v3-ActClass
type: CodeSystem
node role: treeRoot
id:
  v: v3-ActClass
text:
  status:
    v: generated
  div: Generated Narrative: CodeSystem v3-ActClass Properties This code system defines the following properties for its concepts Name Code URI Type Description Not Selectable notSelectable http://hl7.org/fhir/concept-properties#notSelectable boolean Indicates that the code is abstract - only intended to be used as a selector for other concepts Deprecated deprecated http://hl7.org/fhir/concept-properties#deprecated dateTime The date at which a concept was deprecated. Concepts that are deprecated but not inactive can still be used, but their use is discouraged Inactive inactive http://hl7.org/fhir/concept-properties#inactive boolean True if the concept is not considered active - e.g. not a valid concept any more Concepts This case-sensitive code system http://hl7.org/fhir/v3/ActClass defines the following codes in a Is-A hierarchy: Lvl Code Display Definition Not Selectable Deprecated Inactive 1 ACT act 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. Pa…
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-ballot-status
  value: string
    v: External
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm
  value: integer
    v: 0
extension:
  extension:
    url:
      v: packageId
    value: id
      v: hl7.fhir.uv.xver-r3.r4b
  extension:
    url:
      v: version
    value: string
      v: 0.0.1-snapshot-2
  url:
    v: http://hl7.org/fhir/StructureDefinition/package-source
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-wg
  value: code
    v: fhir
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status
  value: code
    v: trial-use
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom
      value: canonical
        v: http://hl7.org/fhir/3.0/ImplementationGuide/hl7.fhir.uv.xver-r3.r4b
        link: http://hl7.org/fhir/3.0/ImplementationGuide/hl7.fhir.uv.xver-r3.r4b
url:
  v: http://hl7.org/fhir/v3/ActClass
version:
  v: 2016-11-11
name:
  v: v3 Code System ActClass
status:
  v: active
experimental:
  v: false
date:
  v: 2016-11-10T23:00:00+10:00
publisher:
  v: FHIR Infrastructure
contact:
  name:
    v: FHIR Infrastructure
  telecom:
    system:
      v: url
    value:
      v: http://www.hl7.org/Special/committees/fiwg
description:
  v: **** MISSING DEFINITIONS ****
jurisdiction:
  coding:
    system:
      v: http://unstats.un.org/unsd/methods/m49/m49.htm
    code:
      v: 001
    display:
      v: World
case sensitive:
  v: true
value set:
  v: http://hl7.org/fhir/ValueSet/v3-ActClass
  link: http://hl7.org/fhir/ValueSet/v3-ActClass
hierarchy meaning:
  v: is-a
content:
  v: complete
property:
  code:
    v: notSelectable
  uri:
    v: http://hl7.org/fhir/concept-properties#notSelectable
  description:
    v: Indicates that the code is abstract - only intended to be used as a selector for other concepts
  type:
    v: boolean
property:
  code:
    v: deprecated
  uri:
    v: http://hl7.org/fhir/concept-properties#deprecated
  description:
    v: The date at which a concept was deprecated. Concepts that are deprecated but not inactive can still be used, but their use is discouraged
  type:
    v: dateTime
property:
  code:
    v: inactive
  uri:
    v: http://hl7.org/fhir/concept-properties#inactive
  description:
    v: True if the concept is not considered active - e.g. not a valid concept any more
  type:
    v: boolean
concept:
  code:
    v: ACT
  display:
    v: act
  definition:
    v: 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 t…
  concept:
    code:
      v: _ActClassRecordOrganizer
    display:
      v: record organizer
    definition:
      v: 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.
    property:
      code:
        v: notSelectable
      value: boolean
        v: true
    concept:
      code:
        v: COMPOSITION
      display:
        v: composition
      definition:
        v: 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.
    concept:
      code:
        v: CONTAINER
      display:
        v: record container
      definition:
        v: 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.
    concept:
      code:
        v: EXTRACT
      display:
        v: extract
      definition:
        v: 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.
    concept:
      code:
        v: FOLDER
      display:
        v: folder
      definition:
        v: 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.
    concept:
      code:
        v: GROUPER
      display:
        v: grouper
      definition:
        v: 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.
  concept:
    code:
      v: ACCM
    display:
      v: accommodation
    definition:
      v: 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.
  concept:
    code:
      v: ACCT
    display:
      v: account
    definition:
      v: A financial account established to track the net result of financial acts.
  concept:
    code:
      v: ACSN
    display:
      v: accession
    definition:
      v: 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).
  concept:
    code:
      v: ADJUD
    display:
      v: financial adjudication
    definition:
      v: 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
  concept:
    code:
      v: CACT
    display:
      v: control act

v: DOC

v: document

v: 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.

code:
  v: DOCCLIN
display:
  v: clinical document
definition:
  v: 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.
concept:
  code:
    v: CDALVLONE
  display:
    v: CDA Level One clinical document
  definition:
    v: A clinical document that conforms to Level One of the HL7 Clinical Document Architecture (CDA)

v: CATEGORY

v: category

v: 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.

v: DOCBODY

v: document body

v: 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.

v: DOCSECT

v: document section

v: 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.

v: TOPIC

v: topic

v: 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.

v: EHR

v: electronic health record

v: 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.

v: CLUSTER

v: Cluster

v: 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.

v: 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.

code:
  v: ACTN
display:
  v: action
definition:
  v: 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).

code:
  v: INFO
display:
  v: information
definition:
  v: 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.

code:
  v: STC
display:
  v: state transition control
definition:
  v: 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.

code:
  v: CNTRCT
display:
  v: contract
definition:
  v: An agreement of obligation between two or more parties that is subject to contractual law and enforcement.
concept:
  code:
    v: FCNTRCT
  display:
    v: financial contract
  definition:
    v: A contract whose value is measured in monetary terms.
  concept:
    code:
      v: COV
    display:
      v: coverage
    definition:
      v: 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.

code:
  v: CONC
display:
  v: concern
definition:
  v: 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.
concept:
  code:
    v: HCASE
  display:
    v: public health case
  definition:
    v: 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.
concept:
  code:
    v: OUTBR
  display:
    v: outbreak
  definition:
    v: 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.

code:
  v: CONS
display:
  v: consent
definition:
  v: 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.

code:
  v: CONTREG
display:
  v: container registration
definition:
  v: An Act where a container is registered either via an automated sensor, such as a barcode reader, or by manual receipt

code:
  v: CTTEVENT
display:
  v: clinical trial timepoint event
definition:
  v: 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.

code:
  v: DISPACT
display:
  v: disciplinary action
definition:
  v: 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:

code:
  v: EXPOS
display:
  v: exposure
definition:
  v: 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 th…
concept:
  code:
    v: AEXPOS
  display:
    v: acquisition exposure
  definition:
    v: 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.
concept:
  code:
    v: TEXPOS
  display:
    v: transmission exposure
  definition:
    v: 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.

code:
  v: INC
display:
  v: incident
definition:
  v: An event that occurred outside of the control of one or more of the parties involved. Includes the concept of an accident.

code:
  v: INFRM
display:
  v: inform
definition:
  v: 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.

code:
  v: INVE
display:
  v: invoice element
definition:
  v: Represents concepts related to invoice processing in health care

code:
  v: LIST
display:
  v: working list
definition:
  v: 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.

code:
  v: MPROT
display:
  v: monitoring program
definition:
  v: An officially or unofficially instituted program to track acts of a particular type or categorization.

code:
  v: OBS
display:
  v: observation
definition:
  v: 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-observation…
concept:
  code:
    v: _ActClassROI
  display:
    v: ActClassROI
  definition:
    v: 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.
  property:
    code:
      v: notSelectable
    value: boolean
      v: true
  concept:
    code:
      v: ROIBND
    display:
      v: bounded ROI
    definition:
      v: 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).
  concept:
    code:
      v: ROIOVL
    display:
      v: overlay ROI
    definition:
      v: 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.
concept:
  code:
    v: _SubjectPhysicalPosition
  display:
    v: subject physical position
  definition:
    v: The spatial relationship of a subject whether human, other animal, or plant, to a frame of reference such as gravity or a collection device.
  property:
    code:
      v: notSelectable
    value: boolean
      v: true
  concept:
    code:
      v: _SubjectBodyPosition
    display:
      v: subject body position
    definition:
      v: 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.
    property:
      code:
        v: notSelectable
      value: boolean
        v: true
    property:
      code:
        v: deprecated
      value: dateTime
        v: 2009-07-12
    concept:
      code:
        v: LLD
      display:
        v: left lateral decubitus
      definition:
        v: 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.
      property:
        value: dateTime
    concept:
      code:
        v: PRN
      display:
        v: prone
      definition:
        v: 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.
      property:
        value: dateTime
    concept:
      code:
        v: RLD
      display:
        v: right lateral decubitus
      definition:
        v: 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.
      property:
        value: dateTime
    concept:
      code:
        v: SFWL
      display:
        v: Semi-Fowler's
      definition:
        v: 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.
      property:
        value: dateTime
    concept:
      code:
        v: SIT
      display:
        v: sitting
      definition:
        v: 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.
      property:
        value: dateTime
    concept:
      code:
        v: STN
      display:
        v: standing
      definition:
        v: 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.
      property:
        value: dateTime
    concept:
      code:
        v: SUP
      display:
        v: supine
      definition:
        v: 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.
      property:
        value: dateTime
concept:
  code:
    v: ALRT
  display:
    v: detected issue
  definition:
    v: 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).
concept:
  code:
    v: BATTERY
  display:
    v: battery
  definition:
    v: 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.
concept:
  code:
    v: CLNTRL
  display:
    v: clinical trial
  definition:
    v: 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.
concept:
  code:
    v: CNOD
  display:
    v: Condition Node
  definition:
    v: 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.
  property:
    code:
      v: deprecated
    value: dateTime
      v: 2009-07-12
concept:
  code:
    v: COND
  display:
    v: Condition
  definition:
    v: 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
  property:
    code:
      v: deprecated
    value: dateTime
      v: 2012-11-09
  concept:
    code:
      v: CASE
    display:
      v: public health case
    definition:
      v: 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.
    property:
      code:
        v: deprecated
      value: dateTime
        v: 2012-11-09
    concept:
      code:
        v: OUTB
      display:
        v: outbreak
      definition:
        v: 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.
      property:
        value: dateTime
concept:
  code:
    v: DGIMG
  display:
    v: diagnostic image
  definition:
    v: Class for holding attributes unique to diagnostic images.
concept:
  code:
    v: GEN
  display:
    v: genomic observation

v: deprecated

dateTime
v: 2009-07-12

v: deprecated

dateTime
v: 2009-07-12

v: deprecated

dateTime
v: 2009-07-12

v: deprecated

dateTime
v: 2009-07-12

v: deprecated

dateTime
v: 2009-07-12

v: deprecated

dateTime
v: 2009-07-12

v: deprecated

dateTime
v: 2009-07-12

v: RTRD

v: reverse trendelenburg

v: 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.

code:
  v: deprecated
value: dateTime
  v: 2009-07-12

v: TRD

v: trendelenburg

v: 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.

code:
  v: deprecated
value: dateTime
  v: 2009-07-12

v: deprecated

dateTime
v: 2012-11-09

v: Description:An observation of genomic phenomena.

code:
  v: DETPOL
display:
  v: determinant peptide
definition:
  v: Description:A determinant peptide in a polypeptide as described by polypeptide.

code:
  v: EXP
display:
  v: expression level
definition:
  v: Description:An expression level of genes/proteins or other expressed genomic entities.

code:
  v: LOC
display:
  v: locus
definition:
  v: Description:The position of a gene (or other significant sequence) on the genome.

code:
  v: PHN
display:
  v: phenotype
definition:
  v: Description:A genomic phenomenon that is expressed externally in the organism.

code:
  v: POL
display:
  v: polypeptide
definition:
  v: Description:A polypeptide resulting from the translation of a gene.

code:
  v: SEQ
display:
  v: bio sequence
definition:
  v: Description:A sequence of biomolecule like the DNA, RNA, protein and the like.

code:
  v: SEQVAR
display:
  v: bio sequence variation
definition:
  v: Description:A variation in a sequence as described by BioSequence.

code:
  v: INVSTG
display:
  v: investigation
definition:
  v: 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.

code:
  v: OBSSER
display:
  v: observation series
definition:
  v: 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.
concept:
  code:
    v: OBSCOR
  display:
    v: correlated observation sequences
  definition:
    v: 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.

code:
  v: POS
display:
  v: position
definition:
  v: An observation denoting the physical location of a person or thing based on a reference coordinate system.
concept:
  code:
    v: POSACC
  display:
    v: position accuracy
  definition:
    v: 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.
concept:
  code:
    v: POSCOORD
  display:
    v: position coordinate
  definition:
    v: 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.

code:
  v: SPCOBS
display:
  v: specimen observation
definition:
  v: An observation on a specimen in a laboratory environment that may affect processing, analysis or result interpretation

code:
  v: VERIF
display:
  v: Verification
definition:
  v: 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.

code:
  v: PCPR
display:
  v: care provision
definition:
  v: 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.
concept:
  code:
    v: ENC
  display:
    v: encounter
  definition:
    v: 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.

code:
  v: POLICY
display:
  v: policy
definition:
  v: 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
concept:
  code:
    v: JURISPOL
  display:
    v: jurisdictional policy
  definition:
    v: 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.
concept:
  code:
    v: ORGPOL
  display:
    v: organizational policy
  definition:
    v: 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.
concept:
  code:
    v: SCOPOL
  display:
    v: scope of practice policy
  definition:
    v: 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.
concept:
  code:
    v: STDPOL
  display:
    v: standard of practice policy
  definition:
    v: 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.

code:
  v: PROC
display:
  v: procedure
definition:
  v: 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.
concept:
  code:
    v: SBADM
  display:
    v: substance administration
  definition:
    v: 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
concept:
  code:
    v: SBEXT
  display:
    v: Substance Extraction
  definition:
    v: Description: The act of removing a substance from the subject.
  concept:
    code:
      v: SPECCOLLECT
    display:
      v: Specimen Collection
    definition:
      v: A procedure for obtaining a specimen from a source entity.

code:
  v: REG
display:
  v: registration
definition:
  v: 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.

code:
  v: REV
display:
  v: review
definition:
  v: The act of examining and evaluating the subject, usually another act. For example, "This prescription needs to be reviewed in 2 months."

code:
  v: SPCTRT
display:
  v: specimen treatment
definition:
  v: A procedure or treatment performed on a specimen to prepare it for analysis

code:
  v: SPLY
display:
  v: supply
definition:
  v: 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.
concept:
  code:
    v: DIET
  display:
    v: diet
  definition:
    v: 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.
  property:
    code:
      v: deprecated
    value: dateTime
      v: 2009-08-20

code:
  v: STORE
display:
  v: storage
definition:
  v: 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.

code:
  v: SUBST
display:
  v: Substitution
definition:
  v: 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.

code:
  v: TRFR
display:
  v: transfer
definition:
  v: 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.

code:
  v: TRNS
display:
  v: transportation
definition:
  v: 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.)

code:
  v: XACT
display:
  v: financial transaction
definition:
  v: 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.

code:
  v: _ActClassContainer
display:
  v: ActClassContainer
definition:
  v: ActClassContainer
property:
  code:
    v: notSelectable
  value: boolean
    v: true
property:
  code:
    v: inactive
  value: boolean
    v: true
concept:
  code:
    v: ENTRY
  display:
    v: entry
  definition:
    v: 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.
  property:
    code:
      v: inactive
    value: boolean
      v: true
concept:
  code:
    v: ORGANIZER
  display:
    v: organizer
  definition:
    v: 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.
  property:
    code:
      v: inactive
    value: boolean
      v: true

code:
  v: DOCCNTNT
property:
  code:
    v: inactive
  value: boolean
    v: true

code:
  v: DOCLIST
property:
  code:
    v: inactive
  value: boolean
    v: true

code:
  v: DOCLSTITM
property:
  code:
    v: inactive
  value: boolean
    v: true

code:
  v: DOCPARA
property:
  code:
    v: inactive
  value: boolean
    v: true

code:
  v: DOCTBL
property:
  code:
    v: inactive
  value: boolean
    v: true

code:
  v: LINKHTML
property:
  code:
    v: inactive
  value: boolean
    v: true

code:
  v: LOCALATTR
property:
  code:
    v: inactive
  value: boolean
    v: true

code:
  v: LOCALMRKP
property:
  code:
    v: inactive
  value: boolean
    v: true

code:
  v: ordered
property:
  code:
    v: inactive
  value: boolean
    v: true

code:
  v: REFR
property:
  code:
    v: inactive
  value: boolean
    v: true

code:
  v: TBLCOL
property:
  code:
    v: inactive
  value: boolean
    v: true

code:
  v: TBLCOLGP
property:
  code:
    v: inactive
  value: boolean
    v: true

code:
  v: TBLDATA
property:
  code:
    v: inactive
  value: boolean
    v: true

code:
  v: TBLHDR
property:
  code:
    v: inactive
  value: boolean
    v: true

code:
  v: TBLROW
property:
  code:
    v: inactive
  value: boolean
    v: true

code:
  v: tbody
property:
  code:
    v: inactive
  value: boolean
    v: true

code:
  v: tfoot
property:
  code:
    v: inactive
  value: boolean
    v: true

code:
  v: thead
property:
  code:
    v: inactive
  value: boolean
    v: true

code:
  v: unordered
property:
  code:
    v: inactive
  value: boolean
    v: true