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-C-CDA cannot represent multiple patient names such as alias / maiden name because it is restricted to a single patientRole with a single US Realm name element. Suggestions have been posed which use multiple 'given' attributes, but these are misleading since a maiden name is a family name, not a given name (plus, conformance statement 7163 states the 2nd given name SHALL be the middle name or initial).
C83 allowed for (and recommended) multiple name elements, so CCDA should likewise allow multiple name elements.
-Prior Constraints:
iv. This patientRole SHALL contain exactly one [1..1] patient (CONF:5283).
1. This patient SHALL contain exactly one [1..1] name (CONF:5284).
...Down in US Realm Patient Name, it ...
2. SHALL contain exactly one [1..1] family (CONF:7159).-Constraints After the Change:
1. This patient SHALL contain at least one [1..*] name (CONF:5284).
a. The content of name SHALL be a conformant US Realm Patient Name (PTN.US.FIELDED) (2.16.840.1.113883.10.20.22.5.1) (CONF:10411).
- CONF-5284
-Conformance statements 5322 & 7263 should be clarified regarding how to model multiple race codes.
-Prior Conformance Statements:
6.This patient MAY contain zero or one [0..1] raceCode, which SHALL be selected from ValueSet Race ... (CONF:5322)
7.This patient MAY contain zero or more [0..*] sdtc:raceCode, where the @code SHALL be selected from ValueSet Race ... (CONF:7263}Conformance Statements After Update:
6. This patient MAY contain zero or one [0..1] raceCode, which SHALL be selected from ValueSet Race urn:oid:2.16.840.1.113883.1.11.14914 DYNAMIC (CONF:5322).
Note: To record additional raceCode, use the extension element sdtc:raceCode.
7. This patient MAY contain zero or more [0..*] sdtc:raceCode, which SHALL be selected from ValueSet Race urn:oid:2.16.840.1.113883.1.11.14914 DYNAMIC (CONF:7263).
-CONF:5322, CONF:7263
i. This assignedAuthor SHALL contain exactly one [1..1] id (CONF:5449) such that it
1. SHALL contain exactly one [1..1] @root (CONF:16786).
a. If this assignedAuthor is an assignedPerson the assignedAuthor id SHALL contain exactly one [1..1] @root="2.16.840.1.113883.4.6" National Provider Identifier (CONF:19521).ALSO - where does the CONF:32882 - CONF:32885 come from.
- Conformance Statements After Update
If this assignedAuthor is an assignedPerson
ii. This assignedAuthor SHOULD contain zero or one [0..1] id (CONF:1198-32882) such that it
If id with @root="2.16.840.1.113883.4.6" National Provider Identifier is unknown then
1. MAY contain zero or one [0..1] @nullFlavor="UNK" Unknown (CodeSystem: HL7NullFlavor urn:oid:2.16.840.1.113883.5.1008) (CONF:1198-32883).
2. SHALL contain exactly one [1..1] @root="2.16.840.1.113883.4.6" National Provider Identifier (CONF:1198-32884).
3. SHOULD contain zero or one [0..1] @extension (CONF:1198-32885).
-Add guidance for how to record an unknown NPI.
I. This assignedAuthor SHALL contain exactly one [1..1] id (CONF:5449) such that it
1.SHALL contain exactly one [1..1] @root="2.16.840.1.113883.4.6" National Provider
Identifier (CONF:16786).
- CONF:5449
-Update US Realm Header to allow nullFlavor on peformer type
-Conformance Statements Prior to Change:
US Realm Header
[ClinicalDocument: templateId 2.16.840.1.113883.10.20.22.1.1(open)]
This assignedEntity SHOULD contain zero or one [0..1] code (CONF:14842).
i.The code, if present, SHALL contain exactly one [1..1] @code, which SHOULD be selected from CodeSystem NUCCProviderTaxonomy (2.16.840.1.113883.6.101) (CONF:14843).Conformance Statements After Update:b. This assignedEntity SHOULD contain zero or one [0..1] code, which SHOULD be selected from CodeSystem Healthcare Provider Taxonomy (HIPAA) (urn:oid:2.16.840.1.113883.6.101) DYNAMIC (CONF:14842).
-CONF:7731, 8309, 8304, 8254
In ART-DECOR we define that the author have the cardinality 1..1. The validation tool created the check accordingly. If we want to have more than one author per document, sequoia need to update in ART-DECOR the cardinality to 1..* ; and then we regenerate the validation tool.
Abderrazek requested additional information including the testing permanent link. Didi added the following to the JIRA ticket on 5/25/18. The issue reported referenced this permanent link:https://gazellecontent.sequoiaproject.org/EVSClient/detailedResult.seam?type=CDA&oid=1.3.6.1.4.1.12559.11.28.11125
I am seeing an unexpected error when attempting to validate an Unstructured Document using the Sequoia C-CDA R1.1 validator. It is not allowing multiple <author> attributes. The constraint the validator indicates is being violated states that there can be only a single author/assignedAuthor in an <author> element, but doesn’t limit the document to only having a single <author> element.
However, the validator is enforcing only a single <author> element rather than a single <assignedAuthor> element.
-The constraint indicated requires that the <author> element have exactly one <assignedAuthor> child element (the US Realm Clinical Docment Header :
-However, the validator is enforcing only a single <author> element rather than a single <assignedAuthor> element.
-
JIRA update from Abderrazek - May 14, 2018:The definition in ART-DECOR is wrong in C-CDA 2.1 indeed: https://gazellecontent.sequoiaproject.org/art-decor/decor-templates--ccda-?section=templates&id=2.16.840.1.113883.10.20.22.1.1&effectiveDate=2015-08-01T00:00:00&language=en-US
In administrativeGender you need to update mandatory with required , after that we need to regenerate the validation tool. I though that sequoia is managing these kind of modifications in ART-DECOR, and I remark that this modification is still not performed. Modifications in ART-DECOR should not ber performed by Gazelle team in order to keep consistency for sequoia.
-Stevenson, Kent J <Kent.Stevenson@ManTech.com>Thu 4/26/2018 12:57 PM
I am seeing an unexpected error when attempting to validate an Unstructured Document using the Sequoia C-CDA R1.1 validator. It is not allowing the use of nullFlavor for/ClinicalDocument/recordTarget/patientRole/patient/administrativeGenderCode. The constraint the validator indicates is being violated doesn’t say that nullFlavor cannot be used. Rather, it says that administrativeGenderCode element is required and must use the Administrative Gender (HL7 V3) value set. In section 3.6 of C-CDA R2.1 it states that unless nullFlavor is specifically prohibited or unless the terminology binding is to the @code attribute, a nullFlavor is allowed for required elements. The nullFlavor is not specifically prohibited for administrativeGenderCode and the terminology binding is to the element, not the @code attribute—so the use of nullFlavor should be allowed.
File Name patient1666580073_34133-9_2.16.840.1.113883.3.198^1666580073_34133-9_BFD....xml
OID : 1.3.6.1.4.1.12559.11.28.11289
Schematron : N/A (Version N/A)
Schematron Validation Result : N/A
Validation Date : 4/25/18 4:14:49 PM (CEST GMT+0200)
Model Based Validator : HL7 - C-CDA R2.1 - Meaningful Use Stage 3 (Version N/A)
Model Based Validation Result : FAILED SC
Permanent link : https://gazellecontent.sequoiaproject.org/EVSClient/detailedResult.seam?type=CDA&oid=1.3.6.1.4.1.12559.11.28.11289
Data Visibility : Public
- The validator is not producing the correct behavior. The assessment provided by the submitter is an accurate assessment of the validation expectations.