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

effectiveTime Use

This is an abstracted universal definition of effectiveTime in C-CDA documents:

Per the RIM, the effectiveTime, also referred to as the “biologically relevant time,” is the time at which the act holds for the patient.

• @value - Use this when the event (i.e. encounter, assessment, measurement or administration) only occurred at a single point in time
• low/@value - Use this when the target act starts, or will start, at a point in time and could end in the future (known or unknown). If C-CDA only includes an effectiveTime/low it means the ‘act’ is ongoing and active.
• high/@value - Use this when the target act starts at a point in time and could end.
  • Omit <high> element to indicate act is ongoing (prefered). If your system must include a high element, use high/@nullFlavor="NA" (Not Applicable).
  • Use nullFlavor="UNK" if act has ended If it has ended, and the end time is unknown
  • Do NOT use nullFlavor="UNK" when you aren’t certain if the act has ended. Omit the element or use nullFlavor="NI" (No information).

In general, we do not recommend use of other elements (e.g. <center>, <width> or <period>) within effectiveTime with the exception of the use of <period> for medication administration schedules.

Only include known specificity. For example, if you only know a person’s birthday to day, only include to day effectiveTime/@value="20121111". Do not pad out time with zeros.

When reporting time it is best practice to include a timezone offset. effectiveTime/@value="20140104123506-0500"

If specificity to seconds is not available - either of these patterns is possible. Some systems will always send the additional zeros whether significant or not:

effectiveTime/@value="201401041235-0500" effectiveTime/@value="20140104123500-0500"

When time zone is not specified the time SHALL be interpreted as local, not UTC. To indicate the time zone of UTC include +0000.