├── .gitignore
├── fhir
    ├── problems
    │   └── noKnownProblems.xml
    ├── results
    │   ├── RESULT_Use_of_String_Value.xml
    │   ├── RESULT_Panel_with_Two_Ordinal_Values.xml
    │   └── RESULT_Value_Less_Than_Physical_Quantity.xml
    ├── immunizations
    │   └── Unknown_Immunization_Status.xml
    ├── allergies_and_adverse_reactions
    │   └── Domain_Allergies_XMLExamples.xml
    └── medications
    │   ├── Domain_Medications_XMLExamples.xml
    │   ├── alogrithm.md
    │   └── medication_1.xml
├── .gitmodules
├── cda
    ├── problems
    │   └── noKnownProblems.xml
    ├── results
    │   ├── RESULT_Use_of_String_Value.xml
    │   ├── RESULT_Value_Less_Than_Physical_Quantity.xml
    │   └── RESULT_Panel_with_Two_Ordinal_Values.xml
    ├── immunizations
    │   └── Unknown_Immunization_Status.xml
    ├── medications
    │   ├── medication_1.xml
    │   └── Domain_Medications_XMLExamples.xml
    └── allergies_and_adverse_reactions
    │   └── Domain_Allergies_XMLExamples.xml
├── README.md
└── load_cda.rb


/.gitignore:
--------------------------------------------------------------------------------
1 | *sw?
2 | 


--------------------------------------------------------------------------------
/fhir/problems/noKnownProblems.xml:
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1 | <TODO>
2 | 


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/fhir/results/RESULT_Use_of_String_Value.xml:
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1 | <TODO>
2 | 


--------------------------------------------------------------------------------
/fhir/immunizations/Unknown_Immunization_Status.xml:
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1 | <TODO>
2 | 


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/fhir/results/RESULT_Panel_with_Two_Ordinal_Values.xml:
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1 | <TODO>
2 | 


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/fhir/results/RESULT_Value_Less_Than_Physical_Quantity.xml:
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1 | <TODO>
2 | 


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/fhir/allergies_and_adverse_reactions/Domain_Allergies_XMLExamples.xml:
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1 | <TODO>
2 | 


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/.gitmodules:
--------------------------------------------------------------------------------
1 | 
2 | 
3 | [submodule "sample_ccdas"]
4 | 	path = sample_ccdas
5 | 	url = https://github.com/chb/sample_ccdas
6 | 


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/cda/problems/noKnownProblems.xml:
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1 | <observation classCode="OBS" moodCode="EVN" negationInd="true"> 
2 |   <!-- Problem Observation template --> 
3 |   <templateId root="2.16.840.1.113883.10.20.22.4.4" /> 
4 |   <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4" codeSystemName="HL7ActCode" /> 
5 |   <statusCode code="completed" /> 
6 |   <value xsi:type="CD" code="55607006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"  displayName="Problem" /> 
7 | </observation>
8 | 


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/fhir/medications/Domain_Medications_XMLExamples.xml:
--------------------------------------------------------------------------------
 1 | <MedicationPrescription xmlns="http://hl7.org/fhir">
 2 |   <identifier>
 3 |     <use value="official"/>
 4 |     <system value="???"/>
 5 |     <value value="cdbd33f0-6cde-11db-9fe1-0800200c9a66"/>
 6 |   </identifier>
 7 |   <text>
 8 |     <status value="generated"/>
 9 |     <div xmlns="http://www.w3.org/1999/xhtml">
10 |       <table>
11 |         <thead>
12 |           ...
13 |         </thead>
14 |         <tr>
15 |           <td>Proventil 0.09 MG/ACTUAT inhalant solution</td>
16 |           <td>2 puffs q6 hours PRN wheezing</td>
17 |           <td>Jan 3, 2011</td>
18 |           <td>Active</td>
19 |           <td>Asthma</td>
20 |           <td>Generic Substitition Allowed</td>
21 |         </tr>
22 |       </table>
23 |     </div>
24 |   </text>
25 | </MedicationPrescription>
26 | 


--------------------------------------------------------------------------------
/README.md:
--------------------------------------------------------------------------------
 1 | # Translating the agreed CDA examples to FHIR
 2 | 
 3 | ## Installation
 4 | ```
 5 |   git clone https://github.com/FHIR/cda-examples-to-fhir
 6 |   cd cda-examples-to-fhir
 7 |   git submodule update # to load smart-platform sample_ccdas
 8 | ```
 9 | 
10 | ## Description
11 | 
12 | Source of examples: http://wiki.hl7.org/index.php?title=CDA_Template_Example_Task_Force
13 | 
14 | What does it involve? Well, I think:
15 | * tracking the CDA Example task force output
16 | * creating FHIR equivalents
17 | * adding them to the spec directly, or sending them on to one of the editors (e.g. Me, Lloyd, Ewout) to add
18 | 
19 | 
20 | 
21 | ## File tree description
22 | 
23 | * cda folder is loaded automaticaly by script - load_cda.rb (add more sources to script file)
24 | * fhir translation files created automaticaly so you should just fill them with valid content
25 | * sample_ccdas - contains https://github.com/chb/sample_ccdas repository
26 | 


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/cda/results/RESULT_Use_of_String_Value.xml:
--------------------------------------------------------------------------------
 1 | <organizer classCode="BATTERY" moodCode="EVN">
 2 | 	<templateId root="2.16.840.1.113883.10.20.22.4.1"/>
 3 | 	<id root="f1aa44dd-6f39-4f5c-b267-897c3824b563"/>
 4 | 	<code code="5778-6" displayName="Color of Urine" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
 5 | 	<statusCode code="completed"/>
 6 | 	<effectiveTime value="201310230910+0500"/>
 7 | 	<component>
 8 | 		<observation classCode="OBS" moodCode="EVN">
 9 | 			<templateId root="2.16.840.1.113883.10.20.22.4.2"/>
10 | 			<id root="f1aa44dd-6f39-4f5c-b267-897c3824b563"/>
11 | 			<code code="5778-6" displayName="Color of Urine" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
12 | 			<text>
13 | 				<reference value="#SomeReferenceGoesHere1"/>
14 | 			</text>
15 | 			<statusCode code="completed"/>
16 | 			<effectiveTime value="20131023090823+0500"/>
17 | 			<!-- Representing a result returned as unstructured string-->
18 | 			<value xsi:type="ST">Yellow</value>
19 | 			<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"/>
20 | 		</observation>
21 | 	</component>
22 | </organizer>
23 | 


--------------------------------------------------------------------------------
/fhir/medications/alogrithm.md:
--------------------------------------------------------------------------------
 1 | # Questions
 2 | 
 3 | * What is container for "History of medication use" in FHIR?
 4 | * Do we map medications from medication section to MedicationStatment/MedicationPrescription/MedicationAdministration?
 5 | * Do we need track identifier from cda, if so - what system?
 6 | * How to extract text from cda for concrete medication
 7 | * Do translate inline resources - like prescriber or medication? What about nested nested resources (like organization in medication)?
 8 | 
 9 | ## Steps
10 | 
11 | * Map medication section LOINC(10160=0) to set of medication statments
12 | 
13 | 
14 | ## substanceAdministration => MedicationPrescription
15 | 
16 | SA = entry/substanceAdministration
17 | MP = MedicationPrescription
18 | 
19 | * SA/id => MP.identifier
20 | * ? => dateWritten
21 | * SA/statusCode => MP.status
22 | * SA/entryRelationship[@typeCode="REFR"]/supply/author[@typeCode="AUT"] => MP.prescriber
23 | * SA/entryRelationship[@typeCode="RSON"] => MP.reasonForPrescribing
24 | 
25 | * SA/entryRelationship[@typeCode="REFR"/supply/product => MP.medication
26 | 
27 | ## author => Practitioner
28 | 
29 | * telecom => telecom
30 | * addr => address
31 | 
32 | ## SA/entryRelationship/supply/product => medication
33 | 
34 | 


--------------------------------------------------------------------------------
/load_cda.rb:
--------------------------------------------------------------------------------
 1 | system('rm -rf cda')
 2 | system('mkdir cda')
 3 | {
 4 | 'ALLERGIES AND ADVERSE REACTIONS' => [
 5 |   'http://raw.github.com/aswain/AnnotatedExamples/XML-Examples/Domain_Allergies_XMLExamples.xml'
 6 |   ],
 7 |   'PROBLEMS' => [
 8 |     'https://raw.github.com/donaldson-ed/taskforceExample/master/noKnownProblems.xml'
 9 |   ],
10 |   'IMMUNIZATIONS' => [
11 |     'https://raw.github.com/brettmarquard/HL7-C-CDA-Task-Force-Examples/master/Unknown_Immunization_Status.xml'
12 |   ],
13 |   'MEDICATIONS' => [
14 |     'https://raw.github.com/aswain/AnnotatedExamples/XML-Examples/Domain_Medications_XMLExamples.xml'
15 |   ],
16 |   'RESULTS' => [
17 |     'https://raw.github.com/jddamore/HL7-Task-Force-Examples/master/RESULT_Value_Less_Than_Physical_Quantity.xml',
18 |     'https://raw.github.com/jddamore/HL7-Task-Force-Examples/master/RESULT_Panel_with_Two_Ordinal_Values.xml',
19 |     'https://raw.github.com/jddamore/HL7-Task-Force-Examples/master/RESULT_Use_of_String_Value.xml'
20 |   ]
21 | }.each do |section, paths|
22 |   dir = section.gsub(' ','_').downcase
23 |   system("mkdir cda/#{dir}")
24 |   system("mkdir fhir/#{dir}")
25 |   paths.each do |pth|
26 |     system("cd cda/#{dir} && wget #{pth}")
27 |     fhile_name = File.basename(pth)
28 |     fhile_path = "fhir/#{dir}/#{fhile_name}"
29 | 
30 |     unless File.exists?(fhile_path)
31 |      system("echo '<TODO>' >> #{fhile_path}")
32 |     end
33 |   end
34 | end
35 | 


--------------------------------------------------------------------------------
/cda/immunizations/Unknown_Immunization_Status.xml:
--------------------------------------------------------------------------------
 1 |     <substanceAdministration moodCode="EVN" classCode="SBADM" negationInd="false" nullFlavor="NI">
 2 |          <!--  We selected NI for this example, C-CDA R2 may describe other appropriate nullFlavors -->
 3 |         <templateId root="2.16.840.1.113883.10.20.22.4.52"/>
 4 |         <!--  ****   Immunization activity template    **** -->
 5 |         <id root="e6f1ba43-c0ed-4b9b-9f12-f435d8ad8f88"/>
 6 |         <!-- No information on whether the patient received a vaccination -->
 7 |         <text>
 8 |             <reference value="#immun1"/>
 9 |         </text>
10 |         <statusCode nullFlavor="completed"/>
11 |         <effectiveTime value="199911"/>
12 |         <!-- Date which you do not know whether or not patient received a vaccination -->
13 |         <consumable>
14 |             <manufacturedProduct classCode="MANU">
15 |                 <!-- ** Immunization medication information ** -->
16 |                 <templateId root="2.16.840.1.113883.10.20.22.4.54"/>
17 |                 <manufacturedMaterial>
18 |                     <!-- Needed to use nullFlavor of OTH since templates requires CVX in code element-->
19 |                     <code nullFlavor="OTH">
20 |                         <!-- Optional original text -->
21 |                         <originalText>Vaccination</originalText>
22 |                         <translation code="71181003" displayName="vaccine"
23 |                             codeSystem="2.16.840.1.113883.6.96"
24 |                             codeSystemName="SNOMED CT"/>
25 |                     </code>
26 |                 </manufacturedMaterial>
27 |             </manufacturedProduct>
28 |         </consumable>
29 |     </substanceAdministration>
30 | 
31 | 


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/cda/results/RESULT_Value_Less_Than_Physical_Quantity.xml:
--------------------------------------------------------------------------------
 1 | <organizer classCode="BATTERY" moodCode="EVN">
 2 | 	<templateId root="2.16.840.1.113883.10.20.22.4.1"/>
 3 | 	<id root="df0f809e-f0a9-4a30-aad0-92b5cc868b67"/>
 4 | 	<code code="42637-9" displayName="Natriuretic Peptide B [Mass/Volume] In Blood" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
 5 | 	<statusCode code="completed"/>
 6 | 	<effectiveTime value="201310200908+0500"/>
 7 | 	<component>
 8 | 		<observation classCode="OBS" moodCode="EVN">
 9 | 			<templateId root="2.16.840.1.113883.10.20.22.4.2"/>
10 | 			<id root="df0f809e-f0a9-4a30-aad0-92b5cc868b67"/>
11 | 			<code code="42637-9" displayName="Natriuretic Peptide B [Mass/Volume] In Blood" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
12 | 			<text>
13 | 				<reference value="#SomeReferenceGoesHere2"/>
14 | 			</text>
15 | 			<statusCode code="completed"/>
16 | 			<effectiveTime value="201310200908+0500"/>
17 | 			<!-- Representing a result of less than with type of interval -->
18 | 			<value xsi:type="IVL_PQ">
19 | 				<!-- The lower bound for most physical measures of less than will be zero-->
20 | 				<low value="0" unit="pg/mL"/>
21 | 				<!-- The upper bound is based upon information returned in lab result, such as less than 5pg/mL-->
22 | 				<high value="5" unit="pg/mL"/>
23 | 			</value>
24 | 			<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"/>
25 | 			<referenceRange>
26 | 				<observationRange>
27 | 					<!-- Reference ranges can be expressed as structured physical quantity interval-->
28 | 					<value xsi:type="IVL_PQ">
29 | 						<low value="0" unit="pg/mL"/>
30 | 						<high value="100" unit="pg/mL"/>
31 | 					</value>
32 | 					<!-- This interpretation code denotes that this reference range is for normal results. This is not the interpretation a specific patient value-->
33 | 					<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"/>
34 | 				</observationRange>
35 | 			</referenceRange>
36 | 		</observation>
37 | 	</component>
38 | </organizer>


--------------------------------------------------------------------------------
/fhir/medications/medication_1.xml:
--------------------------------------------------------------------------------
  1 | <MedicationPrescription xmlns="http://hl7.org/fhir">
  2 |   <contained>
  3 |     <Practitioner id="prescriber1">
  4 |       <text>
  5 |         <status value="generated"/>
  6 |         <div xmlns="http://www.w3.org/1999/xhtml">
  7 |           <p>Pattricia Patty Primary, M.D.</p>
  8 |         </div>
  9 |       </text>
 10 |       <identifier>
 11 |         <use value="official"/>
 12 |         <system value="???"/>
 13 |         <value value="5555555555"/>
 14 |       </identifier>
 15 |       <name>
 16 |         <use value="official"/>
 17 |         <family value="Primary"/>
 18 |         <given value="Patricia"/>
 19 |         <given value="Patty"/>
 20 |         <suffix value="M.D."/>
 21 |       </name>
 22 |       <telecom>
 23 |         <system value="phone"/>
 24 |         <value value="tel:+1(555)555-1004"/>
 25 |         <use value="work"/>
 26 |       </telecom>
 27 |       <address>
 28 |         <use value="work"/>
 29 |         <line value="1004 Healthcare Drive"/>
 30 |         <city value="Portland"/>
 31 |         <zip value="OR"/>
 32 |         <country value="NLD"/>
 33 |       </address>
 34 |     </Practitioner>
 35 | 
 36 |     <Medication id="med1">
 37 |       <name value="Proventil 0.09 MG/ACTUAT inhalant solution"/>
 38 |       <code>
 39 |         <coding>
 40 |           <system value="http://rxnorm???"/>
 41 |           <code value="219483"/>
 42 |           <display value="Proventil HFA"/>
 43 |         </coding>
 44 |         <coding>
 45 |           <system value="2.16.840.1.113883.6.88"/>
 46 |           <code value="573621"/>
 47 |           <display value="Proventil 0.09 MG/ACTUAT inhalant solution"/>
 48 |         </coding>
 49 |       </code>
 50 |       <manufacturer>
 51 |         <!-- ups what is reference -->
 52 |         <display value="Medication Factory Inc."/>
 53 |       </manufacturer>
 54 |       <!-- <isBrand value="true"/> -->
 55 |       <!-- <kind value="product"/> -->
 56 |     </Medication>
 57 | 
 58 |   </contained>
 59 |   <text>
 60 |     <status value="generated"/>
 61 |     <div xmlns="http://www.w3.org/1999/xhtml">
 62 |       <table>
 63 |         <thead>
 64 |           ...
 65 |         </thead>
 66 |         <tr>
 67 |           <td>Proventil 0.09 MG/ACTUAT inhalant solution</td>
 68 |           <td>2 puffs q6 hours PRN wheezing</td>
 69 |           <td>Jan 3, 2011</td>
 70 |           <td>Active</td>
 71 |           <td>Asthma</td>
 72 |           <td>Generic Substitition Allowed</td>
 73 |         </tr>
 74 |       </table>
 75 |     </div>
 76 |   </text>
 77 |   <identifier>
 78 |     <use value="official"/>
 79 |     <system value="???"/>
 80 |     <value value="cdbd33f0-6cde-11db-9fe1-0800200c9a66"/>
 81 |   </identifier>
 82 |   <dateWritten value="2013-05-25T19:32:52+01:00"/>
 83 |   <status value="active"/>
 84 |   <patient>
 85 |     ...
 86 |   </patient>
 87 |   <prescriber>
 88 |     <reference value="#prescriber1"/>
 89 |     <display value="Pattricia Patty Primary M.D."/>
 90 |   </prescriber>
 91 |   <!-- <encounter> </encounter> -->
 92 |   <reasonForPrescribing>
 93 |     <coding>
 94 |       <system value="http://snomed.info/id"/>
 95 |       <code value="195967001"/>
 96 |       <display value="Asthma"/>
 97 |     </coding>
 98 |     <!-- loosing effective time and finding marker -->
 99 |   </reasonForPrescribing>
100 |   <medication> <!--   Linked to a RESOURCE Medication   -->
101 |     <reference value="#med1"/>
102 |     <display value=""/>
103 |   </medication>
104 | </MedicationPrescription>
105 | 


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/cda/results/RESULT_Panel_with_Two_Ordinal_Values.xml:
--------------------------------------------------------------------------------
 1 | <organizer classCode="BATTERY" moodCode="EVN">
 2 | 	<templateId root="2.16.840.1.113883.10.20.22.4.1"/>
 3 | 	<id root="b5684bf0-eb6f-46dd-9f2e-b6cbcc4196fd"/>
 4 | 	<code code="70163-1" displayName="Chlamydia trachomatis/Neisseria gonorrhoeae rRNA panel" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
 5 | 	<statusCode code="completed"/>
 6 | 	<effectiveTime value="201310221426+0500"/>
 7 | 	<component>
 8 | 		<observation classCode="OBS" moodCode="EVN">
 9 | 			<templateId root="2.16.840.1.113883.10.20.22.4.2"/>
10 | 			<id root="5a6be91a-32d5-4d24-a8bd-07d10a3ef14d"/>
11 | 			<code code="50387-0" displayName="Chlamydia trachomatis rRNA" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
12 | 			<text>
13 | 				<reference value="#SomeReferenceGoesHere3"/>
14 | 			</text>
15 | 			<statusCode code="completed"/>
16 | 			<effectiveTime value="201310221426+0500"/>
17 | 			<!-- Representing a result of an ordinal test (See LOINC axes) as negative in SNOMED-->
18 | 			<value xsi:type="CO" code="260385009" codeSystemName="SNOMED-CT" displayName ="Negative" codeSystem ="2.16.840.1.113883.6.96"/>
19 | 			<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"/>
20 | 			<referenceRange>
21 | 				<observationRange>
22 | 					<value xsi:type="CO" code="260385009" codeSystemName="SNOMED-CT" displayName ="Negative" codeSystem ="2.16.840.1.113883.6.96"/>
23 | 					<!-- This interpretation code denotes that this reference range is for normal results. This is not the interpretation a specific patient value-->
24 | 					<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"/>
25 | 				</observationRange>
26 | 			</referenceRange>
27 | 		</observation>
28 | 	</component>
29 | 	<component>
30 | 		<observation classCode="OBS" moodCode="EVN">
31 | 			<templateId root="2.16.840.1.113883.10.20.22.4.2"/>
32 | 			<id root="404bba0e-1c76-4265-afb5-1a57b55e128b"/>
33 | 			<code code="50388-8" displayName="Neisseria gonorrhoeae rRNA" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
34 | 			<text>
35 | 				<reference value="#SomeReferenceGoesHere4"/>
36 | 			</text>
37 | 			<statusCode code="completed"/>
38 | 			<effectiveTime value="201310221426+0500"/>
39 | 			<!-- Representing a result of an ordinal test (See LOINC axes) as positive in SNOMED-->
40 | 			<value xsi:type="CO" code="10828004" codeSystemName="SNOMED-CT" displayName ="Positive" codeSystem ="2.16.840.1.113883.6.96"/>
41 | 			<interpretationCode code="A" codeSystem="2.16.840.1.113883.5.83"/>
42 | 			<referenceRange>
43 | 				<observationRange>
44 | 					<value xsi:type="CO" code="260385009" codeSystemName="SNOMED-CT" displayName ="Negative" codeSystem ="2.16.840.1.113883.6.96"/>
45 | 					<!-- This interpretation code denotes that this reference range is for normal results. This is not the interpretation a specific patient value-->
46 | 					<interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"/>
47 | 				</observationRange>
48 | 			</referenceRange>
49 | 			<referenceRange>
50 | 				<observationRange>
51 | 					<value xsi:type="CO" code="10828004" codeSystemName="SNOMED-CT" displayName ="Positive" codeSystem ="2.16.840.1.113883.6.96"/>
52 | 					<!-- This optional second interpretation code denotes that this reference range is for abnormal results. This is not the interpretation a specific patient value-->
53 | 					<interpretationCode code="A" codeSystem="2.16.840.1.113883.5.83"/>
54 | 				</observationRange>
55 | 			</referenceRange>
56 | 		</observation>
57 | 	</component>
58 | </organizer>
59 | 


--------------------------------------------------------------------------------
/cda/medications/medication_1.xml:
--------------------------------------------------------------------------------
  1 | <entry typeCode="DRIV">
  2 |   <substanceAdministration classCode="SBADM" moodCode="EVN">
  3 |     <!-- ** Medication activity ** -->
  4 |     <templateId root="2.16.840.1.113883.10.20.22.4.16"/>
  5 |     <id root="cdbd33f0-6cde-11db-9fe1-0800200c9a66"/>
  6 |     <statusCode code="active"/>
  7 |     <effectiveTime xsi:type="IVL_TS">
  8 |       <low value="20110103"/>
  9 |     </effectiveTime>
 10 |     <effectiveTime xsi:type="PIVL_TS" institutionSpecified="true"
 11 |       operator="A">
 12 |       <period value="6" unit="h"/>
 13 |     </effectiveTime>
 14 |     <routeCode code="C38216" codeSystem="2.16.840.1.113883.3.26.1.1"
 15 |       codeSystemName="NCI Thesaurus"
 16 |       displayName="RESPIRATORY (INHALATION)"/>
 17 |     <doseQuantity value="2"/>
 18 |     <administrationUnitCode code="PUFF" displayName="Puff"
 19 |       codeSystem="2.16.840.1.113883.5.85"
 20 |       codeSystemName="orderableDrugForm"/>
 21 |     <consumable>
 22 |       <manufacturedProduct classCode="MANU">
 23 |         <!-- ** Medication information ** -->
 24 |         <templateId root="2.16.840.1.113883.10.20.22.4.23"/>
 25 |         <id root="2a620155-9d11-439e-92b3-5d9815ff4ee8"/>
 26 |         <manufacturedMaterial>
 27 |           <code code="573621"
 28 |             displayName="Proventil 0.09 MG/ACTUAT inhalant solution"
 29 |             codeSystem="2.16.840.1.113883.6.88"
 30 |             codeSystemName="RxNorm"/>
 31 |         </manufacturedMaterial>
 32 |         <manufacturerOrganization>
 33 |           <name>Medication Factory Inc.</name>
 34 |         </manufacturerOrganization>
 35 |       </manufacturedProduct>
 36 |     </consumable>
 37 |     <performer>
 38 |       <assignedEntity>
 39 |         <id extension="5555555555" root="2.16.840.1.113883.4.6"/>
 40 |         <addr nullFlavor="UNK"/>
 41 |         <telecom use="WP" value="tel: +1(555)555-1004"/>
 42 |         <representedOrganization>
 43 |           <id root="2.16.840.1.113883.19.5.9999.1393"/>
 44 |           <name>Community Health and Hospitals</name>
 45 |           <telecom use="WP" value="tel: +1(555)555-5000"/>
 46 |           <addr nullFlavor="UNK"/>
 47 |         </representedOrganization>
 48 |       </assignedEntity>
 49 |     </performer>
 50 |     <participant typeCode="CSM">
 51 |       <participantRole classCode="MANU">
 52 |         <!-- ** Drug vehicle ** -->
 53 |         <templateId root="2.16.840.1.113883.10.20.22.4.24"/>
 54 |         <code code="412307009" displayName="drug vehicle"
 55 |           codeSystem="2.16.840.1.113883.6.96"/>
 56 |         <playingEntity classCode="MMAT">
 57 |           <code code="324049" displayName="Aerosol"
 58 |             codeSystem="2.16.840.1.113883.6.88"
 59 |             codeSystemName="RxNorm"/>
 60 |           <name>Aerosol</name>
 61 |         </playingEntity>
 62 |       </participantRole>
 63 |     </participant>
 64 |     <entryRelationship typeCode="RSON">
 65 |       <observation classCode="OBS" moodCode="EVN">
 66 |         <!-- ** Indication ** -->
 67 |         <templateId root="2.16.840.1.113883.10.20.22.4.19"/>
 68 |         <id root="db734647-fc99-424c-a864-7e3cda82e703"
 69 |           extension="45665"/>
 70 |         <code code="404684003" displayName="Finding"
 71 |           codeSystem="2.16.840.1.113883.6.96"
 72 |           codeSystemName="SNOMED CT"/>
 73 |         <statusCode code="completed"/>
 74 |         <effectiveTime>
 75 |           <low value="20110103"/>
 76 |         </effectiveTime>
 77 |         <value xsi:type="CD" code="195967001" displayName="Asthma"
 78 |           codeSystem="2.16.840.1.113883.6.96"/>
 79 |       </observation>
 80 |     </entryRelationship>
 81 |     <entryRelationship typeCode="REFR">
 82 |       <supply classCode="SPLY" moodCode="INT">
 83 |         <!-- ** Medication supply order ** -->
 84 |         <templateId root="2.16.840.1.113883.10.20.22.4.17"/>
 85 |         <id nullFlavor="NI"/>
 86 |         <statusCode code="completed"/>
 87 |         <effectiveTime xsi:type="IVL_TS">
 88 |           <low value="20070103"/>
 89 |           <high nullFlavor="UNK"/>
 90 |         </effectiveTime>
 91 |         <repeatNumber value="1"/>
 92 |         <quantity value="75"/>
 93 |         <product>
 94 |           <manufacturedProduct classCode="MANU">
 95 |             <!-- ** Medication information ** -->
 96 |             <templateId root="2.16.840.1.113883.10.20.22.4.23"/>
 97 |             <id root="2a620155-9d11-439e-92b3-5d9815ff4ee8"/>
 98 |             <manufacturedMaterial>
 99 |               <code code="573621"
100 |                 codeSystem="2.16.840.1.113883.6.88"
101 |                 displayName="Proventil 0.09 MG/ACTUAT inhalant solution">
102 |                 <translation code="219483"
103 |                   codeSystem="2.16.840.1.113883.6.88"
104 |                   displayName="Proventil HFA"
105 |                   codeSystemName="RxNorm"/>
106 |               </code>
107 |             </manufacturedMaterial>
108 |             <manufacturerOrganization>
109 |               <name>Medication Factory Inc.</name>
110 |             </manufacturerOrganization>
111 |           </manufacturedProduct>
112 |         </product>
113 |         <author typeCode="AUT">
114 |           <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
115 |           <time value="201208151235-0800"/>
116 |           <assignedAuthor>
117 |             <id extension="5555555555" root="2.16.840.1.113883.4.6"/>
118 |             <code code="207QA0505X" displayName="Adult Medicine"
119 |               codeSystem="2.16.840.1.113883.6.101"
120 |               codeSystemName="NUCC"/>
121 |             <addr>
122 |               <streetAddressLine>1004 Healthcare Drive </streetAddressLine>
123 |               <city>Portland</city>
124 |               <state>OR</state>
125 |               <postalCode>99123</postalCode>
126 |               <country>US</country>
127 |             </addr>
128 |             <telecom use="WP" value="tel:+1(555)555-1004"/>
129 |             <assignedPerson>
130 |               <name>
131 |                 <given>Patricia</given>
132 |                 <given qualifier="CL">Patty</given>
133 |                 <family>Primary</family>
134 |                 <suffix qualifier="AC">M.D.</suffix>
135 |               </name>
136 |             </assignedPerson>
137 |           </assignedAuthor>
138 |         </author>
139 |         <entryRelationship typeCode="SUBJ" inversionInd="true">
140 |           <act classCode="ACT" moodCode="INT">
141 |             <!-- ** Instruction ** -->
142 |             <templateId root="2.16.840.1.113883.10.20.22.4.20"/>
143 |             <code code="409073007"
144 |               codeSystem="2.16.840.1.113883.6.96"
145 |               displayName="instruction"/>
146 |             <text>
147 |               <reference value="#MedSec_1"/> label in spanish </text>
148 |             <statusCode code="completed"/>
149 |           </act>
150 |         </entryRelationship>
151 |       </supply>
152 |     </entryRelationship>
153 |     <entryRelationship typeCode="REFR">
154 |       <supply classCode="SPLY" moodCode="EVN">
155 |         <!-- ** Medication dispense ** -->
156 |         <templateId root="2.16.840.1.113883.10.20.22.4.18"/>
157 |         <id root="1.2.3.4.56789.1"
158 |           extension="cb734647-fc99-424c-a864-7e3cda82e704"/>
159 |         <statusCode code="completed"/>
160 |         <effectiveTime value="201208151450-0800"/>
161 |         <repeatNumber value="1"/>
162 |         <quantity value="75"/>
163 |         <product>
164 |           <manufacturedProduct classCode="MANU">
165 |             <!-- ** Medication information ** -->
166 |             <templateId root="2.16.840.1.113883.10.20.22.4.23"/>
167 |             <id root="2a620155-9d11-439e-92b3-5d9815ff4ee8"/>
168 |             <manufacturedMaterial>
169 |               <code code="573621"
170 |                 codeSystem="2.16.840.1.113883.6.88"
171 |                 displayName="Proventil 0.09 MG/ACTUAT inhalant solution">
172 |                 <originalText>
173 |                   <reference value="#MedSec_1"/>
174 |                 </originalText>
175 |               </code>
176 |             </manufacturedMaterial>
177 |             <manufacturerOrganization>
178 |               <name>Medication Factory Inc.</name>
179 |             </manufacturerOrganization>
180 |           </manufacturedProduct>
181 |         </product>
182 |         <performer>
183 |           <assignedEntity>
184 |             <id extension="333222222" root="2.16.840.1.113883.4.6"/>
185 |             <addr>
186 |               <streetAddressLine>1016 Health
187 |                 Drive</streetAddressLine>
188 |               <city>Portland</city>
189 |               <state>OR</state>
190 |               <postalCode>99123</postalCode>
191 |               <country>US</country>
192 |             </addr>
193 |             <telecom use="WP" value="tel:+1(555)555-1016"/>
194 |             <assignedPerson>
195 |               <name>
196 |                 <given>Susan</given>
197 |                 <family>Script</family>
198 |                 <suffix qualifier="AC">Pharm.D.</suffix>
199 |               </name>
200 |             </assignedPerson>
201 |             <representedOrganization>
202 |               <name>People's Pharmacy</name>
203 |             </representedOrganization>
204 |           </assignedEntity>
205 |         </performer>
206 |       </supply>
207 |     </entryRelationship>
208 |     <precondition typeCode="PRCN">
209 |       <criterion>
210 |         <!-- ** Precondition for substance administration ** -->
211 |         <templateId root="2.16.840.1.113883.10.20.22.4.25"/>
212 |         <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
213 |         <value xsi:type="CD" code="56018004"
214 |           codeSystem="2.16.840.1.113883.6.96" displayName="Wheezing"/>
215 |       </criterion>
216 |     </precondition>
217 |   </substanceAdministration>
218 | </entry>
219 | 


--------------------------------------------------------------------------------
/cda/medications/Domain_Medications_XMLExamples.xml:
--------------------------------------------------------------------------------
  1 | <?xml version="1.0" encoding="UTF-8"?>
  2 | <!-- Medications Domain Examples -->
  3 | 
  4 | <!-- *********** Example 1: Patient taking pre-coordinated medication *********** -->
  5 | <component>
  6 |   <section>
  7 |     <!-- *** Medications section with entries required *** -->
  8 |     <templateId root="2.16.840.1.113883.10.20.22.2.1.1"/>
  9 |     <code code="10160-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"
 10 |       displayName="HISTORY OF MEDICATION USE"/>
 11 |     <title>MEDICATIONS</title>
 12 |     <text>
 13 |       <table border="1" width="100%">
 14 |         <thead>
 15 |           <tr>
 16 |             <th>Medication</th>
 17 |             <th>Directions</th>
 18 |             <th>Start Date</th>
 19 |             <th>Status</th>
 20 |             <th>Indications</th>
 21 |             <th>Fill Instructions</th>
 22 |           </tr>
 23 |         </thead>
 24 |         <tbody>
 25 |           <tr>
 26 |             <td>Proventil 0.09 MG/ACTUAT inhalant solution</td>
 27 |             <td>2 puffs q6 hours PRN wheezing</td>
 28 |             <td>Jan 3, 2011</td>
 29 |             <td>Active</td>
 30 |             <td>Asthma</td>
 31 |             <td>Generic Substitition Allowed</td>
 32 |           </tr>
 33 |           <tr>
 34 |             <td>Atenolol 25 MG Oral Tablet</td>
 35 |             <td>1 every 12 hours Orally</td>
 36 |             <td>Mar 18, 2012</td>
 37 |             <td>Active</td>
 38 |             <td>Hypertension</td>
 39 |             <td>-none-</td>
 40 |           </tr>
 41 |         </tbody>
 42 |       </table>
 43 |     </text>
 44 |     <entry typeCode="DRIV">
 45 |       <substanceAdministration classCode="SBADM" moodCode="EVN">
 46 |         <!-- ** Medication activity ** -->
 47 |         <templateId root="2.16.840.1.113883.10.20.22.4.16"/>
 48 |         <id root="cdbd33f0-6cde-11db-9fe1-0800200c9a66"/>
 49 |         <statusCode code="active"/>
 50 |         <effectiveTime xsi:type="IVL_TS">
 51 |           <low value="20110103"/>
 52 |         </effectiveTime>
 53 |         <effectiveTime xsi:type="PIVL_TS" institutionSpecified="true"
 54 |           operator="A">
 55 |           <period value="6" unit="h"/>
 56 |         </effectiveTime>
 57 |         <routeCode code="C38216" codeSystem="2.16.840.1.113883.3.26.1.1"
 58 |           codeSystemName="NCI Thesaurus"
 59 |           displayName="RESPIRATORY (INHALATION)"/>
 60 |         <doseQuantity value="2"/>
 61 |         <administrationUnitCode code="PUFF" displayName="Puff"
 62 |           codeSystem="2.16.840.1.113883.5.85"
 63 |           codeSystemName="orderableDrugForm"/>
 64 |         <consumable>
 65 |           <manufacturedProduct classCode="MANU">
 66 |             <!-- ** Medication information ** -->
 67 |             <templateId root="2.16.840.1.113883.10.20.22.4.23"/>
 68 |             <id root="2a620155-9d11-439e-92b3-5d9815ff4ee8"/>
 69 |             <manufacturedMaterial>
 70 |               <code code="573621"
 71 |                 displayName="Proventil 0.09 MG/ACTUAT inhalant solution"
 72 |                 codeSystem="2.16.840.1.113883.6.88"
 73 |                 codeSystemName="RxNorm"/>
 74 |             </manufacturedMaterial>
 75 |             <manufacturerOrganization>
 76 |               <name>Medication Factory Inc.</name>
 77 |             </manufacturerOrganization>
 78 |           </manufacturedProduct>
 79 |         </consumable>
 80 |         <performer>
 81 |           <assignedEntity>
 82 |             <id extension="5555555555" root="2.16.840.1.113883.4.6"/>
 83 |             <addr nullFlavor="UNK"/>
 84 |             <telecom use="WP" value="tel: +1(555)555-1004"/>
 85 |             <representedOrganization>
 86 |               <id root="2.16.840.1.113883.19.5.9999.1393"/>
 87 |               <name>Community Health and Hospitals</name>
 88 |               <telecom use="WP" value="tel: +1(555)555-5000"/>
 89 |               <addr nullFlavor="UNK"/>
 90 |             </representedOrganization>
 91 |           </assignedEntity>
 92 |         </performer>
 93 |         <participant typeCode="CSM">
 94 |           <participantRole classCode="MANU">
 95 |             <!-- ** Drug vehicle ** -->
 96 |             <templateId root="2.16.840.1.113883.10.20.22.4.24"/>
 97 |             <code code="412307009" displayName="drug vehicle"
 98 |               codeSystem="2.16.840.1.113883.6.96"/>
 99 |             <playingEntity classCode="MMAT">
100 |               <code code="324049" displayName="Aerosol"
101 |                 codeSystem="2.16.840.1.113883.6.88"
102 |                 codeSystemName="RxNorm"/>
103 |               <name>Aerosol</name>
104 |             </playingEntity>
105 |           </participantRole>
106 |         </participant>
107 |         <entryRelationship typeCode="RSON">
108 |           <observation classCode="OBS" moodCode="EVN">
109 |             <!-- ** Indication ** -->
110 |             <templateId root="2.16.840.1.113883.10.20.22.4.19"/>
111 |             <id root="db734647-fc99-424c-a864-7e3cda82e703"
112 |               extension="45665"/>
113 |             <code code="404684003" displayName="Finding"
114 |               codeSystem="2.16.840.1.113883.6.96"
115 |               codeSystemName="SNOMED CT"/>
116 |             <statusCode code="completed"/>
117 |             <effectiveTime>
118 |               <low value="20110103"/>
119 |             </effectiveTime>
120 |             <value xsi:type="CD" code="195967001" displayName="Asthma"
121 |               codeSystem="2.16.840.1.113883.6.96"/>
122 |           </observation>
123 |         </entryRelationship>
124 |         <entryRelationship typeCode="REFR">
125 |           <supply classCode="SPLY" moodCode="INT">
126 |             <!-- ** Medication supply order ** -->
127 |             <templateId root="2.16.840.1.113883.10.20.22.4.17"/>
128 |             <id nullFlavor="NI"/>
129 |             <statusCode code="completed"/>
130 |             <effectiveTime xsi:type="IVL_TS">
131 |               <low value="20070103"/>
132 |               <high nullFlavor="UNK"/>
133 |             </effectiveTime>
134 |             <repeatNumber value="1"/>
135 |             <quantity value="75"/>
136 |             <product>
137 |               <manufacturedProduct classCode="MANU">
138 |                 <!-- ** Medication information ** -->
139 |                 <templateId root="2.16.840.1.113883.10.20.22.4.23"/>
140 |                 <id root="2a620155-9d11-439e-92b3-5d9815ff4ee8"/>
141 |                 <manufacturedMaterial>
142 |                   <code code="573621"
143 |                     codeSystem="2.16.840.1.113883.6.88"
144 |                     displayName="Proventil 0.09 MG/ACTUAT inhalant solution">
145 |                     <translation code="219483"
146 |                       codeSystem="2.16.840.1.113883.6.88"
147 |                       displayName="Proventil HFA"
148 |                       codeSystemName="RxNorm"/>
149 |                   </code>
150 |                 </manufacturedMaterial>
151 |                 <manufacturerOrganization>
152 |                   <name>Medication Factory Inc.</name>
153 |                 </manufacturerOrganization>
154 |               </manufacturedProduct>
155 |             </product>
156 |             <author typeCode="AUT">
157 |               <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
158 |               <time value="201208151235-0800"/>
159 |               <assignedAuthor>
160 |                 <id extension="5555555555" root="2.16.840.1.113883.4.6"/>
161 |                 <code code="207QA0505X" displayName="Adult Medicine"
162 |                   codeSystem="2.16.840.1.113883.6.101"
163 |                   codeSystemName="NUCC"/>
164 |                 <addr>
165 |                   <streetAddressLine>1004 Healthcare Drive </streetAddressLine>
166 |                   <city>Portland</city>
167 |                   <state>OR</state>
168 |                   <postalCode>99123</postalCode>
169 |                   <country>US</country>
170 |                 </addr>
171 |                 <telecom use="WP" value="tel:+1(555)555-1004"/>
172 |                 <assignedPerson>
173 |                   <name>
174 |                     <given>Patricia</given>
175 |                     <given qualifier="CL">Patty</given>
176 |                     <family>Primary</family>
177 |                     <suffix qualifier="AC">M.D.</suffix>
178 |                   </name>
179 |                 </assignedPerson>
180 |               </assignedAuthor>
181 |             </author>
182 |             <entryRelationship typeCode="SUBJ" inversionInd="true">
183 |               <act classCode="ACT" moodCode="INT">
184 |                 <!-- ** Instruction ** -->
185 |                 <templateId root="2.16.840.1.113883.10.20.22.4.20"/>
186 |                 <code code="409073007"
187 |                   codeSystem="2.16.840.1.113883.6.96"
188 |                   displayName="instruction"/>
189 |                 <text>
190 |                   <reference value="#MedSec_1"/> label in spanish </text>
191 |                 <statusCode code="completed"/>
192 |               </act>
193 |             </entryRelationship>
194 |           </supply>
195 |         </entryRelationship>
196 |         <entryRelationship typeCode="REFR">
197 |           <supply classCode="SPLY" moodCode="EVN">
198 |             <!-- ** Medication dispense ** -->
199 |             <templateId root="2.16.840.1.113883.10.20.22.4.18"/>
200 |             <id root="1.2.3.4.56789.1"
201 |               extension="cb734647-fc99-424c-a864-7e3cda82e704"/>
202 |             <statusCode code="completed"/>
203 |             <effectiveTime value="201208151450-0800"/>
204 |             <repeatNumber value="1"/>
205 |             <quantity value="75"/>
206 |             <product>
207 |               <manufacturedProduct classCode="MANU">
208 |                 <!-- ** Medication information ** -->
209 |                 <templateId root="2.16.840.1.113883.10.20.22.4.23"/>
210 |                 <id root="2a620155-9d11-439e-92b3-5d9815ff4ee8"/>
211 |                 <manufacturedMaterial>
212 |                   <code code="573621"
213 |                     codeSystem="2.16.840.1.113883.6.88"
214 |                     displayName="Proventil 0.09 MG/ACTUAT inhalant solution">
215 |                     <originalText>
216 |                       <reference value="#MedSec_1"/>
217 |                     </originalText>
218 |                   </code>
219 |                 </manufacturedMaterial>
220 |                 <manufacturerOrganization>
221 |                   <name>Medication Factory Inc.</name>
222 |                 </manufacturerOrganization>
223 |               </manufacturedProduct>
224 |             </product>
225 |             <performer>
226 |               <assignedEntity>
227 |                 <id extension="333222222" root="2.16.840.1.113883.4.6"/>
228 |                 <addr>
229 |                   <streetAddressLine>1016 Health
230 |                     Drive</streetAddressLine>
231 |                   <city>Portland</city>
232 |                   <state>OR</state>
233 |                   <postalCode>99123</postalCode>
234 |                   <country>US</country>
235 |                 </addr>
236 |                 <telecom use="WP" value="tel:+1(555)555-1016"/>
237 |                 <assignedPerson>
238 |                   <name>
239 |                     <given>Susan</given>
240 |                     <family>Script</family>
241 |                     <suffix qualifier="AC">Pharm.D.</suffix>
242 |                   </name>
243 |                 </assignedPerson>
244 |                 <representedOrganization>
245 |                   <name>People's Pharmacy</name>
246 |                 </representedOrganization>
247 |               </assignedEntity>
248 |             </performer>
249 |           </supply>
250 |         </entryRelationship>
251 |         <precondition typeCode="PRCN">
252 |           <criterion>
253 |             <!-- ** Precondition for substance administration ** -->
254 |             <templateId root="2.16.840.1.113883.10.20.22.4.25"/>
255 |             <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
256 |             <value xsi:type="CD" code="56018004"
257 |               codeSystem="2.16.840.1.113883.6.96" displayName="Wheezing"/>
258 |           </criterion>
259 |         </precondition>
260 |       </substanceAdministration>
261 |     </entry>
262 |     <entry typeCode="DRIV">
263 |       <substanceAdministration classCode="SBADM" moodCode="EVN">
264 |         <!-- ** Medication activity ** -->
265 |         <templateId root="2.16.840.1.113883.10.20.22.4.16"/>
266 |         <id root="6c844c75-aa34-411c-b7bd-5e4a9f206e29"/>
267 |         <statusCode code="active"/>
268 |         <effectiveTime xsi:type="IVL_TS">
269 |           <low value="20120318"/>
270 |         </effectiveTime>
271 |         <effectiveTime xsi:type="PIVL_TS" institutionSpecified="true"
272 |           operator="A">
273 |           <period value="12" unit="h"/>
274 |         </effectiveTime>
275 |         <routeCode code="C38288" codeSystem="2.16.840.1.113883.3.26.1.1"
276 |           codeSystemName="NCI Thesaurus" displayName="ORAL"/>
277 |         <doseQuantity value="1"/>
278 |         <consumable>
279 |           <manufacturedProduct classCode="MANU">
280 |             <!-- ** Medication information ** -->
281 |             <templateId root="2.16.840.1.113883.10.20.22.4.23"/>
282 |             <id root="2a620155-9d11-439e-92b3-5d9815ff4ee8"/>
283 |             <manufacturedMaterial>
284 |               <code code="197380" displayName="Atenolol 25 MG Oral Tablet"
285 |                 codeSystem="2.16.840.1.113883.6.88"
286 |                 codeSystemName="RxNorm"/>
287 |             </manufacturedMaterial>
288 |           </manufacturedProduct>
289 |         </consumable>
290 |         <entryRelationship typeCode="RSON">
291 |           <observation classCode="OBS" moodCode="EVN">
292 |             <!-- ** Indication ** -->
293 |             <templateId root="2.16.840.1.113883.10.20.22.4.19"/>
294 |             <id root="e63166c7-6482-4a44-83a1-37ccdbde725b"/>
295 |             <code code="404684003" displayName="Finding"
296 |               codeSystem="2.16.840.1.113883.6.96"
297 |               codeSystemName="SNOMED CT"/>
298 |             <statusCode code="completed"/>
299 |             <value xsi:type="CD" code="38341003" displayName="Hypertension"
300 |               codeSystem="2.16.840.1.113883.6.96"/>
301 |           </observation>
302 |         </entryRelationship>
303 |       </substanceAdministration>
304 |     </entry>
305 |   </section>
306 | </component>
307 | 
308 | <!-- *********** Example 2: Patient is not known to be taking any medications *********** -->
309 | <component>
310 |   <section>
311 |     <!-- *** Medications section with entries required *** -->
312 |     <templateId root="2.16.840.1.113883.10.20.22.2.1.1"/>
313 |     <code code="10160-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"
314 |       displayName="HISTORY OF MEDICATION USE"/>
315 |     <title>MEDICATIONS</title>
316 |     <text>
317 |       <paragraph>No known medications</paragraph>
318 |     </text>
319 |     <entry typeCode="DRIV">
320 |       <substanceAdministration classCode="SBADM" moodCode="EVN" negationInd="true">
321 |         <!-- ** Medication activity ** -->
322 |         <templateId root="2.16.840.1.113883.10.20.22.4.16"/>
323 |         <id root="072f00fc-4f9d-4516-8d6f-ed00ed523fe0"/>
324 |         <statusCode code="active"/>
325 |         <effectiveTime xsi:type="IVL_TS">
326 |           <low value="20110103"/>
327 |         </effectiveTime>
328 |         <consumable>
329 |           <manufacturedProduct classCode="MANU">
330 |             <!-- ** Medication information ** -->
331 |             <templateId root="2.16.840.1.113883.10.20.22.4.23"/>
332 |             <manufacturedMaterial>
333 |               <code nullFlavor="OTH" codeSystem="2.16.840.1.113883.6.88">
334 |                 <translation code="410942007" displayName="drug or medication"
335 |                   codeSystem="2.16.840.1.113883.6.96"  codeSystemName="SNOMED CT"/>
336 |               </code>
337 |             </manufacturedMaterial>
338 |           </manufacturedProduct>
339 |         </consumable>
340 |       </substanceAdministration>
341 |     </entry>
342 |   </section>
343 | </component>
344 | 


--------------------------------------------------------------------------------
/cda/allergies_and_adverse_reactions/Domain_Allergies_XMLExamples.xml:
--------------------------------------------------------------------------------
  1 | <?xml version="1.0" encoding="UTF-8"?>
  2 | <!-- Allergies Domain Examples -->
  3 | 
  4 | <!-- *********** Example 1: Patient with allergies to different substances *********** -->
  5 | <component>
  6 |     <section>
  7 |         <!-- Allergies section with entries required -->
  8 |         <templateId root="2.16.840.1.113883.10.20.22.2.6.1"/>
  9 |         <code code="48765-2" codeSystem="2.16.840.1.113883.6.1"/>
 10 |         <title>ALLERGIES AND ADVERSE REACTIONS</title>
 11 |         <text>
 12 |             <table border="1" width="100%">
 13 |                 <thead>
 14 |                     <tr>
 15 |                         <th>Substance</th>
 16 |                         <th>Reaction</th>
 17 |                         <th>Severity of Reaction</th>
 18 |                         <th>Severity of Allergy/Intolerance</th>
 19 |                     </tr>
 20 |                 </thead>
 21 |                 <tbody>
 22 |                     <tr>
 23 |                         <td>
 24 |                             <content ID="substance1">Erythromycin 0.02 MG/MG Topical Gel</content>
 25 |                         </td>
 26 |                         <td>
 27 |                             <content ID="reaction1">Hives</content>
 28 |                         </td>
 29 |                         <td>
 30 |                             <content ID="reactionseverity1">Moderate</content>
 31 |                         </td>
 32 |                         <td>
 33 |                             <content ID="allergyseverity1">Moderate to severe</content>
 34 |                         </td>
 35 |                     </tr>
 36 |                     <tr>
 37 |                         <td>
 38 |                             <content ID="substance2">Bactrim</content>
 39 |                         </td>
 40 |                         <td>
 41 |                             <content ID="reaction2">Tongue swelling</content>
 42 |                         </td>
 43 |                         <td>
 44 |                             <content ID="reactionseverity2">Mild to moderate</content>
 45 |                         </td>
 46 |                         <td>
 47 |                             <content ID="allergyseverity2">Moderate</content>
 48 |                         </td>
 49 |                     </tr>
 50 |                     <tr>
 51 |                         <td>
 52 |                             <content ID="substance3">Peanut</content>
 53 |                         </td>
 54 |                         <td>
 55 |                             <content ID="reaction3">Anaphylaxis</content>
 56 |                         </td>
 57 |                         <td>
 58 |                             <content ID="reactionseverity3">Severe</content>
 59 |                         </td>
 60 |                         <td>
 61 |                             <content ID="allergyseverity3">Severe</content>
 62 |                         </td>
 63 |                     </tr>
 64 |                     <tr>
 65 |                         <td>
 66 |                             <content ID="substance4">Felis Catus Dander</content>
 67 |                         </td>
 68 |                         <td>
 69 |                             <content ID="reaction4">Eye Swelling</content>
 70 |                         </td>
 71 |                         <td>
 72 |                             <content ID="reactionseverity4">Mild</content>
 73 |                         </td>
 74 |                         <td>
 75 |                             <content ID="allergyseverity4">Mild to moderate</content>
 76 |                         </td>
 77 |                     </tr>
 78 |                 </tbody>
 79 |             </table>
 80 |         </text>
 81 |         
 82 |         <!-- Medication allergy: Erythromycin -->
 83 |         <!-- The allergy problem act contains nested clinical statements associated with the allergy/intolerance -->
 84 |         <entry typeCode="DRIV">
 85 |             <!-- Entry typeCode value 'DRIV' indicates that section narrative is derived from the entry -->
 86 |             <act classCode="ACT" moodCode="EVN">
 87 |                 <!-- Allergy problem act template -->
 88 |                 <templateId root="2.16.840.1.113883.10.20.22.4.30"/>
 89 |                 <id root="372e09ea-4047-4d3d-973f-ca8ebd0167cf"/>
 90 |                 <code code="CONC" codeSystem="2.16.840.1.113883.5.6"/>
 91 |                 <!-- The statusCode represents the need to continue tracking the allergy -->
 92 |                 <statusCode code="active"/>
 93 |                 <!-- 'Active' indicates that this is of ongoing concern to the provider -->
 94 |                 <effectiveTime>
 95 |                     <!-- The low value represents when the allergy was first recorded in the patient's chart -->
 96 |                     <low value="199805011145-0800"/>
 97 |                 </effectiveTime>
 98 |                 <!-- This author participant indicates the provider who recorded the allergy -->
 99 |                 <author>
100 |                     <!-- Same as when the allergy was first recorded in the patient's chart -->
101 |                     <time value="199805011145-0800"/>
102 |                     <assignedAuthor>
103 |                         <id extension="66778899" root="2.16.840.1.113883.4.6"/>
104 |                         <!-- This ID points back to a provider described in the header -->
105 |                     </assignedAuthor>
106 |                 </author>
107 |                 
108 |                 <!-- The entryRelationship typeCode describes the relationship between the allergy act and 
109 |                     the nested allergy/intolerance observation -->
110 |                 <entryRelationship typeCode="SUBJ" inversionInd="true">
111 |                     <!-- 'SUBJ' indicates that the allergy act is the outer element and the 
112 |                         allergy/intolerance observation is the inner element -->
113 |                     <observation classCode="OBS" moodCode="EVN">
114 |                         <!-- Allergy/intolerance observation template -->
115 |                         <templateId root="2.16.840.1.113883.10.20.22.4.7"/>
116 |                         <id root="116ab756-4b6a-4ff0-8898-efb5e886f507"/>
117 |                         <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
118 |                         <!-- 'ASSERTION' indicates that the observation code is a finding or other nominalized statement -->
119 |                         <!-- The text reference points back to the narrative -->
120 |                         <text>
121 |                             <reference value="#substance1"/>
122 |                         </text>
123 |                         <!-- Observation statusCode represents the status of the observation itself -->
124 |                         <statusCode code="completed"/>
125 |                         <effectiveTime>
126 |                             <!-- The low value reflects the date of onset of the allergy -->
127 |                             <low value="19951201"/>
128 |                             <!-- Absence of effectiveTime/high means the allergy/intolerance is not resolved -->
129 |                         </effectiveTime>
130 |                         <value xsi:type="CD" code="416098002" displayName="Drug allergy"
131 |                             codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
132 |                         <!-- This participant is used to describe the substance responsible for the allergy/intolerance -->
133 |                         <participant typeCode="CSM">
134 |                             <!-- 'CSM' indicates that the substance is consumable; this will be the value for all substances -->
135 |                             <participantRole classCode="MANU">
136 |                                 <playingEntity classCode="MMAT">
137 |                                     <!-- Common MU Data Set: medication allergies; 
138 |                                         vocab requirement: RxNorm, August 6, 2012 Release -->
139 |                                     <code code="310152" displayName="Erythromycin 0.02 MG/MG Topical Gel"
140 |                                         codeSystem="2.16.840.1.113883.6.88"
141 |                                         codeSystemName="RxNorm">
142 |                                         <!-- The translation contains an alternate code for substance -->
143 |                                         <translation code="63937KV33D" displayName="Erythromycin" 
144 |                                             codeSystemName="UNII" codeSystem="2.16.840.1.113883.4.9"/>
145 |                                     </code>
146 |                                 </playingEntity>
147 |                             </participantRole>
148 |                         </participant>
149 |                         
150 |                         <entryRelationship typeCode="MFST" inversionInd="true">
151 |                             <!-- 'MFST' indicates that this reaction is a manifestation of 
152 |                                 exposure to the substance-->
153 |                             <observation classCode="OBS" moodCode="EVN">
154 |                                 <!-- Reaction observation template -->
155 |                                 <templateId root="2.16.840.1.113883.10.20.22.4.9"/>
156 |                                 <id root="0d93556b-ad77-4e88-ae62-f50d43560c52"/>
157 |                                 <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
158 |                                 <text>
159 |                                     <reference value="#reaction1"/>
160 |                                 </text>
161 |                                 <statusCode code="completed"/>
162 |                                 <effectiveTime>
163 |                                     <low value="199512011205-0800"/>
164 |                                     <high value="199512020835-0800"/>
165 |                                 </effectiveTime>
166 |                                 <value xsi:type="CD" code="126485001"
167 |                                     codeSystem="2.16.840.1.113883.6.96" displayName="Urticaria"/>
168 |                                 
169 |                                 <!-- This severity observation describes the severity of the reaction -->
170 |                                 <entryRelationship typeCode="SUBJ" inversionInd="true">
171 |                                     <observation classCode="OBS" moodCode="EVN">
172 |                                         <!-- Severity observation template -->
173 |                                         <templateId
174 |                                             root="2.16.840.1.113883.10.20.22.4.8"/>
175 |                                         <code code="SEV" displayName="Severity Observation"
176 |                                             codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
177 |                                         <text>
178 |                                             <reference value="#reactionseverity1"/>
179 |                                         </text>
180 |                                         <statusCode code="completed"/>
181 |                                         <value xsi:type="CD" code="6736007" displayName="Moderate"
182 |                                             codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
183 |                                     </observation>
184 |                                 </entryRelationship>
185 |                             </observation>
186 |                         </entryRelationship>
187 |                         
188 |                         <!-- This severity observation describes the severity of the allergy/intolerance -->
189 |                         <entryRelationship typeCode="SUBJ" inversionInd="true">
190 |                             <observation classCode="OBS" moodCode="EVN">
191 |                                 <!-- Severity observation template -->
192 |                                 <templateId root="2.16.840.1.113883.10.20.22.4.8"/>
193 |                                 <code code="SEV" displayName="Severity Observation"
194 |                                     codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
195 |                                 <text>
196 |                                     <reference value="#allergyseverity1"/>
197 |                                 </text>
198 |                                 <statusCode code="completed"/>
199 |                                 <value xsi:type="CD" code="371924009" displayName="Moderate to severe"
200 |                                     codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
201 |                             </observation>
202 |                         </entryRelationship>
203 |                     </observation>
204 |                 </entryRelationship>
205 |             </act>
206 |         </entry>
207 |         
208 |         <!-- Medication allergy: Bactrim -->
209 |         <!-- The allergy problem act contains nested clinical statements associated with the allergy/intolerance -->
210 |         <entry typeCode="DRIV">
211 |             <!-- Entry typeCode value 'DRIV' indicates that section narrative is derived from the entry -->
212 |             <act classCode="ACT" moodCode="EVN">
213 |                 <!-- Allergy problem act template -->
214 |                 <templateId root="2.16.840.1.113883.10.20.22.4.30"/>
215 |                 <id root="4ffd3420-0f60-425c-aaca-6255c8d8c890"/>
216 |                 <code code="CONC" codeSystem="2.16.840.1.113883.5.6"/>
217 |                 <!-- The statusCode represents the need to continue tracking the allergy -->
218 |                 <statusCode code="active"/>
219 |                 <!-- 'Active' indicates that this is of ongoing concern to the provider -->
220 |                 <effectiveTime>
221 |                     <!-- The low value represents when the allergy was first recorded in the patient's chart -->
222 |                     <low value="200808010915-0800"/>
223 |                 </effectiveTime>
224 |                 <!-- This author participant indicates the provider who recorded the allergy -->
225 |                 <author>
226 |                     <!-- Same as when the allergy was first recorded in the patient's chart -->
227 |                     <time value="200808010915-0800"/>
228 |                     <assignedAuthor>
229 |                         <id extension="22334455" root="2.16.840.1.113883.4.6"/>
230 |                         <!-- This ID points back to a provider described in the header -->
231 |                     </assignedAuthor>
232 |                 </author>
233 |                 
234 |                 <!-- The entryRelationship typeCode describes the relationship between the allergy act and 
235 |                     the nested allergy/intolerance observation -->
236 |                 <entryRelationship typeCode="SUBJ" inversionInd="true">
237 |                     <!-- 'SUBJ' indicates that the allergy act is the outer element and the 
238 |                         allergy/intolerance observation is the inner element -->
239 |                     <observation classCode="OBS" moodCode="EVN">
240 |                         <!-- Allergy/intolerance observation template -->
241 |                         <templateId root="2.16.840.1.113883.10.20.22.4.7"/>
242 |                         <id root="7db863de-8f1b-4684-8a6d-d96add4322b0"/>
243 |                         <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
244 |                         <!-- 'ASSERTION' indicates that the observation code is a finding or other nominalized statement -->
245 |                         <!-- The text reference points back to the narrative -->
246 |                         <text>
247 |                             <reference value="#substance2"/>
248 |                         </text>
249 |                         <!-- Observation statusCode represents the status of the observation itself -->
250 |                         <statusCode code="completed"/>
251 |                         <effectiveTime>
252 |                             <!-- The low value reflects the date of onset of the allergy -->
253 |                             <low value="1992"/>
254 |                             <!-- Patient has estimated the year when the allergy was known to be active -->
255 |                         </effectiveTime>
256 |                         <value xsi:type="CD" code="416098002" displayName="Drug allergy"
257 |                             codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
258 |                         <!-- This participant is used to describe the substance responsible for the allergy/intolerance -->
259 |                         <participant typeCode="CSM">
260 |                             <!-- 'CSM' indicates that the substance is consumable; this will be the value for all substances -->
261 |                             <participantRole classCode="MANU">
262 |                                 <playingEntity classCode="MMAT">
263 |                                     <!-- Common MU Data Set: medication allergies; 
264 |                                         vocab requirement: RxNorm, August 6, 2012 Release -->
265 |                                     <code code="151399" displayName="Bactrim"
266 |                                         codeSystem="2.16.840.1.113883.6.88"
267 |                                         codeSystemName="RxNorm">
268 |                                     </code>
269 |                                 </playingEntity>
270 |                             </participantRole>
271 |                         </participant>
272 |                         
273 |                         <entryRelationship typeCode="MFST" inversionInd="true">
274 |                             <!-- 'MFST' indicates that this reaction is a manifestation of 
275 |                                 exposure to the substance-->
276 |                             <observation classCode="OBS" moodCode="EVN">
277 |                                 <!-- Reaction observation template -->
278 |                                 <templateId root="2.16.840.1.113883.10.20.22.4.9"/>
279 |                                 <id root="b6a9f22d-aec3-42e2-ad76-f72b5e005e13"/>
280 |                                 <code code="ASSERTION"
281 |                                     codeSystem="2.16.840.1.113883.5.4"/>
282 |                                 <text>
283 |                                     <reference value="#reaction2"/>
284 |                                 </text>
285 |                                 <statusCode code="completed"/>
286 |                                 <effectiveTime>
287 |                                     <low value="19921001"/>
288 |                                     <high value="19921001"/>
289 |                                 </effectiveTime>
290 |                                 <value xsi:type="CD" code="421262002"
291 |                                     codeSystem="2.16.840.1.113883.6.96" displayName="Tongue swelling"/>
292 |                                 
293 |                                 <!-- This severity observation describes the severity of the reaction -->
294 |                                 <entryRelationship typeCode="SUBJ" inversionInd="true">
295 |                                     <observation classCode="OBS" moodCode="EVN">
296 |                                         <!-- Severity observation template -->
297 |                                         <templateId
298 |                                             root="2.16.840.1.113883.10.20.22.4.8"/>
299 |                                         <code code="SEV" displayName="Severity Observation"
300 |                                             codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
301 |                                         <text>
302 |                                             <reference value="#reactionseverity2"/>
303 |                                         </text>
304 |                                         <statusCode code="completed"/>
305 |                                         <value xsi:type="CD" code="371923003" displayName="Mild to moderate"
306 |                                             codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
307 |                                     </observation>
308 |                                 </entryRelationship>
309 |                             </observation>
310 |                         </entryRelationship>
311 |                         
312 |                         <!-- This severity observation describes the severity of the allergy/intolerance -->
313 |                         <entryRelationship typeCode="SUBJ" inversionInd="true">
314 |                             <observation classCode="OBS" moodCode="EVN">
315 |                                 <!-- Severity observation template -->
316 |                                 <templateId root="2.16.840.1.113883.10.20.22.4.8"/>
317 |                                 <code code="SEV" displayName="Severity Observation"
318 |                                     codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
319 |                                 <text>
320 |                                     <reference value="#allergyseverity2"/>
321 |                                 </text>
322 |                                 <statusCode code="completed"/>
323 |                                 <value xsi:type="CD" code="6736007" displayName="Moderate"
324 |                                     codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
325 |                             </observation>
326 |                         </entryRelationship>
327 |                     </observation>
328 |                 </entryRelationship>
329 |             </act>
330 |         </entry>
331 |         
332 |         <!-- Food allergy: peanuts -->
333 |         <!-- The allergy problem act contains nested clinical statements associated with the allergy/intolerance -->
334 |         <entry typeCode="DRIV">
335 |             <!-- Entry typeCode value 'DRIV' indicates that section narrative is derived from the entry -->
336 |             <act classCode="ACT" moodCode="EVN">
337 |                 <!-- Allergy problem act template -->
338 |                 <templateId root="2.16.840.1.113883.10.20.22.4.30"/>
339 |                 <id root="d75db1d8-f9ff-424f-88ee-35d6ffd43323"/>
340 |                 <code code="CONC" codeSystem="2.16.840.1.113883.5.6"/>
341 |                 <!-- The statusCode represents the need to continue tracking the allergy -->
342 |                 <statusCode code="active"/>
343 |                 <!-- 'Active' indicates that this is of ongoing concern to the provider -->
344 |                 <effectiveTime>
345 |                     <!-- The low value represents when the allergy was first recorded in the patient's chart -->
346 |                     <low value="199805011145-0800"/>
347 |                 </effectiveTime>
348 |                 <!-- This author participant indicates the provider who recorded the allergy -->
349 |                 <author>
350 |                     <!-- Same as when the allergy was first recorded in the patient's chart -->
351 |                     <time value="199805011145-0800"/>
352 |                     <assignedAuthor>
353 |                         <id extension="66778899" root="2.16.840.1.113883.4.6"/>
354 |                         <!-- This ID points back to a provider described in the header -->
355 |                     </assignedAuthor>
356 |                 </author>
357 |                 
358 |                 <!-- The entryRelationship typeCode describes the relationship between the allergy act and 
359 |                     the nested allergy/intolerance observation -->
360 |                 <entryRelationship typeCode="SUBJ" inversionInd="true">
361 |                     <!-- 'SUBJ' indicates that the allergy act is the outer element and the 
362 |                         allergy/intolerance observation is the inner element -->
363 |                     <observation classCode="OBS" moodCode="EVN">
364 |                         <!-- Allergy/intolerance observation template -->
365 |                         <templateId root="2.16.840.1.113883.10.20.22.4.7"/>
366 |                         <id root="e70b70c6-48d2-47af-8138-9470ed249bab"/>
367 |                         <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
368 |                         <!-- 'ASSERTION' indicates that the observation code is a finding or other nominalized statement -->
369 |                         <!-- The text reference points back to the narrative -->
370 |                         <text>
371 |                             <reference value="#substance3"/>
372 |                         </text>
373 |                         <!-- Observation statusCode represents the status of the observation itself -->
374 |                         <statusCode code="completed"/>
375 |                         <effectiveTime>
376 |                             <!-- The low value reflects the date of onset of the allergy -->
377 |                             <low value="1988"/>
378 |                             <!-- Patient has estimated the year when the allergy was known to be active -->
379 |                         </effectiveTime>
380 |                         <value xsi:type="CD" code="414285001" displayName="Food allergy"
381 |                             codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
382 |                         <!-- This author participant indicates the provider who observed the allergy/intolerance -->
383 |                         <author>
384 |                             <time value="199805011145-0800"/>
385 |                             <assignedAuthor>
386 |                                 <id extension="66778899" root="2.16.840.1.113883.4.6"/>
387 |                                 <!-- This ID points back to a provider described in the header -->
388 |                             </assignedAuthor>
389 |                         </author>
390 |                         <!-- This participant is used to describe the substance responsible for the allergy/intolerance -->
391 |                         <participant typeCode="CSM">
392 |                             <!-- 'CSM' indicates that the substance is consumable; this will be the value for all substances -->
393 |                             <participantRole classCode="MANU">
394 |                                 <playingEntity classCode="MMAT">
395 |                                     <code code="QE1QX61B99R" displayName="PEANUT"
396 |                                         codeSystemName="UNII" codeSystem="2.16.840.1.113883.4.9">
397 |                                     </code>
398 |                                 </playingEntity>
399 |                             </participantRole>
400 |                         </participant>
401 |                         
402 |                         <entryRelationship typeCode="MFST" inversionInd="true">
403 |                             <!-- 'MFST' indicates that this reaction is a manifestation of 
404 |                                 exposure to the substance-->
405 |                             <observation classCode="OBS" moodCode="EVN">
406 |                                 <!-- Reaction observation template -->
407 |                                 <templateId root="2.16.840.1.113883.10.20.22.4.9"/>
408 |                                 <id root="8927c5d5-1b20-4ea2-9538-55045e4998a4"/>
409 |                                 <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
410 |                                 <text>
411 |                                     <reference value="#reaction3"/>
412 |                                 </text>
413 |                                 <statusCode code="completed"/>
414 |                                 <effectiveTime nullFlavor="UNK"/>
415 |                                 <!-- 'UNK' indicates that when the time when the reaction occurred is unknown -->
416 |                                 <value xsi:type="CD" code="39579001"
417 |                                     codeSystem="2.16.840.1.113883.6.96" displayName="Anaphylaxis"/>
418 |                                 
419 |                                 <!-- This severity observation describes the severity of the reaction -->
420 |                                 <entryRelationship typeCode="SUBJ" inversionInd="true">
421 |                                     <observation classCode="OBS" moodCode="EVN">
422 |                                         <!-- Severity observation template -->
423 |                                         <templateId
424 |                                             root="2.16.840.1.113883.10.20.22.4.8"/>
425 |                                         <code code="SEV" displayName="Severity Observation"
426 |                                             codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
427 |                                         <text>
428 |                                             <reference value="#reactionseverity3"/>
429 |                                         </text>
430 |                                         <statusCode code="completed"/>
431 |                                         <value xsi:type="CD" code="24484000" displayName="Severe"
432 |                                             codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
433 |                                     </observation>
434 |                                 </entryRelationship>
435 |                             </observation>
436 |                         </entryRelationship>
437 |                         
438 |                         <!-- This severity observation describes the severity of the allergy/intolerance -->
439 |                         <entryRelationship typeCode="SUBJ" inversionInd="true">
440 |                             <observation classCode="OBS" moodCode="EVN">
441 |                                 <!-- Severity observation template -->
442 |                                 <templateId root="2.16.840.1.113883.10.20.22.4.8"/>
443 |                                 <code code="SEV" displayName="Severity Observation"
444 |                                     codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
445 |                                 <text>
446 |                                     <reference value="#allergyseverity3"/>
447 |                                 </text>
448 |                                 <statusCode code="completed"/>
449 |                                 <value xsi:type="CD" code="24484000" displayName="Severe"
450 |                                     codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
451 |                             </observation>
452 |                         </entryRelationship>
453 |                     </observation>
454 |                 </entryRelationship>
455 |             </act>
456 |         </entry>
457 |         
458 |         <!-- Animal allergy: cat dander -->
459 |         <!-- The allergy problem act contains nested clinical statements associated with the allergy/intolerance -->
460 |         <entry typeCode="DRIV">
461 |             <!-- Entry typeCode value 'DRIV' indicates that section narrative is derived from the entry -->
462 |             <act classCode="ACT" moodCode="EVN">
463 |                 <!-- Allergy problem act template -->
464 |                 <templateId root="2.16.840.1.113883.10.20.22.4.30"/>
465 |                 <id root="dd8f01c9-fb0d-4744-aeda-75e7f208dca7"/>
466 |                 <code code="CONC" codeSystem="2.16.840.1.113883.5.6"/>
467 |                 <!-- The statusCode represents the need to continue tracking the allergy -->
468 |                 <statusCode code="active"/>
469 |                 <!-- 'Active' indicates that this is of ongoing concern to the provider -->
470 |                 <effectiveTime>
471 |                     <!-- The low value represents when the allergy was first recorded in the patient's chart -->
472 |                     <low value="199805011145-0800"/>
473 |                 </effectiveTime>
474 |                 <!-- This author participant indicates the provider who recorded the allergy -->
475 |                 <author>
476 |                     <!-- Same as when the allergy was first recorded in the patient's chart -->
477 |                     <time value="199805011145-0800"/>
478 |                     <assignedAuthor>
479 |                         <id extension="66778899" root="2.16.840.1.113883.4.6"/>
480 |                         <!-- This ID points back to a provider described in the header -->
481 |                     </assignedAuthor>
482 |                 </author>
483 |                 
484 |                 <!-- The entryRelationship typeCode describes the relationship between the allergy act and 
485 |                     the nested allergy/intolerance observation -->
486 |                 <entryRelationship typeCode="SUBJ" inversionInd="true">
487 |                     <!-- 'SUBJ' indicates that the allergy act is the outer element and the 
488 |                         allergy/intolerance observation is the inner element -->
489 |                     <observation classCode="OBS" moodCode="EVN">
490 |                         <!-- Allergy/intolerance observation template -->
491 |                         <templateId root="2.16.840.1.113883.10.20.22.4.7"/>
492 |                         <id root="ed0ecdda-9e76-4d2b-b5df-8339b37af255"/>
493 |                         <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
494 |                         <!-- 'ASSERTION' indicates that the observation code is a finding or other nominalized statement -->
495 |                         <!-- The text reference points back to the narrative -->
496 |                         <text>
497 |                             <reference value="#substance4"/>
498 |                         </text>
499 |                         <!-- Observation statusCode represents the status of the observation itself -->
500 |                         <statusCode code="completed"/>
501 |                         <effectiveTime>
502 |                             <!-- The low value reflects the date of onset of the allergy -->
503 |                             <low value="1988"/>
504 |                             <!-- Patient has estimated the year when the allergy was known to be active -->
505 |                         </effectiveTime>
506 |                         <value xsi:type="CD" code="419199007" displayName="Allergy to substance"
507 |                             codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
508 |                         <!-- This participant is used to describe the substance responsible for the allergy/intolerance -->
509 |                         <participant typeCode="CSM">
510 |                             <!-- 'CSM' indicates that the substance is consumable; this will be the value for all substances -->
511 |                             <participantRole classCode="MANU">
512 |                                 <playingEntity classCode="MMAT">
513 |                                     <code code="ZDNZAC0L08" displayName="Felis catus dander"
514 |                                         codeSystemName="UNII" codeSystem="2.16.840.1.113883.4.9">
515 |                                     </code>
516 |                                 </playingEntity>
517 |                             </participantRole>
518 |                         </participant>
519 |                         
520 |                         <entryRelationship typeCode="MFST" inversionInd="true">
521 |                             <!-- 'MFST' indicates that this reaction is a manifestation of 
522 |                                 exposure to the substance-->
523 |                             <observation classCode="OBS" moodCode="EVN">
524 |                                 <!-- Reaction observation template -->
525 |                                 <templateId root="2.16.840.1.113883.10.20.22.4.9"/>
526 |                                 <id root="5e92ec19-0cb6-4efc-b323-337861a9a10b"/>
527 |                                 <code code="ASSERTION"
528 |                                     codeSystem="2.16.840.1.113883.5.4"/>
529 |                                 <text>
530 |                                     <reference value="#reaction4"/>
531 |                                 </text>
532 |                                 <statusCode code="completed"/>
533 |                                 <!-- A reaction to cat dander was observed for 3 days in January 2009 -->
534 |                                 <effectiveTime>
535 |                                     <low value="20090116"/>
536 |                                     <high value="2009019"/>
537 |                                 </effectiveTime>
538 |                                 <value xsi:type="CD" code="45177002"
539 |                                     codeSystem="2.16.840.1.113883.6.96" displayName="Eye swelling"/>
540 |                                 
541 |                                 <!-- This severity observation describes the severity of the reaction -->
542 |                                 <entryRelationship typeCode="SUBJ" inversionInd="true">
543 |                                     <observation classCode="OBS" moodCode="EVN">
544 |                                         <!-- Severity observation template -->
545 |                                         <templateId
546 |                                             root="2.16.840.1.113883.10.20.22.4.8"/>
547 |                                         <code code="SEV" displayName="Severity Observation"
548 |                                             codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
549 |                                         <text>
550 |                                             <reference value="#reactionseverity4"/>
551 |                                         </text>
552 |                                         <statusCode code="completed"/>
553 |                                         <value xsi:type="CD" code="255604002" displayName="Mild"
554 |                                             codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
555 |                                     </observation>
556 |                                 </entryRelationship>
557 |                             </observation>
558 |                         </entryRelationship>
559 |                         
560 |                         <!-- This severity observation describes the severity of the allergy/intolerance -->
561 |                         <entryRelationship typeCode="SUBJ" inversionInd="true">
562 |                             <observation classCode="OBS" moodCode="EVN">
563 |                                 <!-- Severity observation template -->
564 |                                 <templateId root="2.16.840.1.113883.10.20.22.4.8"/>
565 |                                 <code code="SEV" displayName="Severity Observation"
566 |                                     codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>
567 |                                 <text>
568 |                                     <reference value="#allergyseverity4"/>
569 |                                 </text>
570 |                                 <statusCode code="completed"/>
571 |                                 <value xsi:type="CD" code="371923003" displayName="Mild to moderate"
572 |                                     codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
573 |                             </observation>
574 |                         </entryRelationship>
575 |                     </observation>
576 |                 </entryRelationship>
577 |             </act>
578 |         </entry>
579 |     </section>
580 | </component>


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