Consolidated CDA (C-CDA)
3.0.0 - STU3 United States of America flag

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. The current version which supersedes this version is 4.0.0. For a full list of available versions, see the Directory of published versions

Logical Model: Patient Referral Act

Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/PatientReferralAct Version: 3.0.0
Draft as of 2024-05-18 Computable Name: PatientReferralAct
Other Identifiers: OID:2.16.840.1.113883.10.20.22.4.140

This template represents the type of referral (e.g., for dental care, to a specialist, for aging problems) and represents whether the referral is for full care or shared care. It may contain a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).

Usage:

Formal Views of Template Content

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

This structure is derived from Act

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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-priorityCode: SHOULD contain priorityCode
should-author: SHOULD contain author
... Slices for templateId 1..* II Slice: Unordered, Open by value:root
.... templateId:patient-referral-act 1..1 II
..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.140
..... @extension 0..0
... @classCode 1..1 cs Fixed Value: PCPR
... @moodCode 1..1 cs Binding: Patient Referral Act moodCode . (required)
... code 1..1 CD Binding: Referral Types . (required)
... 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
.... @nullFlavor 0..0
.... @code 1..1 cs Binding: ActStatus . (required)
... effectiveTime 1..1 IVL_TS The effectiveTime represents the time when the future referral is intended to take place.
... priorityCode 0..1 CE
... author 0..* AuthorParticipation Base for all types and resources
... participant 0..* Participant2
.... @typeCode 1..1 cs
.... participantRole 1..1 ParticipantRole
..... code 0..1 CE Binding: Healthcare Provider Taxonomy . (preferred)
... Slices for entryRelationship 0..* EntryRelationship The following entryRelationship represents a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).
Slice: Unordered, Open by profile:observation
.... entryRelationship:entryRelationship1 0..* EntryRelationship The following entryRelationship represents whether the referral is for full or shared care.
..... @typeCode 1..1 cs Fixed Value: SUBJ
..... observation C 1..1 Observation should-priorityCode: SHOULD contain priorityCode
...... @classCode 1..1 cs Fixed Value: OBS
...... @moodCode 1..1 cs Fixed Value: RQO
...... code 1..1 CD
....... @code 1..1 cs Required Pattern: ASSERTION
....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.4
...... statusCode 1..1 CS
....... @code 1..1 cs Fixed Value: completed
...... priorityCode 0..1 CE Binding: ActPriority . (preferred)
...... value 1..1 CD Binding: Care Model . (preferred)
.... entryRelationship:indication 0..* EntryRelationship
..... @typeCode 1..1 cs Fixed Value: RSON
..... observation 1..1 Indication Base for all types and resources

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Act.moodCoderequiredPatientReferralActMoodCode .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.66
Act.coderequiredReferralTypes .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.56
Act.statusCode.coderequiredActStatus .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933
Act.participant.participantRole.codepreferredHealthcareProviderTaxonomy . (a valid code from http://nucc.org/provider-taxonomy)
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066
Act.entryRelationship:entryRelationship1.observation.priorityCodepreferredActPriority .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.16866
Act.entryRelationship:entryRelationship1.observation.valuepreferredCareModel .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.61

Constraints

IdGradePath(s)DetailsRequirements
should-authorwarningActSHOULD contain author
: author.exists()
should-priorityCodewarningAct, Act.entryRelationship:entryRelationship1.observationSHOULD contain priorityCode
: priorityCode.exists()
should-text-ref-valuewarningActSHOULD contain text/reference/@value
: text.reference.value.exists()
value-starts-octothorpeerrorAct.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')
NameFlagsCard.TypeDescription & Constraintsdoco
.. 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-priorityCode: SHOULD contain priorityCode
should-author: SHOULD contain author
... Slices for templateId 1..* II Slice: Unordered, Open by value:root
.... templateId:patient-referral-act 1..1 II
..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.140
... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
Fixed Value: PCPR
... @moodCode 1..1 cs Binding: Patient Referral Act moodCode . (required)
... code 1..1 CD Binding: Referral Types . (required)
... 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 Binding: ActStatus . (required)
... effectiveTime 1..1 IVL_TS The effectiveTime represents the time when the future referral is intended to take place.
... priorityCode 0..1 CE Binding: ActPriority (example)
... author 0..* AuthorParticipation Base for all types and resources
... participant 0..* Participant2
.... @typeCode 1..1 cs Binding: CDAParticipationType (required)
.... participantRole 1..1 ParticipantRole
..... code 0..1 CE Binding: Healthcare Provider Taxonomy . (preferred)
... Slices for entryRelationship 0..* EntryRelationship The following entryRelationship represents a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).
Slice: Unordered, Open by profile:observation
.... entryRelationship:entryRelationship1 0..* EntryRelationship The following entryRelationship represents whether the referral is for full or shared care.
..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
Fixed Value: SUBJ
..... observation C 1..1 Observation should-priorityCode: SHOULD contain priorityCode
...... @classCode 1..1 cs Binding: CDAActClassObservation (required)
Fixed Value: OBS
...... @moodCode 1..1 cs Binding: XActMoodDocumentObservation (2.0.0) (required)
Fixed Value: RQO
...... code 1..1 CD Binding: ObservationType (example)
....... @code 1..1 cs Required Pattern: ASSERTION
....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.4
...... statusCode 1..1 CS Binding: ActStatus (required)
....... @code 1..1 cs Fixed Value: completed
...... priorityCode 0..1 CE Binding: ActPriority . (preferred)
...... value 1..1 CD Binding: Care Model . (preferred)
.... entryRelationship:indication 0..* EntryRelationship
..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
Fixed Value: RSON
..... observation C 1..1 Indication Base for all types and resources
should-text-ref-value: SHOULD contain text/reference/@value
should-effectiveTime: SHOULD contain effectiveTime
indication-value: If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Act.classCoderequiredFixed Value: PCPR
http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
Act.moodCoderequiredPatientReferralActMoodCode .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.66
Act.coderequiredReferralTypes .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.56
Act.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.statusCode.coderequiredActStatus .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933
Act.priorityCodeexampleActPriority
http://terminology.hl7.org/ValueSet/v3-ActPriority
Act.participant.typeCoderequiredCDAParticipationType
http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Act.participant.participantRole.codepreferredHealthcareProviderTaxonomy . (a valid code from http://nucc.org/provider-taxonomy)
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066
Act.entryRelationship:entryRelationship1.typeCoderequiredFixed Value: SUBJ
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Act.entryRelationship:entryRelationship1.observation.classCoderequiredFixed Value: OBS
http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
Act.entryRelationship:entryRelationship1.observation.moodCoderequiredFixed Value: RQO
http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
Act.entryRelationship:entryRelationship1.observation.codeexampleObservationType
http://terminology.hl7.org/ValueSet/v3-ObservationType
Act.entryRelationship:entryRelationship1.observation.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.entryRelationship:entryRelationship1.observation.priorityCodepreferredActPriority .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.16866
Act.entryRelationship:entryRelationship1.observation.valuepreferredCareModel .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.61
Act.entryRelationship:indication.typeCoderequiredFixed Value: RSON
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship

Constraints

IdGradePath(s)DetailsRequirements
indication-valueerrorAct.entryRelationship:indication.observationIf the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
: value.exists() or (%resource.descendants().ofType(CDA.Observation).where(id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension) and value.exists()))
should-authorwarningActSHOULD contain author
: author.exists()
should-effectiveTimewarningAct.entryRelationship:indication.observationSHOULD contain effectiveTime
: effectiveTime.exists()
should-priorityCodewarningAct, Act.entryRelationship:entryRelationship1.observationSHOULD contain priorityCode
: priorityCode.exists()
should-text-ref-valuewarningActSHOULD contain text/reference/@value
: text.reference.value.exists()
should-text-ref-valuewarningAct.entryRelationship:indication.observationSHOULD contain text/reference/@value
: text.reference.value.exists()
value-starts-octothorpeerrorAct.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')
NameFlagsCard.TypeDescription & Constraintsdoco
.. 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-priorityCode: SHOULD contain priorityCode
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
.... templateId:patient-referral-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: 2.16.840.1.113883.10.20.22.4.140
... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
Fixed Value: PCPR
... @moodCode 1..1 cs Binding: Patient Referral Act moodCode . (required)
... @negationInd 0..1 bl
... id 1..* II In the case of a Consultation Note where this referral is being fulfilled by this consultation, this id would be referenced in the inFullfilmentOf/order/id of the Consultation Note.
... code 1..1 CD Binding: Referral Types . (required)
... 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)
.... @code 1..1 cs Binding: ActStatus . (required)
.... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 1..1 IVL_TS The effectiveTime represents the time when the future referral is intended to take place.
... 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
.... @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: CDAParticipationType (required)
.... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
Fixed Value: OP
.... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
.... time 0..1 IVL_TS
.... awarenessCode 0..1 CE
.... participantRole 1..1 ParticipantRole
..... @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
..... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
..... id 0..* II
..... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
..... code 0..1 CE Binding: Healthcare Provider Taxonomy . (preferred)
..... addr 0..* AD
..... telecom 0..* TEL
..... playingDevice 0..1 Device
..... playingEntity 0..1 PlayingEntity
..... scopingEntity 0..1 Entity
... Slices for entryRelationship 0..* EntryRelationship The following entryRelationship represents a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).
Slice: Unordered, Open by profile:observation
.... entryRelationship:entryRelationship1 0..* EntryRelationship The following entryRelationship represents whether the referral is for full or shared care.
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId 0..1 II
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 0..* II
..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
Fixed Value: SUBJ
..... @inversionInd 0..1 bl
..... @contextConductionInd 0..1 bl
..... @negationInd 0..1 bl
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 0..1 Act
..... encounter 0..1 Encounter
..... observation C 1..1 Observation should-priorityCode: SHOULD contain priorityCode
...... @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
...... @classCode 1..1 cs Binding: CDAActClassObservation (required)
Fixed Value: OBS
...... @moodCode 1..1 cs Binding: XActMoodDocumentObservation (2.0.0) (required)
Fixed Value: RQO
...... @negationInd 0..1 bl
...... id 0..* II
...... code 1..1 CD Binding: ObservationType (example)
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @code 1..1 cs Required Pattern: ASSERTION
....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.4
....... @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
...... derivationExpr 0..1 ST
...... text 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 . (preferred)
...... repeatNumber 0..1 IVL_INT
...... languageCode 0..1 CS Binding: AllLanguages (required)
...... value 1..1 CD Binding: Care Model . (preferred)
...... interpretationCode 0..* CE Binding: CDAObservationInterpretation (required)
...... methodCode 0..* CE Binding: ObservationMethod (example)
...... targetSiteCode 0..* CD
...... subject 0..1 Subject
...... specimen 0..* Specimen
...... performer 0..* Performer2
...... author 0..* Author
...... informant 0..* Informant
...... participant 0..* Participant2
...... entryRelationship 0..* EntryRelationship
...... reference 0..* Reference
...... precondition 0..* Precondition
...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
...... referenceRange 0..* InfrastructureRoot
....... @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 0..1 cs Binding: CDAActRelationshipType (required)
Fixed Value: REFV
....... observationRange 1..1 ObservationRange
...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
..... 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:indication 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: RSON
..... @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 Indication Base for all types and resources
should-text-ref-value: SHOULD contain text/reference/@value
should-effectiveTime: SHOULD contain effectiveTime
indication-value: If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure 0..1 Procedure
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
... reference 0..* Reference
... precondition 0..* Precondition
... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Act.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.templateId:patient-referral-act.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.classCoderequiredFixed Value: PCPR
http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
Act.moodCoderequiredPatientReferralActMoodCode .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.66
Act.coderequiredReferralTypes .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.56
Act.text.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.text.compressionrequiredCDACompressionAlgorithm
http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Act.text.mediaTypeexampleMediaType
http://terminology.hl7.org/ValueSet/v3-MediaType
Act.text.representationrequiredBinaryDataEncoding
http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Act.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.statusCode.coderequiredActStatus .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933
Act.priorityCodeexampleActPriority
http://terminology.hl7.org/ValueSet/v3-ActPriority
Act.languageCoderequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages
from the FHIR Standard
Act.participant.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant.typeCoderequiredCDAParticipationType
http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Act.participant.contextControlCoderequiredFixed Value: OP
http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
Act.participant.participantRole.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant.participantRole.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant.participantRole.classCoderequiredCDARoleClassRoot
http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
Act.participant.participantRole.codepreferredHealthcareProviderTaxonomy . (a valid code from http://nucc.org/provider-taxonomy)
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066
Act.entryRelationship:entryRelationship1.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:entryRelationship1.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:entryRelationship1.typeCoderequiredFixed Value: SUBJ
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Act.entryRelationship:entryRelationship1.observation.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:entryRelationship1.observation.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:entryRelationship1.observation.classCoderequiredFixed Value: OBS
http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
Act.entryRelationship:entryRelationship1.observation.moodCoderequiredFixed Value: RQO
http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
Act.entryRelationship:entryRelationship1.observation.codeexampleObservationType
http://terminology.hl7.org/ValueSet/v3-ObservationType
Act.entryRelationship:entryRelationship1.observation.code.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:entryRelationship1.observation.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.entryRelationship:entryRelationship1.observation.statusCode.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:entryRelationship1.observation.priorityCodepreferredActPriority .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.16866
Act.entryRelationship:entryRelationship1.observation.languageCoderequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages
from the FHIR Standard
Act.entryRelationship:entryRelationship1.observation.valuepreferredCareModel .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.61
Act.entryRelationship:entryRelationship1.observation.interpretationCoderequiredCDAObservationInterpretation
http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation
Act.entryRelationship:entryRelationship1.observation.methodCodeexampleObservationMethod
http://terminology.hl7.org/ValueSet/v3-ObservationMethod
Act.entryRelationship:entryRelationship1.observation.referenceRange.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:entryRelationship1.observation.referenceRange.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:entryRelationship1.observation.referenceRange.typeCoderequiredFixed Value: REFV
http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType
Act.entryRelationship:indication.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:indication.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:indication.typeCoderequiredFixed Value: RSON
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship

Constraints

IdGradePath(s)DetailsRequirements
indication-valueerrorAct.entryRelationship:indication.observationIf the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
: value.exists() or (%resource.descendants().ofType(CDA.Observation).where(id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension) and value.exists()))
should-authorwarningActSHOULD contain author
: author.exists()
should-effectiveTimewarningAct.entryRelationship:indication.observationSHOULD contain effectiveTime
: effectiveTime.exists()
should-priorityCodewarningAct, Act.entryRelationship:entryRelationship1.observationSHOULD contain priorityCode
: priorityCode.exists()
should-text-ref-valuewarningActSHOULD contain text/reference/@value
: text.reference.value.exists()
should-text-ref-valuewarningAct.entryRelationship:indication.observationSHOULD contain text/reference/@value
: text.reference.value.exists()
value-starts-octothorpeerrorAct.text.referenceIf 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: 7 elements(7 nested mandatory elements)
Fixed: 6 elements
Prohibited: 2 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Act.templateId
  • The element 1 is sliced based on the value of Act.entryRelationship

Differential View

This structure is derived from Act

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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-priorityCode: SHOULD contain priorityCode
should-author: SHOULD contain author
... Slices for templateId 1..* II Slice: Unordered, Open by value:root
.... templateId:patient-referral-act 1..1 II
..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.140
..... @extension 0..0
... @classCode 1..1 cs Fixed Value: PCPR
... @moodCode 1..1 cs Binding: Patient Referral Act moodCode . (required)
... code 1..1 CD Binding: Referral Types . (required)
... 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
.... @nullFlavor 0..0
.... @code 1..1 cs Binding: ActStatus . (required)
... effectiveTime 1..1 IVL_TS The effectiveTime represents the time when the future referral is intended to take place.
... priorityCode 0..1 CE
... author 0..* AuthorParticipation Base for all types and resources
... participant 0..* Participant2
.... @typeCode 1..1 cs
.... participantRole 1..1 ParticipantRole
..... code 0..1 CE Binding: Healthcare Provider Taxonomy . (preferred)
... Slices for entryRelationship 0..* EntryRelationship The following entryRelationship represents a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).
Slice: Unordered, Open by profile:observation
.... entryRelationship:entryRelationship1 0..* EntryRelationship The following entryRelationship represents whether the referral is for full or shared care.
..... @typeCode 1..1 cs Fixed Value: SUBJ
..... observation C 1..1 Observation should-priorityCode: SHOULD contain priorityCode
...... @classCode 1..1 cs Fixed Value: OBS
...... @moodCode 1..1 cs Fixed Value: RQO
...... code 1..1 CD
....... @code 1..1 cs Required Pattern: ASSERTION
....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.4
...... statusCode 1..1 CS
....... @code 1..1 cs Fixed Value: completed
...... priorityCode 0..1 CE Binding: ActPriority . (preferred)
...... value 1..1 CD Binding: Care Model . (preferred)
.... entryRelationship:indication 0..* EntryRelationship
..... @typeCode 1..1 cs Fixed Value: RSON
..... observation 1..1 Indication Base for all types and resources

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Act.moodCoderequiredPatientReferralActMoodCode .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.66
Act.coderequiredReferralTypes .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.56
Act.statusCode.coderequiredActStatus .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933
Act.participant.participantRole.codepreferredHealthcareProviderTaxonomy . (a valid code from http://nucc.org/provider-taxonomy)
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066
Act.entryRelationship:entryRelationship1.observation.priorityCodepreferredActPriority .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.16866
Act.entryRelationship:entryRelationship1.observation.valuepreferredCareModel .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.61

Constraints

IdGradePath(s)DetailsRequirements
should-authorwarningActSHOULD contain author
: author.exists()
should-priorityCodewarningAct, Act.entryRelationship:entryRelationship1.observationSHOULD contain priorityCode
: priorityCode.exists()
should-text-ref-valuewarningActSHOULD contain text/reference/@value
: text.reference.value.exists()
value-starts-octothorpeerrorAct.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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-priorityCode: SHOULD contain priorityCode
should-author: SHOULD contain author
... Slices for templateId 1..* II Slice: Unordered, Open by value:root
.... templateId:patient-referral-act 1..1 II
..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.140
... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
Fixed Value: PCPR
... @moodCode 1..1 cs Binding: Patient Referral Act moodCode . (required)
... code 1..1 CD Binding: Referral Types . (required)
... 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 Binding: ActStatus . (required)
... effectiveTime 1..1 IVL_TS The effectiveTime represents the time when the future referral is intended to take place.
... priorityCode 0..1 CE Binding: ActPriority (example)
... author 0..* AuthorParticipation Base for all types and resources
... participant 0..* Participant2
.... @typeCode 1..1 cs Binding: CDAParticipationType (required)
.... participantRole 1..1 ParticipantRole
..... code 0..1 CE Binding: Healthcare Provider Taxonomy . (preferred)
... Slices for entryRelationship 0..* EntryRelationship The following entryRelationship represents a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).
Slice: Unordered, Open by profile:observation
.... entryRelationship:entryRelationship1 0..* EntryRelationship The following entryRelationship represents whether the referral is for full or shared care.
..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
Fixed Value: SUBJ
..... observation C 1..1 Observation should-priorityCode: SHOULD contain priorityCode
...... @classCode 1..1 cs Binding: CDAActClassObservation (required)
Fixed Value: OBS
...... @moodCode 1..1 cs Binding: XActMoodDocumentObservation (2.0.0) (required)
Fixed Value: RQO
...... code 1..1 CD Binding: ObservationType (example)
....... @code 1..1 cs Required Pattern: ASSERTION
....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.4
...... statusCode 1..1 CS Binding: ActStatus (required)
....... @code 1..1 cs Fixed Value: completed
...... priorityCode 0..1 CE Binding: ActPriority . (preferred)
...... value 1..1 CD Binding: Care Model . (preferred)
.... entryRelationship:indication 0..* EntryRelationship
..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
Fixed Value: RSON
..... observation C 1..1 Indication Base for all types and resources
should-text-ref-value: SHOULD contain text/reference/@value
should-effectiveTime: SHOULD contain effectiveTime
indication-value: If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Act.classCoderequiredFixed Value: PCPR
http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
Act.moodCoderequiredPatientReferralActMoodCode .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.66
Act.coderequiredReferralTypes .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.56
Act.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.statusCode.coderequiredActStatus .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933
Act.priorityCodeexampleActPriority
http://terminology.hl7.org/ValueSet/v3-ActPriority
Act.participant.typeCoderequiredCDAParticipationType
http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Act.participant.participantRole.codepreferredHealthcareProviderTaxonomy . (a valid code from http://nucc.org/provider-taxonomy)
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066
Act.entryRelationship:entryRelationship1.typeCoderequiredFixed Value: SUBJ
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Act.entryRelationship:entryRelationship1.observation.classCoderequiredFixed Value: OBS
http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
Act.entryRelationship:entryRelationship1.observation.moodCoderequiredFixed Value: RQO
http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
Act.entryRelationship:entryRelationship1.observation.codeexampleObservationType
http://terminology.hl7.org/ValueSet/v3-ObservationType
Act.entryRelationship:entryRelationship1.observation.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.entryRelationship:entryRelationship1.observation.priorityCodepreferredActPriority .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.16866
Act.entryRelationship:entryRelationship1.observation.valuepreferredCareModel .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.61
Act.entryRelationship:indication.typeCoderequiredFixed Value: RSON
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship

Constraints

IdGradePath(s)DetailsRequirements
indication-valueerrorAct.entryRelationship:indication.observationIf the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
: value.exists() or (%resource.descendants().ofType(CDA.Observation).where(id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension) and value.exists()))
should-authorwarningActSHOULD contain author
: author.exists()
should-effectiveTimewarningAct.entryRelationship:indication.observationSHOULD contain effectiveTime
: effectiveTime.exists()
should-priorityCodewarningAct, Act.entryRelationship:entryRelationship1.observationSHOULD contain priorityCode
: priorityCode.exists()
should-text-ref-valuewarningActSHOULD contain text/reference/@value
: text.reference.value.exists()
should-text-ref-valuewarningAct.entryRelationship:indication.observationSHOULD contain text/reference/@value
: text.reference.value.exists()
value-starts-octothorpeerrorAct.text.referenceIf reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
: value.exists() implies value.startsWith('#')

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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-priorityCode: SHOULD contain priorityCode
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
.... templateId:patient-referral-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: 2.16.840.1.113883.10.20.22.4.140
... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
Fixed Value: PCPR
... @moodCode 1..1 cs Binding: Patient Referral Act moodCode . (required)
... @negationInd 0..1 bl
... id 1..* II In the case of a Consultation Note where this referral is being fulfilled by this consultation, this id would be referenced in the inFullfilmentOf/order/id of the Consultation Note.
... code 1..1 CD Binding: Referral Types . (required)
... 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)
.... @code 1..1 cs Binding: ActStatus . (required)
.... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 1..1 IVL_TS The effectiveTime represents the time when the future referral is intended to take place.
... 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
.... @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: CDAParticipationType (required)
.... @contextControlCode 0..1 cs Binding: CDAContextControl (required)
Fixed Value: OP
.... sdtcFunctionCode 0..1 CE XML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
.... time 0..1 IVL_TS
.... awarenessCode 0..1 CE
.... participantRole 1..1 ParticipantRole
..... @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
..... @classCode 0..1 cs Binding: CDARoleClassRoot (required)
..... id 0..* II
..... sdtcIdentifiedBy 0..* IdentifiedBy XML Namespace: urn:hl7-org:sdtc
XML: identifiedBy (urn:hl7-org:sdtc)
..... code 0..1 CE Binding: Healthcare Provider Taxonomy . (preferred)
..... addr 0..* AD
..... telecom 0..* TEL
..... playingDevice 0..1 Device
..... playingEntity 0..1 PlayingEntity
..... scopingEntity 0..1 Entity
... Slices for entryRelationship 0..* EntryRelationship The following entryRelationship represents a reference to another act in the document instance representing the clinical reason for the referral (e.g., problem, concern, procedure).
Slice: Unordered, Open by profile:observation
.... entryRelationship:entryRelationship1 0..* EntryRelationship The following entryRelationship represents whether the referral is for full or shared care.
..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
..... realmCode 0..* CS
..... typeId 0..1 II
...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
...... @assigningAuthorityName 0..1 st
...... @displayable 0..1 bl
...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
...... @extension 1..1 st
..... templateId 0..* II
..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
Fixed Value: SUBJ
..... @inversionInd 0..1 bl
..... @contextConductionInd 0..1 bl
..... @negationInd 0..1 bl
..... sequenceNumber 0..1 INT
..... seperatableInd 0..1 BL
..... act 0..1 Act
..... encounter 0..1 Encounter
..... observation C 1..1 Observation should-priorityCode: SHOULD contain priorityCode
...... @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
...... @classCode 1..1 cs Binding: CDAActClassObservation (required)
Fixed Value: OBS
...... @moodCode 1..1 cs Binding: XActMoodDocumentObservation (2.0.0) (required)
Fixed Value: RQO
...... @negationInd 0..1 bl
...... id 0..* II
...... code 1..1 CD Binding: ObservationType (example)
....... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
....... @code 1..1 cs Required Pattern: ASSERTION
....... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.5.4
....... @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
...... derivationExpr 0..1 ST
...... text 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 . (preferred)
...... repeatNumber 0..1 IVL_INT
...... languageCode 0..1 CS Binding: AllLanguages (required)
...... value 1..1 CD Binding: Care Model . (preferred)
...... interpretationCode 0..* CE Binding: CDAObservationInterpretation (required)
...... methodCode 0..* CE Binding: ObservationMethod (example)
...... targetSiteCode 0..* CD
...... subject 0..1 Subject
...... specimen 0..* Specimen
...... performer 0..* Performer2
...... author 0..* Author
...... informant 0..* Informant
...... participant 0..* Participant2
...... entryRelationship 0..* EntryRelationship
...... reference 0..* Reference
...... precondition 0..* Precondition
...... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
...... referenceRange 0..* InfrastructureRoot
....... @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 0..1 cs Binding: CDAActRelationshipType (required)
Fixed Value: REFV
....... observationRange 1..1 ObservationRange
...... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
..... 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:indication 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: RSON
..... @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 Indication Base for all types and resources
should-text-ref-value: SHOULD contain text/reference/@value
should-effectiveTime: SHOULD contain effectiveTime
indication-value: If the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
..... observationMedia 0..1 ObservationMedia
..... organizer 0..1 Organizer
..... procedure 0..1 Procedure
..... regionOfInterest 0..1 RegionOfInterest
..... substanceAdministration 0..1 SubstanceAdministration
..... supply 0..1 Supply
... reference 0..* Reference
... precondition 0..* Precondition
... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
XML: precondition2 (urn:hl7-org:sdtc)
... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Act.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.templateId:patient-referral-act.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.classCoderequiredFixed Value: PCPR
http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0
Act.moodCoderequiredPatientReferralActMoodCode .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.66
Act.coderequiredReferralTypes .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.56
Act.text.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.text.compressionrequiredCDACompressionAlgorithm
http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Act.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Act.text.mediaTypeexampleMediaType
http://terminology.hl7.org/ValueSet/v3-MediaType
Act.text.representationrequiredBinaryDataEncoding
http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Act.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.statusCode.coderequiredActStatus .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933
Act.priorityCodeexampleActPriority
http://terminology.hl7.org/ValueSet/v3-ActPriority
Act.languageCoderequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages
from the FHIR Standard
Act.participant.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant.typeCoderequiredCDAParticipationType
http://hl7.org/cda/stds/core/ValueSet/CDAParticipationType
Act.participant.contextControlCoderequiredFixed Value: OP
http://hl7.org/cda/stds/core/ValueSet/CDAContextControl
Act.participant.participantRole.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant.participantRole.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.participant.participantRole.classCoderequiredCDARoleClassRoot
http://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot
Act.participant.participantRole.codepreferredHealthcareProviderTaxonomy . (a valid code from http://nucc.org/provider-taxonomy)
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.1066
Act.entryRelationship:entryRelationship1.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:entryRelationship1.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:entryRelationship1.typeCoderequiredFixed Value: SUBJ
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Act.entryRelationship:entryRelationship1.observation.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:entryRelationship1.observation.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:entryRelationship1.observation.classCoderequiredFixed Value: OBS
http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
Act.entryRelationship:entryRelationship1.observation.moodCoderequiredFixed Value: RQO
http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
Act.entryRelationship:entryRelationship1.observation.codeexampleObservationType
http://terminology.hl7.org/ValueSet/v3-ObservationType
Act.entryRelationship:entryRelationship1.observation.code.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:entryRelationship1.observation.statusCoderequiredActStatus
http://terminology.hl7.org/ValueSet/v3-ActStatus
Act.entryRelationship:entryRelationship1.observation.statusCode.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:entryRelationship1.observation.priorityCodepreferredActPriority .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.16866
Act.entryRelationship:entryRelationship1.observation.languageCoderequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages
from the FHIR Standard
Act.entryRelationship:entryRelationship1.observation.valuepreferredCareModel .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.61
Act.entryRelationship:entryRelationship1.observation.interpretationCoderequiredCDAObservationInterpretation
http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation
Act.entryRelationship:entryRelationship1.observation.methodCodeexampleObservationMethod
http://terminology.hl7.org/ValueSet/v3-ObservationMethod
Act.entryRelationship:entryRelationship1.observation.referenceRange.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:entryRelationship1.observation.referenceRange.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:entryRelationship1.observation.referenceRange.typeCoderequiredFixed Value: REFV
http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType
Act.entryRelationship:indication.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:indication.typeId.nullFlavorrequiredCDANullFlavor
http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Act.entryRelationship:indication.typeCoderequiredFixed Value: RSON
http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship

Constraints

IdGradePath(s)DetailsRequirements
indication-valueerrorAct.entryRelationship:indication.observationIf the ID element does not reference a problem recorded elsewhere in the document, then observation/value must be populated with a coded entry.
: value.exists() or (%resource.descendants().ofType(CDA.Observation).where(id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension) and value.exists()))
should-authorwarningActSHOULD contain author
: author.exists()
should-effectiveTimewarningAct.entryRelationship:indication.observationSHOULD contain effectiveTime
: effectiveTime.exists()
should-priorityCodewarningAct, Act.entryRelationship:entryRelationship1.observationSHOULD contain priorityCode
: priorityCode.exists()
should-text-ref-valuewarningActSHOULD contain text/reference/@value
: text.reference.value.exists()
should-text-ref-valuewarningAct.entryRelationship:indication.observationSHOULD contain text/reference/@value
: text.reference.value.exists()
value-starts-octothorpeerrorAct.text.referenceIf 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: 7 elements(7 nested mandatory elements)
Fixed: 6 elements
Prohibited: 2 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Act.templateId
  • The element 1 is sliced based on the value of Act.entryRelationship

 

Other representations of profile: CSV, Excel