Consolidated CDA (C-CDA)
4.0.0-ballot - STU4 Ballot United States of America flag

Consolidated CDA (C-CDA), published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 4.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/CDA-ccda/ and changes regularly. See the Directory of published versions

Logical Model: CareTeamMemberAct - Detailed Descriptions

Draft as of 2024-12-19

Definitions for the CareTeamMemberAct logical model.

Guidance on how to interpret the contents of this table can be found here

0. Act
Logical ContainerClinicalDocument (CDA Class)
ValidationInstance of this type are validated by templateId
XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
2. Act.templateId
Control1..?
SlicingThis element introduces a set of slices on Act.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ root
  • value @ extension
  • 4. Act.templateId:care-team-member-act
    Slice Namecare-team-member-act
    Control1..1
    6. Act.templateId:care-team-member-act.root
    Control1..?
    Pattern Value2.16.840.1.113883.10.20.22.4.500.1
    8. Act.templateId:care-team-member-act.extension
    Control1..?
    Pattern Value2024-05-01
    10. Act.classCode
    Comments

    SHALL contain exactly one [1..1] @classCode="PCPR" Provision of Care (CONF:4515-53).

    Fixed ValuePCPR
    12. Act.moodCode
    Comments

    SHALL contain exactly one [1..1] @moodCode="EVN" Event (CONF:4515-54).

    Fixed ValueEVN
    14. Act.code
    ShortCare team information panel
    Comments

    SHALL contain exactly one [1..1] code (CONF:4515-27).

    16. Act.code.code
    Control1..?
    Pattern Value92707-9
    18. Act.code.codeSystem
    ShortLOINC
    Control1..?
    Pattern Value2.16.840.1.113883.6.1
    20. Act.text
    ShortSHOULD reference the portion of section narrative text corresponding to this entry
    22. Act.text.reference
    Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
    24. Act.statusCode
    Comments

    SHALL contain exactly one [1..1] statusCode (CONF:4515-62).

    Control1..?
    26. Act.statusCode.nullFlavor
    Control0..0
    28. Act.statusCode.code
    Control1..?
    BindingThe codes SHALL be taken from ActStatus
    (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
    30. Act.effectiveTime
    Comments

    SHALL contain exactly one [1..1] effectiveTime (CONF:4515-33).

    Control1..?
    32. Act.effectiveTime.low
    Comments

    This effectiveTime SHALL contain exactly one [1..1] low (CONF:4515-167).

    Control1..?
    34. Act.effectiveTime.high
    Comments

    This effectiveTime MAY contain zero or one [0..1] high (CONF:4515-168).

    36. Act.performer
    Comments

    SHALL contain exactly one [1..1] performer (CONF:4515-160)

    Control1..1
    38. Act.performer.sdtcFunctionCode
    Short𝗨𝗦𝗖𝗗𝗜: Care Team Member Role - This sdtc:functionCode represents the function or role of the member on the care team. For example, the care team member roles on the care team can be a caregiver and a professional nurse or a primary care provider and the care coordinator.
    Comments

    MAY contain zero or one [0..1] sdtc:functionCode, which SHOULD be selected from ValueSet Care Team Member Function urn:oid:2.16.840.1.113762.1.4.1099.30 DYNAMIC (CONF:4515-161).

    BindingThe codes SHOULD be taken from Care Team Member Function .
    (preferred to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30)
    XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namefunctionCode.
    40. Act.performer.assignedEntity
    Comments

    SHALL contain exactly one [1..1] assignedEntity (CONF:4515-175).

    Invariants4515-180: If the assignedEntity/id is not referencing a Performer elsewhere in the document with an assignedPerson populated, this assignedEntity SHALL contain exactly one [1..1] assignedPerson (CONF:4515-180). (assignedPerson.exists() or (%resource.descendants().ofType(CDA.Performer2).where(assignedEntity.assignedPerson.exists() and assignedEntity.id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension))))
    should-addr: SHOULD contain addr (addr.exists())
    should-telecom: SHOULD contain telecom (telecom.exists())
    should-assignedPerson: SHOULD contain assignedPerson (assignedPerson.exists())
    42. Act.performer.assignedEntity.id
    Short𝗨𝗦𝗖𝗗𝗜: Care Team Member Identifier
    Comments

    This assignedEntity SHALL contain at least one [1..*] id (CONF:4515-176).

    44. Act.performer.assignedEntity.id.root
    Comments

    Such ids SHOULD contain zero or one [0..1] @root="2.16.840.1.113883.4.6" National Provider Identifier (CONF:4515-177).

    Invariantsshould-npi: SHOULD be NPI ($this = '2.16.840.1.113883.4.6')
    46. Act.performer.assignedEntity.addr
    Short𝗨𝗦𝗖𝗗𝗜: Care Team Member Location
    Comments

    This assignedEntity SHOULD contain zero or more [0..*] addr (CONF:4515-182).

    Typehttp://hl7.org/cda/stds/core/StructureDefinition/AD(US Realm Address)
    48. Act.performer.assignedEntity.telecom
    Short𝗨𝗦𝗖𝗗𝗜: Care Team Member Telecom
    Comments

    This assignedEntity SHOULD contain zero or more [0..*] telecom (CONF:4515-183).

    50. Act.performer.assignedEntity.assignedPerson
    Short𝗨𝗦𝗖𝗗𝗜: Care Team Member Name
    Comments

    This assignedEntity SHOULD contain zero or one [0..1] assignedPerson (CONF:4515-178).

    52. Act.performer.assignedEntity.assignedPerson.name
    Comments

    The assignedPerson, if present, SHALL contain exactly one [1..1] US Realm Person Name (PN.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.1.1) (CONF:4515-179).

    Control1..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/PN(US Realm Person Name (PN.US.FIELDED))
    54. Act.performer.assignedEntity.representedOrganization
    Comments

    This assignedEntity MAY contain zero or one [0..1] representedOrganization (CONF:4515-181).

    56. Act.performer.assignedEntity.representedOrganization.telecom
    Control1..?
    58. Act.performer.assignedEntity.representedOrganization.addr
    Control1..?
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/AD(US Realm Address)
    60. Act.participant
    Comments

    MAY contain zero or more [0..*] participant (CONF:4515-171) such that it

    SlicingThis element introduces a set of slices on Act.participant. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ typeCode
    • 62. Act.participant:location
      Slice Namelocation
      ShortThis participant represents the location where the care team member provides the service.
      Control0..*
      64. Act.participant:location.typeCode
      Comments

      SHALL contain exactly one [1..1] @typeCode="LOC" Location (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90) (CONF:4515-174).

      Fixed ValueLOC
      66. Act.participant:location.participantRole
      Comments

      SHALL contain exactly one [1..1] participantRole (CONF:4515-173).

      68. Act.participant:addl-functions
      Slice Nameaddl-functions
      ShortThis participant is used to express additional care team functions performed by this member of the team. Include additional participant to record additional roles (functionCode) this Care Team member plays.
      Comments

      MAY contain zero or more [0..*] participant (CONF:4515-76) such that it

      Control0..*
      70. Act.participant:addl-functions.typeCode
      Comments

      SHALL contain exactly one [1..1] @typeCode="IND" Indirect Target (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90) (CONF:4515-78).

      Fixed ValueIND
      72. Act.participant:addl-functions.sdtcFunctionCode
      Shortsdtc:functionCode
      Comments

      SHALL contain exactly one [1..1] sdtc:functionCode, which SHALL be selected from ValueSet Care Team Member Function urn:oid:2.16.840.1.113762.1.4.1099.30 DYNAMIC (CONF:4515-169).

      Control1..?
      BindingThe codes SHALL be taken from Care Team Member Function .
      (required to http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30)
      74. Act.participant:addl-functions.participantRole
      Comments

      required element with fixed nullFlavor

      76. Act.participant:addl-functions.participantRole.nullFlavor
      Comments

      This participantRole SHALL contain exactly one [1..1] @nullFlavor="NI" No Information. (CONF:4515-172).

      Control1..?
      Pattern ValueNA
      78. Act.entryRelationship
      Comments

      MAY contain zero or one [0..1] entryRelationship (CONF:4515-94) such that it

      SlicingThis element introduces a set of slices on Act.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • profile @ observation
      • profile @ act
      • exists @ encounter
      • exists @ observation
      • exists @ act
      • 80. Act.entryRelationship:encounter
        Slice Nameencounter
        ShortentryRelationship
        Comments

        MAY contain zero or more [0..*] entryRelationship (CONF:4515-86) such that it

        Control0..*
        82. Act.entryRelationship:encounter.typeCode
        Comments

        SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-87).

        Fixed ValueREFR
        84. Act.entryRelationship:encounter.act
        Control0..0
        86. Act.entryRelationship:encounter.encounter
        Comments

        SHALL contain exactly one [1..1] encounter (CONF:4515-88).

        Control1..?
        Invariants4515-90: If the first id does not match an encounter/id from an encounter elsewhere within the same document and the id does not contain @nullFlavor="NA", then this entry SHALL conform to the Encounter Activity (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.49:2015-08-01) (CONF:4515-90). (id.first().nullFlavor = 'NA' or (%resource.descendants().ofType(CDA.Encounter).where(hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/EncounterActivity') and id.exists($this.root = %context.id.first().root and $this.extension ~ %context.id.first().extension))))
        88. Act.entryRelationship:encounter.encounter.id
        Comments

        This encounter SHALL contain exactly one [1..1] id (CONF:4515-89).

        Control1..1
        90. Act.entryRelationship:encounter.observation
        Control0..0
        92. Act.entryRelationship:note
        Slice Namenote
        ShortThis is the note activity to narratively describe information about the member on the care team.
        Comments

        MAY contain zero or more [0..*] entryRelationship (CONF:4515-91) such that it

        Control0..*
        94. Act.entryRelationship:note.typeCode
        Comments

        SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-92).

        Fixed ValueREFR
        96. Act.entryRelationship:note.act
        Comments

        SHALL contain exactly one [1..1] Note Activity (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.202:2016-11-01) (CONF:4515-93).

        Control1..?
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act(Note Activity)
        98. Act.entryRelationship:note.encounter
        Control0..0
        100. Act.entryRelationship:note.observation
        Control0..0
        102. Act.entryRelationship:schedule
        Slice Nameschedule
        ShortThis is the schedule of when or how frequently the care team member participates (or provides care to the patient) on the care team.
        Control0..1
        104. Act.entryRelationship:schedule.typeCode
        Comments

        SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-96).

        Fixed ValueREFR
        106. Act.entryRelationship:schedule.act
        Control0..0
        108. Act.entryRelationship:schedule.encounter
        Control0..0
        110. Act.entryRelationship:schedule.observation
        Comments

        SHALL contain exactly one [1..1] Care Team Member Schedule Observation (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.500.3:2022-06-01) (CONF:4515-95).

        Control1..?
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Care Team Member Schedule Observation)