that covers the cost of services provided to crime victims for injuries or losses related to the occurrence of a crime.
Definition: An employee assistance program is run by an employer or employee organization for the purpose of providing benefits and covering all or part of the cost for employees to receive counseling, referrals, and advice in dealing with stressful issues in their lives. These may include substance abuse, bereavement, marital problems, weight issues, or general wellness issues. The services are usually provided by a third-party, rather than the company itself, and the company receives only summary statistical data from the service provider. Employee's names and services received are kept confidential.
Definition: A set of codes used to indicate a government program that is an organized structure for administering and funding coverage of a benefit package for covered parties meeting eligibility criteria, typically related to employment, health and financial status. Government programs are established or permitted by legislation with provisions for ongoing government oversight. Regulation mandates the structure of the program, the manner in which it is funded and administered, covered benefits, provider types, eligibility criteria and financial participation. A government agency is charged with implementing the program in accordance to the regulation Example: Federal employee health benefit program in the U.S.
Definition: A government program that provides health coverage to individuals who are considered medically uninsurable or high risk, and who have been denied health insurance due to a serious health condition. In certain cases, it also applies to those who have been quoted very high premiums a" again, due to a serious health condition. The pool charges premiums for coverage. Because the pool covers high-risk people, it incurs a higher level of claims than premiums can cover. The insurance industry pays into the pool to make up the difference and help it remain viable.
Definition: Services provided directly and through contracted and operated indigenous peoples health programs. Example: Indian Health Service in the U.S.
Definition: A government program that provides coverage for health services to military personnel, retirees, and dependents. A covered party who is a subscriber can choose from among Fee-for-Service (FFS) plans, and their Preferred Provider Organizations (PPO), or Plans offering a Point of Service (POS) Product, or Health Maintenance Organizations. Example: In the U.S., TRICARE, CHAMPUS.
Definition: A government mandated program with specific eligibility requirements based on premium contributions made during employment, length of employment, age, and employment status, e.g., being retired, disabled, or a dependent of a covered party under this program. Benefits typically include ambulatory, inpatient, and long-term care, such as hospice care, home health care and respite care.
Definition: A social service program funded by a public or governmental entity. Example: Programs providing habilitation, food, lodging, medicine, transportation, equipment, devices, products, education, training, counseling, alteration of living or work space, and other resources to persons meeting eligibility criteria.
Definition: Services provided directly and through contracted and operated veteran health programs.
Codes dealing with the management of Detected Issue observations
Codes dealing with the management of Detected Issue observations for the administrative and patient administrative acts domains.
Used to temporarily override normal authorization rules to gain access to data in a case of emergency. Use of this override code will typically be monitored, and a procedure to verify its proper use may be triggered when used.
Description: Indicates that the permissions have been externally verified and the request should be processed.
Consulted other supplier/pharmacy, therapy confirmed
Assessed patient, therapy is appropriate
Description: The patient has the appropriate indication or diagnosis for the action to be taken.
Description: It has been confirmed that the appropriate pre-requisite therapy has been tried.
Consulted other supply source, therapy still appropriate
Consulted prescriber and recommended change, prescriber declined
Interacting Therapy No Longer Active/Planned
Concurrent therapy triggering alert is no longer on-going or planned
Patient's existing supply was lost/wasted
Supply date is intended to carry patient over weekend
Supply is intended for use during a leave of absence from an institution.
additional quantity on separate dispense
Description: Supply is different than expected as an additional quantity has been supplied in a separate dispense.
Order is performed as issued, but other action taken to mitigate potential adverse effects
Provided education or training to the patient on appropriate therapy use
Instituted an additional therapy to mitigate potential negative effects
Temporarily Suspended Concurrent Therapy
Suspended existing therapy that triggered interaction for the duration of this therapy
Aborted existing therapy that triggered interaction.
Arranged to monitor patient for adverse effects
Concepts that identify the type or nature of exposure interaction. Examples include "household", "care giver", "intimate partner", "common space", "common substance", etc. to further describe the nature of interaction.
Description: Exposure participants' interaction occurred in a child care setting
Description: An interaction where the exposure participants traveled in/on the same vehicle (not necessarily concurrently, e.g. both are passengers of the same plane, but on different flights of that plane).
Health Care Interaction - Not Patient Care
Description: Exposure participants' interaction occurred during the course of health care delivery or in a health care delivery setting, but did not involve the direct provision of care (e.g. a janitor cleaning a patient's hospital room).
Description: Exposure interaction occurred in context of one providing care for the other, i.e. a babysitter providing care for a child, a home-care aide providing assistance to a paraplegic.
Description: Exposure participants' interaction occurred when both were patients being treated in the same (acute) health care delivery facility.
Description: Exposure participants' interaction occurred when one visited the other who was a patient being treated in a health care delivery facility.
Description: Exposure interaction occurred in context of domestic interaction, i.e. both participants reside in the same household.
Description: Exposure participants' interaction occurred in the course of one or both participants being incarcerated at a correctional facility
Description: Exposure interaction was intimate, i.e. participants are intimate companions (e.g. spouses, domestic partners).
Description: Exposure participants' interaction occurred in the course of one or both participants being resident at a long term care facility (second participant may be a visitor, worker, resident or a physical place or object within the facility).
Description: An interaction where the exposure participants were both present in the same location/place/space.
Description: Exposure participants' interaction occurred during the course of health care delivery by a provider (e.g. a physician treating a patient in her office).
Description: Exposure participants' interaction occurred in an academic setting (e.g., participants are fellow students, or student and teacher).
Description: An interaction where the exposure participants are social associates or members of the same extended family
Description: An interaction where the exposure participants shared or co-used a common substance (e.g. drugs, needles, or common food item).
Description: An interaction where the exposure participants traveled together in/on the same vehicle/trip (e.g. concurrent co-passengers).
Description: Exposure interaction occurred in a work setting, i.e. participants are co-workers.
A type of transaction that represents a charge for a service or product. Expressed in monetary terms.
A type of transaction that represents a reversal of a previous charge for a service or product. Expressed in monetary terms. It has the opposite effect of a standard charge.
Set of codes indicating the type of incident or accident.
Incident or accident as the result of a motor vehicle accident
Incident or accident is the result of a school place accident.
Incident or accident is the result of a sporting accident.
Incident or accident is the result of a work place accident
Description: The type of health information to which the subject of the information or the subject's delegate consents or dissents.
Description: Provide consent to collect, use, disclose, or access adverse drug reaction information for a patient.
Description: Provide consent to collect, use, disclose, or access all information for a patient.
Description: Provide consent to collect, use, disclose, or access allergy information for a patient.
Description: Provide consent to collect, use, disclose, or access informational consent information for a patient.
Description: Provide consent to collect, use, disclose, or access demographics information for a patient.
Description: Provide consent to collect, use, disclose, or access diagnostic imaging information for a patient.
Description: Provide consent to collect, use, disclose, or access immunization information for a patient.
Description: Provide consent to collect, use, disclose, or access lab test result information for a patient.
Description: Provide consent to collect, use, disclose, or access medical condition information for a patient.
Definition: Provide consent to view or access medical condition information for a patient.
Description:Provide consent to collect, use, disclose, or access mental health information for a patient.
Description: Provide consent to collect, use, disclose, or access common observation information for a patient.
Description: Provide consent to collect, use, disclose, or access coverage policy or program for a patient.
Description: Provide consent to collect, use, disclose, or access provider information for a patient.
Description: Provide consent to collect, use, disclose, or access professional service information for a patient.
Description:Provide consent to collect, use, disclose, or access substance abuse information for a patient.
Concepts conveying the context in which authorization given under jurisdictional law, by organizational policy, or by a patient consent directive permits the collection, access, use or disclosure of specified patient health information.
Authorization to collect, access, use, or disclose specified patient health information in accordance with jurisdictional law, organizational policy, or a patient's consent directive, which may be implied, deemed, opt-in, opt-out, or explicit.
Authorization to collect, access, use, or disclose specified patient health information as explicitly consented to by the subject of the information or the subject's representative.
Authorization to collect, access, use, or disclose specified patient health information in accordance with judicial system protocol, such as in the case of a subpoena or court order.
Authorization to collect, access, use, or disclose specified patient health information where deemed necessary to avert potential danger to other persons in accordance with jurisdictional law, organizational policy, or standards of practice. For example, disclosure about a person threatening violence.
Authorization to collect, access, use, or disclose specified patient health information in accordance with emergency information transfer protocol dictated by jurisdictional law, organization policy, or standards of practice. For example, sharing of health information during disaster response.
Authorization to collect, access, use, or disclose specified patient health information necessary to avert potential public welfare risk in accordance with jurisdictional law, organizational policy, or standards of practice. For example, reporting that a person is a victim of abuse or demonstrating suicidal tendencies.
Authorization to collect, access, use, or disclose specified patient health information for public health, welfare, and safety purposes in accordance with jurisdictional law, organizational policy, or standards of practice. For example, public health reporting of notifiable conditions.
Definition:Indicates the set of information types which may be manipulated or referenced, such as for recommending access restrictions.
Definition:All information pertaining to a patient's allergy and intolerance records.
Description: All information pertaining to a patient's adverse drug reactions.
Definition:All information pertaining to a patient's common observation records (height, weight, blood pressure, temperature, etc.).
Definition:All information pertaining to a patient's demographics (such as name, date of birth, gender, address, etc).
Definition:All information pertaining to a patient's diagnostic image records (orders & results).
Definition:All information pertaining to a patient's vaccination records.
Description: All information pertaining to a patient's lab test records (orders & results)
Definition:All information pertaining to a patient's medical condition records.
Description: All information pertaining to a patient's mental health records.
Definition:All information pertaining to a patient's professional service records (such as smoking cessation, counseling, medication review, mental health).
Definition:All information pertaining to a patient's medication records (orders, dispenses and other active medications).
Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results.
Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee and other cost elements such as bonus, retroactive adjustment and transaction fees.
Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc.
Payment initiated by the payor as the result of adjudicating a submitted invoice that arrived to the payor from an electronic source that did not provide a conformant set of HL7 messages (e.g. web claim submission).
Bonus payments based on performance, volume, etc. as agreed to by the payor.
An amount still owing to the payor but the payment is 0$ and this cannot be settled until a future payment is made.
Fees deducted on behalf of a payee for tuition and continuing education.
Fees deducted on behalf of a payee for charges based on a shorter payment frequency (i.e. next day versus biweekly payments.
Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee.
Payment is based on a payment intent for a previously submitted Invoice, based on formal adjudication results..
Payment initiated by the payor as the result of adjudicating a paper (original, may have been faxed) invoice.
An amount that was owed to the payor as indicated, by a carry forward adjusment, in a previous payment advice
Professional association fee that is collected by the payor from the practitioner/provider on behalf of the association
Retroactive adjustment such as fee rate adjustment due to contract negotiations.
Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee, etc.
Transaction counts and value totals by invoice type (e.g. RXDINV - Pharmacy Dispense)
Transaction counts and value totals by each instance of an invoice payee.
Transaction counts and value totals by each instance of an invoice payor.
Transaction counts and value totals by each instance of a messaging application on a single processor. It is a registered identifier known to the receivers.
Codes representing a service or product that is being invoiced (billed). The code can represent such concepts as "office visit", "drug X", "wheelchair" and other billable items such as taxes, service charges and discounts.
An identifying data string for healthcare products.
United Nations Standard Products and Services Classification
Description:United Nations Standard Products and Services Classification, managed by Uniform Code Council (UCC): www.unspsc.org
An identifying data string for A substance used as a medication or in the preparation of medication.
Description:Global Trade Item Number is an identifier for trade items developed by GS1 (comprising the former EAN International and Uniform Code Council).
Description:Universal Product Code is one of a wide variety of bar code languages widely used in the United States and Canada for items in stores.
The detail item codes to identify charges or changes to the total billing of a claim due to insurance rules and payments.
The billable item codes to identify adjudicator specified components to the total billing of a claim.
That portion of the eligible charges which a covered party must pay for each service and/or product. It is a percentage of the eligible amount for the service/product that is typically charged after the covered party has met the policy deductible. This amount represents the covered party's coinsurance that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.
That portion of the eligible charges which a covered party must pay for each service and/or product. It is a defined amount per service/product of the eligible amount for the service/product. This amount represents the covered party's copayment that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.
That portion of the eligible charges which a covered party must pay in a particular period (e.g. annual) before the benefits are payable by the adjudicator. This amount represents the covered party's deductible that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.
The guarantor, who may be the patient, pays the entire charge for a service. Reasons for such action may include: there is no insurance coverage for the service (e.g. cosmetic surgery); the patient wishes to self-pay for the service; or the insurer denies payment for the service due to contractual provisions such as the need for prior authorization.
That total amount of the eligible charges which a covered party must periodically pay for services and/or products prior to the Medicaid program providing any coverage. This amount represents the covered party's spend down that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results
The covered party pays a percentage of the cost of covered services.
The billable item codes to identify modifications to a billable item charge. As for example after hours increase in the office visit fee.
Premium paid on service fees in compensation for practicing outside of normal working hours.
Premium paid on service fees in compensation for practicing in a remote location.
Premium paid on service fees in compensation for practicing at a location other than normal working location.
The billable item codes to identify provider supplied charges or changes to the total billing of a claim.
A charge to compensate the provider when a patient cancels an appointment with insufficient time for the provider to make another appointment with another patient.
A reduction in the amount charged as a percentage of the amount. For example a 5% discount for volume purchase.
A premium on a service fee is requested because, due to extenuating circumstances, the service took an extraordinary amount of time or supplies.
Under agreement between the parties (payor and provider), a guaranteed level of income is established for the provider over a specific, pre-determined period of time. The normal course of business for the provider is submission of fee-for-service claims. Should the fee-for-service income during the specified period of time be less than the agreed to amount, a top-up amount is paid to the provider equal to the difference between the fee-for-service total and the guaranteed income amount for that period of time. The details of the agreement may specify (or not) a requirement for repayment to the payor in the event that the fee-for-service income exceeds the guaranteed amount.
Anticipated or actual final fee associated with treating a patient.
Anticipated or actual initial fee associated with treating a patient.
An increase in the amount charged as a percentage of the amount. For example, 12% markup on product cost.
A charge to compensate the provider when a patient does not show for an appointment.
Anticipated or actual periodic fee associated with treating a patient. For example, expected billing cycle such as monthly, quarterly. The actual period (e.g. monthly, quarterly) is specified in the unit quantity of the Invoice Element.
The amount for a performance bonus that is being requested from a payor for the performance of certain services (childhood immunizations, influenza immunizations, mammograms, pap smears) on a sliding scale. That is, for 90% of childhood immunizations to a maximum of $2200/yr. An invoice is created at the end of the service period (one year) and a code is submitted indicating the percentage achieved and the dollar amount claimed.
A charge is requested because the patient failed to pick up the item and it took an amount of time to return it to stock for future use.
A charge to cover the cost of travel time and/or cost in conjuction with providing a service or product. It may be charged per kilometer or per hour based on the effective agreement.
Premium paid on service fees in compensation for providing an expedited response to an urgent situation.
The billable item codes to identify modifications to a billable item charge by a tax factor applied to the amount. As for example 7% provincial sales tax.
Federal tax on transactions such as the Goods and Services Tax (GST)
Tax levied by the provincial or state jurisdiction such as Provincial Sales Tax
An identifying data string for medical facility accommodations.
Accommodation type. In Intent mood, represents the accommodation type requested. In Event mood, represents accommodation assigned/used. In Definition mood, represents the available accommodation type.
Description:Accommodation type. In Intent mood, represents the accommodation type requested. In Event mood, represents accommodation assigned/used. In Definition mood, represents the available accommodation type.
Accommodations used in the care of diseases that are transmitted through casual contact or respiratory transmission.
Accommodations in which there is only 1 bed.
Uniquely designed and elegantly decorated accommodations with many amenities available for an additional charge.
Accommodations in which there are 2 beds.
Accommodations in which there are 3 or more beds.
An identifying data string for healthcare procedures.
Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results. Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements.
Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results. Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements. The domain is only specified for an intermediate invoice element group (non-root or non-top level) for an Invoice.
A grouping of invoice element groups and details including the ones specifying the compound ingredients being invoiced. It may also contain generic detail items such as markup.
A grouping of invoice element details including the one specifying an ingredient drug being invoiced. It may also contain generic detail items such as tax or markup.
A grouping of invoice element groups and details including the ones specifying the compound supplies being invoiced. It may also contain generic detail items such as markup.
A grouping of invoice element details including the one specifying the drug being invoiced. It may also contain generic detail items such as markup.
A grouping of invoice element details including the ones specifying the frame fee and the frame dispensing cost that are being invoiced.
A grouping of invoice element details including the ones specifying the lens fee and the lens dispensing cost that are being invoiced.
A grouping of invoice element details including the one specifying the product (good or supply) being invoiced. It may also contain generic detail items such as tax or discount.
Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results. Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements. Codes from this domain reflect the type of Invoice such as Pharmacy Dispense, Clinical Service and Clinical Product. The domain is only specified for the root (top level) invoice element group for an Invoice.
Clinical product invoice where the Invoice Grouping contains one or more billable item and is supported by clinical product(s). For example, a crutch or a wheelchair.
Clinical Services Invoice which can be used to describe a single service, multiple services or repeated services. [1] Single Clinical services invoice where the Invoice Grouping contains one billable item and is supported by one clinical service. For example, a single service for an office visit or simple clinical procedure (e.g. knee mobilization). [2] Multiple Clinical services invoice where the Invoice Grouping contains more than one billable item, supported by one or more clinical services. The services can be distinct and over multiple dates, but for the same patient. This type of invoice includes a series of treatments which must be adjudicated together. For example, an adjustment and ultrasound for a chiropractic session where fees are associated for each of the services and adjudicated (invoiced) together. [3] Repeated Clinical services invoice where the Invoice Grouping contains one or more billable item, supported by the same clinical service repeated over a period of time. For example, the same Chiropractic adjustment (service or treatment) delivered on 3 separate occasions over a period of time at the discretion of the provider (e.g. month).
A clinical Invoice Grouping consisting of one or more services and one or more product. Billing for these service(s) and product(s) are supported by multiple clinical billable events (acts). All items in the Invoice Grouping must be adjudicated together to be acceptable to the Adjudicator. For example , a brace (product) invoiced together with the fitting (service).
Invoice Grouping without clinical justification. These will not require identification of participants and associations from a clinical context such as patient and provider. Examples are interest charges and mileage.
A clinical Invoice Grouping consisting of one or more oral health services. Billing for these service(s) are supported by multiple clinical billable events (acts). All items in the Invoice Grouping must be adjudicated together to be acceptable to the Adjudicator.
HealthCare facility preferred accommodation invoice.
Pharmacy dispense invoice for a compound.
Pharmacy dispense invoice not involving a compound
Clinical services invoice where the Invoice Group contains one billable item for multiple clinical services in one or more sessions.
Vision dispense invoice for up to 2 lens (left and right), frame and optional discount. Eye exams are invoiced as a clinical service invoice.
Identifies the different types of summary information that can be reported by queries dealing with Statement of Financial Activity (SOFA). The summary information is generally used to help resolve balance discrepancies between providers and payors.
Total counts and total net amounts adjudicated for all Invoice Groupings that were adjudicated within a time period based on the adjudication date of the Invoice Grouping.
adjud. nullified prior-period electronic amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.
adjud. nullified prior-period electronic count
Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.
adjud. nullified prior-period manual amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.
adjud. nullified prior-period manual count
Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.
adjud. nullified same-period electronic amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently nullified in the specified period and submitted electronically.
adjud. nullified same-period electronic count
Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently nullified in the specified period and submitted electronically.
adjud. nullified same-period manual amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.
adjud. nullified same-period manual count
Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.
adjud. non-payee payable prior-period electronic amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.
adjud. non-payee payable prior-period electronic count
Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.
adjud. non-payee payable prior-period manual amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.
adjud. non-payee payable prior-period manual count
Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.
adjud. non-payee payable same-period electronic amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.
adjud. non-payee payable same-period electronic count
Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.
adjud. non-payee payable same-period manual amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.
adjud. non-payee payable same-period manual count
Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.
adjud. payee payable prior-period electronic amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.
adjud. payee payable prior-period electronic count
Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.
adjud. payee payable prior-period manual amout
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.
adjud. payee payable prior-period manual count
Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.
adjud. payee payable same-period electronic amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.
adjud. payee payable same-period electronic count
Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.
adjud. payee payable same-period manual amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.
adjud. payee payable same-period manual count
Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.
adjud. refused prior-period electronic amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted electronically.
adjud. refused prior-period electronic count
Identifies the total number of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted electronically.
adjud. refused prior-period manual amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted manually.
adjud. refused prior-period manual count
Identifies the total number of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted manually.
adjud. refused same-period electronic amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted electronically.
adjud. refused same-period electronic count
Identifies the total number of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted electronically.
adjud. refused same-period manual amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted manually.
Identifies the total number of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted manually.
Total counts and total net amounts paid for all Invoice Groupings that were paid within a time period based on the payment date.
paid nullified prior-period electronic amount
Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted electronically.
paid nullified prior-period electronic count
Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted electronically.
paid nullified prior-period manual amount
Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually.
paid nullified prior-period manual count
Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually.
paid nullified same-period electronic amount
Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently nullified in the specified period and submitted electronically.
paid nullified same-period electronic count
Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently cancelled in the specified period and submitted electronically.
paid nullified same-period manual amount
Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually.
Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually.
paid non-payee payable prior-period electronic amount
Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.
paid non-payee payable prior-period electronic count
Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.
paid non-payee payable prior-period manual amount
Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.
paid non-payee payable prior-period manual count
Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.
paid non-payee payable same-period electronic amount
Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.
paid non-payee payable same-period electronic count
Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.
paid non-payee payable same-period manual amount
Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.
paid non-payee payable same-period manual count
Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.
paid payee payable prior-period electronic amount
Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.
paid payee payable prior-period electronic count
Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.
paid payee payable prior-period manual amount
Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.
paid payee payable prior-period manual count
Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.
paid payee payable same-period electronic amount
Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.
paid payee payable same-period electronic count
Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.
paid payee payable same-period manual amount
Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.
paid payee payable same-period manual count
Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.
Total counts and total net amounts billed for all Invoice Groupings that were submitted within a time period. Adjudicated invoice elements are included.
Identifies the total net amount billed for all submitted Invoice Groupings within a time period and submitted electronically. Adjudicated invoice elements are included.
Identifies the total number of submitted Invoice Groupings within a time period and submitted electronically. Adjudicated invoice elements are included.
Identifies the total net amount billed for all submitted Invoice Groupings that were nullified within a time period and submitted electronically. Adjudicated invoice elements are included.
Identifies the total number of submitted Invoice Groupings that were nullified within a time period and submitted electronically. Adjudicated invoice elements are included.
Identifies the total net amount billed for all submitted Invoice Groupings that are pended or held by the payor, within a time period and submitted electronically. Adjudicated invoice elements are not included.
Identifies the total number of submitted Invoice Groupings that are pended or held by the payor, within a time period and submitted electronically. Adjudicated invoice elements are not included.
Insurance coverage problems have been encountered. Additional explanation information to be supplied.
Electronic form with supporting or additional information to follow.
Fax with supporting or additional information to follow.
The medical service was provided to a patient in good faith that they had medical coverage, although no evidence of coverage was available before service was rendered.
Knowingly over the payor's published time limit for this invoice possibly due to a previous payor's delays in processing. Additional reason information will be supplied.
Manual review of the invoice is requested. Additional information to be supplied. This may be used in the case of an appeal.
The medical service and/or product was provided to a patient that has coverage in another jurisdiction.
The service provided is required for orthodontic purposes. If the covered party has orthodontic coverage, then the service may be paid.
Paper documentation (or other physical format) with supporting or additional information to follow.
Public Insurance has been exhausted. Invoice has not been sent to Public Insuror and therefore no Explanation Of Benefits (EOB) is provided with this Invoice submission.
Allows provider to explain lateness of invoice to a subsequent payor.
Rules of practice do not require a physician's referral for the provider to perform a billable service.
The same service was delivered within a time period that would usually indicate a duplicate billing. However, the repeated service is a medical necessity and therefore not a duplicate.
The service provided is not related to another billed service. For example, 2 unrelated services provided on the same day to the same patient which may normally result in a refused payment for one of the items.
The provider has received a verbal permission from an authoritative source to perform the service or supply the item being invoiced.
Provides codes associated with ActClass value of LIST (working list)
List of acts representing a care plan. The acts can be in a varierty of moods including event (EVN) to record acts that have been carried out as part of the care plan.
Codes used to identify different types of 'duration-based' working lists. Examples include "Continuous/Chronic", "Short-Term" and "As-Needed".
act medication therapy duration working list
Definition:A collection of concepts that identifies different types of 'duration-based' mediation working lists. Examples:"Continuous/Chronic" "Short-Term" and "As Needed"
Definition:A list of medications which the patient is only expected to consume for the duration of the current order or limited set of orders and which is not expected to be renewed.
Definition:A list of medications which are expected to be continued beyond the present order and which the patient should be assumed to be taking unless explicitly stopped.
Definition:A list of medications which the patient is intended to be administered only once.
Definition:A list of medications which the patient will consume intermittently based on the behavior of the condition for which the medication is indicated.
A monitoring program that focuses on narcotics and/or commonly abused substances that are subject to legal restriction.
Definition:A monitoring program that focuses on a drug which is under investigation and has not received regulatory approval for the condition being investigated
Description:A drug that can be prescribed (and reimbursed) only if it meets certain criteria.
Medicines designated in this way may be supplied for patient use without a prescription. The exact form of categorisation will vary in different realms.
Some form of prescription is required before the related medicine can be supplied for a patient. The exact form of regulation will vary in different realms.
Definition:A drug that requires prior approval (to be reimbursed) before being dispensed
Description:A drug that requires special access permission to be prescribed and dispensed.
Description:Concepts representing indications (reasons for clinical action) other than diagnosis and symptoms.
Description:Contrast agent required for imaging study.
Description:Provision of prescription or direction to consume a product for purposes of bowel clearance in preparation for a colonoscopy.
Description:Provision of medication as a preventative measure during a treatment or other period of increased risk.
Description:Provision of medication during pre-operative phase; e.g., antibiotics before dental surgery or bowel prep before colon surgery.
Description:Provision of medication for pregnancy --e.g., vitamins, antibiotic treatments for vaginal tract colonization, etc.
Identifies the type of verification investigation being undertaken with respect to the subject of the verification activity. Examples: Verification of eligibility for coverage under a policy or program - aka enrolled/covered by a policy or program Verification of record - e.g., person has record in an immunization registry Verification of enumeration - e.g. NPI Verification of Board Certification - provider specific Verification of Certification - e.g. JAHCO, NCQA, URAC Verification of Conformance - e.g. entity use with HIPAA, conformant to the CCHIT EHR system criteria Verification of Provider Credentials Verification of no adverse findings - e.g. on National Provider Data Bank, Health Integrity Protection Data Base (HIPDB)
Definition:Indicates that the paper version of the record has, should be or is being verified against the electronic version.
Code identifying the method or the movement of payment instructions. Codes are drawn from X12 data element 591 (PaymentMethodCode)
A written order to a bank to pay the amount specified from funds on deposit.
Electronic Funds Transfer (EFT) deposit into the payee's bank account
A fill providing sufficient supply for one day
A supply action where there is no 'valid' order for the supplied medication. E.g. Emergency vacation supply, weekend supply (when prescriber is unavailable to provide a renewal prescription)
An emergency supply where the expectation is that a formal order authorizing the supply will be provided at a later date.
The initial fill against an order. (This includes initial fills against refill orders.)
A first fill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets).
A first fill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.)
A first fill where the strength supplied is less than the ordered strength. (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).
A fill where a small portion is provided to allow for determination of the therapy effectiveness and patient tolerance.
A supply action to restock a smaller more local dispensary.
A fill against an order that has already been filled (or partially filled) at least once.
A supply action that provides sufficient material for a single dose.
A refill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets.)
A refill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets.) and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).
The first fill against an order that has already been filled at least once at another facility.
refill partial strength (first fill this facility)
The first fill against an order that has already been filled at least once at another facility and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).
A refill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.)
A refill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.) and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).
A fill against an order that has already been filled (or partially filled) at least once and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).
A fill where the remainder of a 'complete' fill is provided after a trial fill has been provided.
A fill where the remainder of a 'complete' fill is provided after a trial fill has been provided and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).
A supply action that provides sufficient material for a single dose via multiple products. E.g. 2 50mg tablets for a 100mg unit dose.
Description:Types of policies that further specify the ActClassPolicy value set.
A policy deeming certain information to be private to an individual or organization. Definition: A mandate, obligation, requirement, rule, or expectation relating to privacy. Discussion: ActPrivacyPolicyType codes support the designation of the 1..* policies that are applicable to an Act such as a Consent Directive, a Role such as a VIP Patient, or an Entity such as a patient who is a minor. 1..* ActPrivacyPolicyType values may be associated with an Act or Role to indicate the policies that govern the assignment of an Act or Role confidentialityCode. Use of multiple ActPrivacyPolicyType values enables fine grain specification of applicable policies, but must be carefully assigned to ensure cogency and avoid creation of conflicting policy mandates. Usage Note: Statutory title may be named in the ActClassPolicy Act Act.title to specify which privacy policy is being referenced.
Definition: Specifies the type of consent directive indicated by an ActClassPolicy e.g., a 3rd party authorization to disclose or consent for a substitute decision maker (SDM) or a notice of privacy policy. Usage Note: ActConsentDirective codes are used to specify the type of Consent Directive to which a Consent Directive Act conforms.
This general consent directive specifically limits disclosure of health information for purpose of emergency treatment. Additional parameters may further limit the disclosure to specific users, roles, duration, types of information, and impose uses obligations. Definition: Opt-in to disclosure of health information for emergency only consent directive.
Acknowledgement of custodian notice of privacy practices. Usage Notes: This type of consent directive acknowledges a custodian's notice of privacy practices including its permitted collection, access, use and disclosure of health information to users and for purposes of use specified.
This general consent directive permits disclosure of health information. Additional parameter may limit authorized users, purpose of use, user obligations, duration, or information types permitted to be disclosed, and impose uses obligations. Definition: Opt-in to disclosure of health information consent directive.
This general consent directive prohibits disclosure of health information. Additional parameters may permit access to some information types by certain users, roles, purposes of use, durations and impose user obligations. Definition: Opt-out of disclosure of health information consent directive.
A mandate, obligation, requirement, rule, or expectation characterizing the value or importance of a resource and may include its vulnerability. (Based on ISO7498-2:1989. Note: The vulnerability of personally identifiable sensitive information may be based on concerns that the unauthorized disclosure may result in social stigmatization or discrimination.) Description: Types of Sensitivity policy that apply to Acts or Roles. A sensitivity policy is adopted by an enterprise or group of enterprises (a 'policy domain') through a formal data use agreement that stipulates the value, importance, and vulnerability of information. A sensitivity code representing a sensitivity policy may be associated with criteria such as categories of information or sets of information identifiers (e.g., a value set of clinical codes or branch in a code system hierarchy). These criteria may in turn be used for the Policy Decision Point in a Security Engine. A sensitivity code may be used to set the confidentiality code used on information about Acts and Roles to trigger the security mechanisms required to control how security principals (i.e., a person, a machine, a software application) may act on the information (e.g., collection, access, use, or disclosure). Sensitivity codes are never assigned to the transport or business envelope containing patient specific information being exchanged outside of a policy domain as this would disclose the information intended to be protected by the policy. When sensitive information is exchanged with others outside of a policy domain, the confidentiality code on the transport or business envelope conveys the receiver's responsibilities and indicates the how the information is to be safeguarded without unauthorized disclosure of the sensitive information. This ensures that sensitive information is treated by receivers as the sender intends, accomplishing interoperability without point to point negotiations. Usage Note: Sensitivity codes are not useful for interoperability outside of a policy domain because sensitivity policies are typically localized and vary drastically across policy domains even for the same information category because of differing organizational business rules, security policies, and jurisdictional requirements. For example, an employee's sensitivity code would make little sense for use outside of a policy domain. 'Taboo' would rarely be useful outside of a policy domain unless there are jurisdictional requirements requiring that a provider disclose sensitive information to a patient directly. Sensitivity codes may be more appropriate in a legacy system's Master Files in order to notify those who access a patient's orders and observations about the sensitivity policies that apply. Newer systems may have a security engine that uses a sensitivity policy's criteria directly. The specializable InformationSensitivityPolicy Act.code may be useful in some scenarios if used in combination with a sensitivity identifier and/or Act.title.
Types of sensitivity policies that apply to Acts. Act.confidentialityCode is defined in the RIM as "constraints around appropriate disclosure of information about this Act, regardless of mood." Usage Note: ActSensitivity codes are used to bind information to an Act.confidentialityCode according to local sensitivity policy so that those confidentiality codes can then govern its handling across enterprises. Internally to a policy domain, however, local policies guide the access control system on how end users in that policy domain are able to use information tagged with these sensitivity values.
Policy for handling alcohol or drug-abuse information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to alcohol or drug-abuse information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling genetic disease information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to genetic disease information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling HIV or AIDS information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to HIV or AIDS information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling psychiatry information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to psychiatry information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling sickle cell disease information, which is afforded heightened confidentiality. Information handling protocols are based on organizational policies related to sickle cell disease information, which is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then the Act valued with this ActCode should be associated with an Act valued with any applicable laws from the ActPrivacyLaw code system.
sexual assault, abuse, or domestic violence information sensitivity
Policy for handling sexual assault, abuse, or domestic violence information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to sexual assault, abuse, or domestic violence information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
sexuality and reproductive health information sensitivity
Policy for handling sexuality and reproductive health information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to sexuality and reproductive health information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
sexually transmitted disease information sensitivity
Policy for handling sexually transmitted disease information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to sexually transmitted disease information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information not to be initially disclosed or discussed with patient except by a physician assigned to patient in this case. Information handling protocols based on organizational policies related to sensitive patient information that must be initially discussed with the patient by an attending physician before being disclosed to the patient. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. Open Issue: This definition conflates a rule and a characteristic, and there may be a similar issue with ts sibling codes.
Types of sensitivity policies that may apply to a sensitive attribute on an Entity. Usage Note: EntitySensitivity codes are used to convey a policy that is applicable to sensitive information conveyed by an entity attribute. May be used to bind a Role.confidentialityCode associated with an Entity per organizational policy. Role.confidentialityCode is defined in the RIM as "an indication of the appropriate disclosure of information about this Role with respect to the playing Entity."
Policy for handling all demographic information about an information subject, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to all demographic about an information subject, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to an information subject's date of birth, which will be afforded heightened confidentiality.Policies may govern sensitivity of information related to an information subject's date of birth, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
gender and sexual orientation information sensitivity
Policy for handling information related to an information subject's gender and sexual orientation, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's gender and sexual orientation, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
living arrangement information sensitivity
Policy for handling information related to an information subject's living arrangement, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's living arrangement, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to an information subject's marital status, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's marital status, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to an information subject's race, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's race, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to an information subject's religious affiliation, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's religion, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Notes: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Types of sensitivity policies that apply to Roles. Usage Notes: RoleSensitivity codes are used to bind information to a Role.confidentialityCode per organizational policy. Role.confidentialityCode is defined in the RIM as "an indication of the appropriate disclosure of information about this Role with respect to the playing Entity."
Policy for handling trade secrets such as financial information or intellectual property, which will be afforded heightened confidentiality. Description: Since the service class can represent knowledge structures that may be considered a trade or business secret, there is sometimes (though rarely) the need to flag those items as of business level confidentiality. Usage Notes: No patient related information may ever be of this confidentiality level. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to an employer which is deemed classified to protect an employee who is the information subject, and which will be afforded heightened confidentiality. Description: Policies may govern sensitivity of information related to an employer, such as law enforcement or national security, the identity of which could impact the privacy, well-being, or safety of an information subject who is an employee. Usage Notes: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to the location of the information subject, which will be afforded heightened confidentiality. Description: Policies may govern sensitivity of information related to the location of the information subject, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Notes: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
sensitive service provider information sensitivity
Policy for handling information related to a provider of sensitive services, which will be afforded heightened confidentiality. Description: Policies may govern sensitivity of information related to providers who deliver sensitive healthcare services in order to protect the privacy, well-being, and safety of the provider and of patients receiving sensitive services. Usage Notes: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to an adolescent, which will be afforded heightened confidentiality per applicable organizational or jurisdictional policy. An enterprise may have a policy that requires that adolescent patient information be provided heightened confidentiality. Information deemed sensitive typically includes health information and patient role information including patient status, demographics, next of kin, and location. Usage Note: For use within an enterprise in which an adolescent is the information subject. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to a celebrity (people of public interest (VIP), which will be afforded heightened confidentiality. Celebrities are people of public interest (VIP) about whose information an enterprise may have a policy that requires heightened confidentiality. Information deemed sensitive may include health information and patient role information including patient status, demographics, next of kin, and location. Usage Note: For use within an enterprise in which the information subject is deemed a celebrity or very important person. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to a diagnosis, health condition or health problem, which will be afforded heightened confidentiality. Diagnostic, health condition or health problem related information may be deemed sensitive by organizational policy, and require heightened confidentiality. Usage Note: For use within an enterprise that provides heightened confidentiality to diagnostic, health condition or health problem related information deemed sensitive. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to a drug, which will be afforded heightened confidentiality. Drug information may be deemed sensitive by organizational policy, and require heightened confidentiality. Usage Note: For use within an enterprise that provides heightened confidentiality to drug information deemed sensitive. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to an employee, which will be afforded heightened confidentiality. When a patient is an employee, an enterprise may have a policy that requires heightened confidentiality. Information deemed sensitive typically includes health information and patient role information including patient status, demographics, next of kin, and location. Usage Note: Policy for handling information related to an employee, which will be afforded heightened confidentiality. Description: When a patient is an employee, an enterprise may have a policy that requires heightened confidentiality. Information deemed sensitive typically includes health information and patient role information including patient status, demographics, next of kin, and location.
Policy for handling information reported by the patient about another person, e.g., a family member, which will be afforded heightened confidentiality. Sensitive information reported by the patient about another person, e.g., family members may be deemed sensitive by default. The flag may be set or cleared on patient's request. Usage Note: For sensitive information relayed by or about a patient, which is deemed sensitive within the enterprise (i.e., by default regardless of whether the patient requested that the information be deemed sensitive.) If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
For sensitive information relayed by or about a patient, which is deemed sensitive within the enterprise (i.e., by default regardless of whether the patient requested that the information be deemed sensitive.) If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. Usage Note: For use within an enterprise that provides heightened confidentiality to certain types of information designated by a patient as sensitive. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
This is the healthcare analog to the US Intelligence Community's concept of a Special Access Program. Compartment codes may be used in as a field value in an initiator's clearance to indicate permission to access and use an IT Resource with a security label having the same compartment value in security category label field. Map: Aligns with ISO 2382-8 definition of Compartment - "A division of data into isolated blocks with separate security controls for the purpose of reducing risk."
A security category label field value, which indicates that access and use of an IT resource is restricted to members of human resources department or workflow.
A security category label field value, which indicates that access and use of an IT resource is restricted to members of a research project.
A security category label field value, which indicates that access and use of an IT resource is restricted to members of records management department or workflow.
A mandate, obligation, requirement, rule, or expectation conveyed as security metadata between senders and receivers required to establish the reliability, authenticity, and trustworthiness of their transactions. Trust security metadata are observation made about aspects of trust applicable to an IT resource (data, information object, service, or system capability). Trust applicable to IT resources is established and maintained in and among security domains, and may be comprised of observations about the domain's trust authority, trust framework, trust policy, trust interaction rules, means for assessing and monitoring adherence to trust policies, mechanisms that enforce trust, and quality and reliability measures of assurance in those mechanisms. [Based on ISO IEC 10181-1 and NIST SP 800-63-2] For example, identity proofing , level of assurance, and Trust Framework.
Type of security metadata about the formal declaration by an authority or neutral third party that validates the technical, security, trust, and business practice conformance of Trust Agents to facilitate security, interoperability, and trust among participants within a security domain or trust framework.
Type of security metadata about privacy and security requirements with which a security domain must comply. [ISO IEC 10181-1]
Type of security metadata about the digital quality or reliability of a trust assertion, activity, capability, information exchange, mechanism, process, or protocol.
Type of security metadata about a set of security-relevant data issued by a security authority or trusted third party, together with security information which is used to provide the integrity and data origin authentication services for an IT resource (data, information object, service, or system capability). [Based on ISO IEC 10181-1]
Type of security metadata about a complete set of contracts, regulations, or commitments that enable participating actors to rely on certain assertions by other actors to fulfill their information security requirements. [Kantara Initiative]
Type of security metadata about a security architecture system component that supports enforcement of security policies.
Description:A mandate, obligation, requirement, rule, or expectation unilaterally imposed on benefit coverage under a policy or program by a sponsor, underwriter or payor on: The activity of another party The behavior of another party The manner in which an act is executed Examples:A clinical protocol imposed by a payer to which a provider must adhere in order to be paid for providing the service. A formulary from which a provider must select prescribed drugs in order for the patient to incur a lower copay.
Types of security policies that further specify the ActClassPolicy value set. Examples: obligation to encrypt refrain from redisclosure without consent
Conveys the mandated workflow action that an information custodian, receiver, or user must perform. Usage Notes: Per ISO 22600-2, ObligationPolicy instances 'are event-triggered and define actions to be performed by manager agent'. Per HL7 Composite Security and Privacy Domain Analysis Model: This value set refers to the action required to receive the permission specified in the privacy rule. Per OASIS XACML, an obligation is an operation specified in a policy or policy that is performed in conjunction with the enforcement of an access control decision.
Custodian system must remove any information that could result in identifying the information subject.
Custodian system must make available to an information subject upon request an accounting of certain disclosures of the individual’s protected health information over a period of time. Policy may dictate that the accounting include information about the information disclosed, the date of disclosure, the identification of the receiver, the purpose of the disclosure, the time in which the disclosing entity must provide a response and the time period for which accountings of disclosure can be requested.
Custodian system must monitor systems to ensure that all users are authorized to operate on information objects.
Custodian system must monitor and maintain retrievable log for each user and operation on information.
Custodian security system must retrieve, evaluate, and comply with the information handling directions of the Confidentiality Code associated with an information target.
Custodian security system must retrieve, evaluate, and comply with applicable information subject consent directives.
comply with jurisdictional privacy policy
Custodian security system must retrieve, evaluate, and comply with applicable jurisdictional privacy policies associated with the target information.
comply with organizational privacy policy
Custodian security system must retrieve, evaluate, and comply with applicable organizational privacy policies associated with the target information.
comply with organizational security policy
Custodian security system must retrieve, evaluate, and comply with the organizational security policies associated with the target information.
Custodian security system must retrieve, evaluate, and comply with applicable policies associated with the target information.
Custodian system must strip information of data that would allow the identification of the source of the information or the information subject.
Custodian system must remove target information from access after use.
Custodian system must render information unreadable by algorithmically transforming plaintext into ciphertext. Usage Notes: A mathematical transposition of a file or data stream so that it cannot be deciphered at the receiving end without the proper key. Encryption is a security feature that assures that only the parties who are supposed to be participating in a videoconference or data transfer are able to do so. It can include a password, public and private keys, or a complex combination of all. (Per Infoway.)
Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext when "at rest" or in storage.
Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext while "in transit" or being transported by any means.
Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext while in use such that operations permitted on the target information are limited by the license granted to the end user.
Custodian system must require human review and approval for permission requested.
Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext. User may be provided a key to decrypt per license or "shared secret".
Custodian must limit access and disclosure to the minimum information required to support an authorized user's purpose of use. Usage Note: Limiting the information available for access and disclosure to that an authorized user or receiver "needs to know" in order to perform permitted workflow or purpose of use.
Custodian must create and/or maintain human readable security label tags as required by policy. Map: Aligns with ISO 22600-3 Section A.3.4.3 description of privacy mark: "If present, the privacy-mark is not used for access control. The content of the privacy-mark may be defined by the security policy in force (identified by the security-policy-identifier) which may define a list of values to be used. Alternately, the value may be determined by the originator of the security-label."
Custodian system must strip information of data that would allow the identification of the source of the information or the information subject. Custodian may retain a key to relink data necessary to reidentify the information subject.
Custodian system must remove information, which is not authorized to be access, used, or disclosed from records made available to otherwise authorized users.
Conveys prohibited actions which an information custodian, receiver, or user is not permitted to perform unless otherwise authorized or permitted under specified circumstances. Usage Notes: ISO 22600-2 species that a Refrain Policy "defines actions the subjects must refrain from performing". Per HL7 Composite Security and Privacy Domain Analysis Model: May be used to indicate that a specific action is prohibited based on specific access control attributes e.g., purpose of use, information type, user role, etc.
no disclosure without subject authorization
Prohibition on disclosure without information subject's authorization.
Prohibition on collection or storage of the information.
Prohibition on disclosure without organizational approved patient restriction.
no disclosure without information subject's consent directive
Prohibition on disclosure without a consent directive from the information subject.
Prohibition on Integration into other records.
Prohibition on disclosure except to entities on specific access list.
Prohibition on disclosure without an interagency service agreement or memorandum of understanding (MOU).
no disclosure without organizational authorization
Prohibition on disclosure without organizational authorization.
no disclosure to patient, family or caregivers without attending provider's authorization
Prohibition on disclosing information to patient, family or caregivers without attending provider's authorization. Usage Note: The information may be labeled with the ActInformationSensitivity TBOO code, triggering application of this RefrainPolicy code as a handling caveat controlling access. Maps to FHIR NOPAT: Typically, this is used on an Alert resource, when the alert records information on patient abuse or non-compliance. FHIR print name is "keep information from patient". Maps to the French realm - code: INVISIBLE_PATIENT. displayName: Document non visible par le patient codingScheme: 1.2.250.1.213.1.1.4.13 French use case: A label for documents that the author chose to hide from the patient until the content can be disclose to the patient in a face to face meeting between a healthcare professional and the patient (in French law some results like cancer diagnosis or AIDS diagnosis must be announced to the patient by a healthcare professional and should not be find out by the patient alone).
Prohibition on collection of the information beyond time necessary to accomplish authorized purpose of use is prohibited.
no redisclosure without consent directive
Prohibition on redisclosure without patient consent directive.
no redisclosure without information subject's consent directive
Prohibition on redisclosure without a consent directive from the information subject.
no disclosure without jurisdictional authorization
Prohibition on disclosure without authorization under jurisdictional law.
Prohibition on associating de-identified or pseudonymized information with other information in a manner that could or does result in disclosing information intended to be masked.
Prohibition on use of the information beyond the purpose of use initially authorized.
Prohibition on disclosure except to principals with access permission to specific VIP information.
no disclosure without originator authorization
Prohibition on disclosure except as permitted by the information originator.
The method that a product is obtained for use by the subject of the supply act (e.g. patient). Product examples are consumable or durable goods.
Temporary supply of a product without transfer of ownership for the product.
Temporary supply of a product with financial compensation, without transfer of ownership for the product.
Transfer of ownership for a product for financial compensation.
Description:Specimen has been received by the participating organization/department.
Description:Specimen has been placed into storage at a participating location.
Description:Specimen has been put in transit to a participating receiver.
Set of codes related to specimen treatments
The lowering of specimen pH through the addition of an acid
The act rendering alkaline by impregnating with an alkali; a conferring of alkaline qualities.
The removal of fibrin from whole blood or plasma through physical or chemical means
The passage of a liquid through a filter, accomplished by gravity, pressure or vacuum (suction).
The act or process by which an acid and a base are combined in such proportions that the resulting compound is neutral.
The addition of calcium back to a specimen after it was removed by chelating agents
The filtration of a colloidal substance through a semipermeable medium that allows only the passage of small molecules.
Description: Describes the type of substance administration being performed. This should not be used to carry codes for identification of products. Use an associated role or entity to carry such information.
The introduction of a drug into a subject with the intention of altering its biologic state with the intent of improving its health status.
Description: The introduction of material into a subject with the intent of providing nutrition or other dietary supplements (e.g. minerals or vitamins).
The introduction of an immunogen with the intent of stimulating an immune response, aimed at preventing subsequent infections by more viable agents.
An additional immunization administration within a series intended to bolster or enhance immunity.
The first immunization administration in a series intended to produce immunity
Description: A task or action that a user may perform in a clinical information system (e.g., medication order entry, laboratory test results review, problem list entry).
A clinician creates a request for a service to be performed for a given patient.
A clinician creates a request for a laboratory test to be done for a given patient.
A clinician creates a request for the administration of one or more medications to a given patient.
A person enters documentation about a given patient.
Description: A person reviews a list of known allergies of a given patient.
A clinician enters a clinical note about a given patient
A clinician enters a diagnosis for a given patient.
A person provides a discharge instruction to a patient.
A clinician enters a discharge summary for a given patient.
A person provides a patient-specific education handout to a patient.
A pathologist enters a report for a given patient.
A clinician enters a problem for a given patient.
A radiologist enters a report for a given patient.
Description: A person reviews a list of immunizations due or received for a given patient.
Description: A person reviews a list of health care reminders for a given patient.
Description: A person reviews a list of wellness or preventive care reminders for a given patient.
A person (e.g., clinician, the patient herself) reviews patient information in the electronic medical record.
Description: A person enters a known allergy for a given patient.
clinical decision support intervention review
A person reviews a recommendation/assessment provided automatically by a clinical decision support application for a given patient.
A person reviews a clinical note of a given patient.
A person reviews a discharge summary of a given patient.
A person reviews a list of diagnoses of a given patient.
Description: A person enters an immunization due or received for a given patient.
A person reviews a list of laboratory results of a given patient.
A person reviews a list of microbiology results of a given patient.
microbiology organisms results review task
A person reviews organisms of microbiology results of a given patient.
microbiology sensitivity test results review task
A person reviews the sensitivity test of microbiology results of a given patient.
A person reviews a list of medication orders submitted to a given patient
medication administration record work list review task
A clinician reviews a work list of medications to be administered to a given patient.
A person reviews a list of orders submitted to a given patient.
A person reviews a pathology report of a given patient.
A person reviews a list of problems of a given patient.
A person reviews a radiology report of a given patient.
Description: A person enters a health care reminder for a given patient.
Description: A person enters a wellness or preventive care reminder for a given patient.
A person reviews a Risk Assessment Instrument report of a given patient.
A person reviews a Falls Risk Assessment Instrument report of a given patient.
Characterizes how a transportation act was or will be carried out. Examples: Via private transport, via public transit, via courier.
Definition: Characterizes how a patient was or will be transported to the site of a patient encounter. Examples: Via ambulance, via public transit, on foot.
Identifies the kinds of observations that can be performed
Identifies the type of observation that is made about a specimen that may affect its processing, analysis or further result interpretation
Describes the artificial blood identifier that is associated with the specimen.
An observation that reports the dilution of a sample.
The dilution of a sample performed by automated equipment. The value is specified by the equipment
The dilution of the specimen made prior to being loaded onto analytical equipment
The value of the dilution of a sample after it had been analyzed at a prior dilution value
Domain provides codes that qualify the ActLabObsEnvfctsCode domain. (Environmental Factors)
An observation that relates to factors that may potentially cause interference with the observation
The Fibrin Index of the specimen. In the case of only differentiating between Absent and Present, recommend using 0 and 1
An observation of the hemolysis index of the specimen in g/L
An observation that describes the icterus index of the specimen. It is recommended to use mMol/L of bilirubin
An observation used to describe the Lipemia Index of the specimen. It is recommended to use the optical turbidity at 600 nm (in absorbance units).
An observation that reports the volume of a sample.
The available quantity of specimen. This is the current quantity minus any planned consumption (e.g., tests that are planned)
The quantity of specimen that is used each time the equipment uses this substance
The current quantity of the specimen, i.e., initial quantity minus what has been actually used.
The initial quantity of the specimen in inventory
Description:Provides a categorization for annotations recorded directly against the patient .
Description:A note that is specific to a patient's diagnostic images, either historical, current or planned.
Description:A general or uncategorized note.
A note that is specific to a patient's immunizations, either historical, current or planned.
Description:A note that is specific to a patient's laboratory results, either historical, current or planned.
Description:A note that is specific to a patient's medications, either historical, current or planned.
Description: A DNA segment that contributes to phenotype/function. In the absence of demonstrated function a gene may be characterized by sequence, transcription or homology
Description: Observation codes which describe characteristics of the immunization material.
Description: Indicates the valid antigen count.
Description: Indicates whether an antigen is valid or invalid.
A code that is used to indicate the type of case safety report received from sender. The current code example reference is from the International Conference on Harmonisation (ICH) Expert Workgroup guideline on Clinical Safety Data Management: Data Elements for Transmission of Individual Case Safety Reports. The unknown/unavailable option allows the transmission of information from a secondary sender where the initial sender did not specify the type of report. Example concepts include: Spontaneous, Report from study, Other.
Indicates that the ICSR is describing problems that a patient experienced after receiving a vaccine product.
Indicates that the ICSR is describing a problem with the actual vaccine product such as physical defects (cloudy, particulate matter) or inability to confer immunity.
Definition:The set of LOINC codes for the act of determining the period of time that has elapsed since an entity was born or created.
Definition:General specification of age with no implied method of determination.
Definition:Age at onset of associated adverse event; no implied method of determination.
Description:This observation represents an 'average' or 'expected' half-life typical of the product.
Definition: A characteristic of an oral solid dosage form of a medicinal product, indicating whether it has one or more coatings such as sugar coating, film coating, or enteric coating. Only coatings to the external surface or the dosage form should be considered (for example, coatings to individual pellets or granules inside a capsule or tablet are excluded from consideration). Constraints: The Observation.value must be a Boolean (BL) with true for the presence or false for the absence of one or more coatings on a solid dosage form.
Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the color or colors that most predominantly define the appearance of the dose form. SPLCOLOR is not an FDA specification for the actual color of solid dosage forms or the names of colors that can appear in labeling. Constraints: The Observation.value must be a single coded value or a list of multiple coded values, specifying one or more distinct colors that approximate of the color(s) of distinct areas of the solid dosage form, such as the different sides of a tablet or one-part capsule, or the different halves of a two-part capsule. Bands on banded capsules, regardless of the color, are not considered when assigning an SPLCOLOR. Imprints on the dosage form, regardless of their color are not considered when assigning an SPLCOLOR. If more than one color exists on a particular side or half, then the most predominant color on that side or half is recorded. If the gelatin capsule shell is colorless and transparent, use the predominant color of the contents that appears through the colorless and transparent capsule shell. Colors can include: Black;Gray;White;Red;Pink;Purple;Green;Yellow;Orange;Brown;Blue;Turquoise.
Description: A characteristic representing a single file reference that contains two or more views of the same dosage form of the product; in most cases this should represent front and back views of the dosage form, but occasionally additional views might be needed in order to capture all of the important physical characteristics of the dosage form. Any imprint and/or symbol should be clearly identifiable, and the viewer should not normally need to rotate the image in order to read it. Images that are submitted with SPL should be included in the same directory as the SPL file.
Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the alphanumeric text that appears on the solid dosage form, including text that is embossed, debossed, engraved or printed with ink. The presence of other non-textual distinguishing marks or symbols is recorded by SPLSYMBOL. Examples: Included in SPLIMPRINT are alphanumeric text that appears on the bands of banded capsules and logos and other symbols that can be interpreted as letters or numbers. Constraints: The Observation.value must be of type Character String (ST). Excluded from SPLIMPRINT are internal and external cut-outs in the form of alphanumeric text and the letter 'R' with a circle around it (when referring to a registered trademark) and the letters 'TM' (when referring to a 'trade mark'). To record text, begin on either side or part of the dosage form. Start at the top left and progress as one would normally read a book. Enter a semicolon to show separation between words or line divisions.
Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the number of equal pieces that the solid dosage form can be divided into using score line(s). Example: One score line creating two equal pieces is given a value of 2, two parallel score lines creating three equal pieces is given a value of 3. Constraints: Whether three parallel score lines create four equal pieces or two intersecting score lines create two equal pieces using one score line and four equal pieces using both score lines, both have the scoring value of 4. Solid dosage forms that are not scored are given a value of 1. Solid dosage forms that can only be divided into unequal pieces are given a null-value with nullFlavor other (OTH).
Description: A characteristic of an oral solid dosage form of a medicinal product, specifying the two dimensional representation of the solid dose form, in terms of the outside perimeter of a solid dosage form when the dosage form, resting on a flat surface, is viewed from directly above, including slight rounding of corners. SPLSHAPE does not include embossing, scoring, debossing, or internal cut-outs. SPLSHAPE is independent of the orientation of the imprint and logo. Shapes can include: Triangle (3 sided); Square; Round; Semicircle; Pentagon (5 sided); Diamond; Double circle; Bullet; Hexagon (6 sided); Rectangle; Gear; Capsule; Heptagon (7 sided); Trapezoid; Oval; Clover; Octagon (8 sided); Tear; Freeform.
Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the longest single dimension of the solid dosage form as a physical quantity in the dimension of length (e.g., 3 mm). The length is should be specified in millimeters and should be rounded to the nearest whole millimeter. Example: SPLSIZE for a rectangular shaped tablet is the length and SPLSIZE for a round shaped tablet is the diameter.
Definition: A characteristic of an oral solid dosage form of a medicinal product, to describe whether or not the medicinal product has a mark or symbol appearing on it for easy and definite recognition. Score lines, letters, numbers, and internal and external cut-outs are not considered marks or symbols. See SPLSCORING and SPLIMPRINT for these characteristics. Constraints: The Observation.value must be a Boolean (BL) with true indicating the presence and false for the absence of marks or symbols. Example:
Distinguishes the kinds of coded observations that could be the trigger for clinical issue detection. These are observations that are not measurable, but instead can be defined with codes. Coded observation types include: Allergy, Intolerance, Medical Condition, Pregnancy status, etc.
Code for the mechanism by which disease was acquired by the living subject involved in the public health case. Includes sexually transmitted, airborne, bloodborne, vectorborne, foodborne, zoonotic, nosocomial, mechanical, dermal, congenital, environmental exposure, indeterminate.
Communication of an agent from a living subject or environmental source to a living subject through indirect contact via oral or nasal inhalation.
Communication of an agent from one animal to another proximate animal.
Communication of an agent from an animal to a proximate person.
Communication of an agent from one living subject to another living subject through direct contact with any body fluid.
Communication of an agent to a living subject through direct contact with blood or blood products whether the contact with blood is part of a therapeutic procedure or not.
Communication of an agent from a living subject or environmental source to a living subject via agent migration through intact skin.
Communication of an agent from an environmental surface or source to a living subject by direct contact.
Communication of an agent from a living subject or environmental source to a living subject through oral contact with material contaminated by person or animal fecal material.
Communication of an agent from an non-living material to a living subject through direct contact.
Communication of an agent from a food source to a living subject via oral consumption.
Communication of an agent from a person to a proximate person.
Communication of an agent to a living subject via an undetermined route.
Communication of an agent from one living subject to another living subject through direct contact with mammalian milk or colostrum.
Communication of an agent from any entity to a living subject while the living subject is in the patient role in a healthcare facility.
Communication of an agent from a living subject or environmental source to a living subject where the acquisition of the agent is not via the alimentary canal.
Communication of an agent from a living subject to the progeny of that living subject via agent migration across the maternal-fetal placental membranes while in utero.
Communication of an agent from one living subject to another living subject through direct contact with genital or oral tissues as part of a sexual act.
Communication of an agent from one living subject to another living subject through direct contact with blood or blood products where the contact with blood is part of a therapeutic procedure.
Communication of an agent from a living subject acting as a required intermediary in the agent transmission process to a recipient living subject via direct contact.
Communication of an agent from a contaminated water source to a living subject whether the water is ingested as a food or not. The route of entry of the water may be through any bodily orifice.
Codes used to define various metadata aspects of a health quality measure.
Indicates that the observation is carrying out an aggregation calculation, contained in the value element.
Identifies the organization(s) who own the intellectual property represented by the eMeasure.
Summary of relevant clinical guidelines or other clinical recommendations supporting this eMeasure.
Description of individual terms, provided as needed.
Disclaimer information for the eMeasure.
The timestamp when the eMeasure was last packaged in the Measure Authoring Tool.
Used to allow measure developers to provide additional guidance for implementers to understand greater specificity than could be provided in the logic for data criteria.
Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range).
Describes the items counted by the measure (e.g., patients, encounters, procedures, etc.)
A significant word that aids in discoverability.
The start date of the measurement period.
The method of adjusting for clinical severity and conditions present at the start of care that can influence patient outcomes for making valid comparisons of outcome measures across providers. Indicates whether an eMeasure is subject to the statistical process for reducing, removing, or clarifying the influences of confounding factors to allow more useful comparisons.
Describes how to combine information calculated based on logic in each of several populations into one summarized result. It can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure. (e.g., pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two). Open Issue: The description does NOT align well with the definition used in the HQMF specfication; correct the MSGAGG definition, and the possible distinction of MSRAGG as a child of AGGREGATE.
health quality measure improvement notation
Information on whether an increase or decrease in score is the preferred result. This should reflect information on which way is better, an increase or decrease in score.
The list of jurisdiction(s) for which the measure applies.
Type of person or organization that is expected to report the issue.
The maximum time that may elapse following completion of the measure until the measure report must be sent to the receiver.
Indicates how the calculation is performed for the eMeasure (e.g., proportion, continuous variable, ratio)
Location(s) in which care being measured is rendered Usage Note: MSRSET is used rather than RoleCode because the setting applies to what is being measured, as opposed to participating directly in the health quality measure documantion itself).
The time period for which the eMeasure applies.
Indicates whether the eMeasure is used to examine a process or an outcome over time (e.g., Structure, Process, Outcome).
Succinct statement of the need for the measure. Usually includes statements pertaining to Importance criterion: impact, gap in care and evidence.
Identifies bibliographic citations or references to clinical practice guidelines, sources of evidence, or other relevant materials supporting the intent and rationale of the eMeasure.
Comparison of results across strata can be used to show where disparities exist or where there is a need to expose differences in results. For example, Centers for Medicare & Medicaid Services (CMS) in the U.S. defines four required Supplemental Data Elements (payer, ethnicity, race, and gender), which are variables used to aggregate data into various subgroups. Additional supplemental data elements required for risk adjustment or other purposes of data aggregation can be included in the Supplemental Data Element section.
Describes the strata for which the measure is to be evaluated. There are three examples of reasons for stratification based on existing work. These include: (1) evaluate the measure based on different age groupings within the population described in the measure (e.g., evaluate the whole [age 14-25] and each sub-stratum [14-19] and [20-25]); (2) evaluate the eMeasure based on either a specific condition, a specific discharge location, or both; (3) evaluate the eMeasure based on different locations within a facility (e.g., evaluate the overall rate for all intensive care units and also some strata include additional findings [specific birth weights for neonatal intensive care units]).
Can be a URL or hyperlinks that link to the transmission formats that are specified for a particular reporting program.
A sequence of values in the "absolute" time domain. This is the same time domain that all HL7 timestamps use. It is time as measured by the Gregorian calendar
A sequence of values in a "relative" time domain. The time is measured relative to the earliest effective time in the Observation Series containing this sequence.
This Observation Series type contains waveforms of a "representative beat" (a.k.a. "median beat" or "average beat"). The waveform samples are measured in relative time, relative to the beginning of the beat as defined by the Observation Series effective time. The waveforms are not directly acquired from the subject, but rather algorithmically derived from the "rhythm" waveforms.
This Observation type contains ECG "rhythm" waveforms. The waveform samples are measured in absolute time (a.k.a. "subject time" or "effective time"). These waveforms are usually "raw" with some minimal amount of noise reduction and baseline filtering applied.
Description: Reporting codes that are related to an immunization event.
Description: The class room associated with the patient during the immunization event.
Description: The school grade or level the patient was in when immunized.
Description: The school the patient attended when immunized.
Description: The school division or district associated with the patient during the immunization event.
Description: The patient's teacher when immunized.
Observation types for specifying criteria used to assert that a subject is included in a particular population.
Criteria which specify subjects who should be removed from the eMeasure population and denominator before determining if numerator criteria are met. Denominator exclusions are used in proportion and ratio measures to help narrow the denominator.
Criteria which specify the removal of a subject, procedure or unit of measurement from the denominator, only if the numerator criteria are not met. Denominator exceptions allow for adjustment of the calculated score for those providers with higher risk populations. Denominator exceptions are used only in proportion eMeasures. They are not appropriate for ratio or continuous variable eMeasures. Denominator exceptions allow for the exercise of clinical judgment and should be specifically defined where capturing the information in a structured manner fits the clinical workflow. Generic denominator exception reasons used in proportion eMeasures fall into three general categories: Medical reasons Patient (or subject) reasons System reasons
Criteria for specifying the entities to be evaluated by a specific quality measure, based on a shared common set of characteristics (within a specific measurement set to which a given measure belongs). The denominator can be the same as the initial population, or it may be a subset of the initial population to further constrain it for the purpose of the eMeasure. Different measures within an eMeasure set may have different denominators. Continuous Variable eMeasures do not have a denominator, but instead define a measure population.
Criteria for specifying the entities to be evaluated by a specific quality measure, based on a shared common set of characteristics (within a specific measurement set to which a given measure belongs).
Criteria for specifying the patients to be evaluated by a specific quality measure, based on a shared common set of characteristics (within a specific measurement set to which a given measure belongs). Details often include information based upon specific age groups, diagnoses, diagnostic and procedure codes, and enrollment periods.
Criteria for specifying the measure population as a narrative description (e.g., all patients seen in the Emergency Department during the measurement period). This is used only in continuous variable eMeasures.
Criteria for specifying subjects who should be removed from the eMeasure's Initial Population and Measure Population. Measure Population Exclusions are used in Continuous Variable measures to help narrow the Measure Population before determining the value(s) of the continuous variable(s).
Criteria for specifying the processes or outcomes expected for each patient, procedure, or other unit of measurement defined in the denominator for proportion measures, or related to (but not directly derived from) the denominator for ratio measures (e.g., a numerator listing the number of central line blood stream infections and a denominator indicating the days per thousand of central line usage in a specific time period).
Criteria for specifying instances that should not be included in the numerator data. (e.g., if the number of central line blood stream infections per 1000 catheter days were to exclude infections with a specific bacterium, that bacterium would be listed as a numerator exclusion). Numerator Exclusions are used only in ratio eMeasures.
Types of observations that can be made about Preferences.
An observation about how important a preference is to the target of the preference.
Indicates that the observation is of an unexpected negative occurrence in the subject suspected to result from the subject's exposure to one or more agents. Observation values would be the symptom resulting from the reaction.
Description:Refines classCode OBS to indicate an observation in which observation.value contains a finding or other nominalized statement, where the encoded information in Observation.value is not altered by Observation.code. For instance, observation.code="ASSERTION" and observation.value="fracture of femur present" is an assertion of a clinical finding of femur fracture.
Definition:An observation that provides a characterization of the level of harm to an investigation subject as a result of a reaction or event.
An observation that states whether the disease was likely acquired outside the jurisdiction of observation, and if so, the nature of the inter-jurisdictional relationship. OpenIssue: This code could be moved to LOINC if it can be done before there are significant implemenations using it.
A clinical judgment as to the worst case result of a future exposure (including substance administration). When the worst case result is assessed to have a life-threatening or organ system threatening potential, it is considered to be of high criticality.
An observation that states the mechanism by which disease was acquired by the living subject involved in the public health case. OpenIssue: This code could be moved to LOINC if it can be done before there are significant implemenations using it.
Includes all codes defining types of indications such as diagnosis, symptom and other indications such as contrast agents for lab tests.
Admitting diagnosis are the diagnoses documented for administrative purposes as the basis for a hospital admission.
Discharge diagnosis are the diagnoses documented for administrative purposes as the time of hospital discharge.
Intermediate diagnoses are those diagnoses documented for administrative purposes during the course of a hospital stay.
The type of injury that the injury coding specifies.
Description: Accuracy determined as per the GIS tier code system.
Indicates that the observation is of a person’s living situation in a household including the household composition and circumstances.
There is a clinical issue for the therapy that makes continuation of the therapy inappropriate. Open Issue: The definition of this code does not correctly represent the concept space of its specializations (children)
Identifies types of detectyed issues for Act class "ALRT" for the administrative and patient administrative acts domains.
The requesting party has insufficient authorization to invoke the interaction.
Description: One or more records in the query response have been suppressed due to consent or privacy restrictions.
Description:The specified element did not pass business-rule validation.
The ID of the patient, order, etc., was not found. Used for transactions other than additions, e.g. transfer of a non-existent patient.
The ID of the patient, order, etc., already exists. Used in response to addition transactions (Admit, New Order, etc.).
There may be an issue with the patient complying with the intentions of the proposed therapy
The proposed therapy appears to duplicate an existing therapy
Description:The proposed therapy appears to have the same intended therapeutic benefit as an existing therapy, though the specific mechanisms of action vary.
Description:The proposed therapy appears to have the same intended therapeutic benefit as an existing therapy and uses the same mechanisms of action as the existing therapy.
Description:The proposed therapy is frequently misused or abused and therefore should be used with caution and/or monitoring.
Description:The request is suspected to have a fraudulent basis.
A similar or identical therapy was recently ordered by a different practitioner.
This patient was recently supplied a similar or identical therapy from a different pharmacy or supplier.
Proposed dosage instructions for therapy differ from standard practice.
Description:Proposed dosage is inappropriate due to patient's medical condition.
Proposed length of therapy differs from standard practice.
Proposed length of therapy is longer than standard practice
Proposed length of therapy is longer than standard practice for the identified indication or diagnosis
Proposed length of therapy is shorter than that necessary for therapeutic effect
Proposed length of therapy is shorter than standard practice for the identified indication or diagnosis
Proposed dosage exceeds standard practice
Proposed dosage exceeds standard practice for the patient's age
Proposed dosage exceeds standard practice for the patient's height or body surface area
Proposed dosage exceeds standard practice for the patient's weight
Proposed dosage interval/timing differs from standard practice
Proposed dosage interval/timing differs from standard practice for the identified indication or diagnosis
Proposed dosage is below suggested therapeutic levels
Proposed dosage is below suggested therapeutic levels for the patient's age
Proposed dosage is below suggested therapeutic levels for the patient's height or body surface area
Proposed dosage is below suggested therapeutic levels for the patient's weight
Description:The maximum quantity of this drug allowed to be administered within a particular time-range (month, year, lifetime) has been reached or exceeded.
Proposed therapy may be inappropriate or contraindicated due to conditions or characteristics of the patient
Proposed therapy may be inappropriate or contraindicated due to patient age
Proposed therapy is outside of the standard practice for an adult patient.
Proposed therapy is outside of standard practice for a geriatric patient.
Proposed therapy is outside of the standard practice for a pediatric patient.
Proposed therapy may be inappropriate or contraindicated due to an existing/recent patient condition or diagnosis
Proposed therapy may be inappropriate or contraindicated when breast-feeding
Proposed therapy may be inappropriate or contraindicated during pregnancy
Description:Proposed therapy may be inappropriate or contraindicated because of a common but non-patient specific reaction to the product. Example:There is no record of a specific sensitivity for the patient, but the presence of the sensitivity is common and therefore caution is warranted.
Proposed therapy may be inappropriate or contraindicated due to patient genetic indicators.
Proposed therapy may be inappropriate or contraindicated due to patient gender.
Proposed therapy may be inappropriate or contraindicated due to recent lab test results
Proposed therapy may be inappropriate or contraindicated based on the potential for a patient reaction to the proposed product
Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to the proposed product. (Allergies are immune based reactions.)
Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to the proposed product. (Intolerances are non-immune based sensitivities.)
Proposed therapy may be inappropriate or contraindicated because of a potential patient reaction to a cross-sensitivity related product.
Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to a cross-sensitivity related product. (Allergies are immune based reactions.)
Proposed therapy may be inappropriate or contraindicated because of a recorded prior adverse reaction to a cross-sensitivity related product.
Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to a cross-sensitivity related product. (Intolerances are non-immune based sensitivities.)
Description:A local business rule relating multiple elements has been violated.
Description:The specified code is not valid against the list of codes allowed for the element.
Description:The specified code has been deprecated and should no longer be used. Select another code from the code system.
Description:The element does not follow the formatting or type rules defined for the field.
Description:The request is missing elements or contains elements which cause it to not meet the legal standards for actioning.
Description:The length of the data specified falls out of the range defined for the element.
Description:The length of the data specified is greater than the maximum length defined for the element.
Description:The length of the data specified is less than the minimum length defined for the element.
Description:The specified element must be specified with a non-null value under certain conditions. In this case, the conditions are true but the element is still missing or null.
Description:The specified element is mandatory and was not included in the instance.
Description:More than one element with the same value exists in the set. Duplicates not permission in this set in a set.
Description: Element in submitted message will not persist in data storage based on detected issue.
Description:The number of repeating elements falls outside the range of the allowed number of repetitions.
Description:The number of repeating elements is above the maximum number of repetitions allowed.
Description:The number of repeating elements is below the minimum number of repetitions allowed.
Description: Metadata associated with the identification (e.g. name or gender) does not match the identification being verified.
Description: One or more records in the query response have a status of 'obsolete'.
Identifies types of detected issues regarding the administration or supply of an item to a patient.
Administration of the proposed therapy may be inappropriate or contraindicated as proposed
Proposed therapy may interact with certain foods
Proposed therapy may interact with an existing or recent therapeutic product
Proposed therapy may interact with an existing or recent drug therapy
Proposed therapy may interact with existing or recent natural health product therapy
Proposed therapy may interact with a non-prescription drug (e.g. alcohol, tobacco, Aspirin)
Definition:The same or similar treatment has previously been attempted with the patient without achieving a positive effect.
Description:Proposed therapy may be contraindicated or ineffective based on an existing or recent drug therapy.
Description:Proposed therapy may be inappropriate or ineffective based on the proposed start or end time.
Definition:Proposed therapy may be inappropriate or ineffective because the end of administration is too close to another planned therapy.
Definition:Proposed therapy may be inappropriate or ineffective because the start of administration is too late after the onset of the condition.
Proposed therapy may be inappropriate or ineffective based on the proposed start or end time.
Proposed therapy may be inappropriate or ineffective because the end of administration is too close to another planned therapy
Proposed therapy may be inappropriate or ineffective because the start of administration is too late after the onset of the condition
Supplying the product at this time may be inappropriate or indicate compliance issues with the associated therapy
Definition:The requested action has already been performed and so this request has no effect
Definition:The therapy being performed is in some way out of alignment with the requested therapy.
Definition:The status of the request being fulfilled has changed such that it is no longer actionable. This may be because the request has expired, has already been completely fulfilled or has been otherwise stopped or disabled. (Not used for 'suspended' orders.)
Definition:The therapy being performed is not sufficiently equivalent to the therapy which was requested.
Definition:The therapy being performed is not generically equivalent (having the identical biological action) to the therapy which was requested.
Definition:The therapy being performed is not therapeutically equivalent (having the same overall patient effect) to the therapy which was requested.
Definition:The therapy is being performed at a time which diverges from the time the therapy was requested
Definition:The therapy action is being performed outside the bounds of the time period requested
too soon within frequency based on the usage
Definition:The therapy action is being performed too soon after the previous occurrence based on the requested frequency
Definition:There should be no actions taken in fulfillment of a request that has been held or suspended.
The patient is receiving a subsequent fill significantly later than would be expected based on the amount previously supplied and the therapy dosage instructions
The patient is receiving a subsequent fill significantly earlier than would be expected based on the amount previously supplied and the therapy dosage instructions
Description: While the record was accepted in the repository, there is a more recent version of a record of this type.
Definition:The proposed therapy goes against preferences or consent constraints recorded in the patient's record.
violates stated preferences, alternate available
Definition:The proposed therapy goes against preferences or consent constraints recorded in the patient's record. An alternate therapy meeting those constraints is available.
Categorization of types of observation that capture the main clinical knowledge subject which may be a medication, a laboratory test, a disease.
Categorization of types of observation that capture a knowledge subtopic which might be treatment, etiology, or prognosis.
Hypersensitivity resulting in an adverse reaction upon exposure to an agent.
Hypersensitivity to an agent caused by an immunologic response to an initial exposure
An allergy to a substance other than a drug or a food. E.g. Latex, pollen, etc.
An allergy to a substance generally consumed for nutritional purposes.
Hypersensitivity resulting in an adverse reaction upon exposure to a drug.
Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure
Hypersensitivity resulting in an adverse reaction upon exposure to environmental conditions.
Hypersensitivity resulting in an adverse reaction upon exposure to food.
A subjective evaluation of the seriousness or intensity associated with another observation.
Shape of the region on the object being referenced
A circle defined by two (column,row) pairs. The first point is the center of the circle and the second point is a point on the perimeter of the circle.
An ellipse defined by four (column,row) pairs, the first two points specifying the endpoints of the major axis and the second two points specifying the endpoints of the minor axis.
A single point denoted by a single (column,row) pair, or multiple points each denoted by a (column,row) pair.
A series of connected line segments with ordered vertices denoted by (column,row) pairs; if the first and last vertices are the same, it is a closed polygon.
Description:Indicates that result data has been corrected.
Code set to define specialized/allowed diets
A diet exclusively composed of oatmeal, semolina, or rice, to be extremely easy to eat and digest.
A diet that uses carbohydrates sparingly. Typically with a restriction in daily energy content (e.g. 1600-2000 kcal).
No enteral intake of foot or liquids whatsoever, no smoking. Typically 6 to 8 hours before anesthesia.
A diet consisting of a formula feeding, either for an infant or an adult, to provide nutrition either orally or through the gastrointestinal tract via tube, catheter or stoma.
A diet low in fat, particularly to patients with hepatic diseases.
A low protein diet for patients with renal failure.
A strictly liquid diet, that can be fully absorbed in the intestine, and therefore may not contain fiber. Used before enteral surgeries.
A diet low in sodium for patients with congestive heart failure and/or renal failure.
A normal diet, i.e. no special preparations or restrictions for medical reasons. This is notwithstanding any preferences the patient might have regarding special foods, such as vegetarian, kosher, etc.
A no fat diet for acute hepatic diseases.
Patient is supplied with parenteral nutrition, typically described in terms of i.v. medications.
A diet that seeks to reduce body fat, typically low energy content (800-1600 kcal).
A diet that avoids ingredients that might cause digestion problems, e.g., avoid excessive fat, avoid too much fiber (cabbage, peas, beans).
A diet that is not intended to be complete but is added to other diets.
This is not really a diet, since it contains little nutritional value, but is essentially just water. Used before coloscopy examinations.
Diet with low content of the amino-acids valin, leucin, and isoleucin, for "maple syrup disease."
Definition: A public or government health program that administers and funds coverage for prescription drugs to assist program eligible who meet financial and health status criteria.
Description:Indicates that a result is complete. No further results are to come. This maps to the 'complete' state in the observation result status code.
Description:Indicates that a result is incomplete. There are further results to come. This maps to the 'active' state in the observation result status code.
An observation identifying security metadata about an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security metadata are used to name security labels. Rationale: According to ISO/TS 22600-3:2009(E) A.9.1.7 SECURITY LABEL MATCHING, Security label matching compares the initiator's clearance to the target's security label. All of the following must be true for authorization to be granted: The security policy identifiers shall be identical The classification level of the initiator shall be greater than or equal to that of the target (that is, there shall be at least one value in the classification list of the clearance greater than or equal to the classification of the target), and For each security category in the target label, there shall be a security category of the same type in the initiator's clearance and the initiator's classification level shall dominate that of the target. Examples: SecurityObservationType security label fields include: Confidentiality classification Compartment category Sensitivity category Security mechanisms used to ensure data integrity or to perform authorized data transformation Indicators of an IT resource completeness, veracity, reliability, trustworthiness, or provenance. Usage Note: SecurityObservationType codes designate security label field types, which are valued with an applicable SecurityObservationValue code as the "security label tag".
Type of security metadata observation made about the category of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security category metadata is defined by ISO/IEC 2382-8:1998(E/F)/ T-REC-X.812-1995 as: "A nonhierarchical grouping of sensitive information used to control access to data more finely than with hierarchical security classification alone." Rationale: A security category observation supports requirement to specify the type of IT resource to facilitate application of appropriate levels of information security according to a range of levels of impact or consequences that might result from the unauthorized disclosure, modification, or use of the information or information system. A resource is assigned to a specific category of information (e.g., privacy, medical, proprietary, financial, investigative, contractor sensitive, security management) defined by an organization or in some instances, by a specific law, Executive Order, directive, policy, or regulation. [FIPS 199] Examples: Types of security categories include: Compartment: A division of data into isolated blocks with separate security controls for the purpose of reducing risk. (ISO 2382-8). A security label tag that "segments" an IT resource by indicating that access and use is restricted to members of a defined community or project. (HL7 Healthcare Classification System) Sensitivity: The characteristic of an IT resource which implies its value or importance and may include its vulnerability. (ISO 7492-2) Privacy metadata for information perceived as undesirable to share. (HL7 Healthcare Classification System)
Type of security metadata observation made about the classification of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security classification is defined by ISO/IEC 2382-8:1998(E/F)/ T-REC-X.812-1995 as: "The determination of which specific degree of protection against access the data or information requires, together with a designation of that degree of protection." Security classification metadata is based on an analysis of applicable policies and the risk of financial, reputational, or other harm that could result from unauthorized disclosure. Rationale: A security classification observation may indicate that the confidentiality level indicated by an Act or Role confidentiality attribute has been overridden by the entity responsible for ascribing the SecurityClassificationObservationValue. This supports the business requirement for increasing or decreasing the level of confidentiality (classification or declassification) based on parameters beyond the original assignment of an Act or Role confidentiality. Examples: Types of security classification include: HL7 Confidentiality Codes such as very restricted, unrestricted, and normal. Intelligence community examples include top secret, secret, and confidential. Usage Note: Security classification observation type codes designate security label field types, which are valued with an applicable SecurityClassificationObservationValue code as the "security label tag".
Type of security metadata observation made about the control of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security control metadata convey instructions to users and receivers for secure distribution, transmission, and storage; dictate obligations or mandated actions; specify any action prohibited by refrain policy such as dissemination controls; and stipulate the permissible purpose of use of an IT resource. Rationale: A security control observation supports requirement to specify applicable management, operational, and technical controls (i.e., safeguards or countermeasures) prescribed for an information system to protect the confidentiality, integrity, and availability of the system and its information. [FIPS 199] Examples: Types of security control metadata include: handling caveats dissemination controls obligations refrain policies purpose of use constraints
Type of security metadata observation made about the integrity of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Rationale: A security integrity observation supports the requirement to guard against improper information modification or destruction, and includes ensuring information non-repudiation and authenticity. (44 U.S.C., SEC. 3542) Examples: Types of security integrity metadata include: Integrity status, which indicates the completeness or workflow status of an IT resource (data, information object, service, or system capability) Integrity confidence, which indicates the reliability and trustworthiness of an IT resource Integrity control, which indicates pertinent handling caveats, obligations, refrain policies, and purpose of use for the resource Data integrity, which indicate the security mechanisms used to ensure that the accuracy and consistency are preserved regardless of changes made (ISO/IEC DIS 2382-8) Alteration integrity, which indicate the security mechanisms used for authorized transformations of the resource Integrity provenance, which indicates the entity responsible for a report or assertion relayed "second-hand" about an IT resource
security alteration integrity observation
Type of security metadata observation made about the alteration integrity of an IT resource (data, information object, service, or system capability), which indicates the mechanism used for authorized transformations of the resource. Examples: Types of security alteration integrity observation metadata, which may value the observation with a code used to indicate the mechanism used for authorized transformation of an IT resource, including: translation syntactic transformation semantic mapping redaction masking pseudonymization anonymization
Type of security metadata observation made about the data integrity of an IT resource (data, information object, service, or system capability), which indicates the security mechanism used to preserve resource accuracy and consistency. Data integrity is defined by ISO 22600-23.3.21 as: "The property that data has not been altered or destroyed in an unauthorized manner", and by ISO/IEC 2382-8: The property of data whose accuracy and consistency are preserved regardless of changes made." Examples: Types of security data integrity observation metadata, which may value the observation, include cryptographic hash function and digital signature.
security integrity confidence observation
Type of security metadata observation made about the integrity confidence of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Examples: Types of security integrity confidence observation metadata, which may value the observation, include highly reliable, uncertain reliability, and not reliable. Usage Note: A security integrity confidence observation on an Act may indicate that a valued Act.uncertaintycode attribute has been overridden by the entity responsible for ascribing the SecurityIntegrityConfidenceObservationValue. This supports the business requirements for increasing or decreasing the assessment of the reliability or trustworthiness of an IT resource based on parameters beyond the original assignment of an Act statement level of uncertainty.
security integrity provenance observation
Type of security metadata observation made about the provenance integrity of an IT resource (data, information object, service, or system capability), which indicates the lifecycle completeness of an IT resource in terms of workflow status such as its creation, modification, suspension, and deletion; locations in which the resource has been collected or archived, from which it may be retrieved, and the history of its distribution and disclosure. Integrity provenance metadata about an IT resource may be used to assess its veracity, reliability, and trustworthiness. Examples: Types of security integrity provenance observation metadata, which may value the observation about an IT resource, include: completeness or workflow status, such as authentication the entity responsible for original authoring or informing about an IT resource the entity responsible for a report or assertion about an IT resource relayed “second-handâ€? the entity responsible for excerpting, transforming, or compiling an IT resource
security integrity provenance asserted by observation
Type of security metadata observation made about the integrity provenance of an IT resource (data, information object, service, or system capability), which indicates the entity that made assertions about the resource. The asserting entity may not be the original informant about the resource. Examples: Types of security integrity provenance asserted by observation metadata, which may value the observation, including: assertions about an IT resource by a patient assertions about an IT resource by a clinician assertions about an IT resource by a device
security integrity provenance reported by observation
Type of security metadata observation made about the integrity provenance of an IT resource (data, information object, service, or system capability), which indicates the entity that reported the existence of the resource. The reporting entity may not be the original author of the resource. Examples: Types of security integrity provenance reported by observation metadata, which may value the observation, include: reports about an IT resource by a patient reports about an IT resource by a clinician reports about an IT resource by a device
Type of security metadata observation made about the integrity status of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Indicates the completeness of an IT resource in terms of workflow status, which may impact users that are authorized to access and use the resource. Examples: Types of security integrity status observation metadata, which may value the observation, include codes from the HL7 DocumentCompletion code system such as legally authenticated, in progress, and incomplete.
An observation identifying trust metadata about an IT resource (data, information object, service, or system capability), which may be used as a trust attribute to populate a computable trust policy, trust credential, trust assertion, or trust label field in a security label or trust policy, which are principally used for authentication, authorization, and access control decisions.
Type of security metadata observation made about the formal declaration by an authority or neutral third party that validates the technical, security, trust, and business practice conformance of Trust Agents to facilitate security, interoperability, and trust among participants within a security domain or trust framework.
Type of security metadata observation made about privacy and security requirements with which a security domain must comply. [ISO IEC 10181-1]
Type of security metadata observation made about a set of security-relevant data issued by a security authority or trusted third party, together with security information which is used to provide the integrity and data origin authentication services for an IT resource (data, information object, service, or system capability). [Based on ISO IEC 10181-1] For example, A Certificate Policy (CP), which is a named set of rules that indicates the applicability of a certificate to a particular community and/or class of application with common security requirements. For example, a particular Certificate Policy might indicate the applicability of a type of certificate to the authentication of electronic data interchange transactions for the trading of goods within a given price range. [Trust Service Principles and Criteria for Certification Authorities Version 2.0 March 2011 Copyright 2011 by Canadian Institute of Chartered Accountants. A Certificate Practice Statement (CSP), which is a statement of the practices which an Authority employs in issuing and managing certificates. [Trust Service Principles and Criteria for Certification Authorities Version 2.0 March 2011 Copyright 2011 by Canadian Institute of Chartered Accountants.]
Type of security metadata observation made about a complete set of contracts, regulations or commitments that enable participating actors to rely on certain assertions by other actors to fulfill their information security requirements. [Kantara Initiative]
Type of security metadata observation made about the digital quality or reliability of a trust assertion, activity, capability, information exchange, mechanism, process, or protocol.
Type of security metadata observation made about a security architecture system component that supports enforcement of security policies.
Definition: A government health program that provides coverage on a fee for service basis for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. Discussion: The structure and business processes for underwriting and administering a subsidized fee for service program is further specified by the Underwriter and Payer Role.class and Role.code.
Definition: Government mandated program providing coverage, disability income, and vocational rehabilitation for injuries sustained in the work place or in the course of employment. Employers may either self-fund the program, purchase commercial coverage, or pay a premium to a government entity that administers the program. Employees may be required to pay premiums toward the cost of coverage as well.
An identifying code for healthcare interventions/procedures.
Definition: An identifying code for billable services, as opposed to codes for similar services used to identify them for functional purposes.
Domain provides the root for HL7-defined detailed or rich codes for the Act classes.
A qualitative measure of the degree of exposure to the causative agent. This includes concepts such as "low", "medium" and "high". This quantifies how the quantity that was available to be administered to the target differs from typical or background levels of the substance.
Description: Exposure to an agent at a relatively high level above background.
Description: Exposure to an agent at a relatively low level above background.
Description: Exposure to an agent at a relatively moderate level above background.A
v3 Code System ActInvoiceElementModifier
Processing consideration and clarification codes.
Electronic form with supporting information to follow.
Fax with supporting information to follow.
Represents the last invoice from the perspective of the provider.
Paper documentation (or other physical format) with supporting information to follow.
OpenIssue: In Ballot 2009May, a strong Negative vote was lodged against several of the concept definitions in the vocabulary used for Act.moodCode. The vote was found "Persuasive With Mod", with the understanding that M and M would undertake a detailed review of these concept definitions for a future release of the RIM.
These are moods describing activities as they progress in the business cycle, from defined, through planned and ordered to completed.
Definition: A definition of a kind of act that can occur . OpenIssue: The semantic constructs embodied in DEF and CRT moods seem indistinguishable, and their uses can readily be determined by the context in which these are used. Therefore, this OpenIssue has been created to declare that it is likely that ActMood.DEF will be "retired" in the future in favor of the more general ActMood.CRT.
Definition: A kind of act that defines a permission that has been granted.
Definition: A kind of act that may occur during the specified time period.
Definition: An act that actually happens (may be an ongoing act or a documentation of a past act).
Definition: An intention or plan for an act. >UsageNotes: The final outcome of the intent, the act that is intended to occur, is always an event. However the final outcome may be reached indirectly via steps through other intents, such as promise, permission request, or an appointment that may lead to an actual event to occur. Alternatively, the intended act may never occur.
Definition: A desire to have an act occur.
Definition: A request (or order) for an act that is part of a defined request/fulfillment cycle. UsageNotes: Use of an HL7 defined request/fulfillment framework is not required to use this mood code.
Definition: A request act that is specialized for the appointment scheduling request/fulfillment cycle. An appointment request is fulfilled only and completely by an appointment (APT), i.e., all that the appointment request intends is to create an appointment (the actual act may well not happen if that is the professional decision during the appointment).
Definition: A request for a permission to perform the act. Typically a payer (or possibly a supervisor) is being requested to give permission to perform the act. As opposed to the RQO, the requestee is not asked to perform or cause to perform the act but only to give the permission.
Definition: A request act that is specialized for an event request/fulfillment cycle. UsageNotes: The fulfillment cycle may involve intermediary fulfilling acts in moods such as PRMS, APT, or even another RQO before being fulfilled by the final event. UsageNotes: The concepts of a "request" and an "order" are viewed as different, because there is an implication of a mandate associated with order. In practice, however, this distinction has no general functional value in the inter-operation of health care computing. "Orders" are commonly refused for a variety of clinical and business reasons, and the notion of a "request" obligates the recipient (the fulfiller) to respond to the sender (the author). Indeed, in many regions, including Australia and Europe, the common term used is "request." Thus, the concept embodies both notions, as there is no useful distinction to be made. If a mandate is to be associated with a request, this will be embodied in the "local" business rules applied to the transactions. Should HL7 desire to provide a distinction between these in the future, the individual concepts could be added as specializations of this concept. The critical distinction here, is the difference between this concept and an "intent", of which it is a specialization. An intent involves decisions by a single party, the author. A request, however, involves decisions by two parties, the author and the fulfiller, with an obligation on the part of the fulfiller to respond to the request indicating that the fulfiller will indeed fulfill the request.
Definition: A suggestion that an act might be performed. Not an explicit request, and professional responsibility may or may not be present.
Definition: A suggestion that an act should be performed with an acceptance of some degree of professional responsibility for the resulting act. Not an explicit request. . UsageNotes: Where there is no clear definition or applicable concept of "professional responsibilityâ€?, RMD becomes indistinguishable from PRP. .
Definition: A commitment to perform an act (may be either solicited or unsolicited). The committer becomes responsible to the other party for executing the act, and, as a consequence, the other party may rely on the first party to perform or cause to perform the act. UsageNotes: Commitments may be retracted or cancelled.
Definition: An act that has been scheduled to be performed at a specific place and time.
Definition: An act that expresses condition statements for other acts.
Deprecation Comment: This concept This codes should no longer be used. Instead, set attribute Act.isCriterionInd to "true" and use the desired mood for your criterion. Definition: A condition that must be true for the source act to be considered.
Deprecation Comment: This concept This codes should no longer be used. Instead, set attribute Act.isCriterionInd to "true" and use the desired mood for your criterion. Definition: A criterion (CRT) that has_match = an event (EVN).
A criterion expressed over goals (ActMood.GOL).
A criterion expressed over intents (ActMood.INT).
A criterion expressed over promises (ActMood.PRMS).
A criterion expressed over requests or orders (ActMood.RQO).
A criterion expressed over risks (ActMood.RSK).
Definition: An act that is considered to have some noteworthy likelihood of occurring in the future (has_match = event). Examples:Prognosis of a condition, Expected date of discharge from hospital, patient will likely need an emergency decompression of the intracranial pressure by morning. UsageNotes:INT (intent) reflects a plan for the future, which is a declaration to do something. This contrasts with expectation, which is a prediction that something will happen in the future. GOL (goal) reflects a hope rather than a prediction. RSK (risk) reflects a potential negative event that may or may not be expected to happen.
Definition: An expectation that is considered to be desirable to occur in the future Examples:Target weight below 80Kg, Stop smoking, Regain ability to walk, goal is to administer thrombolytics to candidate patients presenting with acute myocardial infarction. UsageNotes: INT (intent) reflects a plan for the future, which is a declaration to do something. This contrasts with goal which doesn't represent an intention to act, merely a hope for an eventual result. A goal is distinct from the intended actions to reach that goal. "I will reduce the dose of drug x to 20mg" is an intent. "I hope to be able to get the patient to the point where I can reduce the dose of drug x to 20mg" is a goal. EXPEC (expectation) reflects a prediction rather than a hope. RSK (risk) reflects a potential negative event rather than a hope.
Definition:An act that may occur in the future and which is regarded as undesirable Examples:Increased risk of DVT, at risk for sub-acute bacterial endocarditis. UsageNotes:Note: An observation in RSK mood expresses the undesirable act, and not the underlying risk factor. A risk factor that is present (e.g. obesity, smoking, etc) should be expressed in event mood. INT (intent) reflects a plan for the future, which is a declaration to do something. This contrasts with RSK (risk), which is the potential that something negative will occur that may or may not ever happen. GOL (goal) reflects a hope to achieve something. EXPEC (expectation) is the prediction of a positive or negative event. This contrasts with RSK (risk), which is the potential that something negative will occur that may or may not ever happen, and may not be expected to happen.
Definition: One of a set of acts that specify an option for the property values that the parent act may have. Typically used in definitions or orders to describe alternatives. An option can only be used as a group, that is, all assigned values must be used together. The actual mood of the act is the same as the parent act, and they must be linked by an actrelationship with type = OPTN.
A set of codes (e.g., for routine, emergency), specifying the urgency under which the Act happened, can happen, is happening, is intended to happen, or is requested/demanded to happen.
As soon as possible, next highest priority after stat.
Filler should contact the placer as soon as results are available, even for preliminary results. (Was "C" in HL7 verion 2.3's reporting priority.)
Filler should contact the placer (or target) to schedule the service. (Was "C" in HL7 version 2.3's TQ-priority component.)
Filler should contact the placer to schedule the service. (Was "C" in HL7 version 2.3's TQ-priority component.)
Filler should contact the service recipient (target) to schedule the service. (Was "C" in HL7 version 2.3's TQ-priority component.)
Beneficial to the patient but not essential for survival.
An unforeseen combination of circumstances or the resulting state that calls for immediate action.
Used to indicate that a service is to be performed prior to a scheduled surgery. When ordering a service and using the pre-op priority, a check is done to see the amount of time that must be allowed for performance of the service. When the order is placed, a message can be generated indicating the time needed for the service so that it is not ordered in conflict with a scheduled operation.
An "as needed" order should be accompanied by a description of what constitutes a need. This description is represented by an observation service predicate as a precondition.
Routine service, do at usual work hours.
A report should be prepared and sent as quickly as possible.
With highest priority (e.g., emergency).
It is critical to come as close as possible to the requested time (e.g., for a through antimicrobial level).
Drug is to be used as directed by the prescriber.
A set of codes specifying the motivation, cause, or rationale of an Act, when such rationale is not reasonably represented as an ActRelationship of type "has reason" linking to another Act. Examples: Example reasons that might qualify for being coded in this field might be: "routine requirement", "infectious disease reporting requirement", "on patient request", "required by law".
Identifies the reason the patient is assigned to this accommodation type
Accommodation requested is not available.
Accommodation is assigned for floor convenience.
Description:Codes used to specify reasons or criteria relating to coverage provided under a policy or program. May be used to convey reasons pertaining to coverage contractual provisions, including criteria for eligibility, coverage limitations, coverage maximums, or financial participation required of covered parties.
Identifies the reason or rational for why a person is eligibile for benefits under an insurance policy or progam. Examples: A person is a claimant under an automobile insurance policy are client deceased & adopted client has been given a new policy identifier. A new employee is eligible for health insurance as an employment benefit. A person meets a government program eligibility criteria for financial, age or health status.
Identifies the reason or rational for why a person is not eligibile for benefits under an insurance policy. Examples are client deceased & adopted client has been given a new policy identifier.
When a client has no contact with the health system for an extended period, coverage is suspended. Client will be reinstated to original start date upon proof of identification, residency etc. Example: Coverage may be suspended during a strike situation, when employer benefits for employees are not covered (i.e. not in effect).
Definition: Identifies the reason or rational for why a person is eligibile for benefits under an insurance policy or progam. Examples: A person is a claimant under an automobile insurance policy are client deceased & adopted client has been given a new policy identifier. A new employee is eligible for health insurance as an employment benefit. A person meets a government program eligibility criteria for financial, age or health status.
A person becomes eligible for a program based on age. Example: In the U.S., a person who is 65 years of age or older is eligible for Medicare.
A person becomes eligible for insurance or a program because of crime related health condition or injury. Example: A person is a claimant under the U.S. Crime Victims Compensation program.
A person becomes a claimant under a disability income insurance policy or a disability rehabilitation program because of a health condition or injury which limits the person's ability to earn an income or function without institutionalization.
A person becomes eligible for insurance provided as an employment benefit based on employment status.
A person becomes eligible for a program based on financial criteria. Example: A person whose family income is below a financial threshold for eligibility for Medicaid or SCHIP.
A person becomes eligible for a program because of a qualifying health condition or injury. Examples: A person is determined to have a qualifying health conditions include pregnancy, HIV/AIDs, tuberculosis, end stage renal disease, breast or cervical cancer, or other condition requiring specialized health services, hospice, institutional or community based care provided under a program
A person becomes eligible for a program based on more than one criterion. Examples: In the U.S., a child whose familiy income meets Medicaid financial thresholds and whose age is less than 18 is eligible for the Early and Periodic Screening, Diagnostic, and Treatment program (EPSDT). A person whose family income meets Medicaid financial thresholds and whose age is 65 years or older is eligible for Medicaid and Medicare, and are referred to as dual eligibles.
A person becomes a claimant under a property and casualty insurance policy because of a related health condition or injury resulting from a circumstance covered under the terms of the policy. Example: A person is a claimant under a homeowners insurance policy because of an injury sustained on the policyholderaTMs premises.
A person becomes eligible for a program based on statutory criteria. Examples: A person is a member of an indigenous group, a veteran of military service, or in the U.S., a recipient of adoption assistance and foster care under Title IV-E of the Social Security.
A person becomes a claimant under a motor vehicle accident insurance because of a motor vehicle accident related health condition or injury.
A person becomes eligible for insurance or a program because of a work related health condition or injury. Example: A person is a claimant under the U.S. Black Lung Program.
Description:The rationale or purpose for an act relating to information management, such as archiving information for the purpose of complying with an enterprise data retention policy.
Description:The rationale or purpose for an act relating to health information management, such as archiving information for the purpose of complying with an organization policy or jurisdictional law relating to data retention.
To perform one or more operations on information to which the patient has not consented as deemed necessary by authorized entities for providing care in the best interest of the patient; providing immediately needed health care for an emergent condition; or for protecting public or third party safety. Usage Notes: Used to convey the reason that a provider or other entity may or has accessed personal healthcare information. Typically, this involves overriding the subject's consent directives.
To perform one or more operations on information to which the patient has not consented by authorized entities for treating a condition which poses an immediate threat to the patient's health and which requires immediate medical intervention. Usage Notes: The patient is unable to provide consent, but the provider determines they have an urgent healthcare related reason to access the record.
To perform one or more operations on information to which the patient declined to consent for providing health care. Usage Notes: The patient, while able to give consent, has not. However the provider believes it is in the patient's interest to access the record without patient consent.
To perform one or more operations on information to which the patient has not consented for public safety reasons. Usage Notes: The patient, while able to give consent, has not. However, the provider believes that access to masked patient information is justified because of concerns related to public safety.
To perform one or more operations on information to which the patient has not consented for third party safety. Usage Notes: The patient, while able to give consent, has not. However, the provider believes that access to masked patient information is justified because of concerns related to the health and safety of one or more third parties.
Reason for performing one or more operations on information, which may be permitted by source system's security policy in accordance with one or more privacy policies and consent directives. Usage Notes: The rationale or purpose for an act relating to the management of personal health information, such as collecting personal health information for research or public health purposes.
To perform one or more operations on information for marketing services and products related to health care.
To perform one or more operations on information used for conducting administrative and contractual activities related to the provision of health care.
To perform one or more operations on information used for cadaveric organ, eye or tissue donation.
To perform one or more operations on information used for fraud detection and prevention processes.
To perform one or more operations on information used within government processes.
To perform one or more operations on information for conducting activities related to meeting accreditation criteria.
To perform one or more operations on information used for conducting activities required to meet a mandate.
To perform one or more operations on information used for handling deceased patient matters.
To perform one or more operation operations on information used to manage a patient directory. Examples: facility enterprise payer health information exchange patient directory
To perform one or more operations on information for conducting activities required by legal proceeding.
To perform one or more operations on information used for assessing results and comparative effectiveness achieved by health care practices and interventions.
To perform one or more operations on information used for conducting activities to meet program accounting requirements.
To perform one or more operations on information used for conducting administrative activities to improve health care quality.
To perform one or more operations on information to administer the electronic systems used for the delivery of health care.
To perform one or more operations on information to administer health care coverage to an enrollee under a policy or program.
To perform one or more operations on information used for operational activities conducted to administer the delivery of health care to a patient.
To perform one or more operations on information in processes related to ensuring the safety of health care.
To perform one or more operations on information used for monitoring performance of recommended health care practices and interventions.
To perform one or more operations on information used within the health records management process.
To perform one or more operations on information used in training and education.
To perform one or more operations on information for conducting financial or contractual activities related to payment for provision of health care.
To perform one or more operations on information for provision of additional clinical evidence in support of a request for coverage or payment for health services.
To perform one or more operations on information for conducting prior authorization or predetermination of coverage for services.
To perform one or more operations on information for conducting activities related to coverage under a program or policy.
To perform one or more operations on information used for conducting eligibility determination for coverage in a program or policy. May entail review of financial status or disability assessment.
To perform one or more operations on information used for conducting eligibility verification of coverage in a program or policy. May entail provider contacting coverage source (e.g., government health program such as workers compensation or health plan) for confirmation of enrollment, eligibility for specific services, and any applicable copays.
To perform one or more operations on information used for enrolling a covered party in a program or policy. May entail recording of covered party's and any dependent's demographic information and benefit choices.
To perform one or more operations on information about the amount remitted for a health care claim.
To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge.
To perform one or more operations on information for conducting scientific investigations in accordance with clinical trial protocols to obtain health care knowledge.
To perform one or more operations on information in response to a patient's request.
To perform one or more operations on information in response to a request by a family member authorized by the patient.
To perform one or more operations on information in response to a request by a person appointed as the patient's legal representative.
To perform one or more operations on information in response to a request by a person authorized by the patient.
To perform one or more operations on information for conducting public health activities, such as the reporting of notifiable conditions.
To perform one or more operations on information used for provision of immediately needed health care to a population of living subjects located in a disaster zone.
To perform one or more operations on information used to prevent injury or disease to living subjects who may be the target of violence.
To perform one or more operations on information for provision of health care.
To perform one or more operations on information for provision of health care coordination.
To perform health care as part of the clinical trial protocol.
To perform one or more operations on information for provision of immediately needed health care for an emergent condition.
To perform one or more operations on information for provision of health care to a population of living subjects, e.g., needle exchange program.
Description:The rationale or purpose for an act relating to the management of personal information, such as disclosing personal tax information for the purpose of complying with a court order.
Description:Administrative and contractual processes required to support an activity, product, or service
Definition:To provide information as a result of a subpoena.
Description:Operational activities conducted for the purposes of meeting of criteria defined by an accrediting entity for an activity, product, or service
Description:Operational activities required to meet a mandate related to an activity, product, or service
Description:Operational activities conducted to administer information relating to entities involves with an activity, product, or service
Description:Operational activities conducted for the purposes of assessing the results of an activity, product, or service
Description:Operational activities conducted to meet program accounting requirements related to an activity, product, or service
Description:Operational activities conducted for the purposes of improving the quality of an activity, product, or service
Description:Operational activities conducted to administer the electronic systems used for an activity, product, or service
Description:Administrative, financial, and contractual processes related to payment for an activity, product, or service
Description:Investigative activities conducted for the purposes of obtaining knowledge
Description:Provision of a service, product, or capability to an individual or organization
Description: Types of reasons why a substance is invalid for use.
Description: Storage conditions caused the substance to be ineffective.
Description: Cold chain was not maintained for the substance.
Description: The lot from which the substance was drawn was expired.
administered outside recommended schedule or practice
The substance was administered outside of the recommended schedule or practice.
Description: The substance was recalled by the manufacturer.
Domain specifies the codes used to describe reasons why a Provider is cancelling an Invoice or Invoice Grouping.
The covered party (patient) specified with the Invoice is not correct.
The billing information, specified in the Invoice Elements, is not correct. This could include incorrect costing for items included in the Invoice.
The policy specified with the Invoice is not correct. For example, it may belong to another Adjudicator or Covered Party.
The provider specified with the Invoice is not correct.
A coded description of the reason for why a patient did not receive a scheduled immunization. (important for public health strategy
Definition:Testing has shown that the patient already has immunity to the agent targeted by the immunization.
Definition:The patient currently has a medical condition for which the vaccine is contraindicated or for which precaution is warranted.
Definition:There was no supply of the product on hand to perform the service.
Definition:The patient or their guardian objects to receiving the vaccine.
Definition:The patient or their guardian objects to receiving the vaccine because of philosophical beliefs.
Definition:The patient or their guardian objects to receiving the vaccine on religious grounds.
Definition:The intended vaccine has expired or is otherwise believed to no longer be effective. Example:Due to temperature exposure.
Definition:The patient or their guardian objects to receiving the vaccine because of concerns over its safety.
Indicates why a fulfiller refused to fulfill a supply order, and considered it important to notify other providers of their decision. E.g. "Suspect fraud", "Possible abuse", "Contraindicated". (used when capturing 'refusal to fill' annotations)
Definition:The order has been stopped by the prescriber but this fact has not necessarily captured electronically. Example:A verbal stop, a fax, etc.
Definition:Order has not been fulfilled within a reasonable amount of time, and may not be current.
Definition:Data needed to safely act on the order which was expected to become available independent of the order is not yet available Example:Lab results, diagnostic imaging, etc.
Definition:Product not available or manufactured. Cannot supply.
Definition:The dispenser has ethical, religious or moral objections to fulfilling the order/dispensing the product.
Definition:Fulfiller not able to provide appropriate care associated with fulfilling the order. Example:Therapy requires ongoing monitoring by fulfiller and fulfiller will be ending practice, leaving town, unable to schedule necessary time, etc.
Definition:Specifies the reason that an event occurred in a clinical research study.
Definition:The event occurred so that a test or observation performed at a prior event could be performed again due to conditions set forth in the protocol.
Definition:The event occurred due to it being scheduled in the research protocol.
Definition:The event occurred in order to terminate the subject's participation in the study.
Definition:The event that occurred was initiated by a study participant (e.g. the subject or the investigator), and did not occur for protocol reasons.
Definition:SSpecifies the reason that a test was performed or observation collected in a clinical research study. Note:This set of codes are not strictly reasons, but are used in the currently Normative standard. Future revisions of the specification will model these as ActRelationships and thes codes may subsequently be retired. Thus, these codes should not be used for new specifications.
Definition:The observation or test was neither defined or scheduled in the study protocol.
Definition:The observation or test occurred due to it being defined in the research protocol, and during an activity or event that was scheduled in the protocol.
:The observation or test occurred as defined in the research protocol, but at a point in time not specified in the study protocol.
Description:Indicates why the prescription should be suspended.
Description:This therapy has been ordered as a backup to a preferred therapy. This order will be released when and if the preferred therapy is unsuccessful.
Description:Clarification is required before the order can be acted upon.
Description:The current level of the medication in the patient's system is too high. The medication is suspended to allow the level to subside to a safer level.
Description:The patient has been admitted to a care facility and their community medications are suspended until hospital discharge.
Description:The therapy would interfere with a planned lab test and the therapy is being withdrawn until the test is completed.
Description:Patient not available for a period of time due to a scheduled therapy, leave of absence or other reason.
Description:The patient is pregnant or breast feeding. The therapy will be resumed when the pregnancy is complete and the patient is no longer breastfeeding.
Description:The patient is believed to be allergic to a substance that is part of the therapy and the therapy is being temporarily withdrawn to confirm.
Description:The drug interacts with a short-term treatment that is more urgently required. This order will be resumed when the short-term treatment is complete.
Description:Another short-term co-occurring therapy fulfills the same purpose as this therapy. This therapy will be resumed when the co-occuring therapy is complete.
Description:The patient is believed to have an intolerance to a substance that is part of the therapy and the therapy is being temporarily withdrawn to confirm.
Description:The drug is contraindicated for patients receiving surgery and the patient is scheduled to be admitted for surgery in the near future. The drug will be resumed when the patient has sufficiently recovered from the surgery.
Description:The patient was previously receiving a medication contraindicated with the current medication. The current medication will remain on hold until the prior medication has been cleansed from their system.
Description:Identifies reasons for nullifying (retracting) a particular control act.
Description:The decision on which the recorded information was based was changed before the decision had an effect. Example:Aborted prescription before patient left office, released prescription before suspend took effect.
Description:The information was recorded incorrectly or was recorded in the wrong record.
Description: There is no match for the record in the database.
Description: Reasons to refuse a transaction to be undone.
The record is already in the requested state.
Description: There is no match for the product in the master file repository.
Description: There is no match for the service in the master file repository.
Description: There is no match for the record and version.
Definition:The user does not have permission
Description: The agent does not have permission.
Description: The user does not have permission.
Description: The record and version requested to update is not the current version.
Identifies why a specific query, request, or other trigger event occurred.
Description:Indicates the reason the medication order should be aborted.
Description:The medication is no longer being manufactured or is otherwise no longer available.
Description:The therapy has been found to not have the desired therapeutic benefit on the patient.
Description:Monitoring the patient while taking the medication, the decision has been made that the therapy is no longer appropriate.
Description:The underlying condition has been resolved or has evolved such that a different treatment is no longer needed.
Description:The product does not have (or no longer has) coverage under the patientaTMs insurance policy.
Description:The patient refused to take the product.
Description:The manufacturer or other agency has requested that stocks of a medication be removed from circulation.
Description:Item in current order is no longer in use as requested and a new one has/will be created to replace it.
Description:The medication is being re-prescribed at a different dosage.
Description:Current order was issued with incorrect data and a new order has/will be created to replace it.
Description:<The patient is not (or is no longer) able to use the medication in a manner prescribed. Example:CanaTMt swallow.
Definition:A collection of concepts that indicate why the prescription should be released from suspended state.
Definition:The original reason for suspending the medication has ended.
Types of reason why a prescription is being changed.
Order was created with incorrect data and is changed to reflect the intended accuracy of the order.
Order is changed based on a clinical reason.
Definition:Identifies why the dispense event was not completed.
Definition:Order to be fulfilled was aborted
Definition:Order to be fulfilled was suspended
Definition:Patient did not come to get medication
Definition:Patient changed their mind regarding obtaining medication
Definition:Patient requested a revised quantity of medication
Definition:A collection of concepts that indicates the reason for a "bulk supply" of medication.
Definition:The bulk supply is issued to replenish a ward for local dispensing. (Includes both mobile and fixed-location ward stocks.)
Definition:The bulk supply will be administered within a long term care facility.
Definition:The bulk supply is intended for general clinician office use.
Definition:The bulk supply is being transferred to another dispensing facility to. Example:Alleviate a temporary shortage.
Definition:The bulk supply is intended for dispensing according to a specific program. Example:Mass immunization.
pharmacy supply request renewal refusal reason
Definition:A collection of concepts that identifies why a renewal prescription has been refused.
Definition:Patient has already been given a new (renewal) prescription.
family physician must authorize further fills
Definition:Request for further authorization must be done through patient's family physician.
Definition:Therapy has been changed and new prescription issued
Definition:Patient must see prescriber prior to further fills.
Definition:Original prescriber is no longer available to prescribe and no other prescriber has taken responsibility for the patient.
Definition:Patient no longer or has never been under this prescribers care.
Description:This product is not available or manufactured.
prescriber stopped medication for patient
Renewing or original prescriber informed patient to stop using the medication.
Definition:The patient should have medication remaining.
Definition:A collection of concepts that indicates why the prescription should no longer be allowed to be dispensed (but can still administer what is already being dispensed).
Definition:The patient's medical condition has nearly abated.
Description:The patient has an intolerance to the medication.
Definition:The current medication will be replaced by a new strength of the same medication.
Definition:A new therapy will be commenced when current supply exhausted.
Description:Identifies why a change is being made to a record.
Description:Information has changed since the record was created.
Description:Previously recorded information was erroneous and is being corrected.
Information is combined into the record.
Description:New information has become available to supplement the record.
Information is separated from the record.
Definition:A collection of concepts identifying why the patient's profile is being queried.
Definition: To evaluate for service authorization, payment, reporting, or performance/outcome measures.
Definition:To obtain records as part of patient care.
Definition:Patient requests information from their profile.
Definition:To evaluate the provider's current practice for professional-improvement reasons.
Description:Review for the purpose of regulatory compliance.
Definition:To provide research data, as authorized by the patient.
Description:To validate the patient's record. Example:Merging or unmerging records.
Definition:Indicates why the request to transfer a prescription from one dispensing facility to another has been refused.
Definition:The prescription may not be reassigned from the original pharmacy.
Definition:The target facility does not recognize the dispensing facility.
Description: Identifies why a request to add (or activate) a record is being refused. Examples include the receiving system not able to match the identifier and find that record in the receiving system, having no permission, or a detected issue exists which precludes the requested action.
Reasons for cancelling or rescheduling an Appointment
The time slots previously allocated are now blocked and no longer available for booking Appointments
Patient unable to pay and not covered by insurance
The medical condition of the Patient has changed
The Physician is in a meeting. For example, he/she may request administrative time to talk to family after appointment
Indicates why the act revision (status update) is being refused.
Ordered quantity has already been completely fulfilled.
Definition:Indicates why the requested authorization to prescribe or dispense a medication has been refused.
Definition:Patient not eligible for drug
Definition:Patient does not meet required protocol
Definition:Provider is not authorized to prescribe or dispense
Reasons why substitution of a substance administration request is not permitted.
Definition: Patient has had a prior allergic intolerance response to alternate product or one of its components.
Definition: Patient has compliance issues with medication such as differing appearance, flavor, size, shape or consistency.
The prescribed product has specific clinical release or other therapeutic characteristics not shared by other substitutable medications.
Definition: The specific manufactured drug is part of a clinical trial.
Indicates that the decision to substitute or to not substitute was driven by a desire to maintain consistency with a pre-existing therapy. I.e. The performer provided the same item/service as had been previously provided rather than providing exactly what was ordered, or rather than substituting with a lower-cost equivalent.
Indicates that the decision to substitute or to not substitute was driven by a policy expressed within the formulary.
In the case of 'substitution', indicates that the substitution occurred because the ordered item was not in stock. In the case of 'no substitution', indicates that a cheaper equivalent was not substituted because it was not in stock.
Indicates that the decision to substitute or to not substitute was driven by a jurisdictional regulatory requirement mandating or prohibiting substitution.
The explanation for why a patient is moved from one location to another within the organization
Moved to an error in placing the patient in the original location.
Definition: This domain is used to document reasons for providing a billable service; the billable services may include both clinical services and social services.
Reason for Clinical Service being performed. This domain excludes reasons specified by diagnosed conditions. Examples of values from this domain include duplicate therapy and fraudulent prescription.
Description:The level of coverage under the policy or program is available only to children
Description:The level of coverage under the policy or program is available only to a subscriber's dependents.
Description:The level of coverage under the policy or program is available to an employee and his or her children.
Description:The level of coverage under the policy or program is available only to an employee.
Description:The level of coverage under the policy or program is available to an employee and his or her spouse.
Description:The level of coverage under the policy or program is available to a subscriber's family.
Description:The level of coverage under the policy or program is available to an individual.
Description:The level of coverage under the policy or program is available to a subscriber's spouse and children
Description:The level of coverage under the policy or program is available only to a subscribers spouse
v3 Code System ActRelationshipCheckpoint
Condition is tested every time before execution of the service (WHILE condition DO service).
Condition is tested at the end of a repeated service execution. The service is repeated only if the condition is true (DO service WHILE condition).
Condition is tested once before the service is executed (IF condition THEN service).
Condition must be true throughout the execution and the service is interrupted (asynchronously) as soon as the condition turns false (asynchronous WHILE loop). The service must be interruptible.
Condition is a loop checkpoint, i.e. it is a step of an activity plan and, if negative causes the containing loop to exit.
Detach this branch from the other branches so it will not be resynchronized with the other branches.
When all other concurrent branches are terminated, interrupt and discontinue this branch.
Wait for any one of the branches in the set of exclusive wait branches to terminate, then discontinue all the other exclusive wait branches.
The pre-condition associated with the branch is evaluated once and if true the branch may be entered. All other exclusive branches compete with each other and only one will be selected. This implements a COND, IF and CASE conditionals, or "XOR-split." The order in which the branches are considered may be specified in the priorityNumber attribute.
A branch is selected as soon as the pre-condition associated with the branch evaluates to true. If the condition is false, the branch may be entered later, when the condition turns true. All other exclusive branches compete with each other and only one will be selected. Each waiting branch executes in parallel with the default join code wait (see below). The order in which the branches are considered may be specified in the Service_relationship.priority_nmb.
A branch is executed if its associated preconditions permit. If associated preconditions do not permit, the branch is dropped. Inclusive branches are not suppressed and do not suppress other branches.
A branch is executed as soon as its associated conditions permit. If the condition is false, the branch may be entered later, when the condition turns true. Inclusive branches are not suppressed and do not suppress other branches. Each waiting branch executes in parallel with the default join code wait (see below).
<ns1:p>Used to indicate that the target of the relationship will be a filtered subset of the total related set of targets.</ns1:p><ns1:p>Used when there is a need to limit the number of components to the first, the last, the next, the total, the average or some other filtered or calculated subset.</ns1:p>
Used to indicate that the participation is a filtered subset of the total participations of the same type owned by the Act. Used when there is a need to limit the participations to the first, the last, the next or some other filtered subset.
An occurrence that is scheduled to occur in the future. An Act whose effective time is greater than 'now', where 'now' is the time the instance is authored.
Represents a 'summary' of all acts that are scheduled to occur in the future (whose effective time is greater than 'now' where is the time the instance is authored.). The effectiveTime represents the outer boundary of all occurrences, repeatNumber represents the total number of repetitions, etc.
Restricted to the latest known occurrence that is scheduled to occur. The Act with the highest known effective time.
Restricted to the nearest recent known occurrence scheduled to occur in the future. The Act with the lowest effective time, still greater than 'now'. ('now' is the time the instance is authored.)
An occurrence that occurred or was scheduled to occur in the past. An Act whose effective time is less than 'now'. ('now' is the time the instance is authored.)
Restricted to the earliest known occurrence that occurred or was scheduled to occur in the past. The Act with the lowest effective time. ('now' is the time the instance is authored.)
Represents a 'summary' of all acts that previously occurred or were scheduled to occur. The effectiveTime represents the outer boundary of all occurrences, repeatNumber represents the total number of repetitions, etc. ('now' is the time the instance is authored.)
Restricted to the most recent known occurrence that occurred or was scheduled to occur in the past. The Act with the most recent effective time, still less than 'now'. ('now' is the time the instance is authored.)
Represents a 'summary' of all acts that have occurred or were scheduled to occur and which are scheduled to occur in the future. The effectiveTime represents the outer boundary of all occurrences, repeatNumber represents the total number of repetitions, etc.
The occurrence whose value attribute is greater than all other occurrences at the time the instance is created.
The occurrence whose value attribute is less than all other occurrences at the time the instance is created.
The source is an excerpt from the target.
Description: A directed association between a source Act and a target Act. Usage Note: This code should never be transmitted in an instance as the value of ActRelationship.typeCode (attribute)
Codes that describe the relationship between an Act and a financial instrument such as a financial transaction, account or invoice element.
Expresses values for describing the relationship relationship between an InvoiceElement or InvoiceElementGroup and a billable act.
A relationship that provides an ability to associate a financial transaction (target) as a charge to a clinical act (source). A clinical act may have a charge associated with the execution or delivery of the service. The financial transaction will define the charge (bill) for delivery or performance of the service. Charges and costs are distinct terms. A charge defines what is charged or billed to another organization or entity within an organization. The cost defines what it costs an organization to perform or deliver a service or product.
A relationship that provides an ability to associate a financial transaction (target) as a cost to a clinical act (source). A clinical act may have an inherit cost associated with the execution or delivery of the service. The financial transaction will define the cost of delivery or performance of the service. Charges and costs are distinct terms. A charge defines what is charged or billed to another organization or entity within an organization. The cost defines what it costs an organization to perform or deliver a service or product.
Expresses values for describing the relationship between a FinancialTransaction and an Account.
A credit relationship ties a financial transaction (target) to an account (source). A credit, once applied (posted), may have either a positive or negative effect on the account balance, depending on the type of account. An asset account credit will decrease the account balance. A non-asset account credit will decrease the account balance.
A debit relationship ties a financial transaction (target) to an account (source). A debit, once applied (posted), may have either a positive or negative effect on the account balance, depending on the type of account. An asset account debit will increase the account balance. A non-asset account debit will decrease the account balance.
Specifies under what circumstances (target Act) the source-Act may, must, must not or has occurred
A contraindication is just a negation of a reason, i.e. it gives a condition under which the action is not to be done. Both, source and target can be any kind of service; target service is in criterion mood. How the strength of a contraindication is expressed (e.g., relative, absolute) is left as an open issue. The priorityNumber attribute could be used.
A requirement to be true before a service is performed. The target can be any service in criterion mood. For multiple pre-conditions a conjunction attribute (AND, OR, XOR) is applicable.
Description: The reason or rationale for a service. A reason link is weaker than a trigger, it only suggests that some service may be or might have been a reason for some action, but not that this reason requires/required the action to be taken. Also, as opposed to the trigger, there is no strong timely relation between the reason and the action. As well as providing various types of information about the rationale for a service, the RSON act relationship is routinely used between a SBADM act and an OBS act to describe the indication for use of a medication. Child concepts may be used to describe types of indication. Discussion: In prior releases, the code "SUGG" (suggests) was expressed as "an inversion of the reason link." That code has been retired in favor of the inversion indicator that is an attribute of ActRelationship.
Definition: The source act is performed to block the effects of the target act. This act relationship should be used when describing near miss type incidents where potential harm could have occurred, but the action described in the source act blocked the potential harmful effects of the incident actually occurring.
Description: The source act is intended to help establish the presence of a (an adverse) situation described by the target act. This is not limited to diseases but can apply to any adverse situation or condition of medical or technical nature.
Description: The source act is intented to provide immunity against the effects of the target act (the target act describes an infectious disease)
Description: The source act is intended to provide active immunity against the effects of the target act (the target act describes an infectious disease)
Description: The source act is intended to provide passive immunity against the effects of the target act (the target act describes an infectious disease).
The source act removes or lessens the occurrence or effect of the target act.
Definition: The source act is performed to recover from the effects of the target act.
Description: The source act is intended to reduce the risk of of an adverse situation to emerge as described by the target act. This is not limited to diseases but can apply to any adverse situation or condition of medical or technical nature.
Description: The source act is intended to improve a pre-existing adverse situation described by the target act. This is not limited to diseases but can apply to any adverse situation or condition of medical or technical nature.
Description: The source act is intended to offer an additional treatment for the management or cure of a pre-existing adverse situation described by the target act. This is not limited to diseases but can apply to any adverse situation or condition of medical or technical nature. It is not a requirement that the non-adjunctive treatment is explicitly specified.
Description: The source act is intended to provide long term maintenance improvement or management of a pre-existing adverse situation described by the target act. This is not limited to diseases but can apply to any adverse situation or condition of medical or technical nature.
Description: The source act is intended to provide palliation for the effects of the target act.
Description: The source act is intented to provide symptomatic relief for the effects of the target act.
A pre-condition that if true should result in the source Act being executed. The target is in typically in criterion mood. When reported after the fact (i.e. the criterion has been met) it may be in Event mood. A delay between the trigger and the triggered action can be specified. Discussion: This includes the concept of a required act for a service or financial instrument such as an insurance plan or policy. In such cases, the trigger is the occurrence of a specific condition such as coverage limits being exceeded.
Abstract collector for ActRelationhsip types that relate two acts by their timing.
Abstract collector for ActRelationship types that relate two acts by their approximate timing.
A relationship in which the source act's effective time ends near the end of the target act's effective time. Near is defined separately as a time interval. Usage Note: Inverse code is ENS
A relationship in which the source act's effective time ends with the end of the target act's effective time. UsageNote: This code is reflexive. Therefore its inverse code is itself.
A relationship in which the source act's effective time is the same as the target act's effective time. UsageNote: This code is reflexive. Therefore its inverse code is itself.
The source Act starts before the start of the target Act, and ends with the target Act. UsageNote: Inverse code is SASECWE
A relationship in which the source act's effective time ends near the start of the target act's effective time. Near is defined separately as a time interval. Usage Note: Inverse code is ENE
The source Act ends when the target act starts (i.e. if we say "ActOne ECWS ActTwo", it means that ActOne ends when ActTwo starts, therefore ActOne is the source and ActTwo is the target). UsageNote: Inverse code is SCWE
A relationship in which the source act's effective time starts near the end of the target act's effective time. Near is defined separately as a time interval. Usage Note: Inverse code is SNS
The source Act starts when the target act ends (i.e. if we say "ActOne SCWE ActTwo", it means that ActOne starts when ActTwo ends, therefore ActOne is the source and ActTwo is the target). UsageNote: Inverse code is SBSECWS
A relationship in which the source act's effective time starts near the start of the target act's effective time. Near is defined separately as a time interval. Usage Note: Inverse code is SNE
A relationship in which the source act's effective time starts with the start of the target act's effective time. UsageNote: This code is reflexive. Therefore its inverse code is itself.
The source Act starts with.the target Act and ends before the end of the target Act. UsageNote: Inverse code is SCWSEAE
The source Act starts with the target Act, and ends after the end of the target Act.
A relationship in which the source act ends after the target act starts. UsageNote: Inverse code is SBE
A relationship in which the source act ends after the target act ends. UsageNote: Inverse code is EBE
starts after start of, ends after end of
The source Act starts after start of the target Act and ends after end of the target Act. UsageNote: Inverse code is SBSEBE
The source Act contains the end of the target Act. UsageNote: Inverse code is EDU
The source Act start after the start of the target Act, and contains the end of the target Act. UsageNote: Inverse code is SBSEASEBE
The source Act contains the time of the target Act. UsageNote: Inverse code is DURING
The source Act starts after the start of the target Act (i.e. if we say "ActOne SAS ActTwo", it means that ActOne starts after the start of ActTwo, therefore ActOne is the source and ActTwo is the target). UsageNote: Inverse code is SBS
A relationship in which the source act starts after the target act ends. UsageNote: Inverse code is EBS
A relationship in which the source act's effective time is wholly within the target act's effective time (including end points, as defined in the act's effective times) UsageNote: Inverse code is SBSEAE
The source Act starts after start of the target Act, and ends with the target Act. UsageNote: Inverse code is SBSECWE
A relationship in which the source act's effective time ends after or concurrent with the start of the target act's effective time. Usage Note: Inverse code is EBSORECWS
A relationship in which the source act's effective time ends after or concurrent with the end of the target act's effective time. Usage Note: Inverse code is EBEORECW
The source Act is independent of the time of the target Act. UsageNote: This code is reflexive. Therefore its inverse code is itself.
A relationship in which the source act's effective time starts after or concurrent with the end of the target act's effective time. Usage Note: Inverse code is SBEORSCWE
starts after or concurrent with start of
A relationship in which the source act's effective time starts after or concurrent with the start of the target act's effective time. Usage Note: Inverse code is SBSORSCW
A relationship in which the source act's effective time starts before or concurrent with the end of the target act's effective time. Usage Note: Inverse code is SAEORSCWE
A relationship in which the source act's effective time overlaps the target act's effective time in any way. UsageNote: This code is reflexive. Therefore its inverse code is itself.
A relationship in which the source act ends within the target act's effective time (including end points, as defined in the act's effective times) UsageNote: Inverse code is SBEEAE
The source Act contains the start of the target Act, and ends before the end of the target Act. UsageNote: Inverse code is SASSBEEAS
The source Act contains the start of the target Act. UsageNote: Inverse code is SDU
A relationship in which the source act starts within the target act's effective time (including end points, as defined in the act's effective times) UsageNote: Inverse code is SBSEAS
The source Act starts before the end of the target Act (i.e. if we say "ActOne SBE ActTwo", it means that ActOne starts before the end of ActTwo, therefore ActOne is the source and ActTwo is the target). UsageNote: Inverse code is EAS
The source Act ends before the end of the target Act (i.e. if we say "ActOne EBE ActTwo", it means that ActOne ends before the end of ActTwo, therefore ActOne is the source and ActTwo is the target). UsageNote: Inverse code is EAE
starts before start of, ends before end of
The source Act starts before the start of the target Act, and ends before the end of the target Act. UsageNote: Inverse code is SASEAE
A relationship in which the source act's effective time ends before or concurrent with the start of the target act's effective time. Usage Note: Inverse code is EASORECWS
A relationship in which the source act ends before the target act starts. UsageNote: Inverse code is SAE
A relationship in which the source act's effective time ends before or concurrent with the end of the target act's effective time. Usage Note: Inverse code is EAEORECW
starts before or concurrent with start of
A relationship in which the source act's effective time starts before or concurrent with the start of the target act's effective time. Usage Note: Inverse code is SASORSCW
A relationship in which the source act begins before the target act begins. UsageNote: Inverse code is SAS
A relationship in which the target act authorizes or certifies the source act.
Description: An assertion that an act was the cause of another act.This is stronger and more specific than the support link. The source (cause) is typically an observation, but may be any act, while the target may be any act. Examples: a growth of Staphylococcus aureus may be considered the cause of an abscess contamination of the infusion bag was deemed to be the cause of the infection that the patient experienced lack of staff on the shift was deemed to be a supporting factor (proximal factor) causing the patient safety incident where the patient fell out of bed because the bed-sides had not been put up which caused the night patient to fall out of bed
The target act is a component of the source act, with no semantics regarding composition or aggregation implied.
A relationship from an Act to a Control Variable. For example, if a Device makes an Observation, this relates the Observation to its Control Variables documenting the device's settings that influenced the observation.
The target Acts are aggregated by the source Act. Target Acts may have independent existence, participate in multiple ActRelationships, and do not contribute to the meaning of the source. UsageNotes: This explicitly represents the conventional notion of aggregation. The target Act is part of a collection of Acts (no implication is made of cardinality, a source of Acts may contain zero, one, or more member target Acts). It is expected that this will be primarily used with _ActClassRecordOrganizer, BATTERY, and LIST
A collection of sub-services as steps or subtasks performed for the source service. Services may be performed sequentially or concurrently. UsageNotes: Sequence of steps may be indicated by use of _ActRelationshipTemporallyPertains, as well as via ActRelationship.sequenceNumber, ActRelationship.pauseQuantity, Target.priorityCode. OpenIssue: Need Additional guidelines on when each approach should be used.
The relationship that links to a Transportation Act (target) from another Act (source) indicating that the subject of the source Act entered into the source Act by means of the target Transportation act.
The relationship that links to a Transportation Act (target) from another Act (source) indicating that the subject of the source Act departed from the source Act by means of the target Transportation act.
The source Act is a composite of the target Acts. The target Acts do not have an existence independent of the source Act. UsageNote: In UML 1.1, this is a "composition" defined as: "A form of aggregation with strong ownership and coincident lifetime as part of the whole. Parts with non-fixed multiplicity may be created after the composite itself, but once created they live and die with it (i.e., they share lifetimes). Such parts can also be explicitly removed before the death of the composite. Composition may be recursive."
A relationship in which the source act is covered by or is under the authority of a target act. A financial instrument such as an Invoice Element is covered by one or more specific instances of an Insurance Policy.
Associates a derived Act with its input parameters. E.G., an anion-gap observation can be associated as being derived from given sodium-, (potassium-,), chloride-, and bicarbonate-observations. The narrative content (Act.text) of a source act is wholly machine-derived from the collection of target acts.
Expresses an association that links two instances of the same act over time, indicating that the instance are part of the same episode, e.g. linking two condition nodes for episode of illness; linking two encounters for episode of encounter.
Indicates that the target Act provides evidence in support of the action represented by the source Act. The target is not a 'reason' for the source act, but rather gives supporting information on why the source act is an appropriate course of action. Possible targets might be clinical trial results, journal articles, similar successful therapies, etc. Rationale: Provides a mechanism for conveying clinical justification for non-approved or otherwise non-traditional therapies.
Description:The source act is aggravated by the target act. (Example "chest pain" EXACBY "exercise")
This is the inversion of support. Used to indicate that a given observation is explained by another observation or condition.
the target act documents a set of circumstances (events, risks) which prevent successful completion, or degradation of quality of, the source Act. UsageNote: This provides the semantics to document barriers to care
A relationship that limits or restricts the source act by the elements of the target act. For example, an authorization may be limited by a financial amount (up to $500). Target Act must be in EVN.CRIT mood.
Definition: Indicates that the attributes and associations of the target act provide metadata (for example, identifiers, authorship, etc.) for the source act. Constraint: Source act must have either a mood code that is not "EVN" (event) or its "isCriterion" attribute must set to "true". Target act must be an Act with a mood code of EVN and with isCriterionInd attribute set to "true".
An assertion that a new observation may be the manifestation of another existing observation or action. This assumption is attributed to the same actor who asserts the manifestation. This is stronger and more specific than an inverted support link. For example, an agitated appearance can be asserted to be the manifestation (effect) of a known hyperthyroxia. This expresses that one might not have realized a symptom if it would not be a common manifestation of a known condition. The target (cause) may be any service, while the source (manifestation) must be an observation.
Used to assign a "name" to a condition thread. Source is a condition node, target can be any service.
An observation that should follow or does actually follow as a result or consequence of a condition or action (sometimes called "post-conditional".) Target must be an observation as a goal, risk or any criterion. For complex outcomes a conjunction attribute (AND, OR, XOR) can be used. An outcome link is often inverted to describe an outcome assessment.
The target act is a desired outcome of the source act. Source is any act (typically an intervention). Target must be an observation in criterion mood.
A desired state that a service action aims to maintain. E.g., keep systolic blood pressure between 90 and 110 mm Hg. Source is an intervention service. Target must be an observation in criterion mood.
A desired outcome that a service action aims to meet finally. Source is any service (typically an intervention). Target must be an observation in criterion mood.
A goal that one defines given a patient's health condition. Subsequently planned actions aim to meet that goal. Source is an observation or condition node, target must be an observation in goal mood.
A noteworthy undesired outcome of a patient's condition that is either likely enough to become an issue or is less likely but dangerous enough to be addressed.
This is a very unspecific relationship from one item of clinical information to another. It does not judge about the role the pertinent information plays.
A relationship in which the target act is a predecessor instance to the source act. Generally each of these instances is similar, but no identical. In healthcare coverage it is used to link a claim item to a previous claim item that might have claimed for the same set of services.
A relationship in which the target act is referred to by the source act. This permits a simple reference relationship that distinguishes between the referent and the referee.
Indicates that the source act makes use of (or will make use of) the information content of the target act. UsageNotes: A usage relationship only makes sense if the target act is authored and occurs independently of the source act. Otherwise a simpler relationship such as COMP would be appropriate. Rationale: There is a need when defining a clinical trial protocol to indicate that the protocol makes use of other protocol or treatment specifications. This is stronger than the assertion of "references". References may exist without usage, and in a clinical trial protocol is common to assert both: what other specifications does this trial use and what other specifications does it merely reference.
Reference ranges are essentially descriptors of a class of result values assumed to be "normal", "abnormal", or "critical." Those can vary by sex, age, or any other criterion. Source and target are observations, the target is in criterion mood. This link type can act as a trigger in case of alarms being triggered by critical results.
Description:The source act is wholly or partially alleviated by the target act. (Example "chest pain" RELVBY "sublingual nitroglycerin administration")
An act relationship indicating that the source act follows the target act. The source act should in principle represent the same kind of act as the target. Source and target need not have the same mood code (mood will often differ). The target of a sequel is called antecedent. Examples for sequel relationships are: revision, transformation, derivation from a prototype (as a specialization is a derivation of a generalization), followup, realization, instantiation.
An addendum (source) to an existing service object (target), containing supplemental information. The addendum is itself an original service object linked to the supplemented service object. The supplemented service object remains in place and its content and status are unaltered.
Indicates that the target observation(s) provide an initial reference for the source observation or observation group. UsageConstraints: Both source and target must be Observations or specializations thereof.
Description:The source act complies with, adheres to, conforms to, or is permissible under (in whole or in part) the policy, contract, agreement, law, conformance criteria, certification guidelines or requirement conveyed by the target act. Examples for compliance relationships are: audits of adherence with a security policy, certificate of conformance to system certification requirements, or consent directive in compliance with or permissible under a privacy policy.
The source act documents the target act.
The source act fulfills (in whole or in part) the target act. Source act must be in a mood equal or more actual than the target act.
The source act is a single occurrence of a repeatable target act. The source and target act can be in any mood on the "completion track" but the source act must be as far as or further along the track than the target act (i.e., the occurrence of an intent can be an event but not vice versa).
Relates either an appointment request or an appointment to the order for the service being scheduled.
Associates a specific time (and associated resources) with a scheduling request or other intent.
The generalization relationship can be used to express categorical knowledge about services (e.g., amilorid, triamterene, and spironolactone have the common generalization potassium sparing diuretic).
A goal-evaluation links an observation (intent or actual) to a goal to indicate that the observation evaluates the goal. Given the goal and the observation, a "goal distance" (e.g., goal to observation) can be "calculated" and need not be sent explicitly.
Used to capture the link between a potential service ("master" or plan) and an actual service, where the actual service instantiates the potential service. The instantiation may override the master's defaults.
Definition: Used to link a newer version or 'snapshot' of a business object (source) to an older version or 'snapshot' of the same business object (target). Usage:The identifier of the Act should be the same for both source and target. If the identifiers are distinct, RPLC should be used instead. Name from source to target = "modifiesPrior" Name from target to source = "modifiesByNew"
A trigger-match links an actual service (e.g., an observation or procedure that took place) with a service in criterion mood. For example if the trigger is "observation of pain" and pain is actually observed, and if that pain-observation caused the trigger to fire, that pain-observation can be linked with the trigger.
A relationship between a source Act that provides more detailed properties to the target Act. The source act thus is a specialization of the target act, but instead of mentioning all the inherited properties it only mentions new property bindings or refinements. The typical use case is to specify certain alternative variants of one kind of Act. The priorityNumber attribute is used to weigh refinements as preferred over other alternative refinements. Example: several routing options for a drug are specified as one SubstanceAdministration for the general treatment with attached refinements for the various routing options.
Description:A relationship in which the target act is carried out to determine whether an effect attributed to the source act can be recreated.
A relationship between a source Act that seeks to reverse or undo the action of the prior target Act. Example: A posted financial transaction (e.g., a debit transaction) was applied in error and must be reversed (e.g., by a credit transaction) the credit transaction is identified as an undo (or reversal) of the prior target transaction. Constraints: the "completion track" mood of the target Act must be equally or more "actual" than the source act. I.e., when the target act is EVN the source act can be EVN, or any INT. If the target act is INT, the source act can be INT.
A replacement source act replaces an existing target act. The state of the target act being replaced becomes obselete, but the act is typically still retained in the system for historical reference. The source and target must be of the same type.
Definition: A new act that carries forward the intention of the original act, but does not completely replace it. The status of the predecessor act must be 'completed'. The original act is the target act and the successor is the source act.
A condition thread relationship specifically links condition nodes together to form a condition thread. The source is the new condition node and the target links to the most recent node of the existing condition thread.
The source is a direct quote from the target.
Used when the target Act is a transformation of the source Act. (For instance, used to show that a CDA document is a transformation of a DICOM SR document.)
Used to indicate that an existing service is suggesting evidence for a new observation. The assumption of support is attributed to the same actor who asserts the observation. Source must be an observation, target may be any service (e.g., to indicate a status post).
A specialization of "has support" (SPRT), used to relate a secondary observation to a Region of Interest on a multidimensional observation, if the ROI specifies the true boundaries of the secondary observation as opposed to only marking the approximate area. For example, if the start and end of an ST elevation episode is visible in an EKG, this relation would indicate the ROI bounds the "ST elevation" observation -- the ROI defines the true beginning and ending of the episode. Conversely, if a ROI simply contains ST elevation, but it does not define the bounds (start and end) of the episode, the more general "has support" relation is used. Likewise, if a ROI on an image defines the true bounds of a "1st degree burn", the relation "has bounded support" is used; but if the ROI only points to the approximate area of the burn, the general "has support" relation is used.
Relates an Act to its subject Act that the first Act is primarily concerned with. Examples The first Act may be a ControlAct manipulating the subject Act The first act is a region of interest (ROI) that defines a region within the subject Act. The first act is a reporting or notification Act, that echos the subject Act for a specific new purpose. Constraints An Act may have multiple subject acts. Rationale The ActRelationshipType "has subject" is similar to the ParticipationType "subject", Acts that primarily operate on physical subjects use the Participation, those Acts that primarily operate on other Acts (other information) use the ActRelationship.
The target observation qualifies (refines) the semantics of the source observation. UsageNote: This is not intended to replace concept refinement and qualification via vocabulary. It is used when there are multiple components which together provide the complete understanding of the source Act.
An act that contains summary values for a list or set of subordinate acts. For example, a summary of transactions for a particular accounting period.
Description:Indicates that the target Act represents the result of the source observation Act. FormalConstraint: Source Act must be an Observation or specialization there-of. Source Act must not have the value attribute specified UsageNote: This relationship allows the result of an observation to be fully expressed as RIM acts as opposed to being embedded in the value attribute. For example, sending a Document act as the result of an imaging observation, sending a list of Procedures and/or other acts as the result of a medical history observation. The valueNegationInd attribute on the source Act has the same semantics of "negated finding" when it applies to the target of a VALUE ActRelationship as it does to the value attribute. On the other hand, if the ActRelationship.negationInd is true for a VALUE ActRelationship, that means the specified observation does not have the indicated value but does not imply a negated finding. Because the semantics are extremely close, it is recommended that Observation.valueNegationInd be used, not ActRelationship.negationInd. OpenIssue: The implications of negationInd on ActRelationship and the valueNegationind on Observation.
An anatomical location on an organism which can be the focus of an act.
An anatomical location on a human which can be the focus of an act.
The set of body locations to or through which a drug product may be administered.
Codes representing the defined possible states of an Act, as defined by the Act class state machine.
Encompasses the expected states of an Act, but excludes "nullified" and "obsolete" which represent unusual terminal states for the life-cycle.
The Act has been terminated prior to the originally intended completion.
The Act can be performed or is being performed
The Act has been abandoned before activation.
An Act that has terminated normally after all of its constituents have been performed.
An Act that is still in the preparatory stages has been put aside. No action can occur until the Act is released.
An Act that is in the preparatory stages and may not yet be acted upon
An Act that has been activated (actions could or have been performed against it), but has been temporarily disabled. No further action should be taken against it until it is released
This Act instance was created in error and has been 'removed' and is treated as though it never existed. A record is retained for audit purposes only.
This Act instance has been replaced by a new instance.
Description: A jurisdictional mandate in the US relating to privacy.
Definition: A jurisdictional mandate in the U.S. relating to privacy. Usage Note: ActPrivacyLaw codes may be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialtyCode complies. May be used to further specify rationale for assignment of other ActPrivacyPolicy codes in the US realm, e.g., ETH and 42CFRPart2 can be differentiated from ETH and Title38Part1.
42 CFR Part 2 stipulates the right of an individual who has applied for or been given diagnosis or treatment for alcohol or drug abuse at a federally assisted program. Definition: Non-disclosure of health information relating to health care paid for by a federally assisted substance abuse program without patient consent. Usage Note: May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialityCode complies.
U.S. Federal regulations governing the protection of human subjects in research (codified at Subpart A of 45 CFR part 46) that has been adopted by 15 U.S. Federal departments and agencies in an effort to promote uniformity, understanding, and compliance with human subject protections. Existing regulations governing the protection of human subjects in Food and Drug Administration (FDA)-regulated research (21 CFR parts 50, 56, 312, and 812) are separate from the Common Rule but include similar requirements. Definition: U.S. federal laws governing research-related privacy policies. Usage Note: May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialtyCode complies.
The U.S. Public Law 104-191 Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule (45 CFR Part 164 Subpart E) permits access, use and disclosure of certain personal health information (PHI as defined under the law) for purposes of Treatment, Payment, and Operations, and requires that the provider ask that patients acknowledge the Provider's Notice of Privacy Practices as permitted conduct under the law. Definition: Notification of HIPAA Privacy Practices. Usage Note: May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialtyCode complies.
The U.S. Public Law 104-191 Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule (45 CFR Part 164 Section 164.508) requires authorization for certain uses and disclosure of psychotherapy notes. Definition: Authorization that must be obtained for disclosure of psychotherapy notes. Usage Note: May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialityCode complies.
Section 13405(a) of the Health Information Technology for Economic and Clinical Health Act (HITECH) stipulates the right of an individual to have disclosures regarding certain health care items or services for which the individual pays out of pocket in full restricted from a health plan. Definition: Non-disclosure of health information to a health plan relating to health care items or services for which an individual pays out of pocket in full. Usage Note: May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialityCode complies.
Title 38 Part 1-protected information may only be disclosed to a third party with the special written consent of the patient except where expressly authorized by 38 USC 7332. VA may disclose this information for specific purposes to: VA employees on a need to know basis - more restrictive than Privacy Act need to know; contractors who need the information in order to perform or fulfill the duties of the contract; and researchers who provide assurances that the information will not be identified in any report. This information may also be disclosed without consent where patient lacks decision-making capacity; in a medical emergency for the purpose of treating a condition which poses an immediate threat to the health of any individual and which requires immediate medical intervention; for eye, tissue, or organ donation purposes; and disclosure of HIV information for public health purposes. Definition: Title 38 Part 1 - §1.462 Confidentiality restrictions. (a) General. The patient records to which §§1.460 through 1.499 of this part apply may be disclosed or used only as permitted by these regulations and may not otherwise be disclosed or used in any civil, criminal, administrative, or legislative proceedings conducted by any Federal, State, or local authority. Any disclosure made under these regulations must be limited to that information which is necessary to carry out the purpose of the disclosure. SUBCHAPTER III--PROTECTION OF PATIENT RIGHTS Sec. 7332. Confidentiality of certain medical records (a)(1) Records of the identity, diagnosis, prognosis, or treatment of any patient or subject which are maintained in connection with the performance of any program or activity (including education, training, treatment, rehabilitation, or research) relating to drug abuse, alcoholism or alcohol abuse, infection with the human immunodeficiency virus, or sickle cell anemia which is carried out by or for the Department under this title shall, except as provided in subsections (e) and (f), be confidential, and (section 5701 of this title to the contrary notwithstanding) such records may be disclosed only for the purposes and under the circumstances expressly authorized under subsection (b). Usage Note: May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialityCode complies.
Specifies that the act statement is made without explicit tagging of uncertainty. This is the normal statement, meaning that it is not free of errors and uncertainty may still exist.
Specifies that the originator of the Act statement does not have full confidence in the applicability (i.e., in event mood: factual truth) of the statement.
Description: Code that specifies whether an address part names the street, city, country, postal code, post box, etc. Discussion: The hierarchical nature of these concepts shows composition. E.g. "Street Name" is part of "Street Address Line"
This can be a unit designator, such as apartment number, suite number, or floor. There may be several unit designators in an address (e.g., "3rd floor, Appt. 342"). This can also be a designator pointing away from the location, rather than specifying a smaller location within some larger one (e.g., Dutch "t.o." means "opposite to" for house boats located across the street facing houses).
Description: An address line is for either an additional locator, a delivery address or a street address.
A delivery address line is frequently used instead of breaking out delivery mode, delivery installation, etc. An address generally has only a delivery address line or a street address line, but not both.
Description: A street address line is frequently used instead of breaking out build number, street name, street type, etc. An address generally has only a delivery address line or a street address line, but not both.
The numeric portion of a building number
The number of a building, house or lot alongside the street. Also known as "primary street number". This does not number the street but rather the building.
Any alphabetic character, fraction or other text that may appear after the numeric portion of a building number
The name of the party who will take receipt at the specified address, and will take on responsibility for ensuring delivery to the target recipient
A geographic sub-unit delineated for demographic purposes.
A sub-unit of a state or province. (49 of the United States of America use the term "county;" Louisiana uses the term "parish".)
The name of the city, town, village, or other community or delivery center
Delimiters are printed without framing white space. If no value component is provided, the delimiter appears as a line break.
Indicates the type of delivery installation (the facility to which the mail will be delivered prior to final shipping via the delivery mode.) Example: post office, letter carrier depot, community mail center, station, etc.
The location of the delivery installation, usually a town or city, and is only required if the area is different from the municipality. Area to which mail delivery service is provided from any postal facility or service such as an individual letter carrier, rural route, or postal route.
A number, letter or name identifying a delivery installation. E.g., for Station A, the delivery installation qualifier would be 'A'.
Indicates the type of service offered, method of delivery. For example: post office box, rural route, general delivery, etc.
Represents the routing information such as a letter carrier route number. It is the identifying number of the designator (the box number or rural route number).
A value that uniquely identifies the postal address.
Description:An intersection denotes that the actual address is located AT or CLOSE TO the intersection OF two or more streets.
A numbered box located in a post station.
A sub-unit of a country with limited sovereignty in a federally organized country.
The base name of a roadway or artery recognized by a municipality (excluding street type and direction)
The designation given to the street. (e.g. Street, Avenue, Crescent, etc.)
The number or name of a specific unit contained within a building or complex, as assigned by that building or complex.
Indicates the type of specific unit contained within a building or complex. E.g. Appartment, Floor
A postal code designating a region defined by the postal service.
Codes that provide guidance around the circumstances in which a given address should be used.
Description: Address uses that can apply to both postal and telecommunication addresses.
Description: A flag indicating that the address is bad, in fact, useless.
Description: Indicates that the address is considered sensitive and should only be shared or published in accordance with organizational controls governing patient demographic information with increased sensitivity. Uses of Addresses. Lloyd to supply more complete description.
Description: A communication address at a home, attempted contacts for business purposes might intrude privacy and chances are one will contact family or other household members instead of the person one wishes to call. Typically used with urgent cases, or if no other contacts are available.
Description: The primary home, to reach a person after business hours.
Description: A vacation home, to reach a person while on vacation.
This address is no longer in use. Usage Note: Address may also carry valid time ranges. This code is used to cover the situations where it is known that the address is no longer valid, but no particular time range for its use is known.
Description: A temporary address, may be good for visit or mailing. Note that an address history can provide more detailed information.
Description: An office address. First choice for business related contacts during business hours.
Description: Indicates a work place address or telecommunication address that reaches the individual or organization directly without intermediaries. For phones, often referred to as a 'private line'.
Description: Indicates a work place address or telecommunication address that is a 'standard' address which may reach a reception service, mail-room, or other intermediary prior to the target entity.
Description: Address uses that only apply to postal addresses, not telecommunication addresses.
Description: Used primarily to visit an address.
Description: Address uses that only apply to telecommunication addresses, not postal addresses.
Description: An automated answering machine used for less urgent cases and if the main purpose of contact is to leave a message or access an automated announcement.
Description: A contact specifically designated to be used for emergencies. This is the first choice in emergencies, independent of any other use codes.
Description: A telecommunication device that moves and stays with its owner. May have characteristics of all other use codes, suitable for urgent matters, not the first choice for routine business.
Description: A paging device suitable to solicit a callback or to leave a very short message.
The gender of a person used for adminstrative purposes (as opposed to clinical gender)
The gender of a person could not be uniquely defined as male or female, such as hermaphrodite.
v3 Code System AmericanIndianAlaskaNativeLanguages
American Indian and Alaska Native languages currently being used in the United States.
The Gregorian calendar is the calendar in effect in most countries of Christian influence since approximately 1582. This calendar superceded the Julian calendar.
The week with the month's first Thursday in it (analagous to the ISO 8601 definition for week of the year).
The Gregorian calendar is in effect in the most countries of Christian influence since approximately 1582. This calendar superceded the Julian calendar.
Internet Assigned Numbers Authority (IANA) Charset Types
HL7 is indifferent to the use of this Charset.
Identifies how to interpret the instance of the code, codeSystem value in a set of translations. Since HL7 (or a government body) may mandate that codes from certain value sets be sent in conformant messages, other synonyms that are sent in the translation set need to be distinguished among the originally captured source, the HL7 specified code, or some future role. When this code is NULL, it indicates that the translation is an undefined type. When valued, this property must contain one of the following values: SRC - Source (or original) code HL7 - HL7 Specified or Mandated SH - both HL7 mandated and the original code (precoordination) There may be additional values added to this value set as we work through the use of codes in messages and determine other Use Cases requiring special interpretation of the translations.
Identifies how to interpret the instance of the code, codeSystem value in a set of translations. Since HL7 (or a government body) may mandate that codes from certain code systems be sent in conformant messages, other synonyms that are sent in the translation set need to be distinguished among the originally captured source, the HL7 specified code, or some future role. When this code is NULL, it indicates that the translation is an undefined type. When valued, this property must contain one of the following values: SRC - Source (or original) code HL7 - HL7 Specified or Mandated SH - both HL7 mandated and the original code (precoordination) There may be additional values added to this code system as we work through the use of codes in messages and determine other Use Cases requiring special interpretation of the translations.
Originally produced code, required by the specification describing the use of the coded concept.
Description: Post-coded from free text source</description>
Post-coded from free text source, required by the specification describing the use of the coded concept.
Description: Required standard code for HL7.
Both HL7 mandated and the original code (precoordination)
v3 Code System CommunicationFunctionType
Describes the type of communication function that the associated entity plays in the associated transmission.
The entity is the receiver of the transmission.
The entity is the one to which the response or reply to the transmission should be sent.
The entity is the sender of the transmission.
A named tag set for metadata used to populate a security category label field that "segments" an IT resource per policy by indicating that access and use is restricted to members of a defined community or project. (HL7 Healthcare Privacy and Security Classification System) Usage Note: This is the healthcare analog to the US Intelligence Community's concept of a Special Access Program. Compartment codes may be used in as a field value in an initiator's clearance to indicate permission to access and use an IT Resource with a security label having the same compartment value in security category label field. Map: Aligns with ISO 2382-8 definition of Compartment - "A division of data into isolated blocks with separate security controls for the purpose of reducing risk."
bzip-2 compression format. See [http://www.bzip.org/] for more information.
The deflate compressed data format as specified in RFC 1951 [http://www.ietf.org/rfc/rfc1951.txt].
A compressed data format that is compatible with the widely used GZIP utility as specified in RFC 1952 [http://www.ietf.org/rfc/rfc1952.txt] (uses the deflate algorithm).
Original UNIX compress algorithm and file format using the LZC algorithm (a variant of LZW). Patent encumbered and less efficient than deflate.
7z compression file format. See [http://www.7-zip.org/7z.html] for more information.
A compressed data format that also uses the deflate algorithm. Specified as RFC 1950 [http://www.ietf.org/rfc/rfc1952.txt]
A set of codes specifying the security classification of acts and roles in accordance with the definition for concept domain "Confidentiality".
A specializable code and its leaf codes used in Confidentiality value sets to value the Act.Confidentiality and Role.Confidentiality attribute in accordance with the definition for concept domain "Confidentiality".
Definition: Privacy metadata indicating that the information has been de-identified, and there are mitigating circumstances that prevent re-identification, which minimize risk of harm from unauthorized disclosure. The information requires protection to maintain low sensitivity. Examples: Includes anonymized, pseudonymized, or non-personally identifiable information such as HIPAA limited data sets. Map: No clear map to ISO 13606-4 Sensitivity Level (1) Care Management: RECORD_COMPONENTs that might need to be accessed by a wide range of administrative staff to manage the subject of care's access to health services. Usage Note: This metadata indicates the receiver may have an obligation to comply with a data use agreement.
Definition: Privacy metadata indicating moderately sensitive information, which presents moderate risk of harm if disclosed without authorization. Examples: Includes allergies of non-sensitive nature used inform food service; health information a patient authorizes to be used for marketing, released to a bank for a health credit card or savings account; or information in personal health record systems that are not governed under health privacy laws. Map: Partial Map to ISO 13606-4 Sensitivity Level (2) Clinical Management: Less sensitive RECORD_COMPONENTs that might need to be accessed by a wider range of personnel not all of whom are actively caring for the patient (e.g. radiology staff). Usage Note: This metadata indicates that the receiver may be obligated to comply with the receiver's terms of use or privacy policies.
Definition: Privacy metadata indicating that the information is typical, non-stigmatizing health information, which presents typical risk of harm if disclosed without authorization. Examples: In the US, this includes what HIPAA identifies as the minimum necessary protected health information (PHI) given a covered purpose of use (treatment, payment, or operations). Includes typical, non-stigmatizing health information disclosed in an application for health, workers compensation, disability, or life insurance. Map: Partial Map to ISO 13606-4 Sensitivity Level (3) Clinical Care: Default for normal clinical care access (i.e. most clinical staff directly caring for the patient should be able to access nearly all of the EHR). Maps to normal confidentiality for treatment information but not to ancillary care, payment and operations. Usage Note: This metadata indicates that the receiver may be obligated to comply with applicable jurisdictional privacy law or disclosure authorization.
Privacy metadata indicating highly sensitive, potentially stigmatizing information, which presents a high risk to the information subject if disclosed without authorization. May be pre-empted by jurisdictional law, e.g., for public health reporting or emergency treatment. Examples: Includes information that is additionally protected such as sensitive conditions mental health, HIV, substance abuse, domestic violence, child abuse, genetic disease, and reproductive health; or sensitive demographic information such as a patient's standing as an employee or a celebrity. May be used to indicate proprietary or classified information that is not related to an individual, e.g., secret ingredients in a therapeutic substance; or the name of a manufacturer. Map: Partial Map to ISO 13606-4 Sensitivity Level (3) Clinical Care: Default for normal clinical care access (i.e. most clinical staff directly caring for the patient should be able to access nearly all of the EHR). Maps to normal confidentiality for treatment information but not to ancillary care, payment and operations.. Usage Note: This metadata indicates that the receiver may be obligated to comply with applicable, prevailing (default) jurisdictional privacy law or disclosure authorization..
Definition: Privacy metadata indicating that the information is not classified as sensitive. Examples: Includes publicly available information, e.g., business name, phone, email or physical address. Usage Note: This metadata indicates that the receiver has no obligation to consider additional policies when making access control decisions. Note that in some jurisdictions, personally identifiable information must be protected as confidential, so it would not be appropriate to assign a confidentiality code of "unrestricted" to that information even if it is publicly available.
. Privacy metadata indicating that the information is extremely sensitive and likely stigmatizing health information that presents a very high risk if disclosed without authorization. This information must be kept in the highest confidence. Examples: Includes information about a victim of abuse, patient requested information sensitivity, and taboo subjects relating to health status that must be discussed with the patient by an attending provider before sharing with the patient. May also include information held under “legal lockâ€? or attorney-client privilege Map: This metadata indicates that the receiver may not disclose this information except as directed by the information custodian, who may be the information subject. Usage Note: This metadata indicates that the receiver may not disclose this information except as directed by the information custodian, who may be the information subject.
Description: By accessing subject / role and relationship based rights (These concepts are mutually exclusive, one and only one is required for a valid confidentiality coding.) Deprecation Comment:Deprecated due to updated confidentiality codes under ActCode
Description: Since the service class can represent knowledge structures that may be considered a trade or business secret, there is sometimes (though rarely) the need to flag those items as of business level confidentiality. However, no patient related information may ever be of this confidentiality level. Deprecation Comment: Replced by ActCode.B
Description: Only clinicians may see this item, billing and administration persons can not access this item without special permission. Deprecation Comment:Deprecated due to updated confidentiality codes under ActCode
Description: Access only to individual persons who are mentioned explicitly as actors of this service and whose actor type warrants that access (cf. to actor type code). Deprecation Comment:Deprecated due to updated confidentiality codes under ActCode
Description: By information type, only for service catalog entries (multiples allowed). Not to be used with actual patient data! Deprecation Comment:Deprecated due to updated confidentiality codes under ActCode
Description: Alcohol/drug-abuse related item Deprecation Comment:Replced by ActCode.ETH
Description: HIV and AIDS related item Deprecation Comment:Replced by ActCode.HIV
Description: Psychiatry related item Deprecation Comment:Replced by ActCode.PSY
Description: Sexual assault / domestic violence related item Deprecation Comment:Replced by ActCode.SDV
Description: Modifiers of role based access rights (multiple allowed) Deprecation Comment:Deprecated due to updated confidentiality codes under ActCode
Description: Celebrities are people of public interest (VIP) including employees, whose information require special protection. Deprecation Comment:Replced by ActCode.CEL
Description: Information for which the patient seeks heightened confidentiality. Sensitive information is not to be shared with family members. Information reported by the patient about family members is sensitive by default. Flag can be set or cleared on patient's request. Deprecation Comment:Deprecated due to updated confidentiality codes under ActCode
Description: Information not to be disclosed or discussed with patient except through physician assigned to patient in this case. This is usually a temporary constraint only, example use is a new fatal diagnosis or finding, such as malignancy or HIV. Deprecation Note:Replced by ActCode.TBOO
The type of cap associated with a container
A cap designed to be difficult to open for children. Generally requires multiple simultaneous actions (e.g. squeeze and twist) to open. Used for products that may be dangerous if ingested or overdosed by children.
A cap designed to be easily removed. For products intended to be opened by persons with limited strength or dexterity.
A non-reactive plastic film covering over the opening of a container.
A foil covering (type of foil not specified) over the opening of a container
A non-threaded cap that forms a tight-fitting closure on a container by pushing the fitted end into the conatiner opening
A threaded cap that is screwed onto the opening of a container
A material in a blood collection container that facilites the separation of of blood cells from serum or plasma
A gelatinous type of separator material.
No separator material is present in the container.
Description: Identifies the order in which content should be processed.
Description:The content should be processed in a sequential fashion.
Description:The content may be processed in any order.
A code that specifies how an ActRelationship or Participation contributes to the context of an Act, and whether it may be propagated to descendent Acts whose association allows such propagation (see also attributes Participation.contextControlCode, ActRelationship.contextControlCode, ActRelationship.contextConductionInd).
The association adds to the existing context associated with the Act. Both this association and any associations propagated from ancestor Acts are interpreted as being related to this Act.
The association adds to the existing context associated with the Act, but will not propagate to any descendant Acts reached by conducting ActRelationships (see contextControlCode). Examples: If an 'Author' Participation were marked as "Additive, Non-Propagating" it means that the author will be added to the set of author participations that have propagated from ancestor Acts for the purpose of this Act. However only the previously propagated authors will propagate to any child Acts that allow context to be propagated.
The association adds to the existing context associated with the Act, and will propagate to any descendant Acts reached by conducting ActRelationships (see contextControlCode). Examples: If an 'Author' Participation were marked as "Additive, Propagating" it means that the author will be added to the set of author participations that have propagated from ancestor Acts, and will itself propagate with the other authors to any child Acts that allow context to be propagated.
The association applies only to the current Act and will not propagate to any child Acts that are related via a conducting ActRelationship (refer to contextConductionInd).
The association is added to the existing context associated with the Act, but overrides an association with the same typeCode. However, this overriding association will not propagate to any descendant Acts reached by conducting ActRelationships (see contextControlCode). Examples: If an 'Author' Participation were marked as "Overriding, Non-Propagating" it means that the author will replace the set of author participations that have propagated from ancestor Acts. Furthermore, no author participations whatsoever will propagate to any child Acts that allow context to be propagated.
The association adds to the existing context associated with the Act, but replaces associations propagated from ancestor Acts whose typeCodes are the same or more specific.
The association is added to the existing context associated with the Act, but overrides an association with the same typeCode. This overriding association will propagate to any descendant Acts reached by conducting ActRelationships (see contextControlCode). Examples: If an 'Author' Participation were marked as "Overriding, Propagating" it means that the author will replace the set of author participations that have propagated from ancestor Acts, and will itself be the only author to propagate to any child Acts that allow context to be propagated.
The association propagates to any child Acts that are related via a conducting ActRelationship (refer to contextConductionInd).
Description:Act on an object or objects.
Description:Fundamental operation in an Information System (IS) that results only in the act of bringing an object into existence. Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface. For an HL7 Act, the state transitions per the HL7 Reference Information Model.
Description:Fundamental operation in an Information System (IS) that results only in the removal of information about an object from memory or storage. Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface.
Description:Fundamental operation in an IS that results only in initiating performance of a single or set of programs (i.e., software objects). Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface.
Description:Fundamental operation in an Information System (IS) that results only in the flow of information about an object to a subject. Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface.
Definition:Fundamental operation in an Information System (IS) that results only in the revision or alteration of an object. Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface.
Description:Fundamental operation in an Information System (IS) that results only in the addition of information to an object already in existence. Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface.
Description:Change the status of an object representing an Act.
Description:Change the status of an object representing an Act to "aborted", i.e., terminated prior to the originally intended completion. For an HL7 Act, the state transitions per the HL7 Reference Information Model.
Description:Change the status of an object representing an Act to "active", i.e., so it can be performed or is being performed, for the first time. (Contrast with REACTIVATE.) For an HL7 Act, the state transitions per the HL7 Reference Information Model.
Description:Change the status of an object representing an Act to "cancelled", i.e., abandoned before activation. For an HL7 Act, the state transitions per the HL7 Reference Information Model.
Description:Change the status of an object representing an Act to "completed", i.e., terminated normally after all of its constituents have been performed. For an HL7 Act, the state transitions per the HL7 Reference Information Model.
Description:Change the status of an object representing an Act to "held", i.e., put aside an Act that is still in preparatory stages. No action can occur until the Act is released. For an HL7 Act, the state transitions per the HL7 Reference Information Model.
Description:Change the status of an object representing an Act to a normal state. For an HL7 Act, the state transitions per the HL7 Reference Information Model.
Description:Change the status of an object representing an Act to "nullified", i.e., treat as though it never existed. For an HL7 Act, the state transitions per the HL7 Reference Information Model.
Description:Change the status of an object representing an Act to "obsolete" when it has been replaced by a new instance. For an HL7 Act, the state transitions per the HL7 Reference Information Model.
Description:Change the status of a formerly active object representing an Act to "active", i.e., so it can again be performed or is being performed. (Contrast with ACTIVATE.) For an HL7 Act, the state transitions per the HL7 Reference Information Model.
Description:Change the status of an object representing an Act so it is no longer "held", i.e., allow action to occur. For an HL7 Act, the state transitions per the HL7 Reference Information Model.
Description:Change the status of a suspended object representing an Act to "active", i.e., so it can be performed or is being performed. For an HL7 Act, the state transitions per the HL7 Reference Information Model.
Definition:Change the status of an object representing an Act to suspended, i.e., so it is temporarily not in service.
Domain values for the Device.Alert_levelCode
Shut Down, Fix Problem and Re-initialize
Identifies the current completion state of a clinical document.
A completion status in which a document has been signed manually or electronically by one or more individuals who attest to its accuracy. No explicit determination is made that the assigned individual has performed the authentication. While the standard allows multiple instances of authentication, it would be typical to have a single instance of authentication, usually by the assigned individual.
A completion status in which information has been orally recorded but not yet transcribed.
A completion status in which document content, other than dictation, has been received but has not been translated into the final electronic format. Examples include paper documents, whether hand-written or typewritten, and intermediate electronic forms, such as voice to text.
A completion status in which information is known to be missing from a transcribed document.
A workflow status where the material has been assigned to personnel to perform the task of transcription. The document remains in this state until the document is transcribed.
A completion status in which a document has been signed manually or electronically by the individual who is legally responsible for that document. This is the most mature state in the workflow progression.
A completion status in which a document was created in error or was placed in the wrong chart. The document is no longer available.
A completion status in which a document is transcribed but not authenticated.
A completion status where the document is complete and there is no expectation that the document will be signed.
Identifies the storage status of a document.
A storage status in which a document is available on-line.
A storage status in which a document is available on-line and is also stored off-line for long-term access.
A storage status in which a document has been stored off-line for long-term access.
A storage status in which a document is no longer available in this system.
Years of education that a person has completed
Associate's or technical degree complete
College or baccalaureate degree complete
Graduate or professional Degree complete
High School or secondary school degree complete
Employment in which the employee is expected to work at least a standard work week (defined by the US Bureau of Labor Statistics as 35-44 hours per week)
Employment in which the employee is expected to work less than a standard work week (defined by the US Bureau of Labor Statistics as 35-44 hours per week)
Courtesies extended to the staff of the entity providing service.
Classifies the Entity class and all of its subclasses. The terminology is hierarchical. At the top is this HL7-defined domain of high-level categories (such as represented by the Entity subclasses). Each of these terms must be harmonized and is specializable. The value sets beneath are drawn from multiple, frequently external, domains that reflect much more fine-grained typing.
Classifies the Entity class and all of its subclasses. The terminology is hierarchical. At the top is this HL7-defined domain of high-level categories (such as represented by the Entity subclasses). Each of these terms must be harmonized and is specializable. The code systems beneath are drawn from multiple, frequently external, domains that reflect much more fine-grained typing.
A health chart included to serve as a document receiving entity in the management of medical records.
Anything that essentially has the property of life, independent of current state (a dead human corpse is still essentially a living subject).
A subtype of living subject that includes all living things except the species Homo Sapiens.
A living subject from the animal kingdom.
All single celled living organisms including protozoa, bacteria, yeast, viruses, etc.
A living subject from the order of plants.
A living subject of the species homo sapiens.
Any thing that has extension in space and mass, may be of living or non-living origin.
A substance that is fully defined by an organic or inorganic chemical formula, includes mixtures of other chemical substances. Refine using, e.g., IUPAC codes.
Naturally occurring, processed or manufactured entities that are primarily used as food for humans and animals.
Corresponds to the ManufacturedMaterial class
A type of container that can hold other containers or other holders.
A subtype of ManufacturedMaterial used in an activity, without being substantially changed through that activity. The kind of device is identified by the code attribute inherited from Entity. Usage: This includes durable (reusable) medical equipment as well as disposable equipment.
A physical artifact that stores information about the granting of authorization.
Class to contain unique attributes of diagnostic imaging equipment.
A social or legal structure formed by human beings.
An agency of the people of a state often assuming some authority over a certain matter. Includes government, governmental agencies, associations.
A politically organized body of people bonded by territory, culture, or ethnicity, having sovereignty (to a certain extent) granted by other states (enclosing or neighboring states). This includes countries (nations), provinces (e.g., one of the United States of America or a French departement), counties or municipalities. Refine using, e.g., ISO country codes, FIPS-PUB state codes, etc.
A politically organized body of people bonded by territory and known as a nation.
A physical place or site with its containing structure. May be natural or man-made. The geographic position of a place may or may not be constant.
The territory of a city, town or other municipality.
The territory of a county, parish or other division of a state or province.
The territory of a state, province, department or other division of a sovereign country.
A grouping of resources (personnel, material, or places) to be used for scheduling purposes. May be a pool of like-type resources, a team, or combination of personnel, material and places.
Material intended to hold another material for purpose of storage or transport.
A material intended to hold other materials for purposes of storage or transportation
A container having dimensions that adjust somewhat based on the amount and shape of the material placed within it.
A small bag or container made of a soft material.
A small bag or packet containing a small portion of a substance.
A container having a fixed and inflexible dimensions and volume
Container intended to contain sufficient material for only one use.
A small sealed glass container that holds a measured amount of a medicinal substance.
Individually dosed ophthalmic solution. One time eye dropper dispenser.
A container either glass or plastic and a narrow neck, for storing liquid.
A container intended to contain sufficient material for more than one use. (I.e. Material is intended to be removed from the container at more than one discrete time period.)
A container, typically rounded, either glass or plastic with a narrow neck and capable of storing liquid.
A bottle of yellow to brown color. Used to store light-sensitive materials
A bottle with a cap designed to release the contained liquid in droplets of a specific size.
A 6-sided container commonly made from paper or cardboard used for solid forms.
A metal container in which a material is hermetically sealed to enable storage over long periods.
A sealed container of liquid or powder intended to be loaded into a device.
A pressurized metal container holding a substance released as a spray or aerosol.
A container of glass, earthenware, plastic, etc. Top of the container has a diameter of similar size to the diameter of the container as a whole
A deep vessel for holding liquids, with a handle and often with a spout or lip shape for pouring.
A lidded container made of thin sheet metal.
A long hollow rigid or flexible cylinder. Material is extruded by squeezing the container.
A small cylindrical glass for holding liquid medicines.
A bubblepack. Medications sealed individually, separated into doses.
A bubble pack card. Multiple individual/separated doses.
A container intended to contain sufficient material for more than one use, but grouped or organized to provide individual access to sufficient material for a single use. Often used to ensure that the proper type and amount of material is consumed/expended for each use.
Rotatable dispenser. Eg. Birth control package.
Object that is thin, flat, and circular. Doses of medication often contained in bubbles on the disk.
Special packaging that will help patients take their medications on a regular basis.
A continuous strip of plastic sectioned into individual pouches, each one containing the quantity of 1 or more medications intended to be administered at a specific time
A container for a diverse collection of products intended to be used together for some purpose (e.g. Medicinal kits often contain a syringe, a needle and the injectable medication).
A kit in which the components are interconnected.
A device with direct or indirect therapeutic purpose. Values for EntityCode when EntityClass = "DEV"
A device used to allow access to a part of a body
A hollow tube used to administer a substance into a vein, artery or body cavity
A line used to administer a substance into an artery
A line used to administer a substance into a vein
A device intended to administer a substance to a subject
A device intended to administer liquid into a subject via a
A device which can contain a cartridge for injection purposes. Eg. Insulin pen.
A device used to apply a liquid or powder to a surface.
A small device used for inhaling medicine in the form of a vapour or gas in order to ease a respiratory condition such as asthma or to relieve nasal congestion.
The device used to inhale the doses of medication contained in the disk form.
A device that is used to raise, compress, or transfer liquids or gases and is operated by a piston or similar mechanism.
Set of codes related to specimen additives
ACD Solution A of trisodium citrate, 22.0g/L; citric acid, 8.0 g/L; and dextrose 24.5 g/L. Used in Blood banking and histocompatibilty testing
ACD Solution B of trisodium citrate, 13.2g/L; citric acid, 4.8 g/L; and dextrose 14.7 g/L. Used in Blood banking and histocompatibilty testing.
50% V/V acetic acid in water. Used as a urine preservative
Sodium Chloride 3.0g, Potassium Chloride 0.2g, Calcium Chloride 0.1g, Magnesium Chloride 0.1g, Monopotassium Phosphate 0.2g, Disodium Phosphate 1.15g, Sodium Thiogly collate 1.0g, Distilled Water 1 liter
Any medium used to maintain bacterial viability (e.g. Stuart's, Cary-Blair, Amies)
Formaldehyde 4% w/v; methyl alcohol 1% w/v; phosphate buffering salts. Tissue preservative
Powdered boric acid (usually 10 g) added to 24-hour urine collections as a preservative.
Picric acid, saturated aqueous solution (750.0 ml), 37-40% formalin (250.0 ml), glacial acetic acid (50.0 ml). Tissue preservative.
50% skim milk in 0.01 M phosphate-buffered saline. Maintain virus viability
A 3.2% solution of Sodium Citrate in water. Used as a blood preservative
A 3.8% solution of Sodium Citrate in water. Used as a blood preservative
A modification of buffered 10% formalin used as a general tissue preservative.
Sodium Thioglycollate 1.5 g, Disodium Hydrogen Phosphate 1.1 g, Sodium Chloride 5.0 g, Calcium Chloride 0.09 g, Agar 5.0 g, per Liter of Water
Any of a number of non-nutritive buffered media used to maintain Chlamydia viability during transportation to the laboratory
Buffered tri-sodium citrate solution with theophylline, adenosine and dipyridamole
Any of a number of non-nutritive buffered media used to maintain enteric bacterial viability during transportation to the laboratory
A 10% v/v solution in water of formalin( a 37% solution of formaldehyde and water). Used for tissue preservation.
Thrombin plus soybean trypsin inhibitor. For use in identifying fibrn degredation products.
Sodium fluoride, 10mg added as a urine preservative.
Sodium fluoride, 100mg added as a urine preservative.
A solution of HCl containing 6moles of hydrogen ion/L. Used as a Urine Preservative.
6N Nitric acid used to preserve urine for heavy metal analysis.
A transport medium formulated to maintain Bordetella pertussis viability.
5% Glutaraldehyde, 4% Formaldehyde in 0.08M buffer. Tissue preservation
Potassium oxalate and sodium fluoride in a 1.25:1 ratio
Modified Hank's balanced salt solution supplemented with bovine serum albumin, gelatin, sucrose and glutamic acid. It is buffered to pH 7.3+ or - 0.2 with HEPES buffer. Phenol red is used to indicate pH. Vancomycin, Amphotericin B and Colistin are used to
Modified Hank's balanced salt solution supplemented with bovine serum albumin, gelatin, sucrose and glutamic acid. It is buffered to pH 7.3+ or - 0.2 with Hepes buffer. Phenol red is used to indicate pH. Gentamicin and amphotericin B are used to inhibit c
Modified Hank's balanced salt solution supplemented with protein stabilizers, sucrose and glutamic acid. It is buffered to pH 7.3+ or - 0.2 with Hepes buffer. Phenol red is used to indicate pH. Vancomycin, Amphotericin B and Colistin are used to inhibit c
1M potassium citrate, pH 7.0 2.5 ml, 0.1M magnesium sulfate 5.0 ml, 0.1M N-ethyl malemide 5.0 ml, dH2O 87.5 ml, ammonium sulfate 55gm. Preserve antigens for Immunofluorescence procedures
A buffered medium with ammonium sulfate added to preserve antigens for Immunofluorescence procedures
No additive. Specifically identifes the specimen as having no additives.
0.12 g NaCl, 0.004 g MgSO, 0.004 g, CaCl, 0.142 g Na2HPO4 and 0.136 g KH2PO4 per liter of distilled water. Maintain Acanthaoemba viability.
Diatomaceous earth. For glucose determination blood samples
Sodium polyanethol sulfonate 0.35% in 0.85% sodium chloride
Sodium polyanethol sulfonate in saline. Anticomplementary and antiphagocytic properties. Used in blood culture collection.
Polymer separator gel with clot activator
Sodium Glycerophosphate 10.0g, Calcium Chloride 0.1g, Mercaptoacetic Acid 1.0ml, Distilled Water 1 liter
2-Isopropyl-5-methyl phenol. A preservative for 24 Hr Urine samples
A nutritive medium with a reducing agent (sodium thioglycolate) which, due to a chemical reaction, removes oxygen from the broth.
Also known as Methylbenzene; Toluol; Phenylmethane. A preservative for 24 Hr Urine samples
A buffered salt solution with antifungal agents added for the collection and transport of Ureaplasma specimens.
Sucrose 74.6g, Potassium hydrogenphosphate 0.52g, L-glutamic acid 0.72g, Bovine serum albumin 5.0g, Gentamicin 50mg, Potassium dihydrogenphosphate 1.25g, L-15 medium 9.9L, Water to 10L. Maintain Virus viability.
3.8% Citrate buffered to a pH of 5.5 for Westergren Sedimentation Rate
A manufactured product that is produced from the raw blood oi a donor with the intention of using it in a recipient transfusion.
A Type of medicine that creates an immune protection without the recipient experiencing the disease.
A substance whose therapeutic effect is produced by chemical action within the body.
Any substance or mixture of substances manufactured, sold or represented for use in: (a) the diagnosis, treatment, mitigation or prevention of a disease, disorder, abnormal physical state, or its symptoms, in human beings or animals; (b) restoring, correcting or modifying organic functions in human beings or animals.
Indicates types of allergy and intolerance agents which are non-drugs. (E.g. foods, latex, etc.)
Further classifies entities of classCode ORG.
The group of persons who occupy a single housing unit.
Codes identifying nation states. Allows for finer grained specification of Entity with classcode <= NAT Example:ISO3166 country codes.
An organization that provides religious rites of worship.
The location of a wing of a building (e.g. East Wing). The same room number for the same floor number can be distinguished by wing number in some situations
Codes to characterize a Resource Group using categories that typify its membership and/or function . Example: PractitionerGroup
EntityDeterminer in natural language grammar is the class of words that comprises articles, demonstrative pronouns, and quantifiers. In the RIM, determiner is a structural code in the Entity class to distinguish whether any given Entity object stands for some, any one, or a specific thing.
Description:A determiner that specifies that the Entity object represents a particular physical thing (as opposed to a universal, kind, or class of physical thing). Discussion: It does not matter whether an INSTANCE still exists as a whole at the point in time (or process) when we mention it, for example, a drug product lot is an INSTANCE even though it has been portioned out for retail purpose.
A determiner that specifies that the Entity object represents a particular collection of physical things (as opposed to a universal, kind, or class of physical thing). While the collection may resolve to having only a single individual (or even no individuals), the potential should exist for it to cover multiple individuals.
Description:A determiner that specifies that the Entity object represents a universal, kind or class of physical thing (as opposed to a particular thing).
A determiner that specifies that the Entity object represents a universal, kind or class of collections physical things. While the collection may resolve to having only a single individual (or even no individuals), the potential should exist for it to cover multiple individuals.
The described quantified determiner indicates that the given Entity is taken as a general description of a specific amount of a thing. For example, QUANTIFIED_KIND of syringe (quantity = 3,) stands for exactly three syringes.
Critical to keep at body temperature 36-38C
Critical ambient - must not be refrigerated or frozen.
Critical. Do not expose to atmosphere. Do not uncap.
Critical frozen. Specimen must not be allowed to thaw until immediately prior to testing.
Critical refrigerated - must not be allowed to freeze or warm until imediately prior to testing.
Container is free of heavy metals, including lead.
Protect from light (eg. Wrap in aluminum foil).
Keep at refrigerated temperature:4-8C Accidental warming or freezing is of little consequence.
Ultra cold frozen -75 to -85C. Ultra cold freezer is typically at temperature of dry ice.
Indicates that a prefix like "Dr." or a suffix like "M.D." or "Ph.D." is an academic title.
The name the person was given at the time of adoption.
A name that a person had shortly after being born. Usually for family names but may be used to mark given names at birth that may have changed later.
A callme name is (usually a given name) that is preferred when a person is directly addressed.
Indicates that a name part is just an initial. Initials do not imply a trailing period since this would not work with non-Latin scripts. Initials may consist of more than one letter, e.g., "Ph." could stand for "Philippe" or "Th." for "Thomas".
For organizations a suffix indicating the legal status, e.g., "Inc.", "Co.", "AG", "GmbH", "B.V." "S.A.", "Ltd." etc.
In Europe and Asia, there are still people with nobility titles (aristocrats). German "von" is generally a nobility title, not a mere voorvoegsel. Others are "Earl of" or "His Majesty King of..." etc. Rarely used nowadays, but some systems do keep track of this.
Primarily in the British Imperial culture people tend to have an abbreviation of their professional organization as part of their credential suffices.
The name assumed from the partner in a marital relationship (hence the "SP"). Usually the spouse's family name. Note that no inference about gender can be made from the existence of spouse names.
Indicates that a prefix or a suffix is a title that applies to the whole name, not just the adjacent name part.
A Dutch "voorvoegsel" is something like "van" or "de" that might have indicated nobility in the past but no longer so. Similar prefixes exist in other languages such as Spanish, French or Portugese.
Description: Medication Name Parts are a means of specifying a range of acceptable "official" forms of the name of a product. They are used as patterns against which input name strings may be matched for automatic identification of products from input text reports. While they cover the concepts held under "doseForm" or "route" or "strength" the name parts are not the same and do not fit into a controlled vocabulary in the same way. By specifying up to 8 name parts a much larger range of possible names can be generated.
Description: This refers to the container if present in the medicinal product name. EXAMPLES: For Optaflu suspension for injection in pre-filled syringe Influenza vaccine (surface antigen, inactivated, prepared in cell culture) (2007/2008 season): pre-filled syringe
Description: This refers to the qualifiers in the name for devices and is at the moment mainly applicable to insulins and inhalation products. EXAMPLES: For the medicinal product Actrapid FlexPen 100 IU/ml Solution for injection Subcutaneous use: FlexPen.
Description: This refers to a flavor of the medicinal product if present in the medicinal product name. Examples: For 'CoughCure Linctus Orange Flavor', the flavor part is "Orange" For 'Wonderdrug Syrup Cherry Flavor', the flavor part is "Cherry"
Description: This refers to the formulation of the medicinal product if present in the medicinal product name. Examples: For 'SpecialMed Sugar Free Cough Syrup', the formulation name part is "Sugar Free" For 'QuickCure Gluten-free Bulk Fibre', the formulation name part is "gluten-free"
Description: This refers to the pharmaceutical form/ if present in the medicinal product name. EXAMPLES: For Agenerase 50 mg soft capsules: Soft Capsules For Ludiomil 25mg-Filmtabletten: Filmtabletten For Optaflu suspension for injection in pre-filled syringe Influenza vaccine (surface antigen, inactivated, prepared in cell culture) (2007/2008 season): suspension for injection
Description: This refers to the product name without the trademark or the name of the marketing authorization holder or any other descriptor reflected in the product name and, if appropriate, whether it is intended e.g. for babies, children or adults. EXAMPLES: Agenerase Optaflu Ludiomil
Description: This refers to the target population for the medicinal product if present in the medicinal product name Examples: For 'Broncho-Drug 3.5 mg-capsules for children', the target population part is "children" For 'Adult Chesty Cough Syrup', the target population part is "adult"
Description: This refers to the product common or scientific name without the trademark or the name of the marketing authorization holder or any other descriptor reflected in the product name. EXAMPLES: For Agenerase: N/A For Optaflu: Influenza vaccine (surface antigen, inactivated, prepared in cell culture) (2007/2008 season) For Ludiomil: N/A
Description: This refers to the strength if present in the medicinal product name. The use of decimal points should be accommodated if required. EXAMPLES: For Agenerase 50 mg soft capsules: 50mg For Ludiomil 25mg-Filmtabletten: 25 mg For Optaflu suspension for injection in pre-filled syringe Influenza vaccine (surface antigen, inactivated, prepared in cell culture) (2007/2008 season): N/A
Description: This refers to a time or time period that may be specified in the text of the medicinal product name Example: For an influenza vaccine 'Drug-FLU season 2008/2009', the time/period part is "2008/2009 season"
Description: This refers to trademark/company element if present in the medicinal product name. EXAMPLES: for Insulin Human Winthrop Comb 15: Winthrop
Description: This refers to the intended use if present in the medicinal product name without the trademark or the name of the marketing authorization holder or any other descriptor reflected in the product name. Examples: For 'Drug-BI Caplets - Heartburn Relief', the intended use part is: "Heartburn Relief" For 'Medicine Honey Syrup for Soothing Coughs' the intended use part is "Soothing Coughs"
v3 Code System EntityNamePartQualifierR2
Description: The qualifier is a set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type. For example, a given name may be flagged as a nickname, a family name may be a pseudonym or a name of public records.
Description:A name part a person acquired. The name part may be acquired by adoption, or the person may have chosen to use the name part for some other reason. Note: this differs from an Other/Psuedonym/Alias in that an acquired name part is acquired on a formal basis rather than an informal one (e.g. registered as part of the official name).
Description:The name assumed from the partner in a marital relationship. Usually the spouse's family name. Note that no inference about gender can be made from the existence of spouse names.
Description:A name that a person was given at birth or established as a consequence of adoption. Note: This is not used for temporary names assigned at birth such as "Baby of Smith" a" which is just a name with a use code of "TEMP".
Description:Used to indicate which of the various name parts is used when interacting with the person.
Description:Indicates that a name part is just an initial. Initials do not imply a trailing period since this would not work with non-Latin scripts. In some languages, initials may consist of more than one letter, e.g., "Ph" could stand for "Philippe" or "Th" For "Thomas".
Description:For organizations a suffix indicating the legal status, e.g., "Inc.", "Co.", "AG", "GmbH", "B.V." "S.A.", "Ltd." etc.
Description:Indicates that the name part is a middle name. Usage Notes: In general, the english "middle name" concept is all of the given names after the first. This qualifier may be used to explicitly indicate which given names are considered to be middle names. The middle name qualifier may also be used with family names. This is a Scandinavian use case, matching the concept of "mellomnavn","mellannamn". Note that there are specific rules that indicate what names may be taken as a mellannamn in different Scandinavian countries.
Description:A prefix has a strong association to the immediately following name part. A prefix has no implicit trailing white space (it has implicit leading white space though).
Description:A suffix has a strong association to the immediately preceding name part. A suffix has no implicit leading white space (it has implicit trailing white space though).
Description:Extra information about the style of a title
Description:Indicates that a title like "Dr.", "M.D." or "Ph.D." is an academic title.
Description:A honorific such as "The Right Honourable" or "Weledelgeleerde Heer".
Description:A nobility title such as Sir, Count, Grafin.
Description:Primarily in the British Imperial culture people tend to have an abbreviation of their professional organization as part of their credential titles.
A delimiter has no meaning other than being literally printed in this name representation. A delimiter has no implicit leading and trailing white space.
Family name, this is the name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.
Given name (don't call it "first name" since this given names do not always come first)
A prefix has a strong association to the immediately following name part. A prefix has no implicit trailing white space (it has implicit leading white space though). Note that prefixes can be inverted.
Description:A suffix has a strong association to the immediately preceding name part. A suffix has no implicit leading white space (it has implicit trailing white space though). Suffices cannot be inverted.
Description: Indicates whether the name part is a given name, family name, prefix, suffix, etc.
Description:A delimiter has no meaning other than being literally printed in this name representation. A delimiter has no implicit leading and trailing white space.
Description:Family name, this is the name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.
Description:Given name. Note: don't call it "first name" since the given names do not always come first.
Description:Part of the name that is acquired as a title due to academic, legal, employment or nobility status etc. Note:Title name parts include name parts that come after the name such as qualifications, even if they are not always considered to be titles.
Identifies the different representations of a name. The representation may affect how the name is used. (E.g. use of Ideographic for formal communications.)
Alphabetic transcription of name (Japanese: romaji)
Ideographic representation of name (e.g., Japanese kanji, Chinese characters)
Syllabic transcription of name (e.g., Japanese kana, Korean hangul)
A name assigned to a person. Reasons some organizations assign alternate names may include not knowing the person's name, or to maintain anonymity. Some, but not necessarily all, of the name types that people call "alias" may fit into this category.
As recorded on a license, record, certificate, etc. (only if different from legal name)
Definition:The formal name as registered in an official (government) registry, but which name might not be commonly used. Particularly used in countries with a law system based on Napoleonic law.
A self asserted name that the person is using or has used.
Includes writer's pseudonym, stage name, etc
A name intended for use in searching or matching.
A name spelled phonetically. There are a variety of phonetic spelling algorithms. This code value does not distinguish between these.Discussion:
A name spelled according to the SoundEx algorithm.
Description: A set of codes advising a system or user which name in a set of names to select for a given purpose.
Description:A name that a person has assumed or has been assumed to them.
Description:A name used in a Professional or Business context . Examples: Continuing to use a maiden name in a professional context, or using a stage performing name (some of these names are also pseudonyms)
Description:Anonymous assigned name (used to protect a persons identity for privacy reasons)
Description:A non-official name by which the person is sometimes known. (This may also be used to record informal names such as a nickname)
Description:A name assumed as part of a religious vocation . e.g . Sister Mary Francis, Brother John
Description:Known as/conventional/the one you normally use
Description:A name used prior to marriage.Note that marriage naming customs vary greatly around the world. This name use is for use by applications that collect and store maiden names. Though the concept of maiden name is often gender specific, the use of this term is not gender specific. The use of this term does not imply any particular history for a person's name, nor should the maiden name be determined algorithmically
Description:Identifies the different representations of a name . The representation may affect how the name is used . (E.g . use of Ideographic for formal communications.)
Description:Alphabetic transcription of name in latin alphabet (Japanese: romaji)
Description:Ideographic representation of name (e.g., Japanese kanji, Chinese characters)
Description:Syllabic transcription of name (e.g., Japanese kana, Korean hangul)
Description:This name is no longer in use (note: Names may also carry valid time ranges . This code is used to cover the situations where it is known that the name is no longer valid, but no particular time range for its use is known)
Description:This name should no longer be used when interacting with the person (i.e . in addition to no longer being used, the name should not be even mentioned when interacting with the person)Note: applications are not required to compare names labeled "Do Not Use" and other names in order to eliminate name parts that are common between the other name and a name labeled "Do Not Use".
Description:The formal name as registered in an official (government) registry, but which name might not be commonly used . May correspond to the concept of legal name
Description:The name as understood by the data enterer, i.e. a close approximation of a phonetic spelling of the name, not based on a phonetic algorithm.
Description:A name intended for use in searching or matching. This is used when the name is incomplete and contains enough details for search matching, but not enough for other uses.
Description:A temporary name. Note that a name valid time can provide more detailed information. This may also be used for temporary names assigned at birth or in emergency situations.
Kinds of risks associated with the handling of the material..
A danger that can be associated with certain living subjects, including humans.
The dangers associated with normal biological materials. I.e. potential risk of unknown infections. Routine biological materials from living subjects.
Material is corrosive and may cause severe injury to skin, mucous membranes and eyes. Avoid any unprotected contact.
The entity is at risk for escaping from containment or control.
Material is highly inflammable and in certain mixtures (with air) may lead to explosions. Keep away from fire, sparks and excessive heat.
Material is an explosive mixture. Keep away from fire, sparks, and heat.
Material known to be infectious with human pathogenic microorganisms. Those who handle this material must take precautions for their protection.
Material contains microorganisms that is an environmental hazard. Must be handled with special care.
Material is solid and sharp (e.g., cannulas). Dispose in hard container.
Material is poisonous to humans and/or animals. Special care must be taken to avoid incorporation, even of small amounts.
Material is a source for ionizing radiation and must be handled with special care to avoid injury of those who handle it and to avoid environmental hazards.
Codes representing the defined possible states of an Entity, as defined by the Entity class state machine.
The 'typical' state. Excludes "nullified" which represents the termination state of an Entity record instance that was created in error.
The state representing the fact that the Entity record is currently active.
Definition: The state representing the fact that the entity is inactive.
The state representing the normal termination of an Entity record.
The state representing the termination of an Entity record instance that was created in error.
In the United States, federal standards for classifying data on ethnicity determine the categories used by federal agencies and exert a strong influence on categorization by state and local agencies and private sector organizations. The federal standards do not conceptually define ethnicity, and they recognize the absence of an anthropological or scientific basis for ethnicity classification. Instead, the federal standards acknowledge that ethnicity is a social-political construct in which an individual's own identification with a particular ethnicity is preferred to observer identification. The standards specify two minimum ethnicity categories: Hispanic or Latino, and Not Hispanic or Latino. The standards define a Hispanic or Latino as a person of "Mexican, Puerto Rican, Cuban, South or Central America, or other Spanish culture or origin, regardless of race." The standards stipulate that ethnicity data need not be limited to the two minimum categories, but any expansion must be collapsible to those categories. In addition, the standards stipulate that an individual can be Hispanic or Latino or can be Not Hispanic or Latino, but cannot be both.
Note that this term remains in the table for completeness, even though within HL7, the notion of "not otherwise coded" term is deprecated.
Code for the mechanism by which the exposure agent was exchanged or potentially exchanged by the participants involved in the exposure.
Description: Communication of an agent from a living subject or environmental source to a living subject through indirect contact via oral or nasal inhalation.
Description: Communication of an agent from a living subject or environmental source to a living subject through direct physical contact.
Description: Communication of an agent from a food source to a living subject via oral consumption.
Description: Communication of an agent to a living subject by contact and/or consumption via an aqueous medium
A relationship between two people characterizing their "familial" relationship
Every morning at institution specified times.
Two times a day at institution specified time
Regular business days (Monday to Friday excluding holidays)
Regular weekends (Saturday and Sunday excluding holidays)
Christian Holidays (Roman/Gregorian [Western] Tradition.)
Easter Sunday. The Easter date is a rather complex calculation based on Astronomical tables describing full moon dates. Details can be found at [http://www.assa.org.au/edm.html, and http://aa.usno.navy.mil/AA/faq/docs/easter.html]. Note that the Christian Orthodox Holidays are based on the Julian calendar.
Good Friday, is the Friday right before Easter Sunday.
Pentecost Sunday, is seven weeks after Easter (the 50th day of Easter).
Description:The Netherlands National Holidays.
Description:Liberation day (May 5 every five years)
United States National Holidays (public holidays for federal employees established by U.S. Federal law 5 U.S.C. 6103).
Columbus Day, the second Monday in October.
Alternative Monday after 4th of July Weekend [5 U.S.C. 6103(b)].
Alternative Friday before 4th of July Weekend [5 U.S.C. 6103(b)].
Labor Day, the first Monday in September.
Dr. Martin Luther King, Jr. Day, the third Monday in January.
Washington's Birthday (Presidential Day) the third Monday in February.
Thanksgiving Day, the fourth Thursday in November.
Every afternoon at institution specified times.
Four times a day at institution specified time
Three times a day at institution specified time
Supports communication of purpose of use at a general level.
The possible modes of updating that occur when an attribute is received by a system that already contains values for that attribute.
Description:The item was (or is to be) added, having not been present immediately before. (If it is already present, this may be treated as an error condition.)
Description:The item was (or is to be) either added or replaced.
Description:The item was (or is to be) removed (sometimes referred to as deleted). If the item is part of a collection, delete any matching items.
Description:This item is part of the identifying information for this object.
Description:There was (or is to be) no change to the item. This is primarily used when this element has not changed, but other attributes in the instance have changed.
Description:The item existed previously and has (or is to be) revised. (If an item does not already exist, this may be treated as an error condition.)
Description:This item provides enough information to allow a processing system to locate the full applicable record by identifying the object.
Description:Description:It is not specified whether or what kind of change has occurred to the item, or whether the item is present as a reference or identifying property.
These concepts apply when the element and/or message is updating a set of items.
Add the message element to the collection of items on the receiving system that correspond to the message element.
Change the item on the receiving system that corresponds to this message element; if a matching element does not exist, add a new one created with the values in the message.
Change the item on the receiving system that corresponds to this message element; do not process if a matching element does not exist.
Delete the item on the receiving system that corresponds to this message element.
Description: AU: If this item exists, update it with these values. If it does not exist, create it with these values. If the item is part of the collection, update each item that matches this item, and if no items match, add a new item to the collection.
Ignore this role, it is not relevant to the update.
Verify - this message element must match a value already in the receiving systems database in order to process the message.
HtmlLinkType values are drawn from HTML 4.0 and describe the relationship between the current document and the anchor that is the target of the link
Designates substitute versions for the document in which the link occurs. When used together with the lang attribute, it implies a translated version of the document. When used together with the media attribute, it implies a version designed for a different medium (or media).
Refers to a document serving as an appendix in a collection of documents.
Refers to a bookmark. A bookmark is a link to a key entry point within an extended document. The title attribute may be used, for example, to label the bookmark. Note that several bookmarks may be defined in each document.
Refers to a document serving as a chapter in a collection of documents.
Refers to a document serving as a table of contents. Some user agents also support the synonym ToC (from "Table of Contents").
Refers to a copyright statement for the current document.
Refers to a document providing a glossary of terms that pertain to the current document.
Refers to a document offering help (more information, links to other sources of information, etc.).
Refers to a document providing an index for the current document.
Refers to the next document in a linear sequence of documents. User agents may choose to preload the "next" document, to reduce the perceived load time.
Refers to the previous document in an ordered series of documents. Some user agents also support the synonym "Previous".
Refers to a document serving as a section in a collection of documents.
Refers to the first document in a collection of documents. This link type tells search engines which document is considered by the author to be the starting point of the collection.
Refers to an external style sheet. See the section on external style sheets for details. This is used together with the link type "Alternate" for user-selectable alternate style sheets.
Refers to a document serving as a subsection in a collection of documents.
Description: The identifier was issued by the system responsible for constructing the instance.
Description: The identifier was provided to the system that constructed the instance, but has not been verified. e.g. a Drivers license entered manually into a system by a user.
Description: The identifier was not issued by the system responsible for constructing the instance, but the system that captured the id has verified the identifier with the issuing authority, or with another system that has verified the identifier.
Description: Codes to specify the scope in which the identifier applies to the object with which it is associated, and used in the datatype property II.
Description: An identifier whose scope is defined by the business practices associated with the object. In contrast to the other scope identifiers, the scope of the use of the id is not necessarily restricted to a single object, but may be reused for other objects closely associated with the object due to business practice.
Description: The identifier associated with a particular object. It remains consistent as the object undergoes state transitions.
Description: An identifier that references a particular object as it existed at a given point in time. The identifier SHALL change with each state transition on the object. I.e. The version identifier of an object prior to a 'suspend' state transition is distinct from the identifier of the object after the state transition. Each version identifier can be tied to exactly one ControlAct event which brought that version into being (though the control act may never be instantiated). NOTE: Applications that do not support versioning of objects must ignore and not persist these ids to avoid confusion resulting from leaving the same identifier on an object that undergoes changes.
Description: An identifier that references a particular object as it existed at a given point in time. The identifier SHALL change with each state transition on the object. Example The version identifier of an object prior to a 'suspend' state transition is distinct from the identifier of the object after the state transition. Each version identifier can be tied to exactly one ControlAct event which brought that version into being (though the control act may never be instantiated). NOTE: Applications that do not support versioning of objects must ignore and not persist these ids to avoid confusion resulting from leaving the same identifier on an object that undergoes changes.
Sensitivity codes are not useful for interoperability outside of a policy domain because sensitivity policies are typically localized and vary drastically across policy domains even for the same information category because of differing organizational business rules, security policies, and jurisdictional requirements. For example, an "employee" sensitivity code would make little sense for use outside of a policy domain. "Taboo" would rarely be useful outside of a policy domain unless there are jurisdictional requirements requiring that a provider disclose sensitive information to a patient directly. Sensitivity codes may be more appropriate in a legacy system's Master Files in order to notify those who access a patient's orders and observations about the sensitivity policies that apply. Newer systems may have a security engine that uses a sensitivity policy's criteria directly. The specializable Sensitivity Act.code may be useful in some scenarious if used in combination with a sensitivity identifier and/or Act.title.
This algorithm is defined in FIPS PUB 180-1: Secure Hash Standard. As of April 17, 1995.
This algorithm is defined in FIPS PUB 180-2: Secure Hash Standard.
A value representing the method of expression of the language. Example: Expressed spoken, expressed written, expressed signed, received spoken, received written, received signed. OpenIssue: Description copied from Concept Domain of same name. Must be verified.
v3 Code System LanguageAbilityProficiency
A value representing the level of proficiency in a language. Example: Excellent, good, fair, poor. OpenIssue: Description copied from Concept Domain of same name. Must be verified.
A code depicting the living arrangements of a person
Definition: Living arrangements lacking a permanent residence.
Definition: A group living arrangement specifically for the care of those in need of temporary and crisis housing assistance. Examples include domestic violence shelters, shelters for displaced or homeless individuals, Salvation Army, Jesus House, etc. Community based services may be provided.
Definition: A living arrangement within a private residence for single family.
Definition: Assisted living in a single family residence for persons with physical, behavioral, or functional health, or socio-economic challenges. There may or may not be on-site supervision but the housing is designed to assist the client with developing independent living skills. Community based services may be provided.
Tells a receiver to ignore just the local markup tags (local_markup, local_header, local_attr) when value="markup", or to ignore the local markup tags and all contained content when value="all"
An equipment can either work autonomously ('Local' control state).
An equipment can be controlled by another system, e.g., LAS computer ('Remote' control state).
v3 Code System ManagedParticipationStatus
Codes representing the defined possible states of a Managed Participation, as defined by the Managed Participation class state machine.
The 'typical' state. Excludes "nullified" which represents the termination state of a participation instance that was created in error.
The state representing the fact that the Participation is in progress.
The terminal state resulting from cancellation of the Participation prior to activation.
The terminal state representing the successful completion of the Participation.
The state representing that fact that the Participation has not yet become active.
The state representing the termination of a Participation instance that was created in error.
The closeness or quality of the mapping between the HL7 concept (as represented by the HL7 concept identifier) and the source coding system. The values are patterned after the similar relationships used in the UMLS Metathesaurus. Because the HL7 coding sy
The first concept is at a more abstract level than the second concept. For example, Hepatitis is broader than Hepatitis A, and endocrine disease is broader than Diabetes Mellitus. Broader than is the opposite of the narrower than relationship.
The two concepts have identical meaning.
The first concept is at a more detailed level than the second concept. For example, Pennicillin G is narrower than Pennicillin, and vellus hair is narrower than hair. Narrower than is the opposite of broader than.
* * * No description supplied * * * Open Issue: The specific meanings of these codes can vary somewhat by jurisdiction and implementation so caution should be used when determining equivalency.
Marriage contract has been declared null and to not have existed
Marriage contract has been declared dissolved and inactive
No marriage contract has ever been entered
Person declares that a domestic partner relationship exists.
Indicates that the receiver has messages for the sender OpenIssue: Description does not make sense relative to name of coding system. Must be reviewed and improved.
Definition: A person playing the role of program eligible under a program based on military status. Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the person's status as a member of the military meets jurisdictional or program criteria
Modified subscription to a query server.
A collection of codes specifying why a valid value is not present.
Description:The value is exceptional (missing, omitted, incomplete, improper). No information as to the reason for being an exceptional value is provided. This is the most general exceptional value. It is also the default exceptional value.
Description:The value as represented in the instance is not a member of the set of permitted data values in the constrained value domain of a variable.
Description:An actual value may exist, but it must be derived from the provided information (usually an EXPR generic data type extension will be used to convey the derivation expressionexpression .
Description:The actual value is not a member of the set of permitted data values in the constrained value domain of a variable. (e.g., concept not provided by required code system). Usage Notes: This flavor and its specializations are most commonly used with the CD datatype and its flavors. However, it may apply to *any* datatype where the constraints of the type are tighter than can be conveyed. For example, a PQ that is for a true measured amount whose units are not supported in UCUM, a need to convey a REAL when the type has been constrained to INT, etc. With coded datatypes, this null flavor may only be used if the vocabulary binding has a coding strength of CNE. By definition, all local codes and original text are part of the value set if the coding strength is CWE.
Description: The actual value has not yet been encoded within the approved value domain. Example: Original text or a local code has been specified but translation or encoding to the approved value set has not yet occurred due to limitations of the sending system. Original text has been captured for a PQ, but not attempt has been made to split the value and unit or to encode the unit in UCUM. Usage Notes: If it is known that it is not possible to encode the concept, OTH should be used instead. However, use of UNC does not necessarily guarantee the concept will be encodable, only that encoding has not been attempted. Data type properties such as original text and translations may be present when this null flavor is included.
There is information on this item available but it has not been provided by the sender due to security, privacy or other reasons. There may be an alternate mechanism for gaining access to this information. Note: using this null flavor does provide information that may be a breach of confidentiality, even though no detail data is provided. Its primary purpose is for those circumstances where it is necessary to inform the receiver that the information does exist without providing any detail.
Known to have no proper value (e.g., last menstrual period for a male).
Description:A proper value is applicable, but not known. Usage Notes: This means the actual value is not known. If the only thing that is unknown is how to properly express the value in the necessary constraints (value set, datatype, etc.), then the OTH or UNC flavor should be used. No properties should be included for a datatype with this property unless: Those properties themselves directly translate to a semantic of "unknown". (E.g. a local code sent as a translation that conveys 'unknown') Those properties further qualify the nature of what is unknown. (E.g. specifying a use code of "H" and a URL prefix of "tel:" to convey that it is the home phone number that is unknown.)
Information was sought but not found (e.g., patient was asked but didn't know)
Information is not available at this time but it is expected that it will be available later.
This information has not been sought (e.g., patient was not asked)
Information is not available at this time (with no expectation regarding whether it will or will not be available in the future).
Description:The specific quantity is not known, but is known to be non-zero and is not specified because it makes up the bulk of the material. e.g. 'Add 10mg of ingredient X, 50mg of ingredient Y, and sufficient quantity of water to 100mL.' The null flavor would be used to express the quantity of water.
The content is greater than zero, but too small to be quantified.
Value is not present in a message. This is only defined in messages, never in application data! All values not present in the message must be replaced by the applicable default, or no-information (NI) as the default of all defaults.
Conveys the mandated workflow action that an information custodian, receiver, or user must perform. Examples: encrypt Usage Note: Per OASIS XACML, an obligation is an operation specified in a policy or policy that is performed in conjunction with the enforcement of an access control decision.
v3 Code System ObservationInterpretation
One or more codes specifying a rough qualitative interpretation of the observation, such as "normal", "abnormal", "below normal", "change up", "resistant", "susceptible", etc. OpenIssue: Description copied from Concept Domain of same name. Must be verified. Note also that this might be identical to the V2 value set of interpretation codes (formerly Abnormal Flags in older versions).
One or more codes specifying a rough qualitative interpretation of the observation, such as "normal", "abnormal", "below normal", "change up", "resistant", "susceptible", etc. OpenIssue: Description copied from Concept Domain of same name. Must be verified. Note also that this might be identical to the V2 code system of interpretation codes (formerly Abnormal Flags in older versions).
Codes that specify interpretation of genetic analysis, such as "positive", "negative", "carrier", "responsive", etc.
The patient is considered as carrier based on the testing results. A carrier is an individual who carries an altered form of a gene which can lead to having a child or offspring in future generations with a genetic disorder.
The patient is considered as carrier based on the testing results. A carrier is an individual who carries an altered form of a gene which can lead to having a child or offspring in future generations with a genetic disorder. Deprecation Comment: This code is currently the same string as the print name for this concept and is inconsistent with the conventions being used for the other codes in the coding system, as it is a full word with initial capitalization, rather than an all upper case mnemonic. The recommendation from OO is to deprecate the code "Carrier" and to add "CAR" as the new active code representation for this concept.
Interpretations of change of quantity and/or severity. At most one of B or W and one of U or D allowed.
The current result or observation value has improved compared to the previous result or observation value (the change is significant as defined in the respective test procedure). [Note: This can be applied to quantitative or qualitative observations.]
The current result has decreased from the previous result for a quantitative observation (the change is significant as defined in the respective test procedure).
The current result has increased from the previous result for a quantitative observation (the change is significant as defined in the respective test procedure).
The current result or observation value has degraded compared to the previous result or observation value (the change is significant as defined in the respective test procedure). [Note: This can be applied to quantitative or qualitative observations.]
Technical exceptions resulting in the inability to provide an interpretation. At most one allowed. Does not imply normality or severity.
The result is below the minimum detection limit (the test procedure or equipment is the limiting factor). Synonyms: Below analytical limit, low off scale.
The result is above the maximum quantifiable limit (the test procedure or equipment is the limiting factor). Synonyms: Above analytical limit, high off scale.
A valid result cannot be obtained for the specified component / analyte due to the presence of anti-complementary substances in the sample.
There is insufficient evidence that the species in question is a good target for therapy with the drug. A categorical interpretation is not possible. [Note: A MIC with "IE" and/or a comment may be reported (without an accompanying S, I or R-categorization).]
A result cannot be considered valid for the specified component / analyte or organism due to failure in the quality control testing component.
A valid result cannot be obtained for the specified organism or cell line due to the presence of cytotoxic substances in the sample or culture.
Interpretation of normality or degree of abnormality (including critical or "alert" level). Concepts in this category are mutually exclusive, i.e., at most one is allowed.
The result or observation value is outside the reference range or expected norm (as defined for the respective test procedure). [Note: Typically applies to non-numeric results.]
The result or observation value is outside a reference range or expected norm at a level at which immediate action should be considered for patient safety (as defined for the respective test procedure). [Note: Typically applies to non-numeric results. Analogous to critical/panic limits for numeric results.]
The result for a quantitative observation is above a reference level at which immediate action should be considered for patient safety (as defined for the respective test procedure). Synonym: Above upper panic limits.
The result for a quantitative observation is below a reference level at which immediate action should be considered for patient safety (as defined for the respective test procedure). Synonym: Below lower panic limits.
The result for a quantitative observation is above the upper limit of the reference range (as defined for the respective test procedure). Synonym: Above high normal
A test result that is significantly higher than the reference (normal) or therapeutic interval, but has not reached the critically high value and might need special attention, as defined by the laboratory or the clinician.[Note: This level is situated between 'H' and 'HH'.] Deprecation Comment: The code 'H>' is being deprecated in order to align with the use of the code 'HU' for "Very high" in V2 Table 0078 "Interpretation Codes". [Note: The use of code 'H>' is non-preferred, as this code is deprecated and on track to be retired; use code 'HU' instead.
A test result that is significantly higher than the reference (normal) or therapeutic interval, but has not reached the critically high value and might need special attention, as defined by the laboratory or the clinician.
The result for a quantitative observation is below the lower limit of the reference range (as defined for the respective test procedure). Synonym: Below low normal
A test result that is significantly lower than the reference (normal) or therapeutic interval, but has not reached the critically low value and might need special attention, as defined by the laboratory or the clinician.[Note: This level is situated between 'L' and 'LL'.] Deprecation Comment: The code 'L<' is being deprecated in order to align with the use of the code 'LU' for "Very low" in V2 Table 0078 "Interpretation Codes". [Note: The use of code 'L<' is non-preferred, as this code is deprecated and on track to be retired; use code 'LU' instead.
A test result that is significantly lower than the reference (normal) or therapeutic interval, but has not reached the critically low value and might need special attention, as defined by the laboratory or the clinician.
The result or observation value is within the reference range or expected norm (as defined for the respective test procedure). [Note: Applies to numeric or non-numeric results.]
Interpretations of anti-microbial susceptibility testing results (microbiology). At most one allowed.
Bacterial strain inhibited in vitro by a concentration of an antimicrobial agent that is associated with uncertain therapeutic effect. Reference: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmonized_Terminolo.htm) Projects: ISO 20776-1, ISO 20776-2 [Note 1: Bacterial strains are categorized as intermediate by applying the appropriate breakpoints in a defined phenotypic test system.] [Note 2: This class of susceptibility implies that an infection due to the isolate can be appropriately treated in body sites where the drugs are physiologically concentrated or when a high dosage of drug can be used.] [Note 3: This class also indicates a "buffer zone," to prevent small, uncontrolled, technical factors from causing major discrepancies in interpretations.] [Note 4: These breakpoints can be altered due to changes in circumstances (e.g., changes in commonly used drug dosages, emergence of new resistance mechanisms).]
The patient is considered as carrier based on the testing results. A carrier is an individual who carries an altered form of a gene which can lead to having a child or offspring in future generations with a genetic disorder. Deprecation Comment: This antimicrobial susceptibility test interpretation concept is recommended by OO to be deprecated as it is no longer recommended for use in susceptibility testing by CLSI (reference CLSI document M100-S22; Vol. 32 No.3; CLSI Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Second Informational Supplement. Jan 2012).
A category used for isolates for which only a susceptible interpretive criterion has been designated because of the absence or rare occurrence of resistant strains. Isolates that have MICs above or zone diameters below the value indicated for the susceptible breakpoint should be reported as non-susceptible. NOTE 1: An isolate that is interpreted as non-susceptible does not necessarily mean that the isolate has a resistance mechanism. It is possible that isolates with MICs above the susceptible breakpoint that lack resistance mechanisms may be encountered within the wild-type distribution subsequent to the time the susceptible-only breakpoint is set. NOTE 2: For strains yielding results in the "nonsusceptible" category, organism identification and antimicrobial susceptibility test results should be confirmed. Synonym: decreased susceptibility.
Bacterial strain inhibited in vitro by a concentration of an antimicrobial agent that is associated with a high likelihood of therapeutic failure. Reference: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmonized_Terminolo.htm) Projects: ISO 20776-1, ISO 20776-2 [Note 1: Bacterial strains are categorized as resistant by applying the appropriate breakpoints in a defined phenotypic test system.] [Note 2: This breakpoint can be altered due to changes in circumstances (e.g., changes in commonly used drug dosages, emergence of new resistance mechanisms).]
A category for isolates where the bacteria (e.g. enterococci) are not susceptible in vitro to a combination therapy (e.g., high-level aminoglycoside and cell wall active agent). This is predictive that this combination therapy will not be effective. Usage Note: Since the use of penicillin or ampicillin alone often results in treatment failure of serious enterococcal or other bacterial infections, combination therapy is usually indicated to enhance bactericidal activity. The synergy between a cell wall active agent (such as penicillin, ampicillin, or vancomycin) and an aminoglycoside (such as gentamicin, kanamycin or streptomycin) is best predicted by screening for high-level bacterial resistance to the aminoglycoside. Open Issue: The print name of the code is very general and the description is very specific to a pair of classes of agents, which may lead to confusion of these concepts in the future should other synergies be found.
Bacterial strain inhibited by in vitro concentration of an antimicrobial agent that is associated with a high likelihood of therapeutic success. Reference: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmonized_Terminolo.htm) Synonym (earlier term): Sensitive Projects: ISO 20776-1, ISO 20776-2 [Note 1: Bacterial strains are categorized as susceptible by applying the appropriate breakpoints in a defined phenotypic system.] [Note 2: This breakpoint can be altered due to changes in circumstances (e.g., changes in commonly used drug dosages, emergence of new resistance mechanisms).]
A category that includes isolates with antimicrobial agent minimum inhibitory concentrations (MICs) that approach usually attainable blood and tissue levels and for which response rates may be lower than for susceptible isolates. Reference: CLSI document M44-A2 2009 "Method for antifungal disk diffusion susceptibility testing of yeasts; approved guideline - second edition" - page 2.
A category for isolates where the bacteria (e.g. enterococci) are susceptible in vitro to a combination therapy (e.g., high-level aminoglycoside and cell wall active agent). This is predictive that this combination therapy will be effective. Usage Note: Since the use of penicillin or ampicillin alone often results in treatment failure of serious enterococcal or other bacterial infections, combination therapy is usually indicated to enhance bactericidal activity. The synergy between a cell wall active agent (such as penicillin, ampicillin, or vancomycin) and an aminoglycoside (such as gentamicin, kanamycin or streptomycin) is best predicted by screening for high-level bacterial resistance to the aminoglycoside. Open Issue: The print name of the code is very general and the description is very specific to a pair of classes of agents, which may lead to confusion of these concepts in the future should other synergies be found.
The observation/test result is interpreted as being outside the inclusion range for a particular protocol within which the result is being reported. Example: A positive result on a Hepatitis screening test. Open Issue: EX, HX, LX: These three concepts do not seem to meet a clear need in the vocabulary, and their use in observation interpretation appears likely to be covered by other existing concepts (e.g., A, H, L). The only apparent significant difference is their reference to use in protocols for exclusion of study subjects. These concepts/codes were proposed by RCRIM for use in the CTLaboratory message. They were submitted and approved in the November 2005 Harmonization cycle in proposal "030103C_VOCAB_RCRIM_l_quade_RCRIM Obs Interp_20051028154455". However, this proposal was not fully implemented in the vocabulary. The proposal recommended creation of the x_ClinicalResearchExclusion domain in ObservationInterpretation with a value set including those three concepts/codes, but there is no subdomain of that name or equivalent with a binding to either of the value sets that contain these concepts/codes. Members of the OO WG have recently attempted to contact members of RCRIM regarding these concepts, both by email and at the recent WGM in Atlanta, without response. It is felt by OO that the best course of action to take at this time is to add this comprehensive Open Issue rather than deprecate these three concepts at this time, until further discussion is held.
The numeric observation/test result is interpreted as being below the low threshold value for a particular protocol within which the result is being reported. Example: A Total White Blood Cell Count falling below a protocol-defined threshold value of 3000/mm^3 Open Issue: EX, HX, LX: These three concepts do not seem to meet a clear need in the vocabulary, and their use in observation interpretation appears likely to be covered by other existing concepts (e.g., A, H, L). The only apparent significant difference is their reference to use in protocols for exclusion of study subjects. These concepts/codes were proposed by RCRIM for use in the CTLaboratory message. They were submitted and approved in the November 2005 Harmonization cycle in proposal "030103C_VOCAB_RCRIM_l_quade_RCRIM Obs Interp_20051028154455". However, this proposal was not fully implemented in the vocabulary. The proposal recommended creation of the x_ClinicalResearchExclusion domain in ObservationInterpretation with a value set including those three concepts/codes, but there is no subdomain of that name or equivalent with a binding to either of the value sets that contain these concepts/codes. Members of the OO WG have recently attempted to contact members of RCRIM regarding these concepts, both by email and at the recent WGM in Atlanta, without response. It is felt by OO that the best course of action to take at this time is to add this comprehensive Open Issue rather than deprecate these three concepts at this time, until further discussion is held.
Interpretations of the presence or absence of a component / analyte or organism in a test or of a sign in a clinical observation. In keeping with laboratory data processing practice, these concepts provide a categorical interpretation of the "meaning" of the quantitative value for the same observation.
The specified component / analyte, organism or clinical sign could neither be declared positive / negative nor detected / not detected by the performed test or procedure. Usage Note: For example, if the specimen was degraded, poorly processed, or was missing the required anatomic structures, then "indeterminate" (i.e. "cannot be determined") is the appropriate response, not "equivocal".
The test or procedure was successfully performed, but the results are borderline and can neither be declared positive / negative nor detected / not detected according to the current established criteria.
An absence finding of the specified component / analyte, organism or clinical sign based on the established threshold of the performed test or procedure. [Note: Negative does not necessarily imply the complete absence of the specified item.]
The presence of the specified component / analyte, organism or clinical sign could not be determined within the limit of detection of the performed test or procedure.
A presence finding of the specified component / analyte, organism or clinical sign based on the established threshold of the performed test or procedure.
The measurement of the specified component / analyte, organism or clinical sign above the limit of detection of the performed test or procedure.
Interpretation of the observed result taking into account additional information (contraindicators) about the patient's situation. Concepts in this category are mutually exclusive, i.e., at most one is allowed.
This result has been evaluated in light of known contraindicators. Once those contraindicators have been taken into account the result is determined to be "Expected" (e.g., presence of drugs in a patient that is taking prescription medication for pain management).
This result has been evaluated in light of known contraindicators. Once those contraindicators have been taken into account the result is determined to be "Unexpected" (e.g., presence of non-prescribed drugs in a patient that is taking prescription medication for pain management).
Interpretations of the presence and level of reactivity of the specified component / analyte with the reagent in the performed laboratory test.
An absence finding used to indicate that the specified component / analyte did not react measurably with the reagent.
A presence finding used to indicate that the specified component / analyte reacted with the reagent above the reliably measurable limit of the performed test.
A weighted presence finding used to indicate that the specified component / analyte reacted with the reagent, but below the reliably measurable limit of the performed test.
A code that provides additional detail about the means or technique used to ascertain the observation. Examples: Blood pressure measurement method: arterial puncture vs. sphygmomanometer (Riva-Rocci), sitting vs. supine position, etc. OpenIssue: Description copied from Concept Domain of same name. Must be verified. Note that the Domain has a full discussion about use of the attribute and constraining that is not appropriate for the value set description. Needs to be improved.
A code that provides additional detail about the means or technique used to ascertain the observation. Examples: Blood pressure measurement method: arterial puncture vs. sphygmomanometer (Riva-Rocci), sitting vs. supine position, etc. OpenIssue: Description copied from Concept Domain of same name. Must be verified. Note that the Domain has a full discussion about use of the attribute and constraining that is not appropriate for the code system description. Needs to be improved.
Provides codes for decision methods, initially for assessing the causality of events.
Reaching a decision through the application of an algorithm designed to weigh the different factors involved.
Reaching a decision through the use of Bayesian statistical analysis.
Reaching a decision by consideration of the totality of factors involved in order to reach a judgement.
A code that provides additional detail about the means or technique used to ascertain the genetic analysis. Example, PCR, Micro Array
Provides additional detail about the aggregation methods used to compute the aggregated values for an observation. This is an abstract code.
Average of non-null values in the referenced set of values
Count of non-null values in the referenced set of values
Largest of all non-null values in the referenced set of values.
The median of all non-null values in the referenced set of values.
Smallest of all non-null values in the referenced set of values.
The most common value of all non-null values in the referenced set of values.
Standard Deviation of the values in the referenced set of values, computed over the population.
Standard Deviation of the values in the referenced set of values, computed over a sample of the population.
Sum of non-null values in the referenced set of values
Variance of the values in the referenced set of values, computed over the population.
Variance of the values in the referenced set of values, computed over a sample of the population.
Verification by means of document. Example: Fax, letter, attachment to e-mail.
verification by means of a response to an electronic query Example: query message to a Covered Party registry application or Coverage Administrator.
Verification by means of electronic token. Example: smartcard, magnetic swipe card, RFID device.
Verification by means of voice. Example: By speaking with or calling the Coverage Administrator or Covered Party
Susceptibility, High Level Aminoglycoside Resistance agar test
Agglutination, Hemagglutination inhibition
Bioassay, Mouse intercerebral inoculation
Differential light absorption chemical test
Chemical, Dipstick colorimetric laboratory test
Coagulation, Tilt tube reptilase induced
Culture, Quantitative microbial, droplet
Quantitative microbial culture, filter paper
Culture, Quantitative microbial, filter paper
Quantitative microbial culture, pad culture
Quantitative microbial culture, pour plate
Culture, Quantitative microbial, pour plate
Quantitative microbial culture, surface streak
Culture, Quantitative microbial, surface streak
Identification, Phage susceptibility typing
Immune stain, Immunofluorescent antibody, direct
Immune stain, Immunofluorescent antibody, indirect
Immune stain, Immunoperoxidase, Avidin-Biotin Complex
Immunoperoxidase, Peroxidase anti-peroxidase complex
Immune stain, Immunoperoxidase, Peroxidase anti-peroxidase complex
Immunoperoxidase, Protein A-peroxidase complex
Immune stain, Immunoperoxidase, Protein A-peroxidase complex
Immunoassay, semi-quantitative, multiple step
Immunoassay, semi-quantitative, single step
Microscopy, Electron microscopy tomography
Microscopy, Electron, thick section transmission
Microscopy, Electron, thin section transmission
Microscopy, Transparent tape direct examination
Molecular, 3 Self-Sustaining Sequence Replication
Molecular, Hybridization Protection Assay
Molecular, Ligation Activated Transcription
Molecular, Nucleic acid probe with amplification Rationale: Duplicate of code 0126. Use code 0126 instead.
Nucleic acid probe with target amplification
Molecular, Nucleic acid probe with target amplification
Molecular, Nucleic acid reverse transcription
Molecular, Nucleic Acid Sequence Based Analysis
Q-Beta Replicase or probe amplification category method
Molecular, Q-Beta Replicase or probe amplification category method
Restriction Fragment Length Polymorphism
Molecular, Restriction Fragment Length Polymorphism
Molecular, Strand Displacement Amplification
Molecular, Transcription Mediated Amplification
Acid fast stain, Kinyoun's cold carbolfuchsin
Stain, Acid fast, Kinyoun's cold carbolfuchsin
Alcian blue with Periodic acid Schiff stain
Stain, Alcian blue with Periodic acid Schiff
Harris regressive hematoxylin and eosin stain
Stain, Harris regressive hematoxylin and eosin
Luxol fast blue with cresyl violet stain
Stain, Luxol fast blue with cresyl violet
Luxol fast blue with Periodic acid-Schiff stain
Stain, Luxol fast blue with Periodic acid-Schiff
Mayers progressive hematoxylin and eosin stain
Stain, Mayers progressive hematoxylin and eosin
Stain, Modified Gomori-Wheatly trichrome
Minimum bactericidal concentration test, macrodilution
Susceptibility, Minimum bactericidal concentration, macrodilution
Minimum bactericidal concentration test, microdilution
Susceptibility, Minimum bactericidal concentration, microdilution
Immunoassay, enzyme-multiplied technique (EMIT)
Fluorescence polarization immunoassay (FPIA)
Anti-complement immunofluorescence (ACIF)
Atomic absorption spectrophotometry (AAS)
Electrochemical, Ion Selective Electrode
Inductively-Coupled Plasma/Mass Spectrometry
Coagulation, Photo Optical Clot Detection
Test methods designed to determine a microorganismaTMs susceptibility to being killed by an antibiotic.
Susceptibility, Antibiotic sensitivity, disk
Susceptibility, BACTEC susceptibility test
Testing to measure the minimum concentration of the antibacterial agent in a given culture medium below which bacterial growth is not inhibited.
Minimum Inhibitory Concentration, macrodilution
Susceptibility, Minimum Inhibitory concentration, macrodilution
Minimum Inhibitory Concentration, microdilution
Susceptibility, Minimum Inhibitory concentration, microdilution
This domain is the root domain to which all HL7-recognized value sets for the Observation.value attribute will be linked when Observation.value has a coded data type. OpenIssue: Description copied from Concept Domain of same name. Must be corrected..
This domain is the root domain to which all HL7-recognized code systems for the Observation.value attribute will be linked when Observation.value has a coded data type. OpenIssue: Description copied from Concept Domain of same name. Must be corrected..
Codes specify the category of observation, evidence, or document used to assess for services, e.g., discharge planning, or to establish eligibility for coverage under a policy or program. The type of evidence is coded as observation values.
Code specifying financial indicators used to assess or establish eligibility for coverage under a policy or program; e.g., pay stub; tax or income document; asset document; living expenses.
Codes specifying asset indicators used to assess or establish eligibility for coverage under a policy or program.
Indicator of annuity ownership or status as beneficiary.
Indicator of real property ownership, e.g., deed or real estate contract.
Indicator of retirement investment account ownership.
Indicator of status as trust beneficiary.
Code specifying income indicators used to assess or establish eligibility for coverage under a policy or program; e.g., pay or pension check, child support payments received or provided, and taxes paid.
Indicator of child support payments received or provided.
Indicator of disability income replacement payment.
Indicator of investment income, e.g., dividend check, annuity payment; real estate rent, investment divestiture proceeds; trust or endowment check.
Indicator of paid employment, e.g., letter of hire, contract, employer letter; copy of pay check or pay stub.
Indicator of retirement payment, e.g., pension check.
Indicator of spousal or partner support payments received or provided; e.g., alimony payment; support stipulations in a divorce settlement.
Indicator of income supplement, e.g., gifting, parental income support; stipend, or grant.
Indicator of tax obligation or payment, e.g., statement of taxable income.
Codes specifying living expense indicators used to assess or establish eligibility for coverage under a policy or program.
Indicator of health expenses; including medication costs, health service costs, financial participations, and health coverage premiums.
Indicator of housing expense, e.g., household appliances, fixtures, furnishings, and maintenance and repairs.
Indicator of mortgage amount, interest, and payments.
Indicator of transportation expenses, e.g., vehicle payments, vehicle insurance, vehicle fuel, and vehicle maintenance and repairs.
Code specifying eligibility indicators used to assess or establish eligibility for coverage under a policy or program eligibility status, e.g., certificates of creditable coverage; student enrollment; adoption, marriage or birth certificate.
Indicator of status as covered member under a policy or program, e.g., member id card or coverage document.
Code specifying non-clinical indicators related to health status used to assess or establish eligibility for coverage under a policy or program, e.g., pregnancy, disability, drug use, mental health issues.
Code specifying observations related to living dependency, such as dependent upon spouse for activities of daily living.
Continued living in private residence requires functional and health care assistance from one or more relatives.
Continued living in private residence requires functional and health care assistance from spouse or life partner.
Continued living in private residence requires functional and health care assistance from one or more unrelated persons.
Code specifying observations related to living situation for a person in a private residence.
Living alone. Maps to PD1-2 Living arrangement (IS) 00742 [A]
Living with one or more dependent children requiring moderate supervision.
Living with disabled spouse requiring functional and health care assistance
Living with one or more dependent children requiring intensive supervision
Living with family. Maps to PD1-2 Living arrangement (IS) 00742 [F]
Living with one or more relatives. Maps to PD1-2 Living arrangement (IS) 00742 [R]
Living only with spouse or life partner. Maps to PD1-2 Living arrangement (IS) 00742 [S]
Living with one or more unrelated persons.
Code specifying observations or indicators related to socio-economic status used to assess to assess for services, e.g., discharge planning, or to establish eligibility for coverage under a policy or program.
Indication of status as illegal immigrant.
Indicates the result of a particular allergy test. E.g. Negative, Mild, Moderate, Severe
Description:Patient exhibits no reaction to the challenge agent.
Description:Patient exhibits a minimal reaction to the challenge agent.
Description:Patient exhibits a mild reaction to the challenge agent.
Description:Patient exhibits moderate reaction to the challenge agent.
Description:Patient exhibits a severe reaction to the challenge agent.
Description:Coded observation values for coverage limitations, for e.g., types of claims or types of parties covered under a policy or program.
Description:Coded observation values for types of covered parties under a policy or program based on their personal relationships or employment status.
Description:Child over an age as specified by coverage policy or program, e.g., student, differently abled, and income dependent.
Description:Dependent biological, adopted, foster child as specified by coverage policy or program.
Description:Person requiring functional and/or financial assistance from another person as specified by coverage policy or program.
Description:Persons registered as a family unit in a domestic partner registry as specified by law and by coverage policy or program.
Description:An individual employed by an employer who receive remuneration in wages, salary, commission, tips, piece-rates, or pay-in-kind through the employeraTMs payment system (i.e., not a contractor) as specified by coverage policy or program.
Description:As specified by coverage policy or program.
Description:Person as specified by coverage policy or program.
Description:A pair of people of the same gender who live together as a family as specified by coverage policy or program, e.g., Naomi and Ruth from the Book of Ruth; Socrates and Alcibiades
Worst case result of a future exposure is assessed to be life-threatening or having high potential for organ system failure.
Worst case result of a future exposure is not assessed to be life-threatening or having high potential for organ system failure.
Unable to assess the worst case result of a future exposure.
Description: The domain contains genetic analysis specific observation values, e.g. Homozygote, Heterozygote, etc.
Description: An individual having different alleles at one or more loci regarding a specific character
Observation values used to indicate the type of scoring (e.g. proportion, ratio) used by a health quality measure.
A measure in which either short-term cross-section or long-term longitudinal analysis is performed over a group of subjects defined by a set of common properties or defining characteristics (e.g., Male smokers between the ages of 40 and 50 years, exposure to treatment, exposure duration).
A measure score in which each individual value for the measure can fall anywhere along a continuous scale (e.g., mean time to thrombolytics which aggregates the time in minutes from a case presenting with chest pain to the time of administration of thrombolytics).
A score derived by dividing the number of cases that meet a criterion for quality (the numerator) by the number of eligible cases within a given time frame (the denominator) where the numerator cases are a subset of the denominator cases (e.g., percentage of eligible women with a mammogram performed in the last year).
A score that may have a value of zero or greater that is derived by dividing a count of one type of data by a count of another type of data (e.g., the number of patients with central lines who develop infection divided by the number of central line days).
Observation values used to indicate what kind of health quality measure is used.
A measure that is composed from one or more other measures and indicates an overall summary of those measures.
A measure related to the efficiency of medical treatment.
A measure related to the level of patient engagement or patient experience of care.
A measure that indicates the result of the performance (or non-performance) of a function or process.
A measure which focuses on a process which leads to a certain outcome, meaning that a scientific basis exists for believing that the process, when executed well, will increase the probability of achieving a desired outcome.
A measure related to the extent of use of clinical resources or cost of care.
A measure related to the structure of patient care.
Observation values used to assert various populations that a subject falls into.
Patients who should be removed from the eMeasure population and denominator before determining if numerator criteria are met. Denominator exclusions are used in proportion and ratio measures to help narrow the denominator.
Denominator exceptions are those conditions that should remove a patient, procedure or unit of measurement from the denominator only if the numerator criteria are not met. Denominator exceptions allow for adjustment of the calculated score for those providers with higher risk populations. Denominator exceptions are used only in proportion eMeasures. They are not appropriate for ratio or continuous variable eMeasures. Denominator exceptions allow for the exercise of clinical judgment and should be specifically defined where capturing the information in a structured manner fits the clinical workflow. Generic denominator exception reasons used in proportion eMeasures fall into three general categories: Medical reasons Patient reasons System reasons
It can be the same as the initial patient population or a subset of the initial patient population to further constrain the population for the purpose of the eMeasure. Different measures within an eMeasure set may have different Denominators. Continuous Variable eMeasures do not have a Denominator, but instead define a Measure Population.
The initial population refers to all entities to be evaluated by a specific quality measure who share a common set of specified characteristics within a specific measurement set to which a given measure belongs.
The initial patient population refers to all patients to be evaluated by a specific quality measure who share a common set of specified characteristics within a specific measurement set to which a given measure belongs. Details often include information based upon specific age groups, diagnoses, diagnostic and procedure codes, and enrollment periods.
Measure population is used only in continuous variable eMeasures. It is a narrative description of the eMeasure population. (e.g., all patients seen in the Emergency Department during the measurement period).
Numerators are used in proportion and ratio eMeasures. In proportion measures the numerator criteria are the processes or outcomes expected for each patient, procedure, or other unit of measurement defined in the denominator. In ratio measures the numerator is related, but not directly derived from the denominator (e.g., a numerator listing the number of central line blood stream infections and a denominator indicating the days per thousand of central line usage in a specific time period).
Numerator Exclusions are used only in ratio eMeasures to define instances that should not be included in the numerator data. (e.g., if the number of central line blood stream infections per 1000 catheter days were to exclude infections with a specific bacterium, that bacterium would be listed as a numerator exclusion.)
Value for Act.partialCompletionCode attribute that implies 81-99% completion
Value for Act.partialCompletionCode attribute that implies 61-80% completion
Value for Act.partialCompletionCode attribute that implies 41-60% completion
Value for Act.partialCompletionCode attribute that implies 1-20% completion
Value for Act.partialCompletionCode attribute that implies 0% completion
Value for Act.partialCompletionCode attribute that implies 21-40% completion
Observation values used to indicate security observation metadata.
Abstract security observation values used to indicate security integrity metadata. Examples: Codes conveying integrity status, integrity confidence, and provenance.
Abstract security metadata observation values used to indicate mechanism used for authorized alteration of an IT resource (data, information object, service, or system capability)
Security metadata observation values used to indicate the use of a more abstract version of the content, e.g., replacing exact value of an age or date field with a range, or remove the left digits of a credit card number or SSN.
Security metadata observation values used to indicate the use of an algorithmic combination of actual values with the result of an aggregate function, e.g., average, sum, or count in order to limit disclosure of an IT resource (data, information object, service, or system capability) to the minimum necessary.
Security metadata observation value conveying the alteration integrity of an IT resource (data, information object, service, or system capability) by used to indicate the mechanism by which software systems can strip portions of the resource that could allow the identification of the source of the information or the information subject. No key to relink the data is retained.
Security metadata observation value used to indicate that the IT resource semantic content has been transformed from one encoding to another. Usage Note: "MAP" code does not indicate the semantic fidelity of the transformed content. To indicate semantic fidelity for maps of HL7 to other code systems, this security alteration integrity observation may be further specified using an Act valued with Value Set: MapRelationship (2.16.840.1.113883.1.11.11052). Semantic fidelity of the mapped IT Resource may also be indicated using a SecurityIntegrityConfidenceObservation.
Security metadata observation value conveying the alteration integrity of an IT resource (data, information object, service, or system capability) by indicating the mechanism by which software systems can make data unintelligible (that is, as unreadable and unusable by algorithmically transforming plaintext into ciphertext) such that it can only be accessed or used by authorized users. An authorized user may be provided a key to decrypt per license or "shared secret". Usage Note: "MASKED" may be used, per applicable policy, as a flag to indicate to a user or receiver that some portion of an IT resource has been further encrypted, and may be accessed only by an authorized user or receiver to which a decryption key is provided.
Security metadata observation value conveying the alteration integrity of an IT resource (data, information object, service, or system capability), by indicating the mechanism by which software systems can strip portions of the resource that could allow the identification of the source of the information or the information subject. Custodian may retain a key to relink data necessary to reidentify the information subject. Rationale: Personal data which has been processed to make it impossible to know whose data it is. Used particularly for secondary use of health data. In some cases, it may be possible for authorized individuals to restore the identity of the individual, e.g.,for public health case management. Based on ISO/TS 25237:2008 Health informatics—Pseudonymization
Security metadata observation value used to indicate the mechanism by which software systems can filter an IT resource (data, information object, service, or system capability) to remove any portion of the resource that is not authorized to be access, used, or disclosed. Usage Note: "REDACTED" may be used, per applicable policy, as a flag to indicate to a user or receiver that some portion of an IT resource has filtered and not included in the content accessed or received.
Metadata observation used to indicate that some information has been removed from the source object when the view this object contains was constructed because of configuration options when the view was created. The content may not be suitable for use as the basis of a record update Usage Note: This is not suitable to be used when information is removed for security reasons - see the code REDACTED for this use.
Security metadata observation value used to indicate that the IT resource syntax has been transformed from one syntactical representation to another. Usage Note: "SYNTAC" code does not indicate the syntactical correctness of the syntactically transformed IT resource.
Security metadata observation value used to indicate that the IT resource has been translated from one human language to another. Usage Note: "TRSLT" does not indicate the fidelity of the translation or the languages translated. The fidelity of the IT Resource translation may be indicated using a SecurityIntegrityConfidenceObservation. To indicate languages, use the Value Set:HumanLanguage (2.16.840.1.113883.1.11.11526)
Security metadata observation value conveying the alteration integrity of an IT resource (data, information object, service, or system capability) which indicates that the resource only retains versions of an IT resource for access and use per applicable policy Usage Note: When this code is used, expectation is that the system has removed historical versions of the data that falls outside the time period deemed to be the effective time of the applicable version.
Abstract security observation values used to indicate data integrity metadata. Examples: Codes conveying the mechanism used to preserve the accuracy and consistency of an IT resource such as a digital signature and a cryptographic hash function.
Security metadata observation value used to indicate the mechanism by which software systems can establish that data was not modified in transit. Rationale: This definition is intended to align with the ISO 22600-2 3.3.19 definition of cryptographic checkvalue: Information which is derived by performing a cryptographic transformation (see cryptography) on the data unit. The derivation of the checkvalue may be performed in one or more steps and is a result of a mathematical function of the key and a data unit. It is usually used to check the integrity of a data unit. Examples: SHA-1 SHA-2 (Secure Hash Algorithm)
Security metadata observation value used to indicate the mechanism by which software systems use digital signature to establish that data has not been modified. Rationale: This definition is intended to align with the ISO 22600-2 3.3.26 definition of digital signature: Data appended to, or a cryptographic transformation (see cryptography) of, a data unit that allows a recipient of the data unit to prove the source and integrity of the data unit and protect against forgery e.g., by the recipient.
Abstract security observation value used to indicate integrity confidence metadata. Examples: Codes conveying the level of reliability and trustworthiness of an IT resource.
Security metadata observation value used to indicate that the veracity or trustworthiness of an IT resource (data, information object, service, or system capability) for a specified purpose of use is perceived to be or deemed by policy to be very high.
Security metadata observation value used to indicate that the veracity or trustworthiness of an IT resource (data, information object, service, or system capability) for a specified purpose of use is perceived to be or deemed by policy to be adequate.
Security metadata observation value used to indicate that the veracity or trustworthiness of an IT resource (data, information object, service, or system capability) for a specified purpose of use is perceived to be or deemed by policy to be uncertain.
Security metadata observation value used to indicate that the veracity or trustworthiness of an IT resource (data, information object, service, or system capability) for a specified purpose of use is perceived to be or deemed by policy to be inadequate.
Abstract security metadata observation value used to indicate the provenance of an IT resource (data, information object, service, or system capability). Examples: Codes conveying the provenance metadata about the entity reporting an IT resource.
Abstract security provenance metadata observation value used to indicate the entity that asserted an IT resource (data, information object, service, or system capability). Examples: Codes conveying the provenance metadata about the entity asserting the resource.
Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a clinician.
Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a device.
Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a healthcare professional.
Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a patient acquaintance.
Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a patient.
Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a payer.
Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a professional.
Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a substitute decision maker.
Abstract security provenance metadata observation value used to indicate the entity that reported the resource (data, information object, service, or system capability). Examples: Codes conveying the provenance metadata about the entity reporting an IT resource.
Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a clinician.
Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a device.
Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a healthcare professional.
Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a patient acquaintance.
Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a patient.
Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a payer.
Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a professional.
Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a substitute decision maker.
Observation value used to indicate aspects of trust applicable to an IT resource (data, information object, service, or system capability).
Values for security trust accreditation metadata observation made about the formal declaration by an authority or neutral third party that validates the technical, security, trust, and business practice conformance of Trust Agents to facilitate security, interoperability, and trust among participants within a security domain or trust framework.
Values for security trust agreement metadata observation made about privacy and security requirements with which a security domain must comply. [ISO IEC 10181-1] [ISO IEC 10181-1]
Values for security trust certificate metadata observation made about a set of security-relevant data issued by a security authority or trusted third party, together with security information which is used to provide the integrity and data origin authentication services for an IT resource (data, information object, service, or system capability). [Based on ISO IEC 10181-1] For example, a Certificate Policy (CP), which is a named set of rules that indicates the applicability of a certificate to a particular community and/or class of application with common security requirements. A particular Certificate Policy might indicate the applicability of a type of certificate to the authentication of electronic data interchange transactions for the trading of goods within a given price range. Another example is Cross Certification with Federal Bridge.
Values for security trust assurance metadata observation made about the digital quality or reliability of a trust assertion, activity, capability, information exchange, mechanism, process, or protocol.
The value assigned as the indicator of the digital quality or reliability of the verification and validation process used to verify the claimed identity of an entity by securely associating an identifier and its authenticator. [Based on ISO 7498-2] For example, the degree of confidence in the vetting process used to establish the identity of the individual to whom the credential was issued, and 2) the degree of confidence that the individual who uses the credential is the individual to whom the credential was issued. [OMB M-04-04 E-Authentication Guidance for Federal Agencies]
Indicator of low digital quality or reliability of the digital reliability of the verification and validation process used to verify the claimed identity of an entity by securely associating an identifier and its authenticator. [Based on ISO 7498-2] The degree of confidence in the vetting process used to establish the identity of the individual to whom the credential was issued, and 2) the degree of confidence that the individual who uses the credential is the individual to whom the credential was issued. [OMB M-04-04 E-Authentication Guidance for Federal Agencies] Low authentication level of assurance indicates that the relying party may have little or no confidence in the asserted identity's validity. Level 1 requires little or no confidence in the asserted identity. No identity proofing is required at this level, but the authentication mechanism should provide some assurance that the same claimant is accessing the protected transaction or data. A wide range of available authentication technologies can be employed and any of the token methods of Levels 2, 3, or 4, including Personal Identification Numbers (PINs), may be used. To be authenticated, the claimant must prove control of the token through a secure authentication protocol. At Level 1, long-term shared authentication secrets may be revealed to verifiers. Assertions issued about claimants as a result of a successful authentication are either cryptographically authenticated by relying parties (using approved methods) or are obtained directly from a trusted party via a secure authentication protocol. [Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.]
Indicator of basic digital quality or reliability of the digital reliability of the verification and validation process used to verify the claimed identity of an entity by securely associating an identifier and its authenticator. [Based on ISO 7498-2] The degree of confidence in the vetting process used to establish the identity of the individual to whom the credential was issued, and 2) the degree of confidence that the individual who uses the credential is the individual to whom the credential was issued. [OMB M-04-04 E-Authentication Guidance for Federal Agencies] Basic authentication level of assurance indicates that the relying party may have some confidence in the asserted identity's validity. Level 2 requires confidence that the asserted identity is accurate. Level 2 provides for single-factor remote network authentication, including identity-proofing requirements for presentation of identifying materials or information. A wide range of available authentication technologies can be employed, including any of the token methods of Levels 3 or 4, as well as passwords. Successful authentication requires that the claimant prove through a secure authentication protocol that the claimant controls the token. Eavesdropper, replay, and online guessing attacks are prevented. Long-term shared authentication secrets, if used, are never revealed to any party except the claimant and verifiers operated by the CSP; however, session (temporary) shared secrets may be provided to independent verifiers by the CSP. Approved cryptographic techniques are required. Assertions issued about claimants as a result of a successful authentication are either cryptographically authenticated by relying parties (using approved methods) or are obtained directly from a trusted party via a secure authentication protocol. [Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.]
medium authentication level of assurance
Indicator of medium digital quality or reliability of the digital reliability of verification and validation of the process used to verify the claimed identity of an entity by securely associating an identifier and its authenticator. [Based on ISO 7498-2] The degree of confidence in the vetting process used to establish the identity of the individual to whom the credential was issued, and 2) the degree of confidence that the individual who uses the credential is the individual to whom the credential was issued. [OMB M-04-04 E-Authentication Guidance for Federal Agencies] Medium authentication level of assurance indicates that the relying party may have high confidence in the asserted identity's validity. Level 3 is appropriate for transactions that need high confidence in the accuracy of the asserted identity. Level 3 provides multifactor remote network authentication. At this level, identity-proofing procedures require verification of identifying materials and information. Authentication is based on proof of possession of a key or password through a cryptographic protocol. Cryptographic strength mechanisms should protect the primary authentication token (a cryptographic key) against compromise by the protocol threats, including eavesdropper, replay, online guessing, verifier impersonation, and man-in-the-middle attacks. A minimum of two authentication factors is required. Three kinds of tokens may be used: "soft" cryptographic token, which has the key stored on a general-purpose computer, "hard" cryptographic token, which has the key stored on a special hardware device, and "one-time password" device token, which has symmetric key stored on a personal hardware device that is a cryptographic module validated at FIPS 140-2 Level 1 or higher. Validation testing of cryptographic modules and algorithms for conformance to Federal Information Processing Standard (FIPS) 140-2, Security Requirements for Cryptographic Modules, is managed by NIST. Authentication requires that the claimant prove control of the token through a secure authentication protocol. The token must be unlocked with a password or biometric representation, or a password must be used in a secure authentication protocol, to establish two-factor authentication. Long-term shared authentication secrets, if used, are never revealed to any party except the claimant and verifiers operated directly by the CSP; however, session (temporary) shared secrets may be provided to independent verifiers by the CSP. Approved cryptographic techniques are used for all operations. Assertions issued about claimants as a result of a successful authentication are either cryptographically authenticated by relying parties (using approved methods) or are obtained directly from a trusted party via a secure authentication protocol. [Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.]
Indicator of high digital quality or reliability of the digital reliability of the verification and validation process used to verify the claimed identity of an entity by securely associating an identifier and its authenticator. [Based on ISO 7498-2] The degree of confidence in the vetting process used to establish the identity of the individual to whom the credential was issued, and 2) the degree of confidence that the individual who uses the credential is the individual to whom the credential was issued. [OMB M-04-04 E-Authentication Guidance for Federal Agencies] High authentication level of assurance indicates that the relying party may have very high confidence in the asserted identity's validity. Level 4 is for transactions that need very high confidence in the accuracy of the asserted identity. Level 4 provides the highest practical assurance of remote network authentication. Authentication is based on proof of possession of a key through a cryptographic protocol. This level is similar to Level 3 except that only “hardâ€? cryptographic tokens are allowed, cryptographic module validation requirements are strengthened, and subsequent critical data transfers must be authenticated via a key that is bound to the authentication process. The token should be a hardware cryptographic module validated at FIPS 140-2 Level 2 or higher overall with at least FIPS 140-2 Level 3 physical security. This level requires a physical token, which cannot readily be copied, and operator authentication at Level 2 and higher, and ensures good, two-factor remote authentication. Level 4 requires strong cryptographic authentication of all parties and all sensitive data transfers between the parties. Either public key or symmetric key technology may be used. Authentication requires that the claimant prove through a secure authentication protocol that the claimant controls the token. Eavesdropper, replay, online guessing, verifier impersonation, and man-in-the-middle attacks are prevented. Long-term shared authentication secrets, if used, are never revealed to any party except the claimant and verifiers operated directly by the CSP; however, session (temporary) shared secrets may be provided to independent verifiers by the CSP. Strong approved cryptographic techniques are used for all operations. All sensitive data transfers are cryptographically authenticated using keys bound to the authentication process. [Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.]
authentication process level of assurance value
The value assigned as the indicator of the digital quality or reliability of a defined sequence of messages between a Claimant and a Verifier that demonstrates that the Claimant has possession and control of a valid token to establish his/her identity, and optionally, demonstrates to the Claimant that he or she is communicating with the intended Verifier. [Based on NIST SP 800-63-2]
low authentication process level of assurance
Indicator of the low digital quality or reliability of a defined sequence of messages between a Claimant and a Verifier that demonstrates that the Claimant has possession and control of a valid token to establish his/her identity, and optionally, demonstrates to the Claimant that he or she is communicating with the intended Verifier. [Based on NIST SP 800-63-2] Low authentication process level of assurance indicates that (1) long-term shared authentication secrets may be revealed to verifiers; and (2) assertions and assertion references require protection from manufacture/modification and reuse attacks. [Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.]
basic authentication process level of assurance
Indicator of the basic digital quality or reliability of a defined sequence of messages between a Claimant and a Verifier that demonstrates that the Claimant has possession and control of a valid token to establish his/her identity, and optionally, demonstrates to the Claimant that he or she is communicating with the intended Verifier. [Based on NIST SP 800-63-2] Basic authentication process level of assurance indicates that long-term shared authentication secrets are never revealed to any other party except Credential Service Provider (CSP). Sessions (temporary) shared secrets may be provided to independent verifiers by CSP. Long-term shared authentication secrets, if used, are never revealed to any other party except Verifiers operated by the Credential Service Provider (CSP); however, session (temporary) shared secrets may be provided to independent Verifiers by the CSP. In addition to Level 1 requirements, assertions are resistant to disclosure, redirection, capture and substitution attacks. Approved cryptographic techniques are required. [Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.]
medium authentication process level of assurance
Indicator of the medium digital quality or reliability of a defined sequence of messages between a Claimant and a Verifier that demonstrates that the Claimant has possession and control of a valid token to establish his/her identity, and optionally, demonstrates to the Claimant that he or she is communicating with the intended Verifier. [Based on NIST SP 800-63-2] Medium authentication process level of assurance indicates that the token can be unlocked with password, biometric, or uses a secure multi-token authentication protocol to establish two-factor authentication. Long-term shared authentication secrets are never revealed to any party except the Claimant and Credential Service Provider (CSP). Authentication requires that the Claimant prove, through a secure authentication protocol, that he or she controls the token. The Claimant unlocks the token with a password or biometric, or uses a secure multi-token authentication protocol to establish two-factor authentication (through proof of possession of a physical or software token in combination with some memorized secret knowledge). Long-term shared authentication secrets, if used, are never revealed to any party except the Claimant and Verifiers operated directly by the CSP; however, session (temporary) shared secrets may be provided to independent Verifiers by the CSP. In addition to Level 2 requirements, assertions are protected against repudiation by the Verifier.
high authentication process level of assurance
Indicator of the high digital quality or reliability of a defined sequence of messages between a Claimant and a Verifier that demonstrates that the Claimant has possession and control of a valid token to establish his/her identity, and optionally, demonstrates to the Claimant that he or she is communicating with the intended Verifier. [Based on NIST SP 800-63-2] High authentication process level of assurance indicates all sensitive data transfer are cryptographically authenticated using keys bound to the authentication process. Level 4 requires strong cryptographic authentication of all communicating parties and all sensitive data transfers between the parties. Either public key or symmetric key technology may be used. Authentication requires that the Claimant prove through a secure authentication protocol that he or she controls the token. All protocol threats at Level 3 are required to be prevented at Level 4. Protocols shall also be strongly resistant to man-in-the-middle attacks. Long-term shared authentication secrets, if used, are never revealed to any party except the Claimant and Verifiers operated directly by the CSP; however, session (temporary) shared secrets may be provided to independent Verifiers by the CSP. Approved cryptographic techniques are used for all operations. All sensitive data transfers are cryptographically authenticated using keys bound to the authentication process. [Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.]
The value assigned as the indicator of the high quality or reliability of the statement from a Verifier to a Relying Party (RP) that contains identity information about a Subscriber. Assertions may also contain verified attributes.
Indicator of the low quality or reliability of the statement from a Verifier to a Relying Party (RP) that contains identity information about a Subscriber. Assertions may also contain verified attributes. Assertions and assertion references require protection from modification and reuse attacks. [Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.]
Indicator of the basic quality or reliability of the statement from a Verifier to a Relying Party (RP) that contains identity information about a Subscriber. Assertions may also contain verified attributes. Assertions are resistant to disclosure, redirection, capture and substitution attacks. Approved cryptographic techniques are required for all assertion protocols. [Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.]
Indicator of the medium quality or reliability of the statement from a Verifier to a Relying Party (RP) that contains identity information about a Subscriber. Assertions may also contain verified attributes. Assertions are protected against repudiation by the verifier. [Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.]
Indicator of the high quality or reliability of the statement from a Verifier to a Relying Party (RP) that contains identity information about a Subscriber. Assertions may also contain verified attributes. Strongly resistant to man-in-the-middle attacks. "Bearer" assertions are not used. "Holder-of-key" assertions may be used. RP maintains records of the assertions. [Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.]
token and credential management level of assurance value)
Indicator of the digital quality or reliability of the activities performed by the Credential Service Provider (CSP) subsequent to electronic authentication registration, identity proofing and issuance activities to manage and safeguard the integrity of an issued credential and its binding to an identity. [Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011]
low token and credential management level of assurance
Indicator of the low digital quality or reliability of the activities performed by the Credential Service Provider (CSP) subsequent to electronic authentication registration, identity proofing and issuance activities to manage and safeguard the integrity of an issued credential and its binding to an identity. Little or no confidence that an individual has maintained control over a token that has been entrusted to him or her and that that token has not been compromised. Characteristics include weak identity binding to tokens and plaintext passwords or secrets not transmitted across a network. [Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011]
basic token and credential management level of assurance
Indicator of the basic digital quality or reliability of the activities performed by the Credential Service Provider (CSP) subsequent to electronic authentication registration, identity proofing and issuance activities to manage and safeguard the integrity of an issued credential and its binding to an identity. Some confidence that an individual has maintained control over a token that has been entrusted to him or her and that that token has not been compromised. Characteristics include: Verification must prove claimant controls the token; token resists online guessing, replay, session hijacking, and eavesdropping attacks; and token is at least weakly resistant to man-in-the middle attacks. [Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011]
medium token and credential management level of assurance
Indicator of the medium digital quality or reliability of the activities performed by the Credential Service Provider (CSP) subsequent to electronic authentication registration, identity proofing and issuance activities to manage and safeguard the integrity of an issued credential and it’s binding to an identity. High confidence that an individual has maintained control over a token that has been entrusted to him or her and that that token has not been compromised. Characteristics include: Ownership of token verifiable through security authentication protocol and credential management protects against verifier impersonation attacks. [Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011]
high token and credential management level of assurance
Indicator of the high digital quality or reliability of the activities performed by the Credential Service Provider (CSP) subsequent to electronic authentication registration, identity proofing and issuance activities to manage and safeguard the integrity of an issued credential and it’s binding to an identity. Very high confidence that an individual has maintained control over a token that has been entrusted to him or her and that that token has not been compromised. Characteristics include: Verifier can prove control of token through a secure protocol; credential management supports strong cryptographic authentication of all communication parties. [Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011]
Indicator of the quality or reliability in the process of ascertaining that an individual is who he or she claims to be.
low identity proofing level of assurance
Indicator of low digital quality or reliability in the process of ascertaining that an individual is who he or she claims to be. Requires that a continuity of identity be maintained but does not require identity proofing. [Based on Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011]
basic identity proofing level of assurance
Indicator of some digital quality or reliability in the process of ascertaining that that an individual is who he or she claims to be. Requires identity proofing via presentation of identifying material or information. [Based on Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011]
medium identity proofing level of assurance
Indicator of high digital quality or reliability in the process of ascertaining that an individual is who he or she claims to be. Requires identity proofing procedures for verification of identifying materials and information. [Based on Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011]
high identity proofing level of assurance
non-repudiation level of assurance value
Indicator of the digital quality or reliability in the process of establishing proof of delivery and proof of origin. [Based on ISO 7498-2]
Indicator of low digital quality or reliability in the process of establishing proof of delivery and proof of origin. [Based on ISO 7498-2]
basic non-repudiation level of assurance
Indicator of basic digital quality or reliability in the process of establishing proof of delivery and proof of origin. [Based on ISO 7498-2]
medium non-repudiation level of assurance
Indicator of medium digital quality or reliability in the process of establishing proof of delivery and proof of origin. [Based on ISO 7498-2]
Indicator of high digital quality or reliability in the process of establishing proof of delivery and proof of origin. [Based on ISO 7498-2]
Indicator of the digital quality or reliability of the information exchange between network-connected devices where the information cannot be reliably protected end-to-end by a single organization’s security controls. [Based on NIST SP 800-63-2]
Indicator of low digital quality or reliability of the information exchange between network-connected devices where the information cannot be reliably protected end-to-end by a single organization’s security controls. [Based on NIST SP 800-63-2]
Indicator of basic digital quality or reliability of the information exchange between network-connected devices where the information cannot be reliably protected end-to-end by a single organization’s security controls. [Based on NIST SP 800-63-2]
Indicator of medium digital quality or reliability of the information exchange between network-connected devices where the information cannot be reliably protected end-to-end by a single organization’s security controls. [Based on NIST SP 800-63-2]
Indicator of high digital quality or reliability of the information exchange between network-connected devices where the information cannot be reliably protected end-to-end by a single organization's security controls. [Based on NIST SP 800-63-2]
Indicator of the digital quality or reliability of single and multi-token authentication. [Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011]
Indicator of the low digital quality or reliability of single and multi-token authentication. Permits the use of any of the token methods of Levels 2, 3, or 4. [Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011]
Indicator of the basic digital quality or reliability of single and multi-token authentication. Requires single factor authentication using memorized secret tokens, pre-registered knowledge tokens, look-up secret tokens, out of band tokens, or single factor one-time password devices. [Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011]
Indicator of the medium digital quality or reliability of single and multi-token authentication. Requires two authentication factors. Provides multi-factor remote network authentication. Permits multi-factor software cryptographic token. [Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011]
Indicator of the high digital quality or reliability of single and multi-token authentication. Requires token that is a hardware cryptographic module validated at validated at Federal Information Processing Standard (FIPS) 140-2 Level 2 or higher overall with at least FIPS 140-2 Level 3 physical security. Level 4 token requirements can be met by using the PIV authentication key of a FIPS 201 compliant Personal Identity Verification (PIV) Card. [Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011]
Values for security trust mechanism metadata observation made about a security architecture system component that supports enforcement of security policies.
Potential values for observations of severity.
Indicates the condition may be life-threatening or has the potential to cause permanent injury.
Indicates the condition may result in some adverse consequences but is unlikely to substantially affect the situation of the subject.
Indicates the condition may result in noticable adverse adverse consequences but is unlikely to be life-threatening or cause permanent injury.
Contains codes for defining the observed, physical position of a subject, such as during an observation, assessment, collection of a specimen, etc. ECG waveforms and vital signs, such as blood pressure, are two examples where a general, observed position typically needs to be noted.
Lying with the front or ventral surface downward; lying face down.
A semi-sitting position in bed with the head of the bed elevated approximately 45 degrees.
Resting the body on the buttocks, typically with upper torso erect or semi erect.
To be stationary, upright, vertical, on one's legs.
Lying on the back, on an inclined plane, typically about 30-45 degrees with head raised and feet lowered.
Lying on the back, on an inclined plane, typically about 30-45 degrees, with head lowered and feet raised.
Values for observations of verification act results Examples: Verified, not verified, verified with warning.
Definition: Coverage is in effect for healthcare service(s) and/or product(s).
Definition: Coverage is in effect for healthcare service(s) and/or product(s) - Pending Investigation
Definition: Coverage is not in effect for healthcare service(s) and/or product(s).
Definition: Coverage is not in effect for healthcare service(s) and/or product(s) - Pending Investigation.
Definition: Coverage is not in effect for healthcare service(s) and/or product(s) - Pending Eligibility Update.
Definition: Coverage is not in effect for healthcare service(s) and/or product(s). May optionally include reasons for the ineligibility.
Description:Used in a patient care message to value simple clinical (non-lab) observations.
Individual Case Safety Report Value Domains
This domain is established as a parent to a variety of value domains being defined to support the communication of Individual Case Safety Reports to regulatory bodies. Arguably, this aggregation is not taxonomically pure, but the grouping will facilitate the management of these domains.
Indicates the specific observation result which is the reason for the action (prescription, lab test, etc.). E.g. Headache, Ear infection, planned diagnostic image (requiring contrast agent), etc.
This code is used to specify the exact function an actor had in a service in all necessary detail. This domain may include local extensions (CWE).
This code is used to specify the exact function an actor is authorized to have in a service in all necessary detail.
This code is used to specify the exact function an actor is authorized to have as a receiver of information that is the subject of a consent directive or consent override.
Description:Caregiver authorized to receive patient health information.
legitimate relationship information receiver
Description:Provider with legitimate relationship authorized to receive patient health information.
Description:Member of care team authorized to receive patient health information.
Description:Entities within specified work area authorized to receive patient health information.
This code is used to specify the exact function an actor is authorized to have in authoring a consent directive.
Description:Legal guardian of the subject of consent authorized to author a consent directive for the subject of consent.
healthcare power of attorney consent author
Description:Person authorized with healthcare power of attorney to author a consent directive for the subject of consent.
Description:Personal representative of the subject of consent authorized to author a consent directive for the subject of consent.
Definition:Provider authorized to mask information to protect the patient, a third party, or to ensure that the provider has consulted with the patient prior to release of this information.
Description:Subject of consent authorized to author a consent directive.
This code is used to specify the exact function an actor is authorized to have in authoring a consent override.
Description:Entity authorized to override a consent directive.
Description:Entity authorized to override a consent directive or privacy policy in an emergency.
Definition: Set of codes indicating the manner in which sponsors, underwriters, and payers participate in a policy or program.
Definition: Set of codes indicating the manner in which payors participate in a policy or program.</
Definition: Manages all operations required to adjudicate fee for service claims or managed care encounter reports.
Definition: Managing the enrollment of covered parties.
Definition: Managing all operations required to administer a fee for service or indemnity health plan including enrolling covered parties and providing customer service, provider contracting, claims payment, care management and utilization review.
Definition: Managing all operations required to administer a managed care plan including enrolling covered parties and providing customer service,, provider contracting, claims payment, care management and utilization review.
Definition: Managing provider contracting, provider services, credentialing, profiling, performance measures, and ensuring network adequacy.
Definition: Managing utilization of services by ensuring that providers adhere to, e.g., payeraTMs clinical protocols for medical appropriateness and standards of medical necessity. May include management of authorizations for services and referrals.
Definition: Set of codes indicating the manner in which sponsors participate in a policy or program. NOTE: use only when the Sponsor is not further specified with a SponsorRoleType as being either a fully insured sponsor or a self insured sponsor.
Definition: Responsibility taken by a sponsor to contract with one or more underwriters for the assumption of full responsibility for the risk and administration of a policy or program.
Definition: Responsibility taken by a sponsor to organize the underwriting of risk and administration of a policy or program.
Definition: Set of codes indicating the manner in which underwriters participate in a policy or program.
Definition: Contracting for the provision and administration of health services to payors while retaining the risk for coverage. Contracting may be for all provision and administration; or for provision of certain types of services; for provision of services by region; and by types of administration, e.g., claims adjudication, enrollment, provider management, and utilization management. Typically done by underwriters for sponsors who need coverage provided to covered parties in multiple regions. The underwriter may act as the payor in some, but not all of the regions in which coverage is provided.
Definition: Underwriting reinsurance for another underwriter for the policy or program.
Definition: Underwriting reinsurance for another reinsurer.
Definition: Delegating risk for a policy or program to one or more subcontracting underwriters, e.g., a major health insurer may delegate risk for provision of coverage under a national health plan to other underwriters by region .
Definition: Provision of underwriting analysis for another underwriter without assumption of risk.
A physician who admitted a patient to a hospital or other care unit that is the context of this service.
In a typical anesthesia setting an anesthesiologist or anesthesia resident in charge of the anesthesia and life support, but only a witness to the surgical procedure itself. To clarify responsibilities anesthesia should always be represented as a separate service related to the surgery.
In a typical anesthesia setting the nurse principally assisting the anesthesiologist during the critical periods.
A device that operates independently of an author on custodian's algorithms for data extraction of existing information for purpose of generating a new artifact. UsageConstraint: ASSEMBLER ParticipationFunction should be used with DEV (device) ParticipationType.
A physician who is primarily responsible for a patient during the hospitalization, which is the context of the service.
A device used by an author to record new information, which may also be used by the author to select existing information for aggregation with newly recorded information for the purpose of generating a new artifact. UsageConstraint: COMPOSER ParticipationFunction should be used with DEV (device) ParticipationType. Usage Note: This code will enable implementers to more specifically represent the manner in which a Device participated in and facilitated the generation of a CDA Clinical Document or a CDA Entry by the responsible Author, which is comprised of the Author's newly entered content, and may include the pre-existing content selected by the Author, for the purpose of establishing the provenance and accountability for these acts.
A physician who discharged a patient from a hospital or other care unit that is the context of this service.
In a typical surgery setting the assistant facing the primary surgeon. The first assistant performs parts of the operation and assists in others (e.g., incision, approach, electrocoutering, ligatures, sutures).
A person (usually female) helping a woman deliver a baby. Responsibilities vary locally, ranging from a mere optional assistant to a full required participant, responsible for (normal) births and pre- and post-natal care for both mother and baby.
In a typical surgery setting the non-sterile nurse handles material supply from the stock, forwards specimen to pathology, and helps with other non-sterile tasks (e.g., phone calls, etc.).
The healthcare provider that holds primary responsibility for the overall care of a patient.
In a typical surgery setting the primary performing surgeon.
A verifier who is accountable for reviewing and asserting that the verification of an Act complies with jurisdictional or organizational policy. UsageConstraint: UsageConstraint: Specifies the exact function that an actor is authorized to have as a verifier of an Act. Connotes that a specialized verifier asserts compliance for veracity of the review per jurisdictional or organizational policy. E.g., The Provider who takes responsibility for authenticity of a record submitted to a payer. REVIEW ParticipationFunction should be used with VFR (verifier)
A physician who made rounds on a patient in a hospital or other care center.
In a typical surgery setting the assistant who primarily holds the hooks.
In a typical surgery setting the nurse in charge of the instrumentation.
In a typical surgery setting there is rarely a third assistant (e.g., in some Hip operations the third assistant postures the affected leg).
A set of codes specifying the modality by which the Entity playing the Role is participating in the Act. Examples: Physically present, over the telephone, written communication. Rationale: Particularly for author (originator) participants this is used to specify whether the information represented by the act was initially provided verbally, (hand-)written, or electronically. Open Issue: There needs to be a reexamination of the hierarchies as there seems to be some muddling between ELECTRONIC and other concepts that involve electronic communication that are in other hierarchies.
Participation by non-human-languaged based electronic signal
Participation by direct action where subject and actor are in the same location. (The participation involves more than communication.)
Participation by direct action where subject and actor are in separate locations, and the actions of the actor are transmitted by electronic or mechanical means. (The participation involves more than communication.)
Participation by pre-recorded voice. Communication is limited to one direction (from the recorder to recipient).
Participation by voice communication where parties speak to each other directly.
Participation by voice communication where the voices of the communicating parties are transported over an electronic medium
Participation by voice and visual communication where the voices and images of the communicating parties are transported over an electronic medium
Participation by human language recorded on a physical material
Participation by text or diagrams printed on paper that have been transmitted over a fax device
Participation by text or diagrams printed on paper or other recording medium
Participation by text or diagrams printed on paper transmitted physically (e.g. by courier service, postal service).
Participation by text or diagrams submitted by computer network, e.g. online survey.
Participation by text or diagrams transmitted over an electronic mail system.
Participation by text or diagrams printed on paper or other recording medium where the recording was performed using a typewriter, typesetter, computer or similar mechanism.
A set of codes specifying whether and how the participant has attested his participation through a signature and or whether such a signature is needed. Examples: A surgical Procedure act object (representing a procedure report) requires a signature of the performing and responsible surgeon, and possibly other participants. (See also: Participation.signatureText.)
The particpant intends to provide a signature.
Signature has been affixed, either written on file, or electronic (incl. digital) signature in Participation.signatureText.
A signature for the service is required of this actor.
Indicates that the target of the participation is involved in some manner in the act, but does not qualify how.
Participations related, but not primary to an act. The Referring, Admitting, and Discharging practitioners must be the same person as those authoring the ControlAct event for their respective trigger events.
The practitioner who is responsible for admitting a patient to a patient encounter.
The practitioner that has responsibility for overseeing a patient's care during a patient encounter.
A person or organization who should be contacted for follow-up questions about the act in place of the author.
An advisor participating in the service by performing evaluations and making recommendations.
The practitioner who is responsible for the discharge of a patient from a patient encounter.
Only with Transportation services. A person who escorts the patient.
A person having referred the subject of the service to the performer (referring physician). Typically, a referring physician will receive a report.
Parties that may or should contribute or have contributed information to the Act. Such information includes information leading to the decision to perform the Act and how to perform the Act (e.g., consultant), information that the Act itself seeks to reveal (e.g., informant of clinical history), or information about what Act was performed (e.g., informant witness).
Definition: A party that originates the Act and therefore has responsibility for the information given in the Act and ownership of this Act. Example: the report writer, the person writing the act definition, the guideline author, the placer of an order, the EKG cart (device) creating a report etc. Every Act should have an author. Authorship is regardless of mood always actual authorship. Examples of such policies might include: The author and anyone they explicitly delegate may update the report; All administrators within the same clinic may cancel and reschedule appointments created by other administrators within that clinic; A party that is neither an author nor a party who is extended authorship maintenance rights by policy, may only amend, reverse, override, replace, or follow up in other ways on this Act, whereby the Act remains intact and is linked to another Act authored by that other party.
A source of reported information (e.g., a next of kin who answers questions about the patient's history). For history questions, the patient is logically an informant, yet the informant of history questions is implicitly the subject.
An entity entering the data into the originating system. The data entry entity is collected optionally for internal quality control purposes. This includes the transcriptionist for dictated text transcribed into electronic form.
A person entering the data into the originating system. The data entry person is collected optionally for internal quality control purposes. This includes the transcriptionist for dictated text.
Only with service events. A person witnessing the action happening without doing anything. A witness is not necessarily aware, much less approves of anything stated in the service event. Example for a witness is students watching an operation or an advanced directive witness.
An entity (person, organization or device) that is in charge of maintaining the information of this act (e.g., who maintains the report or the master service catalog item, etc.).
Target participant that is substantially present in the act and which is directly involved in the action (includes consumed material, devices, etc.).
The target of an Observation action. Links an observation to a Role whose player is the substance or most specific component entity (material, micro-organism, etc.) being measured within the subject. Examples: A "plasma porcelain substance concentration" has analyte a Role with player substance Entity "porcelain". UsageNotes: The Role that this participation connects to may be any Role whose player is that substance measured. Very often, the scoper may indicate the system in which the component is being measured. E.g., for "plasma porcelain" the scoper could be "Plasma".
The catalyst of a chemical reaction, such as an enzyme or a platinum surface. In biochemical reactions, connects the enzyme with the molecular interaction
Participant material that is taken up, diminished, altered, or disappears in the act.
Something incorporated in the subject of a therapy service to achieve a physiologic effect (e.g., heal, relieve, provoke a condition, etc.) on the subject. In an administration service the therapeutic agent is a consumable, in a preparation or dispense service, it is a product. Thus, consumable or product must be specified in accordance with the kind of service.
Participant used in performing the act without being substantially affected by the act (i.e. durable or inert with respect to that particular service). Examples: monitoring equipment, tools, but also access/drainage lines, prostheses, pace maker, etc.
A device that changes ownership due to the service, e.g., a pacemaker, a prosthesis, an insulin injection equipment (pen), etc. Such material may need to be restocked after he service.
A device that does not change ownership due to the service, i.e., a surgical instrument or tool or an endoscope. The distinction between reuseable and non-reuseable must be made in order to know whether material must be re-stocked.
In some organ transplantation services and rarely in transfusion services a donor will be a target participant in the service. However, in most cases transplantation is decomposed in three services: explantation, transport, and implantation. The identity of the donor (recipient) is often irrelevant for the explantation (implantation) service.
Description: The entity playing the associated role is the physical (including energy), chemical or biological substance that is participating in the exposure. For example in communicable diseases, the associated playing entity is the disease causing pathogen.
Description:Direct participation in an exposure act where it is unknown that the participant is the source or subject of the exposure. If the participant is known to be the contact of an exposure then the SBJ participation type should be used. If the participant is known to be the source then the EXSRC participation type should be used.
Description: The entity playing the associated role is the target (contact) of exposure.
Description:The entity playing the associated role is the source of exposure.
Participant material that is brought forth (produced) in the act (e.g., specimen in a specimen collection, access or drainage in a placement service, medication package in a dispense service). It does not matter whether the material produced had existence prior to the service, or whether it is created in the service (e.g., in supply services the product is taken from a stock).
The principle target on which the action happens. Examples: The patient in physical examination, a specimen in a lab observation. May also be a patient's family member (teaching) or a device or room (cleaning, disinfecting, housekeeping). UsageNotes: Not all direct targets are subjects. Consumables and devices used as tools for an act are not subjects. However, a device may be a subject of a maintenance action.
The subject of non-clinical (e.g. laboratory) observation services is a specimen.
Target that is not substantially present in the act and which is not directly affected by the act, but which will be a focus of the record or documentation of the act.
Target on behalf of whom the service happens, but that is not necessarily present in the service. Can occur together with direct target to indicate that a target is both, as in the case where the patient is the indirect beneficiary of a service rendered to a family member, e.g. counseling or given home care instructions. This concept includes a participant, such as a covered party, who derives benefits from a service act covered by a coverage act. Note that the semantic role of the intended recipient who benefits from the happening denoted by the verb in the clause. Thus, a patient who has no coverage under a policy or program may be a beneficiary of a health service while not being the beneficiary of coverage for that service.
Definition: A factor, such as a microorganism, chemical substance, or form of radiation, whose presence, excessive presence, or (in deficiency diseases) relative absence is essential, in whole or in part, for the occurrence of a condition. Constraint: The use of this participation is limited to observations.
The target participation for an individual in a health care coverage act in which the target role is either the policy holder of the coverage, or a covered party under the coverage.
The target person or organization contractually recognized by the issuer as a participant who has assumed fiscal responsibility for another personaTMs financial obligations by guaranteeing to pay for amounts owed to a particular account Example:The subscriber of the patientaTMs health insurance policy signs a contract with the provider to be fiscally responsible for the patient billing account balance amount owed.
Participant who posses an instrument such as a financial contract (insurance policy) usually based on some agreement with the author.
The record target indicates whose medical record holds the documentation of this act. This is especially important when the subject of a service is not the patient himself.
The person (or organization) who receives the product of an Act.
A party, who may or should receive or who has recieved the Act or subsequent or derivative information of that Act. Information recipient is inert, i.e., independent of mood." Rationale: this is a generalization of a too diverse family that the definition can't be any more specific, and the concept is abstract so one of the specializations should be used.
An information recipient to notify for urgent matters about this Act. (e.g., in a laboratory order, critical results are being called by phone right away, this is the contact to call; or for an inpatient encounter, a next of kin to notify when the patient becomes critically ill).
Information recipient to whom an act statement is primarily directed. E.g., a primary care provider receiving a discharge letter from a hospitalist, a health department receiving information on a suspected case of infectious disease. Multiple of these participations may exist on the same act without requiring that recipients be ranked as primary vs. secondary.
A participant (e.g. provider) who has referred the subject of an act (e.g. patient). Typically, a referred by participant will provide a report (e.g. referral).
A secondary information recipient, who receives copies (e.g., a primary care provider receiving copies of results as ordered by specialist).
The facility where the service is done. May be a static building (or room therein) or a moving location (e.g., ambulance, helicopter, aircraft, train, truck, ship, etc.)
The destination for services. May be a static building (or room therein) or a movable facility (e.g., ship).
A location where data about an Act was entered.
The location of origin for services. May be a static building (or room therein) or a movable facility (e.g., ship).
Some services take place at multiple concurrent locations (e.g., telemedicine, telephone consultation). The location where the principal performing actor is located is taken as the primary location (LOC) while the other location(s) are considered "remote."
For services, an intermediate location that specifies a path between origin an destination.
Definition: A person, non-person living subject, organization or device that who actually and principally carries out the action. Device should only be assigned as a performer in circumstances where the device is performing independent of human intervention. Need not be the principal responsible actor. Exampe: A surgery resident operating under supervision of attending surgeon, a search and rescue dog locating survivors, an electronic laboratory analyzer or the laboratory discipline requested to perform a laboratory test. The performer may also be the patient in self-care, e.g. fingerstick blood sugar. The traditional order filler is a performer. This information should accompany every service event. Note: that existing HL7 designs assign an organization as the playing entity of the Role that is the performer. These designs should be revised in subsequent releases to make this the scooping entity for the role involved.
Distributes material used in or generated during the act.
The principal or primary performer of the act.
A person assisting in an act through his substantial presence and involvement This includes: assistants, technicians, associates, or whatever the job titles may be.
The person or organization that has primary responsibility for the act. The responsible party is not necessarily present in an action, but is accountable for the action through the power to delegate, and the duty to review actions with the performing actor after the fact. This responsibility may be ethical, legal, contractual, fiscal, or fiduciary in nature. Example: A person who is the head of a biochemical laboratory; a sponsor for a policy or government program.
A person who verifies the correctness and appropriateness of the service (plan, order, event, etc.) and hence takes on accountability.
A verifier who attests to the accuracy of an act, but who does not have privileges to legally authenticate the act. An example would be a resident physician who sees a patient and dictates a note, then later signs it. Their signature constitutes an authentication.
A verifier who legally authenticates the accuracy of an act. An example would be a staff physician who sees a patient and dictates a note, then later signs it. Their signature constitutes a legal authentication.
Board member of health care organization
Member of the health care organization physician staff
Financial donor to the health care organization
Foreign citizen dignitary of interest to the health care organization
Government dignitary of interest to the organization
Staff member of the health care organization
Very important person of interest to the health care organization
Describes payment terms for a financial transaction, used in an invoice. This is typically expressed as a responsibility of the acceptor or payor of an invoice.
Payment in full for products and/or services is required as soon as the service is performed or goods delivered.
Payment in full for products and/or services is required 30 days from the time the service is performed or goods delivered.
Payment in full for products and/or services is required 60 days from the time the service is performed or goods delivered.
Payment in full for products and/or services is required 90 days from the time the service is performed or goods delivered.
A code identifying a person's disability.
Person requires a wheelchair to be ambulatory
Types of personal relationships between two living subjects. Example: Parent, sibling, unrelated friend, neighbor
v3 Code System ProbabilityDistributionType
The beta-distribution is used for data that is bounded on both sides and may or may not be skewed (e.g., occurs when probabilities are estimated.) Two parameters a and b are available to adjust the curve. The mean m and variance s2 relate as follows: m = a/ (a + b) and s2 = ab/((a + b)2 (a + b + 1)).
Used for data that describes extinction. The exponential distribution is a special form of g-distribution where a = 1, hence, the relationship to mean m and variance s2 are m = b and s2 = b2.
Used to describe the quotient of two c2 random variables. The F-distribution has two parameters n1 and n2, which are the numbers of degrees of freedom of the numerator and denominator variable respectively. The relationship to mean m and variance s2 are: m = n2 / (n2 - 2) and s2 = (2 n2 (n2 + n1 - 2)) / (n1 (n2 - 2)2 (n2 - 4)).
The gamma-distribution used for data that is skewed and bounded to the right, i.e. where the maximum of the distribution curve is located near the origin. The g-distribution has a two parameters a and b. The relationship to mean m and variance s2 is m = a b and s2 = a b2.
The logarithmic normal distribution is used to transform skewed random variable X into a normally distributed random variable U = log X. The log-normal distribution can be specified with the properties mean m and standard deviation s. Note however that mean m and standard deviation s are the parameters of the raw value distribution, not the transformed parameters of the lognormal distribution that are conventionally referred to by the same letters. Those log-normal parameters mlog and slog relate to the mean m and standard deviation s of the data value through slog2 = log (s2/m2 + 1) and mlog = log m - slog2/2.
This is the well-known bell-shaped normal distribution. Because of the central limit theorem, the normal distribution is the distribution of choice for an unbounded random variable that is an outcome of a combination of many stochastic processes. Even for values bounded on a single side (i.e. greater than 0) the normal distribution may be accurate enough if the mean is "far away" from the bound of the scale measured in terms of standard deviations.
Used to describe the quotient of a normal random variable and the square root of a c2 random variable. The t-distribution has one parameter n, the number of degrees of freedom. The relationship to mean m and variance s2 are: m = 0 and s2 = n / (n - 2)
The uniform distribution assigns a constant probability over the entire interval of possible outcomes, while all outcomes outside this interval are assumed to have zero probability. The width of this interval is 2s sqrt(3). Thus, the uniform distribution assigns the probability densities f(x) = sqrt(2 s sqrt(3)) to values m - s sqrt(3) >= x <= m + s sqrt(3) and f(x) = 0 otherwise.
Used to describe the sum of squares of random variables which occurs when a variance is estimated (rather than presumed) from the sample. The only parameter of the c2-distribution is n, so called the number of degrees of freedom (which is the number of independent parts in the sum). The c2-distribution is a special type of g-distribution with parameter a = n /2 and b = 2. Hence, m = n and s2 = 2 n.
Codes used to specify whether a message is part of a production, training, or debugging system.
Identifies debugging type of processing.
Identifies production type of processing.
Identifies initial load mode of processing.
Specifies the state change of a target Act, such as a document or an entry, from its previous state as a predecessor Act. For example, if the target Act is the result of a predecessor Act being "obsoleted" and replaced with the target Act, the source ProvenanceEventCurrentState Act code would be "obsoleted".
Specifies the state change of a target Act, using ActStatus codes, from its previous state as a predecessor Act. For example, if the target Act is the result of a predecessor Act being "obsoleted" and replaced with the target Act, the source ProvenanceEventCurrentState Act code would be "obsoleted".
Specifies the state change of a target Act using DocuymentCompletion codes, from its previous state as a predecessor Act. For example, if the target Act is the result of a predecessor Act being "obsoleted" and replaced with the target Act, the source ProvenanceEventCurrentState Act code would be "obsoleted".
The domain of coded values used as parameters within QueryByParameter queries.
Description:Filter codes used to manage volume of dispenses returned by a parameter-based queries.
Description:Returns all dispenses to date for a prescription.
Description:Returns the most recent dispense for a prescription.
Description:Returns no dispense for a prescription.
Filter codes used to manage types of orders being returned by a parameter-based query.
Return only those orders that do not have results.
Return only those orders that have results.
A "helper" vocabulary used to construct complex query filters based on how and whether a prescription has been dispensed.
Filter to only include SubstanceAdministration orders which have no remaining quantity authorized to be dispensed.
Filter to only include SubstanceAdministration orders which have no fulfilling supply events performed.
Filter to only include SubstanceAdministration orders which have had at least one fulfilling supply event, but which still have outstanding quantity remaining to be authorized.
Description:Indicates how result sets should be filtered based on whether they have associated issues.
Description:Result set should not be filtered based on the presence of issues.
Description:Result set should be filtered to only include records with associated issues.
Description:Result set should be filtered to only include records with associated unmanaged issues.
Definition: Defines the units associated with the magnitude of the maximum size limit of a query response that can be accepted by the requesting application.
Definition: The number of matching instances (number of focal classes). The document header class is the focal class of a document, a record would therefore be equal to a document.
A code classifying the general nature of the response to a given query. Includes whether or not data was found, or whether an error occurred.
No errors, but no data was found matching the query request specification.
Query reponse data found for 1 or more result sets matching the query request specification.
QueryError. Problem with input ParmetersError
A code specifying the state of the Query.
In the United States, federal standards for classifying data on race determine the categories used by federal agencies and exert a strong influence on categorization by state and local agencies and private sector organizations. The federal standards do not conceptually define race, and they recognize the absence of an anthropological or scientific basis for racial classification. Instead, the federal standards acknowledge that race is a social-political construct in which an individual's own identification with one more race categories is preferred to observer identification. The standards use a variety of features to define five minimum race categories. Among these features are descent from "the original peoples" of a specified region or nation. The minimum race categories are American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, and White. The federal standards stipulate that race data need not be limited to the five minimum categories, but any expansion must be collapsible to those categories.
Central Council of Tlingit and Haida Tribes
Native Hawaiian or Other Pacific Islander
Note that this term remains in the table for completeness, even though within HL7, the notion of Other code is deprecated.
Conveys prohibited actions which an information custodian, receiver, or user is not permitted to perform unless otherwise authorized or permitted under specified circumstances. Examples: prohibit redisclosure without consent directive
Specified set of things includes value being evaluated.
Greater than or equal condition applied to comparisons.
A generic comparison selects a record for inclusion in the response if the beginning of the designated element value matches the select string.
Greater than condition applied to comparisons.
Less than or equal condition applied to comparisons.
Less than condition applied to comparisons.
Not equal condition applied to comparisons.
At least one of the condition among all OR conditions must be true.
One and only one of the XOR conditions must be true.
Assigment of spiritual faith affiliation
Specifies whether a response is expected from the addressee of this interaction and what level of detail that response should include
Respond with exceptions and a notification of completion
Respond with exceptions, completion, modifications and include more detail information (if applicable)
Respond with exceptions, completion, and modification with detail (as above), and send positive confirmations even if no modifications are being made.
Respond only with message level acknowledgements, i.e., only notify acceptance or rejection of the message, do not include any application-level detail
Respond with exceptions, completions and modifications or revisions done before completion
Defines the timing and grouping of the response instances. OpenIssue: Description copied from Concept Domain of same name. Must be verified.
Query response to be sent as an HL7 Batch.
Query response to sent as a series of responses at the same time without the use of batch formatting.
Specifies the mode, immediate versus deferred or queued, by which a receiver should communicate its receiver responsibilities.
The receiver may respond in a non-immediate manner. Note: this will be the default value.
The receiver is required to assume that the sender is blocking and behave appropriately by sending an immediate response.
The receiver shall keep any application responses in a queue until such time as the queue is polled.
Codes for the Role class hierarchy. The values in this hierarchy, represent a Role which is an association or relationship between two entities - the entity that plays the role and the entity that scopes the role. Roles names are derived from the name of the playing entity in that role. The role hierarchy stems from three core concepts, or abstract domains: RoleClassOntological is an abstract domain that collects roles in which the playing entity is defined or specified by the scoping entity. RoleClassPartitive collects roles in which the playing entity is in some sense a "part" of the scoping entity. RoleClassAssociative collects all of the remaining forms of association between the playing entity and the scoping entity. This set of roles is further partitioned between: RoleClassPassive which are roles in which the playing entity is used, known, treated, handled, built, or destroyed, etc. under the auspices of the scoping entity. The playing entity is passive in these roles in that the role exists without an agreement from the playing entity. RoleClassMutualRelationship which are relationships based on mutual behavior of the two entities. The basis of these relationship may be formal agreements or they may bede facto behavior. Thus, this sub-domain is further divided into: RoleClassRelationshipFormal in which the relationship is formally defined, frequently by a contract or agreement. Personal relationship which inks two people in a personal relationship. The hierarchy discussed above is represented In the current vocabulary tables as a set of abstract domains, with the exception of the "Personal relationship" which is a leaf concept. OpenIssue: Description copied from Concept Domain of same name. Must be verified.
A general association between two entities that is neither partitive nor ontological.
A relationship that is based on mutual behavior of the two Entities as being related. The basis of such relationship may be agreements (e.g., spouses, contract parties) or they may be de facto behavior (e.g. friends) or may be an incidental involvement with each other (e.g. parties over a dispute, siblings, children).
A relationship between two entities that is formally recognized, frequently by a contract or similar agreement.
Player of the Affiliate role has a business/professional relationship with scoper. Player and scoper may be persons or organization. The Affiliate relationship does not imply membership in a group, nor does it exist for resource scheduling purposes. Example: A healthcare provider is affiliated with another provider as a business associate.
An entity (player) that acts or is authorized to act on behalf of another entity (scoper).
An agent role in which the agent is an Entity acting in the employ of an organization. The focus is on functional role on behalf of the organization, unlike the Employee role where the focus is on the 'Human Resources' relationship between the employee and the organization.
An Entity that is authorized to issue or instantiate permissions, privileges, credentials or other formal/legal authorizations.
The role of a person (player) who is the officer or signature authority for of a scoping entity, usually an organization (scoper).
A person or an organization (player) which provides or receives information regarding another entity (scoper). Examples; patient NOK and emergency contacts; guarantor contact; employer contact.
An entity to be contacted in the event of an emergency.
An individual designated for notification as the next of kin for a given entity.
A role class played by a person who receives benefit coverage under the terms of a particular insurance policy. The underwriter of that policy is the scoping entity. The covered party receives coverage because of some contractual or other relationship with the holder of that policy. Discussion:This reason for coverage is captured in 'Role.code' and a relationship link with type code of indirect authority should be included using the policy holder role as the source, and the covered party role as the target. Note that a particular policy may cover several individuals one of whom may be, but need not be, the policy holder. Thus the notion of covered party is a role that is distinct from that of the policy holder.
Description: A role played by a party making a claim for coverage under a policy or program. A claimant must be either a person or organization, or a group of persons or organizations. A claimant is not a named insured or a program eligible. Discussion: With respect to liability insurance such as property and casualty insurance, a claimant must file a claim requesting indemnification for a loss that the claimant considers covered under the policy of a named insured. The claims adjuster for the policy underwriter will review the claim to determine whether the loss meets the benefit coverage criteria under a policy, and base any indemnification or coverage payment on that review. If a third party is liable in whole or part for the loss, the underwriter may pursue third party liability recovery. A claimant may be involved in civil or criminal legal proceedings involving claims against a defendant party that is indemnified by an insurance policy or to protest the finding of a claims adjustor. With respect to life insurance, a beneficiary designated by a named insured becomes a claimant of the proceeds of coverage, as in the case of a life insurance policy. However, a claimant for coverage under life insurance is not necessarily a designated beneficiary. Note: A claimant is not a named insured. However, a named insured may make a claim under a policy, e.g., an insured driver may make a claim for an injury under his or her comprehensive automobile insurance policy. Similarly, a program eligible may make a claim under program, e.g., an unemployed worker may claim benefits under an unemployment insurance program, but parties playing these covered party role classes are not, for purposes of this vocabulary and in an effort to clearly distinguish role classes, considered claimants. In the case of a named insured making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that either a named insured or an individual insured has filed a claim for a loss. In the case of a program eligible, a role type code INJWKR (injured worker) subtypes the class to indicate that the covered party in a workers compensation program is an injured worker, and as such, has filed a "claim" under the program for benefits. Likewise, a covered role type code UNEMP (unemployed worker) subtypes the program eligible class to indicate that the covered party in an unemployment insurance program has filed a claim for unemployment benefits. Example: A claimant under automobile policy that is not the named insured.
Description: A role played by a party to an insurance policy to which the insurer agrees to indemnify for losses, provides benefits for, or renders services. A named insured may be either a person, non-person living subject, or an organization, or a group of persons, non-person living subjects, or organizations. Discussion: The coded concept NAMED should not be used where a more specific child concept in this Specializable value set applies. In some cases, the named insured may not be the policy holder, e.g., where a policy holder purchases life insurance policy in which another party is the named insured and the policy holder is the beneficiary of the policy. Note: The party playing the role of a named insured is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However, a named insured may make a claim under a policy, e.g., e.g., a party that is the named insured and policy holder under a comprehensive automobile insurance policy may become the claimant for coverage under that policy e.g., if injured in an automobile accident and there is no liable third party. In the case of a named insured making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that a named insured has filed a claim for a loss. Example: The named insured under a comprehensive automobile, disability, or property and casualty policy that is the named insured and may or may not be the policy holder.
Description: A role played by a person covered under a policy or program based on an association with a subscriber, which is recognized by the policy holder. Note: The party playing the role of a dependent is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However, a dependent may make a claim under a policy, e.g., a dependent under a health insurance policy may become the claimant for coverage under that policy for wellness examines or if injured and there is no liable third party. In the case of a dependent making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that the dependent has filed a claim for services covered under the health insurance policy. Example: The dependent has an association with the subscriber such as a financial dependency or personal relationship such as that of a spouse, or a natural or adopted child. The policy holder may be required by law to recognize certain associations or may have discretion about the associations. For example, a policy holder may dictate the criteria for the dependent status of adult children who are students, such as requiring full time enrollment, or may recognize domestic partners as dependents. Under certain circumstances, the dependent may be under the indirect authority of a responsible party acting as a surrogate for the subscriber, for example, if the subscriber is differently abled or deceased, a guardian ad Lidem or estate executor may be appointed to assume the subscriberaTMs legal standing in the relationship with the dependent.
Description: A role played by a party covered under a policy as the policy holder. An individual may be either a person or an organization. Note: The party playing the role of an individual insured is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However, a named insured may make a claim under a policy, e.g., a party that is the named insured and policy holder under a comprehensive automobile insurance policy may become the claimant for coverage under that policy if injured in an automobile accident and there is no liable third party. In the case of an individual insured making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that an individual insured has filed a claim for a loss. Example: The individual insured under a comprehensive automobile, disability, or property and casualty policy that is the policy holder.
Description: A role played by a person covered under a policy based on association with a sponsor who is the policy holder, and whose association may provide for the eligibility of dependents for coverage. Discussion: The policy holder holds the contract with the policy or program underwriter. The subscriber holds a certificate of coverage under the contract. In legal proceedings concerning the policy or program, the terms of the contract takes precedence over the terms of the certificate of coverage if there are any inconsistencies. Note: The party playing the role of a subscriber is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However, a subscriber may make a claim under a policy, e.g., a subscriber under a health insurance policy may become the claimant for coverage under that policy for wellness examines or if injured and there is no liable third party. In the case of a subscriber making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that the subscriber has filed a claim for services covered under the health insurance policy. Example: An employee or a member of an association.
Description: A role played by a party that meets the eligibility criteria for coverage under a program. A program eligible may be either a person, non-person living subject, or an organization, or a group of persons, non-person living subjects, or organizations. Discussion: A program as typically government administered coverage for parties determined eligible under the terms of the program. Note: The party playing a program eligible is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However a program eligible may make a claim under program, e.g., an unemployed worker may claim benefits under an unemployment insurance program, but parties playing these covered party role classes are not, for purposes of this vocabulary and in an effort to clearly distinguish role classes, considered claimants. In the case of a program eligible, a role type code INJWKR (injured worker) subtypes the class to indicate that the covered party in a workers compensation program is an injured worker, and as such, has filed a "claim" under the program for benefits. Likewise, a covered role type code UNEMP (unemployed worker) subtypes the program eligible class to indicate that the covered party in an unemployment insurance program has filed a claim for unemployment benefits. Example: A party meeting eligibility criteria related to health or financial status, e.g., in the U.S., persons meeting health, demographic, or financial criteria established by state and federal law are eligible for Medicaid.
A role played by a provider, always a person, who has agency authority from a Clinical Research Sponsor to direct the conduct of a clinical research trial or study on behalf of the sponsor.
A role played by an entity, usually an organization, that is the sponsor of a clinical research trial or study. The sponsor commissions the study, bears the expenses, is responsible for satisfying all legal requirements concerning subject safety and privacy, and is generally responsible for collection, storage and analysis of the data generated during the trial. No scoper is necessary, as a clinical research sponsor undertakes the role on its own authority and declaration. Clinical research sponsors are usually educational or other research organizations, government agencies or biopharmaceutical companies.
A relationship between a person or organization and a person or organization formed for the purpose of exchanging work for compensation. The purpose of the role is to identify the type of relationship the employee has to the employer, rather than the nature of the work actually performed. (Contrast with AssignedEntity.)
A role played by a member of a military service. Scoper is the military service (e.g. Army, Navy, Air Force, etc.) or, more specifically, the unit (e.g. Company C, 3rd Battalion, 4th Division, etc.)
A person or organization (player) that serves as a financial guarantor for another person or organization (scoper).
An entity that is the subject of an investigation. This role is scoped by the party responsible for the investigation.
A person, non-person living subject, or place that is the subject of an investigation related to a notifiable condition (health circumstance that is reportable within the applicable public health jurisdiction)
Definition:Specifies the administrative functionality within a formal experimental design for which the ResearchSubject role was established. Examples: Screening - role is used for pre-enrollment evaluation portion of the design; enrolled - role is used for subjects admitted to the experimental portion of the design.
A relationship in which the scoper certifies the player ( e. g. a medical care giver, a medical device or a provider organization) to perform certain activities that fall under the jurisdiction of the scoper (e.g., a health authority licensing healthcare providers, a medical quality authority certifying healthcare professionals).
An Entity (player) that is authorized to provide health care services by some authorizing agency (scoper).
A Role of a LivingSubject (player) as an actual or potential recipient of health care services from a healthcare provider organization (scoper). Usage Note: Communication about relationships between patients and specific healthcare practitioners (people) is not done via scoper. Instead this is generally done using the CareProvision act. This allows linkage between patient and a particular healthcare practitioner role and also allows description of the type of care involved in the relationship.
The role of an organization or individual designated to receive payment for a claim against a particular coverage. The scoping entity is the organization that is the submitter of the invoice in question.
The role of an organization that undertakes to accept claims invoices, assess the coverage or payments due for those invoices and pay to the designated payees for those invoices. This role may be either the underwriter or a third-party organization authorized by the underwriter. The scoping entity is the organization that underwrites the claimed coverage.
A role played by a person or organization that holds an insurance policy. The underwriter of that policy is the scoping entity. Discussion:The identifier of the policy is captured in 'Role.id' when the Role is a policy holder. A particular policy may cover several individuals one of whom may be, but need not be, the policy holder. Thus the notion of covered party is a role that is distinct from that of the policy holder.
An entity (player) that has been recognized as having certain training/experience or other characteristics that would make said entity an appropriate performer for a certain activity. The scoper is an organization that educates or qualifies entities.
A role played by an entity, usually an organization that is the sponsor of an insurance plan or a health program. A sponsor is the party that is ultimately accountable for the coverage by employment contract or by law. A sponsor can be an employer, union, government agency, or association. Fully insured sponsors establish the terms of the plan and contract with health insurance plans to assume the risk and to administer the plan. Self-insured sponsors delegate coverage administration, but not risk, to third-party administrators. Program sponsors designate services to be covered in accordance with statute. Program sponsors may administer the coverage themselves, delegate coverage administration, but not risk to third-party administrators, or contract with health insurance plans to assume the risk and administrator a program. Sponsors qualify individuals who may become a policy holder of the plan; where the sponsor is the policy holder, who may become a subscriber or a dependent to a policy under the plan; or where the sponsor is a government agency, who may become program eligibles under a program. The sponsor role may be further qualified by the SponsorRole.code. Entities playing the sponsor role may also play the role of a Coverage Administrator. Example: An employer, union, government agency, or association.
A role played by an individual who is a student of a school, which is the scoping entity.
A role played by a person or an organization. It is the party that accepts fiscal responsibility for insurance plans and the policies created under those plans; administers and accepts fiscal responsibility for a program that provides coverage for services to eligible individuals; and/or has the responsibility to assess the merits of each risk and decide a suitable premium for accepting all or part of the risk. If played by an organization, this role may be further specified by an appropriate RoleCode. Example: A health insurer; Medicaid Program; Lloyd's of London
A person responsible for the primary care of a patient at home.
Links two entities with classCode PSN (person) in a personal relationship. The character of the relationship must be defined by a PersonalRelationshipRoleType code. The player and scoper are determined by PersonalRelationshipRoleType code as well.
The "same" roleclass asserts an identity between playing and scoping entities: that they are in fact instances of the same entity and, in the case of discrepancies (e.g different DOB, gender), that one or both are in error. Usage: playing and scoping entities must have same classcode, but need not have identical attributes or values. Example: a provider registry maintains sets of conflicting demographic data for what is reported to be the same individual.
An association for a playing Entity that is used, known, treated, handled, built, or destroyed, etc. under the auspices of the scoping Entity. The playing Entity is passive in these roles (even though it may be active in other roles), in the sense that the kinds of things done to it in this role happen without an agreement from the playing Entity.
A role in which the playing entity (material) provides access to another entity. The principal use case is intravenous (or other bodily) access lines that preexist and need to be referred to for medication routing instructions.
A physical association whereby two Entities are in some (even lose) spatial relationship with each other such that they touch each other in some way. Examples: the colon is connected (and therefore adjacent) to the jejunum; the colon is adjacent to the liver (even if not actually connected.) UsageConstraints: Adjacency is in principle a symmetrical connection, but scoper and player of the role should, where applicable, be assigned to have scoper be the larger, more central Entity and player the smaller, more distant, appendage.
An adjacency of two Entities held together by a bond which attaches to each of the two entities. Examples: biceps brachii muscle connected to the radius bone, port 3 on a network switch connected to port 5 on a patch panel. UsageConstraints: See Adjacency for the assignment of scoper (larger, more central) and player (smaller, more distant).
A connection between two atoms of a molecule. Examples: double bond between first and second C in ethane, peptide bond between two amino-acid, disulfide bridge between two proteins, chelate and ion associations, even the much weaker van-der-Waals bonds can be considered molecular bonds. UsageConstraints: See connection and adjacency for the assignment of player and scoper.
A connection between two regional parts. Examples: the connection between ascending aorta and the aortic arc, connection between descending colon and sigmoid. UsageConstraints: See connection and adjacency for the assignment of player and scoper.
A material (player) that can be administered to an Entity (scoper).
Relates a place (playing Entity) as the location where a living subject (scoping Entity) was born.
Definition: Relates a place (playing Entity) as the location where a living subject (scoping Entity) died.
A material (player) distributed by a distributor (scoper) who functions between a manufacturer and a buyer or retailer.
Material (player) sold by a retailer (scoper), who also give advice to prospective buyers.
A role played by a place at which the location of an event may be recorded.
A role played by a place at which services may be provided.
A role of a place (player) that is intended to house the provision of services. Scoper is the Entity (typically Organization) that provides these services. This is not synonymous with "ownership."
A role played by a place at which health care services may be provided without prior designation or authorization.
A role played by an entity that has been exposed to a person or animal suffering a contagious disease, or with a location from which a toxin has been distributed. The player of the role is normally a person or animal, but it is possible that other entity types could become exposed. The role is scoped by the source of the exposure, and it is quite possible for a person playing the role of exposed party to also become the scoper a role played by another person. That is to say, once a person has become infected, it is possible, perhaps likely, for that person to infect others. Management of exposures and tracking exposed parties is a key function within public health, and within most public health contexts - exposed parties are known as "contacts."
Entity that is currently in the possession of a holder (scoper), who holds, or uses it, usually based on some agreement with the owner.
The role of a material (player) that is the physical health chart belonging to an organization (scoper).
A role in which the scoping entity designates an identifier for a playing entity.
A manufactured material (player) that is used for its therapeutic properties. The manufacturer is the scoper.
An entity (player) that is maintained by another entity (scoper). This is typical role held by durable equipment. The scoper assumes responsibility for proper operation, quality, and safety.
An Entity (player) for which someone (scoper) is granted by law the right to call the material (player) his own. This entitles the scoper to make decisions about the disposition of that material.
A product regulated by some governmentatl orgnization. The role is played by Material and scoped by Organization. Rationale: To support an entity clone used to identify the NDC number for a drug product.
Relates a place entity (player) as the region over which the scoper (typically an Organization) has certain authority (jurisdiction). For example, the Calgary Regional Health Authority (scoper) has authority over the territory "Region 4 of Alberta" (player) in matters of health.
Description:An entity (player) that is used by another entity (scoper)
A role a product plays when a guarantee is given to the purchaser by the seller (scoping entity) stating that the product is reliable and free from known defects and that the seller will repair or replace defective parts within a given time limit and under certain conditions.
A relationship in which the scoping Entity defines or specifies what the playing Entity is. Thus, the player's "being" (Greek: ontos) is specified.
Description: Specifies the player Entity (the equivalent Entity) as an Entity that is considered to be equivalent to a reference Entity (scoper). The equivalence is in principle a symmetric relationship, however, it is expected that the scoper is a reference entity which serves as reference entity for multiple different equivalent entities. Examples: An innovator's medicine formulation is the reference for "generics", i.e., formulations manufactured differently but having been proven to be biologically equivalent to the reference medicine. Another example is a reference ingredient that serves as basis for quantity specifications (basis of strength, e.g., metoprolol succinate specified in terms of metoprolol tartrate.)
The "same" role asserts an identity between playing and scoping entities, i.e., that they are in fact two records of the same entity instance, and, in the case of discrepancies (e.g different DOB, gender), that one or both are in error. Usage: playing and scoping entities must have same classCode, but need not have identical attributes or values. Example: a provider registry maintains sets of conflicting demographic data for what is reported to be the same individual.
Relates a prevailing record of an Entity (scoper) with another record (player) that it subsumes. Examples: Show a correct new Person object (scoper) that subsumes one or more duplicate Person objects that had accidentally been created for the same physical person. Constraints: Both the player and scoper must have the same classCode.
Relates a specialized material concept (player) to its generalization (scoper).
A special link between pharmaceuticals indicating that the target (scoper) is a generic for the source (player).
An individual piece of material (player) instantiating a class of material (scoper).
An entity that subsumes the identity of another. Used in the context of merging documented entity instances. Both the player and scoper must have the same classCode. The use of this code is deprecated in favor of the term SUBY which is its inverse and is more ontologically correct.
An association between two Entities where the playing Entity is considered in some way "part" of the scoping Entity, e.g., as a member, component, ingredient, or content. Being "part" in the broadest sense of the word can mean anything from being an integral structural component to a mere incidental temporary association of a playing Entity with a (generally larger) scoping Entity.
Relates a material as the content (player) to a container (scoper). Unlike ingredients, the content and a container remain separate (not mixed) and the content can be removed from the container. A content is not part of an empty container.
An exposure agent carrier is an entity that is capable of conveying an exposure agent from one entity to another. The scoper of the role must be the exposure agent (e.g., pathogen).
Description: A vector is a living subject that carries an exposure agent. The vector does not cause the disease itself, but exposes targets to the exposure agent. A mosquito carrying malaria is an example of a vector. The scoper of the role must be the exposure agent (e.g., pathogen).
Description: A fomite is a non-living entity that is capable of conveying exposure agent from one entity to another. A doorknob contaminated with a Norovirus is an example of a fomite. Anyone touching the doorknob would be exposed to the virus. The scoper of the role must be the exposure agent (e.g., pathogen).
Relates a component (player) to a mixture (scoper). E.g., Glucose and Water are ingredients of D5W, latex may be an ingredient in a tracheal tube.
Definition: a therapeutically active ingredient (player) in a mixture (scoper), where the mixture is typically a manufactured pharmaceutical. It is unknown if the quantity of such an ingredient is expressed precisely in terms of the playing ingredient substance, or, if it is specified in terms of a closely related substance (active moiety or reference substance).
Description: Active ingredient, where the ingredient substance (player) is itself the "basis of strength", i.e., where the Role.quantity specifies exactly the quantity of the player substance in the medicine formulation. Examples: Lopressor 50 mg actually contains 50 mg of metoprolol succinate, even though the active moiety is metoprolol, but also: Tenormin 50 mg contain 50 mg of atenolol, as free base, i.e., where the active ingredient atenolol is also the active moiety.
active ingredient - moiety is basis of strength
Description: Active ingredient, where not the ingredient substance (player), but itaTMs active moiety is the "basis of strength", i.e., where the Role.quantity specifies the quantity of the player substance's active moiety in the medicine formulation. Examples: 1 mL of Betopic 5mg/mL eye drops contains 5.6 mg betaxolol hydrochloride equivalent to betaxolol base 5 mg.
active ingredient - reference substance is basis of strength
Description: Active ingredient, where not the ingredient substance (player) but another reference substance with the same active moiety, is the "basis of strength", i.e., where the Role.quantity specifies the quantity of a reference substance, similar but different from the player substance's in the medicine formulation. Examples: Toprol-XL 50 mg contains 47.5 mg of metoprolol succinate equivalent to 50 mg of metoprolol tartrate.
A component (player) added to enhance the action of an active ingredient (scoper) (in the manner of a catalyst) but which has no active effect in and of itself. Such ingredients are significant in defining equivalence of products in a way that inactive ingredients are not.
An ingredient (player) that is added to a base (scoper), that amounts to a minor part of the overall mixture.
A base ingredient (player) is what comprises the major part of a mixture (scoper). E.g., Water in most i.v. solutions, or Vaseline in salves. Among all ingredients of a material, there should be only one base. A base substance can, in turn, be a mixture.
An ingredient whose presence is not intended but may not be reasonably avoided given the circumstances of the mixture's nature or origin.
An ingredient which is not considered therapeutically active, e.g., colors, flavors, stabilizers, or preservatives, fillers, or structural components added to an active ingredient in order to facilitate administration of the active ingredient but without being considered therapeutically active. An inactive ingredient need not be biologically inert, e.g., might be active as an allergen or might have a pleasant taste, but is not an essential constituent delivering the therapeutic effect.
A substance (player) influencing the optical aspect of material (scoper).
A substance (player) added to a mixture (scoper) to make it taste a certain way. In food the use is obvious, in pharmaceuticals flavors can hide disgusting taste of the active ingredient (important in pediatric treatments).
A substance (player) added to a mixture (scoper) to prevent microorganisms (fungi, bacteria) to spoil the mixture.
A stabilizer (player) added to a mixture (scoper) in order to prevent the molecular disintegration of the main substance.
An ingredient (player) of a medication (scoper) that is inseparable from the active ingredients, but has no intended chemical or pharmaceutical effect itself, but which may have some systemic effect on the patient. An example is a collagen matrix used as a base for transplanting skin cells. The collagen matrix can be left permanently in the graft site. Because it is of bovine origin, the patient may exhibit allergies or may have cultural objections to its use.
Relates an entity (player) to a location (scoper) at which it is present in some way. This presence may be limited in time.
Relates an entity (player) (e.g. a device) to a location (scoper) at which it is normally found or stored when not used.
A role played by an entity that is a member of a group. The group provides the scope for this role. Among other uses, groups as used in insurance (groups of covered individuals) and in scheduling where resources may be grouped for scheduling and logistical purposes.
Definition: an association between two Entities where the playing Entity (the part) is a component of the whole (scoper) in the sense of an integral structural component, that is distinct from other parts in the same whole, has a distinct function in the whole, and, as an effect, the full integrity of the whole depends (to some degree) on the presence of this part, even though the part may often be separable from the whole. Discussion: Part is defined in opposition to (a) ingredient (not separable), (b) content (not a functional component), and (c) member (not functionally distinct from other members).
The molecule or ion that is responsible for the intended pharmacological action of the drug substance, excluding those appended or associated parts of the molecule that make the molecule an ester, salt (including a salt with hydrogen or coordination bonds), or other noncovalent derivative (such as a complex, chelate, or clathrate). Examples: heparin-sodium and heparin-potassium have the same active moiety, heparin; the active moiety of morphine-hydrochloride is morphine.
A role played by a material entity that is a specimen for an act. It is scoped by the source of the specimen.
A portion (player) of an original or source specimen (scoper) used for testing or transportation.
A microorganism that has been isolated from other microorganisms or a source matrix.
The player of the role is a child of the scoping entity, in a generic sense.
A role played by an entity that receives credentials from the scoping entity.
A set of codes further specifying the kind of Role; specific classification codes for further qualifying RoleClass codes.
Concepts characterizing the type of association formed by player and scoper when there is a recognized Affiliate role by which the two parties are related. Examples: Business Partner, Business Associate, Colleague
Description:Codes that indicate a specific type of sponsor. Used when the sponsor's role is only either as a fully insured sponsor or only as a self-insured sponsor. NOTE: Where a sponsor may be either, use the SponsorParticipationFunction.code (fully insured or self insured) to indicate the type of responsibility. (CO6-0057)
Description:An employer or organization that contracts with an underwriter to assumes the financial risk and administrative responsibility for coverage of health services for covered parties.
Description:An employer or organization that assumes the financial risk and administrative responsibility for coverage of health services for covered parties.
Description:PayorRoleType for a particular type of policy or program benefit package or plan where more detail about the coverage administration role of the Payor is required. The functions performed by a Payor qualified by a PayorRoleType may be specified by the PayorParticpationFunction value set. Examples:A Payor that is a TPA may administer a managed care plan without underwriting the risk.
Description:A payor that is responsible for functions related to the enrollment of covered parties.
Description:Third party administrator (TPA) is a payor organization that processes health care claims without carrying insurance risk. Third party administrators are prominent players in the managed care industry and have the expertise and capability to administer all or a portion of the claims process. They are normally contracted by a health insurer or self-insuring companies to administer services, including claims administration, premium collection, enrollment and other administrative activities. Self-insured employers often contract with third party administrator to handle their insurance functions. Insurance companies oftentimes outsource the claims, utilization review or membership functions to a TPA. Sometimes TPAs only manage provider networks, only claims or only utilization review. While some third-party administrators may operate as units of insurance companies, they are often independent. However, hospitals or provider organizations desiring to set up their own health plans will often outsource certain responsibilities to TPAs. TPAs may perform one or several payor functions, specified by the PayorParticipationFunction value set, such as provider management, enrollment, utilization management, and fee for service claims adjudication management.
Description:A payor that is responsible for review and case management of health services covered under a policy or program.
The role played by a party who has legal responsibility for another party.
The role played by a person acting as the estate executor for a deceased subscriber or policyholder who was the responsible party
The role played by a person appointed by the court to look out for the best interests of a minor child during the course of legal proceedings.
The role played by a person or institution legally empowered with responsibility for the care of a ward.
A relationship between two people in which one person authorizes another to act for him in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts.
A relationship between two people in which one person authorizes another, usually a family member or relative, to act for him or her in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts that is often limited in the kinds of powers that can be assigned. Unlike ordinary powers of attorney, durable powers can survive for long periods of time, and again, unlike standard powers of attorney, durable powers can continue after incompetency.
A relationship between two people in which one person authorizes another to act for him or her in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts that continues (by its terms) to be effective even though the grantor has become mentally incompetent after signing the document.
A relationship between two people in which one person authorizes another to act for him or her in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts that is often limited in the kinds of powers that can be assigned.
Description:A role type that is used to further qualify a non-person subject playing a role where the role class attribute is set to RoleClass AssignedEntity
Description:Dogs trained to assist the ill or physically challenged.
Biotherapeutic non-person living subject
Description:Animals, including fish and insects, and microorganisms which may participate as assigned entities in biotherapies.
Description:Non-person living subject used as antibiotic. Examples:Bacteriophage, is a virus that infects bacteria.
Description:Maggots raised for biodebridement. Discussion: Maggot Debridement Therapy is the medical use of live maggots for cleaning non-healing wounds. Examples:Removal of burnt skin.
Description:Companion animals, such as dogs, cats, and rabbits, which may be provided to patients to improve general mood, decrease depression and loneliness, and distract from stress-inducing concerns to improve quality of life.
Description:Dogs trained to assist persons who are seeing impaired or blind.
Description:Dogs trained or having the ability to detect imminent seizures or cancers in humans, probably as a result of volatile chemical (odors) given off by the malignancy of the host.
Defines types of certifications for all entities
A role type used to qualify a person's legal status within a country or nation.
A person who has fled his or her home country to find a safe place elsewhere.
A person who is someone of below legal age who has fled his or her home country, without his or her parents, to find a safe place elsewhere at time of categorization.
A person who is legally recognized as a member of a nation or country, with associated rights and obligations.
non-country member without residence permit
A foreigner who is present in a country (which is foreign to him/her) unlawfully or without the country's authorization (may be called an illegal alien).
non-country member minor without residence permit
A person who is below legal age present in a country, without his or her parents, (which is foreign to him/her) unlawfully or without the country's authorization.
A non-country member admitted to the territory of a nation or country as a non-resident for an explicit purpose.
non-country member with residence permit
A foreigner who is a resident of the country but does not have citizenship.
non-country member minor with residence permit
A person who is a resident below legal age of the country without his or her parents and does not have citizenship.
A contact role used for business and/or administrative purposes.
A contact role used to identify a person within a Provider organization that can be contacted for billing purposes (e.g. about the content of the Invoice).
A contact for an organization for administrative purposes. Contact role specifies a person acting as a liason for the organization. Example: HR Department representative.
A contact role used to identify a person within a Payor organization to whom this communication is addressed.
A contact designated for contact in emergent situations.
Played by an individual who is designated as the next of kin for another individual which scopes the role.
Definition: A code representing the type of identifier that has been assigned to the identified entity (IDENT). Examples: Example values include Social Insurance Number, Product Catalog ID, Product Model Number.
Description:Describes types of identifiers other than the primary location registry identifier for a service delivery location. Identifiers may be assigned by a local service delivery organization, a formal body capable of accrediting the location for the capability to provide specific services or the identifier may be assigned at a jurisdictional level.
Description:Identifier assigned to a location by the organization responsible for accrediting the location.
Description:Identifier assigned to a location by a jurisdiction.
Description:Identifier assigned to a location by a local party (which could be the facility itself or organization overseeing a group of facilities).
Code indicating the primary use for which a living subject is bred or grown
Dual purpose. Defined purposes based on species and breed
Animals raised for their fur, hair or skins
Poultry flocks used for chick/poult production
Cattle raised for veal meat production. Implicit is the husbandry method.
Sheep, goats and other mammals raised for their fiber
Identifies the specific hierarchical relationship between the playing and scoping medications. Examples: Generic, Generic Formulation, Therapeutic Class, etc.
Description:A categorization of medicinal products by their therapeutic properties and/or main therapeutic use.
Relates a manufactured drug product to the non-proprietary (generic) representation of its ingredients independent of strength, and form. The scoping entity identifies a unique combination of medicine ingredients; sometimes referred to as "ingredient set".
Relates a manufactured drug product to the non-proprietary (generic) representation of its ingredients and dose form, independent of strength of the ingredients. The scoping entity identifies a unique combination of medicine ingredients in a specific dose form.
Relates a manufactured drug product to the non-proprietary (generic) representation of is ingredients with their strength. The scoping entity identifies a unique combination of medicine ingredients with their strength.
Relates a manufactured drug product to the non-proprietary (generic) representation of its ingredients with their strength in a specific dose form. The scoping entity identifies a unique combination of medicine ingredients with their strength in a single dose form.
The player of the role is a child of the scoping entity.
The player of the role is a child taken into a family through legal means and raised by the scoping person (parent) as his or her own child.
The player of the role is a female child taken into a family through legal means and raised by the scoping person (parent) as his or her own child.
The player of the role is a male child taken into a family through legal means and raised by the scoping person (parent) as his or her own child.
The player of the role is a child receiving parental care and nurture from the scoping person (parent) but not related to him or her through legal or blood ties.
The player of the role is a female child receiving parental care and nurture from the scoping person (parent) but not related to him or her through legal or blood ties.
The player of the role is a male child receiving parental care and nurture from the scoping person (parent) but not related to him or her through legal or blood ties.
Description: The player of the role is a female child (of any type) of scoping entity (parent)
The player of the role is a female offspring of the scoping entity (parent).
The player of the role is a daughter of the scoping person's spouse by a previous union.
The player of the role is an offspring of the scoping entity as determined by birth.
The player of the role is a male offspring of the scoping entity (parent).
Description: The player of the role is a male child (of any type) of scoping entity (parent)
The player of the role is a son of the scoping person's spouse by a previous union.
The player of the role is a child of the scoping person's spouse by a previous union.
Description: A family member not having an immediate genetic or legal relationship e.g. Aunt, cousin, great grandparent, grandchild, grandparent, niece, nephew or uncle.
The player of the role is a sister of the scoping person's mother or father.
Description:The player of the role is a biological sister of the scoping person's biological mother.
Description:The player of the role is a biological sister of the scoping person's biological father.
The player of the role is a relative of the scoping person descended from a common ancestor, such as a grandparent, by two or more steps in a diverging line.
Description:The player of the role is a biological relative of the scoping person descended from a common ancestor on the player's mother's side, such as a grandparent, by two or more steps in a diverging line.
Description:The player of the role is a biological relative of the scoping person descended from a common ancestor on the player's father's side, such as a grandparent, by two or more steps in a diverging line.
The player of the role is a parent of the scoping person's grandparent.
The player of the role is the father of the scoping person's grandparent.
Description:The player of the role is the biological father of the scoping person's biological mother's parent.
Description:The player of the role is the biological father of the scoping person's biological father's parent.
The player of the role is the mother of the scoping person's grandparent.
Description:The player of the role is the biological mother of the scoping person's biological mother's parent.
Description:The player of the role is the biological mother of the scoping person's biological father's parent.
Description:The player of the role is a biological parent of the scoping person's biological mother's parent.
Description:The player of the role is a biological parent of the scoping person's biological father's parent.
The player of the role is a child of the scoping person's son or daughter.
The player of the role is a daughter of the scoping person's son or daughter.
The player of the role is a son of the scoping person's son or daughter.
The player of the role is a parent of the scoping person's mother or father.
The player of the role is the father of the scoping person's mother or father.
Description:The player of the role is the biological father of the scoping person's biological mother.
Description:The player of the role is the biological father of the scoping person's biological father.
The player of the role is the mother of the scoping person's mother or father.
Description:The player of the role is the biological mother of the scoping person's biological mother.
Description:The player of the role is the biological mother of the scoping person's biological father.
Description:The player of the role is the biological parent of the scoping person's biological mother.
Description:The player of the role is the biological parent of the scoping person's biological father.
A relationship between an individual and a member of their spousal partner's immediate family.
The player of the role is the spouse of scoping person's child.
The player of the role is the wife of scoping person's son.
The player of the role is the husband of scoping person's daughter.
The player of the role is the parent of scoping person's husband or wife.
The player of the role is the father of the scoping person's husband or wife.
The player of the role is the mother of the scoping person's husband or wife.
The player of the role is: (1) a sibling of the scoping person's spouse, or (2) the spouse of the scoping person's sibling, or (3) the spouse of a sibling of the scoping person's spouse.
The player of the role is: (1) a brother of the scoping person's spouse, or (2) the husband of the scoping person's sister, or (3) the husband of a sister of the scoping person's spouse.
The player of the role is: (1) a sister of the scoping person's spouse, or (2) the wife of the scoping person's brother, or (3) the wife of a brother of the scoping person's spouse.
The player of the role is a child of scoping person's brother or sister or of the brother or sister of the scoping person's spouse.
The player of the role is a son of the scoping person's brother or sister or of the brother or sister of the scoping person's spouse.
The player of the role is a daughter of the scoping person's brother or sister or of the brother or sister of the scoping person's spouse.
The player of the role is a brother of the scoping person's mother or father.
Description:The player of the role is a biological brother of the scoping person's biological mother.
Description:The player of the role is a biological brother of the scoping person's biological father.
The player of the role is one who begets, gives birth to, or nurtures and raises the scoping entity (child).
The player of the role (parent) has taken the scoper (child) into their family through legal means and raises them as his or her own child.
The player of the role (father) is a male who has taken the scoper (child) into their family through legal means and raises them as his own child.
The player of the role (father) is a female who has taken the scoper (child) into their family through legal means and raises them as her own child.
The player of the role is a male who begets or raises or nurtures the scoping entity (child).
The player of the role (parent) who is a male state-certified caregiver responsible for the scoper (child) who has been placed in the parent's care. The placement of the child is usually arranged through the government or a social-service agency, and temporary. The state, via a jurisdiction recognized child protection agency, stands as in loco parentis to the child, making all legal decisions while the foster parent is responsible for the day-to-day care of the specified child.
The player of the role is a male who begets the scoping entity (child).
Indicates the biologic male parent of a fetus.
The player of the role is the husband of scoping person's mother and not the scoping person's natural father.
The player of the role is a female who conceives, gives birth to, or raises and nurtures the scoping entity (child).
The player is a female whose womb carries the fetus of the scoper. Generally used when the gestational mother and natural mother are not the same.
The player of the role (parent) who is a female state-certified caregiver responsible for the scoper (child) who has been placed in the parent's care. The placement of the child is usually arranged through the government or a social-service agency, and temporary. The state, via a jurisdiction recognized child protection agency, stands as in loco parentis to the child, making all legal decisions while the foster parent is responsible for the day-to-day care of the specified child.
The player of the role is a female who conceives or gives birth to the scoping entity (child).
The player is the biologic female parent of the scoping fetus.
The player of the role is the wife of scoping person's father and not the scoping person's natural mother.
The player of the role (parent) who is a state-certified caregiver responsible for the scoper (child) who has been placed in the parent's care. The placement of the child is usually arranged through the government or a social-service agency, and temporary. The state, via a jurisdiction recognized child protection agency, stands as in loco parentis to the child, making all legal decisions while the foster parent is responsible for the day-to-day care of the specified child.
The player of the role is the spouse of the scoping person's parent and not the scoping person's natural parent.
The player of the role shares one or both parents in common with the scoping entity.
The player of the role is a male sharing one or both parents in common with the scoping entity.
The player of the role is a male related to the scoping entity by sharing only one biological parent.
The player of the role is a male having the same biological parents as the scoping entity.
The scoper was carried in the same womb as the male player and shares common biological parents.
The scoper was carried in the same womb as the male player and shares common biological parents but is the product of a distinct egg/sperm pair.
The male scoper is an offspring of the same egg-sperm pair as the male player.
The player of the role is a son of the scoping person's stepparent.
The player of the role is related to the scoping entity by sharing only one biological parent.
The player of the role is a female related to the scoping entity by sharing only one biological parent.
The player of the role has both biological parents in common with the scoping entity.
The player of the role is a female having the same biological parents as the scoping entity.
The scoper was carried in the same womb as the female player and shares common biological parents.
The scoper was carried in the same womb as the female player and shares common biological parents but is the product of a distinct egg/sperm pair.
The female scoper is an offspring of the same egg-sperm pair as the female player.
The scoper and player were carried in the same womb and shared common biological parents.
The scoper and player were carried in the same womb and share common biological parents but are the product of distinct egg/sperm pairs.
The scoper and player are offspring of the same egg-sperm pair.
The player of the role is a female sharing one or both parents in common with the scoping entity.
The player of the role is a daughter of the scoping person's stepparent.
The player of the role is a child of the scoping person's stepparent.
A person who is important to one's well being; especially a spouse or one in a similar relationship. (The player is the one who is important)
The player of the role cohabits with the scoping person but is not the scoping person's spouse.
Player of the role was previously joined to the scoping person in marriage and this marriage is now dissolved and inactive. Usage Note: This is significant to indicate as some jurisdictions have different legal requirements for former spouse to access the patient's record, from a general friend.
The player of the role is a marriage partner of the scoping person.
The player of the role is a man joined to a woman (scoping person) in marriage.
The player of the role is a woman joined to a man (scoping person) in marriage.
The player of the role is a person who is known, liked, and trusted by the scoping person.
The player of the role lives near or next to the scoping person.
The relationship that a person has with his or her self.
One who shares living quarters with the subject.
Description: A role recognized through the eligibility of an identified party for benefits covered under an insurance policy or a program based on meeting eligibility criteria. Eligibility as a covered party may be conditioned on the party meeting criteria to qualify for coverage under a policy or program, which may be mandated by law. These criteria may be: The sole basis for coverage, e.g., being differently abled may qualify a person for disability coverage May more fully qualify a covered party role e.g, being differently abled may qualify an adult child as a dependent May impact the level of coverage for a covered party under a policy or program, e.g., being differently abled may qualify a program eligible for additional benefits. Discussion: The Abstract Value Set "CoverageRoleType", which was developed for use in the Canadian realm "pre-coordinate" coverage roles with other roles that a covered party must play in order to be eligible for coverage, e.g., "handicapped dependent". These role.codes may only be used with COVPTY to avoid overlapping concepts that would result from using them to specify the specializations of COVPTY, e.g., the role.class DEPEN should not be used with the role.code family dependent because that relationship has overlapping concepts due to the role.code precoodination and is conveyed in FICO with the personal relationship role that has a PART role link to the covered party role. For the same reasons, the role.class DEPEN should not be used with the role.code HANDIC (handicapped dependent); the role.code DIFFABLE (differently abled) should be used instead. In summary, the coded concepts in the Abstract Value Set "CoveredPartyRoleType" can be "post-coordinated" with the "RoleClassCoveredParty" Abstract Value Set. Decoupling these concepts is intended to support an expansive range of covered party concepts and their semantic comparability.
Role recognized through the issuance of insurance coverage to an identified covered party who has this relationship with the policy holder such as the policy holder themselves (self), spouse, child, etc
The player of the role is dependent of the scoping entity.
Covered party is a dependent of the policy holder with a physical or mental disability causing a disadvantage that makes independent achievement unusually difficult.
Covered party is an injured party with a legal claim for compensation against a policy holder under an insurance policy.
Covered party is the policy holder. Also known as the subscriber.
Covered party is an individual that the policy holder has assumed responsibility for, such as foster child or legal ward.
Covered party to an insurance policy has coverage through full-time or part-time attendance at a recognized educational institution as defined by a particular insurance policy.
Covered party to an insurance policy has coverage through full-time attendance at a recognized educational institution as defined by a particular insurance policy.
Covered party to an insurance policy has coverage through part-time attendance at a recognized educational institution as defined by a particular insurance policy.
A child taken into one's family through legal means and raised as one's own child.
A child of one's brother or sister or of the brother or sister of one's spouse.
One that begets or brings forth offspring or a person who brings up and cares for for another (Webster's Collegiate Dictionary)
A child receiving parental care and nurture from a person who is related to them through marriage to their parent.
A role recognized through the eligibility of an identified living subject for benefits covered under an insurance policy or a program. Eligibility as a covered party may be conditioned on a relationship with (1) the policy holder such as the policy holder who is covered as an individual under a poliy or as a party sponsored for coverage by the policy holder. Example:An employee as a subscriber; or (2) on being scoped another covered party such as the subscriber, as in the case of a dependent. Discussion: The Abstract Value Set "CoverageRoleType", which was developed for use in the Canadian realm "pre-coordinate" coverage roles with other roles that a covered party must play in order to be eligible for coverage, e.g., "handicapped dependent". Other codes in the Abstract Value Set CoveredPartyRoleType domain can be "post-coordinated" with the EligiblePartyRoleType codes to denote comparable concepts. Decoupling the concepts is intended to support a wider range of concepts and semantic comparability of coded concepts.
DescriptionA role recognized through the eligibility of a party play a claimant for benefits covered or provided under an insurance policy.
Description: A person playing the role of program eligible under a program based on allegations of being the victim of a crime. Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is "program eligible" and the person's status as a crime victim meets jurisdictional or program criteria.
Description: A person playing the role of program eligible under a workers compensation program based on the filing of work-related injury claim. Discussion: This CoveredPartyRoleType.code is used when the CoveredPartyRole class code is either "program eligible", a "named insured", and "individual insured", or "dependent", and the person's status as differently abled or "handicapped" meets jurisdictional, policy, or program criteria.
Description: A role recognized through the eligibility of a party to play a dependent for benefits covered or provided under a health insurance policy because of an association with the subscriber that is recognized by the policy underwriter.
Description: A person playing the role of an individual insured with continuity of coverage under a policy which is being terminated based on loss of original status that was the basis for coverage. Criteria for qualifying for continuity of coverage may be set by law. Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the person's status as a continuity of coverage beneficiary meets jurisdictional or policy criteria.
Description: A person playing the role of program eligible under a program based on meeting criteria for health or functional limitation set by law or by the program. Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible", "named insured", "individual insured", or "dependent", and the person's status as differently abled meets jurisdictional, policy, or program criteria.
Description: A person, who is a minor or is deemed incompetent, who plays the role of a program eligible where eligibility for coverage is based on meeting program eligibility criteria for status as a ward of a court or jurisdiction. Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is a "claimant", "program eligible", a "named insured", an "individual Insured" or a "dependent", and the person's status as a ward meets program or policy criteria. In the case of a ward covered under a program providing financial or health benefits, a governmental agency may take temporary custody of a minor or incompetent for his/her protection and care, e.g., if the ward is suffering from neglect or abuse, or has been in trouble with the law.
A role recognized through the eligibility of a party to play an individual insured for benefits covered or provided under an insurance policy where the party is also the policy holder.
Description: A person playing the role of an individual insured under a policy based on meeting criteria for the employment status of retired set by law or the policy. Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the person's status as a retiree meets jurisdictional or policy criteria.
Description:A role recognized through the eligibility of a party to play a program eligible for benefits covered or provided under a program.
Description: A person playing the role of program eligible under a program based on aboriginal ancestry or as a member of an aboriginal community. Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is "program eligible" and the person's status as a member of an indigenous people meets jurisdictional or program criteria.
Description: A person playing the role of program eligible under a program based on active military status. Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the persons status as active duty military meets jurisdictional or program criteria.
Description: A person playing the role of program eligible under a program based on retired military status. Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the persons status as retired military meets jurisdictional or program criteria.
Description: A person playing the role of program eligible under a program based on status as a military veteran. Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the persons status as a veteran meets jurisdictional or program criteria.
Description: A role recognized through the eligibility of a party to play a subscriber for benefits covered or provided under a health insurance policy.
Specifies the administrative functionality within a formal experimental design for which the ResearchSubject role was established. Examples: screening - role is used for pre-enrollment evaluation portion of the design; enrolled - role is used for subjects admitted to the active treatment portion of the design.
Definition:The specific role being played by a research subject participating in the active treatment or primary data collection portion of a research study.
Definition:The specific role being played by a research subject participating in the pre-enrollment evaluation portion of a research study.
A role of a place that further classifies the setting (e.g., accident site, road side, work site, community location) in which services are delivered.
A role of a place that further classifies a setting that is intended to house the provision of services.
A role of a place that further classifies the clinical setting (e.g., cardiology clinic, primary care clinic, rehabilitation hospital, skilled nursing facility) in which care is delivered during an encounter.
A practice setting where diagnostic procedures or therapeutic interventions are performed
Cardiovascular diagnostics or therapeutics unit
A practice setting where cardiovascular diagnostic procedures or therapeutic interventions are performed (e.g., cardiac catheterization lab, echocardiography suite)
Gastroenterology diagnostics or therapeutics lab
A practice setting where GI procedures (such as endoscopies) are performed
Radiology diagnostics or therapeutics unit
A practice setting where radiology services (diagnostic or therapeutic) are provided (X12N 261QR0200N)
An acute care institution that provides medical, surgical, or psychiatric care and treatment for the sick or the injured.
(1) A hospital including a physical plant and personnel that provides multidisciplinary diagnosis and treatment for diseases that have one or more of the following characteristics: is permanent; leaves residual disability; is caused by nonreversible pathological alteration; requires special training of the patient for rehabilitation; and/or may be expected to require a long period of supervision or care. In addition, patients require the safety, security, and shelter of these specialized inpatient or partial hospitalization settings. (2) A hospital that provides medical and skilled nursing services to patients with long-term illnesses who are not in an acute phase but who require an intensity of services not available in nursing homes
A health care facility operated by the Department of Defense or other military operation.
Healthcare facility that cares for patients with psychiatric illness(s).
Description: A location that plays the role of delivering services which may include life training and/or social support to people with addictions.
Description: A location that plays the role of delivering services which may include adaptation, rehabilitation and social integration services for people with intellectual and/or pervasive development disorders such as autism or severe behaviour disorder.
parents with adjustment difficulties center
Description: A location that plays the role of delivering services which may social support services for adolescents who are pregnant or have child and are experiencing adaptation issues/difficulties in their current or eventual parenting role.
Description: A location that plays the role of delivering services which may include adaptation, rehabilitation and social integration services for people with physical impairments.
Description: A location that plays the role of delivering services for people with hearing impairments.
physical impairment - motor skills center
Description: A location that plays the role of delivering services for people with motor skill impairments.
physical impairment - visual skills center
Description: A location that plays the role of delivering services for people with visual skill impairments.
youths with adjustment difficulties center
Description: A location that plays the role of delivering services which may include life training and/or social support services for the adaption, rehabilitation and social integration of youths with adjustment difficulties.
A specialty unit in hospital that focuses on chronic respirator patients and pulmonary failure
The section of a health care facility for providing rapid treatment to victims of sudden illness or trauma.
Description: A location that plays the role of delivering services which may include tests done based on clinical specimens to get health information about a patient as pertaining to the diagnosis, treatment and prevention of disease. Hospital laboratories may be further divided into specialized units such as Anatomic Pathology, Microbiology, and Biochemistry.
Description: A location that plays the role of delivering services which may include tests are done on clinical specimens to get health information about a patient pertaining to the diagnosis, treatment, and prevention of disease for a hospital visit longer than one day.
Description: A location that plays the role of delivering services which may include tests are done on clinical specimens to get health information about a patient pertaining to the diagnosis, treatment, and prevention of disease for same day visits.
Description: A location that plays the role of delivering services which may include the branch of medicine that uses ionizing and non-ionizing radiation to diagnose and treat diseases. The radiology unit may be further divided into subspecialties such as Imaging, Cardiovascular, Thoracic, and Ultrasound.
Description: A location that plays the role of delivering services which may include collecting specimens and/or samples from patients for laboratory testing purposes, but does not perform any tests or analysis functions.
Description: A location that plays the role of delivering services which may include providing judicious, safe, efficacious, appropriate and cost effective use of medicines for treatment of patients for visits longer than one day. The distinction between inpatient pharmacies and retail (or outpatient) pharmacies is that they are part of a patient's continuity of care while staying in the hospital.
Description: A location that plays the role of delivering services which include biochemistry, hematology, microbiology, immunochemistry, and toxicology.
Description: A location that plays the role of delivering services which may include providing judicious, safe, efficacious, appropriate and cost effective use of medicines for treatment of patients for outpatient visits and may also be used for discharge prescriptions.
Ambulatory Health Care Facilities; Clinic/Center; Rehabilitation: Cardiac Facilities
Description: A location that plays the role of delivering services which may include examination, diagnosis, treatment, management, and prevention of diseases and disorders of the eye as well as prescribing and fitting appropriate corrective lenses (glasses or contact lenses) as needed. Optometry clinics may also provide tests for visual field screening, measuring intra-ocular pressure and ophthalmoscopy, as and when required.
Location where healthcare service was delivered, identified as the healthcare provider's practice office.
A role of a place that further classifies a setting that is intended to house the provision of non-clinical services.
Location address where medical supplies were transported to for use.
Location (mobile) where healthcare service was delivered.
Location (mobile) where healthcare service was delivered, identified specifically as an ambulance.
Location where healthcare service was delivered, identified as a pharmacy.
Location of an accident where healthcare service was delivered, such as a roadside.
Community location where healthcare is delivered.
Description: A location that plays the role of delivering services which may include providing front-line services to the population of a defined geographic area such as: healthcare services and social services, preventive or curative, rehabilitation or reintegration.
location where healthcare was delivered which is the residence of the Patient.
Location where healthcare service was delivered, identified as a school or educational facility.
Description: A location that plays the role of delivering services which may include: social emergency services required for a young person as required under any jurisdictional youth laws, child placement, and family mediation in the defined geographical area the SDL is responsible for. It may provide expertise in a judiciary setting on child custody, adoption and biological history research.
Location where healthcare service was delivered, identified as a work place.
A specimen used for initial calibration settings of an instrument
A set of patient samples in which the individuals of the group may or may not be identified.
Aliquots of individual specimens combined to form a single specimen representing all of the included individuals.
A specimen that has been collected from a patient.
A specimen specifically used to verify the sensitivity, specificity, accuracy or other perfomance parameter of a diagnostic test.
Quality Control specimen submitted to the lab whose identity and composition is not known to the lab.
Specimen used for testing proficiency of an organization performing testing (how does this differ from O?)
A specimen used for evaluation of operator proficiency (operator in what context?)
A specimen used for periodic calibration checks of instruments
A portion of an original patent sample that is tested at the same time as the original sample
A party that makes a claim for coverage under a policy.
An individual or organization that makes or gives a promise, assurance, pledge to pay or has paid the healthcare service provider.
A party that meets the eligibility criteria for coverage under a program.
The recipient for the service(s) and/or product(s) when they are not the covered party.
A party covered under a policy based on association with a subscriber.
A member of the covered party's family. This could be the spouse, a parent, a grand parent, a sibling, etc.
A party covered under a policy as the policyholder.
A party to an insurance policy to whom the insurer agrees to indemnify for losses, provides benefits for, or renders services.
A party covered under a policy based on association with a sponsor who is the policy holder, and whose association may provide for the eligibility of dependents for coverage
Description: Codes representing possible states of a RoleLink, as defined by the RoleLink class state machine.
Description: The 'typical' state. Excludes "nullified" which represents the termination state of a RoleLink instance that was created in error.
Description: The state indicates the RoleLink is in progress.
Description: The terminal state resulting from abandoning the RoleLink prior to or after activation.
Description: The terminal state representing the successful completion of the RoleLink.
Description: The state indicates the RoleLink has not yet become active.
Description: The state representing the termination of a RoleLink instance that was created in error.
This relationship indicates the source Role is available to the target Role as a backup. An entity in a backup role will be available as a substitute or replacement in the event that the entity assigned the role is unavailable. In medical roles where it is critical that the function be performed and there is a possibility that the individual assigned may be ill or otherwise indisposed, another individual is assigned to cover for the individual originally assigned the role. A backup may be required to be identified, but unless the backup is actually used, he/she would not assume the assigned entity role.
This relationship indicates the target Role provides or receives information regarding the target role. For example, AssignedEntity is a contact for a ServiceDeliveryLocation.
The source Role has direct authority over the target role in a chain of authority.
Description: The source role provides identification for the target role. The source role must be IDENT. The player entity of the source role is constrained to be the same as (i.e. the equivalent of, or equal to) the player of the target role if present. If the player is absent from the source role, then it is assumed to be the same as the player of the target role.
The source Role has indirect authority over the target role in a chain of authority.
The target Role is part of the Source Role.
This relationship indicates that the source Role replaces (or subsumes) the target Role. Allows for new identifiers and/or new effective time for a registry entry or a certification, etc.
Codes representing the defined possible states of an Role, as defined by the Role class state machine.
The 'typical' state. Excludes "nullified" which represents the termination state of a Role instance that was created in error.
The state representing the fact that the Entity is currently active in the Role.
The terminal state resulting from cancellation of the role prior to activation.
The state representing that fact that the role has not yet become active.
The state that represents a suspension of the Entity playing the Role. This state is arrived at from the "active" state.
The state representing the successful termination of the Role.
The state representing the termination of a Role instance that was created in error.
The path the administered medication takes to get into the body or into contact with the body.
Route of substance administration classified by administration method.
Infusion, intravenous catheter, continuous
Infusion, intravenous catheter, intermittent
Infusion, intravenous catheter, pca pump
Inhalation, intermittent positive pressure breathing (ippb)
Instillation, continuous ambulatory peritoneal dialysis port
Topical application, intracoronal (dental)
Route of substance administration classified by site.
Security observation values used to indicate security control metadata. V:SecurityControl is the union of V:SecurityPolicy,V:ObligationPolicy, V:RefrainPolicy, V:PurposeOfUse, and V:GeneralPurpose of Use used to populate the SecurityControlObservationValue attribute in order to convey one or more nonhierarchical security control metadata dictating handling caveats, purpose of use, dissemination controls and other refrain policies, and obligations to which a custodian or receiver is required to comply.
Types of security policies that further specify the ActClassPolicy value set. Examples: encrypt prohibit redisclosure without consent directive
Operations that can be used to associate concepts in a terminology.
Form the set-difference with this value, i.e., exclude this element or set from the resulting set.
Form the union with this value, i.e., include this element or set in the resulting set.
Form the convex hull with the value. The convex hull is defined over ordered domains and is the smallest contiguous superset (interval) that of all the operand sets.
Form the periodic hull with the value. The periodic hull is defined over ordered domains and is the periodic set that contains all contiguous supersets of pairs of intervals generated by the operand periodic intervals.
Identifies what sort of change is permitted or has occurred between the item that was ordered/requested and the one that was/will be provided.
Some conditions may be attached to an allowable substitution. An allowable substitution is based on a match to any other attributes that may be specified.
Confirmation with Contact Person prior to making any substitutions has or will occur.
Notification to the Contact Person, prior to substitution and through normal institutional procedures, has or will be made.
These values are defined within the XHTML 4.0 Table Model
Target person has been informed about the issue but currently denies it.
Target person is fully aware of the issue.
Target person is not capable of comprehending the issue.
Target person is marginally aware of the issue.
Target person is partially aware of the issue.
Target person has not yet been informed of the issue.
v3 Code System TelecommunicationCapabilities
Description: Concepts that define the telecommunication capabilities of a particular device. Used to identify the expected capabilities to be found at a particular telecommunication address.
Description: This device can receive data calls (i.e. modem).
Description: This device can receive faxes.
Description: This device can receive SMS messages.
Description: This device is a text telephone.
Description: This device can receive voice calls (i.e. talking to another person, or a recording device, or a voice activated computer).
before lunch (from lat. ante cibus diurnus)
before breakfast (from lat. ante cibus matutinus)
before dinner (from lat. ante cibus vespertinus)
Description: meal (from lat. ante cibus)
Description: lunch (from lat. cibus diurnus)
Description: breakfast (from lat. cibus matutinus)
Description: dinner (from lat. cibus vespertinus)
Description: Prior to beginning a regular period of extended sleep (this would exclude naps). Note that this might occur at different times of day depending on a person's regular sleep schedule.
after lunch (from lat. post cibus diurnus)
after breakfast (from lat. post cibus matutinus)
after dinner (from lat. post cibus vespertinus)
Description: Upon waking up from a regular period of sleep, in order to start regular activities (this would exclude waking up from a nap or temporarily waking up during a period of sleep) Usage Notes: e.g. Take pulse rate on waking in management of thyrotoxicosis. Take BP on waking in management of hypertension Take basal body temperature on waking in establishing date of ovulation
v3 Code System TransmissionRelationshipTypeCode
Description: A code specifying the meaning and purpose of every TransmissionRelationship instance. Each of its values implies specific constraints to what kinds of Transmission objects can be related and in which way.
Description:A transmission relationship indicating that the source transmission follows the target transmission.
INDIAN ENTITIES RECOGNIZED AND ELIGIBLE TO RECEIVE SERVICES FROM THE UNITED STATES BUREAU OF INDIAN AFFAIRS
NATIVE ENTITIES WITHIN THE STATE OF ALASKA RECOGNIZED AND ELIGIBLE TO RECEIVE SERVICES FROM THE UNITED STATES BUREAU OF INDIAN AFFAIRS
Arctic Village (See Native Village of Venetie Trib
Asa carsarmiut Tribe (formerly Native Village of M
Native Village of Barrow Inupiat Traditional Gover
Native Village of Chuathbaluk (Russian Mission, Ku
Curyung Tribal Council (formerly Native Village of
Organized Village of Grayling (aka Holikachuk)
Iqurmuit Traditional Council (formerly Native Vill
Native Village of Kluti Kaah (aka Copper Center)
Native Village of Kwinhagak (aka Quinhagak)
Native Village of Marshall (aka Fortuna Ledge)
Metlakatla Indian Community, Annette Island Reserv
Native Village of Nanwalek (aka English Bay)
New Koliganek Village Council (formerly Koliganek
Native Village of Nuiqsut (aka Nooiksut)
Nunakauyarmiut Tribe (formerly Native Village of T
Orutsararmuit Native Village (aka Bethel)
Pribilof Islands Aleut Communities of St. Paul & S
Qagan Tayagungin Tribe of Sand Point Village
Saint George Island(See Pribilof Islands Aleut Com
Saint Paul Island (See Pribilof Islands Aleut Comm
Central Council of the Tlingit and Haida Indian Tb
Village of Venetie (See Native Village of Venetie
Native Village of Venetie Tribal Government (Arcti
NATIVE ENTITIES WITHIN THE CONTIGUOUS 48 STATES
Absentee-Shawnee Tribe of Indians of Oklahoma
Assiniboine and Sioux Tribes of the Fort Peck Indi
Havasupai Tribe of the Havasupai Reservation, Ariz
Ho-Chunk Nation of Wisconsin (formerly known as th
Hoh Indian Tribe of the Hoh Indian Reservation, Wa
Hopland Band of Pomo Indians of the Hopland Ranche
Houlton Band of Maliseet Indians of Maine
Hualapai Indian Tribe of the Hualapai Indian Reser
Inaja Band of Diegueno Mission Indians of the Inaj
Augustine Band of Cahuilla Mission Indians of the
Ione Band of Miwok Indians of California
Jackson Rancheria of Me-Wuk Indians of California
Jicarilla Apache Tribe of the Jicarilla Apache Ind
Kaibab Band of Paiute Indians of the Kaibab Indian
Kalispel Indian Community of the Kalispel Reservat
Bad River Band of the Lake Superior Tribe of Chipp
Kashia Band of Pomo Indians of the Stewarts Point
Keweenaw Bay Indian Community of L'Anse and Ontona
Kickapoo Tribe of Indians of the Kickapoo Reservat
Bay Mills Indian Community of the Sault Ste. Marie
La Jolla Band of Luiseno Mission Indians of the La
La Posta Band of Diegueno Mission Indians of the L
Lac Courte Oreilles Band of Lake Superior Chippewa
Lac du Flambeau Band of Lake Superior Chippewa Ind
Lac Vieux Desert Band of Lake Superior Chippewa In
Las Vegas Tribe of Paiute Indians of the Las Vegas
Little River Band of Ottawa Indians of Michigan
Little Traverse Bay Bands of Odawa Indians of Mich
Bear River Band of the Rohnerville Rancheria, Cali
Los Coyotes Band of Cahuilla Mission Indians of th
Lovelock Paiute Tribe of the Lovelock Indian Colon
Lower Brule Sioux Tribe of the Lower Brule Reserva
Lower Elwha Tribal Community of the Lower Elwha Re
Lower Sioux Indian Community of Minnesota Mdewakan
Lummi Tribe of the Lummi Reservation, Washington
Makah Indian Tribe of the Makah Indian Reservation
Manchester Band of Pomo Indians of the Manchester-
Manzanita Band of Diegueno Mission Indians of the
Berry Creek Rancheria of Maidu Indians of Californ
Mashantucket Pequot Tribe of Connecticut
Match-e-be-nash-she-wish Band of Pottawatomi India
Mechoopda Indian Tribe of Chico Rancheria, Califor
Mesa Grande Band of Diegueno Mission Indians of th
Mescalero Apache Tribe of the Mescalero Reservatio
Middletown Rancheria of Pomo Indians of California
Minnesota Chippewa Tribe, Minnesota (Six component
Bois Forte Band (Nett Lake); Fond du Lac Band; Gra
Mississippi Band of Choctaw Indians, Mississippi
Moapa Band of Paiute Indians of the Moapa River In
Mooretown Rancheria of Maidu Indians of California
Morongo Band of Cahuilla Mission Indians of the Mo
Muckleshoot Indian Tribe of the Muckleshoot Reserv
Narragansett Indian Tribe of Rhode Island
Big Pine Band of Owens Valley Paiute Shoshone Indi
Navajo Nation, Arizona, New Mexico & Utah
Nisqually Indian Tribe of the Nisqually Reservatio
Northern Cheyenne Tribe of the Northern Cheyenne I
Northfork Rancheria of Mono Indians of California
Northwestern Band of Shoshoni Nation of Utah (Wash
Oglala Sioux Tribe of the Pine Ridge Reservation,
Big Sandy Rancheria of Mono Indians of California
Otoe-Missouria Tribe of Indians, Oklahoma
Paiute-Shoshone Indians of the Bishop Community of
Paiute-Shoshone Tribe of the Fallon Reservation an
Paiute-Shoshone Indians of the Lone Pine Community
Pala Band of Luiseno Mission Indians of the Pala R
Big Valley Band of Pomo Indians of the Big Valley
Paskenta Band of Nomlaki Indians of California
Pauma Band of Luiseno Mission Indians of the Pauma
Pechanga Band of Luiseno Mission Indians of the Pe
Picayune Rancheria of Chukchansi Indians of Califo
Pinoleville Rancheria of Pomo Indians of Californi
Agua Caliente Band of Cahuilla Indians of the Agua
Blackfeet Tribe of the Blackfeet Indian Reservatio
Pit River Tribe, California (includes Big Bend, Lo
Pokagon Band of Potawatomi Indians of Michigan
Port Gamble Indian Community of the Port Gamble Re
Potter Valley Rancheria of Pomo Indians of Califor
Prairie Band of Potawatomi Indians, Kansas
Prairie Island Indian Community of Minnesota Mdewa
Bridgeport Paiute Indian Colony of California
Puyallup Tribe of the Puyallup Reservation, Washin
Pyramid Lake Paiute Tribe of the Pyramid Lake Rese
Buena Vista Rancheria of Me-Wuk Indians of Califor
Quartz Valley Indian Community of the Quartz Valle
Quechan Tribe of the Fort Yuma Indian Reservation,
Quileute Tribe of the Quileute Reservation, Washin
Quinault Tribe of the Quinault Reservation, Washin
Ramona Band or Village of Cahuilla Mission Indians
Red Cliff Band of Lake Superior Chippewa Indians o
Red Lake Band of Chippewa Indians of the Red Lake
Redwood Valley Rancheria of Pomo Indians of Califo
Burns Paiute Tribe of the Burns Paiute Indian Colo
Resighini Rancheria, California (formerly known as
Rincon Band of Luiseno Mission Indians of the Rinc
Robinson Rancheria of Pomo Indians of California
Rosebud Sioux Tribe of the Rosebud Indian Reservat
Round Valley Indian Tribes of the Round Valley Res
Rumsey Indian Rancheria of Wintun Indians of Calif
Sac and Fox Tribe of the Mississippi in Iowa
Sac and Fox Nation of Missouri in Kansas and Nebra
Saginaw Chippewa Indian Tribe of Michigan, Isabell
Cabazon Band of Cahuilla Mission Indians of the Ca
Salt River Pima-Maricopa Indian Community of the S
San Carlos Apache Tribe of the San Carlos Reservat
San Juan Southern Paiute Tribe of Arizona
San Manual Band of Serrano Mission Indians of the
San Pasqual Band of Diegueno Mission Indians of Ca
Santa Rosa Indian Community of the Santa Rosa Ranc
Santa Rosa Band of Cahuilla Mission Indians of the
Santa Ynez Band of Chumash Mission Indians of the
Santa Ysabel Band of Diegueno Mission Indians of t
Cachil DeHe Band of Wintun Indians of the Colusa I
Santee Sioux Tribe of the Santee Reservation of Ne
Sauk-Suiattle Indian Tribe of Washington
Sault Ste. Marie Tribe of Chippewa Indians of Mich
Scotts Valley Band of Pomo Indians of California
Seminole Tribe of Florida, Dania, Big Cypress, Bri
Shakopee Mdewakanton Sioux Community of Minnesota
Sherwood Valley Rancheria of Pomo Indians of Calif
Shingle Springs Band of Miwok Indians, Shingle Spr
Shoalwater Bay Tribe of the Shoalwater Bay Indian
Shoshone Tribe of the Wind River Reservation, Wyom
Shoshone-Bannock Tribes of the Fort Hall Reservati
Shoshone-Paiute Tribes of the Duck Valley Reservat
Sisseton-Wahpeton Sioux Tribe of the Lake Traverse
Skokomish Indian Tribe of the Skokomish Reservatio
Skull Valley Band of Goshute Indians of Utah
Cahuilla Band of Mission Indians of the Cahuilla R
Soboba Band of Luiseno Indians, California (former
Sokaogon Chippewa Community of the Mole Lake Band
Southern Ute Indian Tribe of the Southern Ute Rese
Spirit Lake Tribe, North Dakota (formerly known as
Spokane Tribe of the Spokane Reservation, Washingt
Squaxin Island Tribe of the Squaxin Island Reserva
St. Croix Chippewa Indians of Wisconsin, St. Croix
St. Regis Band of Mohawk Indians of New York
Standing Rock Sioux Tribe of North & South Dakota
Cahto Indian Tribe of the Laytonville Rancheria, C
Stockbridge-Munsee Community of Mohican Indians of
Suquamish Indian Tribe of the Port Madison Reserva
Swinomish Indians of the Swinomish Reservation, Wa
Sycuan Band of Diegueno Mission Indians of Califor
Table Bluff Reservation - Wiyot Tribe, California
Te-Moak Tribe of Western Shoshone Indians of Nevad
Ak Chin Indian Community of the Maricopa (Ak Chin)
California Valley Miwok Tribe, California (formerl
Three Affiliated Tribes of the Fort Berthold Reser
Tonawanda Band of Seneca Indians of New York
Torres-Martinez Band of Cahuilla Mission Indians o
Tule River Indian Tribe of the Tule River Reservat
Tulalip Tribes of the Tulalip Reservation, Washing
Campo Band of Diegueno Mission Indians of the Camp
Tuolumne Band of Me-Wuk Indians of the Tuolumne Ra
Turtle Mountain Band of Chippewa Indians of North
Twenty-Nine Palms Band of Mission Indians of Calif
United Auburn Indian Community of the Auburn Ranch
United Keetoowah Band of Cherokee Indians of Oklah
Upper Lake Band of Pomo Indians of Upper Lake Ranc
Upper Sioux Indian Community of the Upper Sioux Re
Ute Indian Tribe of the Uintah & Ouray Reservation
Capitan Grande Band of Diegueno Mission Indians of
Ute Mountain Tribe of the Ute Mountain Reservation
Utu Utu Gwaitu Paiute Tribe of the Benton Paiute R
Walker River Paiute Tribe of the Walker River Rese
Wampanoag Tribe of Gay Head (Aquinnah) of Massachu
Washoe Tribe of Nevada & California (Carson Colony
White Mountain Apache Tribe of the Fort Apache Res
Wichita and Affiliated Tribes (Wichita, Keechi, Wa
Barona Group of Capitan Grande Band of Mission Ind
Yavapai-Apache Nation of the Camp Verde Indian Res
Yavapai-Prescott Tribe of the Yavapai Reservation,
Yerington Paiute Tribe of the Yerington Colony & C
Yomba Shoshone Tribe of the Yomba Reservation, Nev
Yurok Tribe of the Yurok Reservation, California
Zuni Tribe of the Zuni Reservation, New Mexico
Viejas (Baron Long) Group of Capitan Grande Band o
Catawba Indian Nation (aka Catawba Tribe of South
Chemehuevi Indian Tribe of the Chemehuevi Reservat
Cher-Ae Heights Indian Community of the Trinidad R
Cheyenne River Sioux Tribe of the Cheyenne River R
Chicken Ranch Rancheria of Me-Wuk Indians of Calif
Chippewa-Cree Indians of the Rocky Boy's Reservati
Cloverdale Rancheria of Pomo Indians of California
Coeur D'Alene Tribe of the Coeur D'Alene Reservati
Cold Springs Rancheria of Mono Indians of Californ
Colorado River Indian Tribes of the Colorado River
Confederated Salish & Kootenai Tribes of the Flath
Confederated Tribes of the Chehalis Reservation, W
Confederated Tribes of the Colville Reservation, W
Confederated Tribes of the Coos, Lower Umpqua and
Confederated Tribes of the Goshute Reservation, Ne
Confederated Tribes of the Grand Ronde Community o
Confederated Tribes of the Siletz Reservation, Ore
Confederated Tribes of the Umatilla Reservation, O
Confederated Tribes of the Warm Springs Reservatio
Confederated Tribes and Bands of the Yakama Indian
Cortina Indian Rancheria of Wintun Indians of Cali
Cow Creek Band of Umpqua Indians of Oregon
Coyote Valley Band of Pomo Indians of California
Crow Creek Sioux Tribe of the Crow Creek Reservati
Cuyapaipe Community of Diegueno Mission Indians of
Death Valley Timbi-Sha Shoshone Band of California
Delaware Nation, Oklahoma (formerly Delaware Tribe
Dry Creek Rancheria of Pomo Indians of California
Duckwater Shoshone Tribe of the Duckwater Reservat
Eastern Band of Cherokee Indians of North Carolina
Arapahoe Tribe of the Wind River Reservation, Wyom
Elem Indian Colony of Pomo Indians of the Sulphur
Enterprise Rancheria of Maidu Indians of Californi
Flandreau Santee Sioux Tribe of South Dakota
Forest County Potawatomi Community of Wisconsin Po
Fort Belknap Indian Community of the Fort Belknap
Fort Bidwell Indian Community of the Fort Bidwell
Fort Independence Indian Community of Paiute India
Fort McDermitt Paiute and Shoshone Tribes of the F
Aroostook Band of Micmac Indians of Maine
Fort McDowell Yavapai Nation, Arizona (formerly th
Fort Mojave Indian Tribe of Arizona, California
Gila River Indian Community of the Gila River Indi
Grand Traverse Band of Ottawa & Chippewa Indians o
Greenville Rancheria of Maidu Indians of Californi
Grindstone Indian Rancheria of Wintun-Wailaki Indi
Hannahville Indian Community of Wisconsin Potawato
Abbott Laboratories (includes Ross Products Division)
Bayer Corporation (includes Miles, Inc. and Cutter Laboratories)
Berna Products Corporation (includes Swiss Serum and Vaccine Institute Berne)
Centeon L.L.C. (includes Armour Pharmaceutical Company)
Evans Medical Limited (an affiliate of Medeva Pharmaceuticals, Inc.)
The Research Foundation for Microbial Diseases of Osaka University (BIKEN)
Massachusetts Public Health Biologic Laboratories
Bioport Corporation (formerly Michigan Biologic Products Institute)
NABI (formerly North American Biologicals, Inc.)
Novartis Pharmaceutical Corporation (includes Ciba-Geigy Limited and Sandoz Limited)
Parkedale Pharmaceuticals (formerly Parke-Davis)
Aventis Pasteur Inc. (formerly Pasteur Merieux Connaught; includes Connaught Laboratories and Pasteur Merieux)
Swiss Serum and Vaccine Inst. [Inactive - use BPC]
Swiss Serum and Vaccine Inst. [Inactive-use BPC]
United States Army Medical Research and Materiel Command
Wyeth-Ayerst (includes Wyeth-Lederle Vaccines and Pediatrics, Wyeth Laboratories, Lederle Laboratories, and Praxis Biologics)
Description: Coded concepts representing Binding Realms (used for Context Binding of terminology in HL7 models) and/or Namespace Realms (used to help ensure unique identification of HL7 artifacts). This value set is partitioned into three sections: Affiliate realms, Binding realms and Namespace realms. All affiliate realm codes may automatically be used as both binding realms and namespace realms. Furthermore, affiliate realms are the only realms that have authority over the creation of binding realms. (Note that 'affiliate' includes the idea of both international affiliates and the HL7 International organization.) All other codes must be associated with an owning affiliate realm and must appear as a specialization of _BindingRealm or _NamespaceRealm. For affiliates whose concepts align with nations, the country codes from ISO 3166-1 2-character alpha are used for the code when possible so these codes should not be used for other realm types. It is recommended that binding realm and namespace codes submitted by affiliates use the realm code as a prefix to avoid possible collisions with ISO codes. However, tooling does not currently support namepace realm codes greater than 2 characters. Open Issue: The name of the concept property "owningAffiliate" should be changed to better reflect that the property value is the human readable name of the organizational entity that manages the Realm identified by the Realm Code. Open Issue: In spite of the inability of tooling to process codes longer than 2 characters, there is at least one realm codes ('SOA') that was added that is 3 characters in length.
Description: Coded concepts representing Binding Realms (used for Context Binding of terminology in HL7 models) and/or Namespace Realms (used to help ensure unique identification of HL7 artifacts). This code system is partitioned into three sections: Affiliate realms, Binding realms and Namespace realms. All affiliate realm codes may automatically be used as both binding realms and namespace realms. Furthermore, affiliate realms are the only realms that have authority over the creation of binding realms. (Note that 'affiliate' includes the idea of both international affiliates and the HL7 International organization.) All other codes must be associated with an owning affiliate realm and must appear as a specialization of _BindingRealm or _NamespaceRealm. For affiliates whose concepts align with nations, the country codes from ISO 3166-1 2-character alpha are used for the code when possible so these codes should not be used for other realm types. It is recommended that binding realm and namespace codes submitted by affiliates use the realm code as a prefix to avoid possible collisions with ISO codes. However, tooling does not currently support namepace realm codes greater than 2 characters. Open Issue: The name of the concept property "owningAffiliate" should be changed to better reflect that the property value is the human readable name of the organizational entity that manages the Realm identified by the Realm Code. Open Issue: In spite of the inability of tooling to process codes longer than 2 characters, there is at least one realm codes ('SOA') that was added that is 3 characters in length.
Description: Concepts that can be used as Binding Realms when creating Binding Statements. These codes are permitted to appear in the InfrastructureRoot.realmCode attribute.
Description: Realm codes for official HL7 organizational bodies. This includes both the HL7 International organization as well as all recognized international affiliates (past and present). These groups have the ability to bind vocabulary and develop artifacts. As well, they have the ability to have "ownership" over other binding realms and namespace realms via the owningAffiliate property of those other realm codes.
Description: Realm code for use of Argentina
Description: Realm code for use of Austria
Description: Realm code for use of Australia
Description: Realm code for use of Brazil
Description: Realm code for use of Canada
Description: Realm code for use of Switzerland
Description: Realm code for use of Chile
Description: Realm code for use of China
Description: Realm code for use of Localized Version
Description: Realm code for use of Czech Republic
Description: Realm code for use of Germany
Description: Realm code for use of Denmark
Description: Realm code for use of Spain
Description: Realm code for use of Finland
Description: Realm code for use of France
Description: Realm code for use of Greece
Description: Realm code for use of Croatia
Description: Realm code for use of Ireland
Description: Realm code for use of India
Description: Realm code for use of Italy
Description: Realm code for use of Japan
Description: Realm code for use of Korea
Description: Realm code for use of Lithuania
Description: Realm code for use of Mexico
Description: Realm code for use of The Netherlands
Description: Realm code for use of New Zealand
Description: Realm code for use of Romania
Description: Realm code for use of Russian Federation
Description: Realm code for use of Sweden
Description: Realm code for use of Southern Africa
Description: Realm code for use of Turkey
Description: Realm code for use of Taiwan
Description: Realm code for use of United Kingdom
Description: Realm code for use of United States of America
Description: Realm code for use of Universal realm or context, used in every instance
Description: Realm code for use of Uruguay
Description: Realm code for use of Unclassified Realm
Description: Realm code for use of Great Britain
Description: Realm code for use of Representative Realm
Description: Realm code for use of Example Realm
Description: Codes that can be used in the "realm" portion of HL7 v3 artifact identifiers.
Description: An artifact created for local use only. This realm namespace has no owning affiliate. Its use is uncontrolled, i.e. anyone can create artifacts using this realm namespace. Because of this, there is a significant likelihood of artifact identifier collisions. Implementers are encouraged to register their artifacts under an affiliate owned and controlled namespace to avoid such collision problems where possible.
Description: Identifies allowed codes for HL7aTMs v3 conformance property.
Description: Implementers receiving this property must not raise an error if the data is received, but will not perform any useful function with the data. This conformance level is not used in profiles or other artifacts that are specific to the "sender" or "initiator" of a communication.
Description: All implementers are prohibited from transmitting this content, and may raise an error if they receive it.
Description: All implementers must support this property. I.e. they must be able to transmit, or to receive and usefully handle the concept.
Description: The element is considered "required" (i.e. must be supported) from the perspective of systems that consume instances, but is "undetermined" for systems that generate instances. Used only as part of specifications that define both initiator and consumer expectations.
Description: The element is considered "required" (i.e. must be supported) from the perspective of systems that generate instances, but is "undetermined" for systems that consume instances. Used only as part of specifications that define both initiator and consumer expectations.
Description: The conformance expectations for this element have not yet been determined.
Any elastic aeriform fluid in which the molecules are separated from one another and have free paths.
A state of substance that is an intermediate one entered into as matter goes from solid to gas; liquids are also intermediate in that they have neither the orderliness of a crystal nor the randomness of a gas. (Note: This term should not be used to describe solutions, only pure chemicals in their liquid state.)
A liquid soap or detergent used to clean the hair and scalp and is often used as a vehicle for dermatologic agents.
An unctuous, combustible substance which is liquid, or easily liquefiable, on warming, and is soluble in ether but insoluble in water. Such substances, depending on their origin, are classified as animal, mineral, or vegetable oils.
A liquid preparation that contains one or more chemical substances dissolved, i.e., molecularly dispersed, in a suitable solvent or mixture of mutually miscible solvents.
A sterile solution intended to bathe or flush open wounds or body cavities; they're used topically, never parenterally.
A liquid preparation, intended for the irrigative cleansing of the vagina, that is prepared from powders, liquid solutions, or liquid concentrates and contains one or more chemical substances dissolved in a suitable solvent or mutually miscible solvents.
A rectal preparation for therapeutic, diagnostic, or nutritive purposes.
A clear, pleasantly flavored, sweetened hydroalcoholic liquid containing dissolved medicinal agents; it is intended for oral use.
An aqueous solution which is most often used for its deodorant, refreshing, or antiseptic effect.
An oral solution containing high concentrations of sucrose or other sugars; the term has also been used to include any other liquid dosage form prepared in a sweet and viscid vehicle, including oral suspensions.
A solution or mixture of various substances in oil, alcoholic solutions of soap, or emulsions intended for external application.
A two-phase system in which one liquid is dispersed throughout another liquid in the form of small droplets.
A semisolid dosage form containing one or more drug substances dissolved or dispersed in a suitable base; more recently, the term has been restricted to products consisting of oil-in-water emulsions or aqueous microcrystalline dispersions of long chain fatty acids or alcohols that are water washable and more cosmetically and aesthetically acceptable.
The term "lotion" has been used to categorize many topical suspensions, solutions and emulsions intended for application to the skin.
A semisolid preparation intended for external application to the skin or mucous membranes.
A liquid preparation which consists of solid particles dispersed throughout a liquid phase in which the particles are not soluble.
A semisolid system consisting of either suspensions made up of small inorganic particles or large organic molecules interpenetrated by a liquid.
A semisolid dosage form that contains one or more drug substances intended for topical application.
A paste formulation intended to clean and/or polish the teeth, and which may contain certain additional agents.
A solid dosage form usually in the form of a rectangle that is meant to be chewed.
A solid dosage form in the shape of a small ball.
A substance that serves to produce solid union between two surfaces.
A naturally produced angular solid of definite form in which the ultimate units from which it is built up are systematically arranged; they are usually evenly spaced on a regular space lattice.
A circular plate-like organ or structure.
A sweetened and flavored insoluble plastic material of various shapes which when chewed, releases a drug substance into the oral cavity.
A drug delivery system that contains an adhesived backing and that permits its ingredients to diffuse from some portion of it (e.g., the backing itself, a reservoir, the adhesive, or some other component) into the body from the external site where it is applied.
A small sterile solid mass consisting of a highly purified drug (with or without excipients) made by the formation of granules, or by compression and molding.
A small, round solid dosage form containing a medicinal agent intended for oral administration.
A solid dosage form in which the drug is enclosed within either a hard or soft soluble container or "shell" made from a suitable form of gelatin.
A solid dosage form in which the drug is enclosed within either a hard or soft soluble container made from a suitable form of gelatin, and which releases a drug (or drugs) in such a manner to allow a reduction in dosing frequency as compared to that drug (or drugs) presented as a conventional dosage form.
Rationale: Duplicate of code ERENTCAP. Use code ERENTCAP instead.
A solid dosage form containing medicinal substances with or without suitable diluents.
A solid dosage form containing medicinal substances with or without suitable diluents that is intended to be chewed, producing a pleasant tasting residue in the oral cavity that is easily swallowed and does not leave a bitter or unpleasant after-taste.
A solid dosage form containing medicinal substances which disintegrates rapidly, usually within a matter of seconds, when placed upon the tongue.
A solid dosage form containing a drug which allows at least a reduction in dosing frequency as compared to that drug presented in conventional dosage form.
A solid preparation containing one or more medicaments, usually in a flavored, sweetened base which is intended to dissolve or disintegrate slowly in the mouth.
An intimate mixture of dry, finely divided drugs and/or chemicals that may be intended for internal or external use.
A solid body of various weights and shapes, adapted for introduction into the rectal, vaginal, or urethral orifice of the human body; they usually melt, soften, or dissolve at body temperature.
A wad of absorbent material usually wound around one end of a small stick and used for applying medication or for removing material from an area.
A thin slice of material containing a medicinal agent.
v3 Code System substanceAdminSubstitution
Identifies what sort of change is permitted or has occurred between the therapy that was ordered and the therapy that was/will be provided.
Description: Substitution occurred or is permitted with another product that may potentially have different ingredients, but having the same biological and therapeutic effects.
Description: Substitution occurred or is permitted with another bioequivalent and therapeutically equivalent product.
Description: Substitution occurred or is permitted with another product that is a: pharmaceutical alternative containing the same active ingredient but is formulated with different salt, ester pharmaceutical equivalent that has the same active ingredient, strength, dosage form and route of administration Examples: Pharmaceutical alternative: Erythromycin Ethylsuccinate for Erythromycin Stearate Pharmaceutical equivalent: Lisonpril for Zestril
Description: Substitution occurred or is permitted between equivalent Brands but not Generics Examples: Zestril for Prinivil Coumadin for Jantoven
Description: Substitution occurred or is permitted between equivalent Generics but not Brands Examples: Lisnopril (Lupin Corp) for Lisnopril (Wockhardt Corp)
Description: Substitution occurred or is permitted with another product having the same therapeutic objective and safety profile. Examples: ranitidine for Tagamet
Description: Substitution occurred or is permitted between therapeutically equivalent Brands but not Generics > Examples: Zantac for Tagamet
Description: Substitution occurred or is permitted between therapeutically equivalent Generics but not Brands > Examples: Ranitidine for cimetidine
Description: This substitution was performed or is permitted based on formulary guidelines.
No substitution occurred or is permitted.
Description: Used to enumerate the typical confidentiality constraints placed upon a clinical document. Usage Note: x_BasicConfidentialityKind is a subset of Confidentiality codes that are used as metadata indicating the receiver responsibility to comply with normally applicable jurisdictional privacy law or disclosure authorization; that the receiver may not disclose this information except as directed by the information custodian, who may be the information subject; or that the receiver may not disclose this information except as directed by the information custodian, who may be the information subject.