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
<ClinicalDocument xmlns="urn:hl7-org:v3">
<realmCode code="US"/>
<typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040"/>
<!-- US Realm Header Template -->
<templateId root="2.16.840.1.113883.10.20.22.1.1" extension="2024-05-01"/>
<!-- Globally unique identifier for the document -->
<id root="2.16.840.1.113883.19.5.99999.1" extension="TT988"/>
<code displayName="Summarization of Episode Note" codeSystemName="LOINC"
codeSystem="2.16.840.1.113883.6.1" code="34133-9"/>
<!-- Title of the document -->
<title>Patient Chart Summary</title>
<effectiveTime value="20120915103000-0800"/>
<confidentialityCode displayName="normal" codeSystemName="Confidentiality"
codeSystem="2.16.840.1.113883.5.25" code="N"/>
<languageCode code="en-US"/>
<recordTarget>
<patientRole>
<!-- Example Social Security Number using the actual SSN OID. -->
<id root="2.16.840.1.113883.4.1" extension="444222222"/>
<addr nullFlavor="UNK"/>
<telecom nullFlavor="UNK"/>
<patient>
<name use="L">
<given>Eve</given>
<family>Betterhalf</family>
</name>
<administrativeGenderCode displayName="Female"
codeSystemName="AdministrativeGender" codeSystem="2.16.840.1.113883.5.1"
code="F"/>
<!-- Date of birth need only be precise to the day -->
<birthTime value="19750501"/>
<maritalStatusCode displayName="Married"
codeSystemName="MaritalStatusCode" codeSystem="2.16.840.1.113883.5.2" code="M"/>
<!-- One root element for each race; use translations to associate detailed race with categories in the root -->
<!-- CDC Race and Ethnicity code set contains the five minimum race and ethnicity categories defined by OMB Standards -->
<raceCode displayName="White"
codeSystemName="Race & Ethnicity - CDC" codeSystem="2.16.840.1.113883.6.238" code="2106-3">
<!-- To specify a detailed race and associated it with a category, use the translation element -->
<translation xsi:type="CD" displayName="Irish"
codeSystem="2.16.840.1.113883.6.238" code="2113-9"/>
</raceCode>
<!-- The raceCode extension is only used if raceCode is valued. It can be used to convey additional races or details.
But when conveying details using translation elements, send only categories in the root node, and place the detail in a translation -->
<sdtc:raceCode xmlns:sdtc="urn:hl7-org:sdtc"
displayName="Native Hawaiian or Other Pacific Islander" codeSystemName="Race & Ethnicity - CDC"
codeSystem="2.16.840.1.113883.6.238" code="2076-8">
<translation xsi:type="CD" displayName="Native Hawaiian"
codeSystem="2.16.840.1.113883.6.238" code="2079-2"/>
</sdtc:raceCode>
<ethnicGroupCode displayName="Not Hispanic or Latino"
codeSystemName="Race & Ethnicity - CDC" codeSystem="2.16.840.1.113883.6.238" code="2186-5"/>
<languageCommunication>
<languageCode code="en"/>
<!-- "en" is ISO 639-1 alpha-2 code for "English" -->
<modeCode displayName="Expressed spoken"
codeSystemName="LanguageAbilityMode" codeSystem="2.16.840.1.113883.5.60" code="ESP"/>
<proficiencyLevelCode displayName="Good"
codeSystemName="LanguageAbilityProficiency" codeSystem="2.16.840.1.113883.5.61" code="G"/>
<!-- Patient's preferred language -->
<preferenceInd value="true"/>
</languageCommunication>
</patient>
</patientRole>
</recordTarget>
<author>
<time value="20130815103000-0800"/>
<assignedAuthor>
<id root="2.16.840.1.113883.4.6" extension="5555555555"/>
<code displayName="Adult Medicine Physician"
codeSystemName="Healthcare Provider Taxonomy (HIPAA)" codeSystem="2.16.840.1.113883.6.101" code="207QA0505X"/>
<addr nullFlavor="UNK"/>
<telecom nullFlavor="UNK"/>
<assignedPerson>
<name>
<given>Patricia</given>
<given qualifier="CL">Patty</given>
<family>Primary</family>
<suffix qualifier="AC">M.D.</suffix>
</name>
</assignedPerson>
</assignedAuthor>
</author>
<custodian>
<assignedCustodian>
<representedCustodianOrganization>
<id root="2.16.840.1.113883.4.6" extension="321CX"/>
<name>Good Health HIE</name>
<telecom nullFlavor="UNK"/>
<addr use="WP">
<streetAddressLine>1009 Healthcare Drive</streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>99123</postalCode>
<country>US</country>
</addr>
</representedCustodianOrganization>
</assignedCustodian>
</custodian>
<legalAuthenticator>
<time value="20130815103000-0800"/>
<signatureCode code="S"/>
<assignedEntity>
<id nullFlavor="UNK"/>
<addr nullFlavor="UNK"/>
<telecom nullFlavor="UNK"/>
<assignedPerson>
<name nullFlavor="UNK"/>
</assignedPerson>
</assignedEntity>
</legalAuthenticator>
<component>
<structuredBody>
<component>
<section/>
</component>
</structuredBody>
</component>
</ClinicalDocument>