Consolidated CDA (C-CDA)
3.0.0 - STU
Consolidated CDA (C-CDA)
3.0.0 - STU
Consolidated CDA (C-CDA), published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 3.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/CDA-ccda/ and changes regularly. See the Directory of published versions
| Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/DrugMonitoringAct | Version: 3.0.0 | |||
| Draft as of 2024-05-07 | Computable Name: DrugMonitoringAct | |||
| Other Identifiers: OID:2.16.840.1.113883.10.20.22.4.123 | ||||
This template represents the act of monitoring the patient’s medication and includes a participation to record the person responsible for monitoring the medication. The prescriber of the medication is not necessarily the same person or persons monitoring the drug. The effectiveTime indicates the time when the activity is intended to take place.
For example, a cardiologist may prescribe a patient Warfarin. The patient’s primary care provider may monitor the patient’s INR and adjust the dosing of the Warfarin based on these laboratory results. Here the person designated to monitor the drug is the primary care provider.
Usage:
Description of Template, Differentials, Snapshots and how the different presentations work.
This structure is derived from Act
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Act |
C | 1..1 | Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value |
  Slices for templateId |
1..* | II | Slice: Unordered, Open by value:root | |
   templateId:drug-monitoring-act |
1..1 | II | ||
  @root |
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.123 | |
  @extension |
0..0 | |||
 @classCode |
1..1 | cs | Fixed Value: ACT | |
| @moodCode |
1..1 | cs | Fixed Value: INT | |
| id |
1..* | II | ||
| code |
1..1 | CD | ||
| @code |
1..1 | cs | Required Pattern: 395170001 | |
 @codeSystem |
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.96 | |
| text |
0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
| reference |
C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
| statusCode |
1..1 | CS | ||
| @nullFlavor |
0..0 | |||
| @code |
1..1 | cs | Binding: ActStatus  (required) | |
| effectiveTime |
1..1 | IVL_TS | ||
 Slices for participant |
1..* | Participant2 | Slice: Unordered, Open by value:typeCode | |
| participant:responsible |
1..* | Participant2 | ||
| @typeCode |
1..1 | cs | Fixed Value: RESP | |
 participantRole |
1..1 | ParticipantRole | ||
| @classCode |
1..1 | cs | Fixed Value: ASSIGNED | |
| id |
1..* | II | ||
| playingEntity |
1..1 | PlayingEntity | ||
| @classCode |
1..1 | cs | Fixed Value: PSN | |
 name |
1..1 | USRealmPersonNamePNUSFIELDED | Base for all types and resources | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| Act.statusCode.code | required | ActStatus http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933 |
| Id | Grade | Path(s) | Details | Requirements |
| should-text-ref-value | warning | Act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| value-starts-octothorpe | error | Act.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 |
|---|---|---|---|---|
| Act |
C | 1..1 | Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value |
| Slices for templateId |
1..* | II | Slice: Unordered, Open by value:root | |
| templateId:drug-monitoring-act |
1..1 | II | ||
 @root |
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.123 | |
| @classCode |
1..1 | cs | Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT | |
| @moodCode |
1..1 | cs | Binding: XDocumentActMood (2.0.0) (required) Fixed Value: INT | |
| id |
1..* | II | ||
| code |
1..1 | CD | Binding: v3 Code System ActCode (example) | |
| @code |
1..1 | cs | Required Pattern: 395170001 | |
| @codeSystem |
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.96 | |
| text |
0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
| reference |
C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
| statusCode |
1..1 | CS | Binding: ActStatus (required) | |
| @code |
1..1 | cs | Binding: ActStatus (required) | |
| effectiveTime |
1..1 | IVL_TS | ||
| Slices for participant |
1..* | Participant2 | Slice: Unordered, Open by value:typeCode | |
| participant:responsible |
1..* | Participant2 | ||
| @typeCode |
1..1 | cs | Binding: CDAParticipationType (required) Fixed Value: RESP | |
| participantRole |
1..1 | ParticipantRole | ||
| @classCode |
1..1 | cs | Binding: CDARoleClassRoot (required) Fixed Value: ASSIGNED | |
| id |
1..* | II | ||
| playingEntity |
1..1 | PlayingEntity | ||
| @classCode |
1..1 | cs | Binding: EntityClassRoot (required) Fixed Value: PSN | |
| name |
C | 1..1 | USRealmPersonNamePNUSFIELDED | Base for all types and resources pn-no-ls: No PN name part may have a qualifier of LS. 81-9371: The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). 81-9372: The string **SHALL NOT** contain name parts (CONF:81-9372). |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code | URI |
| Act.classCode | required | Fixed Value: ACThttp://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0 | |
| Act.moodCode | required | Fixed Value: INThttp://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0 | |
| Act.code | example | ActCodehttp://terminology.hl7.org/ValueSet/v3-ActCode | |
| Act.statusCode | required | ActStatushttp://terminology.hl7.org/ValueSet/v3-ActStatus | |
| Act.statusCode.code | required | ActStatus http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933 | |
| Act.participant:responsible.typeCode | required | Fixed Value: RESPhttp://hl7.org/cda/stds/core/ValueSet/CDAParticipationType | |
| Act.participant:responsible.participantRole.classCode | required | Fixed Value: ASSIGNEDhttp://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot | |
| Act.participant:responsible.participantRole.playingEntity.classCode | required | Fixed Value: PSNhttp://terminology.hl7.org/ValueSet/v3-EntityClassRoot |
| Id | Grade | Path(s) | Details | Requirements |
| 81-9371 | error | Act.participant:responsible.participantRole.playingEntity.name | The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). : conformsTo('http://hl7.org/cda/us/ccda/StructureDefinition/USRealmPatientNamePTNUSFIELDED') or item.xmlText.exists() | |
| 81-9372 | error | Act.participant:responsible.participantRole.playingEntity.name | The string **SHALL NOT** contain name parts (CONF:81-9372). : item.xmlText.exists() implies (item.delimiter | item.family | item.given | item.prefix | item.suffix).empty() | |
| pn-no-ls | error | Act.participant:responsible.participantRole.playingEntity.name | No PN name part may have a qualifier of LS. : (item.delimiter | item.family | item.given | item.prefix | item.suffix).where(qualifier.where($this = 'LS').exists()).empty() | |
| should-text-ref-value | warning | Act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| value-starts-octothorpe | error | Act.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 |
|---|---|---|---|---|
| Act |
C | 1..1 | Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value |
| @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:drug-monitoring-act |
1..1 | II | ||
| @nullFlavor |
0..1 | cs | Binding: CDANullFlavor (required) | |
| @assigningAuthorityName |
0..1 | st | ||
| @displayable |
0..1 | bl | ||
| @root |
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.123 | |
| @classCode |
1..1 | cs | Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT | |
| @moodCode |
1..1 | cs | Binding: XDocumentActMood (2.0.0) (required) Fixed Value: INT | |
| @negationInd |
0..1 | bl | ||
| id |
1..* | II | ||
| code |
1..1 | CD | Binding: v3 Code System ActCode (example) | |
| @nullFlavor |
0..1 | cs | Binding: CDANullFlavor (required) | |
| @code |
1..1 | cs | Required Pattern: 395170001 | |
| @codeSystem |
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.96 | |
| @codeSystemName |
0..1 | st | ||
| @codeSystemVersion |
0..1 | st | ||
| @displayName |
0..1 | st | ||
| @sdtcValueSet |
0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
| @sdtcValueSetVersion |
0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
| originalText |
0..1 | ED | ||
| qualifier |
0..* | CR | ||
| translation |
0..* | CD | ||
| text |
0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
| @nullFlavor |
0..1 | cs | Binding: CDANullFlavor (required) | |
| @compression |
0..1 | cs | Binding: CDACompressionAlgorithm (required) | |
| @integrityCheck |
0..1 | bin | ||
| @integrityCheckAlgorithm |
0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required) | |
| @language |
0..1 | cs | ||
| @mediaType |
0..1 | cs | Binding: MediaType (example) | |
| @representation |
0..1 | cs | Binding: CDABinaryDataEncoding (required) | |
| xmlText |
0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string. | |
| reference |
C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
| thumbnail |
0..1 | ED | ||
| statusCode |
1..1 | CS | Binding: ActStatus (required) | |
| @code |
1..1 | cs | Binding: ActStatus (required) | |
| @sdtcValueSet |
0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
| @sdtcValueSetVersion |
0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
| effectiveTime |
1..1 | IVL_TS | ||
| priorityCode |
0..1 | CE | Binding: ActPriority (example) | |
| languageCode |
0..1 | CS | Binding: AllLanguages (required) | |
| subject |
0..1 | Subject | ||
| specimen |
0..* | Specimen | ||
| performer |
0..* | Performer2 | ||
| author |
0..* | Author | ||
| informant |
0..* | Informant | ||
| Slices for participant |
1..* | Participant2 | Slice: Unordered, Open by value:typeCode | |
| participant:responsible |
1..* | Participant2 | ||
| @nullFlavor |
0..1 | cs | Binding: CDANullFlavor (required) | |
| realmCode |
0..* | CS | ||
 typeId |
0..1 | II | ||
 @nullFlavor |
0..1 | cs | Binding: CDANullFlavor (required) | |
| @assigningAuthorityName |
0..1 | st | ||
| @displayable |
0..1 | bl | ||
| @root |
1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
| @extension |
1..1 | st | ||
| templateId |
0..* | II | ||
| @typeCode |
1..1 | cs | Binding: CDAParticipationType (required) Fixed Value: RESP | |
| @contextControlCode |
0..1 | cs | Binding: CDAContextControl (required) Fixed Value: OP | |
| sdtcFunctionCode |
0..1 | CE | XML Namespace: urn:hl7-org:sdtc XML: functionCode (urn:hl7-org:sdtc) | |
| time |
0..1 | IVL_TS | ||
| awarenessCode |
0..1 | CE | ||
| participantRole |
1..1 | ParticipantRole | ||
| @nullFlavor |
0..1 | cs | Binding: CDANullFlavor (required) | |
| realmCode |
0..* | CS | ||
| typeId |
0..1 | II | ||
| @nullFlavor |
0..1 | cs | Binding: CDANullFlavor (required) | |
| @assigningAuthorityName |
0..1 | st | ||
| @displayable |
0..1 | bl | ||
| @root |
1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
| @extension |
1..1 | st | ||
| templateId |
0..* | II | ||
| @classCode |
1..1 | cs | Binding: CDARoleClassRoot (required) Fixed Value: ASSIGNED | |
| id |
1..* | II | ||
| sdtcIdentifiedBy |
0..* | IdentifiedBy | XML Namespace: urn:hl7-org:sdtc XML: identifiedBy (urn:hl7-org:sdtc) | |
| code |
0..1 | CE | Binding: CDARoleCode (example) | |
| addr |
0..* | AD | ||
| telecom |
0..* | TEL | ||
| playingDevice |
0..1 | Device | ||
| playingEntity |
1..1 | PlayingEntity | ||
| @nullFlavor |
0..1 | cs | Binding: CDANullFlavor (required) | |
| realmCode |
0..* | CS | ||
| typeId |
0..1 | II | ||
| @nullFlavor |
0..1 | cs | Binding: CDANullFlavor (required) | |
| @assigningAuthorityName |
0..1 | st | ||
| @displayable |
0..1 | bl | ||
| @root |
1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
| @extension |
1..1 | st | ||
| templateId |
0..* | II | ||
| @classCode |
1..1 | cs | Binding: EntityClassRoot (required) Fixed Value: PSN | |
| @determinerCode |
0..1 | cs | Binding: EntityDeterminer (required) Fixed Value: INSTANCE | |
| code |
0..1 | CE | Binding: CDAEntityCode (example) | |
| quantity |
0..* | PQ | ||
| name |
C | 1..1 | USRealmPersonNamePNUSFIELDED | Base for all types and resources pn-no-ls: No PN name part may have a qualifier of LS. 81-9371: The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). 81-9372: The string **SHALL NOT** contain name parts (CONF:81-9372). |
| sdtcBirthTime |
0..1 | TS | XML Namespace: urn:hl7-org:sdtc XML: birthTime (urn:hl7-org:sdtc) | |
| desc |
0..1 | ED | ||
| scopingEntity |
0..1 | Entity | ||
| entryRelationship |
0..* | EntryRelationship | ||
| reference |
0..* | Reference | ||
| precondition |
0..* | Precondition | ||
| sdtcPrecondition2 |
0..* | Precondition2 | XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc) | |
| sdtcInFulfillmentOf1 |
0..* | InFulfillmentOf1 | XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc) | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code | URI |
| Act.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.typeId.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.templateId:drug-monitoring-act.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.classCode | required | Fixed Value: ACThttp://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0 | |
| Act.moodCode | required | Fixed Value: INThttp://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0 | |
| Act.code | example | ActCodehttp://terminology.hl7.org/ValueSet/v3-ActCode | |
| Act.code.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.text.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.text.compression | required | CDACompressionAlgorithmhttp://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm | |
| Act.text.integrityCheckAlgorithm | required | IntegrityCheckAlgorithmhttp://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0 | |
| Act.text.mediaType | example | MediaTypehttp://terminology.hl7.org/ValueSet/v3-MediaType | |
| Act.text.representation | required | BinaryDataEncodinghttp://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding | |
| Act.statusCode | required | ActStatushttp://terminology.hl7.org/ValueSet/v3-ActStatus | |
| Act.statusCode.code | required | ActStatus http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933 | |
| Act.priorityCode | example | ActPriorityhttp://terminology.hl7.org/ValueSet/v3-ActPriority | |
| Act.languageCode | required | AllLanguageshttp://hl7.org/fhir/ValueSet/all-languagesfrom the FHIR Standard | |
| Act.participant:responsible.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.participant:responsible.typeId.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.participant:responsible.typeCode | required | Fixed Value: RESPhttp://hl7.org/cda/stds/core/ValueSet/CDAParticipationType | |
| Act.participant:responsible.contextControlCode | required | Fixed Value: OPhttp://hl7.org/cda/stds/core/ValueSet/CDAContextControl | |
| Act.participant:responsible.participantRole.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.participant:responsible.participantRole.typeId.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.participant:responsible.participantRole.classCode | required | Fixed Value: ASSIGNEDhttp://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot | |
| Act.participant:responsible.participantRole.code | example | CDARoleCodehttp://hl7.org/cda/stds/core/ValueSet/CDARoleCode | |
| Act.participant:responsible.participantRole.playingEntity.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.participant:responsible.participantRole.playingEntity.typeId.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.participant:responsible.participantRole.playingEntity.classCode | required | Fixed Value: PSNhttp://terminology.hl7.org/ValueSet/v3-EntityClassRoot | |
| Act.participant:responsible.participantRole.playingEntity.determinerCode | required | Fixed Value: INSTANCEhttp://terminology.hl7.org/ValueSet/v3-EntityDeterminer | |
| Act.participant:responsible.participantRole.playingEntity.code | example | CDAEntityCodehttp://hl7.org/cda/stds/core/ValueSet/CDAEntityCode |
| Id | Grade | Path(s) | Details | Requirements |
| 81-9371 | error | Act.participant:responsible.participantRole.playingEntity.name | The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). : conformsTo('http://hl7.org/cda/us/ccda/StructureDefinition/USRealmPatientNamePTNUSFIELDED') or item.xmlText.exists() | |
| 81-9372 | error | Act.participant:responsible.participantRole.playingEntity.name | The string **SHALL NOT** contain name parts (CONF:81-9372). : item.xmlText.exists() implies (item.delimiter | item.family | item.given | item.prefix | item.suffix).empty() | |
| pn-no-ls | error | Act.participant:responsible.participantRole.playingEntity.name | No PN name part may have a qualifier of LS. : (item.delimiter | item.family | item.given | item.prefix | item.suffix).where(qualifier.where($this = 'LS').exists()).empty() | |
| should-text-ref-value | warning | Act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| value-starts-octothorpe | error | Act.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 Act
Summary
Mandatory: 16 elements
Fixed: 5 elements
Prohibited: 2 elements
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Differential View
This structure is derived from Act
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Act |
C | 1..1 | Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value |
| Slices for templateId |
1..* | II | Slice: Unordered, Open by value:root | |
| templateId:drug-monitoring-act |
1..1 | II | ||
| @root |
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.123 | |
| @extension |
0..0 | |||
| @classCode |
1..1 | cs | Fixed Value: ACT | |
| @moodCode |
1..1 | cs | Fixed Value: INT | |
| id |
1..* | II | ||
| code |
1..1 | CD | ||
| @code |
1..1 | cs | Required Pattern: 395170001 | |
| @codeSystem |
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.96 | |
| text |
0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
| reference |
C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
| statusCode |
1..1 | CS | ||
| @nullFlavor |
0..0 | |||
| @code |
1..1 | cs | Binding: ActStatus (required) | |
| effectiveTime |
1..1 | IVL_TS | ||
| Slices for participant |
1..* | Participant2 | Slice: Unordered, Open by value:typeCode | |
| participant:responsible |
1..* | Participant2 | ||
| @typeCode |
1..1 | cs | Fixed Value: RESP | |
| participantRole |
1..1 | ParticipantRole | ||
| @classCode |
1..1 | cs | Fixed Value: ASSIGNED | |
| id |
1..* | II | ||
| playingEntity |
1..1 | PlayingEntity | ||
| @classCode |
1..1 | cs | Fixed Value: PSN | |
| name |
1..1 | USRealmPersonNamePNUSFIELDED | Base for all types and resources | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| Act.statusCode.code | required | ActStatus http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933 |
| Id | Grade | Path(s) | Details | Requirements |
| should-text-ref-value | warning | Act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| value-starts-octothorpe | error | Act.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 |
|---|---|---|---|---|
| Act |
C | 1..1 | Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value |
| Slices for templateId |
1..* | II | Slice: Unordered, Open by value:root | |
| templateId:drug-monitoring-act |
1..1 | II | ||
| @root |
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.123 | |
| @classCode |
1..1 | cs | Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT | |
| @moodCode |
1..1 | cs | Binding: XDocumentActMood (2.0.0) (required) Fixed Value: INT | |
| id |
1..* | II | ||
| code |
1..1 | CD | Binding: v3 Code System ActCode (example) | |
| @code |
1..1 | cs | Required Pattern: 395170001 | |
| @codeSystem |
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.96 | |
| text |
0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
| reference |
C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
| statusCode |
1..1 | CS | Binding: ActStatus (required) | |
| @code |
1..1 | cs | Binding: ActStatus (required) | |
| effectiveTime |
1..1 | IVL_TS | ||
| Slices for participant |
1..* | Participant2 | Slice: Unordered, Open by value:typeCode | |
| participant:responsible |
1..* | Participant2 | ||
| @typeCode |
1..1 | cs | Binding: CDAParticipationType (required) Fixed Value: RESP | |
| participantRole |
1..1 | ParticipantRole | ||
| @classCode |
1..1 | cs | Binding: CDARoleClassRoot (required) Fixed Value: ASSIGNED | |
| id |
1..* | II | ||
| playingEntity |
1..1 | PlayingEntity | ||
| @classCode |
1..1 | cs | Binding: EntityClassRoot (required) Fixed Value: PSN | |
| name |
C | 1..1 | USRealmPersonNamePNUSFIELDED | Base for all types and resources pn-no-ls: No PN name part may have a qualifier of LS. 81-9371: The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). 81-9372: The string **SHALL NOT** contain name parts (CONF:81-9372). |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code | URI |
| Act.classCode | required | Fixed Value: ACThttp://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0 | |
| Act.moodCode | required | Fixed Value: INThttp://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0 | |
| Act.code | example | ActCodehttp://terminology.hl7.org/ValueSet/v3-ActCode | |
| Act.statusCode | required | ActStatushttp://terminology.hl7.org/ValueSet/v3-ActStatus | |
| Act.statusCode.code | required | ActStatus http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933 | |
| Act.participant:responsible.typeCode | required | Fixed Value: RESPhttp://hl7.org/cda/stds/core/ValueSet/CDAParticipationType | |
| Act.participant:responsible.participantRole.classCode | required | Fixed Value: ASSIGNEDhttp://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot | |
| Act.participant:responsible.participantRole.playingEntity.classCode | required | Fixed Value: PSNhttp://terminology.hl7.org/ValueSet/v3-EntityClassRoot |
| Id | Grade | Path(s) | Details | Requirements |
| 81-9371 | error | Act.participant:responsible.participantRole.playingEntity.name | The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). : conformsTo('http://hl7.org/cda/us/ccda/StructureDefinition/USRealmPatientNamePTNUSFIELDED') or item.xmlText.exists() | |
| 81-9372 | error | Act.participant:responsible.participantRole.playingEntity.name | The string **SHALL NOT** contain name parts (CONF:81-9372). : item.xmlText.exists() implies (item.delimiter | item.family | item.given | item.prefix | item.suffix).empty() | |
| pn-no-ls | error | Act.participant:responsible.participantRole.playingEntity.name | No PN name part may have a qualifier of LS. : (item.delimiter | item.family | item.given | item.prefix | item.suffix).where(qualifier.where($this = 'LS').exists()).empty() | |
| should-text-ref-value | warning | Act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| value-starts-octothorpe | error | Act.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 |
|---|---|---|---|---|
| Act |
C | 1..1 | Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value |
| @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:drug-monitoring-act |
1..1 | II | ||
| @nullFlavor |
0..1 | cs | Binding: CDANullFlavor (required) | |
| @assigningAuthorityName |
0..1 | st | ||
| @displayable |
0..1 | bl | ||
| @root |
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.123 | |
| @classCode |
1..1 | cs | Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT | |
| @moodCode |
1..1 | cs | Binding: XDocumentActMood (2.0.0) (required) Fixed Value: INT | |
| @negationInd |
0..1 | bl | ||
| id |
1..* | II | ||
| code |
1..1 | CD | Binding: v3 Code System ActCode (example) | |
| @nullFlavor |
0..1 | cs | Binding: CDANullFlavor (required) | |
| @code |
1..1 | cs | Required Pattern: 395170001 | |
| @codeSystem |
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.96 | |
| @codeSystemName |
0..1 | st | ||
| @codeSystemVersion |
0..1 | st | ||
| @displayName |
0..1 | st | ||
| @sdtcValueSet |
0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
| @sdtcValueSetVersion |
0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
| originalText |
0..1 | ED | ||
| qualifier |
0..* | CR | ||
| translation |
0..* | CD | ||
| text |
0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
| @nullFlavor |
0..1 | cs | Binding: CDANullFlavor (required) | |
| @compression |
0..1 | cs | Binding: CDACompressionAlgorithm (required) | |
| @integrityCheck |
0..1 | bin | ||
| @integrityCheckAlgorithm |
0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required) | |
| @language |
0..1 | cs | ||
| @mediaType |
0..1 | cs | Binding: MediaType (example) | |
| @representation |
0..1 | cs | Binding: CDABinaryDataEncoding (required) | |
| xmlText |
0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string. | |
| reference |
C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
| thumbnail |
0..1 | ED | ||
| statusCode |
1..1 | CS | Binding: ActStatus (required) | |
| @code |
1..1 | cs | Binding: ActStatus (required) | |
| @sdtcValueSet |
0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc) | |
| @sdtcValueSetVersion |
0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc) | |
| effectiveTime |
1..1 | IVL_TS | ||
| priorityCode |
0..1 | CE | Binding: ActPriority (example) | |
| languageCode |
0..1 | CS | Binding: AllLanguages (required) | |
| subject |
0..1 | Subject | ||
| specimen |
0..* | Specimen | ||
| performer |
0..* | Performer2 | ||
| author |
0..* | Author | ||
| informant |
0..* | Informant | ||
| Slices for participant |
1..* | Participant2 | Slice: Unordered, Open by value:typeCode | |
| participant:responsible |
1..* | Participant2 | ||
| @nullFlavor |
0..1 | cs | Binding: CDANullFlavor (required) | |
| realmCode |
0..* | CS | ||
| typeId |
0..1 | II | ||
| @nullFlavor |
0..1 | cs | Binding: CDANullFlavor (required) | |
| @assigningAuthorityName |
0..1 | st | ||
| @displayable |
0..1 | bl | ||
| @root |
1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
| @extension |
1..1 | st | ||
| templateId |
0..* | II | ||
| @typeCode |
1..1 | cs | Binding: CDAParticipationType (required) Fixed Value: RESP | |
| @contextControlCode |
0..1 | cs | Binding: CDAContextControl (required) Fixed Value: OP | |
| sdtcFunctionCode |
0..1 | CE | XML Namespace: urn:hl7-org:sdtc XML: functionCode (urn:hl7-org:sdtc) | |
| time |
0..1 | IVL_TS | ||
| awarenessCode |
0..1 | CE | ||
| participantRole |
1..1 | ParticipantRole | ||
| @nullFlavor |
0..1 | cs | Binding: CDANullFlavor (required) | |
| realmCode |
0..* | CS | ||
| typeId |
0..1 | II | ||
| @nullFlavor |
0..1 | cs | Binding: CDANullFlavor (required) | |
| @assigningAuthorityName |
0..1 | st | ||
| @displayable |
0..1 | bl | ||
| @root |
1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
| @extension |
1..1 | st | ||
| templateId |
0..* | II | ||
| @classCode |
1..1 | cs | Binding: CDARoleClassRoot (required) Fixed Value: ASSIGNED | |
| id |
1..* | II | ||
| sdtcIdentifiedBy |
0..* | IdentifiedBy | XML Namespace: urn:hl7-org:sdtc XML: identifiedBy (urn:hl7-org:sdtc) | |
| code |
0..1 | CE | Binding: CDARoleCode (example) | |
| addr |
0..* | AD | ||
| telecom |
0..* | TEL | ||
| playingDevice |
0..1 | Device | ||
| playingEntity |
1..1 | PlayingEntity | ||
| @nullFlavor |
0..1 | cs | Binding: CDANullFlavor (required) | |
| realmCode |
0..* | CS | ||
| typeId |
0..1 | II | ||
| @nullFlavor |
0..1 | cs | Binding: CDANullFlavor (required) | |
| @assigningAuthorityName |
0..1 | st | ||
| @displayable |
0..1 | bl | ||
| @root |
1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3 | |
| @extension |
1..1 | st | ||
| templateId |
0..* | II | ||
| @classCode |
1..1 | cs | Binding: EntityClassRoot (required) Fixed Value: PSN | |
| @determinerCode |
0..1 | cs | Binding: EntityDeterminer (required) Fixed Value: INSTANCE | |
| code |
0..1 | CE | Binding: CDAEntityCode (example) | |
| quantity |
0..* | PQ | ||
| name |
C | 1..1 | USRealmPersonNamePNUSFIELDED | Base for all types and resources pn-no-ls: No PN name part may have a qualifier of LS. 81-9371: The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). 81-9372: The string **SHALL NOT** contain name parts (CONF:81-9372). |
| sdtcBirthTime |
0..1 | TS | XML Namespace: urn:hl7-org:sdtc XML: birthTime (urn:hl7-org:sdtc) | |
| desc |
0..1 | ED | ||
| scopingEntity |
0..1 | Entity | ||
| entryRelationship |
0..* | EntryRelationship | ||
| reference |
0..* | Reference | ||
| precondition |
0..* | Precondition | ||
| sdtcPrecondition2 |
0..* | Precondition2 | XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc) | |
| sdtcInFulfillmentOf1 |
0..* | InFulfillmentOf1 | XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc) | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code | URI |
| Act.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.typeId.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.templateId:drug-monitoring-act.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.classCode | required | Fixed Value: ACThttp://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0 | |
| Act.moodCode | required | Fixed Value: INThttp://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0 | |
| Act.code | example | ActCodehttp://terminology.hl7.org/ValueSet/v3-ActCode | |
| Act.code.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.text.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.text.compression | required | CDACompressionAlgorithmhttp://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm | |
| Act.text.integrityCheckAlgorithm | required | IntegrityCheckAlgorithmhttp://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0 | |
| Act.text.mediaType | example | MediaTypehttp://terminology.hl7.org/ValueSet/v3-MediaType | |
| Act.text.representation | required | BinaryDataEncodinghttp://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding | |
| Act.statusCode | required | ActStatushttp://terminology.hl7.org/ValueSet/v3-ActStatus | |
| Act.statusCode.code | required | ActStatus http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933 | |
| Act.priorityCode | example | ActPriorityhttp://terminology.hl7.org/ValueSet/v3-ActPriority | |
| Act.languageCode | required | AllLanguageshttp://hl7.org/fhir/ValueSet/all-languagesfrom the FHIR Standard | |
| Act.participant:responsible.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.participant:responsible.typeId.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.participant:responsible.typeCode | required | Fixed Value: RESPhttp://hl7.org/cda/stds/core/ValueSet/CDAParticipationType | |
| Act.participant:responsible.contextControlCode | required | Fixed Value: OPhttp://hl7.org/cda/stds/core/ValueSet/CDAContextControl | |
| Act.participant:responsible.participantRole.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.participant:responsible.participantRole.typeId.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.participant:responsible.participantRole.classCode | required | Fixed Value: ASSIGNEDhttp://hl7.org/cda/stds/core/ValueSet/CDARoleClassRoot | |
| Act.participant:responsible.participantRole.code | example | CDARoleCodehttp://hl7.org/cda/stds/core/ValueSet/CDARoleCode | |
| Act.participant:responsible.participantRole.playingEntity.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.participant:responsible.participantRole.playingEntity.typeId.nullFlavor | required | CDANullFlavorhttp://hl7.org/cda/stds/core/ValueSet/CDANullFlavor | |
| Act.participant:responsible.participantRole.playingEntity.classCode | required | Fixed Value: PSNhttp://terminology.hl7.org/ValueSet/v3-EntityClassRoot | |
| Act.participant:responsible.participantRole.playingEntity.determinerCode | required | Fixed Value: INSTANCEhttp://terminology.hl7.org/ValueSet/v3-EntityDeterminer | |
| Act.participant:responsible.participantRole.playingEntity.code | example | CDAEntityCodehttp://hl7.org/cda/stds/core/ValueSet/CDAEntityCode |
| Id | Grade | Path(s) | Details | Requirements |
| 81-9371 | error | Act.participant:responsible.participantRole.playingEntity.name | The content of name **SHALL** be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). : conformsTo('http://hl7.org/cda/us/ccda/StructureDefinition/USRealmPatientNamePTNUSFIELDED') or item.xmlText.exists() | |
| 81-9372 | error | Act.participant:responsible.participantRole.playingEntity.name | The string **SHALL NOT** contain name parts (CONF:81-9372). : item.xmlText.exists() implies (item.delimiter | item.family | item.given | item.prefix | item.suffix).empty() | |
| pn-no-ls | error | Act.participant:responsible.participantRole.playingEntity.name | No PN name part may have a qualifier of LS. : (item.delimiter | item.family | item.given | item.prefix | item.suffix).where(qualifier.where($this = 'LS').exists()).empty() | |
| should-text-ref-value | warning | Act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
| value-starts-octothorpe | error | Act.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 Act
Summary
Mandatory: 16 elements
Fixed: 5 elements
Prohibited: 2 elements
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
IG © 2019+ Health Level Seven. Package hl7.cda.us.ccda#3.0.0 based on FHIR 5.0.0. Generated 2024-05-07
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