This page is part of the CCDA: Consolidated CDA Release (v3.0.0-ballot: CCDA 3.0 Ballot 1) based on FHIR (HL7® FHIR® Standard) v5.0.0. . For a full list of available versions, see the Directory of published versions
Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/FunctionalStatusSection | Version: 3.0.0-ballot | |||
Draft as of 2023-12-21 | Computable Name: FunctionalStatusSection | |||
Other Identifiers: id: urn:hl7ii:2.16.840.1.113883.10.20.22.2.14:2014-06-09 |
The Functional Status Section contains observations and assessments of a patient’s physical abilities. A patient’s functional status may include information regarding the patient’s ability to perform Activities of Daily Living (ADLs) in areas such as Mobility (e.g., ambulation), Self-Care (e.g., bathing, dressing, feeding, grooming) or Instrumental Activities of Daily Living (IADLs) (e.g., shopping, using a telephone, balancing a check book). Problems that impact function (e.g., dyspnea, dysphagia) can be contained in the section.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from Section
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Section | Section | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @ID, @classCode, @moodCode, id, code, title, text, confidentialityCode, languageCode, subject, author, informant, entry, component Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) | ||
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root, value:extension | |
templateId:section | 1..1 | II | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.2.14 | |
@extension | 1..1 | st | Required Pattern: 2014-06-09 | |
code | 1..1 | CE | Functional Status | |
@code | 1..1 | cs | Required Pattern: 47420-5 | |
@codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
title | 1..1 | ST | ||
text | 1..1 | xhtml | ||
Slices for entry | 0..* | Entry | Slice: Unordered, Open by profile:organizer, profile:observation, profile:supply | |
entry:funcStatusOrganizer | 0..* | Entry | ||
organizer | 1..1 | FunctionalStatusOrganizer | Base for all types and resources | |
entry:funcStatusObs | 0..* | Entry | ||
observation | 1..1 | FunctionalStatusObservation | Base for all types and resources | |
entry:caregiverCharacteristics | 0..* | Entry | ||
observation | 1..1 | CaregiverCharacteristics | Base for all types and resources | |
entry:assessmentScale | 0..* | Entry | ||
observation | 1..1 | AssessmentScaleObservation | Base for all types and resources | |
entry:nonMedSupply | 0..* | Entry | ||
supply | 1..1 | NonMedicinalSupplyActivity | Base for all types and resources | |
entry:selfCareActivity | 0..* | Entry | ||
observation | 1..1 | SelfCareActivitiesADLandIADL | Base for all types and resources | |
entry:sensoryStatus | 0..* | Entry | ||
observation | 1..1 | SensoryStatus | Base for all types and resources | |
Documentation for this format |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Section | 1..1 | Section | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @ID, @classCode, @moodCode, id, code, title, text, confidentialityCode, languageCode, subject, author, informant, entry, component Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) | |
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root, value:extension | |
templateId:section | 1..1 | II | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.2.14 | |
@extension | 1..1 | st | Required Pattern: 2014-06-09 | |
code | 1..1 | CE | Functional Status Binding: DocumentSectionType (example) | |
@code | 1..1 | cs | Required Pattern: 47420-5 | |
@codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
title | 1..1 | ST | ||
text | 1..1 | xhtml | ||
Slices for entry | 0..* | Entry | Slice: Unordered, Open by profile:organizer, profile:observation, profile:supply | |
entry:funcStatusOrganizer | 0..* | Entry | ||
organizer | C | 1..1 | FunctionalStatusOrganizer | Base for all types and resources |
entry:funcStatusObs | 0..* | Entry | ||
observation | C | 1..1 | FunctionalStatusObservation | Base for all types and resources |
entry:caregiverCharacteristics | 0..* | Entry | ||
observation | C | 1..1 | CaregiverCharacteristics | Base for all types and resources |
entry:assessmentScale | 0..* | Entry | ||
observation | C | 1..1 | AssessmentScaleObservation | Base for all types and resources |
entry:nonMedSupply | 0..* | Entry | ||
supply | C | 1..1 | NonMedicinalSupplyActivity | Base for all types and resources |
entry:selfCareActivity | 0..* | Entry | ||
observation | C | 1..1 | SelfCareActivitiesADLandIADL | Base for all types and resources |
entry:sensoryStatus | 0..* | Entry | ||
observation | C | 1..1 | SensoryStatus | Base for all types and resources |
Documentation for this format |
Path | Conformance | ValueSet |
Section.code | example | DocumentSectionType |
Id | Grade | Path(s) | Details | Requirements |
should-author | warning | Section.entry:funcStatusOrganizer.organizer, Section.entry:funcStatusObs.observation, Section.entry:selfCareActivity.observation, Section.entry:sensoryStatus.observation | SHOULD contain author : author.exists() | |
should-effectiveTime | warning | Section.entry:nonMedSupply.supply | SHOULD contain effectiveTime : effectiveTime.exists() | |
should-quantity | warning | Section.entry:nonMedSupply.supply | SHOULD contain quantity : quantity.exists() | |
should-sdtctext-ref-value | warning | Section.entry:funcStatusOrganizer.organizer | SHOULD contain text/reference/@value : sdtcText.reference.value.exists() | |
should-text-ref-value | warning | Section.entry:funcStatusObs.observation, Section.entry:caregiverCharacteristics.observation, Section.entry:assessmentScale.observation, Section.entry:nonMedSupply.supply, Section.entry:selfCareActivity.observation, Section.entry:sensoryStatus.observation | SHOULD contain text/reference/@value : text.reference.value.exists() |
Path | Conformance | ValueSet / Code |
Section.nullFlavor | required | CDANullFlavor |
Section.typeId.nullFlavor | required | CDANullFlavor |
Section.templateId:section.nullFlavor | required | CDANullFlavor |
Section.classCode | required | Fixed Value: DOCSECT |
Section.moodCode | required | Fixed Value: EVN |
Section.code | example | DocumentSectionType |
Section.code.nullFlavor | required | CDANullFlavor |
Section.languageCode | required | AllLanguages |
Section.entry:funcStatusOrganizer.nullFlavor | required | CDANullFlavor |
Section.entry:funcStatusOrganizer.typeId.nullFlavor | required | CDANullFlavor |
Section.entry:funcStatusOrganizer.typeCode | required | XActRelationshipEntry |
Section.entry:funcStatusObs.nullFlavor | required | CDANullFlavor |
Section.entry:funcStatusObs.typeId.nullFlavor | required | CDANullFlavor |
Section.entry:funcStatusObs.typeCode | required | XActRelationshipEntry |
Section.entry:caregiverCharacteristics.nullFlavor | required | CDANullFlavor |
Section.entry:caregiverCharacteristics.typeId.nullFlavor | required | CDANullFlavor |
Section.entry:caregiverCharacteristics.typeCode | required | XActRelationshipEntry |
Section.entry:assessmentScale.nullFlavor | required | CDANullFlavor |
Section.entry:assessmentScale.typeId.nullFlavor | required | CDANullFlavor |
Section.entry:assessmentScale.typeCode | required | XActRelationshipEntry |
Section.entry:nonMedSupply.nullFlavor | required | CDANullFlavor |
Section.entry:nonMedSupply.typeId.nullFlavor | required | CDANullFlavor |
Section.entry:nonMedSupply.typeCode | required | XActRelationshipEntry |
Section.entry:selfCareActivity.nullFlavor | required | CDANullFlavor |
Section.entry:selfCareActivity.typeId.nullFlavor | required | CDANullFlavor |
Section.entry:selfCareActivity.typeCode | required | XActRelationshipEntry |
Section.entry:sensoryStatus.nullFlavor | required | CDANullFlavor |
Section.entry:sensoryStatus.typeId.nullFlavor | required | CDANullFlavor |
Section.entry:sensoryStatus.typeCode | required | XActRelationshipEntry |
Section.component.nullFlavor | required | CDANullFlavor |
Section.component.typeId.nullFlavor | required | CDANullFlavor |
Id | Grade | Path(s) | Details | Requirements |
should-author | warning | Section.entry:funcStatusOrganizer.organizer, Section.entry:funcStatusObs.observation, Section.entry:selfCareActivity.observation, Section.entry:sensoryStatus.observation | SHOULD contain author : author.exists() | |
should-effectiveTime | warning | Section.entry:nonMedSupply.supply | SHOULD contain effectiveTime : effectiveTime.exists() | |
should-quantity | warning | Section.entry:nonMedSupply.supply | SHOULD contain quantity : quantity.exists() | |
should-sdtctext-ref-value | warning | Section.entry:funcStatusOrganizer.organizer | SHOULD contain text/reference/@value : sdtcText.reference.value.exists() | |
should-text-ref-value | warning | Section.entry:funcStatusObs.observation, Section.entry:caregiverCharacteristics.observation, Section.entry:assessmentScale.observation, Section.entry:nonMedSupply.supply, Section.entry:selfCareActivity.observation, Section.entry:sensoryStatus.observation | SHOULD contain text/reference/@value : text.reference.value.exists() |
This structure is derived from Section
Summary
Mandatory: 9 elements (7 nested mandatory elements)
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Differential View
This structure is derived from Section
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Section | Section | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @ID, @classCode, @moodCode, id, code, title, text, confidentialityCode, languageCode, subject, author, informant, entry, component Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) | ||
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root, value:extension | |
templateId:section | 1..1 | II | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.2.14 | |
@extension | 1..1 | st | Required Pattern: 2014-06-09 | |
code | 1..1 | CE | Functional Status | |
@code | 1..1 | cs | Required Pattern: 47420-5 | |
@codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
title | 1..1 | ST | ||
text | 1..1 | xhtml | ||
Slices for entry | 0..* | Entry | Slice: Unordered, Open by profile:organizer, profile:observation, profile:supply | |
entry:funcStatusOrganizer | 0..* | Entry | ||
organizer | 1..1 | FunctionalStatusOrganizer | Base for all types and resources | |
entry:funcStatusObs | 0..* | Entry | ||
observation | 1..1 | FunctionalStatusObservation | Base for all types and resources | |
entry:caregiverCharacteristics | 0..* | Entry | ||
observation | 1..1 | CaregiverCharacteristics | Base for all types and resources | |
entry:assessmentScale | 0..* | Entry | ||
observation | 1..1 | AssessmentScaleObservation | Base for all types and resources | |
entry:nonMedSupply | 0..* | Entry | ||
supply | 1..1 | NonMedicinalSupplyActivity | Base for all types and resources | |
entry:selfCareActivity | 0..* | Entry | ||
observation | 1..1 | SelfCareActivitiesADLandIADL | Base for all types and resources | |
entry:sensoryStatus | 0..* | Entry | ||
observation | 1..1 | SensoryStatus | Base for all types and resources | |
Documentation for this format |
Key Elements View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Section | 1..1 | Section | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @ID, @classCode, @moodCode, id, code, title, text, confidentialityCode, languageCode, subject, author, informant, entry, component Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) | |
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root, value:extension | |
templateId:section | 1..1 | II | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.2.14 | |
@extension | 1..1 | st | Required Pattern: 2014-06-09 | |
code | 1..1 | CE | Functional Status Binding: DocumentSectionType (example) | |
@code | 1..1 | cs | Required Pattern: 47420-5 | |
@codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
title | 1..1 | ST | ||
text | 1..1 | xhtml | ||
Slices for entry | 0..* | Entry | Slice: Unordered, Open by profile:organizer, profile:observation, profile:supply | |
entry:funcStatusOrganizer | 0..* | Entry | ||
organizer | C | 1..1 | FunctionalStatusOrganizer | Base for all types and resources |
entry:funcStatusObs | 0..* | Entry | ||
observation | C | 1..1 | FunctionalStatusObservation | Base for all types and resources |
entry:caregiverCharacteristics | 0..* | Entry | ||
observation | C | 1..1 | CaregiverCharacteristics | Base for all types and resources |
entry:assessmentScale | 0..* | Entry | ||
observation | C | 1..1 | AssessmentScaleObservation | Base for all types and resources |
entry:nonMedSupply | 0..* | Entry | ||
supply | C | 1..1 | NonMedicinalSupplyActivity | Base for all types and resources |
entry:selfCareActivity | 0..* | Entry | ||
observation | C | 1..1 | SelfCareActivitiesADLandIADL | Base for all types and resources |
entry:sensoryStatus | 0..* | Entry | ||
observation | C | 1..1 | SensoryStatus | Base for all types and resources |
Documentation for this format |
Path | Conformance | ValueSet |
Section.code | example | DocumentSectionType |
Id | Grade | Path(s) | Details | Requirements |
should-author | warning | Section.entry:funcStatusOrganizer.organizer, Section.entry:funcStatusObs.observation, Section.entry:selfCareActivity.observation, Section.entry:sensoryStatus.observation | SHOULD contain author : author.exists() | |
should-effectiveTime | warning | Section.entry:nonMedSupply.supply | SHOULD contain effectiveTime : effectiveTime.exists() | |
should-quantity | warning | Section.entry:nonMedSupply.supply | SHOULD contain quantity : quantity.exists() | |
should-sdtctext-ref-value | warning | Section.entry:funcStatusOrganizer.organizer | SHOULD contain text/reference/@value : sdtcText.reference.value.exists() | |
should-text-ref-value | warning | Section.entry:funcStatusObs.observation, Section.entry:caregiverCharacteristics.observation, Section.entry:assessmentScale.observation, Section.entry:nonMedSupply.supply, Section.entry:selfCareActivity.observation, Section.entry:sensoryStatus.observation | SHOULD contain text/reference/@value : text.reference.value.exists() |
Snapshot View
Path | Conformance | ValueSet / Code |
Section.nullFlavor | required | CDANullFlavor |
Section.typeId.nullFlavor | required | CDANullFlavor |
Section.templateId:section.nullFlavor | required | CDANullFlavor |
Section.classCode | required | Fixed Value: DOCSECT |
Section.moodCode | required | Fixed Value: EVN |
Section.code | example | DocumentSectionType |
Section.code.nullFlavor | required | CDANullFlavor |
Section.languageCode | required | AllLanguages |
Section.entry:funcStatusOrganizer.nullFlavor | required | CDANullFlavor |
Section.entry:funcStatusOrganizer.typeId.nullFlavor | required | CDANullFlavor |
Section.entry:funcStatusOrganizer.typeCode | required | XActRelationshipEntry |
Section.entry:funcStatusObs.nullFlavor | required | CDANullFlavor |
Section.entry:funcStatusObs.typeId.nullFlavor | required | CDANullFlavor |
Section.entry:funcStatusObs.typeCode | required | XActRelationshipEntry |
Section.entry:caregiverCharacteristics.nullFlavor | required | CDANullFlavor |
Section.entry:caregiverCharacteristics.typeId.nullFlavor | required | CDANullFlavor |
Section.entry:caregiverCharacteristics.typeCode | required | XActRelationshipEntry |
Section.entry:assessmentScale.nullFlavor | required | CDANullFlavor |
Section.entry:assessmentScale.typeId.nullFlavor | required | CDANullFlavor |
Section.entry:assessmentScale.typeCode | required | XActRelationshipEntry |
Section.entry:nonMedSupply.nullFlavor | required | CDANullFlavor |
Section.entry:nonMedSupply.typeId.nullFlavor | required | CDANullFlavor |
Section.entry:nonMedSupply.typeCode | required | XActRelationshipEntry |
Section.entry:selfCareActivity.nullFlavor | required | CDANullFlavor |
Section.entry:selfCareActivity.typeId.nullFlavor | required | CDANullFlavor |
Section.entry:selfCareActivity.typeCode | required | XActRelationshipEntry |
Section.entry:sensoryStatus.nullFlavor | required | CDANullFlavor |
Section.entry:sensoryStatus.typeId.nullFlavor | required | CDANullFlavor |
Section.entry:sensoryStatus.typeCode | required | XActRelationshipEntry |
Section.component.nullFlavor | required | CDANullFlavor |
Section.component.typeId.nullFlavor | required | CDANullFlavor |
Id | Grade | Path(s) | Details | Requirements |
should-author | warning | Section.entry:funcStatusOrganizer.organizer, Section.entry:funcStatusObs.observation, Section.entry:selfCareActivity.observation, Section.entry:sensoryStatus.observation | SHOULD contain author : author.exists() | |
should-effectiveTime | warning | Section.entry:nonMedSupply.supply | SHOULD contain effectiveTime : effectiveTime.exists() | |
should-quantity | warning | Section.entry:nonMedSupply.supply | SHOULD contain quantity : quantity.exists() | |
should-sdtctext-ref-value | warning | Section.entry:funcStatusOrganizer.organizer | SHOULD contain text/reference/@value : sdtcText.reference.value.exists() | |
should-text-ref-value | warning | Section.entry:funcStatusObs.observation, Section.entry:caregiverCharacteristics.observation, Section.entry:assessmentScale.observation, Section.entry:nonMedSupply.supply, Section.entry:selfCareActivity.observation, Section.entry:sensoryStatus.observation | SHOULD contain text/reference/@value : text.reference.value.exists() |
This structure is derived from Section
Summary
Mandatory: 9 elements (7 nested mandatory elements)
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices: