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
| Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/SexualOrientationObservation | Version: 3.0.0 | |||
| Draft as of 2024-05-18 | Computable Name: SexualOrientationObservation | |||
| Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:hl7ii:2.16.840.1.113883.10.20.22.4.501:2023-05-01 | ||||
This observation represents the sexual orientation of the patient. Defined as:
A persons identification of their emotional, romantic, sexual, or affectional attraction to another person.
This template was informed by the HL7 Gender Harmony project.
This observation is not appropriate for recording patient gender (administrativeGender), Gender Identity (Gender Identity Observation), or birth sex (Birth Sex Observation).
Usage:
Description of Template, Differentials, Snapshots and how the different presentations work.
This structure is derived from SocialHistoryObservation
| Name | Flags | Card. | Type | Description & Constraints  | 
|---|---|---|---|---|
|   Observation | 1..1 | SocialHistoryObservation | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1, templateId, templateId, classCode, moodCode, id, code, text, statusCode, effectiveTime, value, value, value, author, entryRelationship, entryRelationship, entryRelationship Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) | |
|    templateId | 2..* | II | ||
|    Slices for templateId | Content/Rules for all slices | |||
|     templateId:sexual-orientation-obs | 1..1 | II | ||
|      @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.501 | |
|      @extension | 1..1 | st | Required Pattern: 2023-05-01 | |
|    @classCode | 1..1 | cs | ||
|    @moodCode | 1..1 | cs | ||
|    code | 1..1 | CD | ||
|     @code | 1..1 | cs | Required Pattern: 76690-7 | |
|     @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
|    statusCode | 1..1 | CS | ||
|     @code | 1..1 | cs | ||
|    effectiveTime | 1..1 | IVL_TS | The effectiveTime represents the relevant time of the observation. A patient's "sexual orientation" may change and using effectiveTime/low and effectiveTime/high defines the time during which the patient had identified their emotional, romantic, sexual, or affectional attraction to another person. | |
|     low | 1..1 | IVXB_TS | ||
|     high | 0..1 | IVXB_TS | ||
|    value | 1..1 | ANY, BL, ED, ST, CD, CV, CE, CO, SC, II, TEL, AD, EN, INT, REAL, PQ, MO, TS, IVL_PQ, IVL_TS, PIVL_TS, EIVL_TS, SXPR_TS, RTO_PQ_PQ | (USCDI) Alcohol Use, Substance Use, SDOH Problems/Health Concerns | |
|    Slices for value | Content/Rules for all slices | |||
|     value:physical-quantity | 0..0 | |||
|     value:coded | 1..1 | CD | Binding: Sexual Orientation Including nulls and Data Absent Reason  (required) | |
|  Documentation for this format | ||||
| Path | Conformance | ValueSet | URI | 
| Observation.value:coded | required | SexualOrientationIncludingNullsAndDataAbsentReason  http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1240.11 | 
| Name | Flags | Card. | Type | Description & Constraints  | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
|   Observation | C | 1..1 | SocialHistoryObservation | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1, templateId, templateId, classCode, moodCode, id, code, text, statusCode, effectiveTime, value, value, value, author, entryRelationship, entryRelationship, entryRelationship 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-value: SHOULD contain value 4515-8555: If Observation/value is a physical quantity (xsi:type="PQ"): This value SHALL contain exactly one [1..1] @unit, which SHOULD be selected from ValueSet UnitsOfMeasureCaseSensitive urn:oid:2.16.840.1.113883.1.11.12839 DYNAMIC. Note: Base CDA requires that all @unit values SHALL be drawn from UCUM. should-sh-author: SHOULD contain author | ||||||
|    Slices for templateId | 2..* | II | Slice: Unordered, Open by value:root, value:extension | |||||||
|     templateId:social-history-obs | 1..1 | II | ||||||||
|      @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.38 | |||||||
|      @extension | 1..1 | st | Required Pattern: 2022-06-01 | |||||||
|     templateId:sexual-orientation-obs | 1..1 | II | ||||||||
|      @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.501 | |||||||
|      @extension | 1..1 | st | Required Pattern: 2023-05-01 | |||||||
|    @classCode | 1..1 | cs | Binding: CDAActClassObservation (required) Fixed Value: OBS | |||||||
|    @moodCode | 1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN | |||||||
|    id | 1..* | II | ||||||||
|    code | C | 1..1 | CD | Binding: Social History Type  (preferred) 4515-32956: If @codeSystem is not LOINC, then this code **SHALL** contain at least one [1..*] translation, which **SHOULD** be selected from CodeSystem LOINC (urn:oid:2.16.840.1.113883.6.1) (CONF:4515-32956). | ||||||
|     @code | 1..1 | cs | Required Pattern: 76690-7 | |||||||
|     @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |||||||
|    statusCode | 1..1 | CS | Binding: ActStatus (required) | |||||||
|     @code | 1..1 | cs | Fixed Value: completed | |||||||
|    effectiveTime | 1..1 | IVL_TS | The effectiveTime represents the relevant time of the observation. A patient's "sexual orientation" may change and using effectiveTime/low and effectiveTime/high defines the time during which the patient had identified their emotional, romantic, sexual, or affectional attraction to another person. | |||||||
|     low | 1..1 | IVXB_TS | ||||||||
|     high | 0..1 | IVXB_TS | ||||||||
|    Slices for value | 1..1 | (USCDI) Alcohol Use, Substance Use, SDOH Problems/Health Concerns Slice: Unordered, Open by type:$this | ||||||||
|     value | ANY | |||||||||
|     value | BL | |||||||||
|     value | ED | |||||||||
|     value | ST | |||||||||
|     value | CD | |||||||||
|     value | CV | |||||||||
|     value | CE | |||||||||
|     value | CO | |||||||||
|     value | SC | |||||||||
|     value | II | |||||||||
|     value | TEL | |||||||||
|     value | AD | |||||||||
|     value | EN | |||||||||
|     value | INT | |||||||||
|     value | REAL | |||||||||
|     value | PQ | |||||||||
|     value | MO | |||||||||
|     value | TS | |||||||||
|     value | IVL_PQ | |||||||||
|     value | IVL_TS | |||||||||
|     value | PIVL_TS | |||||||||
|     value | EIVL_TS | |||||||||
|     value | SXPR_TS | |||||||||
|     value | RTO_PQ_PQ | |||||||||
|     value:coded | 1..1 | CD | Binding: Sexual Orientation Including nulls and Data Absent Reason  (required) 
 | |||||||
|    Slices for entryRelationship | 0..* | EntryRelationship | Slice: Unordered, Open by profile:act, profile:observation | |||||||
|     entryRelationship:supportingObs | 0..* | EntryRelationship | When an Assessment Scale Observation is contained in a Social History Observation instance that is a Social Determinant of Health Social History Observation, that Assessment Scale Observation MAY contain Assessment Scale Supporting Observations that contain LOINC question and answer pairs from SDOH screening instruments. | |||||||
|      @typeCode | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SPRT | |||||||
|      observation | C | 1..1 | AssessmentScaleObservation | Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value | ||||||
|     entryRelationship:entryReference | 0..* | EntryRelationship | When an Entry Reference is contained in a Social History Template instance that is a Social Determinant of Health Social History, that Entry Reference **MAY** reference an Assessment Scale Observation elsewhere in the document that represent LOINC question and answer pairs from SDOH screening instruments. | |||||||
|      @typeCode | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SPRT | |||||||
|      act | C | 1..1 | EntryReference | Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value | ||||||
|  Documentation for this format | ||||||||||
| Path | Conformance | ValueSet / Code | URI | 
| Observation.classCode | required | Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation | |
| Observation.moodCode | required | Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0 | |
| Observation.code | preferred | SocialHistoryType  http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.80.60 | |
| Observation.statusCode | required | ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus | |
| Observation.value:physical-quantity.unit | preferred | UnitsOfMeasureCaseSensitive (a valid code from UCUM) http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive | |
| Observation.value:coded | required | SexualOrientationIncludingNullsAndDataAbsentReason  http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1240.11 | |
| Observation.entryRelationship:supportingObs.typeCode | required | Fixed Value: SPRT http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship | |
| Observation.entryRelationship:entryReference.typeCode | required | Fixed Value: SPRT http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship | 
| Id | Grade | Path(s) | Details | Requirements | 
| 4515-8555 | error | Observation | If Observation/value is a physical quantity (xsi:type="PQ"): This value SHALL contain exactly one [1..1] @unit, which SHOULD be selected from ValueSet UnitsOfMeasureCaseSensitive urn:oid:2.16.840.1.113883.1.11.12839 DYNAMIC. Note: Base CDA requires that all @unit values SHALL be drawn from UCUM. : | |
| 4515-32956 | warning | Observation.code | If @codeSystem is not LOINC, then this code **SHALL** contain at least one [1..*] translation, which **SHOULD** be selected from CodeSystem LOINC (urn:oid:2.16.840.1.113883.6.1) (CONF:4515-32956). : codeSystem = '2.16.840.1.113883.6.1' or translation.where(codeSystem = '2.16.840.1.113883.6.1').exists() | |
| should-sh-author | warning | Observation | SHOULD contain author : author.exists() | |
| should-text-ref-value | warning | Observation, Observation.entryRelationship:supportingObs.observation, Observation.entryRelationship:entryReference.act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| should-value | warning | Observation | SHOULD contain value : value.exists() | 
| Name | Flags | Card. | Type | Description & Constraints  | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
|   Observation | C | 1..1 | SocialHistoryObservation | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1, templateId, templateId, classCode, moodCode, id, code, text, statusCode, effectiveTime, value, value, value, author, entryRelationship, entryRelationship, entryRelationship 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-value: SHOULD contain value 4515-8555: If Observation/value is a physical quantity (xsi:type="PQ"): This value SHALL contain exactly one [1..1] @unit, which SHOULD be selected from ValueSet UnitsOfMeasureCaseSensitive urn:oid:2.16.840.1.113883.1.11.12839 DYNAMIC. Note: Base CDA requires that all @unit values SHALL be drawn from UCUM. should-sh-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 | 2..* | II | Slice: Unordered, Open by value:root, value:extension | |||||||
|     templateId:social-history-obs | 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: 2.16.840.1.113883.10.20.22.4.38 | |||||||
|      @extension | 1..1 | st | Required Pattern: 2022-06-01 | |||||||
|     templateId:sexual-orientation-obs | 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: 2.16.840.1.113883.10.20.22.4.501 | |||||||
|      @extension | 1..1 | st | Required Pattern: 2023-05-01 | |||||||
|    @classCode | 1..1 | cs | Binding: CDAActClassObservation (required) Fixed Value: OBS | |||||||
|    @moodCode | 1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN | |||||||
|    @negationInd | 0..1 | bl | ||||||||
|    id | 1..* | II | ||||||||
|    code | C | 1..1 | CD | Binding: Social History Type  (preferred) 4515-32956: If @codeSystem is not LOINC, then this code **SHALL** contain at least one [1..*] translation, which **SHOULD** be selected from CodeSystem LOINC (urn:oid:2.16.840.1.113883.6.1) (CONF:4515-32956). | ||||||
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |||||||
|     @code | 1..1 | cs | Required Pattern: 76690-7 | |||||||
|     @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |||||||
|     @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 | 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 | 1..1 | IVL_TS | The effectiveTime represents the relevant time of the observation. A patient's "sexual orientation" may change and using effectiveTime/low and effectiveTime/high defines the time during which the patient had identified their emotional, romantic, sexual, or affectional attraction to another person. | |||||||
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |||||||
|     @value | 0..1 | ts | Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz] | |||||||
|     @operator | 0..1 | cs | Binding: CDASetOperator (required) | |||||||
|     low | 1..1 | IVXB_TS | ||||||||
|     center | 0..1 | TS | ||||||||
|     width | 0..1 | PQ | ||||||||
|     high | 0..1 | IVXB_TS | ||||||||
|    priorityCode | 0..1 | CE | Binding: ActPriority (example) | |||||||
|    repeatNumber | 0..1 | IVL_INT | ||||||||
|    languageCode | 0..1 | CS | Binding: AllLanguages (required) | |||||||
|    Slices for value | 1..1 | (USCDI) Alcohol Use, Substance Use, SDOH Problems/Health Concerns Slice: Unordered, Open by type:$this | ||||||||
|     value | ANY | |||||||||
|     value | BL | |||||||||
|     value | ED | |||||||||
|     value | ST | |||||||||
|     value | CD | |||||||||
|     value | CV | |||||||||
|     value | CE | |||||||||
|     value | CO | |||||||||
|     value | SC | |||||||||
|     value | II | |||||||||
|     value | TEL | |||||||||
|     value | AD | |||||||||
|     value | EN | |||||||||
|     value | INT | |||||||||
|     value | REAL | |||||||||
|     value | PQ | |||||||||
|     value | MO | |||||||||
|     value | TS | |||||||||
|     value | IVL_PQ | |||||||||
|     value | IVL_TS | |||||||||
|     value | PIVL_TS | |||||||||
|     value | EIVL_TS | |||||||||
|     value | SXPR_TS | |||||||||
|     value | RTO_PQ_PQ | |||||||||
|     value:coded | 1..1 | CD | Binding: Sexual Orientation Including nulls and Data Absent Reason  (required) 
 | |||||||
|    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..* | AuthorParticipation | Base for all types and resources | |||||||
|    informant | 0..* | Informant | ||||||||
|    participant | 0..* | Participant2 | ||||||||
|    Slices for entryRelationship | 0..* | EntryRelationship | Slice: Unordered, Open by profile:act, profile:observation | |||||||
|     entryRelationship:supportingObs | 0..* | EntryRelationship | When an Assessment Scale Observation is contained in a Social History Observation instance that is a Social Determinant of Health Social History Observation, that Assessment Scale Observation MAY contain Assessment Scale Supporting Observations that contain LOINC question and answer pairs from SDOH screening instruments. | |||||||
|      @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: SPRT | |||||||
|      @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 | AssessmentScaleObservation | Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value | ||||||
|      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:entryReference | 0..* | EntryRelationship | When an Entry Reference is contained in a Social History Template instance that is a Social Determinant of Health Social History, that Entry Reference **MAY** reference an Assessment Scale Observation elsewhere in the document that represent LOINC question and answer pairs from SDOH screening instruments. | |||||||
|      @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: SPRT | |||||||
|      @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 | ||||||||
|    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) | |||||||
|  Documentation for this format | ||||||||||
| Path | Conformance | ValueSet / Code | URI | 
| Observation.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.typeId.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.templateId:social-history-obs.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.templateId:sexual-orientation-obs.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.classCode | required | Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation | |
| Observation.moodCode | required | Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0 | |
| Observation.code | preferred | SocialHistoryType  http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.80.60 | |
| Observation.code.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.text.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.text.compression | required | CDACompressionAlgorithm http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm | |
| Observation.text.integrityCheckAlgorithm | required | IntegrityCheckAlgorithm http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0 | |
| Observation.text.mediaType | example | MediaType http://terminology.hl7.org/ValueSet/v3-MediaType | |
| Observation.text.representation | required | BinaryDataEncoding http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding | |
| Observation.statusCode | required | ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus | |
| Observation.statusCode.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.effectiveTime.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.effectiveTime.operator | required | CDASetOperator http://hl7.org/cda/stds/core/ValueSet/CDASetOperator | |
| Observation.priorityCode | example | ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority | |
| Observation.languageCode | required | AllLanguages http://hl7.org/fhir/ValueSet/all-languagesfrom the FHIR Standard | |
| Observation.value:physical-quantity.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.value:physical-quantity.unit | preferred | UnitsOfMeasureCaseSensitive (a valid code from UCUM) http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive | |
| Observation.value:coded | required | SexualOrientationIncludingNullsAndDataAbsentReason  http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1240.11 | |
| Observation.interpretationCode | required | CDAObservationInterpretation http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation | |
| Observation.methodCode | example | ObservationMethod http://terminology.hl7.org/ValueSet/v3-ObservationMethod | |
| Observation.entryRelationship:supportingObs.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.entryRelationship:supportingObs.typeId.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.entryRelationship:supportingObs.typeCode | required | Fixed Value: SPRT http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship | |
| Observation.entryRelationship:entryReference.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.entryRelationship:entryReference.typeId.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.entryRelationship:entryReference.typeCode | required | Fixed Value: SPRT http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship | |
| Observation.referenceRange.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.referenceRange.typeId.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.referenceRange.typeCode | required | Fixed Value: REFV http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType | 
| Id | Grade | Path(s) | Details | Requirements | 
| 4515-8555 | error | Observation | If Observation/value is a physical quantity (xsi:type="PQ"): This value SHALL contain exactly one [1..1] @unit, which SHOULD be selected from ValueSet UnitsOfMeasureCaseSensitive urn:oid:2.16.840.1.113883.1.11.12839 DYNAMIC. Note: Base CDA requires that all @unit values SHALL be drawn from UCUM. : | |
| 4515-32956 | warning | Observation.code | If @codeSystem is not LOINC, then this code **SHALL** contain at least one [1..*] translation, which **SHOULD** be selected from CodeSystem LOINC (urn:oid:2.16.840.1.113883.6.1) (CONF:4515-32956). : codeSystem = '2.16.840.1.113883.6.1' or translation.where(codeSystem = '2.16.840.1.113883.6.1').exists() | |
| should-sh-author | warning | Observation | SHOULD contain author : author.exists() | |
| should-text-ref-value | warning | Observation, Observation.entryRelationship:supportingObs.observation, Observation.entryRelationship:entryReference.act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| should-value | warning | Observation | SHOULD contain value : value.exists() | |
| value-starts-octothorpe | error | Observation.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 SocialHistoryObservation
Differential View
This structure is derived from SocialHistoryObservation
| Name | Flags | Card. | Type | Description & Constraints  | 
|---|---|---|---|---|
|   Observation | 1..1 | SocialHistoryObservation | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1, templateId, templateId, classCode, moodCode, id, code, text, statusCode, effectiveTime, value, value, value, author, entryRelationship, entryRelationship, entryRelationship Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) | |
|    templateId | 2..* | II | ||
|    Slices for templateId | Content/Rules for all slices | |||
|     templateId:sexual-orientation-obs | 1..1 | II | ||
|      @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.501 | |
|      @extension | 1..1 | st | Required Pattern: 2023-05-01 | |
|    @classCode | 1..1 | cs | ||
|    @moodCode | 1..1 | cs | ||
|    code | 1..1 | CD | ||
|     @code | 1..1 | cs | Required Pattern: 76690-7 | |
|     @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
|    statusCode | 1..1 | CS | ||
|     @code | 1..1 | cs | ||
|    effectiveTime | 1..1 | IVL_TS | The effectiveTime represents the relevant time of the observation. A patient's "sexual orientation" may change and using effectiveTime/low and effectiveTime/high defines the time during which the patient had identified their emotional, romantic, sexual, or affectional attraction to another person. | |
|     low | 1..1 | IVXB_TS | ||
|     high | 0..1 | IVXB_TS | ||
|    value | 1..1 | ANY, BL, ED, ST, CD, CV, CE, CO, SC, II, TEL, AD, EN, INT, REAL, PQ, MO, TS, IVL_PQ, IVL_TS, PIVL_TS, EIVL_TS, SXPR_TS, RTO_PQ_PQ | (USCDI) Alcohol Use, Substance Use, SDOH Problems/Health Concerns | |
|    Slices for value | Content/Rules for all slices | |||
|     value:physical-quantity | 0..0 | |||
|     value:coded | 1..1 | CD | Binding: Sexual Orientation Including nulls and Data Absent Reason  (required) | |
|  Documentation for this format | ||||
| Path | Conformance | ValueSet | URI | 
| Observation.value:coded | required | SexualOrientationIncludingNullsAndDataAbsentReason  http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1240.11 | 
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints  | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
|   Observation | C | 1..1 | SocialHistoryObservation | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1, templateId, templateId, classCode, moodCode, id, code, text, statusCode, effectiveTime, value, value, value, author, entryRelationship, entryRelationship, entryRelationship 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-value: SHOULD contain value 4515-8555: If Observation/value is a physical quantity (xsi:type="PQ"): This value SHALL contain exactly one [1..1] @unit, which SHOULD be selected from ValueSet UnitsOfMeasureCaseSensitive urn:oid:2.16.840.1.113883.1.11.12839 DYNAMIC. Note: Base CDA requires that all @unit values SHALL be drawn from UCUM. should-sh-author: SHOULD contain author | ||||||
|    Slices for templateId | 2..* | II | Slice: Unordered, Open by value:root, value:extension | |||||||
|     templateId:social-history-obs | 1..1 | II | ||||||||
|      @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.38 | |||||||
|      @extension | 1..1 | st | Required Pattern: 2022-06-01 | |||||||
|     templateId:sexual-orientation-obs | 1..1 | II | ||||||||
|      @root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.501 | |||||||
|      @extension | 1..1 | st | Required Pattern: 2023-05-01 | |||||||
|    @classCode | 1..1 | cs | Binding: CDAActClassObservation (required) Fixed Value: OBS | |||||||
|    @moodCode | 1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN | |||||||
|    id | 1..* | II | ||||||||
|    code | C | 1..1 | CD | Binding: Social History Type  (preferred) 4515-32956: If @codeSystem is not LOINC, then this code **SHALL** contain at least one [1..*] translation, which **SHOULD** be selected from CodeSystem LOINC (urn:oid:2.16.840.1.113883.6.1) (CONF:4515-32956). | ||||||
|     @code | 1..1 | cs | Required Pattern: 76690-7 | |||||||
|     @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |||||||
|    statusCode | 1..1 | CS | Binding: ActStatus (required) | |||||||
|     @code | 1..1 | cs | Fixed Value: completed | |||||||
|    effectiveTime | 1..1 | IVL_TS | The effectiveTime represents the relevant time of the observation. A patient's "sexual orientation" may change and using effectiveTime/low and effectiveTime/high defines the time during which the patient had identified their emotional, romantic, sexual, or affectional attraction to another person. | |||||||
|     low | 1..1 | IVXB_TS | ||||||||
|     high | 0..1 | IVXB_TS | ||||||||
|    Slices for value | 1..1 | (USCDI) Alcohol Use, Substance Use, SDOH Problems/Health Concerns Slice: Unordered, Open by type:$this | ||||||||
|     value | ANY | |||||||||
|     value | BL | |||||||||
|     value | ED | |||||||||
|     value | ST | |||||||||
|     value | CD | |||||||||
|     value | CV | |||||||||
|     value | CE | |||||||||
|     value | CO | |||||||||
|     value | SC | |||||||||
|     value | II | |||||||||
|     value | TEL | |||||||||
|     value | AD | |||||||||
|     value | EN | |||||||||
|     value | INT | |||||||||
|     value | REAL | |||||||||
|     value | PQ | |||||||||
|     value | MO | |||||||||
|     value | TS | |||||||||
|     value | IVL_PQ | |||||||||
|     value | IVL_TS | |||||||||
|     value | PIVL_TS | |||||||||
|     value | EIVL_TS | |||||||||
|     value | SXPR_TS | |||||||||
|     value | RTO_PQ_PQ | |||||||||
|     value:coded | 1..1 | CD | Binding: Sexual Orientation Including nulls and Data Absent Reason  (required) 
 | |||||||
|    Slices for entryRelationship | 0..* | EntryRelationship | Slice: Unordered, Open by profile:act, profile:observation | |||||||
|     entryRelationship:supportingObs | 0..* | EntryRelationship | When an Assessment Scale Observation is contained in a Social History Observation instance that is a Social Determinant of Health Social History Observation, that Assessment Scale Observation MAY contain Assessment Scale Supporting Observations that contain LOINC question and answer pairs from SDOH screening instruments. | |||||||
|      @typeCode | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SPRT | |||||||
|      observation | C | 1..1 | AssessmentScaleObservation | Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value | ||||||
|     entryRelationship:entryReference | 0..* | EntryRelationship | When an Entry Reference is contained in a Social History Template instance that is a Social Determinant of Health Social History, that Entry Reference **MAY** reference an Assessment Scale Observation elsewhere in the document that represent LOINC question and answer pairs from SDOH screening instruments. | |||||||
|      @typeCode | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SPRT | |||||||
|      act | C | 1..1 | EntryReference | Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value | ||||||
|  Documentation for this format | ||||||||||
| Path | Conformance | ValueSet / Code | URI | 
| Observation.classCode | required | Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation | |
| Observation.moodCode | required | Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0 | |
| Observation.code | preferred | SocialHistoryType  http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.80.60 | |
| Observation.statusCode | required | ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus | |
| Observation.value:physical-quantity.unit | preferred | UnitsOfMeasureCaseSensitive (a valid code from UCUM) http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive | |
| Observation.value:coded | required | SexualOrientationIncludingNullsAndDataAbsentReason  http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1240.11 | |
| Observation.entryRelationship:supportingObs.typeCode | required | Fixed Value: SPRT http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship | |
| Observation.entryRelationship:entryReference.typeCode | required | Fixed Value: SPRT http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship | 
| Id | Grade | Path(s) | Details | Requirements | 
| 4515-8555 | error | Observation | If Observation/value is a physical quantity (xsi:type="PQ"): This value SHALL contain exactly one [1..1] @unit, which SHOULD be selected from ValueSet UnitsOfMeasureCaseSensitive urn:oid:2.16.840.1.113883.1.11.12839 DYNAMIC. Note: Base CDA requires that all @unit values SHALL be drawn from UCUM. : | |
| 4515-32956 | warning | Observation.code | If @codeSystem is not LOINC, then this code **SHALL** contain at least one [1..*] translation, which **SHOULD** be selected from CodeSystem LOINC (urn:oid:2.16.840.1.113883.6.1) (CONF:4515-32956). : codeSystem = '2.16.840.1.113883.6.1' or translation.where(codeSystem = '2.16.840.1.113883.6.1').exists() | |
| should-sh-author | warning | Observation | SHOULD contain author : author.exists() | |
| should-text-ref-value | warning | Observation, Observation.entryRelationship:supportingObs.observation, Observation.entryRelationship:entryReference.act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| should-value | warning | Observation | SHOULD contain value : value.exists() | 
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints  | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
|   Observation | C | 1..1 | SocialHistoryObservation | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1, templateId, templateId, classCode, moodCode, id, code, text, statusCode, effectiveTime, value, value, value, author, entryRelationship, entryRelationship, entryRelationship 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-value: SHOULD contain value 4515-8555: If Observation/value is a physical quantity (xsi:type="PQ"): This value SHALL contain exactly one [1..1] @unit, which SHOULD be selected from ValueSet UnitsOfMeasureCaseSensitive urn:oid:2.16.840.1.113883.1.11.12839 DYNAMIC. Note: Base CDA requires that all @unit values SHALL be drawn from UCUM. should-sh-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 | 2..* | II | Slice: Unordered, Open by value:root, value:extension | |||||||
|     templateId:social-history-obs | 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: 2.16.840.1.113883.10.20.22.4.38 | |||||||
|      @extension | 1..1 | st | Required Pattern: 2022-06-01 | |||||||
|     templateId:sexual-orientation-obs | 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: 2.16.840.1.113883.10.20.22.4.501 | |||||||
|      @extension | 1..1 | st | Required Pattern: 2023-05-01 | |||||||
|    @classCode | 1..1 | cs | Binding: CDAActClassObservation (required) Fixed Value: OBS | |||||||
|    @moodCode | 1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN | |||||||
|    @negationInd | 0..1 | bl | ||||||||
|    id | 1..* | II | ||||||||
|    code | C | 1..1 | CD | Binding: Social History Type  (preferred) 4515-32956: If @codeSystem is not LOINC, then this code **SHALL** contain at least one [1..*] translation, which **SHOULD** be selected from CodeSystem LOINC (urn:oid:2.16.840.1.113883.6.1) (CONF:4515-32956). | ||||||
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |||||||
|     @code | 1..1 | cs | Required Pattern: 76690-7 | |||||||
|     @codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |||||||
|     @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 | 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 | 1..1 | IVL_TS | The effectiveTime represents the relevant time of the observation. A patient's "sexual orientation" may change and using effectiveTime/low and effectiveTime/high defines the time during which the patient had identified their emotional, romantic, sexual, or affectional attraction to another person. | |||||||
|     @nullFlavor | 0..1 | cs | Binding: CDANullFlavor (required) | |||||||
|     @value | 0..1 | ts | Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz] | |||||||
|     @operator | 0..1 | cs | Binding: CDASetOperator (required) | |||||||
|     low | 1..1 | IVXB_TS | ||||||||
|     center | 0..1 | TS | ||||||||
|     width | 0..1 | PQ | ||||||||
|     high | 0..1 | IVXB_TS | ||||||||
|    priorityCode | 0..1 | CE | Binding: ActPriority (example) | |||||||
|    repeatNumber | 0..1 | IVL_INT | ||||||||
|    languageCode | 0..1 | CS | Binding: AllLanguages (required) | |||||||
|    Slices for value | 1..1 | (USCDI) Alcohol Use, Substance Use, SDOH Problems/Health Concerns Slice: Unordered, Open by type:$this | ||||||||
|     value | ANY | |||||||||
|     value | BL | |||||||||
|     value | ED | |||||||||
|     value | ST | |||||||||
|     value | CD | |||||||||
|     value | CV | |||||||||
|     value | CE | |||||||||
|     value | CO | |||||||||
|     value | SC | |||||||||
|     value | II | |||||||||
|     value | TEL | |||||||||
|     value | AD | |||||||||
|     value | EN | |||||||||
|     value | INT | |||||||||
|     value | REAL | |||||||||
|     value | PQ | |||||||||
|     value | MO | |||||||||
|     value | TS | |||||||||
|     value | IVL_PQ | |||||||||
|     value | IVL_TS | |||||||||
|     value | PIVL_TS | |||||||||
|     value | EIVL_TS | |||||||||
|     value | SXPR_TS | |||||||||
|     value | RTO_PQ_PQ | |||||||||
|     value:coded | 1..1 | CD | Binding: Sexual Orientation Including nulls and Data Absent Reason  (required) 
 | |||||||
|    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..* | AuthorParticipation | Base for all types and resources | |||||||
|    informant | 0..* | Informant | ||||||||
|    participant | 0..* | Participant2 | ||||||||
|    Slices for entryRelationship | 0..* | EntryRelationship | Slice: Unordered, Open by profile:act, profile:observation | |||||||
|     entryRelationship:supportingObs | 0..* | EntryRelationship | When an Assessment Scale Observation is contained in a Social History Observation instance that is a Social Determinant of Health Social History Observation, that Assessment Scale Observation MAY contain Assessment Scale Supporting Observations that contain LOINC question and answer pairs from SDOH screening instruments. | |||||||
|      @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: SPRT | |||||||
|      @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 | AssessmentScaleObservation | Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value | ||||||
|      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:entryReference | 0..* | EntryRelationship | When an Entry Reference is contained in a Social History Template instance that is a Social Determinant of Health Social History, that Entry Reference **MAY** reference an Assessment Scale Observation elsewhere in the document that represent LOINC question and answer pairs from SDOH screening instruments. | |||||||
|      @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: SPRT | |||||||
|      @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 | ||||||||
|    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) | |||||||
|  Documentation for this format | ||||||||||
| Path | Conformance | ValueSet / Code | URI | 
| Observation.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.typeId.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.templateId:social-history-obs.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.templateId:sexual-orientation-obs.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.classCode | required | Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation | |
| Observation.moodCode | required | Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0 | |
| Observation.code | preferred | SocialHistoryType  http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.88.12.80.60 | |
| Observation.code.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.text.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.text.compression | required | CDACompressionAlgorithm http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm | |
| Observation.text.integrityCheckAlgorithm | required | IntegrityCheckAlgorithm http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0 | |
| Observation.text.mediaType | example | MediaType http://terminology.hl7.org/ValueSet/v3-MediaType | |
| Observation.text.representation | required | BinaryDataEncoding http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding | |
| Observation.statusCode | required | ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus | |
| Observation.statusCode.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.effectiveTime.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.effectiveTime.operator | required | CDASetOperator http://hl7.org/cda/stds/core/ValueSet/CDASetOperator | |
| Observation.priorityCode | example | ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority | |
| Observation.languageCode | required | AllLanguages http://hl7.org/fhir/ValueSet/all-languagesfrom the FHIR Standard | |
| Observation.value:physical-quantity.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.value:physical-quantity.unit | preferred | UnitsOfMeasureCaseSensitive (a valid code from UCUM) http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive | |
| Observation.value:coded | required | SexualOrientationIncludingNullsAndDataAbsentReason  http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1240.11 | |
| Observation.interpretationCode | required | CDAObservationInterpretation http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation | |
| Observation.methodCode | example | ObservationMethod http://terminology.hl7.org/ValueSet/v3-ObservationMethod | |
| Observation.entryRelationship:supportingObs.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.entryRelationship:supportingObs.typeId.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.entryRelationship:supportingObs.typeCode | required | Fixed Value: SPRT http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship | |
| Observation.entryRelationship:entryReference.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.entryRelationship:entryReference.typeId.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.entryRelationship:entryReference.typeCode | required | Fixed Value: SPRT http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship | |
| Observation.referenceRange.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.referenceRange.typeId.nullFlavor | required | CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Observation.referenceRange.typeCode | required | Fixed Value: REFV http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType | 
| Id | Grade | Path(s) | Details | Requirements | 
| 4515-8555 | error | Observation | If Observation/value is a physical quantity (xsi:type="PQ"): This value SHALL contain exactly one [1..1] @unit, which SHOULD be selected from ValueSet UnitsOfMeasureCaseSensitive urn:oid:2.16.840.1.113883.1.11.12839 DYNAMIC. Note: Base CDA requires that all @unit values SHALL be drawn from UCUM. : | |
| 4515-32956 | warning | Observation.code | If @codeSystem is not LOINC, then this code **SHALL** contain at least one [1..*] translation, which **SHOULD** be selected from CodeSystem LOINC (urn:oid:2.16.840.1.113883.6.1) (CONF:4515-32956). : codeSystem = '2.16.840.1.113883.6.1' or translation.where(codeSystem = '2.16.840.1.113883.6.1').exists() | |
| should-sh-author | warning | Observation | SHOULD contain author : author.exists() | |
| should-text-ref-value | warning | Observation, Observation.entryRelationship:supportingObs.observation, Observation.entryRelationship:entryReference.act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| should-value | warning | Observation | SHOULD contain value : value.exists() | |
| value-starts-octothorpe | error | Observation.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 SocialHistoryObservation