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: Risk Concern Act

Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/RiskConcernAct Version: 5.0.0-ballot
Draft as of 2025-12-12 Computable Name: RiskConcernAct
Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:hl7ii:2.16.840.1.113883.10.20.22.4.136:2015-08-01

This template represents a risk concern.

It is a wrapper for a single risk concern which may be derived from a variety of sources within an EHR (such as Problem List, Family History, Social History, Social Worker Note, etc.).

A Risk Concern Act represents a health concern that is a risk. A risk is a clinical or socioeconomic condition that the patient does not currently have, but the probability of developing that condition rises to the level of concern such that an intervention and/or monitoring is needed.

Templates Used

Although open templates may contain any valid CDA content, the following templates are specifically called out by this template:

Optional EntryRelationships: AllergyIntoleranceObservation, AssessmentScaleObservation, CaregiverCharacteristics, CharacteristicsofHomeEnvironment, CulturalandReligiousObservation, EncounterDiagnosis, EntryReference, FamilyHistoryOrganizer, FunctionalStatusObservation, HospitalAdmissionDiagnosis, LongitudinalCareWoundObservation, MentalStatusObservation, NutritionAssessment, NutritionalStatusObservation, PostprocedureDiagnosis, PregnancyStatusObservation, PreoperativeDiagnosis, PriorityPreference, ProblemConcernAct, ProblemObservation, ReactionObservation, ResultObservation, ResultOrganizer, SelfCareActivitiesADLandIADL, SensoryStatus, SmokingStatus, SocialHistoryObservation, SubstanceOrDeviceAllergyIntoleranceObservation, VitalSignObservation

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 Act

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act 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-text-ref-value, should-author
    ... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
    .... templateId:risk-concern-act 1..1 II
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.136
    ..... @extension 1..1 st Required Pattern: 2015-08-01
    ... @classCode 1..1 cs Fixed Value: ACT
    ... @moodCode 1..1 cs Fixed Value: EVN
    ... code 1..1 CD At risk - finding
    .... @code 1..1 cs Required Pattern: 281694009
    .... @codeSystem 1..1 oid, uuid, ruid SNOMED CT
    Required Pattern: 2.16.840.1.113883.6.96
    ... text C 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    ... statusCode 1..1 CS
    .... @nullFlavor 0..0
    .... @code 1..1 cs Binding: ProblemAct statusCode . (required)
    ... effectiveTime 0..1 IVL_TS
    ... author C 0..* AuthorParticipation SHOULD contain author
    ... Slices for entryRelationship 0..* EntryRelationship 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.
    Slice: Unordered, Open by value:typeCode, profile:observation, profile:act, profile:organizer
    .... entryRelationship:problemObservation1 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 ProblemObservation
    .... entryRelationship:allergy-IntoleranceObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 AllergyIntoleranceObservation
    .... entryRelationship:entryReferenceRefr 0..* EntryRelationship The following entryRelationship represents the relationship between two Health Concern Acts where there is a general relationship between the source and the target (Health Concern RELATES TO Health Concern). It can also represent the relationship between a Health Concern and another entry already described in the CDA document instance. The Entry Reference template is used here because the target entry will be defined elsewhere and thus a reference to that instance is all that is required.
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 EntryReference
    .... entryRelationship:entryReferenceComp 0..* EntryRelationship 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). The Enry 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.
    ..... @typeCode 1..1 cs Fixed Value: COMP
    ..... act 1..1 EntryReference
    .... entryRelationship:assessmentScaleObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 AssessmentScaleObservation
    .... entryRelationship:mentalStatusObservation1 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 MentalStatusObservation
    .... entryRelationship:self-CareActivitiesADLandIADL 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 SelfCareActivitiesADLandIADL
    .... entryRelationship:mentalStatusObservation2 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 MentalStatusObservation
    .... entryRelationship:smokingStatus 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 SmokingStatus
    .... entryRelationship:encounterDiagnosis 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 EncounterDiagnosis
    .... entryRelationship:entryRelationship11 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... organizer 1..1 FamilyHistoryOrganizer
    .... entryRelationship:functionalStatusObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 FunctionalStatusObservation
    .... entryRelationship:hospitalAdmissionDiagnosis 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 HospitalAdmissionDiagnosis
    .... entryRelationship:nutritionAssessment 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 NutritionAssessment
    .... entryRelationship:postprocedureDiagnosis 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 PostprocedureDiagnosis
    .... entryRelationship:pregnancyStatusObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 PregnancyStatusObservation
    .... entryRelationship:preoperativeDiagnosis 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 PreoperativeDiagnosis
    .... entryRelationship:reactionObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 ReactionObservation
    .... entryRelationship:resultObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 ResultObservation
    .... entryRelationship:sensoryStatus 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 SensoryStatus
    .... entryRelationship:socialHistoryObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 SocialHistoryObservation
    .... entryRelationship:substanceorDeviceAllergy-IntoleranceObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 SubstanceOrDeviceAllergyIntoleranceObservation
    .... entryRelationship:vitalSignObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 VitalSignObservation
    .... entryRelationship:longitudinalCareWoundObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 LongitudinalCareWoundObservation
    .... entryRelationship:problemObservation2 0..* EntryRelationship The following entryRelationship represents the relationship Health Concern HAS SUPPORT Observation.
    ..... @typeCode 1..1 cs Fixed Value: SPRT
    ..... observation 1..1 ProblemObservation
    .... entryRelationship:caregiverCharacteristics 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 CaregiverCharacteristics
    .... entryRelationship:culturalandReligiousObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 CulturalandReligiousObservation
    .... entryRelationship:characteristicsofHomeEnvironment 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 CharacteristicsofHomeEnvironment
    .... entryRelationship:nutritionalStatusObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 NutritionalStatusObservation
    .... entryRelationship:resultOrganizer 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... organizer 1..1 ResultOrganizer
    .... entryRelationship:priorityPreference1 0..* EntryRelationship The following entryRelationship represents the priority that the patient puts on the health concern.
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 PriorityPreference
    .... entryRelationship:priorityPreference2 0..* EntryRelationship The following entryRelationship represents the priority that the provider puts on the health concern.
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 PriorityPreference
    .... entryRelationship:problemConcernAct 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 ProblemConcernAct
    ... reference 0..* Reference
    .... @typeCode 1..1 cs Fixed Value: REFR
    .... externalDocument 1..1 ExternalDocumentReference

    doco Documentation for this format

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    Act.statusCode.code Base required ProblemAct statusCode . 📦20240606 VSAC v0.24

    Constraints

    Id Grade Path(s) Description Expression
    should-author warning Act SHOULD contain author author.exists()
    should-text-ref-value warning Act SHOULD contain text/reference/@value text.reference.value.exists()
    value-starts-octothorpe error Act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act 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-text-ref-value, should-author
    ... @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:risk-concern-act 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: 2.16.840.1.113883.10.20.22.4.136
    ..... @extension 1..1 st Required Pattern: 2015-08-01
    ... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ... @negationInd 0..1 bl
    ... id 1..* II
    ... code 1..1 CD At risk - finding
    Binding: v3 Code System ActCode (example)
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs Required Pattern: 281694009
    .... @codeSystem 1..1 oid, uuid, ruid SNOMED CT
    Required Pattern: 2.16.840.1.113883.6.96
    .... @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
    .... qualifier 0..* CR
    .... translation 0..* CD
    ... text C 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    .... @integrityCheck 0..1 bin
    .... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    .... @language 0..1 cs
    .... @mediaType 0..1 cs Binding: MediaType (example)
    .... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    .... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    .... thumbnail C 0..1 ED Constraints: ED-1
    ... statusCode 1..1 CS Binding: ActStatus (required)
    .... @code 1..1 cs Binding: ProblemAct statusCode . (required)
    .... @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)
    ... effectiveTime 0..1 IVL_TS
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... subject 0..1 Subject
    ... specimen 0..* Specimen
    ... performer 0..* Performer2
    ... author C 0..* AuthorParticipation SHOULD contain author
    ... informant 0..* Informant
    ... participant 0..* Participant2
    ... Slices for entryRelationship 0..* EntryRelationship 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.
    Slice: Unordered, Open by value:typeCode, profile:observation, profile:act, profile:organizer
    .... entryRelationship:problemObservation1 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 ProblemObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:allergy-IntoleranceObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 AllergyIntoleranceObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:entryReferenceRefr 0..* EntryRelationship The following entryRelationship represents the relationship between two Health Concern Acts where there is a general relationship between the source and the target (Health Concern RELATES TO Health Concern). It can also represent the relationship between a Health Concern and another entry already described in the CDA document instance. The Entry Reference template is used here because the target entry will be defined elsewhere and thus a reference to that instance is all that is required.
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 EntryReference
    ..... 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
    .... entryRelationship:entryReferenceComp 0..* EntryRelationship 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). The Enry 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.
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: COMP
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 EntryReference
    ..... 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
    .... entryRelationship:assessmentScaleObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 AssessmentScaleObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:mentalStatusObservation1 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 MentalStatusObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:self-CareActivitiesADLandIADL 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 SelfCareActivitiesADLandIADL
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:mentalStatusObservation2 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 MentalStatusObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:smokingStatus 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 SmokingStatus
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:encounterDiagnosis 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 EncounterDiagnosis
    ..... 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
    .... entryRelationship:entryRelationship11 0..* EntryRelationship
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    ..... realmCode 0..* CS
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    ...... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
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    ...... @root 1..1 oid, uuid, ruid Fixed Value: 2.16.840.1.113883.1.3
    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
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    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
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    ..... observation 0..1 Observation
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    ..... organizer 1..1 FamilyHistoryOrganizer
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    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:functionalStatusObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
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    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
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    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:hospitalAdmissionDiagnosis 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
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    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
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    ..... observation 0..1 Observation
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    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
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    .... entryRelationship:nutritionAssessment 0..* EntryRelationship
    ..... @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)
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    ...... @displayable 0..1 bl
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    ...... @extension 1..1 st
    ..... templateId 0..* II
    ..... @typeCode 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
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    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
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    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
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    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
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    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:pregnancyStatusObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
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    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:preoperativeDiagnosis 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
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    ..... observation 0..1 Observation
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    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:reactionObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
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    ..... encounter 0..1 Encounter
    ..... observation 1..1 ReactionObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:resultObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 ResultObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:sensoryStatus 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 SensoryStatus
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:socialHistoryObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 SocialHistoryObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:substanceorDeviceAllergy-IntoleranceObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 SubstanceOrDeviceAllergyIntoleranceObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:vitalSignObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 VitalSignObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:longitudinalCareWoundObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 LongitudinalCareWoundObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:problemObservation2 0..* EntryRelationship The following entryRelationship represents the relationship Health Concern HAS SUPPORT Observation.
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: SPRT
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
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    ..... encounter 0..1 Encounter
    ..... observation 1..1 ProblemObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:caregiverCharacteristics 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 CaregiverCharacteristics
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:culturalandReligiousObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 CulturalandReligiousObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:characteristicsofHomeEnvironment 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 CharacteristicsofHomeEnvironment
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:nutritionalStatusObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 NutritionalStatusObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:resultOrganizer 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 1..1 ResultOrganizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:priorityPreference1 0..* EntryRelationship The following entryRelationship represents the priority that the patient puts on the health concern.
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 PriorityPreference
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:priorityPreference2 0..* EntryRelationship The following entryRelationship represents the priority that the provider puts on the health concern.
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 PriorityPreference
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:problemConcernAct 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 ProblemConcernAct
    ..... 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
    ... reference 0..* Reference
    .... @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 1..1 cs Binding: x_ActRelationshipExternalReference (required)
    Fixed Value: REFR
    .... seperatableInd 0..1 BL
    .... externalAct 0..1 ExternalAct
    .... externalObservation 0..1 ExternalObservation
    .... externalProcedure 0..1 ExternalProcedure
    .... externalDocument 1..1 ExternalDocumentReference
    ... precondition 0..* Precondition
    ... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Act.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.templateId:risk-concern-act.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.classCode Base required x_ActClassDocumentEntryAct 📍2.0.0 THO v5.2
    Act.moodCode Base required x_DocumentActMood 📍2.0.0 THO v5.2
    Act.code Base example v3 Code System ActCode 📦3.0.0 THO v7.0
    Act.code.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.text.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.text.compression Base required CDACompressionAlgorithm 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.text.integrityCheckAlgorithm Base required IntegrityCheckAlgorithm 📍2.0.0 THO v5.2
    Act.text.mediaType Base example MediaType 📦3.0.0 THO v7.0
    Act.text.representation Base required CDABinaryDataEncoding 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.statusCode Base required ActStatus 📦3.0.0 THO v7.0
    Act.statusCode.code Base required ProblemAct statusCode . 📦20240606 VSAC v0.24
    Act.priorityCode Base example ActPriority 📦3.0.0 THO v7.0
    Act.languageCode Base required All Languages 📦5.0.0 FHIR Std.
    Act.entryRelationship:problemObservation1.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:problemObservation1.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:problemObservation1.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:allergy-IntoleranceObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:allergy-IntoleranceObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:allergy-IntoleranceObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:entryReferenceRefr.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:entryReferenceRefr.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:entryReferenceRefr.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:entryReferenceComp.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:entryReferenceComp.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:entryReferenceComp.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:assessmentScaleObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:assessmentScaleObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:assessmentScaleObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:mentalStatusObservation1.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:mentalStatusObservation1.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:mentalStatusObservation1.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:self-CareActivitiesADLandIADL.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:self-CareActivitiesADLandIADL.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:self-CareActivitiesADLandIADL.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:mentalStatusObservation2.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:mentalStatusObservation2.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:mentalStatusObservation2.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:smokingStatus.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:smokingStatus.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:smokingStatus.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:encounterDiagnosis.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:encounterDiagnosis.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:encounterDiagnosis.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:entryRelationship11.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:entryRelationship11.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:entryRelationship11.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:functionalStatusObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:functionalStatusObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:functionalStatusObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:hospitalAdmissionDiagnosis.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:hospitalAdmissionDiagnosis.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:hospitalAdmissionDiagnosis.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:nutritionAssessment.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:nutritionAssessment.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:nutritionAssessment.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:postprocedureDiagnosis.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:postprocedureDiagnosis.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:postprocedureDiagnosis.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:pregnancyStatusObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:pregnancyStatusObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:pregnancyStatusObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:preoperativeDiagnosis.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:preoperativeDiagnosis.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:preoperativeDiagnosis.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:reactionObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:reactionObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:reactionObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:resultObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:resultObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:resultObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:sensoryStatus.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:sensoryStatus.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:sensoryStatus.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:socialHistoryObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:socialHistoryObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:socialHistoryObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:substanceorDeviceAllergy-IntoleranceObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:substanceorDeviceAllergy-IntoleranceObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:substanceorDeviceAllergy-IntoleranceObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:vitalSignObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:vitalSignObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:vitalSignObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:longitudinalCareWoundObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:longitudinalCareWoundObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:longitudinalCareWoundObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:problemObservation2.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:problemObservation2.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:problemObservation2.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:caregiverCharacteristics.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:caregiverCharacteristics.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:caregiverCharacteristics.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:culturalandReligiousObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:culturalandReligiousObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:culturalandReligiousObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:characteristicsofHomeEnvironment.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:characteristicsofHomeEnvironment.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:characteristicsofHomeEnvironment.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:nutritionalStatusObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:nutritionalStatusObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:nutritionalStatusObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:resultOrganizer.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:resultOrganizer.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:resultOrganizer.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:priorityPreference1.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:priorityPreference1.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:priorityPreference1.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:priorityPreference2.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:priorityPreference2.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:priorityPreference2.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:problemConcernAct.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:problemConcernAct.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:problemConcernAct.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.reference.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.reference.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.reference.typeCode Base required x_ActRelationshipExternalReference 📦3.0.0 THO v7.0

    Constraints

    Id Grade Path(s) Description Expression
    ED-1 error Act.text.thumbnail Thumbnails cannot contain their own thumbnails thumbnail.empty()
    II-1 error Act.typeId, Act.entryRelationship:problemObservation1.typeId, Act.entryRelationship:allergy-IntoleranceObservation.typeId, Act.entryRelationship:entryReferenceRefr.typeId, Act.entryRelationship:entryReferenceComp.typeId, Act.entryRelationship:assessmentScaleObservation.typeId, Act.entryRelationship:mentalStatusObservation1.typeId, Act.entryRelationship:self-CareActivitiesADLandIADL.typeId, Act.entryRelationship:mentalStatusObservation2.typeId, Act.entryRelationship:smokingStatus.typeId, Act.entryRelationship:encounterDiagnosis.typeId, Act.entryRelationship:entryRelationship11.typeId, Act.entryRelationship:functionalStatusObservation.typeId, Act.entryRelationship:hospitalAdmissionDiagnosis.typeId, Act.entryRelationship:nutritionAssessment.typeId, Act.entryRelationship:postprocedureDiagnosis.typeId, Act.entryRelationship:pregnancyStatusObservation.typeId, Act.entryRelationship:preoperativeDiagnosis.typeId, Act.entryRelationship:reactionObservation.typeId, Act.entryRelationship:resultObservation.typeId, Act.entryRelationship:sensoryStatus.typeId, Act.entryRelationship:socialHistoryObservation.typeId, Act.entryRelationship:substanceorDeviceAllergy-IntoleranceObservation.typeId, Act.entryRelationship:vitalSignObservation.typeId, Act.entryRelationship:longitudinalCareWoundObservation.typeId, Act.entryRelationship:problemObservation2.typeId, Act.entryRelationship:caregiverCharacteristics.typeId, Act.entryRelationship:culturalandReligiousObservation.typeId, Act.entryRelationship:characteristicsofHomeEnvironment.typeId, Act.entryRelationship:nutritionalStatusObservation.typeId, Act.entryRelationship:resultOrganizer.typeId, Act.entryRelationship:priorityPreference1.typeId, Act.entryRelationship:priorityPreference2.typeId, Act.entryRelationship:problemConcernAct.typeId, Act.reference.typeId An II instance must have either a root or an nullFlavor. root.exists() or nullFlavor.exists()
    should-author warning Act SHOULD contain author author.exists()
    should-text-ref-value warning Act SHOULD contain text/reference/@value text.reference.value.exists()
    value-starts-octothorpe error Act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act 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-text-ref-value, should-author
    ... @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:risk-concern-act 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: 2.16.840.1.113883.10.20.22.4.136
    ..... @extension 1..1 st Required Pattern: 2015-08-01
    ... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ... @negationInd 0..1 bl
    ... id 1..* II
    ... code 1..1 CD At risk - finding
    Binding: v3 Code System ActCode (example)
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs Required Pattern: 281694009
    .... @codeSystem 1..1 oid, uuid, ruid SNOMED CT
    Required Pattern: 2.16.840.1.113883.6.96
    .... @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
    .... qualifier 0..* CR
    .... translation 0..* CD
    ... text C 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    .... @integrityCheck 0..1 bin
    .... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    .... @language 0..1 cs
    .... @mediaType 0..1 cs Binding: MediaType (example)
    .... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    .... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    .... thumbnail C 0..1 ED Constraints: ED-1
    ... statusCode 1..1 CS Binding: ActStatus (required)
    .... @code 1..1 cs Binding: ProblemAct statusCode . (required)
    .... @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)
    ... effectiveTime 0..1 IVL_TS
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... subject 0..1 Subject
    ... specimen 0..* Specimen
    ... performer 0..* Performer2
    ... author C 0..* AuthorParticipation SHOULD contain author
    ... informant 0..* Informant
    ... participant 0..* Participant2
    ... Slices for entryRelationship 0..* EntryRelationship 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.
    Slice: Unordered, Open by value:typeCode, profile:observation, profile:act, profile:organizer
    .... entryRelationship:problemObservation1 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 ProblemObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:allergy-IntoleranceObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 AllergyIntoleranceObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:entryReferenceRefr 0..* EntryRelationship The following entryRelationship represents the relationship between two Health Concern Acts where there is a general relationship between the source and the target (Health Concern RELATES TO Health Concern). It can also represent the relationship between a Health Concern and another entry already described in the CDA document instance. The Entry Reference template is used here because the target entry will be defined elsewhere and thus a reference to that instance is all that is required.
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 EntryReference
    ..... 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
    .... entryRelationship:entryReferenceComp 0..* EntryRelationship 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). The Enry 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.
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: COMP
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 EntryReference
    ..... 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
    .... entryRelationship:assessmentScaleObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 AssessmentScaleObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:mentalStatusObservation1 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 MentalStatusObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:self-CareActivitiesADLandIADL 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 SelfCareActivitiesADLandIADL
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:mentalStatusObservation2 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 MentalStatusObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:smokingStatus 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 SmokingStatus
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:encounterDiagnosis 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 EncounterDiagnosis
    ..... 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
    .... entryRelationship:entryRelationship11 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 1..1 FamilyHistoryOrganizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:functionalStatusObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 FunctionalStatusObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:hospitalAdmissionDiagnosis 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 HospitalAdmissionDiagnosis
    ..... 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
    .... entryRelationship:nutritionAssessment 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 NutritionAssessment
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:postprocedureDiagnosis 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 PostprocedureDiagnosis
    ..... 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
    .... entryRelationship:pregnancyStatusObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 PregnancyStatusObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:preoperativeDiagnosis 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 PreoperativeDiagnosis
    ..... 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
    .... entryRelationship:reactionObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 ReactionObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:resultObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 ResultObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:sensoryStatus 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 SensoryStatus
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:socialHistoryObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 SocialHistoryObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:substanceorDeviceAllergy-IntoleranceObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 SubstanceOrDeviceAllergyIntoleranceObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:vitalSignObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 VitalSignObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:longitudinalCareWoundObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 LongitudinalCareWoundObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:problemObservation2 0..* EntryRelationship The following entryRelationship represents the relationship Health Concern HAS SUPPORT Observation.
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: SPRT
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 ProblemObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:caregiverCharacteristics 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 CaregiverCharacteristics
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:culturalandReligiousObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 CulturalandReligiousObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:characteristicsofHomeEnvironment 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 CharacteristicsofHomeEnvironment
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:nutritionalStatusObservation 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 NutritionalStatusObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:resultOrganizer 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 0..1 Observation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 1..1 ResultOrganizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:priorityPreference1 0..* EntryRelationship The following entryRelationship represents the priority that the patient puts on the health concern.
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 PriorityPreference
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:priorityPreference2 0..* EntryRelationship The following entryRelationship represents the priority that the provider puts on the health concern.
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 PriorityPreference
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:problemConcernAct 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 1..1 ProblemConcernAct
    ..... 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
    ... reference 0..* Reference
    .... @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 1..1 cs Binding: x_ActRelationshipExternalReference (required)
    Fixed Value: REFR
    .... seperatableInd 0..1 BL
    .... externalAct 0..1 ExternalAct
    .... externalObservation 0..1 ExternalObservation
    .... externalProcedure 0..1 ExternalProcedure
    .... externalDocument 1..1 ExternalDocumentReference
    ... precondition 0..* Precondition
    ... sdtcPrecondition2 0..* Precondition2 XML Namespace: urn:hl7-org:sdtc
    XML: precondition2 (urn:hl7-org:sdtc)
    ... sdtcInFulfillmentOf1 0..* InFulfillmentOf1 XML Namespace: urn:hl7-org:sdtc
    XML: inFulfillmentOf1 (urn:hl7-org:sdtc)

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    Act.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.templateId:risk-concern-act.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.classCode Base required x_ActClassDocumentEntryAct 📍2.0.0 THO v5.2
    Act.moodCode Base required x_DocumentActMood 📍2.0.0 THO v5.2
    Act.code Base example v3 Code System ActCode 📦3.0.0 THO v7.0
    Act.code.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.text.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.text.compression Base required CDACompressionAlgorithm 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.text.integrityCheckAlgorithm Base required IntegrityCheckAlgorithm 📍2.0.0 THO v5.2
    Act.text.mediaType Base example MediaType 📦3.0.0 THO v7.0
    Act.text.representation Base required CDABinaryDataEncoding 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.statusCode Base required ActStatus 📦3.0.0 THO v7.0
    Act.statusCode.code Base required ProblemAct statusCode . 📦20240606 VSAC v0.24
    Act.priorityCode Base example ActPriority 📦3.0.0 THO v7.0
    Act.languageCode Base required All Languages 📦5.0.0 FHIR Std.
    Act.entryRelationship:problemObservation1.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:problemObservation1.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:problemObservation1.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:allergy-IntoleranceObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:allergy-IntoleranceObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:allergy-IntoleranceObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:entryReferenceRefr.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:entryReferenceRefr.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:entryReferenceRefr.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:entryReferenceComp.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:entryReferenceComp.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:entryReferenceComp.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:assessmentScaleObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:assessmentScaleObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:assessmentScaleObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:mentalStatusObservation1.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:mentalStatusObservation1.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:mentalStatusObservation1.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:self-CareActivitiesADLandIADL.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:self-CareActivitiesADLandIADL.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:self-CareActivitiesADLandIADL.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:mentalStatusObservation2.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:mentalStatusObservation2.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:mentalStatusObservation2.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:smokingStatus.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:smokingStatus.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:smokingStatus.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:encounterDiagnosis.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:encounterDiagnosis.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:encounterDiagnosis.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:entryRelationship11.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:entryRelationship11.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:entryRelationship11.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:functionalStatusObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:functionalStatusObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:functionalStatusObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:hospitalAdmissionDiagnosis.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:hospitalAdmissionDiagnosis.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:hospitalAdmissionDiagnosis.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:nutritionAssessment.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:nutritionAssessment.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:nutritionAssessment.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:postprocedureDiagnosis.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:postprocedureDiagnosis.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:postprocedureDiagnosis.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:pregnancyStatusObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:pregnancyStatusObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:pregnancyStatusObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:preoperativeDiagnosis.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:preoperativeDiagnosis.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:preoperativeDiagnosis.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:reactionObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:reactionObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:reactionObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:resultObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:resultObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:resultObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:sensoryStatus.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:sensoryStatus.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:sensoryStatus.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:socialHistoryObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:socialHistoryObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:socialHistoryObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:substanceorDeviceAllergy-IntoleranceObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:substanceorDeviceAllergy-IntoleranceObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:substanceorDeviceAllergy-IntoleranceObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:vitalSignObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:vitalSignObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:vitalSignObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:longitudinalCareWoundObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:longitudinalCareWoundObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:longitudinalCareWoundObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:problemObservation2.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:problemObservation2.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:problemObservation2.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:caregiverCharacteristics.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:caregiverCharacteristics.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:caregiverCharacteristics.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:culturalandReligiousObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:culturalandReligiousObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:culturalandReligiousObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:characteristicsofHomeEnvironment.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:characteristicsofHomeEnvironment.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:characteristicsofHomeEnvironment.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:nutritionalStatusObservation.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:nutritionalStatusObservation.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:nutritionalStatusObservation.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:resultOrganizer.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:resultOrganizer.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:resultOrganizer.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:priorityPreference1.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:priorityPreference1.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:priorityPreference1.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:priorityPreference2.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:priorityPreference2.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:priorityPreference2.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.entryRelationship:problemConcernAct.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:problemConcernAct.​typeId.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.entryRelationship:problemConcernAct.​typeCode Base required x_ActRelationshipEntryRelationship 📦3.0.0 THO v7.0
    Act.reference.nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.reference.typeId.​nullFlavor Base required CDANullFlavor 📦2.0.2-sd Clinical Document Architecture v2.0
    Act.reference.typeCode Base required x_ActRelationshipExternalReference 📦3.0.0 THO v7.0

    Constraints

    Id Grade Path(s) Description Expression
    ED-1 error Act.text.thumbnail Thumbnails cannot contain their own thumbnails thumbnail.empty()
    II-1 error Act.typeId, Act.entryRelationship:problemObservation1.typeId, Act.entryRelationship:allergy-IntoleranceObservation.typeId, Act.entryRelationship:entryReferenceRefr.typeId, Act.entryRelationship:entryReferenceComp.typeId, Act.entryRelationship:assessmentScaleObservation.typeId, Act.entryRelationship:mentalStatusObservation1.typeId, Act.entryRelationship:self-CareActivitiesADLandIADL.typeId, Act.entryRelationship:mentalStatusObservation2.typeId, Act.entryRelationship:smokingStatus.typeId, Act.entryRelationship:encounterDiagnosis.typeId, Act.entryRelationship:entryRelationship11.typeId, Act.entryRelationship:functionalStatusObservation.typeId, Act.entryRelationship:hospitalAdmissionDiagnosis.typeId, Act.entryRelationship:nutritionAssessment.typeId, Act.entryRelationship:postprocedureDiagnosis.typeId, Act.entryRelationship:pregnancyStatusObservation.typeId, Act.entryRelationship:preoperativeDiagnosis.typeId, Act.entryRelationship:reactionObservation.typeId, Act.entryRelationship:resultObservation.typeId, Act.entryRelationship:sensoryStatus.typeId, Act.entryRelationship:socialHistoryObservation.typeId, Act.entryRelationship:substanceorDeviceAllergy-IntoleranceObservation.typeId, Act.entryRelationship:vitalSignObservation.typeId, Act.entryRelationship:longitudinalCareWoundObservation.typeId, Act.entryRelationship:problemObservation2.typeId, Act.entryRelationship:caregiverCharacteristics.typeId, Act.entryRelationship:culturalandReligiousObservation.typeId, Act.entryRelationship:characteristicsofHomeEnvironment.typeId, Act.entryRelationship:nutritionalStatusObservation.typeId, Act.entryRelationship:resultOrganizer.typeId, Act.entryRelationship:priorityPreference1.typeId, Act.entryRelationship:priorityPreference2.typeId, Act.entryRelationship:problemConcernAct.typeId, Act.reference.typeId An II instance must have either a root or an nullFlavor. root.exists() or nullFlavor.exists()
    should-author warning Act SHOULD contain author author.exists()
    should-text-ref-value warning Act SHOULD contain text/reference/@value text.reference.value.exists()
    value-starts-octothorpe error Act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')

    This structure is derived from Act

    Summary

    Mandatory: 9 elements(34 nested mandatory elements)
    Fixed: 36 elements
    Prohibited: 1 element

    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 Act.templateId
    • The element 4 is sliced based on the values of Act.entryRelationship

    Differential View

    This structure is derived from Act

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act 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-text-ref-value, should-author
    ... Slices for templateId 1..* II Slice: Unordered, Open by value:root, value:extension
    .... templateId:risk-concern-act 1..1 II
    ..... @root 1..1 oid, uuid, ruid Required Pattern: 2.16.840.1.113883.10.20.22.4.136
    ..... @extension 1..1 st Required Pattern: 2015-08-01
    ... @classCode 1..1 cs Fixed Value: ACT
    ... @moodCode 1..1 cs Fixed Value: EVN
    ... code 1..1 CD At risk - finding
    .... @code 1..1 cs Required Pattern: 281694009
    .... @codeSystem 1..1 oid, uuid, ruid SNOMED CT
    Required Pattern: 2.16.840.1.113883.6.96
    ... text C 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    ... statusCode 1..1 CS
    .... @nullFlavor 0..0
    .... @code 1..1 cs Binding: ProblemAct statusCode . (required)
    ... effectiveTime 0..1 IVL_TS
    ... author C 0..* AuthorParticipation SHOULD contain author
    ... Slices for entryRelationship 0..* EntryRelationship 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.
    Slice: Unordered, Open by value:typeCode, profile:observation, profile:act, profile:organizer
    .... entryRelationship:problemObservation1 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 ProblemObservation
    .... entryRelationship:allergy-IntoleranceObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 AllergyIntoleranceObservation
    .... entryRelationship:entryReferenceRefr 0..* EntryRelationship The following entryRelationship represents the relationship between two Health Concern Acts where there is a general relationship between the source and the target (Health Concern RELATES TO Health Concern). It can also represent the relationship between a Health Concern and another entry already described in the CDA document instance. The Entry Reference template is used here because the target entry will be defined elsewhere and thus a reference to that instance is all that is required.
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 EntryReference
    .... entryRelationship:entryReferenceComp 0..* EntryRelationship 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). The Enry 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.
    ..... @typeCode 1..1 cs Fixed Value: COMP
    ..... act 1..1 EntryReference
    .... entryRelationship:assessmentScaleObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 AssessmentScaleObservation
    .... entryRelationship:mentalStatusObservation1 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 MentalStatusObservation
    .... entryRelationship:self-CareActivitiesADLandIADL 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 SelfCareActivitiesADLandIADL
    .... entryRelationship:mentalStatusObservation2 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 MentalStatusObservation
    .... entryRelationship:smokingStatus 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 SmokingStatus
    .... entryRelationship:encounterDiagnosis 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 EncounterDiagnosis
    .... entryRelationship:entryRelationship11 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... organizer 1..1 FamilyHistoryOrganizer
    .... entryRelationship:functionalStatusObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 FunctionalStatusObservation
    .... entryRelationship:hospitalAdmissionDiagnosis 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 HospitalAdmissionDiagnosis
    .... entryRelationship:nutritionAssessment 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 NutritionAssessment
    .... entryRelationship:postprocedureDiagnosis 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 PostprocedureDiagnosis
    .... entryRelationship:pregnancyStatusObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 PregnancyStatusObservation
    .... entryRelationship:preoperativeDiagnosis 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 PreoperativeDiagnosis
    .... entryRelationship:reactionObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 ReactionObservation
    .... entryRelationship:resultObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 ResultObservation
    .... entryRelationship:sensoryStatus 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 SensoryStatus
    .... entryRelationship:socialHistoryObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 SocialHistoryObservation
    .... entryRelationship:substanceorDeviceAllergy-IntoleranceObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 SubstanceOrDeviceAllergyIntoleranceObservation
    .... entryRelationship:vitalSignObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 VitalSignObservation
    .... entryRelationship:longitudinalCareWoundObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 LongitudinalCareWoundObservation
    .... entryRelationship:problemObservation2 0..* EntryRelationship The following entryRelationship represents the relationship Health Concern HAS SUPPORT Observation.
    ..... @typeCode 1..1 cs Fixed Value: SPRT
    ..... observation 1..1 ProblemObservation
    .... entryRelationship:caregiverCharacteristics 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 CaregiverCharacteristics
    .... entryRelationship:culturalandReligiousObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 CulturalandReligiousObservation
    .... entryRelationship:characteristicsofHomeEnvironment 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 CharacteristicsofHomeEnvironment
    .... entryRelationship:nutritionalStatusObservation 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 NutritionalStatusObservation
    .... entryRelationship:resultOrganizer 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... organizer 1..1 ResultOrganizer
    .... entryRelationship:priorityPreference1 0..* EntryRelationship The following entryRelationship represents the priority that the patient puts on the health concern.
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 PriorityPreference
    .... entryRelationship:priorityPreference2 0..* EntryRelationship The following entryRelationship represents the priority that the provider puts on the health concern.
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... observation 1..1 PriorityPreference
    .... entryRelationship:problemConcernAct 0..* EntryRelationship
    ..... @typeCode 1..1 cs Fixed Value: REFR
    ..... act 1..1 ProblemConcernAct
    ... reference 0..* Reference
    .... @typeCode 1..1 cs Fixed Value: REFR
    .... externalDocument 1..1 ExternalDocumentReference

    doco Documentation for this format

    Terminology Bindings (Differential)

    Path Status Usage ValueSet Version Source
    Act.statusCode.code Base required ProblemAct statusCode . 📦20240606 VSAC v0.24

    Constraints

    Id Grade Path(s) Description Expression
    should-author warning Act SHOULD contain author author.exists()
    should-text-ref-value warning Act SHOULD contain text/reference/@value text.reference.value.exists()
    value-starts-octothorpe error Act.text.reference If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative value.exists() implies value.startsWith('#')

    Key Elements View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Act C 1..1 Act 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-text-ref-value, should-author
    ... @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:risk-concern-act 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: 2.16.840.1.113883.10.20.22.4.136
    ..... @extension 1..1 st Required Pattern: 2015-08-01
    ... @classCode 1..1 cs Binding: XActClassDocumentEntryAct (2.0.0) (required)
    Fixed Value: ACT
    ... @moodCode 1..1 cs Binding: XDocumentActMood (2.0.0) (required)
    Fixed Value: EVN
    ... @negationInd 0..1 bl
    ... id 1..* II
    ... code 1..1 CD At risk - finding
    Binding: v3 Code System ActCode (example)
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @code 1..1 cs Required Pattern: 281694009
    .... @codeSystem 1..1 oid, uuid, ruid SNOMED CT
    Required Pattern: 2.16.840.1.113883.6.96
    .... @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
    .... qualifier 0..* CR
    .... translation 0..* CD
    ... text C 0..1 ED SHOULD reference the portion of section narrative text corresponding to this entry
    .... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    .... @compression 0..1 cs Binding: CDACompressionAlgorithm (required)
    .... @integrityCheck 0..1 bin
    .... @integrityCheckAlgorithm 0..1 cs Binding: IntegrityCheckAlgorithm (2.0.0) (required)
    .... @language 0..1 cs
    .... @mediaType 0..1 cs Binding: MediaType (example)
    .... @representation 0..1 cs Binding: CDABinaryDataEncoding (required)
    .... xmlText 0..1 st Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    .... reference C 0..1 TEL Constraints: value-starts-octothorpe
    .... thumbnail C 0..1 ED Constraints: ED-1
    ... statusCode 1..1 CS Binding: ActStatus (required)
    .... @code 1..1 cs Binding: ProblemAct statusCode . (required)
    .... @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)
    ... effectiveTime 0..1 IVL_TS
    ... priorityCode 0..1 CE Binding: ActPriority (example)
    ... languageCode 0..1 CS Binding: AllLanguages (required)
    ... subject 0..1 Subject
    ... specimen 0..* Specimen
    ... performer 0..* Performer2
    ... author C 0..* AuthorParticipation SHOULD contain author
    ... informant 0..* Informant
    ... participant 0..* Participant2
    ... Slices for entryRelationship 0..* EntryRelationship 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.
    Slice: Unordered, Open by value:typeCode, profile:observation, profile:act, profile:organizer
    .... entryRelationship:problemObservation1 0..* EntryRelationship
    ..... @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 1..1 cs Binding: x_ActRelationshipEntryRelationship (required)
    Fixed Value: REFR
    ..... @inversionInd 0..1 bl
    ..... @contextConductionInd 0..1 bl
    ..... @negationInd 0..1 bl
    ..... sequenceNumber 0..1 INT
    ..... seperatableInd 0..1 BL
    ..... act 0..1 Act
    ..... encounter 0..1 Encounter
    ..... observation 1..1 ProblemObservation
    ..... observationMedia 0..1 ObservationMedia
    ..... organizer 0..1 Organizer
    ..... procedure 0..1 Procedure
    ..... regionOfInterest 0..1 RegionOfInterest
    ..... substanceAdministration 0..1 SubstanceAdministration
    ..... supply 0..1 Supply
    .... entryRelationship:allergy-IntoleranceObservation 0..* EntryRelationship
    ..... @nullFlavor 0..1 cs Binding: CDANullFlavor (required)
    ..... realmCode 0..* CS
    .....