| CCD | CONF-101 | reviewed | Testable |
0
|
0
| | An advance directive reference (templateId 2.16.840.1.113883.10.20.1.36) SHALL be
represented with Observation / reference / ExternalDocument | 26 | Section 3.2.2.3 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-107 | reviewed | Testable |
0
|
0
| | Where the value of Observation / reference / seperatableInd is “false”, the
referenced advance directive document SHOULD be included in the CCD exchange package.
The exchange mechanism SHOULD be based on Internet standard RFC 2557 “MIME Encapsulation
of Aggregate Documents, such as HTML (MHTML)” (http://www.ietf.org/rfc/rfc2557.txt).
(See CDA Release 2, section 3 “CDA Document Exchange in HL7 Messages” for examples and
additional details) | 26 | Section 3.2.2.3 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-114 | reviewed | Testable |
0
|
0
| | The value for “ClinicalDocument / participant / associatedEntity / code” in a
next of kin participant SHOULD be selected from ValueSet 2.16.840.1.113883.1.11.19579
FamilyHistoryRelatedSubjectCode DYNAMIC or 2.16.840.1.113883.1.11.20.21
FamilyHistoryPersonCode DYNAMIC | 27 | Section 3.3 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-130 | reviewed | Testable |
0
|
0
| | If the functional status was collected using a standardized assessment
instrument, then the instrument itself SHOULD be represented in the “Organizer / code”
of a result organizer, with a value selected from LOINC (codeSystem
2.16.840.1.113883.6.1) or SNOMED CT (codeSystem 2.16.840.1.113883.6.96) | 29 | Section 3.4.2 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-131 | reviewed | Testable |
0
|
0
| | If the functional status was collected using a standardized assessment
instrument, then the question within that instrument SHOULD be represented in the
“Observation / code” of a result observation, with a value selected from LOINC
(codeSystem 2.16.840.1.113883.6.1) or SNOMED CT (codeSystem
2.16.840.1.113883.6.96) | 29 | Section 3.4.2 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-132 | reviewed | Testable |
0
|
0
| | If the functional status was collected using a standardized assessment instrument
containing questions with enumerated values as answers, then the answer SHOULD be
represented in the “Observation / value” of a result observation | 29 | Section 3.4.2 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-134 | reviewed | Testable |
0
|
0
| | Observation / value in a result observation in the functional status section MAY
be of datatype CE or CD and MAY contain one or more Observation / value / translation,
to represent equivalent values from other code systems | 29 | Section 3.4.2 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-135 | reviewed | Testable |
0
|
0
| | A problem observation or result observation in the functional status section MAY
use codes from the International Classification of Functioning, Disability, and Health
(ICF, http://www.who.int/classifications/icf/en/) (codeSystem
2.16.840.1.113883.6.254) | 29 | Section 3.4.2 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-145 | reviewed | Testable |
0
|
0
| | A problem act (templateId 2.16.840.1.113883.10.20.1.27) SHALL be represented with
Act | 31 | Section 3.5.2.1.1 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-152 | reviewed | Testable |
0
|
0
| | A problem act MAY reference a problem observation, alert observation (see section
3.8 Alerts) or other clinical statement that is the subject of concern, by setting the
value for “Act / entryRelationship / @typeCode” to be “SUBJ” 2.16.840.1.113883.5.1002
ActRelationshipType STATIC | 31 | Section 3.5.2.1.1 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-154 | reviewed | Testable |
0
|
0
| | A problem observation (templateId 2.16.840.1.113883.10.20.1.28) SHALL be
represented with Observation | 31 | Section 3.5.2.1.2 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-159 | reviewed | Testable |
0
|
0
| | The value for “Observation / code” in a problem observation MAY be selected from
ValueSet 2.16.840.1.113883.1.11.20.14 ProblemTypeCode STATIC 20061017 | 32 | Section 3.5.2.1.2 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-160 | reviewed | Testable |
0
|
0
| | The value for “Observation / entryRelationship / @typeCode” in a problem
observation MAY be “SUBJ” “Subject” 2.16.840.1.113883.5.1002 ActRelationshipType STATIC
to reference an age observation (templateId 2.16.840.1.113883.10.20.1.38) | 32 | Section 3.5.2.1.2 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-161 | reviewed | Testable |
0
|
0
| | A problem observation SHALL contain one or more sources of information, as
defined in section 5.2 Source | 32 | Section 3.5.2.1.2 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-162 | reviewed | Testable |
0
|
0
| | A problem observation MAY contain exactly one problem status
observation | 32 | Section 3.5.2.2 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-165 | reviewed | Testable |
0
|
0
| | A problem observation MAY contain exactly one problem healthstatus
observation | 32 | Section 3.5.2.2 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-168 | reviewed | Testable |
0
|
0
| | A problem act MAY contain exactly one episode observation | 33 | Section 3.5.2.3 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-169 | reviewed | Testable |
0
|
0
| | An episode observation (templateId 2.16.840.1.113883.10.20.1.41) SHALL be
represented with Observation | 33 | Section 3.5.2.3 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-177 | reviewed | Testable |
0
|
0
| | An episode observation MAY be the source of one or more entryRelationship whose
value for “entryRelationship / @typeCode” is “SAS” “Starts after start”
2.16.840.1.113883.5.1002 ActRelationshipType STATIC. The target of the entryRelationship
SHALL be a problem act or social history observation. This is used to represent the
temporal sequence of episodes | 33 | Section 3.5.2.3 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|
| CCD | CONF-178 | reviewed | Testable |
0
|
0
| | Patient awareness (templateId 2.16.840.1.113883.10.20.1.48) of a problem,
observation, or other clinical statement SHALL be represented with
participant | 33 | Section 3.5.2.4 | 2/24/15 5:36:05 PM by Jean-François Labbe |
|