Consolidated CDA Release 2.2
2.2 - CI Build

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

## Resource Profile: Study Act

Official URL: http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.6.2.6 | Version: 2.2
Active as of 2022-05-13 | Computable Name: StudyAct
Other Identifiers: : urn:oid:2.16.840.1.113883.10.20.6.2.6

A Study Act contains the DICOM study information that defines the characteristics of a referenced medical study performed on a patient. A study is a collection of one or more series of medical images, presentation states, SR documents, overlays, and/or curves that are logically related for the purpose of diagnosing a patient. Each study is associated with exactly one patient. A study may include composite instances that are created by a single modality, multiple modalities, or by multiple devices of the same modality. The study information is modality-independent. Study Act clinical statements are only instantiated in the DICOM Object Catalog section; in other sections, the SOP Instance Observation is included directly.

Usage:

- Use this Resource Profile: DICOM Object Catalog Section - DCM 121181

### Formal Views of Profile Content

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

- Text Summary
- Differential Table
- Snapshot Table
- Snapshot Table (Must Support)
- All

This structure is derived from CDAR2.Act

Summary

Mandatory: 12 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

- Series Act (http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.63)

Slices

This structure defines the following Slices:

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

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:root
templateId:primary |  | 1..1 | II |
root |  | 1..1 | string | Required Pattern: 2.16.840.1.113883.10.20.6.2.6
id |  | 1..* | II |
root |  | 1..1 | string | The @root contains the OID of the study instance UID since DICOM study ids consist only of an OID
extension |  | 0..0 |  |
code |  | 1..1 | CD |
code |  | 1..1 | string | Required Pattern: 113014
codeSystem |  | 1..1 | string | Required Pattern: 1.2.840.10008.2.16.4
text |  | 0..1 | ED | If present, the text element contains the description of the study.
reference |  | 0..1 | TEL |
value | I | 0..1 | uri | 81-15997: This reference/@value SHALL begin with a '#' and SHALL point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:81-15997).
effectiveTime |  | 0..1 | IVL_TS | If present, the effectiveTime contains the time the study was started
Slices for entryRelationship |  | 0..* | Element | Slice: Unordered, Open by profile:act
entryRelationship:seriesAct |  | 1..* | Element |
typeCode |  | 1..1 | code | Required Pattern: COMP
act |  | 1..1 | SeriesAct |
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: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: 2.16.840.1.113883.10.20.6.2.6
extension |  | 0..1 | string |
id |  | 1..* | II |
nullFlavor |  | 0..1 | code | Binding: NullFlavor (required)
assigningAuthorityName |  | 0..1 | string |
displayable |  | 0..1 | boolean |
root |  | 1..1 | string | The @root contains the OID of the study instance UID since DICOM study ids consist only of an OID
code |  | 1..1 | CD | Binding: v3 Code System ActCode (extensible)
nullFlavor |  | 0..1 | code | Binding: NullFlavor (required)
code |  | 1..1 | string | Required Pattern: 113014
codeSystem |  | 1..1 | string | Required Pattern: 1.2.840.10008.2.16.4
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 | If present, the text element contains the description of the study.
nullFlavor |  | 0..1 | code | Binding: NullFlavor (required)
charset |  | 0..1 | code |
compression |  | 0..1 | code | Binding: CompressionAlgorithm (required)
integrityCheck |  | 0..1 | base64Binary |
integrityCheckAlgorithm |  | 0..1 | code | Binding: IntegrityCheckAlgorithm (required)
language |  | 0..1 | code |
mediaType |  | 0..1 | code |
representation |  | 0..1 | code |
data[x] |  | 0..1 |  |
dataString |  |  | string |
dataBase64Binary |  |  | base64Binary |
reference |  | 0..1 | TEL |
nullFlavor |  | 0..1 | code | Binding: NullFlavor (required)
value | I | 0..1 | uri | 81-15997: This reference/@value SHALL begin with a '#' and SHALL point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:81-15997).
useablePeriod |  | 0..* |  |
useablePeriod |  |  | IVL_TS |
useablePeriod |  |  | EIVL_TS |
useablePeriod |  |  | PIVL_TS |
useablePeriod |  |  | SXPR_TS |
use |  | 0..* | code | Binding: AddressUse (required)
thumbnail |  | 0..1 | ED |
statusCode |  | 0..1 | CS | Binding: ActStatus (required)
effectiveTime |  | 0..1 | IVL_TS | If present, the effectiveTime contains the time the study was started
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..* | Author |
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 | Slice: Unordered, Open by profile:act
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:seriesAct | I | 1..* | Element |
typeCode |  | 1..1 | code | Required Pattern: COMP
inversionInd |  | 0..1 | boolean |
contextConductionInd |  | 1..1 | boolean |
sequenceNumber |  | 0..1 | INT |
negationInd |  | 0..1 | boolean |
seperatableInd |  | 0..1 | BL |
act |  | 1..1 | SeriesAct |
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

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Act |  | 1..1 | CDAR2.Act |
Documentation for this format

This structure is derived from CDAR2.Act

Summary

Mandatory: 12 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

- Series Act (http://hl7.org/fhir/cda/ccda/StructureDefinition/2.16.840.1.113883.10.20.22.4.63)

Slices

This structure defines the following Slices:

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

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:root
templateId:primary |  | 1..1 | II |
root |  | 1..1 | string | Required Pattern: 2.16.840.1.113883.10.20.6.2.6
id |  | 1..* | II |
root |  | 1..1 | string | The @root contains the OID of the study instance UID since DICOM study ids consist only of an OID
extension |  | 0..0 |  |
code |  | 1..1 | CD |
code |  | 1..1 | string | Required Pattern: 113014
codeSystem |  | 1..1 | string | Required Pattern: 1.2.840.10008.2.16.4
text |  | 0..1 | ED | If present, the text element contains the description of the study.
reference |  | 0..1 | TEL |
value | I | 0..1 | uri | 81-15997: This reference/@value SHALL begin with a '#' and SHALL point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:81-15997).
effectiveTime |  | 0..1 | IVL_TS | If present, the effectiveTime contains the time the study was started
Slices for entryRelationship |  | 0..* | Element | Slice: Unordered, Open by profile:act
entryRelationship:seriesAct |  | 1..* | Element |
typeCode |  | 1..1 | code | Required Pattern: COMP
act |  | 1..1 | SeriesAct |
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: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: 2.16.840.1.113883.10.20.6.2.6
extension |  | 0..1 | string |
id |  | 1..* | II |
nullFlavor |  | 0..1 | code | Binding: NullFlavor (required)
assigningAuthorityName |  | 0..1 | string |
displayable |  | 0..1 | boolean |
root |  | 1..1 | string | The @root contains the OID of the study instance UID since DICOM study ids consist only of an OID
code |  | 1..1 | CD | Binding: v3 Code System ActCode (extensible)
nullFlavor |  | 0..1 | code | Binding: NullFlavor (required)
code |  | 1..1 | string | Required Pattern: 113014
codeSystem |  | 1..1 | string | Required Pattern: 1.2.840.10008.2.16.4
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 | If present, the text element contains the description of the study.
nullFlavor |  | 0..1 | code | Binding: NullFlavor (required)
charset |  | 0..1 | code |
compression |  | 0..1 | code | Binding: CompressionAlgorithm (required)
integrityCheck |  | 0..1 | base64Binary |
integrityCheckAlgorithm |  | 0..1 | code | Binding: IntegrityCheckAlgorithm (required)
language |  | 0..1 | code |
mediaType |  | 0..1 | code |
representation |  | 0..1 | code |
data[x] |  | 0..1 |  |
dataString |  |  | string |
dataBase64Binary |  |  | base64Binary |
reference |  | 0..1 | TEL |
nullFlavor |  | 0..1 | code | Binding: NullFlavor (required)
value | I | 0..1 | uri | 81-15997: This reference/@value SHALL begin with a '#' and SHALL point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:81-15997).
useablePeriod |  | 0..* |  |
useablePeriod |  |  | IVL_TS |
useablePeriod |  |  | EIVL_TS |
useablePeriod |  |  | PIVL_TS |
useablePeriod |  |  | SXPR_TS |
use |  | 0..* | code | Binding: AddressUse (required)
thumbnail |  | 0..1 | ED |
statusCode |  | 0..1 | CS | Binding: ActStatus (required)
effectiveTime |  | 0..1 | IVL_TS | If present, the effectiveTime contains the time the study was started
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..* | Author |
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 | Slice: Unordered, Open by profile:act
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:seriesAct | I | 1..* | Element |
typeCode |  | 1..1 | code | Required Pattern: COMP
inversionInd |  | 0..1 | boolean |
contextConductionInd |  | 1..1 | boolean |
sequenceNumber |  | 0..1 | INT |
negationInd |  | 0..1 | boolean |
seperatableInd |  | 0..1 | BL |
act |  | 1..1 | SeriesAct |
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

#### Terminology Bindings

Path | Conformance | ValueSet / Code
Act.templateId:primary.nullFlavor | required | NullFlavor
Act.id.nullFlavor | required | NullFlavor
Act.code | extensible | ActCode
Act.code.nullFlavor | required | NullFlavor
Act.text.nullFlavor | required | NullFlavor
Act.text.compression | required | CompressionAlgorithm
Act.text.integrityCheckAlgorithm | required | IntegrityCheckAlgorithm
Act.text.reference.nullFlavor | required | NullFlavor
Act.text.reference.use | required | AddressUse
Act.statusCode | required | ActStatus
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

#### Constraints

Id | Grade | Path | Details | Requirements
81-15997 | error | Act.text.reference.value | This reference/@value SHALL begin with a '#' and SHALL point to its corresponding narrative (using the approach defined in CDA Release 2, section 4.3.5.1) (CONF:81-15997). : |
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:seriesAct | Only one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act : (observation | regionOfInterest | observationMedia | substanceAdministration | supply | procedure | encounter | organizer | act).count() = 1 |