Difference between revisions of "2.16.840.1.113883.10.22.3.2/static-2016-11-11T000000"

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Revision as of 10:53, 2 July 2018

Id2.16.840.1.113883.10.22.3.2Effective Date2016‑11‑11
StatusKyellow.png DraftVersion Label
NameIPSSectionAllergiesOrIntolerancesDisplay NameIPS Allergies and Intolerances Section
Description
This section documents the relevant allergies or intolerances (conditions) for that patient, describing the kind of reaction (e.g. rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. 
At a minimum, it should list currently active and any relevant historical allergies and adverse reactions.
If no information about allergies is available, or if no allergies are known this should be clearly documented in the section.

The optional author and informant elements are used when necessary to convey the provenance and authoring of the section content in case it is different from what is announced in the CDA header.
ContextParent nodes of template element with id 2.16.840.1.113883.10.22.3.2
ClassificationCDA Section Level Template
Open/ClosedOpen (other than defined elements are allowed)
Used by / Uses
Used by 0 transactions and 1 template, Uses 4 templates
Used by as NameVersion
2.16.840.1.113883.10.22.1.1ContainmentKyellow.png International Patient Summary2017‑04‑11
Uses as NameVersion
2.16.840.1.113883.10.22.4.14ContainmentKyellow.png IPS Body AuthorDYNAMIC
2.16.840.1.113883.10.12.319ContainmentKgreen.png CDA Informant (Body)DYNAMIC
2.16.840.1.113883.10.22.4.5ContainmentKyellow.png IPS Allergy and Intolerance ConcernDYNAMIC
2.16.840.1.113883.10.22.3.15ContainmentKyellow.png IPS Translation SectionDYNAMIC
RelationshipAdaptation: template 2.16.840.1.113883.10.12.201 (2005‑09‑07)
Adaptation: template 2.16.840.1.113883.10.20.1.2 (DYNAMIC)
Example
Example
<section classCode="DOCSECT">
  <templateId root="2.16.840.1.113883.10.22.3.2"/>  <id root="1.2.3.999" extension="__example only__"/>  <code code="48765-2" codeSystem="2.16.840.1.113883.6.1" displayName="Allergies and adverse reactions"/>  <title>Allergies and Intolerances</title>  <text>
    <!-- Textual description of the Allergies and Intolerances -->
  </text>
  <author>
    <!-- template 2.16.840.1.113883.10.22.4.14 'IPS Body Author' (dynamic) -->
  </author>
  <informant>
    <!-- template 2.16.840.1.113883.10.12.319 'CDA Informant (Body)' (dynamic) -->
  </informant>
  <entry typeCode="COMP" contextConductionInd="true">
    <!-- template 2.16.840.1.113883.10.22.4.5 'IPS Allergy and Intolerance Concern' (dynamic) -->
  </entry>
  <component>
    <!-- template 2.16.840.1.113883.10.22.3.15 'IPS Translation Section' (dynamic) -->
  </component>
</section>
Example
No information available
<cda:section>
  <cda:templateId root="2.16.840.1.113883.10.22.3.2"/>  <cda:id root="1.2.3.999" extension="--example only--"/>  <cda:code code="48765-2" codeSystem="2.16.840.1.113883.6.1" displayName="Allergies and adverse reactions"/>  <cda:title>Allergies and Intolerances</cda:title>  <cda:text>
    <!-- Textual description of the Allergies and Intolerances -->
  </cda:text>
  <cda:entry>
    <cda:act classCode="ACT" moodCode="EVN">
      <cda:templateId root="2.16.840.1.113883.10.22.4.5"/>      <cda:id root="1.2.3.999" extension="__example only__"/>      <cda:code code="CONC" codeSystem="2.16.840.1.113883.5.6"/>      <cda:statusCode code="active"/>      <cda:effectiveTime>
        <cda:low nullFlavor="NA"/>      </cda:effectiveTime>
      <cda:entryRelationship typeCode="SUBJ" inversionInd="false">
        <cda:observation classCode="OBS" moodCode="EVN">
          <cda:templateId root="2.16.840.1.113883.10.22.4.1"/>          <cda:code code="OINT" displayName="Allergy or Intolerance" codeSystem="2.16.840.1.113883.5.4"/>          <cda:statusCode code="completed"/>          <cda:effectiveTime>
            <cda:low nullFlavor="NA"/>          </cda:effectiveTime>
          <cda:value code="no-allergy-info" displayName="No information about allergies" codeSystem="2.16.840.1.113883.5.1150.1"/>        </cda:observation>
      </cda:entryRelationship>
    </cda:act>
  </cda:entry>
</cda:section>
ItemDTCardConfDescriptionLabel
hl7:section
1 … 1R(IPS...ces)
Treetree.png@classCode
cs0 … 1FDOCSECT
Treetree.pnghl7:templateId
II1 … 1M(IPS...ces)
Treeblank.pngTreetree.png@root
uid1 … 1F2.16.840.1.113883.10.22.3.2
Treetree.pnghl7:id
II0 … *R(IPS...ces)
Treetree.pnghl7:code
CE.IPS1 … 1M(IPS...ces)
Treeblank.pngTreetree.png@code
CONF1 … 1F48765-2
Treeblank.pngTreetree.png@codeSystem
1 … 1F2.16.840.1.113883.6.1 (Logical Observation Identifier Names and Codes)
Treetree.pnghl7:title
ST1 … 1M(IPS...ces)
Treetree.pnghl7:text
SD.TEXT1 … 1MSection text(IPS...ces)
Treetree.pnghl7:author
0 … *Contains 2.16.840.1.113883.10.22.4.14 IPS Body Author (DYNAMIC)(IPS...ces)
Treeblank.png where [hl7:assignedAuthor]
Treetree.pnghl7:informant
0 … *Contains 2.16.840.1.113883.10.12.319 CDA Informant (Body) (DYNAMIC)(IPS...ces)
Treetree.pnghl7:entry
1 … *MContains 2.16.840.1.113883.10.22.4.5 IPS Allergy and Intolerance Concern (DYNAMIC)(IPS...ces)
Treeblank.png where [hl7:act [hl7:code [(@code = 'CONC' and @codeSystem = '2.16.840.1.113883.5.6')]]]
Treeblank.pngTreetree.png@typeCode
cs1 … 1R
 CONF
The value of @typeCode shall be drawn from value set 2.16.840.1.113883.1.11.19446 x_ActRelationshipEntry (DYNAMIC)
Treeblank.pngTreetree.png@context​Conduction​Ind
bl0 … 1Ftrue
Treetree.pnghl7:component
0 … *Contains 2.16.840.1.113883.10.22.3.15 IPS Translation Section (DYNAMIC)(IPS...ces)
Treeblank.png where [hl7:section]