Id2.16.840.1.113883.10.20.22.4.3Effective Date2015‑08‑01
Statusdraft DraftVersion Label2.1
NameProblemConcernActV3Display NameProblem Concern Act (V3)
Description
This template reflects an ongoing concern on behalf of the provider that placed the concern on a patient’s problem list. So long as the underlying condition is of concern to the provider (i.e., as long as the condition, whether active or resolved, is of ongoing concern and interest to the provider), the statusCode is “active”. Only when the underlying condition is no longer of concern is the statusCode set to “completed”. The effectiveTime/low of the Problem Concern Act asserts when the concern became active. The effectiveTime/high asserts when the concern was completed (e.g., when the clinician deemed there is no longer any need to track the underlying condition). A Problem Concern Act can contain many Problem Observations (templateId 2.16.840.1.113883.10.20.22.4.4). Each Problem Observation is a discrete observation of a condition, and therefore will have a statusCode of “completed”. The many Problem Observations nested under a Problem Concern Act reflect the change in the clinical understanding of a condition over time. For instance, a Concern may initially contain a Problem Observation of “chest pain”: - Problem Concern 1 --- Problem Observation: Chest Pain Later, a new Problem Observation of “esophagitis” will be added, reflecting a better understanding of the nature of the chest pain. The later problem observation will have a more recent author time stamp. - Problem Concern 1 --- Problem Observation (author/time Jan 3, 2012): Chest Pain --- Problem Observation (author/time Jan 6, 2012): Esophagitis Many systems display the nested Problem Observation with the most recent author time stamp, and provide a mechanism for viewing prior observations.
ContextParent nodes of template element with id 2.16.840.1.113883.10.20.22.4.3
ClassificationCDA Entry Level Template
Open/ClosedOpen (other than defined elements are allowed)
Used by / Uses
Used by 8 transactions and 18 templates, Uses 3 templates
Used by as NameVersion
2.16.840.1.113883.3.1937.99.3.4.31Transactionfinal Transfer Summary (V2)2015‑08‑01
2.16.840.1.113883.3.1937.99.3.4.25Transactionfinal Discharge Summary (V3)2015‑08‑01
2.16.840.1.113883.3.1937.99.3.4.29Transactionfinal Progress Note (V3)2015‑08‑01
2.16.840.1.113883.3.1937.99.3.4.26Transactionfinal History and Physical (V3)2015‑08‑01
2.16.840.1.113883.3.1937.99.3.4.22Transactionfinal Consultation Note (V3)2015‑08‑01
2.16.840.1.113883.3.1937.99.3.4.23Transactionfinal Continuity of Care Document (CCD) (V3)2015‑08‑01
2.16.840.1.113883.3.1937.99.3.4.30Transactionfinal Referral Note (V2)2015‑08‑01
2.16.840.1.113883.3.1937.99.3.4.21Transactionfinal Care Plan (V2)2015‑08‑01
2.16.840.1.113883.3.1937.99.61.8.10.3.1Containmentdraft Problem Section (entries required)2014‑02‑04 13:10:32
2.16.840.1.113883.3.1937.99.61.20.10.10Containmentdraft Problem Section (entries required) (V3) (2.1)2015‑11‑03 08:58:40
2.16.840.1.113883.3.1937.99.61.30.10.54Containmentcancelled Health Concern Act (harmonized) (0.1)2020‑10‑08 10:55:41
2.16.840.1.113883.3.1937.99.61.67.10.24Containmentcancelled XeH Alert Act2021‑04‑20 10:00:04
2.16.840.1.113883.3.1937.99.61.67.10.25Containmentcancelled XeH Risk Concern Act2021‑04‑20 10:06:56
2.16.840.1.113883.10.20.22.1.2linkdraft Continuity of Care Document (CCD) (V3) (2.1)2015‑08‑01
2.16.840.1.113883.10.20.22.1.3linkdraft History and Physical (V3) (2.1)2015‑08‑01
2.16.840.1.113883.10.20.22.1.4linkdraft Consultation Note (V3) (2.1)2015‑08‑01
2.16.840.1.113883.10.20.22.1.8linkdraft Discharge Summary (V3) (2.1)2015‑08‑01
2.16.840.1.113883.10.20.22.1.9linkdraft Progress Note (V3) (2.1)2015‑08‑01
2.16.840.1.113883.10.20.22.1.13linkdraft Transfer Summary (V2) (2.1)2015‑08‑01
2.16.840.1.113883.10.20.22.1.14linkdraft Referral Note (V2) (2.1)2015‑08‑01
2.16.840.1.113883.10.20.22.1.15linkdraft Care Plan (V2) (2.1)2015‑08‑01
2.16.840.1.113883.10.20.22.2.5Containmentdraft Problem Section (entries optional) (V3) (2.1)2015‑08‑01
2.16.840.1.113883.10.20.22.2.5.1Containmentdraft Problem Section (entries required) (V3) (2.1)2015‑08‑01
2.16.840.1.113883.10.20.22.2.58linkdraft Health Concerns Section (V2) (2.1)2015‑08‑01
2.16.840.1.113883.10.20.22.4.132Containmentdraft Health Concern Act (V2) (2.1)2015‑08‑01
2.16.840.1.113883.10.20.22.4.136Containmentdraft Risk Concern Act (V2) (2.1)2015‑08‑01
Uses as NameVersion
2.16.840.1.113883.10.20.22.4.4Containmentdraft Problem Observation (V3) (2.1)2015‑08‑01
2.16.840.1.113883.10.20.22.4.119Containmentdraft Author Participation (2.1)2015‑08‑13
2.16.840.1.113883.10.20.22.4.143Containmentdraft Priority Preference (2.1)2015‑08‑13
RelationshipSpecialization: template 2.16.840.1.113883.10.12.301 CDA Act (2005‑09‑07)
ref
ad1bbr-

Version: template 2.16.840.1.113883.10.20.22.4.3 Problem Concern Act (Condition) (2013‑01‑31)
ItemDTCardConfDescriptionLabel
cda:act
ProbdotsctV3
@classCode
cs1 … 1FACTCONFdots9024
 SHALL contain exactly one [1..1] @classCode="ACT" Act (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1198-9024).
@moodCode
cs1 … 1FEVNCONFdots9025
 SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:1198-9025).
cda:templateId
II1 … 1MC-CDA R1.1 templateId root without an extensionCONFdots2936
@root
uid1 … 1F2.16.840.1.113883.10.20.22.4.3
cda:templateId
II1 … 1MSHALL contain exactly one [1..1] templateId (CONF:1198-16772) such that itCONFdots6772
@root
uid1 … 1F2.16.840.1.113883.10.20.22.4.3CONFdots6773
 SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.3" (CONF:1198-16773).
@extension
st1 … 1F2015-08-01CONFdots2509
 SHALL contain exactly one [1..1] @extension="2015-08-01" (CONF:1198-32509).
cda:id
II1 … *SHALL contain at least one [1..*] id (CONF:1198-9026).CONFdots9026
cda:code
CD1 … 1MSHALL contain exactly one [1..1] code (CONF:1198-9027).CONFdots9027
@code
CONF1 … 1FCONC
@codeSystem
1 … 1F2.16.840.1.113883.5.6
cda:statusCode
CS1 … 1RSHALL contain exactly one [1..1] statusCode (CONF:1198-9029).CONFdots9029
cda:effectiveTime
1 … 1MSHALL contain exactly one [1..1] effectiveTime (CONF:1198-9030).CONFdots9030
cda:low
1 … 1This effectiveTime SHALL contain exactly one [1..1] low (CONF:1198-9032).CONFdots9032
cda:high
0 … 1This effectiveTime MAY contain zero or one [0..1] high (CONF:1198-9033).CONFdots9033
cda:author
0 … *RSHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:1198-31146).
Contains 2.16.840.1.113883.10.20.22.4.119 Author Participation (2015‑08‑13)
CONFdots1146
cda:entryRelationship
1 … *MContains 2.16.840.1.113883.10.20.22.4.4 Problem Observation (V3) (2015‑08‑01)CONFdots9034
@typeCode
cs1 … 1FSUBJCONFdots9035
 SHALL contain exactly one [1..1] @typeCode="SUBJ" Has subject (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:1198-9035).
cda:entryRelationship
0 … *The following entryRelationship represents the importance of the concern to a provider.
Contains 2.16.840.1.113883.10.20.22.4.143 Priority Preference (2015‑08‑13)
CONFdots1638
@typeCode
cs1 … 1FREFRCONFdots1639
 SHALL contain exactly one [1..1] @typeCode="REFR" refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1198-31639).