Health Concern Act - Definitions - Consolidated CDA (C-CDA) v4.0.0-ballot

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: HealthConcernAct - Detailed Descriptions

Draft as of 2024-12-19

Definitions for the HealthConcernAct logical model.

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

0. Act
Logical Container	ClinicalDocument (CDA Class)
Validation	Instance of this type are validated by templateId
XML Format	In the XML format, this property has the namespace `urn:hl7-org:v3`.
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`) should-author: SHOULD contain author (`author.exists()`)
2. Act.templateId
Control	1..?
Slicing	This 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:health-concern-act
Slice Name	health-concern-act
Control	1..1
6. Act.templateId:health-concern-act.root
Control	1..?
Pattern Value	`2.16.840.1.113883.10.20.22.4.132`
8. Act.templateId:health-concern-act.extension
Control	1..?
Pattern Value	`2022-06-01`
10. Act.classCode
Comments	SHALL contain exactly one [1..1] @classCode="ACT" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:4515-30750).
Fixed Value	`ACT`
12. Act.moodCode
Comments	SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001) (CONF:4515-30751).
Fixed Value	`EVN`
14. Act.id
Comments	SHALL contain at least one [1..*] id (CONF:4515-30754).
Control	1..?
16. Act.code
Short	Functional status assessment note
Comments	SHALL contain exactly one [1..1] code (CONF:4515-32310).
18. Act.code.code
Control	1..?
Pattern Value	`75310-3`
20. Act.code.codeSystem
Short	LOINC
Control	1..?
Pattern Value	`2.16.840.1.113883.6.1`
22. Act.text
Short	SHOULD reference the portion of section narrative text corresponding to this entry
24. Act.text.reference
Invariants	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (`value.exists() implies value.startsWith('#')`)
26. Act.statusCode
Comments	SHALL contain exactly one [1..1] statusCode (CONF:4515-30758).
Control	1..?
28. Act.statusCode.nullFlavor
Control	0..0
30. Act.statusCode.code
Control	1..?
Binding	The codes SHALL be taken from ProblemAct statusCode (required to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.19`)
32. Act.effectiveTime
Comments	MAY contain zero or one [0..1] effectiveTime (CONF:4515-30759).
34. Act.author
Short	A health concern may be a patient or provider concern. If the author is set to the recordTarget (patient), this is a patient concern. If the author is set to a provider, this is a provider concern. If both patient and provider are set as authors, this is a concern of both the patient and the provider.
Comments	SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:4515-31546).
Type	http://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
36. Act.entryRelationship
Short	When this Health Concern Act is a Social Determinant of Health Health Concern it SHOULD contain zero or more [0..] entryRelationship subentries such that it contains an observation with an observation/value selected from ValueSet [Social Determinant of Health Conditions 2.16.840.1.113762.1.4.1196.788](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1196.788/expansion) DYNAMIC* (CONF:4515-32962).
Comments	MAY contain zero or more [0..*] entryRelationship (CONF:4515-31549) such that it
Slicing	This element introduces a set of slices on `Act.entryRelationship`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ act profile @ observation profile @ organizer value @ typeCode
38. Act.entryRelationship:observations
Slice Name	observations
Control	0..*
40. Act.entryRelationship:observations.typeCode
Fixed Value	`REFR`
42. Act.entryRelationship:observations.observation
Control	1..?
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation(Problem Observation, Allergy - Intolerance Observation, Assessment Scale Observation, Self-Care Activities (ADL and IADL), Mental Status Observation, Smoking Status - Meaningful Use (Deprecated), Functional Status Observation, Nutrition Assessment, Pregnancy Status Observation, Reaction Observation, Result Observation, Sensory Status, Social History Observation, Substance or Device Allergy - Intolerance Observation, Tobacco Use (Deprecated), Vital Sign Observation, Longitudinal Care Wound Observation, Problem Observation, Caregiver Characteristics, Cultural and Religious Observation, Characteristics of Home Environment, Nutritional Status Observation, Priority Preference)
44. Act.entryRelationship:acts
Slice Name	acts
Control	0..*
46. Act.entryRelationship:acts.typeCode
Fixed Value	`REFR`
48. Act.entryRelationship:acts.act
Control	1..?
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act(Encounter Diagnosis, Hospital Admission Diagnosis, Postprocedure Diagnosis, Preoperative Diagnosis, Entry Reference)
50. Act.entryRelationship:organizers
Slice Name	organizers
Control	0..*
52. Act.entryRelationship:organizers.typeCode
Fixed Value	`REFR`
54. Act.entryRelationship:organizers.organizer
Control	1..?
Type	http://hl7.org/cda/stds/core/StructureDefinition/Organizer(Family History Organizer, Result Organizer)
56. Act.entryRelationship:related-entries
Slice Name	related-entries
Short	Where a Health Concern needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry. This may also be used to refer to other Health Concern Acts where there is a general relationship between the source and the target (Health Concern REFERS TO Health Concern). For example, a patient has 2 health concerns identified in a CARE Plan: Failure to Thrive and Poor Feeding; while it could be that one may have caused the other, at the time of care planning and documentation it is not necessary, nor desirable to have to assert what caused what. The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
Comments	MAY contain zero or more [0..*] entryRelationship (CONF:4515-31157) such that it
Control	0..*
58. Act.entryRelationship:related-entries.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-31158).
Fixed Value	`REFR`
60. Act.entryRelationship:related-entries.act
Comments	SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32106).
Control	1..?
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
62. Act.entryRelationship:component-health-concern-acts
Slice Name	component-health-concern-acts
Short	The following entryRelationship represents the relationship between two Health Concern Acts where the target is a component of the source (Health Concern HAS COMPONENT Health Concern). For example, a patient has an Impaired Mobility Health Concern. There may then be the need to document several component health concerns, such as "Unable to Transfer Bed to Chair","Unable to Rise from Commode", "Short of Breath Walking with Walker". The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
Comments	MAY contain zero or more [0..*] entryRelationship (CONF:4515-31160) such that it
Control	0..*
Invariants	4515-32745: The Entry Reference template SHALL contain an id that references a Health Concern Act (CONF:4515-32745). (`%resource.descendants().ofType(CDA.Act).where(templateId.exists($this.root = '2.16.840.1.113883.10.20.22.4.132' and $this.extension = '2022-06-01') and id.exists($this.root = %context.act.id.first().root and $this.extension ~ %context.act.id.first().extension))`)
64. Act.entryRelationship:component-health-concern-acts.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="COMP" Has component (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-31161).
Fixed Value	`COMP`
66. Act.entryRelationship:component-health-concern-acts.act
Comments	SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32107).
Control	1..?
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
68. Act.reference
Short	Where it is necessary to reference an external clinical document such as a Referral document, Discharge Summary document etc., the External Document Reference template can be used to reference this document. However, if this Care Plan document is replacing or appending another Care Plan document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.
Comments	MAY contain zero or more [0..*] reference (CONF:4515-32757).
70. Act.reference.typeCode
Comments	The reference, if present, SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32758).
Fixed Value	`REFR`
72. Act.reference.externalDocument
Comments	The reference, if present, SHALL contain exactly one [1..1] External Document Reference (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.115:2014-06-09) (CONF:4515-32759).
Control	1..?
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument(External Document Reference)

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

0. Act
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type. Base definition for all types defined in FHIR type system.
Short	Base for all types and resources
Control	10..1*
Is Modifier	false
Logical Container	ClinicalDocument (CDA Class)
Validation	Instance of this type are validated by templateId
XML Format	In the XML format, this property has the namespace `urn:hl7-org:v3`.
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`) should-author: SHOULD contain author (`author.exists()`)
2. Act.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
4. Act.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
6. Act.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
8. Act.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
10. Act.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
12. Act.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
14. Act.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
16. Act.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
18. Act.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Slicing	This 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
20. Act.templateId:health-concern-act
Slice Name	health-concern-act
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
22. Act.templateId:health-concern-act.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
24. Act.templateId:health-concern-act.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
26. Act.templateId:health-concern-act.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
28. Act.templateId:health-concern-act.root
Definition	A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Pattern Value	`2.16.840.1.113883.10.20.22.4.132`
30. Act.templateId:health-concern-act.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
Pattern Value	`2022-06-01`
32. Act.classCode
Comments	SHALL contain exactly one [1..1] @classCode="ACT" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:4515-30750).
Control	1..1
Binding	The codes SHALL be taken from XActClassDocumentEntryAct (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`ACT`
34. Act.moodCode
Comments	SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001) (CONF:4515-30751).
Control	1..1
Binding	The codes SHALL be taken from XDocumentActMood (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-xDocumentActMood\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`EVN`
36. Act.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
38. Act.id
Comments	SHALL contain at least one [1..*] id (CONF:4515-30754).
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
40. Act.code
Short	Functional status assessment note
Comments	SHALL contain exactly one [1..1] code (CONF:4515-32310).
Control	1..1
Binding	For example codes, see v3 Code System ActCode (example to `http://terminology.hl7.org/ValueSet/v3-ActCode`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
42. Act.code.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
44. Act.code.code
Definition	The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.
Control	1..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code
Pattern Value	`75310-3`
46. Act.code.codeSystem
Definition	Specifies the code system that defines the code.
Short	LOINC
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System
Pattern Value	`2.16.840.1.113883.6.1`
48. Act.code.codeSystemName
Definition	The common name of the coding system.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Name
50. Act.code.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Version
52. Act.code.displayName
Definition	A name or title for the code, under which the sending system shows the code value to its users.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Display Name
54. Act.code.sdtcValueSet
Definition	The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.
Control	0..1
Type	string(oid: ISO Object Identifier)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSet`.
56. Act.code.sdtcValueSetVersion
Definition	The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSetVersion`.
58. Act.code.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Original Text
60. Act.code.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CR
Label	Qualifier
62. Act.code.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
Label	Translation
64. Act.text
Short	SHOULD reference the portion of section narrative text corresponding to this entry
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
66. Act.text.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
68. Act.text.compression
Definition	Indicates whether the raw byte data is compressed, and what compression algorithm was used.
Control	0..1
Binding	The codes SHALL be taken from CDACompressionAlgorithm (required to `http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Compression
70. Act.text.integrityCheck
Definition	The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.
Control	0..1
Type	base64Binary(bin: Binary Data)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Integrity Check
72. Act.text.integrityCheckAlgorithm
Definition	Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.
Control	0..1
Binding	The codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Integrity Check Algorithm
74. Act.text.language
Definition	For character based information the language property specifies the human language of the text.
Control	0..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Language
76. Act.text.mediaType
Definition	Identifies the type of the encapsulated data and identifies a method to interpret or render the data.
Control	0..1
Binding	For example codes, see MediaType (example to `http://terminology.hl7.org/ValueSet/v3-MediaType`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Media Type
78. Act.text.representation
Control	0..1
Binding	The codes SHALL be taken from CDABinaryDataEncoding (required to `http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
80. Act.text.xmlText
Definition	Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)
Short	Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
Comments	This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as unadorned text.
82. Act.text.reference
Definition	A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TEL
Label	Reference
Invariants	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (`value.exists() implies value.startsWith('#')`)
84. Act.text.thumbnail
Definition	An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Thumbnail
86. Act.statusCode
Comments	SHALL contain exactly one [1..1] statusCode (CONF:4515-30758).
Control	1..1
Binding	The codes SHALL be taken from ActStatus (required to `http://terminology.hl7.org/ValueSet/v3-ActStatus`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
88. Act.statusCode.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..0
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
90. Act.statusCode.code
Definition	The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.
Control	1..1
Binding	The codes SHALL be taken from ProblemAct statusCode (required to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.19`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code
92. Act.statusCode.codeSystem
Definition	Specifies the code system that defines the code.
Control	0..0
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System
94. Act.statusCode.codeSystemName
Definition	The common name of the coding system.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Name
96. Act.statusCode.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Version
98. Act.statusCode.displayName
Definition	A name or title for the code, under which the sending system shows the code value to its users.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Display Name
100. Act.statusCode.sdtcValueSet
Definition	The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.
Control	0..1
Type	string(oid: ISO Object Identifier)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSet`.
102. Act.statusCode.sdtcValueSetVersion
Definition	The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSetVersion`.
104. Act.statusCode.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Original Text
106. Act.statusCode.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/CR
Label	Qualifier
108. Act.statusCode.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
Label	Translation
110. Act.effectiveTime
Comments	MAY contain zero or one [0..1] effectiveTime (CONF:4515-30759).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
112. Act.priorityCode
Control	0..1
Binding	For example codes, see ActPriority (example to `http://terminology.hl7.org/ValueSet/v3-ActPriority`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
114. Act.languageCode
Control	0..1
Binding	The codes SHALL be taken from AllLanguages (required to `http://hl7.org/fhir/ValueSet/all-languages`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
116. Act.subject
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Subject
118. Act.specimen
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Specimen
120. Act.performer
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Performer2
122. Act.author
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	A health concern may be a patient or provider concern. If the author is set to the recordTarget (patient), this is a patient concern. If the author is set to a provider, this is a provider concern. If both patient and provider are set as authors, this is a concern of both the patient and the provider.
Comments	SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:4515-31546).
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
Is Modifier	false
124. Act.informant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Informant
126. Act.participant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Participant2
128. Act.entryRelationship
Short	When this Health Concern Act is a Social Determinant of Health Health Concern it SHOULD contain zero or more [0..] entryRelationship subentries such that it contains an observation with an observation/value selected from ValueSet [Social Determinant of Health Conditions 2.16.840.1.113762.1.4.1196.788](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1196.788/expansion) DYNAMIC* (CONF:4515-32962).
Comments	MAY contain zero or more [0..*] entryRelationship (CONF:4515-31549) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
Slicing	This element introduces a set of slices on `Act.entryRelationship`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ act profile @ observation profile @ organizer value @ typeCode
130. Act.entryRelationship:observations
Slice Name	observations
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
132. Act.entryRelationship:observations.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
134. Act.entryRelationship:observations.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
136. Act.entryRelationship:observations.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
138. Act.entryRelationship:observations.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
140. Act.entryRelationship:observations.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
142. Act.entryRelationship:observations.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
144. Act.entryRelationship:observations.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
146. Act.entryRelationship:observations.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
148. Act.entryRelationship:observations.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
150. Act.entryRelationship:observations.typeCode
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`REFR`
152. Act.entryRelationship:observations.inversionInd
Definition	The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
154. Act.entryRelationship:observations.contextConductionInd
Definition	The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`true`
156. Act.entryRelationship:observations.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
158. Act.entryRelationship:observations.sequenceNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/INT
160. Act.entryRelationship:observations.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
162. Act.entryRelationship:observations.act
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act
164. Act.entryRelationship:observations.encounter
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Encounter
166. Act.entryRelationship:observations.observation
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation(Problem Observation, Allergy - Intolerance Observation, Assessment Scale Observation, Self-Care Activities (ADL and IADL), Mental Status Observation, Smoking Status - Meaningful Use (Deprecated), Functional Status Observation, Nutrition Assessment, Pregnancy Status Observation, Reaction Observation, Result Observation, Sensory Status, Social History Observation, Substance or Device Allergy - Intolerance Observation, Tobacco Use (Deprecated), Vital Sign Observation, Longitudinal Care Wound Observation, Problem Observation, Caregiver Characteristics, Cultural and Religious Observation, Characteristics of Home Environment, Nutritional Status Observation, Priority Preference)
Is Modifier	false
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`) should-author: SHOULD contain author (`author.exists()`)
168. Act.entryRelationship:observations.observationMedia
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
170. Act.entryRelationship:observations.organizer
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Organizer
172. Act.entryRelationship:observations.procedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Procedure
174. Act.entryRelationship:observations.regionOfInterest
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
176. Act.entryRelationship:observations.substanceAdministration
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
178. Act.entryRelationship:observations.supply
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Supply
180. Act.entryRelationship:acts
Slice Name	acts
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
182. Act.entryRelationship:acts.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
184. Act.entryRelationship:acts.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
186. Act.entryRelationship:acts.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
188. Act.entryRelationship:acts.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
190. Act.entryRelationship:acts.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
192. Act.entryRelationship:acts.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
194. Act.entryRelationship:acts.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
196. Act.entryRelationship:acts.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
198. Act.entryRelationship:acts.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
200. Act.entryRelationship:acts.typeCode
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`REFR`
202. Act.entryRelationship:acts.inversionInd
Definition	The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
204. Act.entryRelationship:acts.contextConductionInd
Definition	The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`true`
206. Act.entryRelationship:acts.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
208. Act.entryRelationship:acts.sequenceNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/INT
210. Act.entryRelationship:acts.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
212. Act.entryRelationship:acts.act
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act(Encounter Diagnosis, Hospital Admission Diagnosis, Postprocedure Diagnosis, Preoperative Diagnosis, Entry Reference)
Is Modifier	false
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`)
214. Act.entryRelationship:acts.encounter
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Encounter
216. Act.entryRelationship:acts.observation
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation
218. Act.entryRelationship:acts.observationMedia
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
220. Act.entryRelationship:acts.organizer
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Organizer
222. Act.entryRelationship:acts.procedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Procedure
224. Act.entryRelationship:acts.regionOfInterest
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
226. Act.entryRelationship:acts.substanceAdministration
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
228. Act.entryRelationship:acts.supply
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Supply
230. Act.entryRelationship:organizers
Slice Name	organizers
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
232. Act.entryRelationship:organizers.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
234. Act.entryRelationship:organizers.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
236. Act.entryRelationship:organizers.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
238. Act.entryRelationship:organizers.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
240. Act.entryRelationship:organizers.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
242. Act.entryRelationship:organizers.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
244. Act.entryRelationship:organizers.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
246. Act.entryRelationship:organizers.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
248. Act.entryRelationship:organizers.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
250. Act.entryRelationship:organizers.typeCode
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`REFR`
252. Act.entryRelationship:organizers.inversionInd
Definition	The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
254. Act.entryRelationship:organizers.contextConductionInd
Definition	The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`true`
256. Act.entryRelationship:organizers.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
258. Act.entryRelationship:organizers.sequenceNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/INT
260. Act.entryRelationship:organizers.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
262. Act.entryRelationship:organizers.act
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act
264. Act.entryRelationship:organizers.encounter
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Encounter
266. Act.entryRelationship:organizers.observation
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation
268. Act.entryRelationship:organizers.observationMedia
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
270. Act.entryRelationship:organizers.organizer
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Organizer(Family History Organizer, Result Organizer)
Is Modifier	false
Invariants	should-sdtctext-ref-value: SHOULD contain text/reference/@value (`sdtcText.reference.value.exists()`)
272. Act.entryRelationship:organizers.procedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Procedure
274. Act.entryRelationship:organizers.regionOfInterest
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
276. Act.entryRelationship:organizers.substanceAdministration
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
278. Act.entryRelationship:organizers.supply
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Supply
280. Act.entryRelationship:related-entries
Slice Name	related-entries
Short	Where a Health Concern needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry. This may also be used to refer to other Health Concern Acts where there is a general relationship between the source and the target (Health Concern REFERS TO Health Concern). For example, a patient has 2 health concerns identified in a CARE Plan: Failure to Thrive and Poor Feeding; while it could be that one may have caused the other, at the time of care planning and documentation it is not necessary, nor desirable to have to assert what caused what. The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
Comments	MAY contain zero or more [0..*] entryRelationship (CONF:4515-31157) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
282. Act.entryRelationship:related-entries.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
284. Act.entryRelationship:related-entries.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
286. Act.entryRelationship:related-entries.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
288. Act.entryRelationship:related-entries.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
290. Act.entryRelationship:related-entries.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
292. Act.entryRelationship:related-entries.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
294. Act.entryRelationship:related-entries.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
296. Act.entryRelationship:related-entries.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
298. Act.entryRelationship:related-entries.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
300. Act.entryRelationship:related-entries.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-31158).
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`REFR`
302. Act.entryRelationship:related-entries.inversionInd
Definition	The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
304. Act.entryRelationship:related-entries.contextConductionInd
Definition	The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`true`
306. Act.entryRelationship:related-entries.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
308. Act.entryRelationship:related-entries.sequenceNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/INT
310. Act.entryRelationship:related-entries.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
312. Act.entryRelationship:related-entries.act
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Comments	SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32106).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
Is Modifier	false
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`)
314. Act.entryRelationship:related-entries.encounter
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Encounter
316. Act.entryRelationship:related-entries.observation
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation
318. Act.entryRelationship:related-entries.observationMedia
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
320. Act.entryRelationship:related-entries.organizer
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Organizer
322. Act.entryRelationship:related-entries.procedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Procedure
324. Act.entryRelationship:related-entries.regionOfInterest
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
326. Act.entryRelationship:related-entries.substanceAdministration
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
328. Act.entryRelationship:related-entries.supply
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Supply
330. Act.entryRelationship:component-health-concern-acts
Slice Name	component-health-concern-acts
Short	The following entryRelationship represents the relationship between two Health Concern Acts where the target is a component of the source (Health Concern HAS COMPONENT Health Concern). For example, a patient has an Impaired Mobility Health Concern. There may then be the need to document several component health concerns, such as "Unable to Transfer Bed to Chair","Unable to Rise from Commode", "Short of Breath Walking with Walker". The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
Comments	MAY contain zero or more [0..*] entryRelationship (CONF:4515-31160) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
Invariants	4515-32745: The Entry Reference template SHALL contain an id that references a Health Concern Act (CONF:4515-32745). (`%resource.descendants().ofType(CDA.Act).where(templateId.exists($this.root = '2.16.840.1.113883.10.20.22.4.132' and $this.extension = '2022-06-01') and id.exists($this.root = %context.act.id.first().root and $this.extension ~ %context.act.id.first().extension))`)
332. Act.entryRelationship:component-health-concern-acts.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
334. Act.entryRelationship:component-health-concern-acts.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
336. Act.entryRelationship:component-health-concern-acts.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
338. Act.entryRelationship:component-health-concern-acts.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
340. Act.entryRelationship:component-health-concern-acts.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
342. Act.entryRelationship:component-health-concern-acts.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
344. Act.entryRelationship:component-health-concern-acts.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
346. Act.entryRelationship:component-health-concern-acts.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
348. Act.entryRelationship:component-health-concern-acts.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
350. Act.entryRelationship:component-health-concern-acts.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="COMP" Has component (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-31161).
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`COMP`
352. Act.entryRelationship:component-health-concern-acts.inversionInd
Definition	The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
354. Act.entryRelationship:component-health-concern-acts.contextConductionInd
Definition	The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`true`
356. Act.entryRelationship:component-health-concern-acts.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
358. Act.entryRelationship:component-health-concern-acts.sequenceNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/INT
360. Act.entryRelationship:component-health-concern-acts.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
362. Act.entryRelationship:component-health-concern-acts.act
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Comments	SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32107).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
Is Modifier	false
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`)
364. Act.entryRelationship:component-health-concern-acts.encounter
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Encounter
366. Act.entryRelationship:component-health-concern-acts.observation
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation
368. Act.entryRelationship:component-health-concern-acts.observationMedia
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
370. Act.entryRelationship:component-health-concern-acts.organizer
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Organizer
372. Act.entryRelationship:component-health-concern-acts.procedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Procedure
374. Act.entryRelationship:component-health-concern-acts.regionOfInterest
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
376. Act.entryRelationship:component-health-concern-acts.substanceAdministration
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
378. Act.entryRelationship:component-health-concern-acts.supply
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Supply
380. Act.reference
Short	Where it is necessary to reference an external clinical document such as a Referral document, Discharge Summary document etc., the External Document Reference template can be used to reference this document. However, if this Care Plan document is replacing or appending another Care Plan document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.
Comments	MAY contain zero or more [0..*] reference (CONF:4515-32757).
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Reference
382. Act.reference.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
384. Act.reference.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
386. Act.reference.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
388. Act.reference.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
390. Act.reference.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
392. Act.reference.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
394. Act.reference.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
396. Act.reference.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
398. Act.reference.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
400. Act.reference.typeCode
Comments	The reference, if present, SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32758).
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipExternalReference (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`REFR`
402. Act.reference.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
404. Act.reference.externalAct
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalAct
406. Act.reference.externalObservation
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalObservation
408. Act.reference.externalProcedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalProcedure
410. Act.reference.externalDocument
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Comments	The reference, if present, SHALL contain exactly one [1..1] External Document Reference (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.115:2014-06-09) (CONF:4515-32759).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument(External Document Reference)
Is Modifier	false
Invariants	should-setId: SHOULD contain setId (`setId.exists()`) should-versionNumber: SHOULD contain versionNumber (`versionNumber.exists()`)
412. Act.precondition
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Precondition
414. Act.sdtcPrecondition2
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Precondition2
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`precondition2`.
416. Act.sdtcInFulfillmentOf1
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`inFulfillmentOf1`.

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

0. Act
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Control	1..1
Is Modifier	false
Logical Container	ClinicalDocument (CDA Class)
Validation	Instance of this type are validated by templateId
XML Format	In the XML format, this property has the namespace `urn:hl7-org:v3`.
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`) should-author: SHOULD contain author (`author.exists()`)
2. Act.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
4. Act.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
6. Act.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
8. Act.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
10. Act.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
12. Act.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
14. Act.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
16. Act.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
18. Act.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Slicing	This 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
20. Act.templateId:health-concern-act
Slice Name	health-concern-act
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
22. Act.templateId:health-concern-act.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
24. Act.templateId:health-concern-act.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
26. Act.templateId:health-concern-act.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
28. Act.templateId:health-concern-act.root
Definition	A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Pattern Value	`2.16.840.1.113883.10.20.22.4.132`
30. Act.templateId:health-concern-act.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
Pattern Value	`2022-06-01`
32. Act.classCode
Comments	SHALL contain exactly one [1..1] @classCode="ACT" (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:4515-30750).
Control	1..1
Binding	The codes SHALL be taken from XActClassDocumentEntryAct (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`ACT`
34. Act.moodCode
Comments	SHALL contain exactly one [1..1] @moodCode="EVN" (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001) (CONF:4515-30751).
Control	1..1
Binding	The codes SHALL be taken from XDocumentActMood (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-xDocumentActMood\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`EVN`
36. Act.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
38. Act.id
Comments	SHALL contain at least one [1..*] id (CONF:4515-30754).
Control	1..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
40. Act.code
Short	Functional status assessment note
Comments	SHALL contain exactly one [1..1] code (CONF:4515-32310).
Control	1..1
Binding	For example codes, see v3 Code System ActCode (example to `http://terminology.hl7.org/ValueSet/v3-ActCode`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
42. Act.code.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
44. Act.code.code
Definition	The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.
Control	1..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code
Pattern Value	`75310-3`
46. Act.code.codeSystem
Definition	Specifies the code system that defines the code.
Short	LOINC
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System
Pattern Value	`2.16.840.1.113883.6.1`
48. Act.code.codeSystemName
Definition	The common name of the coding system.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Name
50. Act.code.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Version
52. Act.code.displayName
Definition	A name or title for the code, under which the sending system shows the code value to its users.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Display Name
54. Act.code.sdtcValueSet
Definition	The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.
Control	0..1
Type	string(oid: ISO Object Identifier)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSet`.
56. Act.code.sdtcValueSetVersion
Definition	The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSetVersion`.
58. Act.code.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Original Text
60. Act.code.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CR
Label	Qualifier
62. Act.code.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
Label	Translation
64. Act.text
Short	SHOULD reference the portion of section narrative text corresponding to this entry
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
66. Act.text.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
68. Act.text.compression
Definition	Indicates whether the raw byte data is compressed, and what compression algorithm was used.
Control	0..1
Binding	The codes SHALL be taken from CDACompressionAlgorithm (required to `http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Compression
70. Act.text.integrityCheck
Definition	The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.
Control	0..1
Type	base64Binary(bin: Binary Data)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Integrity Check
72. Act.text.integrityCheckAlgorithm
Definition	Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.
Control	0..1
Binding	The codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm\|2.0.0`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Integrity Check Algorithm
74. Act.text.language
Definition	For character based information the language property specifies the human language of the text.
Control	0..1
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Language
76. Act.text.mediaType
Definition	Identifies the type of the encapsulated data and identifies a method to interpret or render the data.
Control	0..1
Binding	For example codes, see MediaType (example to `http://terminology.hl7.org/ValueSet/v3-MediaType`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Media Type
78. Act.text.representation
Control	0..1
Binding	The codes SHALL be taken from CDABinaryDataEncoding (required to `http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
80. Act.text.xmlText
Definition	Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)
Short	Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
Comments	This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as unadorned text.
82. Act.text.reference
Definition	A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/TEL
Label	Reference
Invariants	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (`value.exists() implies value.startsWith('#')`)
84. Act.text.thumbnail
Definition	An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Thumbnail
86. Act.statusCode
Comments	SHALL contain exactly one [1..1] statusCode (CONF:4515-30758).
Control	1..1
Binding	The codes SHALL be taken from ActStatus (required to `http://terminology.hl7.org/ValueSet/v3-ActStatus`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
88. Act.statusCode.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..0
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
90. Act.statusCode.code
Definition	The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.
Control	1..1
Binding	The codes SHALL be taken from ProblemAct statusCode (required to `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.19`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code
92. Act.statusCode.codeSystem
Definition	Specifies the code system that defines the code.
Control	0..0
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System
94. Act.statusCode.codeSystemName
Definition	The common name of the coding system.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Name
96. Act.statusCode.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Code System Version
98. Act.statusCode.displayName
Definition	A name or title for the code, under which the sending system shows the code value to its users.
Control	0..0
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Display Name
100. Act.statusCode.sdtcValueSet
Definition	The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.
Control	0..1
Type	string(oid: ISO Object Identifier)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSet`.
102. Act.statusCode.sdtcValueSetVersion
Definition	The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`valueSetVersion`.
104. Act.statusCode.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/ED
Label	Original Text
106. Act.statusCode.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/CR
Label	Qualifier
108. Act.statusCode.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	0..0
Type	http://hl7.org/cda/stds/core/StructureDefinition/CD
XML Format	The type of this property is determined using the `xsi:type`attribute.
Label	Translation
110. Act.effectiveTime
Comments	MAY contain zero or one [0..1] effectiveTime (CONF:4515-30759).
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
112. Act.priorityCode
Control	0..1
Binding	For example codes, see ActPriority (example to `http://terminology.hl7.org/ValueSet/v3-ActPriority`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CE
114. Act.languageCode
Control	0..1
Binding	The codes SHALL be taken from AllLanguages (required to `http://hl7.org/fhir/ValueSet/all-languages`)
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
116. Act.subject
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Subject
118. Act.specimen
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Specimen
120. Act.performer
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Performer2
122. Act.author
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	A health concern may be a patient or provider concern. If the author is set to the recordTarget (patient), this is a patient concern. If the author is set to a provider, this is a provider concern. If both patient and provider are set as authors, this is a concern of both the patient and the provider.
Comments	SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:4515-31546).
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Author(Author Participation)
Is Modifier	false
124. Act.informant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Informant
126. Act.participant
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Participant2
128. Act.entryRelationship
Short	When this Health Concern Act is a Social Determinant of Health Health Concern it SHOULD contain zero or more [0..] entryRelationship subentries such that it contains an observation with an observation/value selected from ValueSet [Social Determinant of Health Conditions 2.16.840.1.113762.1.4.1196.788](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1196.788/expansion) DYNAMIC* (CONF:4515-32962).
Comments	MAY contain zero or more [0..*] entryRelationship (CONF:4515-31549) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
Slicing	This element introduces a set of slices on `Act.entryRelationship`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ act profile @ observation profile @ organizer value @ typeCode
130. Act.entryRelationship:observations
Slice Name	observations
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
132. Act.entryRelationship:observations.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
134. Act.entryRelationship:observations.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
136. Act.entryRelationship:observations.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
138. Act.entryRelationship:observations.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
140. Act.entryRelationship:observations.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
142. Act.entryRelationship:observations.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
144. Act.entryRelationship:observations.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
146. Act.entryRelationship:observations.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
148. Act.entryRelationship:observations.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
150. Act.entryRelationship:observations.typeCode
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`REFR`
152. Act.entryRelationship:observations.inversionInd
Definition	The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
154. Act.entryRelationship:observations.contextConductionInd
Definition	The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`true`
156. Act.entryRelationship:observations.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
158. Act.entryRelationship:observations.sequenceNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/INT
160. Act.entryRelationship:observations.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
162. Act.entryRelationship:observations.act
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act
164. Act.entryRelationship:observations.encounter
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Encounter
166. Act.entryRelationship:observations.observation
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation(Problem Observation, Allergy - Intolerance Observation, Assessment Scale Observation, Self-Care Activities (ADL and IADL), Mental Status Observation, Smoking Status - Meaningful Use (Deprecated), Functional Status Observation, Nutrition Assessment, Pregnancy Status Observation, Reaction Observation, Result Observation, Sensory Status, Social History Observation, Substance or Device Allergy - Intolerance Observation, Tobacco Use (Deprecated), Vital Sign Observation, Longitudinal Care Wound Observation, Problem Observation, Caregiver Characteristics, Cultural and Religious Observation, Characteristics of Home Environment, Nutritional Status Observation, Priority Preference)
Is Modifier	false
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`) should-author: SHOULD contain author (`author.exists()`)
168. Act.entryRelationship:observations.observationMedia
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
170. Act.entryRelationship:observations.organizer
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Organizer
172. Act.entryRelationship:observations.procedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Procedure
174. Act.entryRelationship:observations.regionOfInterest
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
176. Act.entryRelationship:observations.substanceAdministration
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
178. Act.entryRelationship:observations.supply
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Supply
180. Act.entryRelationship:acts
Slice Name	acts
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
182. Act.entryRelationship:acts.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
184. Act.entryRelationship:acts.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
186. Act.entryRelationship:acts.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
188. Act.entryRelationship:acts.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
190. Act.entryRelationship:acts.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
192. Act.entryRelationship:acts.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
194. Act.entryRelationship:acts.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
196. Act.entryRelationship:acts.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
198. Act.entryRelationship:acts.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
200. Act.entryRelationship:acts.typeCode
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`REFR`
202. Act.entryRelationship:acts.inversionInd
Definition	The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
204. Act.entryRelationship:acts.contextConductionInd
Definition	The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`true`
206. Act.entryRelationship:acts.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
208. Act.entryRelationship:acts.sequenceNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/INT
210. Act.entryRelationship:acts.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
212. Act.entryRelationship:acts.act
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act(Encounter Diagnosis, Hospital Admission Diagnosis, Postprocedure Diagnosis, Preoperative Diagnosis, Entry Reference)
Is Modifier	false
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`)
214. Act.entryRelationship:acts.encounter
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Encounter
216. Act.entryRelationship:acts.observation
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation
218. Act.entryRelationship:acts.observationMedia
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
220. Act.entryRelationship:acts.organizer
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Organizer
222. Act.entryRelationship:acts.procedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Procedure
224. Act.entryRelationship:acts.regionOfInterest
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
226. Act.entryRelationship:acts.substanceAdministration
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
228. Act.entryRelationship:acts.supply
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Supply
230. Act.entryRelationship:organizers
Slice Name	organizers
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
232. Act.entryRelationship:organizers.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
234. Act.entryRelationship:organizers.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
236. Act.entryRelationship:organizers.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
238. Act.entryRelationship:organizers.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
240. Act.entryRelationship:organizers.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
242. Act.entryRelationship:organizers.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
244. Act.entryRelationship:organizers.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
246. Act.entryRelationship:organizers.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
248. Act.entryRelationship:organizers.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
250. Act.entryRelationship:organizers.typeCode
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`REFR`
252. Act.entryRelationship:organizers.inversionInd
Definition	The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
254. Act.entryRelationship:organizers.contextConductionInd
Definition	The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`true`
256. Act.entryRelationship:organizers.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
258. Act.entryRelationship:organizers.sequenceNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/INT
260. Act.entryRelationship:organizers.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
262. Act.entryRelationship:organizers.act
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act
264. Act.entryRelationship:organizers.encounter
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Encounter
266. Act.entryRelationship:organizers.observation
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation
268. Act.entryRelationship:organizers.observationMedia
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
270. Act.entryRelationship:organizers.organizer
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Organizer(Family History Organizer, Result Organizer)
Is Modifier	false
Invariants	should-sdtctext-ref-value: SHOULD contain text/reference/@value (`sdtcText.reference.value.exists()`)
272. Act.entryRelationship:organizers.procedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Procedure
274. Act.entryRelationship:organizers.regionOfInterest
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
276. Act.entryRelationship:organizers.substanceAdministration
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
278. Act.entryRelationship:organizers.supply
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Supply
280. Act.entryRelationship:related-entries
Slice Name	related-entries
Short	Where a Health Concern needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry. This may also be used to refer to other Health Concern Acts where there is a general relationship between the source and the target (Health Concern REFERS TO Health Concern). For example, a patient has 2 health concerns identified in a CARE Plan: Failure to Thrive and Poor Feeding; while it could be that one may have caused the other, at the time of care planning and documentation it is not necessary, nor desirable to have to assert what caused what. The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
Comments	MAY contain zero or more [0..*] entryRelationship (CONF:4515-31157) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
282. Act.entryRelationship:related-entries.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
284. Act.entryRelationship:related-entries.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
286. Act.entryRelationship:related-entries.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
288. Act.entryRelationship:related-entries.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
290. Act.entryRelationship:related-entries.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
292. Act.entryRelationship:related-entries.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
294. Act.entryRelationship:related-entries.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
296. Act.entryRelationship:related-entries.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
298. Act.entryRelationship:related-entries.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
300. Act.entryRelationship:related-entries.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-31158).
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`REFR`
302. Act.entryRelationship:related-entries.inversionInd
Definition	The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
304. Act.entryRelationship:related-entries.contextConductionInd
Definition	The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`true`
306. Act.entryRelationship:related-entries.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
308. Act.entryRelationship:related-entries.sequenceNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/INT
310. Act.entryRelationship:related-entries.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
312. Act.entryRelationship:related-entries.act
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Comments	SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32106).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
Is Modifier	false
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`)
314. Act.entryRelationship:related-entries.encounter
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Encounter
316. Act.entryRelationship:related-entries.observation
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation
318. Act.entryRelationship:related-entries.observationMedia
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
320. Act.entryRelationship:related-entries.organizer
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Organizer
322. Act.entryRelationship:related-entries.procedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Procedure
324. Act.entryRelationship:related-entries.regionOfInterest
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
326. Act.entryRelationship:related-entries.substanceAdministration
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
328. Act.entryRelationship:related-entries.supply
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Supply
330. Act.entryRelationship:component-health-concern-acts
Slice Name	component-health-concern-acts
Short	The following entryRelationship represents the relationship between two Health Concern Acts where the target is a component of the source (Health Concern HAS COMPONENT Health Concern). For example, a patient has an Impaired Mobility Health Concern. There may then be the need to document several component health concerns, such as "Unable to Transfer Bed to Chair","Unable to Rise from Commode", "Short of Breath Walking with Walker". The Entry Reference template is used here because the target Health Concern Act will be defined elsewhere in the Health Concerns Section and thus a reference to that template is all that is required.
Comments	MAY contain zero or more [0..*] entryRelationship (CONF:4515-31160) such that it
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
Invariants	4515-32745: The Entry Reference template SHALL contain an id that references a Health Concern Act (CONF:4515-32745). (`%resource.descendants().ofType(CDA.Act).where(templateId.exists($this.root = '2.16.840.1.113883.10.20.22.4.132' and $this.extension = '2022-06-01') and id.exists($this.root = %context.act.id.first().root and $this.extension ~ %context.act.id.first().extension))`)
332. Act.entryRelationship:component-health-concern-acts.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
334. Act.entryRelationship:component-health-concern-acts.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
336. Act.entryRelationship:component-health-concern-acts.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
338. Act.entryRelationship:component-health-concern-acts.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
340. Act.entryRelationship:component-health-concern-acts.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
342. Act.entryRelationship:component-health-concern-acts.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
344. Act.entryRelationship:component-health-concern-acts.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
346. Act.entryRelationship:component-health-concern-acts.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
348. Act.entryRelationship:component-health-concern-acts.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
350. Act.entryRelationship:component-health-concern-acts.typeCode
Comments	SHALL contain exactly one [1..1] @typeCode="COMP" Has component (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-31161).
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipEntryRelationship (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`COMP`
352. Act.entryRelationship:component-health-concern-acts.inversionInd
Definition	The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
354. Act.entryRelationship:component-health-concern-acts.contextConductionInd
Definition	The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Default Value	`true`
356. Act.entryRelationship:component-health-concern-acts.negationInd
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
358. Act.entryRelationship:component-health-concern-acts.sequenceNumber
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/INT
360. Act.entryRelationship:component-health-concern-acts.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
362. Act.entryRelationship:component-health-concern-acts.act
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Comments	SHALL contain exactly one [1..1] Entry Reference (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.122) (CONF:4515-32107).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Act(Entry Reference)
Is Modifier	false
Invariants	should-text-ref-value: SHOULD contain text/reference/@value (`text.reference.value.exists()`)
364. Act.entryRelationship:component-health-concern-acts.encounter
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Encounter
366. Act.entryRelationship:component-health-concern-acts.observation
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Observation
368. Act.entryRelationship:component-health-concern-acts.observationMedia
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
370. Act.entryRelationship:component-health-concern-acts.organizer
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Organizer
372. Act.entryRelationship:component-health-concern-acts.procedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Procedure
374. Act.entryRelationship:component-health-concern-acts.regionOfInterest
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
376. Act.entryRelationship:component-health-concern-acts.substanceAdministration
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
378. Act.entryRelationship:component-health-concern-acts.supply
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/Supply
380. Act.reference
Short	Where it is necessary to reference an external clinical document such as a Referral document, Discharge Summary document etc., the External Document Reference template can be used to reference this document. However, if this Care Plan document is replacing or appending another Care Plan document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.
Comments	MAY contain zero or more [0..*] reference (CONF:4515-32757).
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Reference
382. Act.reference.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
384. Act.reference.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/CS
386. Act.reference.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
Invariants	II-1: An II instance must have either a root or an nullFlavor. (`root.exists() or nullFlavor.exists()`)
388. Act.reference.typeId.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from CDANullFlavor (required to `http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Exceptional Value Detail
390. Act.reference.typeId.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Assigning Authority Name
392. Act.reference.typeId.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean(bl: Boolean)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Displayable
394. Act.reference.typeId.root
Definition	Identifies the type as an HL7 Registered model
Control	1..1
Type	string(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Root
Fixed Value	`2.16.840.1.113883.1.3`
396. Act.reference.typeId.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string(st: Character String)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Label	Extension
398. Act.reference.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/II
400. Act.reference.typeCode
Comments	The reference, if present, SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:4515-32758).
Control	1..1
Binding	The codes SHALL be taken from x_ActRelationshipExternalReference (required to `http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference`)
Type	code(cs: Coded Simple Value)
Primitive Value	This primitive element may be present, or absent, or replaced by an extension
XML Format	In the XML format, this property is represented as an attribute.
Fixed Value	`REFR`
402. Act.reference.seperatableInd
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/BL
404. Act.reference.externalAct
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalAct
406. Act.reference.externalObservation
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalObservation
408. Act.reference.externalProcedure
Control	0..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalProcedure
410. Act.reference.externalDocument
Definition	Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.
Short	Base for all types and resources
Comments	The reference, if present, SHALL contain exactly one [1..1] External Document Reference (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.115:2014-06-09) (CONF:4515-32759).
Control	1..1
Type	http://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument(External Document Reference)
Is Modifier	false
Invariants	should-setId: SHOULD contain setId (`setId.exists()`) should-versionNumber: SHOULD contain versionNumber (`versionNumber.exists()`)
412. Act.precondition
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Precondition
414. Act.sdtcPrecondition2
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/Precondition2
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`precondition2`.
416. Act.sdtcInFulfillmentOf1
Control	0..*
Type	http://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
XML Format	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name`inFulfillmentOf1`.