| Item | DT | Card | Conf | Description | Label |
|---|
hl7:observation
| | | R | | VPSP tion |
@classCode
| cs | 0 … 1 | F | OBS |
@moodCode
| cs | 1 … 1 | F | EVN |
hl7:templateId
| II | 1 … 1 | M | | VPSPtion |
@root
| uid | 1 … 1 | F | 2.16.840.1.113883.2.9.10.1.6.61 |
hl7:id
| II | 0 … * | R | | VPSPtion |
hl7:code
| CD.EPSOS | 1 … 1 | R | This element describes the type of condition this observation is referring to. | VPSPtion |
| | CONF | |
hl7:text
| ED | 0 … 1 | R | The <text> element if present 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. | VPSPtion |
| | |
hl7:reference
| TEL | 1 … 1 | M | | VPSPtion |
@value
| | 1 … 1 | R | When used it shall refer to the narrative, typically #{label}-{generated-id}, e.g. #xxx-1
|
hl7:statusCode
| CS | 1 … 1 | M | 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'. | VPSPtion |
@code
| CONF | 1 … 1 | F | completed |
hl7:effectiveTime
| IVL_TS | 1 … 1 | M | The effectiveTime, also referred to as the “biologically relevant time” is the time at which the observation holds for the patient. For a provider seeing a patient in the clinic today, observing a history of heart attack that occurred five years ago, the effectiveTime is five years ago. The <low> and <high> values should be no more precise than known, but as precise as possible.
| VPSPtion |
| | |
hl7:low
| IVXB_TS | 1 … 1 | R | The effectiveTime/low (a.k.a. "onset date") asserts when the condition became biologically active.
| VPSPtion |
hl7:high
| IVXB_TS | 0 … 1 | C | The effectiveTime/high (a.k.a. "resolution date") asserts when the condition e became biologically resolved.
If the date of resolution is not known, then effectiveTime/high will be present with a nullFlavor of "UNK".
| VPSPtion |
| | Constraint | If this condition is known to be resolved, then the effectiveTime/high would be present.
|
hl7:value
| CD.EPSOS | 1 … 1 | M | 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 uncoded, all attributes other than xsi:type='CD' must be absent and - in this case - shall contain a <reference> to the <originalText> in the narrative where the allergy is described.
The coded form shall be used to indicate known absent conditions or the nonavailability of information about them.
| VPSPtion |
| | |
| | CONF | |
hl7:originalText
| | | R | The <originalText> element within the <code> element described above is used as follows: the <value> contains a <reference> to the <originalText> in order to link the coded value to the problem narrative text (minus 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. | VPSPtion |
hl7:reference
| | 0 … 1 | R | The URI given in the value attribute of the <reference> element points to an element in the narrative content that contains the complete text describing the medication. In a CDA document, the URI given in the value attribute of the <reference> element points to an element in the narrative content that contains the complete text describing the medication. | VPSPtion |
| | Example | <reference value="#eP_as_text"/> |
hl7:translation
| CD.EPSOS | 0 … * | | The translation element may be used to transmit a set of other concept descriptors, using for example ICD-10 or other international or jurisdictional code systems. | VPSPtion |
hl7:author
| | 0 … * | | Contains 2.16.840.1.113883.10.12.318 CDA Author (Body) (DYNAMIC) | VPSPtion |
| | |
hl7:informant
| | 0 … * | | Contains 2.16.840.1.113883.10.12.319 CDA Informant (Body) (DYNAMIC) | VPSPtion |
hl7:entryRelationship
| | 0 … 1 | R | Severity
The contained entry describes a subjective assessment of the severity of the condition as evaluated by the clinician.
Contains  | Error: Cannot find template "2.16.840.1.113883.3.1937.777.13.10.29" (DYNAMIC) |
| VPSPtion |
@typeCode
| cs | 1 … 1 | F | SUBJ |
@inversionInd
| bl | 1 … 1 | F | true |
hl7:entryRelationship
| | 0 … 1 | R | Certainty or Verification Status
The contained entry describes the certainty associated with a condition.
Contains | Error: Cannot find template "2.16.840.1.113883.3.1937.777.13.10.22" (DYNAMIC) |
| VPSPtion |
@typeCode
| cs | 1 … 1 | F | SUBJ |
@inversionInd
| bl | 1 … 1 | F | true |
hl7:entryRelationship
| | 0 … 1 | R | Status of the Problem
The contained entry describes the current status of the condition, for example, whether it is active, in remission, resolved, and so on ...
Contains | Error: Cannot find template "2.16.840.1.113883.3.1937.777.13.10.23" (DYNAMIC) |
| VPSPtion |
@typeCode
| cs | 1 … 1 | F | REFR |
@inversionInd
| bl | 0 … 1 | F | false |
Draft
CDA Author (Body)