CDA Examples
1.0.0 - active
CDA Examples
1.0.0 - active
CDA Examples, published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/CDA-Examples/ and changes regularly. See the Directory of published versions
This is an example of a propensity to drug adverse event with information on multiple allergic reactions each with reaction severity. It was based upon discussion with Rob Hausam and John D’Amore and Russ Leftwich in coordination with Patient Care Committee. This sample replaces the Epinephrine sample which had less clinical accuracy/relevance. See DSTU 219 for update regarding act/code.
This file includes examples of the following templates:
<!-- Allergies Section -->
<section xmlns="urn:hl7-org:v3">
<templateId root="2.16.840.1.113883.10.20.22.2.6.1"/>
<templateId root="2.16.840.1.113883.10.20.22.2.6.1" extension="2015-08-01"/>
<!-- Allergies (entries required) section template -->
<code codeSystem="2.16.840.1.113883.6.1" code="48765-2"/>
<title>Allergies, Adverse Reactions and Alerts</title>
<text>
<list listType="unordered">
<item ID="AllergyIntoleranceObservation_1.1">
<table>
<thead>
<tr>
<th>Allergy or Intolerance</th>
<th ID="AllergyIntolerance_1.1Data">Data</th>
</tr>
</thead>
<tbody>
<tr>
<th>Type:</th>
<td ID="AllergyType_1.1D">Drug intolerance (disorder)</td>
</tr>
<tr>
<th>Agent:</th>
<td ID="AllergyAgent_1.1D">Codeine</td>
</tr>
<tr>
<th>Allergy Start Date:</th>
<td>03/15/2010</td>
</tr>
<tr>
<th>Allergy End Date:</th>
<td/>
</tr>
<tr>
<th>Reactions:</th>
<td>
<list listType="unordered">
<item>
<table>
<thead>
<tr>
<th>Start Date</th>
<th>End Date</th>
<th>Reaction</th>
<th>Severity</th>
</tr>
</thead>
<tbody>
<tr>
<td>01/29/2012</td>
<td>01/29/2012</td>
<td ID="REACT_1.1.1D">Nausea</td>
<td ID="SEV_1.1.1D">Severe</td>
</tr>
<tr>
<td>03/15/2010</td>
<td>03/15/2010</td>
<td ID="REACT_1.1.2D">Nausea</td>
<td ID="SEV_1.1.2D">Mild</td>
</tr>
</tbody>
</table>
</item>
</list>
</td>
</tr>
</tbody>
</table>
</item>
</list>
</text>
<entry typeCode="DRIV">
<act moodCode="EVN" classCode="ACT">
<!-- ** Allergy problem act ** -->
<templateId root="2.16.840.1.113883.10.20.22.4.30"/>
<templateId root="2.16.840.1.113883.10.20.22.4.30"
extension="2015-08-01"/>
<id root="4a2ac5fc-0c85-4223-baee-c2e254803974"/>
<code displayName="Allergies, adverse reactions, alerts"
codeSystemName="LOINC" codeSystem="2.16.840.1.113883.5.6" code="CONC"/>
<text>
<reference value="#AllergyIntoleranceObservation_1.1"/>
</text>
<statusCode code="active"/>
<!-- This is the time stamp for when the allergy was first documented as a concern -->
<effectiveTime>
<low value="20140103"/>
</effectiveTime>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
<time value="20140103102500-0500"/>
<assignedAuthor>
<id root="2.16.840.1.113883.4.6" extension="99999999"/>
<!-- Root means NPI number. -->
<code displayName="Family Medicine Physician"
codeSystemName="Health Care Provider Taxonomy" codeSystem="2.16.840.1.113883.6.101" code="207Q00000X"/>
<addr nullFlavor="UNK"/>
<telecom value="tel:555-555-1002" use="WP"/>
<assignedPerson>
<name>
<given>Henry</given>
<family>Seven</family>
</name>
</assignedPerson>
</assignedAuthor>
</author>
<entryRelationship typeCode="SUBJ">
<observation moodCode="EVN" classCode="OBS">
<!-- allergy observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
<templateId root="2.16.840.1.113883.10.20.22.4.7"
extension="2014-06-09"/>
<!-- Substance or Device Allergy Intolerance Observation Template -->
<templateId root="2.16.840.1.113883.10.20.24.3.90"
extension="2014-06-09"/>
<id root="4a2ac5fc-0c85-4223-baee-c2e254803974"/>
<code xsi:type="CD" codeSystem="2.16.840.1.113883.5.4"
code="ASSERTION"/>
<text xsi:type="ED">
<reference value="#AllergyIntoleranceObservation_1.1"/>
</text>
<statusCode code="completed"/>
<effectiveTime>
<low value="20100315"/>
</effectiveTime>
<!-- The time when this was biologically relevant ie True for the patient. -->
<!-- As a minimum time interval over which this is true, populate the effectiveTime/low with the current time. -->
<!-- It would be equally valid to have a longer range of time over which this statement was represented as being true. -->
<!-- As a maximum, you would never indicate an effectiveTime/high that was greater than the current point in time. -->
<value xsi:type="CD" displayName="Intolerance to drug (finding)"
codeSystemName="SNOMED CT" codeSystem="2.16.840.1.113883.6.96" code="59037007">
<originalText>
<reference value="#AllergyType_1.1D"/>
</originalText>
</value>
<author>
<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
<time value="20140103102500-0500"/>
<assignedAuthor>
<id root="2.16.840.1.113883.4.6" extension="99999999"/>
<!-- Root means NPI number. -->
<code displayName="Family Medicine Physician"
codeSystemName="Health Care Provider Taxonomy" codeSystem="2.16.840.1.113883.6.101" code="207Q00000X"/>
<addr nullFlavor="UNK"/>
<telecom value="tel:555-555-1002" use="WP"/>
<assignedPerson>
<name>
<given>Henry</given>
<family>Seven</family>
</name>
</assignedPerson>
</assignedAuthor>
</author>
<informant>
<assignedEntity>
<!-- This is a fictional OID and identifier for the patient. This should be adapted to local implementation -->
<id root="2.16.840.1.113883.3.3208.101.2"
extension="20130607100800-Patient1"/>
<addr use="HP">
<streetAddressLine>1111 StreetName St.</streetAddressLine>
<city>Silver Spring</city>
<state>MD</state>
<postalCode>20901</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1(301)111-1111" use="HP"/>
<assignedPerson>
<name>
<given>Patient</given>
<family>One</family>
</name>
</assignedPerson>
</assignedEntity>
</informant>
<participant typeCode="CSM">
<participantRole classCode="MANU">
<playingEntity classCode="MMAT">
<code displayName="codeine" codeSystemName="RxNorm"
codeSystem="2.16.840.1.113883.6.88" code="2670">
<originalText>
<reference value="#AllergyAgent_1.1D"/>
</originalText>
</code>
</playingEntity>
</participantRole>
</participant>
<entryRelationship typeCode="MFST" inversionInd="true">
<observation moodCode="EVN" classCode="OBS">
<!-- Reaction Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
<templateId root="2.16.840.1.113883.10.20.22.4.9"
extension="2014-06-09"/>
<id root="0506c036-adfb-4e6e-b9e1-eea76177ead5"/>
<code xsi:type="CD" codeSystem="2.16.840.1.113883.5.4"
code="ASSERTION"/>
<statusCode code="completed"/>
<effectiveTime>
<low value="20120129"/>
<!-- Not sure about the effectiveTime for reaction -->
<high value="20120129"/>
</effectiveTime>
<value xsi:type="CD" displayName="Nausea"
codeSystem="2.16.840.1.113883.6.96" code="422587007">
<originalText>
<reference value="#REACT_1.1.1D"/>
</originalText>
</value>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation moodCode="EVN" classCode="OBS">
<!-- Severity Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
<templateId root="2.16.840.1.113883.10.20.22.4.8"
extension="2014-06-09"/>
<code xsi:type="CD" codeSystemName="ActCode"
codeSystem="2.16.840.1.113883.5.4" code="SEV"/>
<statusCode code="completed"/>
<value xsi:type="CD" displayName="Severe"
codeSystemName="SNOMED CT" codeSystem="2.16.840.1.113883.6.96" code="24484000">
<originalText>
<reference value="#SEV_1.1.1D"/>
</originalText>
</value>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
<!-- Note that multiple reactions may be recorded to the same substance ([0..*] -->
<entryRelationship typeCode="MFST" inversionInd="true">
<observation moodCode="EVN" classCode="OBS">
<!-- Reaction Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
<templateId root="2.16.840.1.113883.10.20.22.4.9"
extension="2014-06-09"/>
<id root="fea0b775-f3fe-4e0a-9c4f-4a5c235c2af0"/>
<code xsi:type="CD" codeSystem="2.16.840.1.113883.5.4"
code="ASSERTION"/>
<statusCode code="completed"/>
<effectiveTime>
<low value="20100315"/>
<!-- Not sure about the effectiveTime for reaction -->
<high value="20100315"/>
</effectiveTime>
<value xsi:type="CD" displayName="Nausea"
codeSystem="2.16.840.1.113883.6.96" code="422587007">
<originalText>
<reference value="#REACT_1.1.2D"/>
</originalText>
</value>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation moodCode="EVN" classCode="OBS">
<!-- Severity Observation template -->
<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
<templateId root="2.16.840.1.113883.10.20.22.4.8"
extension="2014-06-09"/>
<code xsi:type="CD" codeSystemName="ActCode"
codeSystem="2.16.840.1.113883.5.4" code="SEV"/>
<statusCode code="completed"/>
<value xsi:type="CD" displayName="Mild"
codeSystemName="SNOMED CT" codeSystem="2.16.840.1.113883.6.96"
code="255604002">
<originalText>
<reference value="#SEV_1.1.2D"/>
</originalText>
</value>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
</act>
</entry>
</section>
IG © Health Level Seven. Package hl7.cda.examples#1.0.0 based on FHIR 5.0.0. Generated 2025-08-28
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