Consolidated CDA Release 2.2
2.2 - CI Build United States of America flag

Consolidated CDA Release 2.2, published by Health Level Seven. This is not an authorized publication; it is the continuous build for version 2.2). This version is based on the current content of https://github.com/HL7/CDA-ccda-2.2/ and changes regularly. See the Directory of published versions

Resource Profile: Advance Directive Observation

Official URL: http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.48 Version: 2.2
Active as of 2022-05-13 Computable Name: AdvanceDirectiveObservation
Other Identifiers: : urn:hl7ii:2.16.840.1.113883.10.20.22.4.48:2015-08-01

This clinical statement represents Advance Directive Observation findings (e.g., resuscitation status is Full Code) rather than orders. It should not be considered a legal document or a substitute for the actual Advance Directive document. The related legal documents are referenced using the reference/externalReference element. The Advance Directive Observation describes the patients directives, including but not limited to: Medications Transfer of Care to Hospital Treatment Procedures Intubation and Ventilation Diagnostic Tests Tests

The observation/value element contains the detailed patient directive which may be coded or text. For example, a category directive may be antibiotics, and the details would be intravenous antibiotics only.

Usage:

Formal Views of Profile Content

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

This structure is derived from CDAR2.Observation

Summary

Mandatory: 20 elements (9 nested mandatory elements)

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element Observation.templateId is sliced based on the values of value:root, value:extension
  • The element Observation.code.translation is sliced based on the values of value:code, value:codeSystem
  • There is a slice with no discriminator at Observation.value
  • The element Observation.participant is sliced based on the values of value:participantRole, value:typeCode
  • The element Observation.participant.templateId is sliced based on the value of value:root
  • The element Observation.reference is sliced based on the values of value:externalDocument, value:typeCode

This structure is derived from CDAR2.Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 1..1CDAR2.Observation
... classCode 1..1codeRequired Pattern: OBS
... moodCode 1..1codeRequired Pattern: EVN
... Slices for templateId 0..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:primary 1..1II
..... root 1..1stringRequired Pattern: 2.16.840.1.113883.10.20.22.4.48
..... extension 1..1stringRequired Pattern: 2015-08-01
... code 1..1CDBinding: Advance Directive Type Code (preferred)
.... Slices for translation 0..*CDSlice: Unordered, Open by value:code, value:codeSystem
..... translation:advanceDirective 1..1CD
...... code 1..1stringRequired Pattern: 75320-2
...... codeSystem 1..1stringRequired Pattern: 2.16.840.1.113883.6.1
... statusCode 1..1CSRequired Pattern: Completed
.... code 1..1stringRequired Pattern: completed
... effectiveTime 1..1IVL_TS
.... low 1..1TS
.... high I1..1TS1198-32449: If the Advance Directive does not have a specified ending time, the <high> element **SHALL** have the nullFlavor attribute set to *NA* (CONF:1198-32449).
... Slices for value 0..*BL, ED, ED, CD, CV, CE, SC, II, TEL, AD, EN, INT, REAL, PQ, MO, TS, IVL_PQ, IVL_TS, PIVL_TS, EIVL_TS, SXPR_TS, RTO_PQ_PQSlice: Unordered, Open by
.... value:value1 I1..1BL, ED, ED, CD, CV, CE, SC, II, TEL, AD, EN, INT, REAL, PQ, MO, TS, IVL_PQ, IVL_TS, PIVL_TS, EIVL_TS, SXPR_TS, RTO_PQ_PQ1198-32493: If type CD, then value will be SNOMED-CT 2.16.840.1.113883.6.96 (CONF:1198-32493).
... author 0..*AuthorParticipation
... Slices for participant 0..*Participant2This custodian (CST) participant identifies a legal representative for the patient's advance directive. Examples of such individuals are called health care agents, substitute decision makers and/or health care proxies. If there is more than one legal representative, a qualifier may be used to designate the legal representative as primary or secondary.
Slice: Unordered, Open by value:participantRole, value:typeCode
.... participant:participant1 0..*Participant2The participant "VRF" represents the clinician(s) who verified the patient advance directive observation.
..... typeCode 1..1codeRequired Pattern: VRF
..... Slices for templateId 0..*IISlice: Unordered, Open by value:root
...... templateId:primary 1..1II
....... root 1..1stringRequired Pattern: 2.16.840.1.113883.10.20.1.58
..... time I0..1IVL_TS1198-8666: The data type of Observation/participant/time in a verification **SHALL** be *TS* (time stamp) (CONF:1198-8666).
..... participantRole 1..1ParticipantRole
...... code 0..1CEBinding: Healthcare Provider Taxonomy (preferred)
...... addr 0..*USRealmAddressADUSFIELDED
...... playingEntity 0..1PlayingEntity
....... name 0..*USRealmPersonNamePNUSFIELDED
.... participant:participant2 0..*Participant2
..... typeCode 1..1codeRequired Pattern: CST
..... participantRole 1..1ParticipantRole
...... classCode 1..1codeRequired Pattern: AGNT
...... code 0..1CEBinding: Personal And Legal Relationship Role Type (preferred)
...... addr 0..1USRealmAddressADUSFIELDED
...... telecom 0..*TEL
...... playingEntity 1..1PlayingEntity
....... code 0..1CEBinding: Healthcare Agent Qualifier (preferred)
....... name 1..1ENRecord the name of the agent who can provide a copy of the Advance Directive in the name element.
... Slices for reference 0..*ElementSlice: Unordered, Open by value:externalDocument, value:typeCode
.... reference:reference1 1..*Element
..... typeCode 1..1codeRequired Pattern: REFR
..... externalDocument 1..1ExternalDocument
...... id 1..*II
...... text 0..1ED
....... reference I0..1TEL1198-8698: The URL of a referenced advance directive document **MAY** be present, and **SHALL** be represented in Observation/reference/ExternalDocument/text/reference (CONF:1198-8698).
1198-8699: If a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699).

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 1..1CDAR2.Observation
... classCode 1..1codeBinding: ActClassObservation (required)
Required Pattern: OBS
... moodCode 1..1codeRequired Pattern: EVN
... negationInd 0..1boolean
... realmCode 0..*CS
... typeId 0..1II
... Slices for templateId 0..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:primary 1..1II
..... nullFlavor 0..1codeBinding: NullFlavor (required)
..... assigningAuthorityName 0..1string
..... displayable 0..1boolean
..... root 1..1stringRequired Pattern: 2.16.840.1.113883.10.20.22.4.48
..... extension 1..1stringRequired Pattern: 2015-08-01
... id 1..*II
... code 1..1CDBinding: Advance Directive Type Code (preferred)
.... nullFlavor 0..1codeBinding: NullFlavor (required)
.... code 0..1string
.... codeSystem 0..1string
.... codeSystemName 0..1string
.... codeSystemVersion 0..1string
.... displayName 0..1string
.... sdtcValueSet 0..1stringXML: valueSet (urn:hl7-org:sdtc)
.... sdtcValueSetVersion 0..1stringXML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1ED
.... qualifier 0..*CR
.... Slices for translation 0..*CDSlice: Unordered, Open by value:code, value:codeSystem
..... translation:advanceDirective 1..1CD
...... nullFlavor 0..1codeBinding: NullFlavor (required)
...... code 1..1stringRequired Pattern: 75320-2
...... codeSystem 1..1stringRequired Pattern: 2.16.840.1.113883.6.1
...... codeSystemName 0..1string
...... codeSystemVersion 0..1string
...... displayName 0..1string
...... sdtcValueSet 0..1stringXML: valueSet (urn:hl7-org:sdtc)
...... sdtcValueSetVersion 0..1stringXML: valueSetVersion (urn:hl7-org:sdtc)
...... originalText 0..1ED
...... qualifier 0..*CR
...... translation 0..*CD
... derivationExpr 0..1ED
... text 0..1ED
... statusCode 1..1CSBinding: ActStatus (required)
Required Pattern: Completed
.... nullFlavor 0..1codeBinding: NullFlavor (required)
.... code 1..1stringRequired Pattern: completed
.... sdtcValueSet 0..1stringXML: valueSet (urn:hl7-org:sdtc)
.... sdtcValueSetVersion 0..1stringXML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 1..1IVL_TS
.... nullFlavor 0..1codeBinding: NullFlavor (required)
.... value 0..1dateTime
.... inclusive 0..1boolean
.... operator 0..1code
.... low 1..1TS
.... high I1..1TS1198-32449: If the Advance Directive does not have a specified ending time, the <high> element **SHALL** have the nullFlavor attribute set to *NA* (CONF:1198-32449).
.... width 0..1PQ
.... center 0..1TS
... priorityCode 0..1CEBinding: ActPriority (extensible)
... repeatNumber 0..1IVL_INT
... languageCode 0..1CSBinding: HumanLanguage (required)
... Slices for value 0..*Slice: Unordered, Open by
.... valueBL
.... valueED
.... valueED
.... valueCD
.... valueCV
.... valueCE
.... valueSC
.... valueII
.... valueTEL
.... valueAD
.... valueEN
.... valueINT
.... valueREAL
.... valuePQ
.... valueMO
.... valueTS
.... valueIVL_PQ
.... valueIVL_TS
.... valuePIVL_TS
.... valueEIVL_TS
.... valueSXPR_TS
.... valueRTO_PQ_PQ
.... value:value1 I1..11198-32493: If type CD, then value will be SNOMED-CT 2.16.840.1.113883.6.96 (CONF:1198-32493).
..... valueBL
..... valueED
..... valueED
..... valueCD
..... valueCV
..... valueCE
..... valueSC
..... valueII
..... valueTEL
..... valueAD
..... valueEN
..... valueINT
..... valueREAL
..... valuePQ
..... valueMO
..... valueTS
..... valueIVL_PQ
..... valueIVL_TS
..... valuePIVL_TS
..... valueEIVL_TS
..... valueSXPR_TS
..... valueRTO_PQ_PQ
... interpretationCode 0..*CEBinding: ObservationInterpretation (required)
... methodCode 0..*CEBinding: ObservationMethod (extensible)
... targetSiteCode 0..*CD
... subject 0..1Element
.... typeCode 1..1codeBinding: ParticipationTargetSubject (required)
Fixed Value: SBJ
.... contextControlCode 1..1codeBinding: ContextControl (required)
Fixed Value: OP
.... awarenessCode 0..1CEBinding: TargetAwareness (extensible)
.... relatedSubject 1..1RelatedSubject
... specimen 0..*Specimen
... performer 0..*Performer2
... author 0..*AuthorParticipation
... informant 0..*Element
.... typeCode 1..1codeBinding: ParticipationInformationGenerator (required)
Fixed Value: INF
.... contextControlCode 1..1codeBinding: ContextControl (required)
Fixed Value: OP
.... assignedEntity 0..1AssignedEntity
.... relatedEntity 0..1RelatedEntity
... Slices for participant 0..*Participant2This custodian (CST) participant identifies a legal representative for the patient's advance directive. Examples of such individuals are called health care agents, substitute decision makers and/or health care proxies. If there is more than one legal representative, a qualifier may be used to designate the legal representative as primary or secondary.
Slice: Unordered, Open by value:participantRole, value:typeCode
.... participant:participant1 0..*Participant2The participant "VRF" represents the clinician(s) who verified the patient advance directive observation.
..... nullFlavor 0..1codeBinding: NullFlavor (required)
..... typeCode 1..1codeBinding: ParticipationType (required)
Required Pattern: VRF
..... contextControlCode 0..1codeBinding: ContextControl (required)
Fixed Value: OP
..... realmCode 0..*CS
..... typeId 0..1II
..... Slices for templateId 0..*IISlice: Unordered, Open by value:root
...... templateId:primary 1..1II
....... nullFlavor 0..1codeBinding: NullFlavor (required)
....... assigningAuthorityName 0..1string
....... displayable 0..1boolean
....... root 1..1stringRequired Pattern: 2.16.840.1.113883.10.20.1.58
....... extension 0..1string
..... sdtcFunctionCode 0..1CEXML: functionCode (urn:hl7-org:sdtc)
..... time I0..1IVL_TS1198-8666: The data type of Observation/participant/time in a verification **SHALL** be *TS* (time stamp) (CONF:1198-8666).
..... awarenessCode 0..1CE
..... participantRole 1..1ParticipantRole
...... classCode 1..1codeBinding: RoleClassRoot (required)
...... templateId 0..*II
...... id 0..*II
...... sdtcIdentifiedBy 0..*IdentifiedByXML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1CEBinding: Healthcare Provider Taxonomy (preferred)
...... addr I0..*USRealmAddressADUSFIELDED
...... telecom 0..*TEL
...... playingDevice 0..1Device
...... playingEntity 0..1PlayingEntity
....... classCode 1..1codeBinding: EntityClassRoot (required)
....... determinerCode 1..1codeBinding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... templateId 0..*II
....... code 0..1CEBinding: EntityCode (extensible)
....... quantity 0..*PQ
....... name I0..*USRealmPersonNamePNUSFIELDED
....... desc 0..1ED
...... scopingEntity 0..1Entity
.... participant:participant2 0..*Participant2
..... nullFlavor 0..1codeBinding: NullFlavor (required)
..... typeCode 1..1codeBinding: ParticipationType (required)
Required Pattern: CST
..... contextControlCode 0..1codeBinding: ContextControl (required)
Fixed Value: OP
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 0..*II
..... sdtcFunctionCode 0..1CEXML: functionCode (urn:hl7-org:sdtc)
..... time 0..1IVL_TS
..... awarenessCode 0..1CE
..... participantRole 1..1ParticipantRole
...... classCode 1..1codeBinding: RoleClassRoot (required)
Required Pattern: AGNT
...... templateId 0..*II
...... id 0..*II
...... sdtcIdentifiedBy 0..*IdentifiedByXML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1CEBinding: Personal And Legal Relationship Role Type (preferred)
...... addr I0..1USRealmAddressADUSFIELDED
...... telecom 0..*TEL
...... playingDevice 0..1Device
...... playingEntity 1..1PlayingEntity
....... classCode 1..1codeBinding: EntityClassRoot (required)
....... determinerCode 1..1codeBinding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... templateId 0..*II
....... code 0..1CEBinding: Healthcare Agent Qualifier (preferred)
....... quantity 0..*PQ
....... name 1..1ENRecord the name of the agent who can provide a copy of the Advance Directive in the name element.
....... desc 0..1ED
...... scopingEntity 0..1Entity
... entryRelationship I0..*Element
.... typeCode 1..1code
.... inversionInd 0..1boolean
.... contextConductionInd 1..1boolean
.... sequenceNumber 0..1INT
.... negationInd 0..1boolean
.... seperatableInd 0..1BL
.... (Choice of one) 1..1
..... observation 0..1Observation
..... regionOfInterest 0..1RegionOfInterest
..... observationMedia 0..1ObservationMedia
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
..... procedure 0..1Procedure
..... encounter 0..1Encounter
..... organizer 0..1Organizer
..... act 0..1Act
... Slices for reference 0..*ElementSlice: Unordered, Open by value:externalDocument, value:typeCode
.... reference:All Slices Content/Rules for all slices
..... typeCode 1..1code
..... seperatableInd 0..1BL
..... externalAct 0..1ExternalAct
..... externalObservation 0..1ExternalObservation
..... externalProcedure 0..1ExternalProcedure
..... externalDocument 0..1ExternalDocument
.... reference:reference1 1..*Element
..... typeCode 1..1codeRequired Pattern: REFR
..... seperatableInd 0..1BL
..... externalAct 0..1ExternalAct
..... externalObservation 0..1ExternalObservation
..... externalProcedure 0..1ExternalProcedure
..... externalDocument 1..1ExternalDocument
...... classCode 1..1codeBinding: ActClassDocument (required)
...... moodCode 1..1codeBinding: ActMood (required)
Fixed Value: EVN
...... templateId 0..*II
...... id 1..*II
...... code 0..1CD​Binding: http://terminology.hl7.org/ValueSet/v3-DocumentType (extensible)
...... text 0..1ED
....... nullFlavor 0..1codeBinding: NullFlavor (required)
....... charset 0..1code
....... compression 0..1codeBinding: CompressionAlgorithm (required)
....... integrityCheck 0..1base64Binary
....... integrityCheckAlgorithm 0..1codeBinding: IntegrityCheckAlgorithm (required)
....... language 0..1code
....... mediaType 0..1code
....... representation 0..1code
....... data[x] 0..1
........ dataStringstring
........ dataBase64Binarybase64Binary
....... reference I0..1TEL1198-8698: The URL of a referenced advance directive document **MAY** be present, and **SHALL** be represented in Observation/reference/ExternalDocument/text/reference (CONF:1198-8698).
1198-8699: If a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699).
....... thumbnail 0..1ED
...... setId 0..1II
...... versionNumber 0..1INT
... precondition 0..*Precondition
... referenceRange 0..*Element
.... typeCode 1..1codeBinding: ActRelationshipPertains (required)
Fixed Value: REFV
.... observationRange 1..1ObservationRange

doco Documentation for this format

This structure is derived from CDAR2.Observation

Summary

Mandatory: 20 elements (9 nested mandatory elements)

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element Observation.templateId is sliced based on the values of value:root, value:extension
  • The element Observation.code.translation is sliced based on the values of value:code, value:codeSystem
  • There is a slice with no discriminator at Observation.value
  • The element Observation.participant is sliced based on the values of value:participantRole, value:typeCode
  • The element Observation.participant.templateId is sliced based on the value of value:root
  • The element Observation.reference is sliced based on the values of value:externalDocument, value:typeCode

Differential View

This structure is derived from CDAR2.Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 1..1CDAR2.Observation
... classCode 1..1codeRequired Pattern: OBS
... moodCode 1..1codeRequired Pattern: EVN
... Slices for templateId 0..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:primary 1..1II
..... root 1..1stringRequired Pattern: 2.16.840.1.113883.10.20.22.4.48
..... extension 1..1stringRequired Pattern: 2015-08-01
... code 1..1CDBinding: Advance Directive Type Code (preferred)
.... Slices for translation 0..*CDSlice: Unordered, Open by value:code, value:codeSystem
..... translation:advanceDirective 1..1CD
...... code 1..1stringRequired Pattern: 75320-2
...... codeSystem 1..1stringRequired Pattern: 2.16.840.1.113883.6.1
... statusCode 1..1CSRequired Pattern: Completed
.... code 1..1stringRequired Pattern: completed
... effectiveTime 1..1IVL_TS
.... low 1..1TS
.... high I1..1TS1198-32449: If the Advance Directive does not have a specified ending time, the <high> element **SHALL** have the nullFlavor attribute set to *NA* (CONF:1198-32449).
... Slices for value 0..*BL, ED, ED, CD, CV, CE, SC, II, TEL, AD, EN, INT, REAL, PQ, MO, TS, IVL_PQ, IVL_TS, PIVL_TS, EIVL_TS, SXPR_TS, RTO_PQ_PQSlice: Unordered, Open by
.... value:value1 I1..1BL, ED, ED, CD, CV, CE, SC, II, TEL, AD, EN, INT, REAL, PQ, MO, TS, IVL_PQ, IVL_TS, PIVL_TS, EIVL_TS, SXPR_TS, RTO_PQ_PQ1198-32493: If type CD, then value will be SNOMED-CT 2.16.840.1.113883.6.96 (CONF:1198-32493).
... author 0..*AuthorParticipation
... Slices for participant 0..*Participant2This custodian (CST) participant identifies a legal representative for the patient's advance directive. Examples of such individuals are called health care agents, substitute decision makers and/or health care proxies. If there is more than one legal representative, a qualifier may be used to designate the legal representative as primary or secondary.
Slice: Unordered, Open by value:participantRole, value:typeCode
.... participant:participant1 0..*Participant2The participant "VRF" represents the clinician(s) who verified the patient advance directive observation.
..... typeCode 1..1codeRequired Pattern: VRF
..... Slices for templateId 0..*IISlice: Unordered, Open by value:root
...... templateId:primary 1..1II
....... root 1..1stringRequired Pattern: 2.16.840.1.113883.10.20.1.58
..... time I0..1IVL_TS1198-8666: The data type of Observation/participant/time in a verification **SHALL** be *TS* (time stamp) (CONF:1198-8666).
..... participantRole 1..1ParticipantRole
...... code 0..1CEBinding: Healthcare Provider Taxonomy (preferred)
...... addr 0..*USRealmAddressADUSFIELDED
...... playingEntity 0..1PlayingEntity
....... name 0..*USRealmPersonNamePNUSFIELDED
.... participant:participant2 0..*Participant2
..... typeCode 1..1codeRequired Pattern: CST
..... participantRole 1..1ParticipantRole
...... classCode 1..1codeRequired Pattern: AGNT
...... code 0..1CEBinding: Personal And Legal Relationship Role Type (preferred)
...... addr 0..1USRealmAddressADUSFIELDED
...... telecom 0..*TEL
...... playingEntity 1..1PlayingEntity
....... code 0..1CEBinding: Healthcare Agent Qualifier (preferred)
....... name 1..1ENRecord the name of the agent who can provide a copy of the Advance Directive in the name element.
... Slices for reference 0..*ElementSlice: Unordered, Open by value:externalDocument, value:typeCode
.... reference:reference1 1..*Element
..... typeCode 1..1codeRequired Pattern: REFR
..... externalDocument 1..1ExternalDocument
...... id 1..*II
...... text 0..1ED
....... reference I0..1TEL1198-8698: The URL of a referenced advance directive document **MAY** be present, and **SHALL** be represented in Observation/reference/ExternalDocument/text/reference (CONF:1198-8698).
1198-8699: If a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699).

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 1..1CDAR2.Observation
... classCode 1..1codeBinding: ActClassObservation (required)
Required Pattern: OBS
... moodCode 1..1codeRequired Pattern: EVN
... negationInd 0..1boolean
... realmCode 0..*CS
... typeId 0..1II
... Slices for templateId 0..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:primary 1..1II
..... nullFlavor 0..1codeBinding: NullFlavor (required)
..... assigningAuthorityName 0..1string
..... displayable 0..1boolean
..... root 1..1stringRequired Pattern: 2.16.840.1.113883.10.20.22.4.48
..... extension 1..1stringRequired Pattern: 2015-08-01
... id 1..*II
... code 1..1CDBinding: Advance Directive Type Code (preferred)
.... nullFlavor 0..1codeBinding: NullFlavor (required)
.... code 0..1string
.... codeSystem 0..1string
.... codeSystemName 0..1string
.... codeSystemVersion 0..1string
.... displayName 0..1string
.... sdtcValueSet 0..1stringXML: valueSet (urn:hl7-org:sdtc)
.... sdtcValueSetVersion 0..1stringXML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1ED
.... qualifier 0..*CR
.... Slices for translation 0..*CDSlice: Unordered, Open by value:code, value:codeSystem
..... translation:advanceDirective 1..1CD
...... nullFlavor 0..1codeBinding: NullFlavor (required)
...... code 1..1stringRequired Pattern: 75320-2
...... codeSystem 1..1stringRequired Pattern: 2.16.840.1.113883.6.1
...... codeSystemName 0..1string
...... codeSystemVersion 0..1string
...... displayName 0..1string
...... sdtcValueSet 0..1stringXML: valueSet (urn:hl7-org:sdtc)
...... sdtcValueSetVersion 0..1stringXML: valueSetVersion (urn:hl7-org:sdtc)
...... originalText 0..1ED
...... qualifier 0..*CR
...... translation 0..*CD
... derivationExpr 0..1ED
... text 0..1ED
... statusCode 1..1CSBinding: ActStatus (required)
Required Pattern: Completed
.... nullFlavor 0..1codeBinding: NullFlavor (required)
.... code 1..1stringRequired Pattern: completed
.... sdtcValueSet 0..1stringXML: valueSet (urn:hl7-org:sdtc)
.... sdtcValueSetVersion 0..1stringXML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 1..1IVL_TS
.... nullFlavor 0..1codeBinding: NullFlavor (required)
.... value 0..1dateTime
.... inclusive 0..1boolean
.... operator 0..1code
.... low 1..1TS
.... high I1..1TS1198-32449: If the Advance Directive does not have a specified ending time, the <high> element **SHALL** have the nullFlavor attribute set to *NA* (CONF:1198-32449).
.... width 0..1PQ
.... center 0..1TS
... priorityCode 0..1CEBinding: ActPriority (extensible)
... repeatNumber 0..1IVL_INT
... languageCode 0..1CSBinding: HumanLanguage (required)
... Slices for value 0..*Slice: Unordered, Open by
.... valueBL
.... valueED
.... valueED
.... valueCD
.... valueCV
.... valueCE
.... valueSC
.... valueII
.... valueTEL
.... valueAD
.... valueEN
.... valueINT
.... valueREAL
.... valuePQ
.... valueMO
.... valueTS
.... valueIVL_PQ
.... valueIVL_TS
.... valuePIVL_TS
.... valueEIVL_TS
.... valueSXPR_TS
.... valueRTO_PQ_PQ
.... value:value1 I1..11198-32493: If type CD, then value will be SNOMED-CT 2.16.840.1.113883.6.96 (CONF:1198-32493).
..... valueBL
..... valueED
..... valueED
..... valueCD
..... valueCV
..... valueCE
..... valueSC
..... valueII
..... valueTEL
..... valueAD
..... valueEN
..... valueINT
..... valueREAL
..... valuePQ
..... valueMO
..... valueTS
..... valueIVL_PQ
..... valueIVL_TS
..... valuePIVL_TS
..... valueEIVL_TS
..... valueSXPR_TS
..... valueRTO_PQ_PQ
... interpretationCode 0..*CEBinding: ObservationInterpretation (required)
... methodCode 0..*CEBinding: ObservationMethod (extensible)
... targetSiteCode 0..*CD
... subject 0..1Element
.... typeCode 1..1codeBinding: ParticipationTargetSubject (required)
Fixed Value: SBJ
.... contextControlCode 1..1codeBinding: ContextControl (required)
Fixed Value: OP
.... awarenessCode 0..1CEBinding: TargetAwareness (extensible)
.... relatedSubject 1..1RelatedSubject
... specimen 0..*Specimen
... performer 0..*Performer2
... author 0..*AuthorParticipation
... informant 0..*Element
.... typeCode 1..1codeBinding: ParticipationInformationGenerator (required)
Fixed Value: INF
.... contextControlCode 1..1codeBinding: ContextControl (required)
Fixed Value: OP
.... assignedEntity 0..1AssignedEntity
.... relatedEntity 0..1RelatedEntity
... Slices for participant 0..*Participant2This custodian (CST) participant identifies a legal representative for the patient's advance directive. Examples of such individuals are called health care agents, substitute decision makers and/or health care proxies. If there is more than one legal representative, a qualifier may be used to designate the legal representative as primary or secondary.
Slice: Unordered, Open by value:participantRole, value:typeCode
.... participant:participant1 0..*Participant2The participant "VRF" represents the clinician(s) who verified the patient advance directive observation.
..... nullFlavor 0..1codeBinding: NullFlavor (required)
..... typeCode 1..1codeBinding: ParticipationType (required)
Required Pattern: VRF
..... contextControlCode 0..1codeBinding: ContextControl (required)
Fixed Value: OP
..... realmCode 0..*CS
..... typeId 0..1II
..... Slices for templateId 0..*IISlice: Unordered, Open by value:root
...... templateId:primary 1..1II
....... nullFlavor 0..1codeBinding: NullFlavor (required)
....... assigningAuthorityName 0..1string
....... displayable 0..1boolean
....... root 1..1stringRequired Pattern: 2.16.840.1.113883.10.20.1.58
....... extension 0..1string
..... sdtcFunctionCode 0..1CEXML: functionCode (urn:hl7-org:sdtc)
..... time I0..1IVL_TS1198-8666: The data type of Observation/participant/time in a verification **SHALL** be *TS* (time stamp) (CONF:1198-8666).
..... awarenessCode 0..1CE
..... participantRole 1..1ParticipantRole
...... classCode 1..1codeBinding: RoleClassRoot (required)
...... templateId 0..*II
...... id 0..*II
...... sdtcIdentifiedBy 0..*IdentifiedByXML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1CEBinding: Healthcare Provider Taxonomy (preferred)
...... addr I0..*USRealmAddressADUSFIELDED
...... telecom 0..*TEL
...... playingDevice 0..1Device
...... playingEntity 0..1PlayingEntity
....... classCode 1..1codeBinding: EntityClassRoot (required)
....... determinerCode 1..1codeBinding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... templateId 0..*II
....... code 0..1CEBinding: EntityCode (extensible)
....... quantity 0..*PQ
....... name I0..*USRealmPersonNamePNUSFIELDED
....... desc 0..1ED
...... scopingEntity 0..1Entity
.... participant:participant2 0..*Participant2
..... nullFlavor 0..1codeBinding: NullFlavor (required)
..... typeCode 1..1codeBinding: ParticipationType (required)
Required Pattern: CST
..... contextControlCode 0..1codeBinding: ContextControl (required)
Fixed Value: OP
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 0..*II
..... sdtcFunctionCode 0..1CEXML: functionCode (urn:hl7-org:sdtc)
..... time 0..1IVL_TS
..... awarenessCode 0..1CE
..... participantRole 1..1ParticipantRole
...... classCode 1..1codeBinding: RoleClassRoot (required)
Required Pattern: AGNT
...... templateId 0..*II
...... id 0..*II
...... sdtcIdentifiedBy 0..*IdentifiedByXML: identifiedBy (urn:hl7-org:sdtc)
...... code 0..1CEBinding: Personal And Legal Relationship Role Type (preferred)
...... addr I0..1USRealmAddressADUSFIELDED
...... telecom 0..*TEL
...... playingDevice 0..1Device
...... playingEntity 1..1PlayingEntity
....... classCode 1..1codeBinding: EntityClassRoot (required)
....... determinerCode 1..1codeBinding: EntityDeterminer (required)
Fixed Value: INSTANCE
....... templateId 0..*II
....... code 0..1CEBinding: Healthcare Agent Qualifier (preferred)
....... quantity 0..*PQ
....... name 1..1ENRecord the name of the agent who can provide a copy of the Advance Directive in the name element.
....... desc 0..1ED
...... scopingEntity 0..1Entity
... entryRelationship I0..*Element
.... typeCode 1..1code
.... inversionInd 0..1boolean
.... contextConductionInd 1..1boolean
.... sequenceNumber 0..1INT
.... negationInd 0..1boolean
.... seperatableInd 0..1BL
.... (Choice of one) 1..1
..... observation 0..1Observation
..... regionOfInterest 0..1RegionOfInterest
..... observationMedia 0..1ObservationMedia
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
..... procedure 0..1Procedure
..... encounter 0..1Encounter
..... organizer 0..1Organizer
..... act 0..1Act
... Slices for reference 0..*ElementSlice: Unordered, Open by value:externalDocument, value:typeCode
.... reference:All Slices Content/Rules for all slices
..... typeCode 1..1code
..... seperatableInd 0..1BL
..... externalAct 0..1ExternalAct
..... externalObservation 0..1ExternalObservation
..... externalProcedure 0..1ExternalProcedure
..... externalDocument 0..1ExternalDocument
.... reference:reference1 1..*Element
..... typeCode 1..1codeRequired Pattern: REFR
..... seperatableInd 0..1BL
..... externalAct 0..1ExternalAct
..... externalObservation 0..1ExternalObservation
..... externalProcedure 0..1ExternalProcedure
..... externalDocument 1..1ExternalDocument
...... classCode 1..1codeBinding: ActClassDocument (required)
...... moodCode 1..1codeBinding: ActMood (required)
Fixed Value: EVN
...... templateId 0..*II
...... id 1..*II
...... code 0..1CD​Binding: http://terminology.hl7.org/ValueSet/v3-DocumentType (extensible)
...... text 0..1ED
....... nullFlavor 0..1codeBinding: NullFlavor (required)
....... charset 0..1code
....... compression 0..1codeBinding: CompressionAlgorithm (required)
....... integrityCheck 0..1base64Binary
....... integrityCheckAlgorithm 0..1codeBinding: IntegrityCheckAlgorithm (required)
....... language 0..1code
....... mediaType 0..1code
....... representation 0..1code
....... data[x] 0..1
........ dataStringstring
........ dataBase64Binarybase64Binary
....... reference I0..1TEL1198-8698: The URL of a referenced advance directive document **MAY** be present, and **SHALL** be represented in Observation/reference/ExternalDocument/text/reference (CONF:1198-8698).
1198-8699: If a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699).
....... thumbnail 0..1ED
...... setId 0..1II
...... versionNumber 0..1INT
... precondition 0..*Precondition
... referenceRange 0..*Element
.... typeCode 1..1codeBinding: ActRelationshipPertains (required)
Fixed Value: REFV
.... observationRange 1..1ObservationRange

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSet / Code
Observation.classCoderequiredPattern: OBS
Observation.templateId:primary.nullFlavorrequiredNullFlavor
Observation.codepreferredAdvance Directive Type Code
Observation.code.nullFlavorrequiredNullFlavor
Observation.code.translation:advanceDirective.nullFlavorrequiredNullFlavor
Observation.statusCoderequiredPattern: Completed
Observation.statusCode.nullFlavorrequiredNullFlavor
Observation.effectiveTime.nullFlavorrequiredNullFlavor
Observation.priorityCodeextensibleActPriority
Observation.languageCoderequiredHumanLanguage
Observation.interpretationCoderequiredObservationInterpretation
Observation.methodCodeextensibleObservationMethod
Observation.subject.typeCoderequiredFixed Value: SBJ
Observation.subject.contextControlCoderequiredFixed Value: OP
Observation.subject.awarenessCodeextensibleTargetAwareness
Observation.informant.typeCoderequiredFixed Value: INF
Observation.informant.contextControlCoderequiredFixed Value: OP
Observation.participant:participant1.nullFlavorrequiredNullFlavor
Observation.participant:participant1.typeCoderequiredPattern: VRF
Observation.participant:participant1.contextControlCoderequiredFixed Value: OP
Observation.participant:participant1.templateId:primary.nullFlavorrequiredNullFlavor
Observation.participant:participant1.participantRole.classCoderequiredRoleClassRoot
Observation.participant:participant1.participantRole.codepreferredHealthcareProviderTaxonomy
Observation.participant:participant1.participantRole.playingEntity.classCoderequiredEntityClassRoot
Observation.participant:participant1.participantRole.playingEntity.determinerCoderequiredFixed Value: INSTANCE
Observation.participant:participant1.participantRole.playingEntity.codeextensibleEntityCode
Observation.participant:participant2.nullFlavorrequiredNullFlavor
Observation.participant:participant2.typeCoderequiredPattern: CST
Observation.participant:participant2.contextControlCoderequiredFixed Value: OP
Observation.participant:participant2.participantRole.classCoderequiredPattern: AGNT
Observation.participant:participant2.participantRole.codepreferredPersonal And Legal Relationship Role Type
Observation.participant:participant2.participantRole.playingEntity.classCoderequiredEntityClassRoot
Observation.participant:participant2.participantRole.playingEntity.determinerCoderequiredFixed Value: INSTANCE
Observation.participant:participant2.participantRole.playingEntity.codepreferredHealthcare Agent Qualifier
Observation.reference:reference1.externalDocument.classCoderequiredActClassDocument
Observation.reference:reference1.externalDocument.moodCoderequiredFixed Value: EVN
Observation.reference:reference1.externalDocument.codeextensible​http://terminology.hl7.org/ValueSet/v3-DocumentType
Observation.reference:reference1.externalDocument.text.nullFlavorrequiredNullFlavor
Observation.reference:reference1.externalDocument.text.compressionrequiredCompressionAlgorithm
Observation.reference:reference1.externalDocument.text.integrityCheckAlgorithmrequiredIntegrityCheckAlgorithm
Observation.referenceRange.typeCoderequiredFixed Value: REFV

Constraints

IdGradePathDetailsRequirements
1198-32449errorObservation.effectiveTime.highIf the Advance Directive does not have a specified ending time, the <high> element **SHALL** have the nullFlavor attribute set to *NA* (CONF:1198-32449).
:
1198-32493errorObservation.value:value1If type CD, then value will be SNOMED-CT 2.16.840.1.113883.6.96 (CONF:1198-32493).
:
1198-8666warningObservation.participant:participant1.timeThe data type of Observation/participant/time in a verification **SHALL** be *TS* (time stamp) (CONF:1198-8666).
:
81-7296errorObservation.participant:participant1.participantRole.addr**SHALL NOT** have mixed content except for white space (CONF:81-7296).
:
81-9371errorObservation.participant:participant1.participantRole.playingEntity.nameThe content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371).
:
81-9372errorObservation.participant:participant1.participantRole.playingEntity.nameThe string **SHALL NOT** contain name parts (CONF:81-9372).
:
81-7296errorObservation.participant:participant2.participantRole.addr**SHALL NOT** have mixed content except for white space (CONF:81-7296).
:
obs-er-1errorObservation.entryRelationshipOnly one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act
: (observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1
1198-8698warningObservation.reference:reference1.externalDocument.text.referenceThe URL of a referenced advance directive document **MAY** be present, and **SHALL** be represented in Observation/reference/ExternalDocument/text/reference (CONF:1198-8698).
:
1198-8699warningObservation.reference:reference1.externalDocument.text.referenceIf a URL is referenced, then it **SHOULD** have a corresponding linkHTML element in narrative block (CONF:1198-8699).
: