The C-CDA on FHIR Implementation Guide is a US Realm Implementation Guide of the FHIR Specification addressing the key aspects of Consolidated CDA (C-CDA) required for Meaningful Use (MU). This IG publication release focuses on providing data mappings for problems, allergies, medications, immunization, patient and procedures (PAMI+), and results, vitals, encounters, and social determinants of health. The clinical document header and document guidance from the earlier publications have not been updated since 2020.
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The C-CDA on FHIR Implementation Guide is a US Realm Implementation Guide of the FHIR Specification addressing the key aspects of Consolidated CDA (C-CDA) required for Meaningful Use (MU). This IG publication release focuses on providing data mappings for problems, allergies, medications, immunization, patient and procedures (PAMI+), and results, vitals, encounters, and social determinants of health. The clinical document header and document guidance from the earlier publications have not been updated since 2020.
The html source contains the word 'SHALL' but it is not in a text phrase marked as a conformance clause: ' <act classCode="ACT" moodCode="EVN"> <templateId root="2.16.840.1.113883.10.20.22.4.3" extension="2015-08-01" /> <templateId root="2.16.840.1.113883.10.20.22.4.3" /> <id root="b46f0fc0-986f-11ee-b9d1-0242ac120002"/> <code code="CONC" codeSystem="2.16.840.1.113883.5.6"/> <statusCode code="active"/> <effectiveTime> <low value="20130101"/> </effectiveTime> <entryRelationship typeCode="SUBJ"> <!-- SDOH Problem --> <observation classCode="OBS" moodCode="EVN"> <templateId root="2.16.840.1.113883.10.20.22.4.4"/> <templateId root="2.16.840.1.113883.10.20.22.4.4" extension="2015-08-01"/> <templateId root="2.16.840.1.113883.10.20.22.4.4" extension="2022-06-01"/> <id extension="68993" root="1.2.840.114350.1.13.6289.1.7.2.768076"/> <id root="093A5380-00CE-11E6-B4C5-0050568B000B" extension="1.1"/> <code code="55607006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Problem"> <originalText>Problem</originalText> <translation code="75326-9" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Problem"/> </code> <statusCode code="completed"/> <effectiveTime> <low value="20100909"/> </effectiveTime> <value xsi:type="CD" code="445281000124101" displayName="Nutrition impaired due to limited access to healthful foods" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"> <translation code="Z59.48" codeSystem="2.16.840.1.113883.6.90" codeSystemName="ICD-10-CM" displayName="Other specified lack of adequate food"/> </value> <!-- Assessment Scale Observation --> <!-- Creates observation referenced by evidence.detail --> <!-- This one: #sdoh1 --> <entryRelationship typeCode="SPRT"> <observation classCode="OBS" moodCode="EVN"> <templateId root="2.16.840.1.113883.10.20.22.4.69"/> <templateId root="2.16.840.1.113883.10.20.22.4.69" extension="2022-06-01"/> <id root="f4dce790-8328-11db-9fe1-0800200c9a44"/> <code code="88122-7" displayName="(I/We) worried whether (my/our) food would run out..." codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/> <statusCode code="completed"/> <effectiveTime value="20100909"/> <value xsi:type="CD" code="LA28397-0" displayName="Often true" codeSystem="2.16.840.1.113883.6.1"> </value> </observation> </entryRelationship> <!-- Creates observation referenced by evidence.detail --> <!-- This one: #sdoh2 --> <entryRelationship typeCode="SPRT"> <observation classCode="OBS" moodCode="EVN"> <templateId root="2.16.840.1.113883.10.20.22.4.69"/> <templateId root="2.16.840.1.113883.10.20.22.4.69" extension="2022-06-01"/> <id root="0e9c5b7c-9def-11ee-8c90-0242ac120002"/> <code code="88124-3" displayName="Food insecurity risk [HVS]" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/> <statusCode code="completed"/> <effectiveTime value="20100909"/> <value xsi:type="CD" code="LA19952-3" displayName="At risk" codeSystem="2.16.840.1.113883.6.1"/> </observation> </entryRelationship> <!-- Date of Diagnosis Act --> <entryRelationship typeCode="COMP"> <act classCode="ACT" moodCode="EVN"> <templateId root="2.16.840.1.113883.10.20.22.4.502" extension="2022-06-01"/> <code code="77975-1" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Earliest date of diagnosis"/> <statusCode code="completed"/> <!-- SHALL to the year (MAY be more specific) --> <effectiveTime value="20100101"/> </act> </entryRelationship> </observation> </entryRelationship> </act> 'CONFORMANCE_STATEMENT_WORD
en/mappingGuidance.html
information
The html source contains the word 'SHOULD' but it is not in a text phrase marked as a conformance clause: 'Note that in C-CDA, timezone offset is a SHOULD, while in FHIR, time zone offset is required when more specific than the day. There may be instances where a CDA date-time value omits a time zone offset and other data from the document may be necessary to populate FHIR dateTime requirements.'CONFORMANCE_STATEMENT_WORD
This element does not match any known slice defined in the profile http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns|6.1.0 (this may not be a problem, but you should check that it's not intended to match a slice)Show Reasoning
This element does not match any known slice Defined in the profile http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns|6.1.0 (this may not be a problem, but you should check that it's not intended to match a slice)
Condition.category[0]: discriminator = true and ($this memberOf 'http://hl7.org/fhir/us/core/ValueSet/us-core-problem-or-health-concern')
,
Condition.category[0]: discriminator = true and ($this memberOf 'http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-condition-category')
Illustrative OID not available for validation in tx.fhir.org as used in C-CDA examples: https://cdasearch.hl7.org/examples/view/Problems/Problem%20Value%2C%20Translation%2C%20Qualifier%20examples This is deliebrately used in this guide to illustrate OID to urn:oid conversion in C-CDA to FHIR when URL is unavailable.
A definition for CodeSystem 'urn:oid:2.16.840.1.113883.3.247.1.1' could not be found, so the code cannot be validated (2 uses)
These are example identifiers with arbitrary identifier systems. There is no reason the validator should know them.
No definition could be found for URL value 'urn:oid:1.3.6.1.4.1.22812.3.2009316.3' (1 uses)
No definition could be found for URL value 'urn:oid:1.3.6.1.4.1.22812.3.2009316.3.4.1.2.1' (2 uses)
No definition could be found for URL value 'urn:oid:1.3.6.1.4.1.22812.3.2009316.3.4.10.2' (4 uses)
No definition could be found for URL value 'urn:oid:1.3.6.1.4.1.22812.3.2009316.3.4.7' (2 uses)
No definition could be found for URL value 'urn:oid:2.16.840.1.113883.19.5.9999.456' (1 uses)
This guide addresses current regulations. Any party interested in future work is invited to participate.
The ImplementationGuide uses package hl7.fhir.us.core#6.1.0 released on 2023-06-30, but the most recent appropriate version is 8.0.1. This reference is getting old and the more recent version should be considered (1 uses)
The ImplementationGuide uses package hl7.fhir.uv.extensions.r4#5.1.0 released on 2024-04-27, but the most recent appropriate version is 5.2.0. This reference is getting old and the more recent version should be considered (1 uses)
This is a validator issue, not an IG issue
Source Code System http://loinc.org is only supported on the terminology server, so the source codes are not validated for performance reasons (2 uses)
Source Code System http://snomed.info/sct is only supported on the terminology server, so the source codes are not validated for performance reasons (8 uses)
Target Code System http://loinc.org is only supported on the terminology server, so the target codes are not validated for performance reasons (2 uses)
Target Code System http://snomed.info/sct is only supported on the terminology server, so the target codes are not validated for performance reasons (7 uses)
This element does not match any known slice defined in the profile http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns|6.1.0 (this may not be a problem, but you should check that it's not intended to match a slice)