Consolidated CDA (C-CDA)
5.0.0-ballot - STU5 Ballot 1 United States of America flag

Consolidated CDA (C-CDA), published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 5.0.0-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: Health Concerns Section

Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/HealthConcernsSection Version: 5.0.0-ballot
Draft as of 2025-12-12 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.

Templates Used

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 4.0.0:

  • New Content

    • Formal Views of Template Content

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

    This structure is derived from Section

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Section 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
    ... @nullFlavor 0..1 cs If a required section contains no information, the @nullFlavor MAY be set to NI
    ... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
    .... templateId:section 1..1 II
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.2.58
    ..... @extension 1..1 st Required Pattern: 2015-08-01
    ... code 1..1 CE Health concerns Document
    .... @code 1..1 cs Required Pattern: 75310-3
    .... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.6.1
    ... text 1..1 xhtml Narrative to be rendered
    ... Slices for entry 0..* Entry Slice: Unordered, Open by profile:observation, profile:act
    .... entry:healthStatus C 0..* Entry
    ..... observation 1..1 HealthStatusObservation
    .... entry:healthConcern C 0..* Entry If section/@nullFlavor is not present:
    ..... act 1..1 HealthConcernAct
    .... entry:riskConcern 0..* Entry
    ..... act 1..1 RiskConcernAct

    doco Documentation for this format

    Constraints

    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'))
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Section 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
    ... @nullFlavor 0..1 cs If a required section contains no information, the @nullFlavor MAY be set to NI
    Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @assigningAuthorityName 0..1 st
    .... @displayable 0..1 bl
    .... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    .... @extension 1..1 st
    .... templateId:section 1..1 II
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... @assigningAuthorityName 0..1 st
    ..... @displayable 0..1 bl
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.2.58
    ..... @extension 1..1 st Required Pattern: 2015-08-01
    ... @ID 0..1 xs:ID Can serve as a target of a linkHtml reference
    ... @classCode 0..1 cs Binding: ActClassRecordOrganizer (required)
    Fixed Value: DOCSECT
    ... @moodCode 0..1 cs Binding: CDAActMood (required)
    Fixed Value: EVN
    ... id 0..1 II Unique instance identifier of a particular document section
    ... code 1..1 CE Health concerns Document
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs Required Pattern: 75310-3
    .... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.6.1
    .... @codeSystemName 0..1 st
    .... @codeSystemVersion 0..1 st
    .... @displayName 0..1 st
    .... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    .... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    .... originalText 0..1 ED
    .... translation 0..* CD
    ... title 1..1 ST Label of a section
    ... text 1..1 xhtml Narrative to be rendered
    ... confidentialityCode 0..1 CE Controls the disclosure of information in this section
    ... languageCode 0..1 CS Human language of character data
    Binding: AllLanguages (required)
    ... subject 0..1 Subject Primary target of the entries recorded in a section
    ... author 0..* Author
    ... informant 0..* Informant
    ... Slices for entry 0..* Entry Slice: Unordered, Open by profile:observation, profile:act
    .... entry:healthStatus C 0..* Entry
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 0..1 cs Binding: x_ActRelationshipEntry (required)
    ..... @contextConductionInd 0..1 bl Fixed Value: true
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 HealthStatusObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entry:healthConcern C 0..* Entry If section/@nullFlavor is not present:
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 0..1 cs Binding: x_ActRelationshipEntry (required)
    ..... @contextConductionInd 0..1 bl Fixed Value: true
    ..... act 1..1 HealthConcernAct
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entry:riskConcern 0..* Entry
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 0..1 cs Binding: x_ActRelationshipEntry (required)
    ..... @contextConductionInd 0..1 bl Fixed Value: true
    ..... act 1..1 RiskConcernAct
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    ... component 0..* InfrastructureRoot Used to nest a Section within a Section
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... realmCode 0..* CS
    .... typeId C 0..1 II Constraints: II-1
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... @assigningAuthorityName 0..1 st
    ..... @displayable 0..1 bl
    ..... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ..... @extension 1..1 st
    .... templateId 0..* II
    .... @typeCode 0..1 cs Fixed Value: COMP
    .... @contextConductionInd 0..1 bl Fixed Value: true
    .... section 1..1 Section

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Section.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.templateId:section.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.classCode Base required ActClassRecordOrganizer 📦3.0.0 THO v7.0
    Section.moodCode Base required CDAActMood 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.code.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.languageCode Base required All Languages 📦5.0.0 FHIR Std.
    Section.entry:healthStatus.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:healthStatus.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:healthStatus.​typeCode Base required x_ActRelationshipEntry 📦3.0.0 THO v7.0
    Section.entry:healthConcern.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:healthConcern.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:healthConcern.​typeCode Base required x_ActRelationshipEntry 📦3.0.0 THO v7.0
    Section.entry:riskConcern.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:riskConcern.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:riskConcern.​typeCode Base required x_ActRelationshipEntry 📦3.0.0 THO v7.0
    Section.component.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.component.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0

    Constraints

    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'))
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Section 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
    ... @nullFlavor 0..1 cs If a required section contains no information, the @nullFlavor MAY be set to NI
    Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @assigningAuthorityName 0..1 st
    .... @displayable 0..1 bl
    .... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    .... @extension 1..1 st
    .... templateId:section 1..1 II
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... @assigningAuthorityName 0..1 st
    ..... @displayable 0..1 bl
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.2.58
    ..... @extension 1..1 st Required Pattern: 2015-08-01
    ... @ID 0..1 xs:ID Can serve as a target of a linkHtml reference
    ... @classCode 0..1 cs Binding: ActClassRecordOrganizer (required)
    Fixed Value: DOCSECT
    ... @moodCode 0..1 cs Binding: CDAActMood (required)
    Fixed Value: EVN
    ... id 0..1 II Unique instance identifier of a particular document section
    ... code 1..1 CE Health concerns Document
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs Required Pattern: 75310-3
    .... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.6.1
    .... @codeSystemName 0..1 st
    .... @codeSystemVersion 0..1 st
    .... @displayName 0..1 st
    .... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    .... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    .... originalText 0..1 ED
    .... translation 0..* CD
    ... title 1..1 ST Label of a section
    ... text 1..1 xhtml Narrative to be rendered
    ... confidentialityCode 0..1 CE Controls the disclosure of information in this section
    ... languageCode 0..1 CS Human language of character data
    Binding: AllLanguages (required)
    ... subject 0..1 Subject Primary target of the entries recorded in a section
    ... author 0..* Author
    ... informant 0..* Informant
    ... Slices for entry 0..* Entry Slice: Unordered, Open by profile:observation, profile:act
    .... entry:healthStatus C 0..* Entry
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 0..1 cs Binding: x_ActRelationshipEntry (required)
    ..... @contextConductionInd 0..1 bl Fixed Value: true
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 HealthStatusObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entry:healthConcern C 0..* Entry If section/@nullFlavor is not present:
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 0..1 cs Binding: x_ActRelationshipEntry (required)
    ..... @contextConductionInd 0..1 bl Fixed Value: true
    ..... act 1..1 HealthConcernAct
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entry:riskConcern 0..* Entry
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 0..1 cs Binding: x_ActRelationshipEntry (required)
    ..... @contextConductionInd 0..1 bl Fixed Value: true
    ..... act 1..1 RiskConcernAct
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    ... component 0..* InfrastructureRoot Used to nest a Section within a Section
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... realmCode 0..* CS
    .... typeId C 0..1 II Constraints: II-1
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... @assigningAuthorityName 0..1 st
    ..... @displayable 0..1 bl
    ..... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ..... @extension 1..1 st
    .... templateId 0..* II
    .... @typeCode 0..1 cs Fixed Value: COMP
    .... @contextConductionInd 0..1 bl Fixed Value: true
    .... section 1..1 Section

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Section.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.templateId:section.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.classCode Base required ActClassRecordOrganizer 📦3.0.0 THO v7.0
    Section.moodCode Base required CDAActMood 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.code.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.languageCode Base required All Languages 📦5.0.0 FHIR Std.
    Section.entry:healthStatus.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:healthStatus.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:healthStatus.​typeCode Base required x_ActRelationshipEntry 📦3.0.0 THO v7.0
    Section.entry:healthConcern.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:healthConcern.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:healthConcern.​typeCode Base required x_ActRelationshipEntry 📦3.0.0 THO v7.0
    Section.entry:riskConcern.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:riskConcern.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:riskConcern.​typeCode Base required x_ActRelationshipEntry 📦3.0.0 THO v7.0
    Section.component.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.component.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0

    Constraints

    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:

    • The element 2 is sliced based on the values of Section.templateId
    • The element 2 is sliced based on the values of Section.entry

    Differential View

    This structure is derived from Section

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Section 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
    ... @nullFlavor 0..1 cs If a required section contains no information, the @nullFlavor MAY be set to NI
    ... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
    .... templateId:section 1..1 II
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.2.58
    ..... @extension 1..1 st Required Pattern: 2015-08-01
    ... code 1..1 CE Health concerns Document
    .... @code 1..1 cs Required Pattern: 75310-3
    .... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.6.1
    ... text 1..1 xhtml Narrative to be rendered
    ... Slices for entry 0..* Entry Slice: Unordered, Open by profile:observation, profile:act
    .... entry:healthStatus C 0..* Entry
    ..... observation 1..1 HealthStatusObservation
    .... entry:healthConcern C 0..* Entry If section/@nullFlavor is not present:
    ..... act 1..1 HealthConcernAct
    .... entry:riskConcern 0..* Entry
    ..... act 1..1 RiskConcernAct

    doco Documentation for this format

    Constraints

    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

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Section 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
    ... @nullFlavor 0..1 cs If a required section contains no information, the @nullFlavor MAY be set to NI
    Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @assigningAuthorityName 0..1 st
    .... @displayable 0..1 bl
    .... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    .... @extension 1..1 st
    .... templateId:section 1..1 II
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... @assigningAuthorityName 0..1 st
    ..... @displayable 0..1 bl
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.2.58
    ..... @extension 1..1 st Required Pattern: 2015-08-01
    ... @ID 0..1 xs:ID Can serve as a target of a linkHtml reference
    ... @classCode 0..1 cs Binding: ActClassRecordOrganizer (required)
    Fixed Value: DOCSECT
    ... @moodCode 0..1 cs Binding: CDAActMood (required)
    Fixed Value: EVN
    ... id 0..1 II Unique instance identifier of a particular document section
    ... code 1..1 CE Health concerns Document
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs Required Pattern: 75310-3
    .... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.6.1
    .... @codeSystemName 0..1 st
    .... @codeSystemVersion 0..1 st
    .... @displayName 0..1 st
    .... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    .... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    .... originalText 0..1 ED
    .... translation 0..* CD
    ... title 1..1 ST Label of a section
    ... text 1..1 xhtml Narrative to be rendered
    ... confidentialityCode 0..1 CE Controls the disclosure of information in this section
    ... languageCode 0..1 CS Human language of character data
    Binding: AllLanguages (required)
    ... subject 0..1 Subject Primary target of the entries recorded in a section
    ... author 0..* Author
    ... informant 0..* Informant
    ... Slices for entry 0..* Entry Slice: Unordered, Open by profile:observation, profile:act
    .... entry:healthStatus C 0..* Entry
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 0..1 cs Binding: x_ActRelationshipEntry (required)
    ..... @contextConductionInd 0..1 bl Fixed Value: true
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 HealthStatusObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entry:healthConcern C 0..* Entry If section/@nullFlavor is not present:
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 0..1 cs Binding: x_ActRelationshipEntry (required)
    ..... @contextConductionInd 0..1 bl Fixed Value: true
    ..... act 1..1 HealthConcernAct
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entry:riskConcern 0..* Entry
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 0..1 cs Binding: x_ActRelationshipEntry (required)
    ..... @contextConductionInd 0..1 bl Fixed Value: true
    ..... act 1..1 RiskConcernAct
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    ... component 0..* InfrastructureRoot Used to nest a Section within a Section
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... realmCode 0..* CS
    .... typeId C 0..1 II Constraints: II-1
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... @assigningAuthorityName 0..1 st
    ..... @displayable 0..1 bl
    ..... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ..... @extension 1..1 st
    .... templateId 0..* II
    .... @typeCode 0..1 cs Fixed Value: COMP
    .... @contextConductionInd 0..1 bl Fixed Value: true
    .... section 1..1 Section

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Section.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.templateId:section.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.classCode Base required ActClassRecordOrganizer 📦3.0.0 THO v7.0
    Section.moodCode Base required CDAActMood 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.code.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.languageCode Base required All Languages 📦5.0.0 FHIR Std.
    Section.entry:healthStatus.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:healthStatus.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:healthStatus.​typeCode Base required x_ActRelationshipEntry 📦3.0.0 THO v7.0
    Section.entry:healthConcern.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:healthConcern.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:healthConcern.​typeCode Base required x_ActRelationshipEntry 📦3.0.0 THO v7.0
    Section.entry:riskConcern.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:riskConcern.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:riskConcern.​typeCode Base required x_ActRelationshipEntry 📦3.0.0 THO v7.0
    Section.component.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.component.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0

    Constraints

    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

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Section 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
    ... @nullFlavor 0..1 cs If a required section contains no information, the @nullFlavor MAY be set to NI
    Binding: CDANullFlavor (required)
    ... realmCode 0..* CS
    ... typeId C 0..1 II Constraints: II-1
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @assigningAuthorityName 0..1 st
    .... @displayable 0..1 bl
    .... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    .... @extension 1..1 st
    .... templateId:section 1..1 II
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... @assigningAuthorityName 0..1 st
    ..... @displayable 0..1 bl
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.2.58
    ..... @extension 1..1 st Required Pattern: 2015-08-01
    ... @ID 0..1 xs:ID Can serve as a target of a linkHtml reference
    ... @classCode 0..1 cs Binding: ActClassRecordOrganizer (required)
    Fixed Value: DOCSECT
    ... @moodCode 0..1 cs Binding: CDAActMood (required)
    Fixed Value: EVN
    ... id 0..1 II Unique instance identifier of a particular document section
    ... code 1..1 CE Health concerns Document
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs Required Pattern: 75310-3
    .... @codeSystem 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.6.1
    .... @codeSystemName 0..1 st
    .... @codeSystemVersion 0..1 st
    .... @displayName 0..1 st
    .... @sdtcValueSet 0..1 oid XML Namespace: urn:hl7-org:sdtc
    XML: valueSet (urn:hl7-org:sdtc)
    .... @sdtcValueSetVersion 0..1 st XML Namespace: urn:hl7-org:sdtc
    XML: valueSetVersion (urn:hl7-org:sdtc)
    .... originalText 0..1 ED
    .... translation 0..* CD
    ... title 1..1 ST Label of a section
    ... text 1..1 xhtml Narrative to be rendered
    ... confidentialityCode 0..1 CE Controls the disclosure of information in this section
    ... languageCode 0..1 CS Human language of character data
    Binding: AllLanguages (required)
    ... subject 0..1 Subject Primary target of the entries recorded in a section
    ... author 0..* Author
    ... informant 0..* Informant
    ... Slices for entry 0..* Entry Slice: Unordered, Open by profile:observation, profile:act
    .... entry:healthStatus C 0..* Entry
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 0..1 cs Binding: x_ActRelationshipEntry (required)
    ..... @contextConductionInd 0..1 bl Fixed Value: true
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 HealthStatusObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entry:healthConcern C 0..* Entry If section/@nullFlavor is not present:
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 0..1 cs Binding: x_ActRelationshipEntry (required)
    ..... @contextConductionInd 0..1 bl Fixed Value: true
    ..... act 1..1 HealthConcernAct
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entry:riskConcern 0..* Entry
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    ..... typeId C 0..1 II Constraints: II-1
    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ...... @assigningAuthorityName 0..1 st
    ...... @displayable 0..1 bl
    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 0..1 cs Binding: x_ActRelationshipEntry (required)
    ..... @contextConductionInd 0..1 bl Fixed Value: true
    ..... act 1..1 RiskConcernAct
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    ... component 0..* InfrastructureRoot Used to nest a Section within a Section
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... realmCode 0..* CS
    .... typeId C 0..1 II Constraints: II-1
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... @assigningAuthorityName 0..1 st
    ..... @displayable 0..1 bl
    ..... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ..... @extension 1..1 st
    .... templateId 0..* II
    .... @typeCode 0..1 cs Fixed Value: COMP
    .... @contextConductionInd 0..1 bl Fixed Value: true
    .... section 1..1 Section

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Section.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.templateId:section.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.classCode Base required ActClassRecordOrganizer 📦3.0.0 THO v7.0
    Section.moodCode Base required CDAActMood 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.code.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.languageCode Base required All Languages 📦5.0.0 FHIR Std.
    Section.entry:healthStatus.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:healthStatus.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:healthStatus.​typeCode Base required x_ActRelationshipEntry 📦3.0.0 THO v7.0
    Section.entry:healthConcern.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:healthConcern.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:healthConcern.​typeCode Base required x_ActRelationshipEntry 📦3.0.0 THO v7.0
    Section.entry:riskConcern.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:riskConcern.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.entry:riskConcern.​typeCode Base required x_ActRelationshipEntry 📦3.0.0 THO v7.0
    Section.component.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Section.component.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0

    Constraints

    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:

    • The element 2 is sliced based on the values of Section.templateId
    • The element 2 is sliced based on the values of Section.entry

     

    Other representations of profile: CSV, Excel