Consolidated CDA Release 2.2, published by Health Level Seven. This is not an authorized publication; it is the continuous build for version 2.2). This version is based on the current content of https://github.com/HL7/CDA-ccda-2.2/ and changes regularly. See the Directory of published versions
Official URL: http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.3 | Version: 2.2 | |||
Active as of 2022-05-13 | Computable Name: ProblemConcernAct | |||
Other Identifiers: : urn:hl7ii:2.16.840.1.113883.10.20.22.4.3:2015-08-01 |
This template reflects an ongoing concern on behalf of the provider that placed the concern on a patients problem list. So long as the underlying condition is of concern to the provider (i.e., as long as the condition, whether active or resolved, is of ongoing concern and interest to the provider), the statusCode is active. Only when the underlying condition is no longer of concern is the statusCode set to completed. The effectiveTime reflects the time that the underlying condition was felt to be a concern; it may or may not correspond to the effectiveTime of the condition (e.g., even five years later, the clinician may remain concerned about a prior heart attack).
The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved.
The effectiveTime/low of the Problem Concern Act asserts when the concern became active. The effectiveTime/high asserts when the concern was completed (e.g., when the clinician deemed there is no longer any need to track the underlying condition).
A Problem Concern Act can contain many Problem Observations (templateId 2.16.840.1.113883.10.20.22.4.4). Each Problem Observation is a discrete observation of a condition, and therefore will have a statusCode of completed. The many Problem Observations nested under a Problem Concern Act reflect the change in the clinical understanding of a condition over time. For instance, a Concern may initially contain a Problem Observation of chest pain:
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from CDAR2.Act
Summary
Mandatory: 16 elements (2 nested mandatory elements)
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
This structure is derived from CDAR2.Act
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Act | 1..1 | CDAR2.Act | ||
classCode | 1..1 | code | Required Pattern: ACT | |
moodCode | 1..1 | code | Required Pattern: EVN | |
Slices for templateId | 0..* | II | Slice: Unordered, Open by value:extension, value:root | |
templateId:primary | 1..1 | II | ||
root | 1..1 | string | Required Pattern: 2.16.840.1.113883.10.20.22.4.3 | |
extension | 1..1 | string | Required Pattern: 2015-08-01 | |
id | 1..* | II | ||
code | 1..1 | CD | ||
code | 1..1 | string | Required Pattern: CONC | |
codeSystem | 1..1 | string | Required Pattern: 2.16.840.1.113883.5.6 | |
statusCode | 1..1 | CS | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. | |
code | 1..1 | string | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. Binding: ProblemAct statusCode (required) | |
effectiveTime | 1..1 | IVL_TS | ||
low | 1..1 | TS | The effectiveTime/low of the Problem Concern Act asserts when the concern became active. | |
high | 0..1 | TS | The effectiveTime/high asserts when the concern was completed (e.g., when the clinician deemed there is no longer any need to track the underlying condition). | |
author | 0..* | AuthorParticipation | ||
Slices for entryRelationship | 0..* | Element | The following entryRelationship represents the importance of the concern to a provider. Slice: Unordered, Open by profile:observation | |
entryRelationship:problem | 1..* | Element | ||
typeCode | 1..1 | code | Required Pattern: SUBJ | |
observation | 1..1 | ProblemObservation | ||
entryRelationship:priority | 0..* | Element | ||
typeCode | 1..1 | code | Required Pattern: REFR | |
observation | 1..1 | PriorityPreference | ||
Documentation for this format |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Act | 1..1 | CDAR2.Act | ||
classCode | 1..1 | code | Required Pattern: ACT | |
moodCode | 1..1 | code | Required Pattern: EVN | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
Slices for templateId | 0..* | II | Slice: Unordered, Open by value:extension, value:root | |
templateId:primary | 1..1 | II | ||
nullFlavor | 0..1 | code | Binding: NullFlavor (required) | |
assigningAuthorityName | 0..1 | string | ||
displayable | 0..1 | boolean | ||
root | 1..1 | string | Required Pattern: 2.16.840.1.113883.10.20.22.4.3 | |
extension | 1..1 | string | Required Pattern: 2015-08-01 | |
id | 1..* | II | ||
code | 1..1 | CD | Binding: v3 Code System ActCode (extensible) | |
nullFlavor | 0..1 | code | Binding: NullFlavor (required) | |
code | 1..1 | string | Required Pattern: CONC | |
codeSystem | 1..1 | string | Required Pattern: 2.16.840.1.113883.5.6 | |
codeSystemName | 0..1 | string | ||
codeSystemVersion | 0..1 | string | ||
displayName | 0..1 | string | ||
sdtcValueSet | 0..1 | string | XML: valueSet (urn:hl7-org:sdtc) | |
sdtcValueSetVersion | 0..1 | string | XML: valueSetVersion (urn:hl7-org:sdtc) | |
originalText | 0..1 | ED | ||
qualifier | 0..* | CR | ||
translation | 0..* | CD | ||
negationInd | 0..1 | boolean | ||
text | 0..1 | ED | ||
statusCode | 1..1 | CS | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. Binding: ActStatus (required) | |
nullFlavor | 0..1 | code | Binding: NullFlavor (required) | |
code | 1..1 | string | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. Binding: ProblemAct statusCode (required) | |
sdtcValueSet | 0..1 | string | XML: valueSet (urn:hl7-org:sdtc) | |
sdtcValueSetVersion | 0..1 | string | XML: valueSetVersion (urn:hl7-org:sdtc) | |
effectiveTime | 1..1 | IVL_TS | ||
nullFlavor | 0..1 | code | Binding: NullFlavor (required) | |
value | 0..1 | dateTime | ||
inclusive | 0..1 | boolean | ||
operator | 0..1 | code | ||
low | 1..1 | TS | The effectiveTime/low of the Problem Concern Act asserts when the concern became active. | |
high | 0..1 | TS | The effectiveTime/high asserts when the concern was completed (e.g., when the clinician deemed there is no longer any need to track the underlying condition). | |
width | 0..1 | PQ | ||
center | 0..1 | TS | ||
priorityCode | 0..1 | CE | Binding: ActPriority (extensible) | |
languageCode | 0..1 | CS | Binding: HumanLanguage (required) | |
subject | 0..1 | Element | ||
typeCode | 1..1 | code | Binding: ParticipationTargetSubject (required) Fixed Value: SBJ | |
contextControlCode | 1..1 | code | Binding: ContextControl (required) Fixed Value: OP | |
awarenessCode | 0..1 | CE | Binding: TargetAwareness (extensible) | |
relatedSubject | 1..1 | RelatedSubject | ||
specimen | 0..* | Specimen | ||
performer | 0..* | Performer2 | ||
author | 0..* | AuthorParticipation | ||
informant | 0..* | Element | ||
typeCode | 1..1 | code | Binding: ParticipationInformationGenerator (required) Fixed Value: INF | |
contextControlCode | 1..1 | code | Binding: ContextControl (required) Fixed Value: OP | |
assignedEntity | 0..1 | AssignedEntity | ||
relatedEntity | 0..1 | RelatedEntity | ||
participant | 0..* | Participant2 | ||
Slices for entryRelationship | I | 0..* | Element | The following entryRelationship represents the importance of the concern to a provider. Slice: Unordered, Open by profile:observation |
entryRelationship:All Slices | Content/Rules for all slices | |||
typeCode | 1..1 | code | ||
inversionInd | 0..1 | boolean | ||
contextConductionInd | 1..1 | boolean | ||
sequenceNumber | 0..1 | INT | ||
negationInd | 0..1 | boolean | ||
seperatableInd | 0..1 | BL | ||
(Choice of one) | 1..1 | |||
observation | 0..1 | Observation | ||
regionOfInterest | 0..1 | RegionOfInterest | ||
observationMedia | 0..1 | ObservationMedia | ||
substanceAdministration | 0..1 | SubstanceAdministration | ||
supply | 0..1 | Supply | ||
procedure | 0..1 | Procedure | ||
encounter | 0..1 | Encounter | ||
organizer | 0..1 | Organizer | ||
act | 0..1 | Act | ||
entryRelationship:problem | I | 1..* | Element | |
typeCode | 1..1 | code | Required Pattern: SUBJ | |
inversionInd | 0..1 | boolean | ||
contextConductionInd | 1..1 | boolean | ||
sequenceNumber | 0..1 | INT | ||
negationInd | 0..1 | boolean | ||
seperatableInd | 0..1 | BL | ||
observation | 1..1 | ProblemObservation | ||
entryRelationship:priority | I | 0..* | Element | |
typeCode | 1..1 | code | Required Pattern: REFR | |
inversionInd | 0..1 | boolean | ||
contextConductionInd | 1..1 | boolean | ||
sequenceNumber | 0..1 | INT | ||
negationInd | 0..1 | boolean | ||
seperatableInd | 0..1 | BL | ||
observation | 1..1 | PriorityPreference | ||
reference | 0..* | Element | ||
typeCode | 1..1 | code | ||
seperatableInd | 0..1 | BL | ||
externalAct | 0..1 | ExternalAct | ||
externalObservation | 0..1 | ExternalObservation | ||
externalProcedure | 0..1 | ExternalProcedure | ||
externalDocument | 0..1 | ExternalDocument | ||
precondition | 0..* | Precondition | ||
Documentation for this format |
This structure is derived from CDAR2.Act
Summary
Mandatory: 16 elements (2 nested mandatory elements)
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Differential View
This structure is derived from CDAR2.Act
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Act | 1..1 | CDAR2.Act | ||
classCode | 1..1 | code | Required Pattern: ACT | |
moodCode | 1..1 | code | Required Pattern: EVN | |
Slices for templateId | 0..* | II | Slice: Unordered, Open by value:extension, value:root | |
templateId:primary | 1..1 | II | ||
root | 1..1 | string | Required Pattern: 2.16.840.1.113883.10.20.22.4.3 | |
extension | 1..1 | string | Required Pattern: 2015-08-01 | |
id | 1..* | II | ||
code | 1..1 | CD | ||
code | 1..1 | string | Required Pattern: CONC | |
codeSystem | 1..1 | string | Required Pattern: 2.16.840.1.113883.5.6 | |
statusCode | 1..1 | CS | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. | |
code | 1..1 | string | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. Binding: ProblemAct statusCode (required) | |
effectiveTime | 1..1 | IVL_TS | ||
low | 1..1 | TS | The effectiveTime/low of the Problem Concern Act asserts when the concern became active. | |
high | 0..1 | TS | The effectiveTime/high asserts when the concern was completed (e.g., when the clinician deemed there is no longer any need to track the underlying condition). | |
author | 0..* | AuthorParticipation | ||
Slices for entryRelationship | 0..* | Element | The following entryRelationship represents the importance of the concern to a provider. Slice: Unordered, Open by profile:observation | |
entryRelationship:problem | 1..* | Element | ||
typeCode | 1..1 | code | Required Pattern: SUBJ | |
observation | 1..1 | ProblemObservation | ||
entryRelationship:priority | 0..* | Element | ||
typeCode | 1..1 | code | Required Pattern: REFR | |
observation | 1..1 | PriorityPreference | ||
Documentation for this format |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Act | 1..1 | CDAR2.Act | ||
classCode | 1..1 | code | Required Pattern: ACT | |
moodCode | 1..1 | code | Required Pattern: EVN | |
realmCode | 0..* | CS | ||
typeId | 0..1 | II | ||
Slices for templateId | 0..* | II | Slice: Unordered, Open by value:extension, value:root | |
templateId:primary | 1..1 | II | ||
nullFlavor | 0..1 | code | Binding: NullFlavor (required) | |
assigningAuthorityName | 0..1 | string | ||
displayable | 0..1 | boolean | ||
root | 1..1 | string | Required Pattern: 2.16.840.1.113883.10.20.22.4.3 | |
extension | 1..1 | string | Required Pattern: 2015-08-01 | |
id | 1..* | II | ||
code | 1..1 | CD | Binding: v3 Code System ActCode (extensible) | |
nullFlavor | 0..1 | code | Binding: NullFlavor (required) | |
code | 1..1 | string | Required Pattern: CONC | |
codeSystem | 1..1 | string | Required Pattern: 2.16.840.1.113883.5.6 | |
codeSystemName | 0..1 | string | ||
codeSystemVersion | 0..1 | string | ||
displayName | 0..1 | string | ||
sdtcValueSet | 0..1 | string | XML: valueSet (urn:hl7-org:sdtc) | |
sdtcValueSetVersion | 0..1 | string | XML: valueSetVersion (urn:hl7-org:sdtc) | |
originalText | 0..1 | ED | ||
qualifier | 0..* | CR | ||
translation | 0..* | CD | ||
negationInd | 0..1 | boolean | ||
text | 0..1 | ED | ||
statusCode | 1..1 | CS | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. Binding: ActStatus (required) | |
nullFlavor | 0..1 | code | Binding: NullFlavor (required) | |
code | 1..1 | string | The statusCode of the Problem Concern Act is the definitive indication of the status of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive indication of whether or not the underlying condition is resolved. Binding: ProblemAct statusCode (required) | |
sdtcValueSet | 0..1 | string | XML: valueSet (urn:hl7-org:sdtc) | |
sdtcValueSetVersion | 0..1 | string | XML: valueSetVersion (urn:hl7-org:sdtc) | |
effectiveTime | 1..1 | IVL_TS | ||
nullFlavor | 0..1 | code | Binding: NullFlavor (required) | |
value | 0..1 | dateTime | ||
inclusive | 0..1 | boolean | ||
operator | 0..1 | code | ||
low | 1..1 | TS | The effectiveTime/low of the Problem Concern Act asserts when the concern became active. | |
high | 0..1 | TS | The effectiveTime/high asserts when the concern was completed (e.g., when the clinician deemed there is no longer any need to track the underlying condition). | |
width | 0..1 | PQ | ||
center | 0..1 | TS | ||
priorityCode | 0..1 | CE | Binding: ActPriority (extensible) | |
languageCode | 0..1 | CS | Binding: HumanLanguage (required) | |
subject | 0..1 | Element | ||
typeCode | 1..1 | code | Binding: ParticipationTargetSubject (required) Fixed Value: SBJ | |
contextControlCode | 1..1 | code | Binding: ContextControl (required) Fixed Value: OP | |
awarenessCode | 0..1 | CE | Binding: TargetAwareness (extensible) | |
relatedSubject | 1..1 | RelatedSubject | ||
specimen | 0..* | Specimen | ||
performer | 0..* | Performer2 | ||
author | 0..* | AuthorParticipation | ||
informant | 0..* | Element | ||
typeCode | 1..1 | code | Binding: ParticipationInformationGenerator (required) Fixed Value: INF | |
contextControlCode | 1..1 | code | Binding: ContextControl (required) Fixed Value: OP | |
assignedEntity | 0..1 | AssignedEntity | ||
relatedEntity | 0..1 | RelatedEntity | ||
participant | 0..* | Participant2 | ||
Slices for entryRelationship | I | 0..* | Element | The following entryRelationship represents the importance of the concern to a provider. Slice: Unordered, Open by profile:observation |
entryRelationship:All Slices | Content/Rules for all slices | |||
typeCode | 1..1 | code | ||
inversionInd | 0..1 | boolean | ||
contextConductionInd | 1..1 | boolean | ||
sequenceNumber | 0..1 | INT | ||
negationInd | 0..1 | boolean | ||
seperatableInd | 0..1 | BL | ||
(Choice of one) | 1..1 | |||
observation | 0..1 | Observation | ||
regionOfInterest | 0..1 | RegionOfInterest | ||
observationMedia | 0..1 | ObservationMedia | ||
substanceAdministration | 0..1 | SubstanceAdministration | ||
supply | 0..1 | Supply | ||
procedure | 0..1 | Procedure | ||
encounter | 0..1 | Encounter | ||
organizer | 0..1 | Organizer | ||
act | 0..1 | Act | ||
entryRelationship:problem | I | 1..* | Element | |
typeCode | 1..1 | code | Required Pattern: SUBJ | |
inversionInd | 0..1 | boolean | ||
contextConductionInd | 1..1 | boolean | ||
sequenceNumber | 0..1 | INT | ||
negationInd | 0..1 | boolean | ||
seperatableInd | 0..1 | BL | ||
observation | 1..1 | ProblemObservation | ||
entryRelationship:priority | I | 0..* | Element | |
typeCode | 1..1 | code | Required Pattern: REFR | |
inversionInd | 0..1 | boolean | ||
contextConductionInd | 1..1 | boolean | ||
sequenceNumber | 0..1 | INT | ||
negationInd | 0..1 | boolean | ||
seperatableInd | 0..1 | BL | ||
observation | 1..1 | PriorityPreference | ||
reference | 0..* | Element | ||
typeCode | 1..1 | code | ||
seperatableInd | 0..1 | BL | ||
externalAct | 0..1 | ExternalAct | ||
externalObservation | 0..1 | ExternalObservation | ||
externalProcedure | 0..1 | ExternalProcedure | ||
externalDocument | 0..1 | ExternalDocument | ||
precondition | 0..* | Precondition | ||
Documentation for this format |
Other representations of profile: CSV, Excel, Schematron
Path | Conformance | ValueSet / Code |
Act.templateId:primary.nullFlavor | required | NullFlavor |
Act.code | extensible | ActCode |
Act.code.nullFlavor | required | NullFlavor |
Act.statusCode | required | ActStatus |
Act.statusCode.nullFlavor | required | NullFlavor |
Act.statusCode.code | required | ProblemAct statusCode |
Act.effectiveTime.nullFlavor | required | NullFlavor |
Act.priorityCode | extensible | ActPriority |
Act.languageCode | required | HumanLanguage |
Act.subject.typeCode | required | Fixed Value: SBJ |
Act.subject.contextControlCode | required | Fixed Value: OP |
Act.subject.awarenessCode | extensible | TargetAwareness |
Act.informant.typeCode | required | Fixed Value: INF |
Act.informant.contextControlCode | required | Fixed Value: OP |
Id | Grade | Path | Details | Requirements |
act-er-1 | error | Act.entryRelationship | Only one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act : (observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1 | |
act-er-1 | error | Act.entryRelationship:problem | Only one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act : (observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1 | |
act-er-1 | error | Act.entryRelationship:priority | Only one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act : (observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1 |