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Template Entlassbericht 2016‑09‑27 18:04:29

Id1.2.276.0.76.3.1.85.200.77.10.43Effective Date2016‑09‑27 18:04:29
Statusdraft DraftVersion Label
NameDGUV_EntlassberichtDisplay NameEntlassbericht
DescriptionTemplate CDA ClinicalDocument (prototype, contains ClinicalDocument.component as StructuredBody)
ContextPathname //
ClassificationCDA Document Level Template
Open/ClosedOpen (other than defined elements are allowed)
Used by / Uses
Used by 0 transactions and 0 templates, Uses 18 templates
Uses as NameVersion
1.2.276.0.76.3.1.85.200.77.10.1Containmentdraft AnamneseDYNAMIC
1.2.276.0.76.3.1.85.200.77.10.2Containmentdraft DiagnoseDYNAMIC
1.2.276.0.76.3.1.85.200.77.10.3Containmentdraft TherapieDYNAMIC
1.2.276.0.76.3.1.85.200.77.10.28Includedraft CDA recordTarget DTHSDYNAMIC
1.2.276.0.76.3.1.85.200.77.10.44Containmentdraft BeschäftigungDYNAMIC
2.16.840.1.113883.10.12.102Includeactive CDA authorDYNAMIC
2.16.840.1.113883.10.12.103Includeactive CDA dataEntererDYNAMIC
2.16.840.1.113883.10.12.104Includeactive CDA custodianDYNAMIC
2.16.840.1.113883.10.12.105Includeactive CDA informationRecipientDYNAMIC
2.16.840.1.113883.10.12.106Includeactive CDA legalAuthenticatorDYNAMIC
2.16.840.1.113883.10.12.107Includeactive CDA authenticatorDYNAMIC
2.16.840.1.113883.10.12.108Includeactive CDA participantDYNAMIC
2.16.840.1.113883.10.12.109Includeactive CDA inFulfillmentOfDYNAMIC
2.16.840.1.113883.10.12.110Includeactive CDA documentationOfDYNAMIC
2.16.840.1.113883.10.12.111Includeactive CDA relatedDocumentDYNAMIC
2.16.840.1.113883.10.12.113Includeactive CDA componentOfDYNAMIC
2.16.840.1.113883.10.12.114Includeactive CDA AuthorizationDYNAMIC
2.16.840.1.113883.10.12.154Includeactive CDA InformantDYNAMIC
RelationshipSpecialization: template 2.16.840.1.113883.10.12.2 CDA ClinicalDocument (with StructuredBody) (2005‑09‑07)
ref
ad1bbr-
ItemDTCardConfDescriptionLabel
hl7:ClinicalDocument
DGUVdotsicht
@classCode
cs0 … 1FDOCCLIN
@moodCode
cs0 … 1FEVN
hl7:realmCode
CS0 … 1RDGUVdotsicht
hl7:typeId
II1 … 1RDGUVdotsicht
@root
uid1 … 1F2.16.840.1.113883.1.3
@extension
st1 … 1FPOCD_HD000040
hl7:templateId
II1 … 1MDGUVdotsicht
@root
uid1 … 1F1.2.276.0.76.3.1.85.200.77.10.43
hl7:templateId
II1 … 1RDGUVdotsicht
@root
uid1 … 1F2.16.840.1.113883.10.12.1
hl7:id
II1 … 1RDGUVdotsicht
hl7:code
CE1 … 1RDGUVdotsicht
@codeSystem
1 … 1F2.16.840.1.113883.6.1
hl7:title
ST0 … 1DGUVdotsicht
hl7:effectiveTime
TS1 … 1RDGUVdotsicht
hl7:confidentialityCode
CE1 … 1RDGUVdotsicht
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.16926 HL7 BasicConfidentialityKind (DYNAMIC)
hl7:languageCode
CS0 … 1DGUVdotsicht
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.11526 HumanLanguage (DYNAMIC)
hl7:setId
II0 … 1DGUVdotsicht
hl7:versionNumber
INT0 … 1DGUVdotsicht
Included1 … *R from 1.2.276.0.76.3.1.85.200.77.10.28 CDA recordTarget DTHS (DYNAMIC)
hl7:recordTarget
1 … *RHeaddotsDTHS
@typeCode
cs0 … 1FRCT
@contextControlCode
cs0 … 1FOP
 Example<recordTarget typeCode="RCT" contextControlCode="OP">
  <patientRole classCode="PAT">
    <!-- ... -->
  </patientRole></recordTarget>
hl7:patientRole
1 … 1MHeaddotsDTHS
@classCode
cs0 … 1FPAT
 Example<patientRole classCode="PAT">
  <id extension="186245" root="1.2.276.0.76.3.1.139.3.871"/>  <patient classCode="PSN" determinerCode="INSTANCE">
    <!-- ... -->
  </patient></patientRole>
hl7:id
II1 … *HeaddotsDTHS
 Example<art:placeholder>
  <id extension="6245" root="2.16.840.1.113883.3.933"/>  <id extension="1543627549" root="1.2.276.0.76.4.1"/></art:placeholder>
hl7:addr
AD0 … *de-DE Adresse des PatientenHeaddotsDTHS
 Example<addr use="HP">
  <streetName>Dorfstraße</streetName>  <houseNumber>54</houseNumber>  <postalCode>51371</postalCode>  <city>Leverkusen</city></addr>
hl7:telecom
TEL0 … *de-DE Kontaktdaten des PatientenHeaddotsDTHS
 Example<art:placeholder>
  <telecom use="H" value="tel:+49.30.140400"/>  <telecom use="MC" value="tel:+49.221.1234567"/>  <telecom value="mailto:herberthannes.mustermann@provider.de"/></art:placeholder>
hl7:patient
0 … 1HeaddotsDTHS
@classCode
cs0 … 1FPSN
@determinerCode
cs0 … 1FINSTANCE
 Example<patient classCode="PSN" determinerCode="INSTANCE">
  <name>
    <!-- ... -->
  </name>  <administrativeGenderCode code="M" codeSystem="2.16.840.1.113883.5.1"/>  <birthTime value="19541223"/></patient>
hl7:name
PN1 … 1MHeaddotsDTHS
 Example<name>
  <given>Johannes</given>  <family>Tremener</family></name>
hl7:administrativeGenderCode
CE1 … 1Rde-DE Geschlecht (administrativ) des PatientenHeaddotsDTHS
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.1 Administrative Gender (HL7 V3) (DYNAMIC)
 Example<administrativeGenderCode code="M" codeSystem="2.16.840.1.113883.5.1"/>
hl7:birthTime
TS.DATE.MIN1 … 1Rde-DE Geburtsdatum des PatientenHeaddotsDTHS
@value
ts1 … 1R
 Example<birthTime value="19491224"/>
hl7:maritalStatusCode
CE0 … 1de-DE Familienstand des PatientenHeaddotsDTHS
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.12212 Marital Status (DYNAMIC)
 Example<maritalStatusCode code="S" displayName="Never Married" codeSystem="2.16.840.1.113883.5.2"/>
hl7:religiousAffiliationCode
CE0 … 1de-DE Religionszugehörigkeit des PatientenHeaddotsDTHS
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.19185 Religious Affiliation (DYNAMIC)
 Example<religiousAffiliationCode code="1077" displayName="Protestant" codeSystem="2.16.840.1.113883.5.1076"/>
hl7:birthplace
0 … 1de-DE Geburtsort des PatientenHeaddotsDTHS
 Example<birthplace>
  <place>
    <addr>Hamburg</addr>  </place></birthplace>
hl7:place
1 … 1MHeaddotsDTHS
hl7:addr
AD1 … 1MHeaddotsDTHS
hl7:languageCommunication
0 … *HeaddotsDTHS
hl7:languageCode
CS0 … 1HeaddotsDTHS
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.11526 HumanLanguage (DYNAMIC)
hl7:modeCode
CE0 … 1HeaddotsDTHS
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.12249 LanguageAbilityMode (DYNAMIC)
hl7:proficiencyLevelCode
CE0 … 1HeaddotsDTHS
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.12199 LanguageAbilityProficiency (DYNAMIC)
hl7:preferenceInd
BL0 … 1HeaddotsDTHS
Included1 … *R from 2.16.840.1.113883.10.12.102 CDA author (DYNAMIC)
hl7:author
1 … *RCDAauthor
@typeCode
cs0 … 1FAUT
@contextControlCode
cs0 … 1FOP
hl7:functionCode
CE0 … 1CDAauthor
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.10267 ParticipationFunction (DYNAMIC)
hl7:time
TS1 … 1RCDAauthor
hl7:assignedAuthor
1 … 1CDAauthor
@classCode
cs0 … 1FASSIGNED
hl7:id
II1 … *RCDAauthor
hl7:code
CE0 … 1CDAauthor
 CONF
shall be drawn from concept domain "RoleCode"
hl7:addr
AD0 … *CDAauthor
hl7:telecom
TEL0 … *CDAauthor
Choice0 … 1Elements to choose from:
hl7:assignedPerson
Contains 2.16.840.1.113883.10.12.152 CDA Person (DYNAMIC)CDAauthor
hl7:assignedAuthoringDevice
Contains 2.16.840.1.113883.10.12.315 CDA Device (DYNAMIC)CDAauthor
hl7:representedOrganization
0 … 1Contains 2.16.840.1.113883.10.12.151 CDA Organization (DYNAMIC)CDAauthor
Included0 … 1 from 2.16.840.1.113883.10.12.103 CDA dataEnterer (DYNAMIC)
hl7:dataEnterer
0 … 1CDAddotserer
@typeCode
cs0 … 1FENT
@contextControlCode
cs0 … 1FOP
hl7:time
TS0 … 1CDAddotserer
hl7:assignedEntity
1 … 1Contains 2.16.840.1.113883.10.12.153 CDA AssignedEntity (DYNAMIC)CDAddotserer
Included0 … * from 2.16.840.1.113883.10.12.154 CDA Informant (DYNAMIC)
hl7:informant
0 … *CDAidotsmant
@typeCode
cs0 … 1FINF
@contextControlCode
cs0 … 1FOP
Choice1 … 1Elements to choose from:
hl7:assignedEntity
Contains 2.16.840.1.113883.10.12.153 CDA AssignedEntity (DYNAMIC)CDAidotsmant
hl7:relatedEntity
Contains 2.16.840.1.113883.10.12.316 CDA RelatedEntity (DYNAMIC)CDAidotsmant
Included1 … 1R from 2.16.840.1.113883.10.12.104 CDA custodian (DYNAMIC)
hl7:custodian
1 … 1RCDAcdotsdian
@typeCode
cs0 … 1FCST
hl7:assignedCustodian
1 … 1CDAcdotsdian
@classCode
cs0 … 1FASSIGNED
hl7:representedCustodianOrganization
1 … 1CDAcdotsdian
@classCode
cs0 … 1FORG
@determinerCode
cs0 … 1FINSTANCE
hl7:id
II1 … *MCDAcdotsdian
hl7:name
ON0 … 1CDAcdotsdian
hl7:telecom
TEL0 … 1CDAcdotsdian
hl7:addr
AD0 … 1CDAcdotsdian
Included0 … * from 2.16.840.1.113883.10.12.105 CDA informationRecipient (DYNAMIC)
hl7:informationRecipient
0 … *CDAidotsient
@typeCode
cs1 … 1R
 CONF
The value of @typeCode shall be drawn from value set 2.16.840.1.113883.1.11.19366 x_InformationRecipient (DYNAMIC)
hl7:intendedRecipient
1 … 1CDAidotsient
@classCode
cs1 … 1R
 CONF
The value of @classCode shall be drawn from value set 2.16.840.1.113883.1.11.16772 x_InformationRecipientRole (DYNAMIC)
hl7:id
II0 … *RCDAidotsient
hl7:addr
AD0 … *CDAidotsient
hl7:telecom
TEL0 … *CDAidotsient
hl7:informationRecipient
0 … 1Contains 2.16.840.1.113883.10.12.152 CDA Person (DYNAMIC)CDAidotsient
hl7:receivedOrganization
0 … 1Contains 2.16.840.1.113883.10.12.151 CDA Organization (DYNAMIC)CDAidotsient
Included0 … 1 from 2.16.840.1.113883.10.12.106 CDA legalAuthenticator (DYNAMIC)
hl7:legalAuthenticator
0 … 1CDAldotsator
@typeCode
cs0 … 1FLA
@contextControlCode
cs0 … 1FOP
hl7:time
TS1 … 1RCDAldotsator
hl7:signatureCode
CS1 … 1RCDAldotsator
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.10282 ParticipationSignature (DYNAMIC)
hl7:assignedEntity
1 … 1Contains 2.16.840.1.113883.10.12.153 CDA AssignedEntity (DYNAMIC)CDAldotsator
Included0 … * from 2.16.840.1.113883.10.12.107 CDA authenticator (DYNAMIC)
hl7:authenticator
0 … *CDAadotsator
@typeCode
cs0 … 1FAUTHEN
hl7:time
TS1 … 1RCDAadotsator
hl7:signatureCode
CS1 … 1RCDAadotsator
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.10282 ParticipationSignature (DYNAMIC)
hl7:assignedEntity
1 … 1Contains 2.16.840.1.113883.10.12.153 CDA AssignedEntity (DYNAMIC)CDAadotsator
Included0 … * from 2.16.840.1.113883.10.12.108 CDA participant (DYNAMIC)
hl7:participant
0 … *CDApdotspant
@typeCode
cs1 … 1R
 CONF
The value of @typeCode shall be drawn from value set 2.16.840.1.113883.1.11.10901 ParticipationType (DYNAMIC)
@contextControlCode
cs0 … 1FOP
hl7:functionCode
CE0 … 1CDApdotspant
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.10267 ParticipationFunction (DYNAMIC)
hl7:time
IVL_TS0 … 1CDApdotspant
hl7:associatedEntity
1 … 1CDApdotspant
@classCode
cs1 … 1R
 CONF
The value of @classCode shall be drawn from value set 2.16.840.1.113883.1.11.19313 RoleClassAssociative (DYNAMIC)
hl7:id
II0 … *CDApdotspant
hl7:code
CE0 … 1CDApdotspant
 CONF
shall be drawn from concept domain "RoleCode"
hl7:addr
AD0 … *CDApdotspant
hl7:telecom
TEL0 … *CDApdotspant
hl7:associatedPerson
0 … 1Contains 2.16.840.1.113883.10.12.152 CDA Person (DYNAMIC)CDApdotspant
hl7:scopingOrganization
0 … 1Contains 2.16.840.1.113883.10.12.151 CDA Organization (DYNAMIC)CDApdotspant
Included0 … * from 2.16.840.1.113883.10.12.109 CDA inFulfillmentOf (DYNAMIC)
hl7:inFulfillmentOf
0 … *CDAidotsntOf
@typeCode
cs0 … 1FFLFS
hl7:order
1 … 1CDAidotsntOf
@classCode
cs0 … 1FACT
@moodCode
cs1 … 1FRQO
hl7:id
II1 … *RCDAidotsntOf
hl7:code
CE0 … 1CDAidotsntOf
 CONF
shall be drawn from concept domain "ActCode"
hl7:priorityCode
CE0 … 1CDAidotsntOf
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.16866 ActPriority (DYNAMIC)
Included0 … * from 2.16.840.1.113883.10.12.110 CDA documentationOf (DYNAMIC)
hl7:documentationOf
0 … *CDAddotsonOf
@typeCode
cs1 … 1FDOC
hl7:serviceEvent
1 … 1CDAddotsonOf
@classCode
cs1 … 1FACT
@moodCode
cs1 … 1FEVN
hl7:id
II0 … *CDAddotsonOf
hl7:code
CE0 … 1CDAddotsonOf
 CONF
shall be drawn from concept domain "ActCode"
hl7:effectiveTime
IVL_TS0 … 1CDAddotsonOf
hl7:performer
0 … *CDAddotsonOf
@typeCode
cs1 … 1R
 CONF
The value of @typeCode shall be drawn from value set 2.16.840.1.113883.1.11.19601 x_ServiceEventPerformer (DYNAMIC)
hl7:functionCode
CE0 … 1CDAddotsonOf
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.10267 ParticipationFunction (DYNAMIC)
hl7:time
IVL_TS0 … 1CDAddotsonOf
hl7:assignedEntity
1 … 1Contains 2.16.840.1.113883.10.12.153 CDA AssignedEntity (DYNAMIC)CDAddotsonOf
Included0 … * from 2.16.840.1.113883.10.12.111 CDA relatedDocument (DYNAMIC)
hl7:relatedDocument
0 … *CDArdotsment
@typeCode
cs1 … 1R
 CONF
The value of @typeCode shall be drawn from value set 2.16.840.1.113883.1.11.11610 x_ActRelationshipDocument (DYNAMIC)
hl7:parentDocument
1 … 1CDArdotsment
@classCode
cs0 … 1FDOCCLIN
@moodCode
cs0 … 1FEVN
hl7:id
II1 … *RCDArdotsment
hl7:code
CD0 … 1CDArdotsment
@codeSystem
CONF0 … 1F2.16.840.1.113883.6.1
hl7:text
ED0 … 1CDArdotsment
hl7:setId
II0 … 1CDArdotsment
hl7:versionNumber
INT0 … 1CDArdotsment
Included0 … * from 2.16.840.1.113883.10.12.114 CDA Authorization (DYNAMIC)
hl7:authorization
0 … *CDAadotstion
@typeCode
cs0 … 1FAUTH
hl7:consent
1 … 1CDAadotstion
@classCode
cs0 … 1FCONS
@moodCode
cs0 … 1FEVN
hl7:id
II0 … *CDAadotstion
hl7:code
CE0 … 1CDAadotstion
 CONF
shall be drawn from concept domain "ActCode"
hl7:statusCode
CS1 … 1RCDAadotstion
@code
CONF0 … 1Fcompleted
Included0 … 1 from 2.16.840.1.113883.10.12.113 CDA componentOf (DYNAMIC)
hl7:componentOf
0 … 1CDAcdotsntOf
@typeCode
cs0 … 1FCOMP
hl7:encompassingEncounter
1 … 1CDAcdotsntOf
@classCode
cs0 … 1FENC
@moodCode
cs0 … 1FEVN
hl7:id
II0 … *CDAcdotsntOf
hl7:code
CE0 … 1CDAcdotsntOf
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.13955 ActEncounterCode (DYNAMIC)
hl7:effectiveTime
IVL_TS1 … 1RCDAcdotsntOf
hl7:dischargeDispositionCode
CE0 … 1CDAcdotsntOf
 CONF
shall be drawn from concept domain "EncounterDischargeDisposition"
hl7:responsibleParty
0 … 1Contains 2.16.840.1.113883.10.12.153 CDA AssignedEntity (DYNAMIC)CDAcdotsntOf
@typeCode
cs0 … 1FRESP
hl7:encounterParticipant
0 … *CDAcdotsntOf
@typeCode
cs1 … 1R
 CONF
The value of @typeCode shall be drawn from value set 2.16.840.1.113883.1.11.19600 x_EncounterParticipant (DYNAMIC)
hl7:time
IVL_TS0 … 1CDAcdotsntOf
hl7:assignedEntity
1 … 1Contains 2.16.840.1.113883.10.12.153 CDA AssignedEntity (DYNAMIC)CDAcdotsntOf
hl7:location
0 … 1CDAcdotsntOf
@typeCode
cs0 … 1FLOC
hl7:healthCareFacility
1 … 1CDAcdotsntOf
@classCode
cs0 … 1FSDLOC
hl7:id
II0 … *CDAcdotsntOf
hl7:code
CE0 … 1CDAcdotsntOf
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.17660 ServiceDeliveryLocationRoleType (DYNAMIC)
hl7:location
0 … 1Contains 2.16.840.1.113883.10.12.317 CDA Place (DYNAMIC)CDAcdotsntOf
hl7:serviceProviderOrganization
0 … 1Contains 2.16.840.1.113883.10.12.151 CDA Organization (DYNAMIC)CDAcdotsntOf
hl7:component
1 … 1RDGUVdotsicht
@typeCode
cs0 … 1FCOMP
@contextConductionInd
bl1 … 1R
hl7:structuredBody
1 … 1RDGUVdotsicht
@classCode
cs0 … 1FDOCBODY
@moodCode
cs0 … 1FEVN
hl7:confidentialityCode
CE0 … 1DGUVdotsicht
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.16926 HL7 BasicConfidentialityKind (DYNAMIC)
hl7:languageCode
CS0 … 1DGUVdotsicht
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.11526 HumanLanguage (DYNAMIC)
hl7:component
1 … *RContains 1.2.276.0.76.3.1.85.200.77.10.2 Diagnose (DYNAMIC)DGUVdotsicht
@typeCode
cs0 … 1FCOMP
@contextConductionInd
bl1 … 1R
hl7:component
1 … *RContains 1.2.276.0.76.3.1.85.200.77.10.3 Therapie (DYNAMIC)DGUVdotsicht
@typeCode
cs0 … 1FCOMP
@contextConductionInd
bl1 … 1R
hl7:component
1 … *RContains 1.2.276.0.76.3.1.85.200.77.10.1 Anamnese (DYNAMIC)DGUVdotsicht
@typeCode
cs0 … 1FCOMP
@contextConductionInd
bl1 … 1R
hl7:component
1 … *RContains 1.2.276.0.76.3.1.85.200.77.10.44 Beschäftigung (DYNAMIC)DGUVdotsicht
@typeCode
cs0 … 1FCOMP
@contextConductionInd
bl1 … 1R