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

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 Probelm Reaction Entry

Official URL: https://profiles.ihe.net/PCC/PSCc/StructureDefinition/IHE.Problem.Reaction.Entry | Version: 0.0.1-current
Draft as of 2025-11-04 | Computable Name: IHE_Problem_Reaction_Entry

TBD…

Usages:

- Use this Logical Model Profile: IHE Allergies and Intolerances Entry

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 1..1 | IHE_PCC_Problem_Entry | XML Namespace: urn:hl7-org:v3 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) Constraints: should-text-ref-value, should-author
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
Slices for templateId | S | 3..* | II | Slice: Unordered, Open by value:root, value:extension
templateId:problem-obs |  | 1..1 | II |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.1.28
@extension |  | 0..1 | st |
templateId:problem-entry |  | 1..1 | II |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 1.3.6.1.4.1.19376.1.5.3.1.4.5
@extension |  | 0..1 | st |
templateId:allergy-int-reaction | S | 1..1 | II |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.1.54
@extension |  | 0..1 | st |
@classCode |  | 1..1 | cs | Binding: CDAActClassObservation (required)
@moodCode |  | 1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN
@negationInd | S | 0..1 | bl | The 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.
id | S | 1..* | II |
sdtcCategory |  | 0..* | CD | XML Namespace: urn:hl7-org:sdtc XML: category (urn:hl7-org:sdtc)
code | S | 1..1 | CD | Binding: ObservationType (example)
derivationExpr |  | 0..1 | ST |
text | S | 1..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@compression |  | 0..1 | cs | Binding: CDACompressionAlgorithm (required)
@integrityCheck |  | 0..1 | bin |
@integrityCheckAlgorithm |  | 0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required)
@language |  | 0..1 | cs |
@mediaType |  | 0..1 | cs | Binding: MediaType (example)
@representation |  | 0..1 | cs | Binding: CDABinaryDataEncoding (required)
xmlText |  | 0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
reference | C | 0..1 | TEL | Constraints: value-starts-octothorpe
thumbnail |  | 0..1 | ED |
statusCode |  | 1..1 | CS | Binding: ActStatus (required)
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@code |  | 1..1 | cs | Fixed Value: completed
@sdtcValueSet |  | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion |  | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
effectiveTime | S | 0..1 | IVL_TS | If 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.
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@value |  | 0..1 | ts | Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
@operator |  | 0..1 | cs | Binding: CDASetOperator (required)
low | S | 1..1 | IVXB_TS | The effectiveTime/low (a.k.a. "onset date") asserts when the condition became biologically active.
center |  | 0..1 | TS |
width |  | 0..1 | PQ |
high | S | 0..1 | IVXB_TS |
priorityCode |  | 0..1 | CE | Binding: ActPriority (example)
repeatNumber |  | 0..1 | IVL_INT |
languageCode |  | 0..1 | CS | Binding: AllLanguages (required)
value | S | 1..* | CD |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@code |  | 0..1 | cs | A 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).
@codeSystem |  | 0..1 | oid, uuid, ruid |
@codeSystemName |  | 0..1 | st |
@codeSystemVersion |  | 0..1 | st |
@displayName |  | 0..1 | st |
@sdtcValueSet |  | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion |  | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
originalText |  | 0..1 | ED |
qualifier |  | 0..* | CR | The 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.
translation |  | 0..* | CD |
interpretationCode |  | 0..* | CE | Binding: CDAObservationInterpretation (required)
methodCode |  | 0..* | CE | Binding: ObservationMethod (example)
targetSiteCode |  | 0..* | CD |
subject |  | 0..1 | Subject |
specimen |  | 0..* | Specimen |
performer |  | 0..* | Performer2 |
author |  | 0..* | Author |
informant |  | 0..* | Informant |
participant |  | 0..* | Participant2 |
Slices for entryRelationship | S | 0..* | EntryRelationship | Slice: Unordered, Open by profile:observation, profile:act
entryRelationship:severity-entry | S | 0..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SUBJ
@inversionInd |  | 1..1 | bl | Fixed Value: true
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
sequenceNumber |  | 0..1 | INT |
seperatableInd |  | 0..1 | BL |
act |  | 0..1 | Act |
encounter |  | 0..1 | Encounter |
observation |  | 1..1 | IHE_PCC_Severity_Entry |
observationMedia |  | 0..1 | ObservationMedia |
organizer |  | 0..1 | Organizer |
procedure |  | 0..1 | Procedure |
regionOfInterest |  | 0..1 | RegionOfInterest |
substanceAdministration |  | 0..1 | SubstanceAdministration |
supply |  | 0..1 | Supply |
entryRelationship:problem-status | S | 0..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
sequenceNumber |  | 0..1 | INT |
seperatableInd |  | 0..1 | BL |
act |  | 0..1 | Act |
encounter |  | 0..1 | Encounter |
observation |  | 1..1 | IHE_Problem_Status_Observation |
observationMedia |  | 0..1 | ObservationMedia |
organizer |  | 0..1 | Organizer |
procedure |  | 0..1 | Procedure |
regionOfInterest |  | 0..1 | RegionOfInterest |
substanceAdministration |  | 0..1 | SubstanceAdministration |
supply |  | 0..1 | Supply |
entryRelationship:health-status | S | 0..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
sequenceNumber |  | 0..1 | INT |
seperatableInd |  | 0..1 | BL |
act |  | 0..1 | Act |
encounter |  | 0..1 | Encounter |
observation | S | 1..1 | IHE_Health_Status_Observation |
observationMedia |  | 0..1 | ObservationMedia |
organizer |  | 0..1 | Organizer |
procedure |  | 0..1 | Procedure |
regionOfInterest |  | 0..1 | RegionOfInterest |
substanceAdministration |  | 0..1 | SubstanceAdministration |
supply |  | 0..1 | Supply |
reference |  | 0..* | Reference |
precondition |  | 0..* | Precondition |
sdtcPrecondition2 |  | 0..* | Precondition2 | XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc)
referenceRange |  | 0..* | InfrastructureRoot |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 0..1 | cs | Binding: CDAActRelationshipType (required) Fixed Value: REFV
observationRange |  | 1..1 | ObservationRange |
sdtcInFulfillmentOf1 |  | 0..* | InFulfillmentOf1 | XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.templateId:problem-obs.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.templateId:problem-entry.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.templateId:allergy-int-reaction.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.classCode | Base | required | CDAActClassObservation | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.moodCode | Base | required | x_ActMoodDocumentObservation | 📍2.0.0 | THO v5.2
Observation.code | Base | example | ObservationType | 📦3.0.0 | THO v6.5
Observation.text.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.text.compression | Base | required | CDACompressionAlgorithm | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.text.integrityCheckAlgorithm | Base | required | IntegrityCheckAlgorithm | 📍2.0.0 | THO v5.2
Observation.text.mediaType | Base | example | MediaType | 📦3.0.0 | THO v6.5
Observation.text.representation | Base | required | CDABinaryDataEncoding | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.statusCode | Base | required | ActStatus | 📦3.0.0 | THO v6.5
Observation.statusCode.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.effectiveTime.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.effectiveTime.​operator | Base | required | CDASetOperator | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.priorityCode | Base | example | ActPriority | 📦3.0.0 | THO v6.5
Observation.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std.
Observation.value.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.interpretationCode | Base | required | CDAObservationInterpretation | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.methodCode | Base | example | ObservationMethod | 📦3.0.0 | THO v6.5
Observation.entryRelationship:severity-entry.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:severity-entry.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:severity-entry.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📦3.0.0 | THO v6.5
Observation.entryRelationship:problem-status.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:problem-status.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:problem-status.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📦3.0.0 | THO v6.5
Observation.entryRelationship:health-status.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:health-status.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:health-status.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📦3.0.0 | THO v6.5
Observation.referenceRange.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.referenceRange.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.referenceRange.​typeCode | Base | required | CDAActRelationshipType | 📦2.0.1-sd | Clinical Document Architecture v2.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
II-1 | error | Observation.typeId, Observation.entryRelationship:severity-entry.typeId, Observation.entryRelationship:problem-status.typeId, Observation.entryRelationship:health-status.typeId, Observation.referenceRange.typeId | An II instance must have either a root or an nullFlavor. | `root.exists() or nullFlavor.exists()`
should-author | warning | Observation | SHOULD contain author | `author.exists()`
should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value | `text.reference.value.exists()`
value-starts-octothorpe | error | Observation.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative | `value.exists() implies value.startsWith('#')`

This structure is derived from IHE_PCC_Problem_Entry

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation |  |  | IHE_PCC_Problem_Entry | XML Namespace: urn:hl7-org:v3 Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class)
templateId |  | 3..* | II |
Slices for templateId |  |  |  | Content/Rules for all slices
templateId:allergy-int-reaction |  | 1..1 | II |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.1.54
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 1..1 | IHE_PCC_Problem_Entry | XML Namespace: urn:hl7-org:v3 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) Constraints: should-text-ref-value, should-author
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
Slices for templateId | S | 3..* | II | Slice: Unordered, Open by value:root, value:extension
templateId:problem-obs |  | 1..1 | II |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.1.28
@extension |  | 0..1 | st |
templateId:problem-entry |  | 1..1 | II |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 1.3.6.1.4.1.19376.1.5.3.1.4.5
@extension |  | 0..1 | st |
templateId:allergy-int-reaction | S | 1..1 | II |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.1.54
@extension |  | 0..1 | st |
@classCode |  | 1..1 | cs | Binding: CDAActClassObservation (required)
@moodCode |  | 1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN
@negationInd | S | 0..1 | bl | The 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.
id | S | 1..* | II |
sdtcCategory |  | 0..* | CD | XML Namespace: urn:hl7-org:sdtc XML: category (urn:hl7-org:sdtc)
code | S | 1..1 | CD | Binding: ObservationType (example)
derivationExpr |  | 0..1 | ST |
text | S | 1..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@compression |  | 0..1 | cs | Binding: CDACompressionAlgorithm (required)
@integrityCheck |  | 0..1 | bin |
@integrityCheckAlgorithm |  | 0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required)
@language |  | 0..1 | cs |
@mediaType |  | 0..1 | cs | Binding: MediaType (example)
@representation |  | 0..1 | cs | Binding: CDABinaryDataEncoding (required)
xmlText |  | 0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
reference | C | 0..1 | TEL | Constraints: value-starts-octothorpe
thumbnail |  | 0..1 | ED |
statusCode |  | 1..1 | CS | Binding: ActStatus (required)
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@code |  | 1..1 | cs | Fixed Value: completed
@sdtcValueSet |  | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion |  | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
effectiveTime | S | 0..1 | IVL_TS | If 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.
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@value |  | 0..1 | ts | Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
@operator |  | 0..1 | cs | Binding: CDASetOperator (required)
low | S | 1..1 | IVXB_TS | The effectiveTime/low (a.k.a. "onset date") asserts when the condition became biologically active.
center |  | 0..1 | TS |
width |  | 0..1 | PQ |
high | S | 0..1 | IVXB_TS |
priorityCode |  | 0..1 | CE | Binding: ActPriority (example)
repeatNumber |  | 0..1 | IVL_INT |
languageCode |  | 0..1 | CS | Binding: AllLanguages (required)
value | S | 1..* | CD |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@code |  | 0..1 | cs | A 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).
@codeSystem |  | 0..1 | oid, uuid, ruid |
@codeSystemName |  | 0..1 | st |
@codeSystemVersion |  | 0..1 | st |
@displayName |  | 0..1 | st |
@sdtcValueSet |  | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion |  | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
originalText |  | 0..1 | ED |
qualifier |  | 0..* | CR | The 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.
translation |  | 0..* | CD |
interpretationCode |  | 0..* | CE | Binding: CDAObservationInterpretation (required)
methodCode |  | 0..* | CE | Binding: ObservationMethod (example)
targetSiteCode |  | 0..* | CD |
subject |  | 0..1 | Subject |
specimen |  | 0..* | Specimen |
performer |  | 0..* | Performer2 |
author |  | 0..* | Author |
informant |  | 0..* | Informant |
participant |  | 0..* | Participant2 |
Slices for entryRelationship | S | 0..* | EntryRelationship | Slice: Unordered, Open by profile:observation, profile:act
entryRelationship:severity-entry | S | 0..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SUBJ
@inversionInd |  | 1..1 | bl | Fixed Value: true
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
sequenceNumber |  | 0..1 | INT |
seperatableInd |  | 0..1 | BL |
act |  | 0..1 | Act |
encounter |  | 0..1 | Encounter |
observation |  | 1..1 | IHE_PCC_Severity_Entry |
observationMedia |  | 0..1 | ObservationMedia |
organizer |  | 0..1 | Organizer |
procedure |  | 0..1 | Procedure |
regionOfInterest |  | 0..1 | RegionOfInterest |
substanceAdministration |  | 0..1 | SubstanceAdministration |
supply |  | 0..1 | Supply |
entryRelationship:problem-status | S | 0..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
sequenceNumber |  | 0..1 | INT |
seperatableInd |  | 0..1 | BL |
act |  | 0..1 | Act |
encounter |  | 0..1 | Encounter |
observation |  | 1..1 | IHE_Problem_Status_Observation |
observationMedia |  | 0..1 | ObservationMedia |
organizer |  | 0..1 | Organizer |
procedure |  | 0..1 | Procedure |
regionOfInterest |  | 0..1 | RegionOfInterest |
substanceAdministration |  | 0..1 | SubstanceAdministration |
supply |  | 0..1 | Supply |
entryRelationship:health-status | S | 0..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
sequenceNumber |  | 0..1 | INT |
seperatableInd |  | 0..1 | BL |
act |  | 0..1 | Act |
encounter |  | 0..1 | Encounter |
observation | S | 1..1 | IHE_Health_Status_Observation |
observationMedia |  | 0..1 | ObservationMedia |
organizer |  | 0..1 | Organizer |
procedure |  | 0..1 | Procedure |
regionOfInterest |  | 0..1 | RegionOfInterest |
substanceAdministration |  | 0..1 | SubstanceAdministration |
supply |  | 0..1 | Supply |
reference |  | 0..* | Reference |
precondition |  | 0..* | Precondition |
sdtcPrecondition2 |  | 0..* | Precondition2 | XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc)
referenceRange |  | 0..* | InfrastructureRoot |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 0..1 | cs | Binding: CDAActRelationshipType (required) Fixed Value: REFV
observationRange |  | 1..1 | ObservationRange |
sdtcInFulfillmentOf1 |  | 0..* | InFulfillmentOf1 | XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.templateId:problem-obs.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.templateId:problem-entry.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.templateId:allergy-int-reaction.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.classCode | Base | required | CDAActClassObservation | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.moodCode | Base | required | x_ActMoodDocumentObservation | 📍2.0.0 | THO v5.2
Observation.code | Base | example | ObservationType | 📦3.0.0 | THO v6.5
Observation.text.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.text.compression | Base | required | CDACompressionAlgorithm | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.text.integrityCheckAlgorithm | Base | required | IntegrityCheckAlgorithm | 📍2.0.0 | THO v5.2
Observation.text.mediaType | Base | example | MediaType | 📦3.0.0 | THO v6.5
Observation.text.representation | Base | required | CDABinaryDataEncoding | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.statusCode | Base | required | ActStatus | 📦3.0.0 | THO v6.5
Observation.statusCode.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.effectiveTime.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.effectiveTime.​operator | Base | required | CDASetOperator | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.priorityCode | Base | example | ActPriority | 📦3.0.0 | THO v6.5
Observation.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std.
Observation.value.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.interpretationCode | Base | required | CDAObservationInterpretation | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.methodCode | Base | example | ObservationMethod | 📦3.0.0 | THO v6.5
Observation.entryRelationship:severity-entry.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:severity-entry.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:severity-entry.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📦3.0.0 | THO v6.5
Observation.entryRelationship:problem-status.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:problem-status.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:problem-status.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📦3.0.0 | THO v6.5
Observation.entryRelationship:health-status.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:health-status.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:health-status.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📦3.0.0 | THO v6.5
Observation.referenceRange.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.referenceRange.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.referenceRange.​typeCode | Base | required | CDAActRelationshipType | 📦2.0.1-sd | Clinical Document Architecture v2.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
II-1 | error | Observation.typeId, Observation.entryRelationship:severity-entry.typeId, Observation.entryRelationship:problem-status.typeId, Observation.entryRelationship:health-status.typeId, Observation.referenceRange.typeId | An II instance must have either a root or an nullFlavor. | `root.exists() or nullFlavor.exists()`
should-author | warning | Observation | SHOULD contain author | `author.exists()`
should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value | `text.reference.value.exists()`
value-starts-octothorpe | error | Observation.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative | `value.exists() implies value.startsWith('#')`

This structure is derived from IHE_PCC_Problem_Entry

Summary

Mandatory: 2 elements

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 1..1 | IHE_PCC_Problem_Entry | XML Namespace: urn:hl7-org:v3 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) Constraints: should-text-ref-value, should-author
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
Slices for templateId | S | 3..* | II | Slice: Unordered, Open by value:root, value:extension
templateId:problem-obs |  | 1..1 | II |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.1.28
@extension |  | 0..1 | st |
templateId:problem-entry |  | 1..1 | II |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 1.3.6.1.4.1.19376.1.5.3.1.4.5
@extension |  | 0..1 | st |
templateId:allergy-int-reaction | S | 1..1 | II |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.1.54
@extension |  | 0..1 | st |
@classCode |  | 1..1 | cs | Binding: CDAActClassObservation (required)
@moodCode |  | 1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN
@negationInd | S | 0..1 | bl | The 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.
id | S | 1..* | II |
sdtcCategory |  | 0..* | CD | XML Namespace: urn:hl7-org:sdtc XML: category (urn:hl7-org:sdtc)
code | S | 1..1 | CD | Binding: ObservationType (example)
derivationExpr |  | 0..1 | ST |
text | S | 1..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@compression |  | 0..1 | cs | Binding: CDACompressionAlgorithm (required)
@integrityCheck |  | 0..1 | bin |
@integrityCheckAlgorithm |  | 0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required)
@language |  | 0..1 | cs |
@mediaType |  | 0..1 | cs | Binding: MediaType (example)
@representation |  | 0..1 | cs | Binding: CDABinaryDataEncoding (required)
xmlText |  | 0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
reference | C | 0..1 | TEL | Constraints: value-starts-octothorpe
thumbnail |  | 0..1 | ED |
statusCode |  | 1..1 | CS | Binding: ActStatus (required)
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@code |  | 1..1 | cs | Fixed Value: completed
@sdtcValueSet |  | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion |  | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
effectiveTime | S | 0..1 | IVL_TS | If 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.
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@value |  | 0..1 | ts | Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
@operator |  | 0..1 | cs | Binding: CDASetOperator (required)
low | S | 1..1 | IVXB_TS | The effectiveTime/low (a.k.a. "onset date") asserts when the condition became biologically active.
center |  | 0..1 | TS |
width |  | 0..1 | PQ |
high | S | 0..1 | IVXB_TS |
priorityCode |  | 0..1 | CE | Binding: ActPriority (example)
repeatNumber |  | 0..1 | IVL_INT |
languageCode |  | 0..1 | CS | Binding: AllLanguages (required)
value | S | 1..* | CD |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@code |  | 0..1 | cs | A 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).
@codeSystem |  | 0..1 | oid, uuid, ruid |
@codeSystemName |  | 0..1 | st |
@codeSystemVersion |  | 0..1 | st |
@displayName |  | 0..1 | st |
@sdtcValueSet |  | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion |  | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
originalText |  | 0..1 | ED |
qualifier |  | 0..* | CR | The 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.
translation |  | 0..* | CD |
interpretationCode |  | 0..* | CE | Binding: CDAObservationInterpretation (required)
methodCode |  | 0..* | CE | Binding: ObservationMethod (example)
targetSiteCode |  | 0..* | CD |
subject |  | 0..1 | Subject |
specimen |  | 0..* | Specimen |
performer |  | 0..* | Performer2 |
author |  | 0..* | Author |
informant |  | 0..* | Informant |
participant |  | 0..* | Participant2 |
Slices for entryRelationship | S | 0..* | EntryRelationship | Slice: Unordered, Open by profile:observation, profile:act
entryRelationship:severity-entry | S | 0..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SUBJ
@inversionInd |  | 1..1 | bl | Fixed Value: true
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
sequenceNumber |  | 0..1 | INT |
seperatableInd |  | 0..1 | BL |
act |  | 0..1 | Act |
encounter |  | 0..1 | Encounter |
observation |  | 1..1 | IHE_PCC_Severity_Entry |
observationMedia |  | 0..1 | ObservationMedia |
organizer |  | 0..1 | Organizer |
procedure |  | 0..1 | Procedure |
regionOfInterest |  | 0..1 | RegionOfInterest |
substanceAdministration |  | 0..1 | SubstanceAdministration |
supply |  | 0..1 | Supply |
entryRelationship:problem-status | S | 0..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
sequenceNumber |  | 0..1 | INT |
seperatableInd |  | 0..1 | BL |
act |  | 0..1 | Act |
encounter |  | 0..1 | Encounter |
observation |  | 1..1 | IHE_Problem_Status_Observation |
observationMedia |  | 0..1 | ObservationMedia |
organizer |  | 0..1 | Organizer |
procedure |  | 0..1 | Procedure |
regionOfInterest |  | 0..1 | RegionOfInterest |
substanceAdministration |  | 0..1 | SubstanceAdministration |
supply |  | 0..1 | Supply |
entryRelationship:health-status | S | 0..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
sequenceNumber |  | 0..1 | INT |
seperatableInd |  | 0..1 | BL |
act |  | 0..1 | Act |
encounter |  | 0..1 | Encounter |
observation | S | 1..1 | IHE_Health_Status_Observation |
observationMedia |  | 0..1 | ObservationMedia |
organizer |  | 0..1 | Organizer |
procedure |  | 0..1 | Procedure |
regionOfInterest |  | 0..1 | RegionOfInterest |
substanceAdministration |  | 0..1 | SubstanceAdministration |
supply |  | 0..1 | Supply |
reference |  | 0..* | Reference |
precondition |  | 0..* | Precondition |
sdtcPrecondition2 |  | 0..* | Precondition2 | XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc)
referenceRange |  | 0..* | InfrastructureRoot |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 0..1 | cs | Binding: CDAActRelationshipType (required) Fixed Value: REFV
observationRange |  | 1..1 | ObservationRange |
sdtcInFulfillmentOf1 |  | 0..* | InFulfillmentOf1 | XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.templateId:problem-obs.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.templateId:problem-entry.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.templateId:allergy-int-reaction.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.classCode | Base | required | CDAActClassObservation | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.moodCode | Base | required | x_ActMoodDocumentObservation | 📍2.0.0 | THO v5.2
Observation.code | Base | example | ObservationType | 📦3.0.0 | THO v6.5
Observation.text.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.text.compression | Base | required | CDACompressionAlgorithm | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.text.integrityCheckAlgorithm | Base | required | IntegrityCheckAlgorithm | 📍2.0.0 | THO v5.2
Observation.text.mediaType | Base | example | MediaType | 📦3.0.0 | THO v6.5
Observation.text.representation | Base | required | CDABinaryDataEncoding | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.statusCode | Base | required | ActStatus | 📦3.0.0 | THO v6.5
Observation.statusCode.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.effectiveTime.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.effectiveTime.​operator | Base | required | CDASetOperator | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.priorityCode | Base | example | ActPriority | 📦3.0.0 | THO v6.5
Observation.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std.
Observation.value.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.interpretationCode | Base | required | CDAObservationInterpretation | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.methodCode | Base | example | ObservationMethod | 📦3.0.0 | THO v6.5
Observation.entryRelationship:severity-entry.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:severity-entry.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:severity-entry.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📦3.0.0 | THO v6.5
Observation.entryRelationship:problem-status.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:problem-status.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:problem-status.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📦3.0.0 | THO v6.5
Observation.entryRelationship:health-status.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:health-status.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:health-status.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📦3.0.0 | THO v6.5
Observation.referenceRange.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.referenceRange.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.referenceRange.​typeCode | Base | required | CDAActRelationshipType | 📦2.0.1-sd | Clinical Document Architecture v2.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
II-1 | error | Observation.typeId, Observation.entryRelationship:severity-entry.typeId, Observation.entryRelationship:problem-status.typeId, Observation.entryRelationship:health-status.typeId, Observation.referenceRange.typeId | An II instance must have either a root or an nullFlavor. | `root.exists() or nullFlavor.exists()`
should-author | warning | Observation | SHOULD contain author | `author.exists()`
should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value | `text.reference.value.exists()`
value-starts-octothorpe | error | Observation.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative | `value.exists() implies value.startsWith('#')`

Differential View

This structure is derived from IHE_PCC_Problem_Entry

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation |  |  | IHE_PCC_Problem_Entry | XML Namespace: urn:hl7-org:v3 Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class)
templateId |  | 3..* | II |
Slices for templateId |  |  |  | Content/Rules for all slices
templateId:allergy-int-reaction |  | 1..1 | II |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.1.54
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Observation | C | 1..1 | IHE_PCC_Problem_Entry | XML Namespace: urn:hl7-org:v3 Base for all types and resources Instance of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) Constraints: should-text-ref-value, should-author
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
Slices for templateId | S | 3..* | II | Slice: Unordered, Open by value:root, value:extension
templateId:problem-obs |  | 1..1 | II |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.1.28
@extension |  | 0..1 | st |
templateId:problem-entry |  | 1..1 | II |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 1.3.6.1.4.1.19376.1.5.3.1.4.5
@extension |  | 0..1 | st |
templateId:allergy-int-reaction | S | 1..1 | II |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.1.54
@extension |  | 0..1 | st |
@classCode |  | 1..1 | cs | Binding: CDAActClassObservation (required)
@moodCode |  | 1..1 | cs | Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: EVN
@negationInd | S | 0..1 | bl | The 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.
id | S | 1..* | II |
sdtcCategory |  | 0..* | CD | XML Namespace: urn:hl7-org:sdtc XML: category (urn:hl7-org:sdtc)
code | S | 1..1 | CD | Binding: ObservationType (example)
derivationExpr |  | 0..1 | ST |
text | S | 1..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@compression |  | 0..1 | cs | Binding: CDACompressionAlgorithm (required)
@integrityCheck |  | 0..1 | bin |
@integrityCheckAlgorithm |  | 0..1 | cs | Binding: IntegrityCheckAlgorithm (2.0.0) (required)
@language |  | 0..1 | cs |
@mediaType |  | 0..1 | cs | Binding: MediaType (example)
@representation |  | 0..1 | cs | Binding: CDABinaryDataEncoding (required)
xmlText |  | 0..1 | st | Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
reference | C | 0..1 | TEL | Constraints: value-starts-octothorpe
thumbnail |  | 0..1 | ED |
statusCode |  | 1..1 | CS | Binding: ActStatus (required)
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@code |  | 1..1 | cs | Fixed Value: completed
@sdtcValueSet |  | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion |  | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
effectiveTime | S | 0..1 | IVL_TS | If 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.
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@value |  | 0..1 | ts | Date Format: YYYYMMDDHHMMSS.UUUU[+|-ZZzz]
@operator |  | 0..1 | cs | Binding: CDASetOperator (required)
low | S | 1..1 | IVXB_TS | The effectiveTime/low (a.k.a. "onset date") asserts when the condition became biologically active.
center |  | 0..1 | TS |
width |  | 0..1 | PQ |
high | S | 0..1 | IVXB_TS |
priorityCode |  | 0..1 | CE | Binding: ActPriority (example)
repeatNumber |  | 0..1 | IVL_INT |
languageCode |  | 0..1 | CS | Binding: AllLanguages (required)
value | S | 1..* | CD |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@code |  | 0..1 | cs | A 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).
@codeSystem |  | 0..1 | oid, uuid, ruid |
@codeSystemName |  | 0..1 | st |
@codeSystemVersion |  | 0..1 | st |
@displayName |  | 0..1 | st |
@sdtcValueSet |  | 0..1 | oid | XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion |  | 0..1 | st | XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
originalText |  | 0..1 | ED |
qualifier |  | 0..* | CR | The 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.
translation |  | 0..* | CD |
interpretationCode |  | 0..* | CE | Binding: CDAObservationInterpretation (required)
methodCode |  | 0..* | CE | Binding: ObservationMethod (example)
targetSiteCode |  | 0..* | CD |
subject |  | 0..1 | Subject |
specimen |  | 0..* | Specimen |
performer |  | 0..* | Performer2 |
author |  | 0..* | Author |
informant |  | 0..* | Informant |
participant |  | 0..* | Participant2 |
Slices for entryRelationship | S | 0..* | EntryRelationship | Slice: Unordered, Open by profile:observation, profile:act
entryRelationship:severity-entry | S | 0..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: SUBJ
@inversionInd |  | 1..1 | bl | Fixed Value: true
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
sequenceNumber |  | 0..1 | INT |
seperatableInd |  | 0..1 | BL |
act |  | 0..1 | Act |
encounter |  | 0..1 | Encounter |
observation |  | 1..1 | IHE_PCC_Severity_Entry |
observationMedia |  | 0..1 | ObservationMedia |
organizer |  | 0..1 | Organizer |
procedure |  | 0..1 | Procedure |
regionOfInterest |  | 0..1 | RegionOfInterest |
substanceAdministration |  | 0..1 | SubstanceAdministration |
supply |  | 0..1 | Supply |
entryRelationship:problem-status | S | 0..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
sequenceNumber |  | 0..1 | INT |
seperatableInd |  | 0..1 | BL |
act |  | 0..1 | Act |
encounter |  | 0..1 | Encounter |
observation |  | 1..1 | IHE_Problem_Status_Observation |
observationMedia |  | 0..1 | ObservationMedia |
organizer |  | 0..1 | Organizer |
procedure |  | 0..1 | Procedure |
regionOfInterest |  | 0..1 | RegionOfInterest |
substanceAdministration |  | 0..1 | SubstanceAdministration |
supply |  | 0..1 | Supply |
entryRelationship:health-status | S | 0..1 | EntryRelationship |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd |  | 0..1 | bl | Fixed Value: false
@contextConductionInd |  | 0..1 | bl |
@negationInd |  | 0..1 | bl |
sequenceNumber |  | 0..1 | INT |
seperatableInd |  | 0..1 | BL |
act |  | 0..1 | Act |
encounter |  | 0..1 | Encounter |
observation | S | 1..1 | IHE_Health_Status_Observation |
observationMedia |  | 0..1 | ObservationMedia |
organizer |  | 0..1 | Organizer |
procedure |  | 0..1 | Procedure |
regionOfInterest |  | 0..1 | RegionOfInterest |
substanceAdministration |  | 0..1 | SubstanceAdministration |
supply |  | 0..1 | Supply |
reference |  | 0..* | Reference |
precondition |  | 0..* | Precondition |
sdtcPrecondition2 |  | 0..* | Precondition2 | XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc)
referenceRange |  | 0..* | InfrastructureRoot |
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
realmCode |  | 0..* | CS |
typeId | C | 0..1 | II | Constraints: II-1
@nullFlavor |  | 0..1 | cs | Binding: CDANullFlavor (required)
@assigningAuthorityName |  | 0..1 | st |
@displayable |  | 0..1 | bl |
@root |  | 1..1 | oid, uuid, ruid | Fixed Value: 2.16.840.1.113883.1.3
@extension |  | 1..1 | st |
templateId |  | 0..* | II |
@typeCode |  | 0..1 | cs | Binding: CDAActRelationshipType (required) Fixed Value: REFV
observationRange |  | 1..1 | ObservationRange |
sdtcInFulfillmentOf1 |  | 0..* | InFulfillmentOf1 | XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Observation.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.templateId:problem-obs.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.templateId:problem-entry.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.templateId:allergy-int-reaction.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.classCode | Base | required | CDAActClassObservation | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.moodCode | Base | required | x_ActMoodDocumentObservation | 📍2.0.0 | THO v5.2
Observation.code | Base | example | ObservationType | 📦3.0.0 | THO v6.5
Observation.text.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.text.compression | Base | required | CDACompressionAlgorithm | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.text.integrityCheckAlgorithm | Base | required | IntegrityCheckAlgorithm | 📍2.0.0 | THO v5.2
Observation.text.mediaType | Base | example | MediaType | 📦3.0.0 | THO v6.5
Observation.text.representation | Base | required | CDABinaryDataEncoding | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.statusCode | Base | required | ActStatus | 📦3.0.0 | THO v6.5
Observation.statusCode.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.effectiveTime.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.effectiveTime.​operator | Base | required | CDASetOperator | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.priorityCode | Base | example | ActPriority | 📦3.0.0 | THO v6.5
Observation.languageCode | Base | required | All Languages | 📦5.0.0 | FHIR Std.
Observation.value.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.interpretationCode | Base | required | CDAObservationInterpretation | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.methodCode | Base | example | ObservationMethod | 📦3.0.0 | THO v6.5
Observation.entryRelationship:severity-entry.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:severity-entry.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:severity-entry.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📦3.0.0 | THO v6.5
Observation.entryRelationship:problem-status.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:problem-status.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:problem-status.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📦3.0.0 | THO v6.5
Observation.entryRelationship:health-status.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:health-status.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.entryRelationship:health-status.​typeCode | Base | required | x_ActRelationshipEntryRelationship | 📦3.0.0 | THO v6.5
Observation.referenceRange.​nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.referenceRange.​typeId.nullFlavor | Base | required | CDANullFlavor | 📦2.0.1-sd | Clinical Document Architecture v2.0
Observation.referenceRange.​typeCode | Base | required | CDAActRelationshipType | 📦2.0.1-sd | Clinical Document Architecture v2.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
II-1 | error | Observation.typeId, Observation.entryRelationship:severity-entry.typeId, Observation.entryRelationship:problem-status.typeId, Observation.entryRelationship:health-status.typeId, Observation.referenceRange.typeId | An II instance must have either a root or an nullFlavor. | `root.exists() or nullFlavor.exists()`
should-author | warning | Observation | SHOULD contain author | `author.exists()`
should-text-ref-value | warning | Observation | SHOULD contain text/reference/@value | `text.reference.value.exists()`
value-starts-octothorpe | error | Observation.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative | `value.exists() implies value.startsWith('#')`

This structure is derived from IHE_PCC_Problem_Entry

Summary

Mandatory: 2 elements

Other representations of profile: CSV, Excel