CONF-166: A problem healthstatus observation (templateId 2.16.840.1.113883.10.20.1.51) SHALL be a conformant status observation (templateId 2.16.840.1.113883.10.20.1.57) (as defined in section 5.1 “Type” and “Status” values), except that the value for “Observation / code” in a problem healthstatus observation SHALL be “11323-3” “Health status” 2.16.840.1.113883.6.1 LOINC STATIC.
5.1 “Type” and “Status” values
The template identifier for a status observation is 2.16.840.1.113883.10.20.1.57.
ASTM CCR defines restricted Type and Status value sets to further define observations in many of the CCR sections. While the value sets differ between sections, the XML representation is constant. Those constraints that are constant across all the sections are defined here, and are then further specialized in the sections above.
A complete mapping between all ASTM CCR Type and Status values and their corresponding RIM (potentially coupled with SNOMED CT, LOINC, etc) representations is beyond the scope of this specification, and is a work item for a subsequent version. ASTM CCR Type values are represented as value sets, which can be conveyed in the code attribute of the various RIM classes (e.g. a value from the ProblemTypeCode value set can be conveyed in Observation.code). Where possible, ASTM CCR Status values have been mapped to HL7 ActStatus values, in which case they are conveyed in the statusCode attribute of the various RIM classes. Where the mapping is complex and incomplete, ASTM CCR Status values can be communicated as related status observations.
Often times, the Type or Status is implied by the codes used to characterize the observation (e.g. an observation of “Do Not Resuscitate” implies an Advance Directive Type “Resuscitation Status”), and/or by values asserted in other RIM attributes (e.g. an Observation.negationInd of “true” implies a Problem Status “Ruled out”). In no case should an ASTM CCR Type or Status value conflict with semantics carried in other RIM attributes.
CONF-508: A status observation (templateId 2.16.840.1.113883.10.20.1.57) SHALL be represented with Observation.
CONF-509: A status observation SHALL be the target of an entryRelationship whose value for “entryRelationship / @typeCode” SHALL be “REFR” 2.16.840.1.113883.5.1002 ActRelationshipType STATIC.
CONF-510: The value for “Observation / @classCode” in a status observation SHALL be “OBS” 2.16.840.1.113883.5.6 ActClass STATIC.
CONF-511: The value for “Observation / @moodCode” in a status observation SHALL be “EVN” 2.16.840.1.113883.5.1001 ActMood STATIC.
CONF-512: A status observation SHALL contain exactly one Observation / code.
CONF-513: The value for “Observation / code” in a status observation SHALL be “33999-4” “Status” 2.16.840.1.113883.6.1 LOINC STATIC.
CONF-514: A status observation SHALL contain exactly one Observation / statusCode.
CONF-515: The value for “Observation / statusCode” in a status observation SHALL be “completed” 2.16.840.1.113883.5.14 ActStatus STATIC.
CONF-516: A status observation SHALL contain exactly one Observation / value, which SHALL be of datatype “CE”.
CONF-517: A status observation SHALL NOT contain any additional Observation attributes.
CONF-518: A status observation SHALL NOT contain any Observation participants.
CONF-519: A status observation SHALL NOT be the source of any Observation relationships.