Paramedicine Summary Of Care CDA
0.0.1-current - ci-build International flag

Paramedicine Summary Of Care CDA, published by IHE Patient Care Coordination Technical Committee. This guide is not an authorized publication; it is the continuous build for version 0.0.1-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/PCC.PCSc/ and changes regularly. See the Directory of published versions

Logical Model: IHE_PCC_Problem_Entry - Detailed Descriptions

Draft as of 2025-11-04

Definitions for the IHE.PCC.Problem.Entry logical model.

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

0. Observation
Definition

Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.


Base definition for all types defined in FHIR type system.

ShortBase for all types and resources
Control10..1*
Is Modifierfalse
Logical ContainerClinicalDocument (CDA Class)
ValidationInstance of this type are validated by templateId
XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
should-author: SHOULD contain author (author.exists())
2. Observation.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
(required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
4. Observation.realmCode
Definition

When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

Control0..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
6. Observation.typeId
Definition

When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

Control0..1
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
8. Observation.typeId.nullFlavor
Definition

If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

Control0..1
BindingThe codes SHALL be taken from CDANullFlavor
(required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
Typecode(cs: Coded Simple Value)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExceptional Value Detail
10. Observation.typeId.assigningAuthorityName
Definition

A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

Control0..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelAssigning Authority Name
12. Observation.typeId.displayable
Definition

Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

Control0..1
Typeboolean(bl: Boolean)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelDisplayable
14. Observation.typeId.root
Definition

Identifies the type as an HL7 Registered model

Control1..1
Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelRoot
Fixed Value2.16.840.1.113883.1.3
16. Observation.typeId.extension
Definition

A character string as a unique identifier within the scope of the identifier root.

Control1..1
Typestring(st: Character String)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
LabelExtension
18. Observation.templateId
Definition

When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

Control2..*
Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
Must Supporttrue
SlicingThis element introduces a set of slices on Observation.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ root
  • value @ extension
  • 20. Observation.templateId:problem-obs
    Slice Nameproblem-obs
    Definition

    When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

    Control1..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
    22. Observation.templateId:problem-obs.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..1
    BindingThe codes SHALL be taken from CDANullFlavor
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    24. Observation.templateId:problem-obs.assigningAuthorityName
    Definition

    A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelAssigning Authority Name
    26. Observation.templateId:problem-obs.displayable
    Definition

    Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

    Control0..1
    Typeboolean(bl: Boolean)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelDisplayable
    28. Observation.templateId:problem-obs.root
    Definition

    A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

    Control1..1
    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelRoot
    Pattern Value2.16.840.1.113883.10.20.1.28
    30. Observation.templateId:problem-obs.extension
    Definition

    A character string as a unique identifier within the scope of the identifier root.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExtension
    32. Observation.templateId:problem-entry
    Slice Nameproblem-entry
    Definition

    When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

    Control1..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
    34. Observation.templateId:problem-entry.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..1
    BindingThe codes SHALL be taken from CDANullFlavor
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    36. Observation.templateId:problem-entry.assigningAuthorityName
    Definition

    A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelAssigning Authority Name
    38. Observation.templateId:problem-entry.displayable
    Definition

    Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

    Control0..1
    Typeboolean(bl: Boolean)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelDisplayable
    40. Observation.templateId:problem-entry.root
    Definition

    A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

    Control1..1
    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelRoot
    Pattern Value1.3.6.1.4.1.19376.1.5.3.1.4.5
    42. Observation.templateId:problem-entry.extension
    Definition

    A character string as a unique identifier within the scope of the identifier root.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExtension
    44. Observation.classCode
    Control1..1
    BindingThe codes SHALL be taken from CDAActClassObservation
    (required to http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    46. Observation.moodCode
    Comments

    SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:1198-9042).

    Control1..1
    BindingThe codes SHALL be taken from XActMoodDocumentObservation (2.0.0)
    (required to http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed ValueEVN
    48. Observation.negationInd
    ShortThe negationInd is used to indicate the absence of the condition in observation/value. A negationInd of "true" coupled with an observation/value of SNOMED code 64572001 "Disease (disorder)" indicates that the patient has no known conditions.
    Comments

    MAY contain zero or one [0..1] @negationInd (CONF:1198-10139).

    Control0..1
    Typeboolean(bl: Boolean)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    XML FormatIn the XML format, this property is represented as an attribute.
    50. Observation.id
    Definition

    The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

    ShortLogical id of this artifact
    Comments

    SHALL contain at least one [1..*] id (CONF:1198-9043).


    Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

    Control10..*1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/IIid
    Is Modifierfalse
    Must Supporttrue
    52. Observation.sdtcCategory
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
    XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namecategory.
    54. Observation.code
    Definition

    Describes what was observed. Sometimes this is called the observation "name".

    ShortType of observation (code / type)
    Comments

    The <code> describes the process of establishing a problem. The code element should be used, as the process of determining the value is important to clinicians (e.g., a diagnosis is a more advanced statement than a symptom). When a physical exam observation is being recorded the code used should be “Finding.” When a review of systems observation is being recorded the code used should be “Symptom.” The recommended vocabulary for describing problems is shown in the table below. Subclasses of this content module may specify other vocabularies. When the list below is used, the codeSystem is '2.16.840.1.113883.6.96' and codeSystemName is SNOMED CT.


    All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

    Control1..1
    This element is affected by the following invariants: obs-7
    BindingFor example codes, see ObservationTypehttp://hl7.org/fhir/ValueSet/observation-codes|5.0.0
    (example to http://terminology.hl7.org/ValueSet/v3-ObservationType)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CDCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    XML FormatThe type of this property is determined using the xsi:typeattribute.
    Requirements

    Knowing what kind of observation is being made is essential to understanding the observation.

    Alternate NamesName
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    56. Observation.derivationExpr
    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ST
    58. Observation.text
    Definition

    A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

    ShortSHOULD reference the portion of section narrative text corresponding to this entryText summary of the resource, for human interpretation
    Comments

    The <text> element is required and points to the text describing the problem being recorded; including any dates, comments, et cetera. The <reference> contains a URI in value attribute. This URI points to the free text description of the problem in the document that is being described.


    Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

    Control10..1
    This element is affected by the following invariants: dom-6
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/EDNarrative
    Is Modifierfalse
    Must Supporttrue
    XML FormatThe type of this property is determined using the xsi:typeattribute.
    Alternate Namesnarrative, html, xhtml, display
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    60. Observation.text.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..1
    BindingThe codes SHALL be taken from CDANullFlavor
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    62. Observation.text.compression
    Definition

    Indicates whether the raw byte data is compressed, and what compression algorithm was used.

    Control0..1
    BindingThe codes SHALL be taken from CDACompressionAlgorithm
    (required to http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCompression
    64. Observation.text.integrityCheck
    Definition

    The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.

    Control0..1
    Typebase64Binary(bin: Binary Data)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelIntegrity Check
    66. Observation.text.integrityCheckAlgorithm
    Definition

    Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.

    Control0..1
    BindingThe codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0)
    (required to http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelIntegrity Check Algorithm
    68. Observation.text.language
    Definition

    For character based information the language property specifies the human language of the text.

    Control0..1
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelLanguage
    70. Observation.text.mediaType
    Definition

    Identifies the type of the encapsulated data and identifies a method to interpret or render the data.

    Control0..1
    BindingFor example codes, see MediaType
    (example to http://terminology.hl7.org/ValueSet/v3-MediaType)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelMedia Type
    72. Observation.text.representation
    Control0..1
    BindingThe codes SHALL be taken from CDABinaryDataEncoding
    (required to http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    74. Observation.text.xmlText
    Definition

    Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)

    ShortAllows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
    Comments

    This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as unadorned text.
    76. Observation.text.reference
    Definition

    A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
    LabelReference
    Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
    78. Observation.text.thumbnail
    Definition

    An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
    LabelThumbnail
    80. Observation.statusCode
    Comments

    SHALL contain exactly one [1..1] statusCode (CONF:1198-9049).

    Control1..1
    BindingThe codes SHALL be taken from ActStatus
    (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
    82. Observation.statusCode.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..1
    BindingThe codes SHALL be taken from CDANullFlavor
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    84. Observation.statusCode.code
    Definition

    The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

    Comments

    A clinical document normally records only those condition observation events that have been completed, not observations that are in any other state. Therefore, the <statusCode> shall always have code='completed'.

    Control1..1
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode
    Fixed Valuecompleted
    86. Observation.statusCode.codeSystem
    Definition

    Specifies the code system that defines the code.

    Control0..0
    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System
    88. Observation.statusCode.codeSystemName
    Definition

    The common name of the coding system.

    Control0..0
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System Name
    90. Observation.statusCode.codeSystemVersion
    Definition

    If applicable, a version descriptor defined specifically for the given code system.

    Control0..0
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System Version
    92. Observation.statusCode.displayName
    Definition

    A name or title for the code, under which the sending system shows the code value to its users.

    Control0..0
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelDisplay Name
    94. Observation.statusCode.sdtcValueSet
    Definition

    The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

    Control0..1
    Typestring(oid: ISO Object Identifier)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
    96. Observation.statusCode.sdtcValueSetVersion
    Definition

    The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
    98. Observation.statusCode.originalText
    Definition

    The text or phrase used as the basis for the coding.

    Control0..0
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
    LabelOriginal Text
    100. Observation.statusCode.qualifier
    Definition

    Specifies additional codes that increase the specificity of the the primary code.

    Control0..0
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
    LabelQualifier
    102. Observation.statusCode.translation
    Definition

    A set of other concept descriptors that translate this concept descriptor into other code systems.

    Control0..0
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
    XML FormatThe type of this property is determined using the xsi:typeattribute.
    LabelTranslation
    104. Observation.effectiveTime
    ShortIf the problem is known to be resolved, but the date of resolution is not known, then the high element **SHALL** be present, and the nullFlavor attribute **SHALL** be set to 'UNK'. Therefore, the existence of a high element within a problem does indicate that the problem has been resolved.
    Comments

    SHALL contain exactly one [1..1] effectiveTime (CONF:1198-9050).

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
    Must Supporttrue
    106. Observation.effectiveTime.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..1
    BindingThe codes SHALL be taken from CDANullFlavor
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    108. Observation.effectiveTime.value
    Definition

    A quantity specifying a point on the axis of natural time. A point in time is most often represented as a calendar expression.

    Control0..1
    TypedateTime(ts: Point in Time)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Date FormatYYYYMMDDHHMMSS.UUUU[+|-ZZzz]
    XML FormatIn the XML format, this property is represented as an attribute.
    110. Observation.effectiveTime.operator
    Definition

    A code specifying whether the set component is included (union) or excluded (set-difference) from the set, or other set operations with the current set component and the set as constructed from the representation stream up to the current point.

    Control0..1
    BindingThe codes SHALL be taken from CDASetOperator
    (required to http://hl7.org/cda/stds/core/ValueSet/CDASetOperator)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Default ValueI
    112. Observation.effectiveTime.low
    Definition

    This is the low limit of the interval.

    ShortThe effectiveTime/low (a.k.a. "onset date") asserts when the condition became biologically active.
    Comments

    This effectiveTime SHALL contain exactly one [1..1] low (CONF:1198-15603).

    Control1..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
    Must Supporttrue
    LabelLow Boundary
    114. Observation.effectiveTime.center
    Definition

    The arithmetic mean of the interval (low plus high divided by 2). The purpose of distinguishing the center as a semantic property is for conversions of intervals from and to point values.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/TS
    LabelCentral Value
    116. Observation.effectiveTime.width
    Definition

    The difference between high and low boundary. The purpose of distinguishing a width property is to handle all cases of incomplete information symmetrically. In any interval representation only two of the three properties high, low, and width need to be stated and the third can be derived.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/PQ
    LabelWidth
    118. Observation.effectiveTime.high
    Definition

    This is the high limit of the interval.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
    Must Supporttrue
    LabelHigh Boundary
    120. Observation.priorityCode
    Control0..1
    BindingFor example codes, see ActPriority
    (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
    122. Observation.repeatNumber
    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-INT
    124. Observation.languageCode
    Control0..1
    BindingThe codes SHALL be taken from AllLanguages
    (required to http://hl7.org/fhir/ValueSet/all-languages)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
    126. Observation.value
    Comments

    The <value> is the condition that was found. This element is required. While the value may be a coded or an un-coded string, the type is always a coded value (xsi:type='CD'). If coded, the code and codeSystem attributes shall be present. The codeSystem should reference a controlled vocabulary describing problems, complaints, symptoms, findings, diagnoses, or functional limitations, e.g., ICD-9, SNOMED-CT or MEDCIN, or others.

    Control1..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
    Must Supporttrue
    XML FormatThe type of this property is determined using the xsi:typeattribute.
    128. Observation.value.nullFlavor
    Definition

    If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

    Control0..1
    BindingThe codes SHALL be taken from CDANullFlavor
    (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelExceptional Value Detail
    130. Observation.value.code
    Definition

    The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

    ShortA negationInd of "true" coupled with an observation/value/@code of SNOMED code 64572001 "Disease (disorder)" indicates that the patient has no known conditions. When the Problem is Social Determinant of Health Observation, the observation/value SHOULD be a SNOMED code selected from ValueSet Social Determinant of Health Conditions 2.16.840.1.113762.1.4.1196.788 DYNAMIC (CONF:4515-32951).
    Comments

    This value MAY contain zero or one [0..1] @code (CONF:1198-31871).

    Control0..1
    Typecode(cs: Coded Simple Value)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode
    132. Observation.value.codeSystem
    Definition

    Specifies the code system that defines the code.

    Control0..1
    Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System
    134. Observation.value.codeSystemName
    Definition

    The common name of the coding system.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System Name
    136. Observation.value.codeSystemVersion
    Definition

    If applicable, a version descriptor defined specifically for the given code system.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelCode System Version
    138. Observation.value.displayName
    Definition

    A name or title for the code, under which the sending system shows the code value to its users.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    LabelDisplay Name
    140. Observation.value.sdtcValueSet
    Definition

    The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

    Control0..1
    Typestring(oid: ISO Object Identifier)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
    142. Observation.value.sdtcValueSetVersion
    Definition

    The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

    Control0..1
    Typestring(st: Character String)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
    144. Observation.value.originalText
    Definition

    The text or phrase used as the basis for the coding.

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
    LabelOriginal Text
    146. Observation.value.qualifier
    Definition

    Specifies additional codes that increase the specificity of the the primary code.

    ShortThe observation/value and all the qualifiers together (often referred to as a post-coordinated expression) make up one concept. Qualifiers constrain the meaning of the primary code, and cannot negate it or change its meaning. Qualifiers can only be used according to well-defined rules of post-coordination and only if the underlying code system defines the use of such qualifiers or if there is a third code system that specifies how other code systems may be combined. In cases where SNOMED CT does not have a precoordinated code that would be appropriate for the problem list, concept post coordination may be used in CDA following the principles outlined in HL7 Version 3 Implementation Guide: TermInfo - Using SNOMED CT in CDA R2 Models, Release 1 using the V3 CD Data type 1 style. This is shown in the sample XML.
    Comments

    This value MAY contain zero or more [0..*] qualifier (CONF:1198-31870).

    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
    LabelQualifier
    148. Observation.value.translation
    Definition

    A set of other concept descriptors that translate this concept descriptor into other code systems.

    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
    XML FormatThe type of this property is determined using the xsi:typeattribute.
    LabelTranslation
    150. Observation.interpretationCode
    Control0..*
    BindingThe codes SHALL be taken from CDAObservationInterpretation
    (required to http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
    152. Observation.methodCode
    Control0..*
    BindingFor example codes, see ObservationMethod
    (example to http://terminology.hl7.org/ValueSet/v3-ObservationMethod)
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
    154. Observation.targetSiteCode
    Definition

    Drawn from concept domain ActSite

    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
    156. Observation.subject
    Definition

    The patient, or group of patients, location, device, organization, procedure or practitioner this observation is about and into whose or what record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the focus element or the code itself specifies the actual focus of the observation.

    ShortWho and/or what the observation is about
    Comments

    One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated. The subject of an Observation may in some cases be a procedure. This supports the regulatory inspection use case where observations are captured during inspections of a procedure that is being performed (independent of any particular patient or whether patient related at all).

    Control0..1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubjectReference(Patient, Group, Device, Location, Organization, Procedure, Practitioner, Medication, Substance, BiologicallyDerivedProduct, NutritionProduct)
    Is Modifierfalse
    Requirements

    Observations have no value if you don't know who or what they're about.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    158. Observation.specimen
    Definition

    The specimen that was used when this observation was made.

    ShortSpecimen used for this observation
    Comments

    Should only be used if not implicit in code found in Observation.code. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

    Control0..*1
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/SpecimenReference(Specimen, Group)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    obs-9: If Observation.specimen is a reference to Group, the group can only have specimens ((reference.resolve().exists() and reference.resolve() is Group) implies reference.resolve().member.entity.resolve().all($this is Specimen))
    160. Observation.performer
    Definition

    Who was responsible for asserting the observed value as "true".

    ShortWho is responsible for the observation
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2Reference(Practitioner, PractitionerRole, Organization, CareTeam, Patient, RelatedPerson)
    Is Modifierfalse
    Requirements

    May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    162. Observation.author
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author
    164. Observation.informant
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
    166. Observation.participant
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
    168. Observation.entryRelationship
    Control0..*
    Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
    Must Supporttrue
    SlicingThis element introduces a set of slices on Observation.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • profile @ observation
    • profile @ act
    • 170. Observation.entryRelationship:severity-entry
      Slice Nameseverity-entry
      Comments

      MAY contain zero or one [0..1] entryRelationship (CONF:1198-9059) such that it

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
      Must Supporttrue
      172. Observation.entryRelationship:severity-entry.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      174. Observation.entryRelationship:severity-entry.realmCode
      Definition

      When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      176. Observation.entryRelationship:severity-entry.typeId
      Definition

      When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
      178. Observation.entryRelationship:severity-entry.typeId.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      180. Observation.entryRelationship:severity-entry.typeId.assigningAuthorityName
      Definition

      A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelAssigning Authority Name
      182. Observation.entryRelationship:severity-entry.typeId.displayable
      Definition

      Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelDisplayable
      184. Observation.entryRelationship:severity-entry.typeId.root
      Definition

      Identifies the type as an HL7 Registered model

      Control1..1
      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelRoot
      Fixed Value2.16.840.1.113883.1.3
      186. Observation.entryRelationship:severity-entry.typeId.extension
      Definition

      A character string as a unique identifier within the scope of the identifier root.

      Control1..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExtension
      188. Observation.entryRelationship:severity-entry.templateId
      Definition

      When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      190. Observation.entryRelationship:severity-entry.typeCode
      Control1..1
      BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
      (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed ValueSUBJ
      192. Observation.entryRelationship:severity-entry.inversionInd
      Definition

      The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

      Comments

      SHALL contain exactly one [1..1] @inversionInd="true" True (CONF:1198-9069).

      Control1..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed Valuetrue
      194. Observation.entryRelationship:severity-entry.contextConductionInd
      Definition

      The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Default Valuetrue
      196. Observation.entryRelationship:severity-entry.negationInd
      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      198. Observation.entryRelationship:severity-entry.sequenceNumber
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
      200. Observation.entryRelationship:severity-entry.seperatableInd
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
      202. Observation.entryRelationship:severity-entry.act
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
      204. Observation.entryRelationship:severity-entry.encounter
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
      206. Observation.entryRelationship:severity-entry.observation
      Control1..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Severity Entry)
      208. Observation.entryRelationship:severity-entry.observationMedia
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
      210. Observation.entryRelationship:severity-entry.organizer
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
      212. Observation.entryRelationship:severity-entry.procedure
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
      214. Observation.entryRelationship:severity-entry.regionOfInterest
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
      216. Observation.entryRelationship:severity-entry.substanceAdministration
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
      218. Observation.entryRelationship:severity-entry.supply
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
      220. Observation.entryRelationship:problem-status
      Slice Nameproblem-status
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
      Must Supporttrue
      222. Observation.entryRelationship:problem-status.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      224. Observation.entryRelationship:problem-status.realmCode
      Definition

      When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      226. Observation.entryRelationship:problem-status.typeId
      Definition

      When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
      228. Observation.entryRelationship:problem-status.typeId.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      230. Observation.entryRelationship:problem-status.typeId.assigningAuthorityName
      Definition

      A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelAssigning Authority Name
      232. Observation.entryRelationship:problem-status.typeId.displayable
      Definition

      Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelDisplayable
      234. Observation.entryRelationship:problem-status.typeId.root
      Definition

      Identifies the type as an HL7 Registered model

      Control1..1
      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelRoot
      Fixed Value2.16.840.1.113883.1.3
      236. Observation.entryRelationship:problem-status.typeId.extension
      Definition

      A character string as a unique identifier within the scope of the identifier root.

      Control1..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExtension
      238. Observation.entryRelationship:problem-status.templateId
      Definition

      When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      240. Observation.entryRelationship:problem-status.typeCode
      Comments

      SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1198-31531).

      Control1..1
      BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
      (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed ValueREFR
      242. Observation.entryRelationship:problem-status.inversionInd
      Definition

      The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed Valuefalse
      244. Observation.entryRelationship:problem-status.contextConductionInd
      Definition

      The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Default Valuetrue
      246. Observation.entryRelationship:problem-status.negationInd
      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      248. Observation.entryRelationship:problem-status.sequenceNumber
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
      250. Observation.entryRelationship:problem-status.seperatableInd
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
      252. Observation.entryRelationship:problem-status.act
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
      254. Observation.entryRelationship:problem-status.encounter
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
      256. Observation.entryRelationship:problem-status.observation
      Control1..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Problem Status Observation)
      258. Observation.entryRelationship:problem-status.observationMedia
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
      260. Observation.entryRelationship:problem-status.organizer
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
      262. Observation.entryRelationship:problem-status.procedure
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
      264. Observation.entryRelationship:problem-status.regionOfInterest
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
      266. Observation.entryRelationship:problem-status.substanceAdministration
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
      268. Observation.entryRelationship:problem-status.supply
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
      270. Observation.entryRelationship:health-status
      Slice Namehealth-status
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
      Must Supporttrue
      272. Observation.entryRelationship:health-status.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      274. Observation.entryRelationship:health-status.realmCode
      Definition

      When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      276. Observation.entryRelationship:health-status.typeId
      Definition

      When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
      278. Observation.entryRelationship:health-status.typeId.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      280. Observation.entryRelationship:health-status.typeId.assigningAuthorityName
      Definition

      A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelAssigning Authority Name
      282. Observation.entryRelationship:health-status.typeId.displayable
      Definition

      Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelDisplayable
      284. Observation.entryRelationship:health-status.typeId.root
      Definition

      Identifies the type as an HL7 Registered model

      Control1..1
      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelRoot
      Fixed Value2.16.840.1.113883.1.3
      286. Observation.entryRelationship:health-status.typeId.extension
      Definition

      A character string as a unique identifier within the scope of the identifier root.

      Control1..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExtension
      288. Observation.entryRelationship:health-status.templateId
      Definition

      When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      290. Observation.entryRelationship:health-status.typeCode
      Comments

      SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1198-31532).

      Control1..1
      BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
      (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed ValueREFR
      292. Observation.entryRelationship:health-status.inversionInd
      Definition

      The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed Valuefalse
      294. Observation.entryRelationship:health-status.contextConductionInd
      Definition

      The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Default Valuetrue
      296. Observation.entryRelationship:health-status.negationInd
      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      298. Observation.entryRelationship:health-status.sequenceNumber
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
      300. Observation.entryRelationship:health-status.seperatableInd
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
      302. Observation.entryRelationship:health-status.act
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
      304. Observation.entryRelationship:health-status.encounter
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
      306. Observation.entryRelationship:health-status.observation
      Control1..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Health Status)
      Must Supporttrue
      308. Observation.entryRelationship:health-status.observationMedia
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
      310. Observation.entryRelationship:health-status.organizer
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
      312. Observation.entryRelationship:health-status.procedure
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
      314. Observation.entryRelationship:health-status.regionOfInterest
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
      316. Observation.entryRelationship:health-status.substanceAdministration
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
      318. Observation.entryRelationship:health-status.supply
      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
      320. Observation.reference
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
      322. Observation.precondition
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
      324. Observation.sdtcPrecondition2
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition2
      XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameprecondition2.
      326. Observation.referenceRange
      Definition

      Relates an Observation to the ObservationRange class, where the expected range of values for a particular observation can be specified.


      Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two referenceRange elements would be used.

      ShortProvides guide for interpretation
      Comments

      Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRootBackboneElement
      Is Modifierfalse
      Requirements

      Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      obs-3: Must have at least a low or a high or text (low.exists() or high.exists() or text.exists())
      328. Observation.referenceRange.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      330. Observation.referenceRange.realmCode
      Definition

      When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
      332. Observation.referenceRange.typeId
      Definition

      When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

      Control0..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
      334. Observation.referenceRange.typeId.nullFlavor
      Definition

      If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

      Control0..1
      BindingThe codes SHALL be taken from CDANullFlavor
      (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExceptional Value Detail
      336. Observation.referenceRange.typeId.assigningAuthorityName
      Definition

      A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

      Control0..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelAssigning Authority Name
      338. Observation.referenceRange.typeId.displayable
      Definition

      Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

      Control0..1
      Typeboolean(bl: Boolean)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelDisplayable
      340. Observation.referenceRange.typeId.root
      Definition

      Identifies the type as an HL7 Registered model

      Control1..1
      Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelRoot
      Fixed Value2.16.840.1.113883.1.3
      342. Observation.referenceRange.typeId.extension
      Definition

      A character string as a unique identifier within the scope of the identifier root.

      Control1..1
      Typestring(st: Character String)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      LabelExtension
      344. Observation.referenceRange.templateId
      Definition

      When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
      346. Observation.referenceRange.typeCode
      Control0..1
      BindingThe codes SHALL be taken from CDAActRelationshipType
      (required to http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType)
      Typecode(cs: Coded Simple Value)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed ValueREFV
      348. Observation.referenceRange.observationRange
      Control1..1
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationRange
      350. Observation.sdtcInFulfillmentOf1
      Control0..*
      Typehttp://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
      XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameinFulfillmentOf1.

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

      0. Observation
      Logical ContainerClinicalDocument (CDA Class)
      ValidationInstance of this type are validated by templateId
      XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
      Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
      should-author: SHOULD contain author (author.exists())
      2. Observation.templateId
      Control2..?
      Must Supporttrue
      SlicingThis element introduces a set of slices on Observation.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ root
      • value @ extension
      • 4. Observation.templateId:problem-obs
        Slice Nameproblem-obs
        Control1..1
        6. Observation.templateId:problem-obs.root
        Control1..?
        Pattern Value2.16.840.1.113883.10.20.1.28
        8. Observation.templateId:problem-entry
        Slice Nameproblem-entry
        Control1..1
        10. Observation.templateId:problem-entry.root
        Control1..?
        Pattern Value1.3.6.1.4.1.19376.1.5.3.1.4.5
        12. Observation.moodCode
        Comments

        SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:1198-9042).

        Fixed ValueEVN
        14. Observation.negationInd
        ShortThe negationInd is used to indicate the absence of the condition in observation/value. A negationInd of "true" coupled with an observation/value of SNOMED code 64572001 "Disease (disorder)" indicates that the patient has no known conditions.
        Comments

        MAY contain zero or one [0..1] @negationInd (CONF:1198-10139).

        Must Supporttrue
        16. Observation.id
        Comments

        SHALL contain at least one [1..*] id (CONF:1198-9043).

        Control1..?
        Must Supporttrue
        18. Observation.code
        Comments

        The <code> describes the process of establishing a problem. The code element should be used, as the process of determining the value is important to clinicians (e.g., a diagnosis is a more advanced statement than a symptom). When a physical exam observation is being recorded the code used should be “Finding.” When a review of systems observation is being recorded the code used should be “Symptom.” The recommended vocabulary for describing problems is shown in the table below. Subclasses of this content module may specify other vocabularies. When the list below is used, the codeSystem is '2.16.840.1.113883.6.96' and codeSystemName is SNOMED CT.

        Must Supporttrue
        20. Observation.text
        ShortSHOULD reference the portion of section narrative text corresponding to this entry
        Comments

        The <text> element is required and points to the text describing the problem being recorded; including any dates, comments, et cetera. The <reference> contains a URI in value attribute. This URI points to the free text description of the problem in the document that is being described.

        Control1..?
        Must Supporttrue
        22. Observation.text.reference
        Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
        24. Observation.statusCode
        Comments

        SHALL contain exactly one [1..1] statusCode (CONF:1198-9049).

        Control1..?
        26. Observation.statusCode.code
        Comments

        A clinical document normally records only those condition observation events that have been completed, not observations that are in any other state. Therefore, the <statusCode> shall always have code='completed'.

        Control1..?
        Fixed Valuecompleted
        28. Observation.effectiveTime
        ShortIf the problem is known to be resolved, but the date of resolution is not known, then the high element **SHALL** be present, and the nullFlavor attribute **SHALL** be set to 'UNK'. Therefore, the existence of a high element within a problem does indicate that the problem has been resolved.
        Comments

        SHALL contain exactly one [1..1] effectiveTime (CONF:1198-9050).

        Must Supporttrue
        30. Observation.effectiveTime.low
        ShortThe effectiveTime/low (a.k.a. "onset date") asserts when the condition became biologically active.
        Comments

        This effectiveTime SHALL contain exactly one [1..1] low (CONF:1198-15603).

        Control1..?
        Must Supporttrue
        32. Observation.effectiveTime.high
        Must Supporttrue
        34. Observation.value
        Comments

        The <value> is the condition that was found. This element is required. While the value may be a coded or an un-coded string, the type is always a coded value (xsi:type='CD'). If coded, the code and codeSystem attributes shall be present. The codeSystem should reference a controlled vocabulary describing problems, complaints, symptoms, findings, diagnoses, or functional limitations, e.g., ICD-9, SNOMED-CT or MEDCIN, or others.

        Control1..?
        Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD, http://hl7.org/cda/stds/core/StructureDefinition/EIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/CO, http://hl7.org/cda/stds/core/StructureDefinition/TEL, http://hl7.org/cda/stds/core/StructureDefinition/EN, http://hl7.org/cda/stds/core/StructureDefinition/BL, http://hl7.org/cda/stds/core/StructureDefinition/AD, http://hl7.org/cda/stds/core/StructureDefinition/PIVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/RTO-PQ-PQ, http://hl7.org/cda/stds/core/StructureDefinition/SXPR-TS, http://hl7.org/cda/stds/core/StructureDefinition/ED, http://hl7.org/cda/stds/core/StructureDefinition/TS, http://hl7.org/cda/stds/core/StructureDefinition/II, http://hl7.org/cda/stds/core/StructureDefinition/ST, http://hl7.org/cda/stds/core/StructureDefinition/PQ, http://hl7.org/cda/stds/core/StructureDefinition/IVL-PQ, http://hl7.org/cda/stds/core/StructureDefinition/CE, http://hl7.org/cda/stds/core/StructureDefinition/MO, http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS, http://hl7.org/cda/stds/core/StructureDefinition/ANY, http://hl7.org/cda/stds/core/StructureDefinition/INT, http://hl7.org/cda/stds/core/StructureDefinition/REAL, http://hl7.org/cda/stds/core/StructureDefinition/CV, http://hl7.org/cda/stds/core/StructureDefinition/SC
        Must Supporttrue
        36. Observation.value.code
        ShortA negationInd of "true" coupled with an observation/value/@code of SNOMED code 64572001 "Disease (disorder)" indicates that the patient has no known conditions. When the Problem is Social Determinant of Health Observation, the observation/value SHOULD be a SNOMED code selected from ValueSet Social Determinant of Health Conditions 2.16.840.1.113762.1.4.1196.788 DYNAMIC (CONF:4515-32951).
        Comments

        This value MAY contain zero or one [0..1] @code (CONF:1198-31871).

        38. Observation.value.qualifier
        ShortThe observation/value and all the qualifiers together (often referred to as a post-coordinated expression) make up one concept. Qualifiers constrain the meaning of the primary code, and cannot negate it or change its meaning. Qualifiers can only be used according to well-defined rules of post-coordination and only if the underlying code system defines the use of such qualifiers or if there is a third code system that specifies how other code systems may be combined. In cases where SNOMED CT does not have a precoordinated code that would be appropriate for the problem list, concept post coordination may be used in CDA following the principles outlined in HL7 Version 3 Implementation Guide: TermInfo - Using SNOMED CT in CDA R2 Models, Release 1 using the V3 CD Data type 1 style. This is shown in the sample XML.
        Comments

        This value MAY contain zero or more [0..*] qualifier (CONF:1198-31870).

        40. Observation.entryRelationship
        Must Supporttrue
        SlicingThis element introduces a set of slices on Observation.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • profile @ observation
        • profile @ act
        • 42. Observation.entryRelationship:severity-entry
          Slice Nameseverity-entry
          Comments

          MAY contain zero or one [0..1] entryRelationship (CONF:1198-9059) such that it

          Control0..1
          Must Supporttrue
          44. Observation.entryRelationship:severity-entry.typeCode
          Fixed ValueSUBJ
          46. Observation.entryRelationship:severity-entry.inversionInd
          Comments

          SHALL contain exactly one [1..1] @inversionInd="true" True (CONF:1198-9069).

          Control1..?
          Fixed Valuetrue
          48. Observation.entryRelationship:severity-entry.observation
          Control1..?
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Severity Entry)
          50. Observation.entryRelationship:problem-status
          Slice Nameproblem-status
          Control0..1
          Must Supporttrue
          52. Observation.entryRelationship:problem-status.typeCode
          Comments

          SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1198-31531).

          Fixed ValueREFR
          54. Observation.entryRelationship:problem-status.inversionInd
          Fixed Valuefalse
          56. Observation.entryRelationship:problem-status.observation
          Control1..?
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Problem Status Observation)
          58. Observation.entryRelationship:health-status
          Slice Namehealth-status
          Control0..1
          Must Supporttrue
          60. Observation.entryRelationship:health-status.typeCode
          Comments

          SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1198-31532).

          Fixed ValueREFR
          62. Observation.entryRelationship:health-status.inversionInd
          Fixed Valuefalse
          64. Observation.entryRelationship:health-status.observation
          Control1..?
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Health Status)
          Must Supporttrue

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

          0. Observation
          Definition

          Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type.

          ShortBase for all types and resources
          Control1..1
          Is Modifierfalse
          Logical ContainerClinicalDocument (CDA Class)
          ValidationInstance of this type are validated by templateId
          XML FormatIn the XML format, this property has the namespace urn:hl7-org:v3.
          Invariantsshould-text-ref-value: SHOULD contain text/reference/@value (text.reference.value.exists())
          should-author: SHOULD contain author (author.exists())
          2. Observation.nullFlavor
          Definition

          If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

          Control0..1
          BindingThe codes SHALL be taken from CDANullFlavor
          (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExceptional Value Detail
          4. Observation.realmCode
          Definition

          When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

          Control0..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
          6. Observation.typeId
          Definition

          When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

          Control0..1
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
          InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
          8. Observation.typeId.nullFlavor
          Definition

          If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

          Control0..1
          BindingThe codes SHALL be taken from CDANullFlavor
          (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
          Typecode(cs: Coded Simple Value)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExceptional Value Detail
          10. Observation.typeId.assigningAuthorityName
          Definition

          A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

          Control0..1
          Typestring(st: Character String)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelAssigning Authority Name
          12. Observation.typeId.displayable
          Definition

          Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

          Control0..1
          Typeboolean(bl: Boolean)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelDisplayable
          14. Observation.typeId.root
          Definition

          Identifies the type as an HL7 Registered model

          Control1..1
          Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelRoot
          Fixed Value2.16.840.1.113883.1.3
          16. Observation.typeId.extension
          Definition

          A character string as a unique identifier within the scope of the identifier root.

          Control1..1
          Typestring(st: Character String)
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          LabelExtension
          18. Observation.templateId
          Definition

          When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

          Control2..*
          Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
          Must Supporttrue
          SlicingThis element introduces a set of slices on Observation.templateId. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ root
          • value @ extension
          • 20. Observation.templateId:problem-obs
            Slice Nameproblem-obs
            Definition

            When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

            Control1..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
            22. Observation.templateId:problem-obs.nullFlavor
            Definition

            If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

            Control0..1
            BindingThe codes SHALL be taken from CDANullFlavor
            (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExceptional Value Detail
            24. Observation.templateId:problem-obs.assigningAuthorityName
            Definition

            A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelAssigning Authority Name
            26. Observation.templateId:problem-obs.displayable
            Definition

            Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

            Control0..1
            Typeboolean(bl: Boolean)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelDisplayable
            28. Observation.templateId:problem-obs.root
            Definition

            A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

            Control1..1
            Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelRoot
            Pattern Value2.16.840.1.113883.10.20.1.28
            30. Observation.templateId:problem-obs.extension
            Definition

            A character string as a unique identifier within the scope of the identifier root.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExtension
            32. Observation.templateId:problem-entry
            Slice Nameproblem-entry
            Definition

            When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

            Control1..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
            34. Observation.templateId:problem-entry.nullFlavor
            Definition

            If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

            Control0..1
            BindingThe codes SHALL be taken from CDANullFlavor
            (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExceptional Value Detail
            36. Observation.templateId:problem-entry.assigningAuthorityName
            Definition

            A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelAssigning Authority Name
            38. Observation.templateId:problem-entry.displayable
            Definition

            Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

            Control0..1
            Typeboolean(bl: Boolean)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelDisplayable
            40. Observation.templateId:problem-entry.root
            Definition

            A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.

            Control1..1
            Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelRoot
            Pattern Value1.3.6.1.4.1.19376.1.5.3.1.4.5
            42. Observation.templateId:problem-entry.extension
            Definition

            A character string as a unique identifier within the scope of the identifier root.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExtension
            44. Observation.classCode
            Control1..1
            BindingThe codes SHALL be taken from CDAActClassObservation
            (required to http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            46. Observation.moodCode
            Comments

            SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:1198-9042).

            Control1..1
            BindingThe codes SHALL be taken from XActMoodDocumentObservation (2.0.0)
            (required to http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed ValueEVN
            48. Observation.negationInd
            ShortThe negationInd is used to indicate the absence of the condition in observation/value. A negationInd of "true" coupled with an observation/value of SNOMED code 64572001 "Disease (disorder)" indicates that the patient has no known conditions.
            Comments

            MAY contain zero or one [0..1] @negationInd (CONF:1198-10139).

            Control0..1
            Typeboolean(bl: Boolean)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            XML FormatIn the XML format, this property is represented as an attribute.
            50. Observation.id
            Comments

            SHALL contain at least one [1..*] id (CONF:1198-9043).

            Control1..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
            Must Supporttrue
            52. Observation.sdtcCategory
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
            XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namecategory.
            54. Observation.code
            Comments

            The <code> describes the process of establishing a problem. The code element should be used, as the process of determining the value is important to clinicians (e.g., a diagnosis is a more advanced statement than a symptom). When a physical exam observation is being recorded the code used should be “Finding.” When a review of systems observation is being recorded the code used should be “Symptom.” The recommended vocabulary for describing problems is shown in the table below. Subclasses of this content module may specify other vocabularies. When the list below is used, the codeSystem is '2.16.840.1.113883.6.96' and codeSystemName is SNOMED CT.

            Control1..1
            BindingFor example codes, see ObservationType
            (example to http://terminology.hl7.org/ValueSet/v3-ObservationType)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
            Must Supporttrue
            XML FormatThe type of this property is determined using the xsi:typeattribute.
            56. Observation.derivationExpr
            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/ST
            58. Observation.text
            ShortSHOULD reference the portion of section narrative text corresponding to this entry
            Comments

            The <text> element is required and points to the text describing the problem being recorded; including any dates, comments, et cetera. The <reference> contains a URI in value attribute. This URI points to the free text description of the problem in the document that is being described.

            Control1..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
            Must Supporttrue
            XML FormatThe type of this property is determined using the xsi:typeattribute.
            60. Observation.text.nullFlavor
            Definition

            If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

            Control0..1
            BindingThe codes SHALL be taken from CDANullFlavor
            (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExceptional Value Detail
            62. Observation.text.compression
            Definition

            Indicates whether the raw byte data is compressed, and what compression algorithm was used.

            Control0..1
            BindingThe codes SHALL be taken from CDACompressionAlgorithm
            (required to http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCompression
            64. Observation.text.integrityCheck
            Definition

            The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.

            Control0..1
            Typebase64Binary(bin: Binary Data)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelIntegrity Check
            66. Observation.text.integrityCheckAlgorithm
            Definition

            Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.

            Control0..1
            BindingThe codes SHALL be taken from IntegrityCheckAlgorithm (2.0.0)
            (required to http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelIntegrity Check Algorithm
            68. Observation.text.language
            Definition

            For character based information the language property specifies the human language of the text.

            Control0..1
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelLanguage
            70. Observation.text.mediaType
            Definition

            Identifies the type of the encapsulated data and identifies a method to interpret or render the data.

            Control0..1
            BindingFor example codes, see MediaType
            (example to http://terminology.hl7.org/ValueSet/v3-MediaType)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelMedia Type
            72. Observation.text.representation
            Control0..1
            BindingThe codes SHALL be taken from CDABinaryDataEncoding
            (required to http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            74. Observation.text.xmlText
            Definition

            Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)

            ShortAllows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
            Comments

            This element is represented in XML as textual content. The actual name "xmlText" will not appear in a CDA instance.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as unadorned text.
            76. Observation.text.reference
            Definition

            A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/TEL
            LabelReference
            Invariantsvalue-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative (value.exists() implies value.startsWith('#'))
            78. Observation.text.thumbnail
            Definition

            An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
            LabelThumbnail
            80. Observation.statusCode
            Comments

            SHALL contain exactly one [1..1] statusCode (CONF:1198-9049).

            Control1..1
            BindingThe codes SHALL be taken from ActStatus
            (required to http://terminology.hl7.org/ValueSet/v3-ActStatus)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
            82. Observation.statusCode.nullFlavor
            Definition

            If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

            Control0..1
            BindingThe codes SHALL be taken from CDANullFlavor
            (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExceptional Value Detail
            84. Observation.statusCode.code
            Definition

            The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

            Comments

            A clinical document normally records only those condition observation events that have been completed, not observations that are in any other state. Therefore, the <statusCode> shall always have code='completed'.

            Control1..1
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode
            Fixed Valuecompleted
            86. Observation.statusCode.codeSystem
            Definition

            Specifies the code system that defines the code.

            Control0..0
            Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode System
            88. Observation.statusCode.codeSystemName
            Definition

            The common name of the coding system.

            Control0..0
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode System Name
            90. Observation.statusCode.codeSystemVersion
            Definition

            If applicable, a version descriptor defined specifically for the given code system.

            Control0..0
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode System Version
            92. Observation.statusCode.displayName
            Definition

            A name or title for the code, under which the sending system shows the code value to its users.

            Control0..0
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelDisplay Name
            94. Observation.statusCode.sdtcValueSet
            Definition

            The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

            Control0..1
            Typestring(oid: ISO Object Identifier)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
            96. Observation.statusCode.sdtcValueSetVersion
            Definition

            The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
            98. Observation.statusCode.originalText
            Definition

            The text or phrase used as the basis for the coding.

            Control0..0
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
            LabelOriginal Text
            100. Observation.statusCode.qualifier
            Definition

            Specifies additional codes that increase the specificity of the the primary code.

            Control0..0
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
            LabelQualifier
            102. Observation.statusCode.translation
            Definition

            A set of other concept descriptors that translate this concept descriptor into other code systems.

            Control0..0
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
            XML FormatThe type of this property is determined using the xsi:typeattribute.
            LabelTranslation
            104. Observation.effectiveTime
            ShortIf the problem is known to be resolved, but the date of resolution is not known, then the high element **SHALL** be present, and the nullFlavor attribute **SHALL** be set to 'UNK'. Therefore, the existence of a high element within a problem does indicate that the problem has been resolved.
            Comments

            SHALL contain exactly one [1..1] effectiveTime (CONF:1198-9050).

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-TS
            Must Supporttrue
            106. Observation.effectiveTime.nullFlavor
            Definition

            If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

            Control0..1
            BindingThe codes SHALL be taken from CDANullFlavor
            (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExceptional Value Detail
            108. Observation.effectiveTime.value
            Definition

            A quantity specifying a point on the axis of natural time. A point in time is most often represented as a calendar expression.

            Control0..1
            TypedateTime(ts: Point in Time)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Date FormatYYYYMMDDHHMMSS.UUUU[+|-ZZzz]
            XML FormatIn the XML format, this property is represented as an attribute.
            110. Observation.effectiveTime.operator
            Definition

            A code specifying whether the set component is included (union) or excluded (set-difference) from the set, or other set operations with the current set component and the set as constructed from the representation stream up to the current point.

            Control0..1
            BindingThe codes SHALL be taken from CDASetOperator
            (required to http://hl7.org/cda/stds/core/ValueSet/CDASetOperator)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            Default ValueI
            112. Observation.effectiveTime.low
            Definition

            This is the low limit of the interval.

            ShortThe effectiveTime/low (a.k.a. "onset date") asserts when the condition became biologically active.
            Comments

            This effectiveTime SHALL contain exactly one [1..1] low (CONF:1198-15603).

            Control1..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
            Must Supporttrue
            LabelLow Boundary
            114. Observation.effectiveTime.center
            Definition

            The arithmetic mean of the interval (low plus high divided by 2). The purpose of distinguishing the center as a semantic property is for conversions of intervals from and to point values.

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/TS
            LabelCentral Value
            116. Observation.effectiveTime.width
            Definition

            The difference between high and low boundary. The purpose of distinguishing a width property is to handle all cases of incomplete information symmetrically. In any interval representation only two of the three properties high, low, and width need to be stated and the third can be derived.

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/PQ
            LabelWidth
            118. Observation.effectiveTime.high
            Definition

            This is the high limit of the interval.

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVXB-TS
            Must Supporttrue
            LabelHigh Boundary
            120. Observation.priorityCode
            Control0..1
            BindingFor example codes, see ActPriority
            (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
            122. Observation.repeatNumber
            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/IVL-INT
            124. Observation.languageCode
            Control0..1
            BindingThe codes SHALL be taken from AllLanguages
            (required to http://hl7.org/fhir/ValueSet/all-languages)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
            126. Observation.value
            Comments

            The <value> is the condition that was found. This element is required. While the value may be a coded or an un-coded string, the type is always a coded value (xsi:type='CD'). If coded, the code and codeSystem attributes shall be present. The codeSystem should reference a controlled vocabulary describing problems, complaints, symptoms, findings, diagnoses, or functional limitations, e.g., ICD-9, SNOMED-CT or MEDCIN, or others.

            Control1..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
            Must Supporttrue
            XML FormatThe type of this property is determined using the xsi:typeattribute.
            128. Observation.value.nullFlavor
            Definition

            If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

            Control0..1
            BindingThe codes SHALL be taken from CDANullFlavor
            (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelExceptional Value Detail
            130. Observation.value.code
            Definition

            The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.

            ShortA negationInd of "true" coupled with an observation/value/@code of SNOMED code 64572001 "Disease (disorder)" indicates that the patient has no known conditions. When the Problem is Social Determinant of Health Observation, the observation/value SHOULD be a SNOMED code selected from ValueSet Social Determinant of Health Conditions 2.16.840.1.113762.1.4.1196.788 DYNAMIC (CONF:4515-32951).
            Comments

            This value MAY contain zero or one [0..1] @code (CONF:1198-31871).

            Control0..1
            Typecode(cs: Coded Simple Value)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode
            132. Observation.value.codeSystem
            Definition

            Specifies the code system that defines the code.

            Control0..1
            Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode System
            134. Observation.value.codeSystemName
            Definition

            The common name of the coding system.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode System Name
            136. Observation.value.codeSystemVersion
            Definition

            If applicable, a version descriptor defined specifically for the given code system.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelCode System Version
            138. Observation.value.displayName
            Definition

            A name or title for the code, under which the sending system shows the code value to its users.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            LabelDisplay Name
            140. Observation.value.sdtcValueSet
            Definition

            The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.

            Control0..1
            Typestring(oid: ISO Object Identifier)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSet.
            142. Observation.value.sdtcValueSetVersion
            Definition

            The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.

            Control0..1
            Typestring(st: Character String)
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.In the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual namevalueSetVersion.
            144. Observation.value.originalText
            Definition

            The text or phrase used as the basis for the coding.

            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/ED
            LabelOriginal Text
            146. Observation.value.qualifier
            Definition

            Specifies additional codes that increase the specificity of the the primary code.

            ShortThe observation/value and all the qualifiers together (often referred to as a post-coordinated expression) make up one concept. Qualifiers constrain the meaning of the primary code, and cannot negate it or change its meaning. Qualifiers can only be used according to well-defined rules of post-coordination and only if the underlying code system defines the use of such qualifiers or if there is a third code system that specifies how other code systems may be combined. In cases where SNOMED CT does not have a precoordinated code that would be appropriate for the problem list, concept post coordination may be used in CDA following the principles outlined in HL7 Version 3 Implementation Guide: TermInfo - Using SNOMED CT in CDA R2 Models, Release 1 using the V3 CD Data type 1 style. This is shown in the sample XML.
            Comments

            This value MAY contain zero or more [0..*] qualifier (CONF:1198-31870).

            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CR
            LabelQualifier
            148. Observation.value.translation
            Definition

            A set of other concept descriptors that translate this concept descriptor into other code systems.

            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
            XML FormatThe type of this property is determined using the xsi:typeattribute.
            LabelTranslation
            150. Observation.interpretationCode
            Control0..*
            BindingThe codes SHALL be taken from CDAObservationInterpretation
            (required to http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
            152. Observation.methodCode
            Control0..*
            BindingFor example codes, see ObservationMethod
            (example to http://terminology.hl7.org/ValueSet/v3-ObservationMethod)
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CE
            154. Observation.targetSiteCode
            Definition

            Drawn from concept domain ActSite

            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/CD
            156. Observation.subject
            Control0..1
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Subject
            158. Observation.specimen
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Specimen
            160. Observation.performer
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Performer2
            162. Observation.author
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Author
            164. Observation.informant
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Informant
            166. Observation.participant
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/Participant2
            168. Observation.entryRelationship
            Control0..*
            Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
            Must Supporttrue
            SlicingThis element introduces a set of slices on Observation.entryRelationship. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • profile @ observation
            • profile @ act
            • 170. Observation.entryRelationship:severity-entry
              Slice Nameseverity-entry
              Comments

              MAY contain zero or one [0..1] entryRelationship (CONF:1198-9059) such that it

              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
              Must Supporttrue
              172. Observation.entryRelationship:severity-entry.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              174. Observation.entryRelationship:severity-entry.realmCode
              Definition

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              176. Observation.entryRelationship:severity-entry.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
              178. Observation.entryRelationship:severity-entry.typeId.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              180. Observation.entryRelationship:severity-entry.typeId.assigningAuthorityName
              Definition

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelAssigning Authority Name
              182. Observation.entryRelationship:severity-entry.typeId.displayable
              Definition

              Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelDisplayable
              184. Observation.entryRelationship:severity-entry.typeId.root
              Definition

              Identifies the type as an HL7 Registered model

              Control1..1
              Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelRoot
              Fixed Value2.16.840.1.113883.1.3
              186. Observation.entryRelationship:severity-entry.typeId.extension
              Definition

              A character string as a unique identifier within the scope of the identifier root.

              Control1..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExtension
              188. Observation.entryRelationship:severity-entry.templateId
              Definition

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              190. Observation.entryRelationship:severity-entry.typeCode
              Control1..1
              BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
              (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed ValueSUBJ
              192. Observation.entryRelationship:severity-entry.inversionInd
              Definition

              The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

              Comments

              SHALL contain exactly one [1..1] @inversionInd="true" True (CONF:1198-9069).

              Control1..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed Valuetrue
              194. Observation.entryRelationship:severity-entry.contextConductionInd
              Definition

              The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Default Valuetrue
              196. Observation.entryRelationship:severity-entry.negationInd
              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              198. Observation.entryRelationship:severity-entry.sequenceNumber
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
              200. Observation.entryRelationship:severity-entry.seperatableInd
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
              202. Observation.entryRelationship:severity-entry.act
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
              204. Observation.entryRelationship:severity-entry.encounter
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
              206. Observation.entryRelationship:severity-entry.observation
              Control1..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Severity Entry)
              208. Observation.entryRelationship:severity-entry.observationMedia
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
              210. Observation.entryRelationship:severity-entry.organizer
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
              212. Observation.entryRelationship:severity-entry.procedure
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
              214. Observation.entryRelationship:severity-entry.regionOfInterest
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
              216. Observation.entryRelationship:severity-entry.substanceAdministration
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
              218. Observation.entryRelationship:severity-entry.supply
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
              220. Observation.entryRelationship:problem-status
              Slice Nameproblem-status
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
              Must Supporttrue
              222. Observation.entryRelationship:problem-status.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              224. Observation.entryRelationship:problem-status.realmCode
              Definition

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              226. Observation.entryRelationship:problem-status.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
              228. Observation.entryRelationship:problem-status.typeId.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              230. Observation.entryRelationship:problem-status.typeId.assigningAuthorityName
              Definition

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelAssigning Authority Name
              232. Observation.entryRelationship:problem-status.typeId.displayable
              Definition

              Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelDisplayable
              234. Observation.entryRelationship:problem-status.typeId.root
              Definition

              Identifies the type as an HL7 Registered model

              Control1..1
              Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelRoot
              Fixed Value2.16.840.1.113883.1.3
              236. Observation.entryRelationship:problem-status.typeId.extension
              Definition

              A character string as a unique identifier within the scope of the identifier root.

              Control1..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExtension
              238. Observation.entryRelationship:problem-status.templateId
              Definition

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              240. Observation.entryRelationship:problem-status.typeCode
              Comments

              SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1198-31531).

              Control1..1
              BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
              (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed ValueREFR
              242. Observation.entryRelationship:problem-status.inversionInd
              Definition

              The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed Valuefalse
              244. Observation.entryRelationship:problem-status.contextConductionInd
              Definition

              The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Default Valuetrue
              246. Observation.entryRelationship:problem-status.negationInd
              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              248. Observation.entryRelationship:problem-status.sequenceNumber
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
              250. Observation.entryRelationship:problem-status.seperatableInd
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
              252. Observation.entryRelationship:problem-status.act
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
              254. Observation.entryRelationship:problem-status.encounter
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
              256. Observation.entryRelationship:problem-status.observation
              Control1..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Problem Status Observation)
              258. Observation.entryRelationship:problem-status.observationMedia
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
              260. Observation.entryRelationship:problem-status.organizer
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
              262. Observation.entryRelationship:problem-status.procedure
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
              264. Observation.entryRelationship:problem-status.regionOfInterest
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
              266. Observation.entryRelationship:problem-status.substanceAdministration
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
              268. Observation.entryRelationship:problem-status.supply
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
              270. Observation.entryRelationship:health-status
              Slice Namehealth-status
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship
              Must Supporttrue
              272. Observation.entryRelationship:health-status.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              274. Observation.entryRelationship:health-status.realmCode
              Definition

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              276. Observation.entryRelationship:health-status.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
              278. Observation.entryRelationship:health-status.typeId.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              280. Observation.entryRelationship:health-status.typeId.assigningAuthorityName
              Definition

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelAssigning Authority Name
              282. Observation.entryRelationship:health-status.typeId.displayable
              Definition

              Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelDisplayable
              284. Observation.entryRelationship:health-status.typeId.root
              Definition

              Identifies the type as an HL7 Registered model

              Control1..1
              Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelRoot
              Fixed Value2.16.840.1.113883.1.3
              286. Observation.entryRelationship:health-status.typeId.extension
              Definition

              A character string as a unique identifier within the scope of the identifier root.

              Control1..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExtension
              288. Observation.entryRelationship:health-status.templateId
              Definition

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              290. Observation.entryRelationship:health-status.typeCode
              Comments

              SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1198-31532).

              Control1..1
              BindingThe codes SHALL be taken from x_ActRelationshipEntryRelationship
              (required to http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed ValueREFR
              292. Observation.entryRelationship:health-status.inversionInd
              Definition

              The entryRelationship.inversionInd can be set to "true" to indicate that the relationship should be interpreted as if the roles of the source and target entries were reversed.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed Valuefalse
              294. Observation.entryRelationship:health-status.contextConductionInd
              Definition

              The entryRelationship.contextConductionInd differs from the otherwise common use of this attribute in that in all other cases where this attribute is used, the value is fixed at "true", whereas here the value is defaulted to "true", and can be changed to "false" when referencing an entry in the same document. Setting the context conduction to false when referencing an entry in the same document keeps clear the fact that the referenced object retains its original context.

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Default Valuetrue
              296. Observation.entryRelationship:health-status.negationInd
              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              298. Observation.entryRelationship:health-status.sequenceNumber
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/INT
              300. Observation.entryRelationship:health-status.seperatableInd
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/BL
              302. Observation.entryRelationship:health-status.act
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Act
              304. Observation.entryRelationship:health-status.encounter
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Encounter
              306. Observation.entryRelationship:health-status.observation
              Control1..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Observation(Health Status)
              Must Supporttrue
              308. Observation.entryRelationship:health-status.observationMedia
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationMedia
              310. Observation.entryRelationship:health-status.organizer
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Organizer
              312. Observation.entryRelationship:health-status.procedure
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Procedure
              314. Observation.entryRelationship:health-status.regionOfInterest
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/RegionOfInterest
              316. Observation.entryRelationship:health-status.substanceAdministration
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/SubstanceAdministration
              318. Observation.entryRelationship:health-status.supply
              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Supply
              320. Observation.reference
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Reference
              322. Observation.precondition
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition
              324. Observation.sdtcPrecondition2
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/Precondition2
              XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameprecondition2.
              326. Observation.referenceRange
              Definition

              Relates an Observation to the ObservationRange class, where the expected range of values for a particular observation can be specified.

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/InfrastructureRoot
              328. Observation.referenceRange.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              330. Observation.referenceRange.realmCode
              Definition

              When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/CS
              332. Observation.referenceRange.typeId
              Definition

              When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.

              Control0..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              InvariantsII-1: An II instance must have either a root or an nullFlavor. (root.exists() or nullFlavor.exists())
              334. Observation.referenceRange.typeId.nullFlavor
              Definition

              If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.

              Control0..1
              BindingThe codes SHALL be taken from CDANullFlavor
              (required to http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExceptional Value Detail
              336. Observation.referenceRange.typeId.assigningAuthorityName
              Definition

              A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.

              Control0..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelAssigning Authority Name
              338. Observation.referenceRange.typeId.displayable
              Definition

              Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).

              Control0..1
              Typeboolean(bl: Boolean)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelDisplayable
              340. Observation.referenceRange.typeId.root
              Definition

              Identifies the type as an HL7 Registered model

              Control1..1
              Typestring(oid: ISO Object Identifier, uuid: DCE Universal Unique Identifier, ruid: HL7 Reserved Identifier Scheme)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelRoot
              Fixed Value2.16.840.1.113883.1.3
              342. Observation.referenceRange.typeId.extension
              Definition

              A character string as a unique identifier within the scope of the identifier root.

              Control1..1
              Typestring(st: Character String)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              LabelExtension
              344. Observation.referenceRange.templateId
              Definition

              When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question

              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/II
              346. Observation.referenceRange.typeCode
              Control0..1
              BindingThe codes SHALL be taken from CDAActRelationshipType
              (required to http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType)
              Typecode(cs: Coded Simple Value)
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed ValueREFV
              348. Observation.referenceRange.observationRange
              Control1..1
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/ObservationRange
              350. Observation.sdtcInFulfillmentOf1
              Control0..*
              Typehttp://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1
              XML FormatIn the XML format, this property has the namespace urn:hl7-org:sdtc.In the XML format, this property has the actual nameinFulfillmentOf1.