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- Including R1.1 templateId in compatible C-CDA R2.1 instances
- Prior Conformance
1. SHALL contain exactly one [1..1] templateId (CONF:1198-xxxx) such that it
a. SHALL contain exactly one [1..1] @root="Doc Template root" (CONF:1198-xxxx).
b. SHALL contain exactly one [1..1] @extension="Doc Template version" (CONF:1198-xxxx).
c. When asserting this templateId, all document, section, and entry templates SHALL include a templateId root without an extension. See C-CDA R2.1 Volume 1 - Design Considerations for additional detail (CONF:1198-xxxx).
- Conformance After Update
2. SHALL contain exactly one [1..1] templateId (CONF:1198-xxxx) such that it
a. SHALL contain exactly one [1..1] @root="Root of Document" (CONF:1198-xxxx
b. SHALL contain exactly one [1..1] @extension="Template version" (CONF:1198-xxxxx).
c. When asserting this templateId, all C-CDA 2.1 section and entry templates that had a previous version in C-CDA R1.1 SHALL include both the C-CDA 2.1 templateId and the C-CDA R1.1 templateId root without an extension. See C-CDA R2.1 Volume 1 - Design Considerations for additional detail (CONF:1198-see below).
-The clinicalDocument.code element of the Care Plan Document template is too narrowly defined - need to use a DYNAMIC binding
-Prior Conformance:
SHALL contain exactly one [1..1] code (CONF:1198-28745).
a. This code SHALL contain exactly one [1..1] @code="52521-2" Overall Plan of Care/Advance Care Directives (CONF:1198-28746).
b. This code SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.6.1" (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1) (CONF:1198-28747).
- Conformation After Update:
3. SHALL contain exactly one [1..1] code (CONF:1198-28745).
a. This code SHALL contain exactly one [1..1] @code, which SHALL be selected from ValueSet Care Plan Document Type urn:oid:2.16.840.1.113762.1.4.1099.10 DYNAMIC (CONF:1198-32959).
-CONF:1098-28746; CONF:1198-32959
- Update to include parentDocument id reference
11.MAY contain zero or more [0..*] relatedDocument (CONF:1198-29893) such that it
a.SHALL contain exactly one [1..1] @typeCode, which SHALL be selected from ValueSet Related Document (append/replace) urn:oid:2.16.840.1.113883.11.20.9.62 STATIC (CONF:1198-31889).
b.SHALL contain exactly one [1..1] parentDocument (CONF:1198-29894).
i.This parentDocument SHALL contain exactly one [1..1] setId (CONF:1198-29895).
ii.This parentDocument SHALL contain exactly one [1..1] versionNumber (CONF:1198-29896).
-Conformance After Update
11. MAY contain zero or more [0..*] relatedDocument (CONF:1198-29893) such that it
a. SHALL contain exactly one [1..1] @typeCode, which SHALL be selected from ValueSet x_ActRelationshipDocument urn:oid:2.16.840.1.113883.1.11.11610 STATIC (CONF:1198-31889).
b. SHALL contain exactly one [1..1] parentDocument (CONF:1198-29894).
i. This parentDocument SHALL contain at least one [1..*] id (CONF:1198-32949).
ii. This parentDocument SHALL contain exactly one [1..1] setId (CONF:1198-29895).
iii. This parentDocument SHALL contain exactly one [1..1] versionNumber (CONF:1198-29896).
-29893
-Update purpose statement
-Prior Purpose Statement
Key differentiators between a Care Plan CDA and CCD (another “snapshot in time” document):
• Requires relationships between various acts:
o Health Concerns
o Problems
o Interventions
o Goals
o Outcomes
-Purpose Statement After Change:
There are 2 required sections:
There are 2 optional sections:
A care plan document can include entry references from the information in these sections to the information (entries) in other sections.
-
-Retire Related Document Table, instead update
Table 23: x_ActRelationshipDocument to include XFRM
a. SHALL contain exactly one [1..1] @typeCode, which SHALL be selected from ValueSet Related Document (append/replace) urn:oid:2.16.840.1.113883.11.20.9.62 STATIC (CONF:1198-31889).
Table 25: Related Document (append/replace)
The Related Document value set is used to constrain a related document to two concepts - append and replace
APND HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 Append
RPLC HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 Replace
-Conformance After Update:
Table 23: x_ActRelationshipDocument
Value Set: x_ActRelationshipDocument urn:oid:2.16.840.1.113883.1.11.11610
Used to enumerate the relationships between two clinical documents for document management.
Code Code System Code System OID Print Name
RPLC HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 Replaces
APND HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 Is appendage
XFRM HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 Transformation
-Modify x_ActRelationshipDocument to include XFRMWe didn't have this value set present in our value sets, so we also need to create it first.Find this value set in VSAC first.
-Prior Value Set Members:
- Value Set Members after the change:
- Use the VSAC as the Source of Truth.
-Update 32367 to SHOULD value set binding
-Prior:1. The code, if present, SHALL contain exactly one [1..1] @code (ValueSet: Personal And Legal Relationship Role Type urn:oid:2.16.840.1.113883.11.20.12.1) (CONF:1198-32367).-After Update:1. The code, if present, SHALL contain exactly one [1..1] @code, which SHOULD be selected from ValueSet Personal And Legal Relationship Role Type urn:oid:2.16.840.1.113883.11.20.12.1 DYNAMIC (CONF:1198-32367).
-''32367,