Intervention Act - Consolidated CDA (C-CDA) v3.0.0

This page is part of the CCDA: Consolidated CDA Release (v3.0.0: CCDA 3.0) generated with FHIR (HL7® FHIR® Standard) v5.0.0. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Logical Model: Intervention Act

Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/InterventionAct				Version: 3.0.0
Draft as of 2024-05-18				Computable Name: InterventionAct
Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:hl7ii:2.16.840.1.113883.10.20.22.4.131:2015-08-01

This template represents an Intervention Act. It is a wrapper for intervention-type activities considered to be parts of the same intervention. For example, an activity such as “elevate head of bed” combined with “provide humidified O2 per nasal cannula” may be the interventions performed for a health concern of “respiratory insufficiency” to achieve a goal of “pulse oximetry greater than 92%”. These intervention activities may be newly described or derived from a variety of sources within an EHR.

Interventions are actions taken to increase the likelihood of achieving the patient’s or providers’ goals. An Intervention Act should contain a reference to a Goal Observation representing the reason for the intervention.

Intervention Acts can be related to each other, or to Planned Intervention Acts. (E.g., a Planned Intervention Act with moodCode of INT could be related to a series of Intervention Acts with moodCode of EVN, each having an effectiveTime containing the time of the intervention.)

All interventions referenced in an Intervention Act must have a moodCode of EVN, indicating that they have occurred.

Usage:

Use this Logical Model: Activities Section and Intervention Act

Formal Views of Template Content

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

Key Elements Table
Differential Table
Snapshot Table
Statistics/References
All

This structure is derived from Act

Name	Flags	Card.	Type	Description & Constraints
Act	C	1..1	Act	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:intervention-act		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.131
@extension		1..1	st	Required Pattern: 2015-08-01
@classCode		1..1	cs	Fixed Value: ACT
@moodCode		1..1	cs	Fixed Value: EVN
id		1..*	II
code		1..1	CD
@code		1..1	cs	Required Pattern: 362956003
@codeSystem		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.6.96
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
statusCode		1..1	CS
@code		1..1	cs	Fixed Value: completed
effectiveTime		0..1	IVL_TS
author		0..*	AuthorParticipation	Base for all types and resources
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by value:typeCode, profile:observation, profile:substanceAdministration, profile:act, profile:procedure, profile:encounter, profile:supply
entryRelationship:advanceDirectiveObservation		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
observation		1..1	AdvanceDirectiveObservation	Base for all types and resources
entryRelationship:immunizationActivity		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
substanceAdministration		1..1	ImmunizationActivity	Base for all types and resources
entryRelationship:medicationActivity		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
substanceAdministration		1..1	MedicationActivity	Base for all types and resources
entryRelationship:interventionAct		0..*	EntryRelationship	The following entryRelationship represents the relationship between two Intervention Acts (Intervention RELATES TO Intervention).
@typeCode		1..1	cs	Fixed Value: REFR
act		1..1	InterventionAct	Base for all types and resources
entryRelationship:procedureActivityProcedure		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
procedure		1..1	ProcedureActivityProcedure	Base for all types and resources
entryRelationship:encounterActivity		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
encounter		1..1	EncounterActivity	Base for all types and resources
entryRelationship:instruction		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
act		1..1	Instruction	Base for all types and resources
entryRelationship:nonMedSupply		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
supply		1..1	NonMedicinalSupplyActivity	Base for all types and resources
entryRelationship:nutritionRecommendation		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
act		1..1	NutritionRecommendation	Base for all types and resources
entryRelationship:entryReferenceRefr		0..*	EntryRelationship	Where an Intervention needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry.
@typeCode		1..1	cs	Fixed Value: REFR
act		1..1	EntryReference	Base for all types and resources
entryRelationship:entryReferenceRson	C	0..*	EntryRelationship	An Intervention Act should reference a Goal Observation. Because the Goal Observation is already described in the CDA document instance's Goals section, rather than repeating the full content of the Goal Observation, the Entry Reference template can be used to reference this entry. The following entryRelationship represents an Entry Reference to Goal Observation. entry-ref-goal: This entryReference template SHALL reference an instance of a Goal Observation template.
@typeCode		1..1	cs	Fixed Value: RSON
act		1..1	EntryReference	Base for all types and resources
entryRelationship:handoffCommunicationParticipants		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
act		1..1	HandoffCommunicationParticipants	Base for all types and resources
entryRelationship:plannedInterventionAct		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
act		1..1	PlannedInterventionAct	Base for all types and resources
reference		0..*	Reference
@typeCode		1..1	cs	Fixed Value: REFR
externalDocument		1..1	ExternalDocumentReference	Base for all types and resources
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
entry-ref-goal	error	Act.entryRelationship:entryReferenceRson	This entryReference template SHALL reference an instance of a Goal Observation template. : %resource.descendants().ofType(CDA.Observation).where(templateId.exists($this.root = '2.16.840.1.113883.10.20.22.4.121' and $this.extension = '2022-06-01') and id.exists($this.root = %context.act.id.first().root and $this.extension ~ %context.act.id.first().extension))
should-author	warning	Act	SHOULD contain author : author.exists()
should-effectiveTime	warning	Act	SHOULD contain effectiveTime : effectiveTime.exists()
should-text-ref-value	warning	Act	SHOULD contain text/reference/@value : text.reference.value.exists()
value-starts-octothorpe	error	Act.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Name	Flags	Card.	Type	Description & Constraints
Act	C	1..1	Act	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:intervention-act		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.131
@extension		1..1	st	Required Pattern: 2015-08-01
@classCode		1..1	cs	Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT
@moodCode		1..1	cs	Binding: XDocumentActMood (2.0.0) (required) Fixed Value: EVN
id		1..*	II
code		1..1	CD	Binding: v3 Code System ActCode (example)
@code		1..1	cs	Required Pattern: 362956003
@codeSystem		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.6.96
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
statusCode		1..1	CS	Binding: ActStatus (required)
@code		1..1	cs	Fixed Value: completed
effectiveTime		0..1	IVL_TS
author		0..*	AuthorParticipation	Base for all types and resources
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by value:typeCode, profile:observation, profile:substanceAdministration, profile:act, profile:procedure, profile:encounter, profile:supply
entryRelationship:advanceDirectiveObservation		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
observation	C	1..1	AdvanceDirectiveObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author should-informant: SHOULD contain informant
entryRelationship:immunizationActivity		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
substanceAdministration	C	1..1	ImmunizationActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-doseQuantity: SHOULD contain doseQuantity dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-performer: SHOULD contain performer should-author: SHOULD contain author
entryRelationship:medicationActivity		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
substanceAdministration	C	1..1	MedicationActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value 1098-7513: SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it SHALL contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). should-routeCode: SHOULD contain routeCode dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-author: SHOULD contain author
entryRelationship:interventionAct		0..*	EntryRelationship	The following entryRelationship represents the relationship between two Intervention Acts (Intervention RELATES TO Intervention).
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
act	C	1..1	InterventionAct	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
entryRelationship:procedureActivityProcedure		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
procedure	C	1..1	ProcedureActivityProcedure	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value active-high-ts-after-document: If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime should-targetSiteCode: SHOULD contain targetSiteCode should-performer: SHOULD contain performer should-author: SHOULD contain author
entryRelationship:encounterActivity		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
encounter	C	1..1	EncounterActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:instruction		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
act	C	1..1	Instruction	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:nonMedSupply		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
supply	C	1..1	NonMedicinalSupplyActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-quantity: SHOULD contain quantity
entryRelationship:nutritionRecommendation		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
act	C	1..1	NutritionRecommendation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime
entryRelationship:entryReferenceRefr		0..*	EntryRelationship	Where an Intervention needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry.
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
act	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:entryReferenceRson	C	0..*	EntryRelationship	An Intervention Act should reference a Goal Observation. Because the Goal Observation is already described in the CDA document instance's Goals section, rather than repeating the full content of the Goal Observation, the Entry Reference template can be used to reference this entry. The following entryRelationship represents an Entry Reference to Goal Observation. entry-ref-goal: This entryReference template SHALL reference an instance of a Goal Observation template.
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: RSON
act	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:handoffCommunicationParticipants		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
act	C	1..1	HandoffCommunicationParticipants	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:plannedInterventionAct		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
act	C	1..1	PlannedInterventionAct	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
reference		0..*	Reference
@typeCode		1..1	cs	Binding: x_ActRelationshipExternalReference (required) Fixed Value: REFR
externalDocument	C	1..1	ExternalDocumentReference	Base for all types and resources should-setId: SHOULD contain setId should-versionNumber: SHOULD contain versionNumber
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Act.classCode	required	Fixed Value: ACT `http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct\|2.0.0`
Act.moodCode	required	Fixed Value: EVN `http://terminology.hl7.org/ValueSet/v3-xDocumentActMood\|2.0.0`
Act.code	example	ActCode `http://terminology.hl7.org/ValueSet/v3-ActCode`
Act.statusCode	required	ActStatus `http://terminology.hl7.org/ValueSet/v3-ActStatus`
Act.entryRelationship:advanceDirectiveObservation.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:immunizationActivity.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:medicationActivity.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:interventionAct.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:procedureActivityProcedure.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:encounterActivity.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:instruction.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:nonMedSupply.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:nutritionRecommendation.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:entryReferenceRefr.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:entryReferenceRson.typeCode	required	Fixed Value: RSON `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:handoffCommunicationParticipants.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:plannedInterventionAct.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.reference.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference`

Constraints

Id	Grade	Path(s)	Details	Requirements
1098-7513	warning	Act.entryRelationship:medicationActivity.substanceAdministration	SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it SHALL contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). : effectiveTime.ofType(CDA.PIVL_TS).exists() or effectiveTime.ofType(CDA.EIVL_TS).exists()
active-high-ts-after-document	error	Act.entryRelationship:procedureActivityProcedure.procedure	If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime : (statusCode.code = 'active' and effectiveTime.high.value.exists()) implies effectiveTime.high.value > %resource.effectiveTime.value
dose-unit-or-admin-unit	error	Act.entryRelationship:immunizationActivity.substanceAdministration, Act.entryRelationship:medicationActivity.substanceAdministration	If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. : doseQuantity.unit.exists() implies administrationUnitCode.empty()
entry-ref-goal	error	Act.entryRelationship:entryReferenceRson	This entryReference template SHALL reference an instance of a Goal Observation template. : %resource.descendants().ofType(CDA.Observation).where(templateId.exists($this.root = '2.16.840.1.113883.10.20.22.4.121' and $this.extension = '2022-06-01') and id.exists($this.root = %context.act.id.first().root and $this.extension ~ %context.act.id.first().extension))
should-author	warning	Act, Act.entryRelationship:interventionAct.act	SHOULD contain author : author.exists()
should-author	warning	Act.entryRelationship:advanceDirectiveObservation.observation, Act.entryRelationship:immunizationActivity.substanceAdministration, Act.entryRelationship:medicationActivity.substanceAdministration, Act.entryRelationship:procedureActivityProcedure.procedure, Act.entryRelationship:plannedInterventionAct.act	SHOULD contain author : author.exists()
should-doseQuantity	warning	Act.entryRelationship:immunizationActivity.substanceAdministration	SHOULD contain doseQuantity : doseQuantity.exists()
should-effectiveTime	warning	Act, Act.entryRelationship:interventionAct.act	SHOULD contain effectiveTime : effectiveTime.exists()
should-effectiveTime	warning	Act.entryRelationship:nonMedSupply.supply, Act.entryRelationship:nutritionRecommendation.act, Act.entryRelationship:plannedInterventionAct.act	SHOULD contain effectiveTime : effectiveTime.exists()
should-informant	warning	Act.entryRelationship:advanceDirectiveObservation.observation	SHOULD contain informant : informant.exists()
should-performer	warning	Act.entryRelationship:immunizationActivity.substanceAdministration, Act.entryRelationship:procedureActivityProcedure.procedure	SHOULD contain performer : performer.exists()
should-quantity	warning	Act.entryRelationship:nonMedSupply.supply	SHOULD contain quantity : quantity.exists()
should-routeCode	warning	Act.entryRelationship:medicationActivity.substanceAdministration	SHOULD contain routeCode : routeCode.exists()
should-setId	warning	Act.reference.externalDocument	SHOULD contain setId : setId.exists()
should-targetSiteCode	warning	Act.entryRelationship:procedureActivityProcedure.procedure	SHOULD contain targetSiteCode : targetSiteCode.exists()
should-text-ref-value	warning	Act, Act.entryRelationship:interventionAct.act	SHOULD contain text/reference/@value : text.reference.value.exists()
should-text-ref-value	warning	Act.entryRelationship:advanceDirectiveObservation.observation, Act.entryRelationship:immunizationActivity.substanceAdministration, Act.entryRelationship:medicationActivity.substanceAdministration, Act.entryRelationship:procedureActivityProcedure.procedure, Act.entryRelationship:encounterActivity.encounter, Act.entryRelationship:instruction.act, Act.entryRelationship:nonMedSupply.supply, Act.entryRelationship:nutritionRecommendation.act, Act.entryRelationship:entryReferenceRefr.act, Act.entryRelationship:entryReferenceRson.act, Act.entryRelationship:handoffCommunicationParticipants.act, Act.entryRelationship:plannedInterventionAct.act	SHOULD contain text/reference/@value : text.reference.value.exists()
should-versionNumber	warning	Act.reference.externalDocument	SHOULD contain versionNumber : versionNumber.exists()
value-starts-octothorpe	error	Act.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Name	Flags	Card.	Type	Description & Constraints
Act	C	1..1	Act	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:intervention-act		1..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.131
@extension		1..1	st	Required Pattern: 2015-08-01
@classCode		1..1	cs	Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT
@moodCode		1..1	cs	Binding: XDocumentActMood (2.0.0) (required) Fixed Value: EVN
@negationInd		0..1	bl
id		1..*	II
code		1..1	CD	Binding: v3 Code System ActCode (example)
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@code		1..1	cs	Required Pattern: 362956003
@codeSystem		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.6.96
@codeSystemName		0..1	st
@codeSystemVersion		0..1	st
@displayName		0..1	st
@sdtcValueSet		0..1	oid	XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion		0..1	st	XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
originalText		0..1	ED
qualifier		0..*	CR
translation		0..*	CD
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@compression		0..1	cs	Binding: CDACompressionAlgorithm (required)
@integrityCheck		0..1	bin
@integrityCheckAlgorithm		0..1	cs	Binding: IntegrityCheckAlgorithm (2.0.0) (required)
@language		0..1	cs
@mediaType		0..1	cs	Binding: MediaType (example)
@representation		0..1	cs	Binding: CDABinaryDataEncoding (required)
xmlText		0..1	st	Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
thumbnail		0..1	ED
statusCode		1..1	CS	Binding: ActStatus (required)
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@code		1..1	cs	Fixed Value: completed
@sdtcValueSet		0..1	oid	XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion		0..1	st	XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
effectiveTime		0..1	IVL_TS
priorityCode		0..1	CE	Binding: ActPriority (example)
languageCode		0..1	CS	Binding: AllLanguages (required)
subject		0..1	Subject
specimen		0..*	Specimen
performer		0..*	Performer2
author		0..*	AuthorParticipation	Base for all types and resources
informant		0..*	Informant
participant		0..*	Participant2
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by value:typeCode, profile:observation, profile:substanceAdministration, profile:act, profile:procedure, profile:encounter, profile:supply
entryRelationship:advanceDirectiveObservation		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation	C	1..1	AdvanceDirectiveObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author should-informant: SHOULD contain informant
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:immunizationActivity		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration	C	1..1	ImmunizationActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-doseQuantity: SHOULD contain doseQuantity dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-performer: SHOULD contain performer should-author: SHOULD contain author
supply		0..1	Supply
entryRelationship:medicationActivity		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration	C	1..1	MedicationActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value 1098-7513: SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it SHALL contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). should-routeCode: SHOULD contain routeCode dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-author: SHOULD contain author
supply		0..1	Supply
entryRelationship:interventionAct		0..*	EntryRelationship	The following entryRelationship represents the relationship between two Intervention Acts (Intervention RELATES TO Intervention).
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	InterventionAct	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:procedureActivityProcedure		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure	C	1..1	ProcedureActivityProcedure	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value active-high-ts-after-document: If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime should-targetSiteCode: SHOULD contain targetSiteCode should-performer: SHOULD contain performer should-author: SHOULD contain author
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:encounterActivity		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter	C	1..1	EncounterActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:instruction		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	Instruction	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:nonMedSupply		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply	C	1..1	NonMedicinalSupplyActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-quantity: SHOULD contain quantity
entryRelationship:nutritionRecommendation		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	NutritionRecommendation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:entryReferenceRefr		0..*	EntryRelationship	Where an Intervention needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:entryReferenceRson	C	0..*	EntryRelationship	An Intervention Act should reference a Goal Observation. Because the Goal Observation is already described in the CDA document instance's Goals section, rather than repeating the full content of the Goal Observation, the Entry Reference template can be used to reference this entry. The following entryRelationship represents an Entry Reference to Goal Observation. entry-ref-goal: This entryReference template SHALL reference an instance of a Goal Observation template.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: RSON
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:handoffCommunicationParticipants		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	HandoffCommunicationParticipants	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:plannedInterventionAct		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	PlannedInterventionAct	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
reference		0..*	Reference
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipExternalReference (required) Fixed Value: REFR
seperatableInd		0..1	BL
externalAct		0..1	ExternalAct
externalObservation		0..1	ExternalObservation
externalProcedure		0..1	ExternalProcedure
externalDocument	C	1..1	ExternalDocumentReference	Base for all types and resources should-setId: SHOULD contain setId should-versionNumber: SHOULD contain versionNumber
precondition		0..*	Precondition
sdtcPrecondition2		0..*	Precondition2	XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc)
sdtcInFulfillmentOf1		0..*	InFulfillmentOf1	XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Act.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.templateId:intervention-act.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.classCode	required	Fixed Value: ACT `http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct\|2.0.0`
Act.moodCode	required	Fixed Value: EVN `http://terminology.hl7.org/ValueSet/v3-xDocumentActMood\|2.0.0`
Act.code	example	ActCode `http://terminology.hl7.org/ValueSet/v3-ActCode`
Act.code.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.text.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.text.compression	required	CDACompressionAlgorithm `http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm`
Act.text.integrityCheckAlgorithm	required	IntegrityCheckAlgorithm `http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm\|2.0.0`
Act.text.mediaType	example	MediaType `http://terminology.hl7.org/ValueSet/v3-MediaType`
Act.text.representation	required	BinaryDataEncoding `http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding`
Act.statusCode	required	ActStatus `http://terminology.hl7.org/ValueSet/v3-ActStatus`
Act.statusCode.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.priorityCode	example	ActPriority `http://terminology.hl7.org/ValueSet/v3-ActPriority`
Act.languageCode	required	AllLanguages `http://hl7.org/fhir/ValueSet/all-languages` from the FHIR Standard
Act.entryRelationship:advanceDirectiveObservation.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:advanceDirectiveObservation.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:advanceDirectiveObservation.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:immunizationActivity.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:immunizationActivity.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:immunizationActivity.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:medicationActivity.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:medicationActivity.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:medicationActivity.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:interventionAct.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:interventionAct.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:interventionAct.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:procedureActivityProcedure.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:procedureActivityProcedure.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:procedureActivityProcedure.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:encounterActivity.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:encounterActivity.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:encounterActivity.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:instruction.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:instruction.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:instruction.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:nonMedSupply.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:nonMedSupply.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:nonMedSupply.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:nutritionRecommendation.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:nutritionRecommendation.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:nutritionRecommendation.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:entryReferenceRefr.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:entryReferenceRefr.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:entryReferenceRefr.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:entryReferenceRson.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:entryReferenceRson.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:entryReferenceRson.typeCode	required	Fixed Value: RSON `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:handoffCommunicationParticipants.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:handoffCommunicationParticipants.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:handoffCommunicationParticipants.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:plannedInterventionAct.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:plannedInterventionAct.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:plannedInterventionAct.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.reference.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.reference.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.reference.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference`

Constraints

Id	Grade	Path(s)	Details	Requirements
1098-7513	warning	Act.entryRelationship:medicationActivity.substanceAdministration	SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it SHALL contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). : effectiveTime.ofType(CDA.PIVL_TS).exists() or effectiveTime.ofType(CDA.EIVL_TS).exists()
active-high-ts-after-document	error	Act.entryRelationship:procedureActivityProcedure.procedure	If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime : (statusCode.code = 'active' and effectiveTime.high.value.exists()) implies effectiveTime.high.value > %resource.effectiveTime.value
dose-unit-or-admin-unit	error	Act.entryRelationship:immunizationActivity.substanceAdministration, Act.entryRelationship:medicationActivity.substanceAdministration	If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. : doseQuantity.unit.exists() implies administrationUnitCode.empty()
entry-ref-goal	error	Act.entryRelationship:entryReferenceRson	This entryReference template SHALL reference an instance of a Goal Observation template. : %resource.descendants().ofType(CDA.Observation).where(templateId.exists($this.root = '2.16.840.1.113883.10.20.22.4.121' and $this.extension = '2022-06-01') and id.exists($this.root = %context.act.id.first().root and $this.extension ~ %context.act.id.first().extension))
should-author	warning	Act, Act.entryRelationship:interventionAct.act	SHOULD contain author : author.exists()
should-author	warning	Act.entryRelationship:advanceDirectiveObservation.observation, Act.entryRelationship:immunizationActivity.substanceAdministration, Act.entryRelationship:medicationActivity.substanceAdministration, Act.entryRelationship:procedureActivityProcedure.procedure, Act.entryRelationship:plannedInterventionAct.act	SHOULD contain author : author.exists()
should-doseQuantity	warning	Act.entryRelationship:immunizationActivity.substanceAdministration	SHOULD contain doseQuantity : doseQuantity.exists()
should-effectiveTime	warning	Act, Act.entryRelationship:interventionAct.act	SHOULD contain effectiveTime : effectiveTime.exists()
should-effectiveTime	warning	Act.entryRelationship:nonMedSupply.supply, Act.entryRelationship:nutritionRecommendation.act, Act.entryRelationship:plannedInterventionAct.act	SHOULD contain effectiveTime : effectiveTime.exists()
should-informant	warning	Act.entryRelationship:advanceDirectiveObservation.observation	SHOULD contain informant : informant.exists()
should-performer	warning	Act.entryRelationship:immunizationActivity.substanceAdministration, Act.entryRelationship:procedureActivityProcedure.procedure	SHOULD contain performer : performer.exists()
should-quantity	warning	Act.entryRelationship:nonMedSupply.supply	SHOULD contain quantity : quantity.exists()
should-routeCode	warning	Act.entryRelationship:medicationActivity.substanceAdministration	SHOULD contain routeCode : routeCode.exists()
should-setId	warning	Act.reference.externalDocument	SHOULD contain setId : setId.exists()
should-targetSiteCode	warning	Act.entryRelationship:procedureActivityProcedure.procedure	SHOULD contain targetSiteCode : targetSiteCode.exists()
should-text-ref-value	warning	Act, Act.entryRelationship:interventionAct.act	SHOULD contain text/reference/@value : text.reference.value.exists()
should-text-ref-value	warning	Act.entryRelationship:advanceDirectiveObservation.observation, Act.entryRelationship:immunizationActivity.substanceAdministration, Act.entryRelationship:medicationActivity.substanceAdministration, Act.entryRelationship:procedureActivityProcedure.procedure, Act.entryRelationship:encounterActivity.encounter, Act.entryRelationship:instruction.act, Act.entryRelationship:nonMedSupply.supply, Act.entryRelationship:nutritionRecommendation.act, Act.entryRelationship:entryReferenceRefr.act, Act.entryRelationship:entryReferenceRson.act, Act.entryRelationship:handoffCommunicationParticipants.act, Act.entryRelationship:plannedInterventionAct.act	SHOULD contain text/reference/@value : text.reference.value.exists()
should-versionNumber	warning	Act.reference.externalDocument	SHOULD contain versionNumber : versionNumber.exists()
value-starts-octothorpe	error	Act.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

This structure is derived from Act

Summary

Mandatory: 9 elements(14 nested mandatory elements)
Fixed: 17 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

The element 2 is sliced based on the values of Act.templateId
The element 7 is sliced based on the values of Act.entryRelationship

Differential View

This structure is derived from Act

Name	Flags	Card.	Type	Description & Constraints
Act	C	1..1	Act	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:intervention-act		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.131
@extension		1..1	st	Required Pattern: 2015-08-01
@classCode		1..1	cs	Fixed Value: ACT
@moodCode		1..1	cs	Fixed Value: EVN
id		1..*	II
code		1..1	CD
@code		1..1	cs	Required Pattern: 362956003
@codeSystem		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.6.96
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
statusCode		1..1	CS
@code		1..1	cs	Fixed Value: completed
effectiveTime		0..1	IVL_TS
author		0..*	AuthorParticipation	Base for all types and resources
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by value:typeCode, profile:observation, profile:substanceAdministration, profile:act, profile:procedure, profile:encounter, profile:supply
entryRelationship:advanceDirectiveObservation		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
observation		1..1	AdvanceDirectiveObservation	Base for all types and resources
entryRelationship:immunizationActivity		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
substanceAdministration		1..1	ImmunizationActivity	Base for all types and resources
entryRelationship:medicationActivity		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
substanceAdministration		1..1	MedicationActivity	Base for all types and resources
entryRelationship:interventionAct		0..*	EntryRelationship	The following entryRelationship represents the relationship between two Intervention Acts (Intervention RELATES TO Intervention).
@typeCode		1..1	cs	Fixed Value: REFR
act		1..1	InterventionAct	Base for all types and resources
entryRelationship:procedureActivityProcedure		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
procedure		1..1	ProcedureActivityProcedure	Base for all types and resources
entryRelationship:encounterActivity		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
encounter		1..1	EncounterActivity	Base for all types and resources
entryRelationship:instruction		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
act		1..1	Instruction	Base for all types and resources
entryRelationship:nonMedSupply		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
supply		1..1	NonMedicinalSupplyActivity	Base for all types and resources
entryRelationship:nutritionRecommendation		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
act		1..1	NutritionRecommendation	Base for all types and resources
entryRelationship:entryReferenceRefr		0..*	EntryRelationship	Where an Intervention needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry.
@typeCode		1..1	cs	Fixed Value: REFR
act		1..1	EntryReference	Base for all types and resources
entryRelationship:entryReferenceRson	C	0..*	EntryRelationship	An Intervention Act should reference a Goal Observation. Because the Goal Observation is already described in the CDA document instance's Goals section, rather than repeating the full content of the Goal Observation, the Entry Reference template can be used to reference this entry. The following entryRelationship represents an Entry Reference to Goal Observation. entry-ref-goal: This entryReference template SHALL reference an instance of a Goal Observation template.
@typeCode		1..1	cs	Fixed Value: RSON
act		1..1	EntryReference	Base for all types and resources
entryRelationship:handoffCommunicationParticipants		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
act		1..1	HandoffCommunicationParticipants	Base for all types and resources
entryRelationship:plannedInterventionAct		0..*	EntryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
act		1..1	PlannedInterventionAct	Base for all types and resources
reference		0..*	Reference
@typeCode		1..1	cs	Fixed Value: REFR
externalDocument		1..1	ExternalDocumentReference	Base for all types and resources
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
entry-ref-goal	error	Act.entryRelationship:entryReferenceRson	This entryReference template SHALL reference an instance of a Goal Observation template. : %resource.descendants().ofType(CDA.Observation).where(templateId.exists($this.root = '2.16.840.1.113883.10.20.22.4.121' and $this.extension = '2022-06-01') and id.exists($this.root = %context.act.id.first().root and $this.extension ~ %context.act.id.first().extension))
should-author	warning	Act	SHOULD contain author : author.exists()
should-effectiveTime	warning	Act	SHOULD contain effectiveTime : effectiveTime.exists()
should-text-ref-value	warning	Act	SHOULD contain text/reference/@value : text.reference.value.exists()
value-starts-octothorpe	error	Act.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Act	C	1..1	Act	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:intervention-act		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.131
@extension		1..1	st	Required Pattern: 2015-08-01
@classCode		1..1	cs	Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT
@moodCode		1..1	cs	Binding: XDocumentActMood (2.0.0) (required) Fixed Value: EVN
id		1..*	II
code		1..1	CD	Binding: v3 Code System ActCode (example)
@code		1..1	cs	Required Pattern: 362956003
@codeSystem		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.6.96
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
statusCode		1..1	CS	Binding: ActStatus (required)
@code		1..1	cs	Fixed Value: completed
effectiveTime		0..1	IVL_TS
author		0..*	AuthorParticipation	Base for all types and resources
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by value:typeCode, profile:observation, profile:substanceAdministration, profile:act, profile:procedure, profile:encounter, profile:supply
entryRelationship:advanceDirectiveObservation		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
observation	C	1..1	AdvanceDirectiveObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author should-informant: SHOULD contain informant
entryRelationship:immunizationActivity		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
substanceAdministration	C	1..1	ImmunizationActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-doseQuantity: SHOULD contain doseQuantity dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-performer: SHOULD contain performer should-author: SHOULD contain author
entryRelationship:medicationActivity		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
substanceAdministration	C	1..1	MedicationActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value 1098-7513: SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it SHALL contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). should-routeCode: SHOULD contain routeCode dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-author: SHOULD contain author
entryRelationship:interventionAct		0..*	EntryRelationship	The following entryRelationship represents the relationship between two Intervention Acts (Intervention RELATES TO Intervention).
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
act	C	1..1	InterventionAct	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
entryRelationship:procedureActivityProcedure		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
procedure	C	1..1	ProcedureActivityProcedure	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value active-high-ts-after-document: If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime should-targetSiteCode: SHOULD contain targetSiteCode should-performer: SHOULD contain performer should-author: SHOULD contain author
entryRelationship:encounterActivity		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
encounter	C	1..1	EncounterActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:instruction		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
act	C	1..1	Instruction	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:nonMedSupply		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
supply	C	1..1	NonMedicinalSupplyActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-quantity: SHOULD contain quantity
entryRelationship:nutritionRecommendation		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
act	C	1..1	NutritionRecommendation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime
entryRelationship:entryReferenceRefr		0..*	EntryRelationship	Where an Intervention needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry.
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
act	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:entryReferenceRson	C	0..*	EntryRelationship	An Intervention Act should reference a Goal Observation. Because the Goal Observation is already described in the CDA document instance's Goals section, rather than repeating the full content of the Goal Observation, the Entry Reference template can be used to reference this entry. The following entryRelationship represents an Entry Reference to Goal Observation. entry-ref-goal: This entryReference template SHALL reference an instance of a Goal Observation template.
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: RSON
act	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:handoffCommunicationParticipants		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
act	C	1..1	HandoffCommunicationParticipants	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:plannedInterventionAct		0..*	EntryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
act	C	1..1	PlannedInterventionAct	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
reference		0..*	Reference
@typeCode		1..1	cs	Binding: x_ActRelationshipExternalReference (required) Fixed Value: REFR
externalDocument	C	1..1	ExternalDocumentReference	Base for all types and resources should-setId: SHOULD contain setId should-versionNumber: SHOULD contain versionNumber
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Act.classCode	required	Fixed Value: ACT `http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct\|2.0.0`
Act.moodCode	required	Fixed Value: EVN `http://terminology.hl7.org/ValueSet/v3-xDocumentActMood\|2.0.0`
Act.code	example	ActCode `http://terminology.hl7.org/ValueSet/v3-ActCode`
Act.statusCode	required	ActStatus `http://terminology.hl7.org/ValueSet/v3-ActStatus`
Act.entryRelationship:advanceDirectiveObservation.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:immunizationActivity.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:medicationActivity.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:interventionAct.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:procedureActivityProcedure.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:encounterActivity.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:instruction.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:nonMedSupply.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:nutritionRecommendation.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:entryReferenceRefr.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:entryReferenceRson.typeCode	required	Fixed Value: RSON `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:handoffCommunicationParticipants.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:plannedInterventionAct.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.reference.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference`

Constraints

Id	Grade	Path(s)	Details	Requirements
1098-7513	warning	Act.entryRelationship:medicationActivity.substanceAdministration	SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it SHALL contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). : effectiveTime.ofType(CDA.PIVL_TS).exists() or effectiveTime.ofType(CDA.EIVL_TS).exists()
active-high-ts-after-document	error	Act.entryRelationship:procedureActivityProcedure.procedure	If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime : (statusCode.code = 'active' and effectiveTime.high.value.exists()) implies effectiveTime.high.value > %resource.effectiveTime.value
dose-unit-or-admin-unit	error	Act.entryRelationship:immunizationActivity.substanceAdministration, Act.entryRelationship:medicationActivity.substanceAdministration	If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. : doseQuantity.unit.exists() implies administrationUnitCode.empty()
entry-ref-goal	error	Act.entryRelationship:entryReferenceRson	This entryReference template SHALL reference an instance of a Goal Observation template. : %resource.descendants().ofType(CDA.Observation).where(templateId.exists($this.root = '2.16.840.1.113883.10.20.22.4.121' and $this.extension = '2022-06-01') and id.exists($this.root = %context.act.id.first().root and $this.extension ~ %context.act.id.first().extension))
should-author	warning	Act, Act.entryRelationship:interventionAct.act	SHOULD contain author : author.exists()
should-author	warning	Act.entryRelationship:advanceDirectiveObservation.observation, Act.entryRelationship:immunizationActivity.substanceAdministration, Act.entryRelationship:medicationActivity.substanceAdministration, Act.entryRelationship:procedureActivityProcedure.procedure, Act.entryRelationship:plannedInterventionAct.act	SHOULD contain author : author.exists()
should-doseQuantity	warning	Act.entryRelationship:immunizationActivity.substanceAdministration	SHOULD contain doseQuantity : doseQuantity.exists()
should-effectiveTime	warning	Act, Act.entryRelationship:interventionAct.act	SHOULD contain effectiveTime : effectiveTime.exists()
should-effectiveTime	warning	Act.entryRelationship:nonMedSupply.supply, Act.entryRelationship:nutritionRecommendation.act, Act.entryRelationship:plannedInterventionAct.act	SHOULD contain effectiveTime : effectiveTime.exists()
should-informant	warning	Act.entryRelationship:advanceDirectiveObservation.observation	SHOULD contain informant : informant.exists()
should-performer	warning	Act.entryRelationship:immunizationActivity.substanceAdministration, Act.entryRelationship:procedureActivityProcedure.procedure	SHOULD contain performer : performer.exists()
should-quantity	warning	Act.entryRelationship:nonMedSupply.supply	SHOULD contain quantity : quantity.exists()
should-routeCode	warning	Act.entryRelationship:medicationActivity.substanceAdministration	SHOULD contain routeCode : routeCode.exists()
should-setId	warning	Act.reference.externalDocument	SHOULD contain setId : setId.exists()
should-targetSiteCode	warning	Act.entryRelationship:procedureActivityProcedure.procedure	SHOULD contain targetSiteCode : targetSiteCode.exists()
should-text-ref-value	warning	Act, Act.entryRelationship:interventionAct.act	SHOULD contain text/reference/@value : text.reference.value.exists()
should-text-ref-value	warning	Act.entryRelationship:advanceDirectiveObservation.observation, Act.entryRelationship:immunizationActivity.substanceAdministration, Act.entryRelationship:medicationActivity.substanceAdministration, Act.entryRelationship:procedureActivityProcedure.procedure, Act.entryRelationship:encounterActivity.encounter, Act.entryRelationship:instruction.act, Act.entryRelationship:nonMedSupply.supply, Act.entryRelationship:nutritionRecommendation.act, Act.entryRelationship:entryReferenceRefr.act, Act.entryRelationship:entryReferenceRson.act, Act.entryRelationship:handoffCommunicationParticipants.act, Act.entryRelationship:plannedInterventionAct.act	SHOULD contain text/reference/@value : text.reference.value.exists()
should-versionNumber	warning	Act.reference.externalDocument	SHOULD contain versionNumber : versionNumber.exists()
value-starts-octothorpe	error	Act.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Act	C	1..1	Act	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:intervention-act		1..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.131
@extension		1..1	st	Required Pattern: 2015-08-01
@classCode		1..1	cs	Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT
@moodCode		1..1	cs	Binding: XDocumentActMood (2.0.0) (required) Fixed Value: EVN
@negationInd		0..1	bl
id		1..*	II
code		1..1	CD	Binding: v3 Code System ActCode (example)
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@code		1..1	cs	Required Pattern: 362956003
@codeSystem		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.6.96
@codeSystemName		0..1	st
@codeSystemVersion		0..1	st
@displayName		0..1	st
@sdtcValueSet		0..1	oid	XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion		0..1	st	XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
originalText		0..1	ED
qualifier		0..*	CR
translation		0..*	CD
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@compression		0..1	cs	Binding: CDACompressionAlgorithm (required)
@integrityCheck		0..1	bin
@integrityCheckAlgorithm		0..1	cs	Binding: IntegrityCheckAlgorithm (2.0.0) (required)
@language		0..1	cs
@mediaType		0..1	cs	Binding: MediaType (example)
@representation		0..1	cs	Binding: CDABinaryDataEncoding (required)
xmlText		0..1	st	Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
thumbnail		0..1	ED
statusCode		1..1	CS	Binding: ActStatus (required)
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@code		1..1	cs	Fixed Value: completed
@sdtcValueSet		0..1	oid	XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion		0..1	st	XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
effectiveTime		0..1	IVL_TS
priorityCode		0..1	CE	Binding: ActPriority (example)
languageCode		0..1	CS	Binding: AllLanguages (required)
subject		0..1	Subject
specimen		0..*	Specimen
performer		0..*	Performer2
author		0..*	AuthorParticipation	Base for all types and resources
informant		0..*	Informant
participant		0..*	Participant2
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by value:typeCode, profile:observation, profile:substanceAdministration, profile:act, profile:procedure, profile:encounter, profile:supply
entryRelationship:advanceDirectiveObservation		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation	C	1..1	AdvanceDirectiveObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author should-informant: SHOULD contain informant
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:immunizationActivity		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration	C	1..1	ImmunizationActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-doseQuantity: SHOULD contain doseQuantity dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-performer: SHOULD contain performer should-author: SHOULD contain author
supply		0..1	Supply
entryRelationship:medicationActivity		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration	C	1..1	MedicationActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value 1098-7513: SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it SHALL contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). should-routeCode: SHOULD contain routeCode dose-unit-or-admin-unit: If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. should-author: SHOULD contain author
supply		0..1	Supply
entryRelationship:interventionAct		0..*	EntryRelationship	The following entryRelationship represents the relationship between two Intervention Acts (Intervention RELATES TO Intervention).
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	InterventionAct	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:procedureActivityProcedure		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure	C	1..1	ProcedureActivityProcedure	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value active-high-ts-after-document: If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime should-targetSiteCode: SHOULD contain targetSiteCode should-performer: SHOULD contain performer should-author: SHOULD contain author
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:encounterActivity		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter	C	1..1	EncounterActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:instruction		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	Instruction	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:nonMedSupply		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply	C	1..1	NonMedicinalSupplyActivity	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-quantity: SHOULD contain quantity
entryRelationship:nutritionRecommendation		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	NutritionRecommendation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:entryReferenceRefr		0..*	EntryRelationship	Where an Intervention needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:entryReferenceRson	C	0..*	EntryRelationship	An Intervention Act should reference a Goal Observation. Because the Goal Observation is already described in the CDA document instance's Goals section, rather than repeating the full content of the Goal Observation, the Entry Reference template can be used to reference this entry. The following entryRelationship represents an Entry Reference to Goal Observation. entry-ref-goal: This entryReference template SHALL reference an instance of a Goal Observation template.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: RSON
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:handoffCommunicationParticipants		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	HandoffCommunicationParticipants	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:plannedInterventionAct		0..*	EntryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	PlannedInterventionAct	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
reference		0..*	Reference
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipExternalReference (required) Fixed Value: REFR
seperatableInd		0..1	BL
externalAct		0..1	ExternalAct
externalObservation		0..1	ExternalObservation
externalProcedure		0..1	ExternalProcedure
externalDocument	C	1..1	ExternalDocumentReference	Base for all types and resources should-setId: SHOULD contain setId should-versionNumber: SHOULD contain versionNumber
precondition		0..*	Precondition
sdtcPrecondition2		0..*	Precondition2	XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc)
sdtcInFulfillmentOf1		0..*	InFulfillmentOf1	XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Act.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.templateId:intervention-act.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.classCode	required	Fixed Value: ACT `http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct\|2.0.0`
Act.moodCode	required	Fixed Value: EVN `http://terminology.hl7.org/ValueSet/v3-xDocumentActMood\|2.0.0`
Act.code	example	ActCode `http://terminology.hl7.org/ValueSet/v3-ActCode`
Act.code.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.text.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.text.compression	required	CDACompressionAlgorithm `http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm`
Act.text.integrityCheckAlgorithm	required	IntegrityCheckAlgorithm `http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm\|2.0.0`
Act.text.mediaType	example	MediaType `http://terminology.hl7.org/ValueSet/v3-MediaType`
Act.text.representation	required	BinaryDataEncoding `http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding`
Act.statusCode	required	ActStatus `http://terminology.hl7.org/ValueSet/v3-ActStatus`
Act.statusCode.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.priorityCode	example	ActPriority `http://terminology.hl7.org/ValueSet/v3-ActPriority`
Act.languageCode	required	AllLanguages `http://hl7.org/fhir/ValueSet/all-languages` from the FHIR Standard
Act.entryRelationship:advanceDirectiveObservation.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:advanceDirectiveObservation.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:advanceDirectiveObservation.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:immunizationActivity.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:immunizationActivity.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:immunizationActivity.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:medicationActivity.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:medicationActivity.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:medicationActivity.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:interventionAct.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:interventionAct.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:interventionAct.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:procedureActivityProcedure.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:procedureActivityProcedure.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:procedureActivityProcedure.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:encounterActivity.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:encounterActivity.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:encounterActivity.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:instruction.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:instruction.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:instruction.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:nonMedSupply.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:nonMedSupply.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:nonMedSupply.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:nutritionRecommendation.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:nutritionRecommendation.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:nutritionRecommendation.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:entryReferenceRefr.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:entryReferenceRefr.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:entryReferenceRefr.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:entryReferenceRson.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:entryReferenceRson.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:entryReferenceRson.typeCode	required	Fixed Value: RSON `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:handoffCommunicationParticipants.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:handoffCommunicationParticipants.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:handoffCommunicationParticipants.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.entryRelationship:plannedInterventionAct.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:plannedInterventionAct.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.entryRelationship:plannedInterventionAct.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`
Act.reference.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.reference.typeId.nullFlavor	required	CDANullFlavor `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`
Act.reference.typeCode	required	Fixed Value: REFR `http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference`

Constraints

Id	Grade	Path(s)	Details	Requirements
1098-7513	warning	Act.entryRelationship:medicationActivity.substanceAdministration	SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7513) such that it SHALL contain exactly one [1..1] @xsi:type="PIVL_TS" or "EIVL_TS" (CONF:1098-28499). : effectiveTime.ofType(CDA.PIVL_TS).exists() or effectiveTime.ofType(CDA.EIVL_TS).exists()
active-high-ts-after-document	error	Act.entryRelationship:procedureActivityProcedure.procedure	If the procedure is active and contains a high effectiveTime, this time SHALL be after the ClinicalDocument/effectiveTime : (statusCode.code = 'active' and effectiveTime.high.value.exists()) implies effectiveTime.high.value > %resource.effectiveTime.value
dose-unit-or-admin-unit	error	Act.entryRelationship:immunizationActivity.substanceAdministration, Act.entryRelationship:medicationActivity.substanceAdministration	If doseQuantity/@unit is present, then administrationUnitCode SHALL NOT be present. : doseQuantity.unit.exists() implies administrationUnitCode.empty()
entry-ref-goal	error	Act.entryRelationship:entryReferenceRson	This entryReference template SHALL reference an instance of a Goal Observation template. : %resource.descendants().ofType(CDA.Observation).where(templateId.exists($this.root = '2.16.840.1.113883.10.20.22.4.121' and $this.extension = '2022-06-01') and id.exists($this.root = %context.act.id.first().root and $this.extension ~ %context.act.id.first().extension))
should-author	warning	Act, Act.entryRelationship:interventionAct.act	SHOULD contain author : author.exists()
should-author	warning	Act.entryRelationship:advanceDirectiveObservation.observation, Act.entryRelationship:immunizationActivity.substanceAdministration, Act.entryRelationship:medicationActivity.substanceAdministration, Act.entryRelationship:procedureActivityProcedure.procedure, Act.entryRelationship:plannedInterventionAct.act	SHOULD contain author : author.exists()
should-doseQuantity	warning	Act.entryRelationship:immunizationActivity.substanceAdministration	SHOULD contain doseQuantity : doseQuantity.exists()
should-effectiveTime	warning	Act, Act.entryRelationship:interventionAct.act	SHOULD contain effectiveTime : effectiveTime.exists()
should-effectiveTime	warning	Act.entryRelationship:nonMedSupply.supply, Act.entryRelationship:nutritionRecommendation.act, Act.entryRelationship:plannedInterventionAct.act	SHOULD contain effectiveTime : effectiveTime.exists()
should-informant	warning	Act.entryRelationship:advanceDirectiveObservation.observation	SHOULD contain informant : informant.exists()
should-performer	warning	Act.entryRelationship:immunizationActivity.substanceAdministration, Act.entryRelationship:procedureActivityProcedure.procedure	SHOULD contain performer : performer.exists()
should-quantity	warning	Act.entryRelationship:nonMedSupply.supply	SHOULD contain quantity : quantity.exists()
should-routeCode	warning	Act.entryRelationship:medicationActivity.substanceAdministration	SHOULD contain routeCode : routeCode.exists()
should-setId	warning	Act.reference.externalDocument	SHOULD contain setId : setId.exists()
should-targetSiteCode	warning	Act.entryRelationship:procedureActivityProcedure.procedure	SHOULD contain targetSiteCode : targetSiteCode.exists()
should-text-ref-value	warning	Act, Act.entryRelationship:interventionAct.act	SHOULD contain text/reference/@value : text.reference.value.exists()
should-text-ref-value	warning	Act.entryRelationship:advanceDirectiveObservation.observation, Act.entryRelationship:immunizationActivity.substanceAdministration, Act.entryRelationship:medicationActivity.substanceAdministration, Act.entryRelationship:procedureActivityProcedure.procedure, Act.entryRelationship:encounterActivity.encounter, Act.entryRelationship:instruction.act, Act.entryRelationship:nonMedSupply.supply, Act.entryRelationship:nutritionRecommendation.act, Act.entryRelationship:entryReferenceRefr.act, Act.entryRelationship:entryReferenceRson.act, Act.entryRelationship:handoffCommunicationParticipants.act, Act.entryRelationship:plannedInterventionAct.act	SHOULD contain text/reference/@value : text.reference.value.exists()
should-versionNumber	warning	Act.reference.externalDocument	SHOULD contain versionNumber : versionNumber.exists()
value-starts-octothorpe	error	Act.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

This structure is derived from Act

Summary

Mandatory: 9 elements(14 nested mandatory elements)
Fixed: 17 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

The element 2 is sliced based on the values of Act.templateId
The element 7 is sliced based on the values of Act.entryRelationship

Other representations of profile: CSV, Excel