Consolidated CDA Release 2.1 StructureDefinition Publication
2.1 - CI Build

Consolidated CDA Release 2.1 StructureDefinition Publication, published by Health Level Seven. This is not an authorized publication; it is the continuous build for version 2.1). This version is based on the current content of https://github.com/HL7/CDA-ccda-2.1-sd/ and changes regularly. See the Directory of published versions

## Logical Model: Entry Reference

Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/EntryReference | Version: 2.1
Draft as of 2023-09-29 | Computable Name: EntryReference
Other Identifiers: id: urn:oid:2.16.840.1.113883.10.20.22.4.122

This template represents the act of referencing another entry in the same CDA document instance. Its purpose is to remove the need to repeat the complete XML representation of the referred entry when relating one entry to another. This template can be used to reference many types of Act class derivations, such as encounters, observations, procedures etc., as it is often necessary when authoring CDA documents to repeatedly reference other Acts of these types. For example, in a Care Plan it is necessary to repeatedly relate Health Concerns, Goals, Activities and Outcomes.

The id is required and must be the same id as the entry/id it is referencing. The id cannot be a null value. Act/Code is set to nullFlavor=”NP” (Not Present). This means the value is not present in the message (in act/Code).

Usage:

- Use this Logical Model: Care Team Organizer, Goal Observation, Health Concern Act, Intervention Act... Show 6 more, Outcome Observation, Planned Intervention Act, Planned Procedure, Procedure Activity Procedure, Risk Concern Act and Social History Observation

### Formal Views of Profile Content

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

- Differential Table
- Key Elements Table
- Snapshot Table
- Statistics/References
- All

This structure is derived from CDAR2.Act

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Act |  |  | CDAR2.Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, @classCode, @moodCode, realmCode, typeId, templateId, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition
classCode |  | 1..1 | cs | Fixed Value: ACT
moodCode |  | 1..1 | cs | Fixed Value: EVN
Slices for templateId |  | 1..* | II | Slice: Unordered, Open by value:root
templateId:primary |  | 1..1 | II |
root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.122
extension |  | 0..0 |  |
id |  | 1..* | II | The ID must equal another entry/id in the same document instance. Application Software must be responsible for resolving the identifier back to its original object and then rendering the information in the correct place in the containing section's narrative text. The ID cannot have Null value (e.g., nullFlavor is not allowed).
code |  | 1..1 | CD |
nullFlavor |  | 1..1 | cs | Fixed Value: NP
statusCode |  | 1..1 | CS |
code |  | 0..1 | cs | Fixed Value: completed
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Act |  | 1..1 | CDAR2.Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, @classCode, @moodCode, realmCode, typeId, templateId, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition Base for all types and resources
@classCode |  | 1..1 | cs | Fixed Value: ACT
@moodCode |  | 1..1 | cs | Fixed Value: EVN
Slices for templateId |  | 1..* | II | Slice: Unordered, Open by value:root
templateId:primary |  | 1..1 | II |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.122
id |  | 1..* | II | The ID must equal another entry/id in the same document instance. Application Software must be responsible for resolving the identifier back to its original object and then rendering the information in the correct place in the containing section's narrative text. The ID cannot have Null value (e.g., nullFlavor is not allowed).
code |  | 1..1 | CD | Binding: v3 Code System ActCode (extensible)
@nullFlavor |  | 1..1 | cs | Binding: NullFlavor (required) Fixed Value: NP
statusCode |  | 1..1 | CS | Binding: ActStatus (required)
@code |  | 0..1 | cs | Fixed Value: completed
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code
Act.code | extensible | ActCode
Act.code.nullFlavor | required | Fixed Value: NP
Act.statusCode | required | ActStatus

#### Constraints

Id | Grade | Path(s) | Details | Requirements
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Act |  | 1..1 | CDAR2.Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, @classCode, @moodCode, realmCode, typeId, templateId, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition Base for all types and resources
@nullFlavor |  | 0..1 | cs | Binding: NullFlavor (required)
@classCode |  | 1..1 | cs | Fixed Value: ACT
@moodCode |  | 1..1 | cs | Fixed Value: EVN
realmCode |  | 0..* | CS |
typeId |  | 0..1 | II |
Slices for templateId |  | 1..* | II | Slice: Unordered, Open by value:root
templateId:primary |  | 1..1 | II |
@nullFlavor |  | 0..1 | cs | Binding: NullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.122
id |  | 1..* | II | The ID must equal another entry/id in the same document instance. Application Software must be responsible for resolving the identifier back to its original object and then rendering the information in the correct place in the containing section's narrative text. The ID cannot have Null value (e.g., nullFlavor is not allowed).
code |  | 1..1 | CD | Binding: v3 Code System ActCode (extensible)
@nullFlavor |  | 1..1 | cs | Binding: NullFlavor (required) Fixed Value: NP
@code |  | 0..1 | cs |
@codeSystem |  | 0..1 | oid, uuid, ruid |
@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 |
@negationInd |  | 0..1 | bl |
text |  | 0..1 | ED |
statusCode |  | 1..1 | CS | Binding: ActStatus (required)
@nullFlavor |  | 0..1 | cs | Binding: NullFlavor (required)
@code |  | 0..1 | cs | Fixed Value: completed
@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 |  | 0..1 | IVL_TS |
priorityCode |  | 0..1 | CE | Binding: ActPriority (extensible)
languageCode |  | 0..1 | CS | Binding: HumanLanguage (required)
subject |  | 0..1 | Subject |
specimen |  | 0..* | Specimen |
performer |  | 0..* | Performer2 |
author |  | 0..* | Author |
informant |  | 0..* | Informant |
participant |  | 0..* | Participant2 |
entryRelationship |  | 0..* | EntryRelationship |
reference |  | 0..* | Reference |
precondition |  | 0..* | Precondition |
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code
Act.nullFlavor | required | NullFlavor
Act.templateId:primary.nullFlavor | required | NullFlavor
Act.code | extensible | ActCode
Act.code.nullFlavor | required | Fixed Value: NP
Act.statusCode | required | ActStatus
Act.statusCode.nullFlavor | required | NullFlavor
Act.priorityCode | extensible | ActPriority
Act.languageCode | required | HumanLanguage (a valid code from `http://terminology.hl7.org/CodeSystem/ietf3066`)

#### Constraints

Id | Grade | Path(s) | Details | Requirements
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |

This structure is derived from CDAR2.Act

Summary

Mandatory: 6 elements
Fixed Value: 4 elements
Prohibited: 1 element

Slices

This structure defines the following Slices:

- The element Act.templateId is sliced based on the value of value:root

Differential View

This structure is derived from CDAR2.Act

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Act |  |  | CDAR2.Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, @classCode, @moodCode, realmCode, typeId, templateId, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition
classCode |  | 1..1 | cs | Fixed Value: ACT
moodCode |  | 1..1 | cs | Fixed Value: EVN
Slices for templateId |  | 1..* | II | Slice: Unordered, Open by value:root
templateId:primary |  | 1..1 | II |
root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.122
extension |  | 0..0 |  |
id |  | 1..* | II | The ID must equal another entry/id in the same document instance. Application Software must be responsible for resolving the identifier back to its original object and then rendering the information in the correct place in the containing section's narrative text. The ID cannot have Null value (e.g., nullFlavor is not allowed).
code |  | 1..1 | CD |
nullFlavor |  | 1..1 | cs | Fixed Value: NP
statusCode |  | 1..1 | CS |
code |  | 0..1 | cs | Fixed Value: completed
Documentation for this format

Key Elements View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Act |  | 1..1 | CDAR2.Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, @classCode, @moodCode, realmCode, typeId, templateId, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition Base for all types and resources
@classCode |  | 1..1 | cs | Fixed Value: ACT
@moodCode |  | 1..1 | cs | Fixed Value: EVN
Slices for templateId |  | 1..* | II | Slice: Unordered, Open by value:root
templateId:primary |  | 1..1 | II |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.122
id |  | 1..* | II | The ID must equal another entry/id in the same document instance. Application Software must be responsible for resolving the identifier back to its original object and then rendering the information in the correct place in the containing section's narrative text. The ID cannot have Null value (e.g., nullFlavor is not allowed).
code |  | 1..1 | CD | Binding: v3 Code System ActCode (extensible)
@nullFlavor |  | 1..1 | cs | Binding: NullFlavor (required) Fixed Value: NP
statusCode |  | 1..1 | CS | Binding: ActStatus (required)
@code |  | 0..1 | cs | Fixed Value: completed
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code
Act.code | extensible | ActCode
Act.code.nullFlavor | required | Fixed Value: NP
Act.statusCode | required | ActStatus

#### Constraints

Id | Grade | Path(s) | Details | Requirements
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Act |  | 1..1 | CDAR2.Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, @classCode, @moodCode, realmCode, typeId, templateId, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition Base for all types and resources
@nullFlavor |  | 0..1 | cs | Binding: NullFlavor (required)
@classCode |  | 1..1 | cs | Fixed Value: ACT
@moodCode |  | 1..1 | cs | Fixed Value: EVN
realmCode |  | 0..* | CS |
typeId |  | 0..1 | II |
Slices for templateId |  | 1..* | II | Slice: Unordered, Open by value:root
templateId:primary |  | 1..1 | II |
@nullFlavor |  | 0..1 | cs | Binding: NullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.122
id |  | 1..* | II | The ID must equal another entry/id in the same document instance. Application Software must be responsible for resolving the identifier back to its original object and then rendering the information in the correct place in the containing section's narrative text. The ID cannot have Null value (e.g., nullFlavor is not allowed).
code |  | 1..1 | CD | Binding: v3 Code System ActCode (extensible)
@nullFlavor |  | 1..1 | cs | Binding: NullFlavor (required) Fixed Value: NP
@code |  | 0..1 | cs |
@codeSystem |  | 0..1 | oid, uuid, ruid |
@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 |
@negationInd |  | 0..1 | bl |
text |  | 0..1 | ED |
statusCode |  | 1..1 | CS | Binding: ActStatus (required)
@nullFlavor |  | 0..1 | cs | Binding: NullFlavor (required)
@code |  | 0..1 | cs | Fixed Value: completed
@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 |  | 0..1 | IVL_TS |
priorityCode |  | 0..1 | CE | Binding: ActPriority (extensible)
languageCode |  | 0..1 | CS | Binding: HumanLanguage (required)
subject |  | 0..1 | Subject |
specimen |  | 0..* | Specimen |
performer |  | 0..* | Performer2 |
author |  | 0..* | Author |
informant |  | 0..* | Informant |
participant |  | 0..* | Participant2 |
entryRelationship |  | 0..* | EntryRelationship |
reference |  | 0..* | Reference |
precondition |  | 0..* | Precondition |
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code
Act.nullFlavor | required | NullFlavor
Act.templateId:primary.nullFlavor | required | NullFlavor
Act.code | extensible | ActCode
Act.code.nullFlavor | required | Fixed Value: NP
Act.statusCode | required | ActStatus
Act.statusCode.nullFlavor | required | NullFlavor
Act.priorityCode | extensible | ActPriority
Act.languageCode | required | HumanLanguage (a valid code from `http://terminology.hl7.org/CodeSystem/ietf3066`)

#### Constraints

Id | Grade | Path(s) | Details | Requirements
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |

This structure is derived from CDAR2.Act

Summary

Mandatory: 6 elements
Fixed Value: 4 elements
Prohibited: 1 element

Slices

This structure defines the following Slices:

- The element Act.templateId is sliced based on the value of value:root

Other representations of profile: CSV, Excel