Consolidated CDA (C-CDA)
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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: ReactionObservation - Detailed Descriptions

Draft as of 2024-12-19

Definitions for the ReactionObservation logical model.

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

0. Observation
Logical ContainerClinicalDocument (CDA Class)
ValidationInstance of this type are validated by templateId
XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
should-effectiveTime: SHOULD contain effectiveTime (effectiveTime.exists())
2. Observation.templateId
Control1..?
SlicingThis element introduces a set of slices on Observation.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ root
  • value @ extension
  • 4. Observation.templateId:reaction-obs
    Slice Namereaction-obs
    Control1..1
    6. Observation.templateId:reaction-obs.root
    Control1..?
    Pattern Value2.16.840.1.113883.10.20.22.4.9
    8. Observation.templateId:reaction-obs.extension
    Control1..?
    Pattern Value2014-06-09
    10. Observation.classCode
    Comments

    SHALL contain exactly one [1..1] @classCode="OBS" Observation (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1098-7325).

    Fixed ValueOBS
    12. Observation.moodCode
    Comments

    SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:1098-7326).

    Fixed ValueEVN
    14. Observation.id
    Comments

    SHALL contain at least one [1..*] id (CONF:1098-7329).

    Control1..?
    16. Observation.code
    Comments

    SHALL contain exactly one [1..1] code (CONF:1098-16851).

    18. Observation.code.code
    Comments

    This code SHALL contain exactly one [1..1] @code="ASSERTION" (CONF:1098-31124).

    Control1..?
    Pattern ValueASSERTION
    20. Observation.code.codeSystem
    Comments

    This code SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.5.4" (CodeSystem: HL7ActCode urn:oid:2.16.840.1.113883.5.4) (CONF:1098-32169).

    Control1..?
    Pattern Value2.16.840.1.113883.5.4
    22. Observation.text
    ShortSHOULD reference the portion of section narrative text corresponding to this entry
    24. Observation.text.reference
    Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
    26. Observation.statusCode
    Comments

    SHALL contain exactly one [1..1] statusCode (CONF:1098-7328).

    Control1..?
    28. Observation.statusCode.code
    Comments

    This statusCode SHALL contain exactly one [1..1] @code="completed" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14 STATIC) (CONF:1098-19114).

    Control1..?
    Fixed Valuecompleted
    30. Observation.effectiveTime
    Comments

    SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-7332).

    Invariantsshould-low: SHOULD contain low (low.exists())
    should-high: SHOULD contain high (high.exists())
    32. Observation.effectiveTime.low
    Comments

    The effectiveTime, if present, SHOULD contain zero or one [0..1] low (CONF:1098-7333).

    34. Observation.effectiveTime.high
    Comments

    The effectiveTime, if present, SHOULD contain zero or one [0..1] high (CONF:1098-7334).

    36. Observation.value
    Comments

    SHALL contain exactly one [1..1] value with @xsi:type="CD", where the code SHALL be selected from ValueSet US Core Condition Codes.

    Control1..1
    BindingThe codes SHALL be taken from US Core Condition Codes
    (required to http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD, http://hl7.org/cda/stds/core/StructureDefinition/EIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/CO, http://hl7.org/cda/stds/core/StructureDefinition/TEL, http://hl7.org/cda/stds/core/StructureDefinition/EN, http://hl7.org/cda/stds/core/StructureDefinition/BL, http://hl7.org/cda/stds/core/StructureDefinition/AD, http://hl7.org/cda/stds/core/StructureDefinition/PIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/RTO-PQ-PQ, http://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS, http://hl7.org/cda/stds/core/StructureDefinition/ED, http://hl7.org/cda/stds/core/StructureDefinition/TS, http://hl7.org/cda/stds/core/StructureDefinition/II, http://hl7.org/cda/stds/core/StructureDefinition/ST, http://hl7.org/cda/stds/core/StructureDefinition/PQ, http://hl7.org/cda/stds/core/StructureDefinition/IVL-PQ, http://hl7.org/cda/stds/core/StructureDefinition/CE, http://hl7.org/cda/stds/core/StructureDefinition/MO, http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/ANY, http://hl7.org/cda/stds/core/StructureDefinition/INT, http://hl7.org/cda/stds/core/StructureDefinition/REAL, http://hl7.org/cda/stds/core/StructureDefinition/CV, http://hl7.org/cda/stds/core/StructureDefinition/SC
    38. Observation.entryRelationship
    SlicingThis element introduces a set of slices on Observation.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • profile @ procedure
    • profile @ substanceAdministration
    • profile @ observation
    • 40. Observation.entryRelationship:procedure
      Slice Nameprocedure
      Comments

      MAY contain zero or more [0..*] entryRelationship (CONF:1098-7337) such that it

      Control0..*
      42. Observation.entryRelationship:procedure.typeCode
      Comments

      SHALL contain exactly one [1..1] @typeCode="RSON" Has reason (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:1098-7338).

      Fixed ValueRSON
      44. Observation.entryRelationship:procedure.inversionInd
      Comments

      SHALL contain exactly one [1..1] @inversionInd="true" True (CONF:1098-7343).

      Control1..?
      Fixed Valuetrue
      46. Observation.entryRelationship:procedure.procedure
      ShortThis procedure activity is intended to contain information about procedures that were performed in response to an allergy reaction.
      Comments

      SHALL contain exactly one [1..1] Procedure Activity Procedure (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.14:2014-06-09) (CONF:1098-15920).

      Control1..?
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure(Procedure Activity Procedure)
      48. Observation.entryRelationship:medication
      Slice Namemedication
      Comments

      MAY contain zero or more [0..*] entryRelationship (CONF:1098-7340) such that it

      Control0..*
      50. Observation.entryRelationship:medication.typeCode
      Comments

      SHALL contain exactly one [1..1] @typeCode="RSON" Has reason (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:1098-7341).

      Fixed ValueRSON
      52. Observation.entryRelationship:medication.inversionInd
      Comments

      SHALL contain exactly one [1..1] @inversionInd="true" True (CONF:1098-7344).

      Control1..?
      Fixed Valuetrue
      54. Observation.entryRelationship:medication.substanceAdministration
      ShortThis medication activity is intended to contain information about medications that were administered in response to an allergy reaction.
      Comments

      SHALL contain exactly one [1..1] Medication Activity (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.16:2014-06-09) (CONF:1098-15921).

      Control1..?
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration(Medication Activity)
      56. Observation.entryRelationship:severity
      Slice Nameseverity
      Comments

      MAY contain zero or one [0..1] entryRelationship (CONF:1098-7580) such that it

      Control0..1
      58. Observation.entryRelationship:severity.typeCode
      Comments

      SHALL contain exactly one [1..1] @typeCode="SUBJ" Has subject (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:1098-7581).

      Fixed ValueSUBJ
      60. Observation.entryRelationship:severity.inversionInd
      Comments

      SHALL contain exactly one [1..1] @inversionInd="true" TRUE (CONF:1098-10375).

      Control1..?
      Fixed Valuetrue
      62. Observation.entryRelationship:severity.observation
      Comments

      SHALL contain exactly one [1..1] Severity Observation (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.8:2014-06-09) (CONF:1098-15922).

      Control1..?
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Severity Observation)