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 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
Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/HealthConcernsSection | Version: 4.0.0 | |||
Draft as of 2025-10-02 | Computable Name: HealthConcernsSection | |||
Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:hl7ii:2.16.840.1.113883.10.20.22.2.58:2015-08-01 |
This section contains data describing an interest or worry about a health state or process that could possibly require attention, intervention, or management. A Health Concern is a health related matter that is of interest, importance or worry to someone, who may be the patient, patient's family or patient's health care provider. Health concerns are derived from a variety of sources within an EHR (such as Problem List, Family History, Social History, Social Worker Note, etc.). Health concerns can be medical, surgical, nursing, allied health or patient-reported concerns.
Problem Concerns are a subset of Health Concerns that have risen to the level of importance that they typically would belong on a classic "Problem List", such as "Diabetes Mellitus" or "Family History of Melanoma" or "Tobacco abuse". These are of broad interest to multiple members of the care team. Examples of other Health Concerns that might not typically be considered a Problem Concern include "Risk of Hyperkalemia" for a patient taking an ACE-inhibitor medication, or "Transportation difficulties" for someone who doesn't drive and has trouble getting to appointments, or "Under-insured" for someone who doesn't have sufficient insurance to properly cover their medical needs such as medications. These are typically most important to just a limited number of care team members.
Although open templates may contain any valid CDA content, the following templates are specifically called out by this template:
Required Entries: HealthConcernAct
Recommended Entries: HealthStatusObservation
Optional Entries: RiskConcernAct
Usages:
You can also check for usages in the FHIR IG Statistics
Changes since version 3.0.0:
Description of Template, Differentials, Snapshots and how the different presentations work.
This structure is derived from Section
Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
---|---|---|---|---|
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C | 1..1 | Section | XML Namespace: urn:hl7-org:v3 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) Constraints: should-health-status-obs, shall-health-concern-act |
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0..1 | cs | If a required section contains no information, the @nullFlavor MAY be set to NI | |
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1..* | II | Slice: Unordered, Open by value:root, value:extension | |
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1..1 | II | ||
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1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.2.58 | |
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1..1 | st | Required Pattern: 2015-08-01 | |
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1..1 | CE | Health concerns Document | |
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1..1 | cs | Required Pattern: 75310-3 | |
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1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
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1..1 | ST | ||
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1..1 | xhtml | ||
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0..* | Entry | Slice: Unordered, Open by profile:observation, profile:act | |
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0..* | Entry | ||
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1..1 | HealthStatusObservation | ||
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0..* | Entry | If section/@nullFlavor is not present: | |
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1..1 | HealthConcernAct | ||
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0..* | Entry | ||
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1..1 | RiskConcernAct | ||
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Id | Grade | Path(s) | Description | Expression |
shall-health-concern-act | error | Section | If section/@nullFlavor is not present, SHALL contain at least one Health Concern Act |
nullFlavor.exists() or entry.where(act.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/HealthConcernAct')).exists()
|
should-health-status-obs | warning | Section | SHOULD contain Health Status Observation |
entry.where(observation.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/HealthStatusObservation'))
|
Path | Status | Usage | ValueSet | Version | Source |
Section.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.templateId:section.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.classCode | Base | required | ActClassRecordOrganizer | 📦3.0.0 | THO v6.5 |
Section.moodCode | Base | required | CDAActMood | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.code.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std. |
Section.entry:healthStatus.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:healthStatus.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:healthStatus.​typeCode | Base | required | x_ActRelationshipEntry | 📦3.0.0 | THO v6.5 |
Section.entry:healthConcern.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:healthConcern.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:healthConcern.​typeCode | Base | required | x_ActRelationshipEntry | 📦3.0.0 | THO v6.5 |
Section.entry:riskConcern.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:riskConcern.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:riskConcern.​typeCode | Base | required | x_ActRelationshipEntry | 📦3.0.0 | THO v6.5 |
Section.component.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.component.typeId.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Id | Grade | Path(s) | Description | Expression |
II-1 | error | Section.typeId, Section.entry:healthStatus.typeId, Section.entry:healthConcern.typeId, Section.entry:riskConcern.typeId, Section.component.typeId | An II instance must have either a root or an nullFlavor. |
root.exists() or nullFlavor.exists()
|
shall-health-concern-act | error | Section | If section/@nullFlavor is not present, SHALL contain at least one Health Concern Act |
nullFlavor.exists() or entry.where(act.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/HealthConcernAct')).exists()
|
should-health-status-obs | warning | Section | SHOULD contain Health Status Observation |
entry.where(observation.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/HealthStatusObservation'))
|
Path | Status | Usage | ValueSet | Version | Source |
Section.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.templateId:section.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.classCode | Base | required | ActClassRecordOrganizer | 📦3.0.0 | THO v6.5 |
Section.moodCode | Base | required | CDAActMood | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.code.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std. |
Section.entry:healthStatus.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:healthStatus.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:healthStatus.​typeCode | Base | required | x_ActRelationshipEntry | 📦3.0.0 | THO v6.5 |
Section.entry:healthConcern.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:healthConcern.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:healthConcern.​typeCode | Base | required | x_ActRelationshipEntry | 📦3.0.0 | THO v6.5 |
Section.entry:riskConcern.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:riskConcern.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:riskConcern.​typeCode | Base | required | x_ActRelationshipEntry | 📦3.0.0 | THO v6.5 |
Section.component.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.component.typeId.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Id | Grade | Path(s) | Description | Expression |
II-1 | error | Section.typeId, Section.entry:healthStatus.typeId, Section.entry:healthConcern.typeId, Section.entry:riskConcern.typeId, Section.component.typeId | An II instance must have either a root or an nullFlavor. |
root.exists() or nullFlavor.exists()
|
shall-health-concern-act | error | Section | If section/@nullFlavor is not present, SHALL contain at least one Health Concern Act |
nullFlavor.exists() or entry.where(act.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/HealthConcernAct')).exists()
|
should-health-status-obs | warning | Section | SHOULD contain Health Status Observation |
entry.where(observation.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/HealthStatusObservation'))
|
This structure is derived from Section
Summary
Mandatory: 9 elements(3 nested mandatory elements)
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Differential View
This structure is derived from Section
Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
---|---|---|---|---|
![]() ![]() |
C | 1..1 | Section | XML Namespace: urn:hl7-org:v3 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) Constraints: should-health-status-obs, shall-health-concern-act |
![]() ![]() ![]() |
0..1 | cs | If a required section contains no information, the @nullFlavor MAY be set to NI | |
![]() ![]() ![]() |
1..* | II | Slice: Unordered, Open by value:root, value:extension | |
![]() ![]() ![]() ![]() |
1..1 | II | ||
![]() ![]() ![]() ![]() ![]() |
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.2.58 | |
![]() ![]() ![]() ![]() ![]() |
1..1 | st | Required Pattern: 2015-08-01 | |
![]() ![]() ![]() |
1..1 | CE | Health concerns Document | |
![]() ![]() ![]() ![]() |
1..1 | cs | Required Pattern: 75310-3 | |
![]() ![]() ![]() ![]() |
1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
![]() ![]() ![]() |
1..1 | ST | ||
![]() ![]() ![]() |
1..1 | xhtml | ||
![]() ![]() ![]() |
0..* | Entry | Slice: Unordered, Open by profile:observation, profile:act | |
![]() ![]() ![]() ![]() |
0..* | Entry | ||
![]() ![]() ![]() ![]() ![]() |
1..1 | HealthStatusObservation | ||
![]() ![]() ![]() ![]() |
0..* | Entry | If section/@nullFlavor is not present: | |
![]() ![]() ![]() ![]() ![]() |
1..1 | HealthConcernAct | ||
![]() ![]() ![]() ![]() |
0..* | Entry | ||
![]() ![]() ![]() ![]() ![]() |
1..1 | RiskConcernAct | ||
![]() |
Id | Grade | Path(s) | Description | Expression |
shall-health-concern-act | error | Section | If section/@nullFlavor is not present, SHALL contain at least one Health Concern Act |
nullFlavor.exists() or entry.where(act.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/HealthConcernAct')).exists()
|
should-health-status-obs | warning | Section | SHOULD contain Health Status Observation |
entry.where(observation.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/HealthStatusObservation'))
|
Key Elements View
Path | Status | Usage | ValueSet | Version | Source |
Section.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.templateId:section.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.classCode | Base | required | ActClassRecordOrganizer | 📦3.0.0 | THO v6.5 |
Section.moodCode | Base | required | CDAActMood | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.code.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std. |
Section.entry:healthStatus.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:healthStatus.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:healthStatus.​typeCode | Base | required | x_ActRelationshipEntry | 📦3.0.0 | THO v6.5 |
Section.entry:healthConcern.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:healthConcern.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:healthConcern.​typeCode | Base | required | x_ActRelationshipEntry | 📦3.0.0 | THO v6.5 |
Section.entry:riskConcern.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:riskConcern.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:riskConcern.​typeCode | Base | required | x_ActRelationshipEntry | 📦3.0.0 | THO v6.5 |
Section.component.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.component.typeId.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Id | Grade | Path(s) | Description | Expression |
II-1 | error | Section.typeId, Section.entry:healthStatus.typeId, Section.entry:healthConcern.typeId, Section.entry:riskConcern.typeId, Section.component.typeId | An II instance must have either a root or an nullFlavor. |
root.exists() or nullFlavor.exists()
|
shall-health-concern-act | error | Section | If section/@nullFlavor is not present, SHALL contain at least one Health Concern Act |
nullFlavor.exists() or entry.where(act.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/HealthConcernAct')).exists()
|
should-health-status-obs | warning | Section | SHOULD contain Health Status Observation |
entry.where(observation.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/HealthStatusObservation'))
|
Snapshot View
Path | Status | Usage | ValueSet | Version | Source |
Section.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.templateId:section.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.classCode | Base | required | ActClassRecordOrganizer | 📦3.0.0 | THO v6.5 |
Section.moodCode | Base | required | CDAActMood | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.code.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std. |
Section.entry:healthStatus.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:healthStatus.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:healthStatus.​typeCode | Base | required | x_ActRelationshipEntry | 📦3.0.0 | THO v6.5 |
Section.entry:healthConcern.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:healthConcern.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:healthConcern.​typeCode | Base | required | x_ActRelationshipEntry | 📦3.0.0 | THO v6.5 |
Section.entry:riskConcern.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:riskConcern.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.entry:riskConcern.​typeCode | Base | required | x_ActRelationshipEntry | 📦3.0.0 | THO v6.5 |
Section.component.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Section.component.typeId.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0 |
Id | Grade | Path(s) | Description | Expression |
II-1 | error | Section.typeId, Section.entry:healthStatus.typeId, Section.entry:healthConcern.typeId, Section.entry:riskConcern.typeId, Section.component.typeId | An II instance must have either a root or an nullFlavor. |
root.exists() or nullFlavor.exists()
|
shall-health-concern-act | error | Section | If section/@nullFlavor is not present, SHALL contain at least one Health Concern Act |
nullFlavor.exists() or entry.where(act.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/HealthConcernAct')).exists()
|
should-health-status-obs | warning | Section | SHOULD contain Health Status Observation |
entry.where(observation.hasTemplateIdOf('http://hl7.org/cda/us/ccda/StructureDefinition/HealthStatusObservation'))
|
This structure is derived from Section
Summary
Mandatory: 9 elements(3 nested mandatory elements)
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices: