This page is part of the CCDA: Consolidated CDA Release (v3.0.0: CCDA 3.0) generated with FHIR (HL7® FHIR® Standard) v5.0.0. This is the current published version. For a full list of available versions, see the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON

Logical Model: Self-Care Activities (ADL and IADL)

This template represents a patient’s daily self-care ability. These activities are called Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). ADLs involve caring for and moving of the body (e.g., dressing, bathing, eating). IADLs support an independent life style (e.g., cooking, managing medications, driving, shopping).

Usage:

• Use this Logical Model: Functional Status Organizer, Functional Status Section, Health Concern Act and Risk Concern Act

Formal Views of Template Content

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

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation	C	1..1	Observation	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root
templateId:self-care-activities		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.128
@extension		0..0
@classCode		1..1	cs	Fixed Value: OBS
@moodCode		1..1	cs	Fixed Value: EVN
code		1..1	CD	If more detailed ADL and IADL activities need to be recorded select the appropriate code from LOINC. Binding: ADL Result Type (preferred)
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
statusCode		1..1	CS
@code		1..1	cs	Fixed Value: completed
effectiveTime		1..1	IVL_TS
value		1..1	CD	Binding: Ability (preferred)
author		0..*	AuthorParticipation	Base for all types and resources
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.code	preferred	ADLResultType http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.47 from https://vsac.nlm.nih.gov
Observation.value	preferred	Ability http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.46 from https://vsac.nlm.nih.gov

Constraints

Id	Grade	Path(s)	Details	Requirements
should-author	warning	Observation	SHOULD contain author : author.exists()
should-text-ref-value	warning	Observation	SHOULD contain text/reference/@value : text.reference.value.exists()
value-starts-octothorpe	error	Observation.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Name	Flags	Card.	Type	Description & Constraints
Observation	C	1..1	Observation	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root
templateId:self-care-activities		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.128
@classCode		1..1	cs	Binding: CDAActClassObservation (required) Fixed Value: OBS
@moodCode		1..1	cs	Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN
code		1..1	CD	If more detailed ADL and IADL activities need to be recorded select the appropriate code from LOINC. Binding: ADL Result Type (preferred)
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
statusCode		1..1	CS	Binding: ActStatus (required)
@code		1..1	cs	Fixed Value: completed
effectiveTime		1..1	IVL_TS
value		1..1	CD	Binding: Ability (preferred)
author		0..*	AuthorParticipation	Base for all types and resources
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.classCode	required	Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
Observation.moodCode	required	Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
Observation.code	preferred	ADLResultType http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.47 from https://vsac.nlm.nih.gov
Observation.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
Observation.value	preferred	Ability http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.46 from https://vsac.nlm.nih.gov

Constraints

Id	Grade	Path(s)	Details	Requirements
should-author	warning	Observation	SHOULD contain author : author.exists()
should-text-ref-value	warning	Observation	SHOULD contain text/reference/@value : text.reference.value.exists()
value-starts-octothorpe	error	Observation.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Name	Flags	Card.	Type	Description & Constraints
Observation	C	1..1	Observation	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root
templateId:self-care-activities		1..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.128
@classCode		1..1	cs	Binding: CDAActClassObservation (required) Fixed Value: OBS
@moodCode		1..1	cs	Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN
@negationInd		0..1	bl
id		0..*	II
code		1..1	CD	If more detailed ADL and IADL activities need to be recorded select the appropriate code from LOINC. Binding: ADL Result Type (preferred)
derivationExpr		0..1	ST
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@compression		0..1	cs	Binding: CDACompressionAlgorithm (required)
@integrityCheck		0..1	bin
@integrityCheckAlgorithm		0..1	cs	Binding: IntegrityCheckAlgorithm (2.0.0) (required)
@language		0..1	cs
@mediaType		0..1	cs	Binding: MediaType (example)
@representation		0..1	cs	Binding: CDABinaryDataEncoding (required)
xmlText		0..1	st	Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
thumbnail		0..1	ED
statusCode		1..1	CS	Binding: ActStatus (required)
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@code		1..1	cs	Fixed Value: completed
@sdtcValueSet		0..1	oid	XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion		0..1	st	XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
effectiveTime		1..1	IVL_TS
priorityCode		0..1	CE	Binding: ActPriority (example)
repeatNumber		0..1	IVL_INT
languageCode		0..1	CS	Binding: AllLanguages (required)
value		1..1	CD	Binding: Ability (preferred)
interpretationCode		0..*	CE	Binding: CDAObservationInterpretation (required)
methodCode		0..*	CE	Binding: ObservationMethod (example)
targetSiteCode		0..*	CD
subject		0..1	Subject
specimen		0..*	Specimen
performer		0..*	Performer2
author		0..*	AuthorParticipation	Base for all types and resources
informant		0..*	Informant
participant		0..*	Participant2
entryRelationship		0..*	EntryRelationship
reference		0..*	Reference
precondition		0..*	Precondition
sdtcPrecondition2		0..*	Precondition2	XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc)
referenceRange		0..*	InfrastructureRoot
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		0..1	cs	Binding: CDAActRelationshipType (required) Fixed Value: REFV
observationRange		1..1	ObservationRange
sdtcInFulfillmentOf1		0..*	InFulfillmentOf1	XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.templateId:self-care-activities.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.classCode	required	Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
Observation.moodCode	required	Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
Observation.code	preferred	ADLResultType http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.47 from https://vsac.nlm.nih.gov
Observation.text.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.text.compression	required	CDACompressionAlgorithm http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Observation.text.integrityCheckAlgorithm	required	IntegrityCheckAlgorithm http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Observation.text.mediaType	example	MediaType http://terminology.hl7.org/ValueSet/v3-MediaType
Observation.text.representation	required	BinaryDataEncoding http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Observation.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
Observation.statusCode.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.priorityCode	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
Observation.languageCode	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages from the FHIR Standard
Observation.value	preferred	Ability http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.46 from https://vsac.nlm.nih.gov
Observation.interpretationCode	required	CDAObservationInterpretation http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation
Observation.methodCode	example	ObservationMethod http://terminology.hl7.org/ValueSet/v3-ObservationMethod
Observation.referenceRange.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.referenceRange.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.referenceRange.typeCode	required	Fixed Value: REFV http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType

Constraints

Id	Grade	Path(s)	Details	Requirements
should-author	warning	Observation	SHOULD contain author : author.exists()
should-text-ref-value	warning	Observation	SHOULD contain text/reference/@value : text.reference.value.exists()
value-starts-octothorpe	error	Observation.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

This structure is derived from Observation

Summary

Mandatory: 7 elements
Fixed: 3 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

• Author Participation (http://hl7.org/cda/us/ccda/StructureDefinition/AuthorParticipation)

Slices

This structure defines the following Slices:

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

Differential View

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation	C	1..1	Observation	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root
templateId:self-care-activities		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.128
@extension		0..0
@classCode		1..1	cs	Fixed Value: OBS
@moodCode		1..1	cs	Fixed Value: EVN
code		1..1	CD	If more detailed ADL and IADL activities need to be recorded select the appropriate code from LOINC. Binding: ADL Result Type (preferred)
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
statusCode		1..1	CS
@code		1..1	cs	Fixed Value: completed
effectiveTime		1..1	IVL_TS
value		1..1	CD	Binding: Ability (preferred)
author		0..*	AuthorParticipation	Base for all types and resources
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.code	preferred	ADLResultType http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.47 from https://vsac.nlm.nih.gov
Observation.value	preferred	Ability http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.46 from https://vsac.nlm.nih.gov

Constraints

Id	Grade	Path(s)	Details	Requirements
should-author	warning	Observation	SHOULD contain author : author.exists()
should-text-ref-value	warning	Observation	SHOULD contain text/reference/@value : text.reference.value.exists()
value-starts-octothorpe	error	Observation.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	1..1	Observation	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root
templateId:self-care-activities		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.128
@classCode		1..1	cs	Binding: CDAActClassObservation (required) Fixed Value: OBS
@moodCode		1..1	cs	Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN
code		1..1	CD	If more detailed ADL and IADL activities need to be recorded select the appropriate code from LOINC. Binding: ADL Result Type (preferred)
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
statusCode		1..1	CS	Binding: ActStatus (required)
@code		1..1	cs	Fixed Value: completed
effectiveTime		1..1	IVL_TS
value		1..1	CD	Binding: Ability (preferred)
author		0..*	AuthorParticipation	Base for all types and resources
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.classCode	required	Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
Observation.moodCode	required	Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
Observation.code	preferred	ADLResultType http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.47 from https://vsac.nlm.nih.gov
Observation.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
Observation.value	preferred	Ability http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.46 from https://vsac.nlm.nih.gov

Constraints

Id	Grade	Path(s)	Details	Requirements
should-author	warning	Observation	SHOULD contain author : author.exists()
should-text-ref-value	warning	Observation	SHOULD contain text/reference/@value : text.reference.value.exists()
value-starts-octothorpe	error	Observation.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	1..1	Observation	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors:@nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-author: SHOULD contain author
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root
templateId:self-care-activities		1..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.128
@classCode		1..1	cs	Binding: CDAActClassObservation (required) Fixed Value: OBS
@moodCode		1..1	cs	Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN
@negationInd		0..1	bl
id		0..*	II
code		1..1	CD	If more detailed ADL and IADL activities need to be recorded select the appropriate code from LOINC. Binding: ADL Result Type (preferred)
derivationExpr		0..1	ST
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@compression		0..1	cs	Binding: CDACompressionAlgorithm (required)
@integrityCheck		0..1	bin
@integrityCheckAlgorithm		0..1	cs	Binding: IntegrityCheckAlgorithm (2.0.0) (required)
@language		0..1	cs
@mediaType		0..1	cs	Binding: MediaType (example)
@representation		0..1	cs	Binding: CDABinaryDataEncoding (required)
xmlText		0..1	st	Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
thumbnail		0..1	ED
statusCode		1..1	CS	Binding: ActStatus (required)
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@code		1..1	cs	Fixed Value: completed
@sdtcValueSet		0..1	oid	XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion		0..1	st	XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
effectiveTime		1..1	IVL_TS
priorityCode		0..1	CE	Binding: ActPriority (example)
repeatNumber		0..1	IVL_INT
languageCode		0..1	CS	Binding: AllLanguages (required)
value		1..1	CD	Binding: Ability (preferred)
interpretationCode		0..*	CE	Binding: CDAObservationInterpretation (required)
methodCode		0..*	CE	Binding: ObservationMethod (example)
targetSiteCode		0..*	CD
subject		0..1	Subject
specimen		0..*	Specimen
performer		0..*	Performer2
author		0..*	AuthorParticipation	Base for all types and resources
informant		0..*	Informant
participant		0..*	Participant2
entryRelationship		0..*	EntryRelationship
reference		0..*	Reference
precondition		0..*	Precondition
sdtcPrecondition2		0..*	Precondition2	XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc)
referenceRange		0..*	InfrastructureRoot
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		0..1	cs	Binding: CDAActRelationshipType (required) Fixed Value: REFV
observationRange		1..1	ObservationRange
sdtcInFulfillmentOf1		0..*	InFulfillmentOf1	XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.templateId:self-care-activities.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.classCode	required	Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
Observation.moodCode	required	Fixed Value: EVN http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
Observation.code	preferred	ADLResultType http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.47 from https://vsac.nlm.nih.gov
Observation.text.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.text.compression	required	CDACompressionAlgorithm http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Observation.text.integrityCheckAlgorithm	required	IntegrityCheckAlgorithm http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Observation.text.mediaType	example	MediaType http://terminology.hl7.org/ValueSet/v3-MediaType
Observation.text.representation	required	BinaryDataEncoding http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Observation.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
Observation.statusCode.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.priorityCode	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
Observation.languageCode	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages from the FHIR Standard
Observation.value	preferred	Ability http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.46 from https://vsac.nlm.nih.gov
Observation.interpretationCode	required	CDAObservationInterpretation http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation
Observation.methodCode	example	ObservationMethod http://terminology.hl7.org/ValueSet/v3-ObservationMethod
Observation.referenceRange.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.referenceRange.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.referenceRange.typeCode	required	Fixed Value: REFV http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType

Constraints

Id	Grade	Path(s)	Details	Requirements
should-author	warning	Observation	SHOULD contain author : author.exists()
should-text-ref-value	warning	Observation	SHOULD contain text/reference/@value : text.reference.value.exists()
value-starts-octothorpe	error	Observation.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

This structure is derived from Observation

Summary

Mandatory: 7 elements
Fixed: 3 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

• Author Participation (http://hl7.org/cda/us/ccda/StructureDefinition/AuthorParticipation)

Slices

This structure defines the following Slices:

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

Other representations of profile: CSV, Excel