Consolidated CDA (C-CDA)
4.0.0 - STU4 United States of America flag

This page is part of the CCDA: Consolidated CDA Release (v4.0.0: CCDA 4.0) generated with FHIR (HL7® FHIR® Standard) v5.0.0. This is the current published version. For a full list of available versions, see the Directory of published versions

Logical Model: HealthConcernAct - Detailed Descriptions

Draft as of 2025-06-20

Definitions for the HealthConcernAct logical model.

Guidance on how to interpret the contents of this table can be foundhere

0. Act
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.


Base definition for all types defined in FHIR type system.

ShortBase for all types and resources
Control10..1*
Is Modifierfalse
Logical ContainerClinicalDocument (CDA Class)
ValidationInstance of this type are validated by templateId
XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
should-author: SHOULD contain author (author.exists())
2. Act.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
(required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
4. Act.realmCode
Definition

When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
6. Act.typeId
Definition

When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
8. Act.typeId.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
(required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
10. Act.typeId.assigningAuthorityName
Definition

A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelAssigning Authority Name
12. Act.typeId.displayable
Definition

Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelDisplayable
14. Act.typeId.root
Definition

Identifies the type as an HL7 Registered model

Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelRoot
Fixed Value2.16.840.1.113883.1.3
16. Act.typeId.extension
Definition

A character string as a unique identifier within the scope of the identifier root.

Control1..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExtension
18. Act.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control1..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
SlicingThis element introduces a set of slices on Act.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ root
  • value @ extension
  • 20. Act.templateId:health-concern-act
    Slice Namehealth-concern-act
    Definition

    When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

    Control1..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
    22. Act.templateId:health-concern-act.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..1
    BindingThe codes SHALL be taken from CDANullFlavor
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    24. Act.templateId:health-concern-act.assigningAuthorityName
    Definition

    A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelAssigning Authority Name
    26. Act.templateId:health-concern-act.displayable
    Definition

    Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

    Control0..1
    Typeboolean(bl: Boolean)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelDisplayable
    28. Act.templateId:health-concern-act.root
    Definition

    A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

    Control1..1
    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelRoot
    Pattern Value2.16.840.1.113883.10.20.22.4.132
    30. Act.templateId:health-concern-act.extension
    Definition

    A character string as a unique identifier within the scope of the identifier root.

    Control1..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExtension
    Pattern Value2022-06-01
    32. Act.classCode
    Comments

    SHALL contain exactly one [1..1] @classCode="ACT" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:4515-30750).

    Control1..1
    BindingThe codes SHALL be taken from XActClassDocumentEntryAct (2.0.0)
    (required to http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed ValueACT
    34. Act.moodCode
    Comments

    SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001) (CONF:4515-30751).

    Control1..1
    BindingThe codes SHALL be taken from XDocumentActMood (2.0.0)
    (required to http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed ValueEVN
    36. Act.negationInd
    Control0..1
    Typeboolean(bl: Boolean)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    38. Act.id
    Comments

    SHALL contain at least one [1..*] id (CONF:4515-30754).

    Control1..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
    40. Act.code
    ShortFunctional status assessment note
    Comments

    SHALL contain exactly one [1..1] code (CONF:4515-32310).

    Control1..1
    BindingFor example codes, see v3 Code System ActCode
    (example to http://terminology.hl7.org/ValueSet/v3-ActCode)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
    42. Act.code.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..1
    BindingThe codes SHALL be taken from CDANullFlavor
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    44. Act.code.code
    Definition

    The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

    Control1..1
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode
    Pattern Value75310-3
    46. Act.code.codeSystem
    Definition

    Specifies the code system that defines the code.

    ShortLOINC
    Control1..1
    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System
    Pattern Value2.16.840.1.113883.6.1
    48. Act.code.codeSystemName
    Definition

    The common name of the coding system.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System Name
    50. Act.code.codeSystemVersion
    Definition

    If applicable, a version descriptor defined specifically for the given code system.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System Version
    52. Act.code.displayName
    Definition

    A name or title for the code, under which the sending system shows the code value to its users.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelDisplay Name
    54. Act.code.sdtcValueSet
    Definition

    The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

    Control0..1
    Typestring(oid: ISO Object Identifier)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
    56. Act.code.sdtcValueSetVersion
    Definition

    The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
    58. Act.code.originalText
    Definition

    The text or phrase used as the basis for the coding.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
    LabelOriginal Text
    60. Act.code.qualifier
    Definition

    Specifies additional codes that increase the specificity of the the primary code.

    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
    LabelQualifier
    62. Act.code.translation
    Definition

    A set of other concept descriptors that translate this concept descriptor into other code systems.

    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
    XML FormatThe type of this property is determined using the xsi:typeattribute.
    LabelTranslation
    64. Act.text
    ShortSHOULD reference the portion of section narrative text corresponding to this entry
    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
    66. Act.text.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..1
    BindingThe codes SHALL be taken from CDANullFlavor
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    68. Act.text.compression
    Definition

    Indicates whether the raw byte data is compressed, and what compression algorithm was used.

    Control0..1
    BindingThe codes SHALL be taken from CDACompressionAlgorithm
    (required to http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCompression
    70. Act.text.integrityCheck
    Definition

    The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.

    Control0..1
    Typebase64Binary(bin: Binary Data)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelIntegrity Check
    72. Act.text.integrityCheckAlgorithm
    Definition

    Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.

    Control0..1
    BindingThe codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0)
    (required to http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelIntegrity Check Algorithm
    74. Act.text.language
    Definition

    For character based information the language property specifies the human language of the text.

    Control0..1
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelLanguage
    76. Act.text.mediaType
    Definition

    Identifies the type of the encapsulated data and identifies a method to interpret or render the data.

    Control0..1
    BindingFor example codes, see MediaType
    (example to http://terminology.hl7.org/ValueSet/v3-MediaType)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelMedia Type
    78. Act.text.representation
    Control0..1
    BindingThe codes SHALL be taken from CDABinaryDataEncoding
    (required to http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    80. Act.text.xmlText
    Definition

    Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)

    ShortAllows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    Comments

    This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as unadorned text.
    82. Act.text.reference
    Definition

    A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
    LabelReference
    Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
    84. Act.text.thumbnail
    Definition

    An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
    LabelThumbnail
    86. Act.statusCode
    Comments

    SHALL contain exactly one [1..1] statusCode (CONF:4515-30758).

    Control1..1
    BindingThe codes SHALL be taken from ActStatus
    (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
    88. Act.statusCode.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..0
    BindingThe codes SHALL be taken from CDANullFlavor
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    90. Act.statusCode.code
    Definition

    The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

    Control1..1
    BindingThe codes SHALL be taken from ProblemAct statusCode .
    (required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.19)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode
    92. Act.statusCode.codeSystem
    Definition

    Specifies the code system that defines the code.

    Control0..0
    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System
    94. Act.statusCode.codeSystemName
    Definition

    The common name of the coding system.

    Control0..0
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System Name
    96. Act.statusCode.codeSystemVersion
    Definition

    If applicable, a version descriptor defined specifically for the given code system.

    Control0..0
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System Version
    98. Act.statusCode.displayName
    Definition

    A name or title for the code, under which the sending system shows the code value to its users.

    Control0..0
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelDisplay Name
    100. Act.statusCode.sdtcValueSet
    Definition

    The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

    Control0..1
    Typestring(oid: ISO Object Identifier)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
    102. Act.statusCode.sdtcValueSetVersion
    Definition

    The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
    104. Act.statusCode.originalText
    Definition

    The text or phrase used as the basis for the coding.

    Control0..0
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
    LabelOriginal Text
    106. Act.statusCode.qualifier
    Definition

    Specifies additional codes that increase the specificity of the the primary code.

    Control0..0
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
    LabelQualifier
    108. Act.statusCode.translation
    Definition

    A set of other concept descriptors that translate this concept descriptor into other code systems.

    Control0..0
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
    XML FormatThe type of this property is determined using the xsi:typeattribute.
    LabelTranslation
    110. Act.effectiveTime
    Comments

    MAY contain zero or one [0..1] effectiveTime (CONF:4515-30759).

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
    112. Act.priorityCode
    Control0..1
    BindingFor example codes, see ActPriority
    (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
    114. Act.languageCode
    Control0..1
    BindingThe codes SHALL be taken from AllLanguages
    (required to http://hl7.org/fhir/ValueSet/all-languages)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
    116. Act.subject
    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Subject
    118. Act.specimen
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
    120. Act.performer
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
    122. Act.author
    ShortA health concern may be a patient or provider concern. If the author is set to the recordTarget (patient), this is a patient concern. If the author is set to a provider, this is a provider concern. If both patient and provider are set as authors, this is a concern of both the patient and the provider.
    Comments

    SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:4515-31546).

    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
    124. Act.informant
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
    126. Act.participant
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
    128. Act.entryRelationship
    ShortWhen this Health Concern Act is a Social Determinant of Health Health Concern it **SHOULD** contain zero or more [0..*] entryRelationship subentries such that it contains an observation with an observation/value selected from ValueSet [Social Determinant of Health Conditions 2.16.840.1.113762.1.4.1196.788](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1196.788/expansion) **DYNAMIC** (CONF:4515-32962).
    Comments

    MAY contain zero or more [0..*] entryRelationship (CONF:4515-31549) such that it

    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
    SlicingThis element introduces a set of slices on Act.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • profile @ act
    • profile @ observation
    • profile @ organizer
    • value @ typeCode
    • 130. Act.entryRelationship:observations
      Slice Nameobservations
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
      132. Act.entryRelationship:observations.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      134. Act.entryRelationship:observations.realmCode
      Definition

      When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      136. Act.entryRelationship:observations.typeId
      Definition

      When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
      138. Act.entryRelationship:observations.typeId.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      140. Act.entryRelationship:observations.typeId.assigningAuthorityName
      Definition

      A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelAssigning Authority Name
      142. Act.entryRelationship:observations.typeId.displayable
      Definition

      Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelDisplayable
      144. Act.entryRelationship:observations.typeId.root
      Definition

      Identifies the type as an HL7 Registered model

      Control1..1
      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelRoot
      Fixed Value2.16.840.1.113883.1.3
      146. Act.entryRelationship:observations.typeId.extension
      Definition

      A character string as a unique identifier within the scope of the identifier root.

      Control1..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExtension
      148. Act.entryRelationship:observations.templateId
      Definition

      When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      150. Act.entryRelationship:observations.typeCode
      Control1..1
      BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
      (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed ValueREFR
      152. Act.entryRelationship:observations.inversionInd
      Definition

      The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      154. Act.entryRelationship:observations.contextConductionInd
      Definition

      The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Default Valuetrue
      156. Act.entryRelationship:observations.negationInd
      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      158. Act.entryRelationship:observations.sequenceNumber
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
      160. Act.entryRelationship:observations.seperatableInd
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
      162. Act.entryRelationship:observations.act
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
      164. Act.entryRelationship:observations.encounter
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
      166. Act.entryRelationship:observations.observation
      Control1..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Problem Observation, Allergy - Intolerance Observation, Assessment Scale Observation, Self-Care Activities (ADL and IADL), Mental Status Observation, Smoking Status - Meaningful Use (Deprecated), Functional Status Observation, Nutrition Assessment, Pregnancy Status Observation, Reaction Observation, Result Observation, Sensory Status, Social History Observation, Substance or Device Allergy - Intolerance Observation, Tobacco Use (Deprecated), Vital Sign Observation, Longitudinal Care Wound Observation, Problem Observation, Caregiver Characteristics, Cultural and Religious Observation, Characteristics of Home Environment, Nutritional Status Observation, Priority Preference)
      168. Act.entryRelationship:observations.observationMedia
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
      170. Act.entryRelationship:observations.organizer
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
      172. Act.entryRelationship:observations.procedure
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
      174. Act.entryRelationship:observations.regionOfInterest
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
      176. Act.entryRelationship:observations.substanceAdministration
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
      178. Act.entryRelationship:observations.supply
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
      180. Act.entryRelationship:acts
      Slice Nameacts
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
      182. Act.entryRelationship:acts.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      184. Act.entryRelationship:acts.realmCode
      Definition

      When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      186. Act.entryRelationship:acts.typeId
      Definition

      When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
      188. Act.entryRelationship:acts.typeId.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      190. Act.entryRelationship:acts.typeId.assigningAuthorityName
      Definition

      A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelAssigning Authority Name
      192. Act.entryRelationship:acts.typeId.displayable
      Definition

      Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelDisplayable
      194. Act.entryRelationship:acts.typeId.root
      Definition

      Identifies the type as an HL7 Registered model

      Control1..1
      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelRoot
      Fixed Value2.16.840.1.113883.1.3
      196. Act.entryRelationship:acts.typeId.extension
      Definition

      A character string as a unique identifier within the scope of the identifier root.

      Control1..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExtension
      198. Act.entryRelationship:acts.templateId
      Definition

      When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      200. Act.entryRelationship:acts.typeCode
      Control1..1
      BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
      (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed ValueREFR
      202. Act.entryRelationship:acts.inversionInd
      Definition

      The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      204. Act.entryRelationship:acts.contextConductionInd
      Definition

      The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Default Valuetrue
      206. Act.entryRelationship:acts.negationInd
      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      208. Act.entryRelationship:acts.sequenceNumber
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
      210. Act.entryRelationship:acts.seperatableInd
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
      212. Act.entryRelationship:acts.act
      Control1..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Encounter Diagnosis, Hospital Admission Diagnosis, Postprocedure Diagnosis, Preoperative Diagnosis)
      214. Act.entryRelationship:acts.encounter
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
      216. Act.entryRelationship:acts.observation
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
      218. Act.entryRelationship:acts.observationMedia
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
      220. Act.entryRelationship:acts.organizer
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
      222. Act.entryRelationship:acts.procedure
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
      224. Act.entryRelationship:acts.regionOfInterest
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
      226. Act.entryRelationship:acts.substanceAdministration
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
      228. Act.entryRelationship:acts.supply
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
      230. Act.entryRelationship:organizers
      Slice Nameorganizers
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
      232. Act.entryRelationship:organizers.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      234. Act.entryRelationship:organizers.realmCode
      Definition

      When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      236. Act.entryRelationship:organizers.typeId
      Definition

      When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
      238. Act.entryRelationship:organizers.typeId.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      240. Act.entryRelationship:organizers.typeId.assigningAuthorityName
      Definition

      A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelAssigning Authority Name
      242. Act.entryRelationship:organizers.typeId.displayable
      Definition

      Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelDisplayable
      244. Act.entryRelationship:organizers.typeId.root
      Definition

      Identifies the type as an HL7 Registered model

      Control1..1
      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelRoot
      Fixed Value2.16.840.1.113883.1.3
      246. Act.entryRelationship:organizers.typeId.extension
      Definition

      A character string as a unique identifier within the scope of the identifier root.

      Control1..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExtension
      248. Act.entryRelationship:organizers.templateId
      Definition

      When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      250. Act.entryRelationship:organizers.typeCode
      Control1..1
      BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
      (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed ValueREFR
      252. Act.entryRelationship:organizers.inversionInd
      Definition

      The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      254. Act.entryRelationship:organizers.contextConductionInd
      Definition

      The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Default Valuetrue
      256. Act.entryRelationship:organizers.negationInd
      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      258. Act.entryRelationship:organizers.sequenceNumber
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
      260. Act.entryRelationship:organizers.seperatableInd
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
      262. Act.entryRelationship:organizers.act
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
      264. Act.entryRelationship:organizers.encounter
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
      266. Act.entryRelationship:organizers.observation
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
      268. Act.entryRelationship:organizers.observationMedia
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
      270. Act.entryRelationship:organizers.organizer
      Control1..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer(Family History Organizer, Result Organizer)
      272. Act.entryRelationship:organizers.procedure
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
      274. Act.entryRelationship:organizers.regionOfInterest
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
      276. Act.entryRelationship:organizers.substanceAdministration
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
      278. Act.entryRelationship:organizers.supply
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
      280. Act.entryRelationship:related-entries
      Slice Namerelated-entries
      ShortWhere a Health Concern needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry. This may also be used to refer to other Health Concern Acts where there is a general relationship between the source and the target (Health Concern REFERS TO Health Concern). For example, a patient has 2 health concerns identified in a CARE Plan: Failure to Thrive and Poor Feeding; while it could be that one may have caused the other, at the time of care planning and documentation it is not necessary, nor desirable to have to assert what caused what. The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
      Comments

      MAY contain zero or more [0..*] entryRelationship (CONF:4515-31157) such that it

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
      282. Act.entryRelationship:related-entries.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      284. Act.entryRelationship:related-entries.realmCode
      Definition

      When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      286. Act.entryRelationship:related-entries.typeId
      Definition

      When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
      288. Act.entryRelationship:related-entries.typeId.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      290. Act.entryRelationship:related-entries.typeId.assigningAuthorityName
      Definition

      A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelAssigning Authority Name
      292. Act.entryRelationship:related-entries.typeId.displayable
      Definition

      Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelDisplayable
      294. Act.entryRelationship:related-entries.typeId.root
      Definition

      Identifies the type as an HL7 Registered model

      Control1..1
      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelRoot
      Fixed Value2.16.840.1.113883.1.3
      296. Act.entryRelationship:related-entries.typeId.extension
      Definition

      A character string as a unique identifier within the scope of the identifier root.

      Control1..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExtension
      298. Act.entryRelationship:related-entries.templateId
      Definition

      When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      300. Act.entryRelationship:related-entries.typeCode
      Comments

      SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-31158).

      Control1..1
      BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
      (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed ValueREFR
      302. Act.entryRelationship:related-entries.inversionInd
      Definition

      The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      304. Act.entryRelationship:related-entries.contextConductionInd
      Definition

      The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Default Valuetrue
      306. Act.entryRelationship:related-entries.negationInd
      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      308. Act.entryRelationship:related-entries.sequenceNumber
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
      310. Act.entryRelationship:related-entries.seperatableInd
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
      312. Act.entryRelationship:related-entries.act
      Comments

      SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32106).

      Control1..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
      314. Act.entryRelationship:related-entries.encounter
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
      316. Act.entryRelationship:related-entries.observation
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
      318. Act.entryRelationship:related-entries.observationMedia
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
      320. Act.entryRelationship:related-entries.organizer
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
      322. Act.entryRelationship:related-entries.procedure
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
      324. Act.entryRelationship:related-entries.regionOfInterest
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
      326. Act.entryRelationship:related-entries.substanceAdministration
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
      328. Act.entryRelationship:related-entries.supply
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
      330. Act.entryRelationship:component-health-concern-acts
      Slice Namecomponent-health-concern-acts
      ShortThe following entryRelationship represents the relationship between two Health Concern Acts where the target is a component of the source (Health Concern HAS COMPONENT Health Concern). For example, a patient has an Impaired Mobility Health Concern. There may then be the need to document several component health concerns, such as "Unable to Transfer Bed to Chair","Unable to Rise from Commode", "Short of Breath Walking with Walker". The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
      Comments

      MAY contain zero or more [0..*] entryRelationship (CONF:4515-31160) such that it

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
      Invariants4515-32745: The Entry Reference template **SHALL** contain an id that references a Health Concern Act (CONF:4515-32745). (%resource.descendants().ofType(CDA.Act).where(templateId.exists($this.root = '2.16.840.1.113883.10.20.22.4.132' and $this.extension = '2022-06-01') and id.exists($this.root = %context.act.id.first().root and $this.extension ~ %context.act.id.first().extension)))
      332. Act.entryRelationship:component-health-concern-acts.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      334. Act.entryRelationship:component-health-concern-acts.realmCode
      Definition

      When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      336. Act.entryRelationship:component-health-concern-acts.typeId
      Definition

      When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
      338. Act.entryRelationship:component-health-concern-acts.typeId.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      340. Act.entryRelationship:component-health-concern-acts.typeId.assigningAuthorityName
      Definition

      A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelAssigning Authority Name
      342. Act.entryRelationship:component-health-concern-acts.typeId.displayable
      Definition

      Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelDisplayable
      344. Act.entryRelationship:component-health-concern-acts.typeId.root
      Definition

      Identifies the type as an HL7 Registered model

      Control1..1
      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelRoot
      Fixed Value2.16.840.1.113883.1.3
      346. Act.entryRelationship:component-health-concern-acts.typeId.extension
      Definition

      A character string as a unique identifier within the scope of the identifier root.

      Control1..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExtension
      348. Act.entryRelationship:component-health-concern-acts.templateId
      Definition

      When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      350. Act.entryRelationship:component-health-concern-acts.typeCode
      Comments

      SHALL contain exactly one [1..1] @typeCode="COMP" Has component (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-31161).

      Control1..1
      BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
      (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed ValueCOMP
      352. Act.entryRelationship:component-health-concern-acts.inversionInd
      Definition

      The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      354. Act.entryRelationship:component-health-concern-acts.contextConductionInd
      Definition

      The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Default Valuetrue
      356. Act.entryRelationship:component-health-concern-acts.negationInd
      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      358. Act.entryRelationship:component-health-concern-acts.sequenceNumber
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
      360. Act.entryRelationship:component-health-concern-acts.seperatableInd
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
      362. Act.entryRelationship:component-health-concern-acts.act
      Comments

      SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32107).

      Control1..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
      364. Act.entryRelationship:component-health-concern-acts.encounter
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
      366. Act.entryRelationship:component-health-concern-acts.observation
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
      368. Act.entryRelationship:component-health-concern-acts.observationMedia
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
      370. Act.entryRelationship:component-health-concern-acts.organizer
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
      372. Act.entryRelationship:component-health-concern-acts.procedure
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
      374. Act.entryRelationship:component-health-concern-acts.regionOfInterest
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
      376. Act.entryRelationship:component-health-concern-acts.substanceAdministration
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
      378. Act.entryRelationship:component-health-concern-acts.supply
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
      380. Act.reference
      ShortWhere it is necessary to reference an external clinical document such as a Referral document, Discharge Summary document etc., the External Document Reference template can be used to reference this document. However, if this Care Plan document is replacing or appending another Care Plan document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.
      Comments

      MAY contain zero or more [0..*] reference (CONF:4515-32757).

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
      382. Act.reference.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      384. Act.reference.realmCode
      Definition

      When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      386. Act.reference.typeId
      Definition

      When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
      388. Act.reference.typeId.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      390. Act.reference.typeId.assigningAuthorityName
      Definition

      A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelAssigning Authority Name
      392. Act.reference.typeId.displayable
      Definition

      Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelDisplayable
      394. Act.reference.typeId.root
      Definition

      Identifies the type as an HL7 Registered model

      Control1..1
      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelRoot
      Fixed Value2.16.840.1.113883.1.3
      396. Act.reference.typeId.extension
      Definition

      A character string as a unique identifier within the scope of the identifier root.

      Control1..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExtension
      398. Act.reference.templateId
      Definition

      When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      400. Act.reference.typeCode
      Comments

      The reference, if present, SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32758).

      Control1..1
      BindingThe codes SHALL be taken from x_ActRelationshipExternalReference
      (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed ValueREFR
      402. Act.reference.seperatableInd
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
      404. Act.reference.externalAct
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalAct
      406. Act.reference.externalObservation
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalObservation
      408. Act.reference.externalProcedure
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalProcedure
      410. Act.reference.externalDocument
      Comments

      The reference, if present, SHALL contain exactly one [1..1] External Document Reference (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.115:2014-06-09) (CONF:4515-32759).

      Control1..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument(External Document Reference)
      412. Act.precondition
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
      414. Act.sdtcPrecondition2
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition2
      XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameprecondition2.
      416. Act.sdtcInFulfillmentOf1
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
      XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameinFulfillmentOf1.

      Guidance on how to interpret the contents of this table can be foundhere

      0. Act
      Logical ContainerClinicalDocument (CDA Class)
      ValidationInstance of this type are validated by templateId
      XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
      Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
      should-author: SHOULD contain author (author.exists())
      2. Act.templateId
      Control1..?
      SlicingThis element introduces a set of slices on Act.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ root
      • value @ extension
      • 4. Act.templateId:health-concern-act
        Slice Namehealth-concern-act
        Control1..1
        6. Act.templateId:health-concern-act.root
        Control1..?
        Pattern Value2.16.840.1.113883.10.20.22.4.132
        8. Act.templateId:health-concern-act.extension
        Control1..?
        Pattern Value2022-06-01
        10. Act.classCode
        Comments

        SHALL contain exactly one [1..1] @classCode="ACT" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:4515-30750).

        Fixed ValueACT
        12. Act.moodCode
        Comments

        SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001) (CONF:4515-30751).

        Fixed ValueEVN
        14. Act.id
        Comments

        SHALL contain at least one [1..*] id (CONF:4515-30754).

        Control1..?
        16. Act.code
        ShortFunctional status assessment note
        Comments

        SHALL contain exactly one [1..1] code (CONF:4515-32310).

        18. Act.code.code
        Control1..?
        Pattern Value75310-3
        20. Act.code.codeSystem
        ShortLOINC
        Control1..?
        Pattern Value2.16.840.1.113883.6.1
        22. Act.text
        ShortSHOULD reference the portion of section narrative text corresponding to this entry
        24. Act.text.reference
        Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
        26. Act.statusCode
        Comments

        SHALL contain exactly one [1..1] statusCode (CONF:4515-30758).

        Control1..?
        28. Act.statusCode.nullFlavor
        Control0..0
        30. Act.statusCode.code
        Control1..?
        BindingThe codes SHALL be taken from ProblemAct statusCode .
        (required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.19)
        32. Act.effectiveTime
        Comments

        MAY contain zero or one [0..1] effectiveTime (CONF:4515-30759).

        34. Act.author
        ShortA health concern may be a patient or provider concern. If the author is set to the recordTarget (patient), this is a patient concern. If the author is set to a provider, this is a provider concern. If both patient and provider are set as authors, this is a concern of both the patient and the provider.
        Comments

        SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:4515-31546).

        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
        36. Act.entryRelationship
        ShortWhen this Health Concern Act is a Social Determinant of Health Health Concern it **SHOULD** contain zero or more [0..*] entryRelationship subentries such that it contains an observation with an observation/value selected from ValueSet [Social Determinant of Health Conditions 2.16.840.1.113762.1.4.1196.788](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1196.788/expansion) **DYNAMIC** (CONF:4515-32962).
        Comments

        MAY contain zero or more [0..*] entryRelationship (CONF:4515-31549) such that it

        SlicingThis element introduces a set of slices on Act.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • profile @ act
        • profile @ observation
        • profile @ organizer
        • value @ typeCode
        • 38. Act.entryRelationship:observations
          Slice Nameobservations
          Control0..*
          40. Act.entryRelationship:observations.typeCode
          Fixed ValueREFR
          42. Act.entryRelationship:observations.observation
          Control1..?
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Problem Observation, Allergy - Intolerance Observation, Assessment Scale Observation, Self-Care Activities (ADL and IADL), Mental Status Observation, Smoking Status - Meaningful Use (Deprecated), Functional Status Observation, Nutrition Assessment, Pregnancy Status Observation, Reaction Observation, Result Observation, Sensory Status, Social History Observation, Substance or Device Allergy - Intolerance Observation, Tobacco Use (Deprecated), Vital Sign Observation, Longitudinal Care Wound Observation, Problem Observation, Caregiver Characteristics, Cultural and Religious Observation, Characteristics of Home Environment, Nutritional Status Observation, Priority Preference)
          44. Act.entryRelationship:acts
          Slice Nameacts
          Control0..*
          46. Act.entryRelationship:acts.typeCode
          Fixed ValueREFR
          48. Act.entryRelationship:acts.act
          Control1..?
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Encounter Diagnosis, Hospital Admission Diagnosis, Postprocedure Diagnosis, Preoperative Diagnosis)
          50. Act.entryRelationship:organizers
          Slice Nameorganizers
          Control0..*
          52. Act.entryRelationship:organizers.typeCode
          Fixed ValueREFR
          54. Act.entryRelationship:organizers.organizer
          Control1..?
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer(Family History Organizer, Result Organizer)
          56. Act.entryRelationship:related-entries
          Slice Namerelated-entries
          ShortWhere a Health Concern needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry. This may also be used to refer to other Health Concern Acts where there is a general relationship between the source and the target (Health Concern REFERS TO Health Concern). For example, a patient has 2 health concerns identified in a CARE Plan: Failure to Thrive and Poor Feeding; while it could be that one may have caused the other, at the time of care planning and documentation it is not necessary, nor desirable to have to assert what caused what. The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
          Comments

          MAY contain zero or more [0..*] entryRelationship (CONF:4515-31157) such that it

          Control0..*
          58. Act.entryRelationship:related-entries.typeCode
          Comments

          SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-31158).

          Fixed ValueREFR
          60. Act.entryRelationship:related-entries.act
          Comments

          SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32106).

          Control1..?
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
          62. Act.entryRelationship:component-health-concern-acts
          Slice Namecomponent-health-concern-acts
          ShortThe following entryRelationship represents the relationship between two Health Concern Acts where the target is a component of the source (Health Concern HAS COMPONENT Health Concern). For example, a patient has an Impaired Mobility Health Concern. There may then be the need to document several component health concerns, such as "Unable to Transfer Bed to Chair","Unable to Rise from Commode", "Short of Breath Walking with Walker". The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
          Comments

          MAY contain zero or more [0..*] entryRelationship (CONF:4515-31160) such that it

          Control0..*
          Invariants4515-32745: The Entry Reference template **SHALL** contain an id that references a Health Concern Act (CONF:4515-32745). (%resource.descendants().ofType(CDA.Act).where(templateId.exists($this.root = '2.16.840.1.113883.10.20.22.4.132' and $this.extension = '2022-06-01') and id.exists($this.root = %context.act.id.first().root and $this.extension ~ %context.act.id.first().extension)))
          64. Act.entryRelationship:component-health-concern-acts.typeCode
          Comments

          SHALL contain exactly one [1..1] @typeCode="COMP" Has component (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-31161).

          Fixed ValueCOMP
          66. Act.entryRelationship:component-health-concern-acts.act
          Comments

          SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32107).

          Control1..?
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
          68. Act.reference
          ShortWhere it is necessary to reference an external clinical document such as a Referral document, Discharge Summary document etc., the External Document Reference template can be used to reference this document. However, if this Care Plan document is replacing or appending another Care Plan document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.
          Comments

          MAY contain zero or more [0..*] reference (CONF:4515-32757).

          70. Act.reference.typeCode
          Comments

          The reference, if present, SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32758).

          Fixed ValueREFR
          72. Act.reference.externalDocument
          Comments

          The reference, if present, SHALL contain exactly one [1..1] External Document Reference (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.115:2014-06-09) (CONF:4515-32759).

          Control1..?
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument(External Document Reference)

          Guidance on how to interpret the contents of this table can be foundhere

          0. Act
          Definition

          Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

          ShortBase for all types and resources
          Control1..1
          Is Modifierfalse
          Logical ContainerClinicalDocument (CDA Class)
          ValidationInstance of this type are validated by templateId
          XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
          Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
          should-author: SHOULD contain author (author.exists())
          2. Act.nullFlavor
          Definition

          If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

          Control0..1
          BindingThe codes SHALL be taken from CDANullFlavor
          (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExceptional Value Detail
          4. Act.realmCode
          Definition

          When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
          6. Act.typeId
          Definition

          When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

          Control0..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
          InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
          8. Act.typeId.nullFlavor
          Definition

          If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

          Control0..1
          BindingThe codes SHALL be taken from CDANullFlavor
          (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExceptional Value Detail
          10. Act.typeId.assigningAuthorityName
          Definition

          A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

          Control0..1
          Typestring(st: Character String)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelAssigning Authority Name
          12. Act.typeId.displayable
          Definition

          Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

          Control0..1
          Typeboolean(bl: Boolean)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelDisplayable
          14. Act.typeId.root
          Definition

          Identifies the type as an HL7 Registered model

          Control1..1
          Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelRoot
          Fixed Value2.16.840.1.113883.1.3
          16. Act.typeId.extension
          Definition

          A character string as a unique identifier within the scope of the identifier root.

          Control1..1
          Typestring(st: Character String)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExtension
          18. Act.templateId
          Definition

          When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

          Control1..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
          SlicingThis element introduces a set of slices on Act.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ root
          • value @ extension
          • 20. Act.templateId:health-concern-act
            Slice Namehealth-concern-act
            Definition

            When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

            Control1..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
            22. Act.templateId:health-concern-act.nullFlavor
            Definition

            If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

            Control0..1
            BindingThe codes SHALL be taken from CDANullFlavor
            (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExceptional Value Detail
            24. Act.templateId:health-concern-act.assigningAuthorityName
            Definition

            A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelAssigning Authority Name
            26. Act.templateId:health-concern-act.displayable
            Definition

            Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

            Control0..1
            Typeboolean(bl: Boolean)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelDisplayable
            28. Act.templateId:health-concern-act.root
            Definition

            A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

            Control1..1
            Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelRoot
            Pattern Value2.16.840.1.113883.10.20.22.4.132
            30. Act.templateId:health-concern-act.extension
            Definition

            A character string as a unique identifier within the scope of the identifier root.

            Control1..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExtension
            Pattern Value2022-06-01
            32. Act.classCode
            Comments

            SHALL contain exactly one [1..1] @classCode="ACT" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:4515-30750).

            Control1..1
            BindingThe codes SHALL be taken from XActClassDocumentEntryAct (2.0.0)
            (required to http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed ValueACT
            34. Act.moodCode
            Comments

            SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001) (CONF:4515-30751).

            Control1..1
            BindingThe codes SHALL be taken from XDocumentActMood (2.0.0)
            (required to http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed ValueEVN
            36. Act.negationInd
            Control0..1
            Typeboolean(bl: Boolean)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            38. Act.id
            Comments

            SHALL contain at least one [1..*] id (CONF:4515-30754).

            Control1..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
            40. Act.code
            ShortFunctional status assessment note
            Comments

            SHALL contain exactly one [1..1] code (CONF:4515-32310).

            Control1..1
            BindingFor example codes, see v3 Code System ActCode
            (example to http://terminology.hl7.org/ValueSet/v3-ActCode)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
            42. Act.code.nullFlavor
            Definition

            If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

            Control0..1
            BindingThe codes SHALL be taken from CDANullFlavor
            (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExceptional Value Detail
            44. Act.code.code
            Definition

            The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

            Control1..1
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode
            Pattern Value75310-3
            46. Act.code.codeSystem
            Definition

            Specifies the code system that defines the code.

            ShortLOINC
            Control1..1
            Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode System
            Pattern Value2.16.840.1.113883.6.1
            48. Act.code.codeSystemName
            Definition

            The common name of the coding system.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode System Name
            50. Act.code.codeSystemVersion
            Definition

            If applicable, a version descriptor defined specifically for the given code system.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode System Version
            52. Act.code.displayName
            Definition

            A name or title for the code, under which the sending system shows the code value to its users.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelDisplay Name
            54. Act.code.sdtcValueSet
            Definition

            The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

            Control0..1
            Typestring(oid: ISO Object Identifier)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
            56. Act.code.sdtcValueSetVersion
            Definition

            The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
            58. Act.code.originalText
            Definition

            The text or phrase used as the basis for the coding.

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
            LabelOriginal Text
            60. Act.code.qualifier
            Definition

            Specifies additional codes that increase the specificity of the the primary code.

            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
            LabelQualifier
            62. Act.code.translation
            Definition

            A set of other concept descriptors that translate this concept descriptor into other code systems.

            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
            XML FormatThe type of this property is determined using the xsi:typeattribute.
            LabelTranslation
            64. Act.text
            ShortSHOULD reference the portion of section narrative text corresponding to this entry
            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
            66. Act.text.nullFlavor
            Definition

            If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

            Control0..1
            BindingThe codes SHALL be taken from CDANullFlavor
            (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExceptional Value Detail
            68. Act.text.compression
            Definition

            Indicates whether the raw byte data is compressed, and what compression algorithm was used.

            Control0..1
            BindingThe codes SHALL be taken from CDACompressionAlgorithm
            (required to http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCompression
            70. Act.text.integrityCheck
            Definition

            The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.

            Control0..1
            Typebase64Binary(bin: Binary Data)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelIntegrity Check
            72. Act.text.integrityCheckAlgorithm
            Definition

            Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.

            Control0..1
            BindingThe codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0)
            (required to http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelIntegrity Check Algorithm
            74. Act.text.language
            Definition

            For character based information the language property specifies the human language of the text.

            Control0..1
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelLanguage
            76. Act.text.mediaType
            Definition

            Identifies the type of the encapsulated data and identifies a method to interpret or render the data.

            Control0..1
            BindingFor example codes, see MediaType
            (example to http://terminology.hl7.org/ValueSet/v3-MediaType)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelMedia Type
            78. Act.text.representation
            Control0..1
            BindingThe codes SHALL be taken from CDABinaryDataEncoding
            (required to http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            80. Act.text.xmlText
            Definition

            Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)

            ShortAllows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
            Comments

            This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as unadorned text.
            82. Act.text.reference
            Definition

            A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
            LabelReference
            Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
            84. Act.text.thumbnail
            Definition

            An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
            LabelThumbnail
            86. Act.statusCode
            Comments

            SHALL contain exactly one [1..1] statusCode (CONF:4515-30758).

            Control1..1
            BindingThe codes SHALL be taken from ActStatus
            (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
            88. Act.statusCode.nullFlavor
            Definition

            If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

            Control0..0
            BindingThe codes SHALL be taken from CDANullFlavor
            (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExceptional Value Detail
            90. Act.statusCode.code
            Definition

            The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

            Control1..1
            BindingThe codes SHALL be taken from ProblemAct statusCode .
            (required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.19)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode
            92. Act.statusCode.codeSystem
            Definition

            Specifies the code system that defines the code.

            Control0..0
            Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode System
            94. Act.statusCode.codeSystemName
            Definition

            The common name of the coding system.

            Control0..0
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode System Name
            96. Act.statusCode.codeSystemVersion
            Definition

            If applicable, a version descriptor defined specifically for the given code system.

            Control0..0
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode System Version
            98. Act.statusCode.displayName
            Definition

            A name or title for the code, under which the sending system shows the code value to its users.

            Control0..0
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelDisplay Name
            100. Act.statusCode.sdtcValueSet
            Definition

            The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

            Control0..1
            Typestring(oid: ISO Object Identifier)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
            102. Act.statusCode.sdtcValueSetVersion
            Definition

            The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
            104. Act.statusCode.originalText
            Definition

            The text or phrase used as the basis for the coding.

            Control0..0
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
            LabelOriginal Text
            106. Act.statusCode.qualifier
            Definition

            Specifies additional codes that increase the specificity of the the primary code.

            Control0..0
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
            LabelQualifier
            108. Act.statusCode.translation
            Definition

            A set of other concept descriptors that translate this concept descriptor into other code systems.

            Control0..0
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
            XML FormatThe type of this property is determined using the xsi:typeattribute.
            LabelTranslation
            110. Act.effectiveTime
            Comments

            MAY contain zero or one [0..1] effectiveTime (CONF:4515-30759).

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
            112. Act.priorityCode
            Control0..1
            BindingFor example codes, see ActPriority
            (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
            114. Act.languageCode
            Control0..1
            BindingThe codes SHALL be taken from AllLanguages
            (required to http://hl7.org/fhir/ValueSet/all-languages)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
            116. Act.subject
            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Subject
            118. Act.specimen
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
            120. Act.performer
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
            122. Act.author
            ShortA health concern may be a patient or provider concern. If the author is set to the recordTarget (patient), this is a patient concern. If the author is set to a provider, this is a provider concern. If both patient and provider are set as authors, this is a concern of both the patient and the provider.
            Comments

            SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:4515-31546).

            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
            124. Act.informant
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
            126. Act.participant
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
            128. Act.entryRelationship
            ShortWhen this Health Concern Act is a Social Determinant of Health Health Concern it **SHOULD** contain zero or more [0..*] entryRelationship subentries such that it contains an observation with an observation/value selected from ValueSet [Social Determinant of Health Conditions 2.16.840.1.113762.1.4.1196.788](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1196.788/expansion) **DYNAMIC** (CONF:4515-32962).
            Comments

            MAY contain zero or more [0..*] entryRelationship (CONF:4515-31549) such that it

            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
            SlicingThis element introduces a set of slices on Act.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • profile @ act
            • profile @ observation
            • profile @ organizer
            • value @ typeCode
            • 130. Act.entryRelationship:observations
              Slice Nameobservations
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
              132. Act.entryRelationship:observations.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              134. Act.entryRelationship:observations.realmCode
              Definition

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              136. Act.entryRelationship:observations.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
              138. Act.entryRelationship:observations.typeId.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              140. Act.entryRelationship:observations.typeId.assigningAuthorityName
              Definition

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelAssigning Authority Name
              142. Act.entryRelationship:observations.typeId.displayable
              Definition

              Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelDisplayable
              144. Act.entryRelationship:observations.typeId.root
              Definition

              Identifies the type as an HL7 Registered model

              Control1..1
              Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelRoot
              Fixed Value2.16.840.1.113883.1.3
              146. Act.entryRelationship:observations.typeId.extension
              Definition

              A character string as a unique identifier within the scope of the identifier root.

              Control1..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExtension
              148. Act.entryRelationship:observations.templateId
              Definition

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              150. Act.entryRelationship:observations.typeCode
              Control1..1
              BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
              (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed ValueREFR
              152. Act.entryRelationship:observations.inversionInd
              Definition

              The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              154. Act.entryRelationship:observations.contextConductionInd
              Definition

              The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Default Valuetrue
              156. Act.entryRelationship:observations.negationInd
              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              158. Act.entryRelationship:observations.sequenceNumber
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
              160. Act.entryRelationship:observations.seperatableInd
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
              162. Act.entryRelationship:observations.act
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
              164. Act.entryRelationship:observations.encounter
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
              166. Act.entryRelationship:observations.observation
              Control1..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Problem Observation, Allergy - Intolerance Observation, Assessment Scale Observation, Self-Care Activities (ADL and IADL), Mental Status Observation, Smoking Status - Meaningful Use (Deprecated), Functional Status Observation, Nutrition Assessment, Pregnancy Status Observation, Reaction Observation, Result Observation, Sensory Status, Social History Observation, Substance or Device Allergy - Intolerance Observation, Tobacco Use (Deprecated), Vital Sign Observation, Longitudinal Care Wound Observation, Problem Observation, Caregiver Characteristics, Cultural and Religious Observation, Characteristics of Home Environment, Nutritional Status Observation, Priority Preference)
              168. Act.entryRelationship:observations.observationMedia
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
              170. Act.entryRelationship:observations.organizer
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
              172. Act.entryRelationship:observations.procedure
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
              174. Act.entryRelationship:observations.regionOfInterest
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
              176. Act.entryRelationship:observations.substanceAdministration
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
              178. Act.entryRelationship:observations.supply
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
              180. Act.entryRelationship:acts
              Slice Nameacts
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
              182. Act.entryRelationship:acts.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              184. Act.entryRelationship:acts.realmCode
              Definition

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              186. Act.entryRelationship:acts.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
              188. Act.entryRelationship:acts.typeId.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              190. Act.entryRelationship:acts.typeId.assigningAuthorityName
              Definition

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelAssigning Authority Name
              192. Act.entryRelationship:acts.typeId.displayable
              Definition

              Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelDisplayable
              194. Act.entryRelationship:acts.typeId.root
              Definition

              Identifies the type as an HL7 Registered model

              Control1..1
              Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelRoot
              Fixed Value2.16.840.1.113883.1.3
              196. Act.entryRelationship:acts.typeId.extension
              Definition

              A character string as a unique identifier within the scope of the identifier root.

              Control1..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExtension
              198. Act.entryRelationship:acts.templateId
              Definition

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              200. Act.entryRelationship:acts.typeCode
              Control1..1
              BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
              (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed ValueREFR
              202. Act.entryRelationship:acts.inversionInd
              Definition

              The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              204. Act.entryRelationship:acts.contextConductionInd
              Definition

              The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Default Valuetrue
              206. Act.entryRelationship:acts.negationInd
              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              208. Act.entryRelationship:acts.sequenceNumber
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
              210. Act.entryRelationship:acts.seperatableInd
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
              212. Act.entryRelationship:acts.act
              Control1..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Encounter Diagnosis, Hospital Admission Diagnosis, Postprocedure Diagnosis, Preoperative Diagnosis)
              214. Act.entryRelationship:acts.encounter
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
              216. Act.entryRelationship:acts.observation
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
              218. Act.entryRelationship:acts.observationMedia
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
              220. Act.entryRelationship:acts.organizer
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
              222. Act.entryRelationship:acts.procedure
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
              224. Act.entryRelationship:acts.regionOfInterest
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
              226. Act.entryRelationship:acts.substanceAdministration
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
              228. Act.entryRelationship:acts.supply
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
              230. Act.entryRelationship:organizers
              Slice Nameorganizers
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
              232. Act.entryRelationship:organizers.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              234. Act.entryRelationship:organizers.realmCode
              Definition

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              236. Act.entryRelationship:organizers.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
              238. Act.entryRelationship:organizers.typeId.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              240. Act.entryRelationship:organizers.typeId.assigningAuthorityName
              Definition

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelAssigning Authority Name
              242. Act.entryRelationship:organizers.typeId.displayable
              Definition

              Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelDisplayable
              244. Act.entryRelationship:organizers.typeId.root
              Definition

              Identifies the type as an HL7 Registered model

              Control1..1
              Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelRoot
              Fixed Value2.16.840.1.113883.1.3
              246. Act.entryRelationship:organizers.typeId.extension
              Definition

              A character string as a unique identifier within the scope of the identifier root.

              Control1..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExtension
              248. Act.entryRelationship:organizers.templateId
              Definition

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              250. Act.entryRelationship:organizers.typeCode
              Control1..1
              BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
              (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed ValueREFR
              252. Act.entryRelationship:organizers.inversionInd
              Definition

              The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              254. Act.entryRelationship:organizers.contextConductionInd
              Definition

              The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Default Valuetrue
              256. Act.entryRelationship:organizers.negationInd
              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              258. Act.entryRelationship:organizers.sequenceNumber
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
              260. Act.entryRelationship:organizers.seperatableInd
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
              262. Act.entryRelationship:organizers.act
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
              264. Act.entryRelationship:organizers.encounter
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
              266. Act.entryRelationship:organizers.observation
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
              268. Act.entryRelationship:organizers.observationMedia
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
              270. Act.entryRelationship:organizers.organizer
              Control1..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer(Family History Organizer, Result Organizer)
              272. Act.entryRelationship:organizers.procedure
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
              274. Act.entryRelationship:organizers.regionOfInterest
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
              276. Act.entryRelationship:organizers.substanceAdministration
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
              278. Act.entryRelationship:organizers.supply
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
              280. Act.entryRelationship:related-entries
              Slice Namerelated-entries
              ShortWhere a Health Concern needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry. This may also be used to refer to other Health Concern Acts where there is a general relationship between the source and the target (Health Concern REFERS TO Health Concern). For example, a patient has 2 health concerns identified in a CARE Plan: Failure to Thrive and Poor Feeding; while it could be that one may have caused the other, at the time of care planning and documentation it is not necessary, nor desirable to have to assert what caused what. The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
              Comments

              MAY contain zero or more [0..*] entryRelationship (CONF:4515-31157) such that it

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
              282. Act.entryRelationship:related-entries.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              284. Act.entryRelationship:related-entries.realmCode
              Definition

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              286. Act.entryRelationship:related-entries.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
              288. Act.entryRelationship:related-entries.typeId.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              290. Act.entryRelationship:related-entries.typeId.assigningAuthorityName
              Definition

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelAssigning Authority Name
              292. Act.entryRelationship:related-entries.typeId.displayable
              Definition

              Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelDisplayable
              294. Act.entryRelationship:related-entries.typeId.root
              Definition

              Identifies the type as an HL7 Registered model

              Control1..1
              Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelRoot
              Fixed Value2.16.840.1.113883.1.3
              296. Act.entryRelationship:related-entries.typeId.extension
              Definition

              A character string as a unique identifier within the scope of the identifier root.

              Control1..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExtension
              298. Act.entryRelationship:related-entries.templateId
              Definition

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              300. Act.entryRelationship:related-entries.typeCode
              Comments

              SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-31158).

              Control1..1
              BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
              (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed ValueREFR
              302. Act.entryRelationship:related-entries.inversionInd
              Definition

              The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              304. Act.entryRelationship:related-entries.contextConductionInd
              Definition

              The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Default Valuetrue
              306. Act.entryRelationship:related-entries.negationInd
              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              308. Act.entryRelationship:related-entries.sequenceNumber
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
              310. Act.entryRelationship:related-entries.seperatableInd
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
              312. Act.entryRelationship:related-entries.act
              Comments

              SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32106).

              Control1..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
              314. Act.entryRelationship:related-entries.encounter
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
              316. Act.entryRelationship:related-entries.observation
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
              318. Act.entryRelationship:related-entries.observationMedia
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
              320. Act.entryRelationship:related-entries.organizer
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
              322. Act.entryRelationship:related-entries.procedure
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
              324. Act.entryRelationship:related-entries.regionOfInterest
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
              326. Act.entryRelationship:related-entries.substanceAdministration
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
              328. Act.entryRelationship:related-entries.supply
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
              330. Act.entryRelationship:component-health-concern-acts
              Slice Namecomponent-health-concern-acts
              ShortThe following entryRelationship represents the relationship between two Health Concern Acts where the target is a component of the source (Health Concern HAS COMPONENT Health Concern). For example, a patient has an Impaired Mobility Health Concern. There may then be the need to document several component health concerns, such as "Unable to Transfer Bed to Chair","Unable to Rise from Commode", "Short of Breath Walking with Walker". The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
              Comments

              MAY contain zero or more [0..*] entryRelationship (CONF:4515-31160) such that it

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
              Invariants4515-32745: The Entry Reference template **SHALL** contain an id that references a Health Concern Act (CONF:4515-32745). (%resource.descendants().ofType(CDA.Act).where(templateId.exists($this.root = '2.16.840.1.113883.10.20.22.4.132' and $this.extension = '2022-06-01') and id.exists($this.root = %context.act.id.first().root and $this.extension ~ %context.act.id.first().extension)))
              332. Act.entryRelationship:component-health-concern-acts.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              334. Act.entryRelationship:component-health-concern-acts.realmCode
              Definition

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              336. Act.entryRelationship:component-health-concern-acts.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
              338. Act.entryRelationship:component-health-concern-acts.typeId.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              340. Act.entryRelationship:component-health-concern-acts.typeId.assigningAuthorityName
              Definition

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelAssigning Authority Name
              342. Act.entryRelationship:component-health-concern-acts.typeId.displayable
              Definition

              Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelDisplayable
              344. Act.entryRelationship:component-health-concern-acts.typeId.root
              Definition

              Identifies the type as an HL7 Registered model

              Control1..1
              Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelRoot
              Fixed Value2.16.840.1.113883.1.3
              346. Act.entryRelationship:component-health-concern-acts.typeId.extension
              Definition

              A character string as a unique identifier within the scope of the identifier root.

              Control1..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExtension
              348. Act.entryRelationship:component-health-concern-acts.templateId
              Definition

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              350. Act.entryRelationship:component-health-concern-acts.typeCode
              Comments

              SHALL contain exactly one [1..1] @typeCode="COMP" Has component (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-31161).

              Control1..1
              BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
              (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed ValueCOMP
              352. Act.entryRelationship:component-health-concern-acts.inversionInd
              Definition

              The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              354. Act.entryRelationship:component-health-concern-acts.contextConductionInd
              Definition

              The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Default Valuetrue
              356. Act.entryRelationship:component-health-concern-acts.negationInd
              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              358. Act.entryRelationship:component-health-concern-acts.sequenceNumber
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
              360. Act.entryRelationship:component-health-concern-acts.seperatableInd
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
              362. Act.entryRelationship:component-health-concern-acts.act
              Comments

              SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32107).

              Control1..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
              364. Act.entryRelationship:component-health-concern-acts.encounter
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
              366. Act.entryRelationship:component-health-concern-acts.observation
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation
              368. Act.entryRelationship:component-health-concern-acts.observationMedia
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
              370. Act.entryRelationship:component-health-concern-acts.organizer
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
              372. Act.entryRelationship:component-health-concern-acts.procedure
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
              374. Act.entryRelationship:component-health-concern-acts.regionOfInterest
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
              376. Act.entryRelationship:component-health-concern-acts.substanceAdministration
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
              378. Act.entryRelationship:component-health-concern-acts.supply
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
              380. Act.reference
              ShortWhere it is necessary to reference an external clinical document such as a Referral document, Discharge Summary document etc., the External Document Reference template can be used to reference this document. However, if this Care Plan document is replacing or appending another Care Plan document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.
              Comments

              MAY contain zero or more [0..*] reference (CONF:4515-32757).

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
              382. Act.reference.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              384. Act.reference.realmCode
              Definition

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              386. Act.reference.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
              388. Act.reference.typeId.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              390. Act.reference.typeId.assigningAuthorityName
              Definition

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelAssigning Authority Name
              392. Act.reference.typeId.displayable
              Definition

              Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelDisplayable
              394. Act.reference.typeId.root
              Definition

              Identifies the type as an HL7 Registered model

              Control1..1
              Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelRoot
              Fixed Value2.16.840.1.113883.1.3
              396. Act.reference.typeId.extension
              Definition

              A character string as a unique identifier within the scope of the identifier root.

              Control1..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExtension
              398. Act.reference.templateId
              Definition

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              400. Act.reference.typeCode
              Comments

              The reference, if present, SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32758).

              Control1..1
              BindingThe codes SHALL be taken from x_ActRelationshipExternalReference
              (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed ValueREFR
              402. Act.reference.seperatableInd
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
              404. Act.reference.externalAct
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalAct
              406. Act.reference.externalObservation
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalObservation
              408. Act.reference.externalProcedure
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalProcedure
              410. Act.reference.externalDocument
              Shorticon Removed:Base for all types and resources
              Comments

              The reference, if present, SHALL contain exactly one [1..1] External Document Reference (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.115:2014-06-09) (CONF:4515-32759).

              Control1..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument(External Document Reference)
              412. Act.precondition
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
              414. Act.sdtcPrecondition2
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition2
              XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameprecondition2.
              416. Act.sdtcInFulfillmentOf1
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
              XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameinFulfillmentOf1.