blob: c346bcb4eece161e3b205daf22bd7dc9c7c5155d [file] [log] [blame]
<?xml version="1.0"?>
<?xml-stylesheet type="text/xsl" href="CDA.xsl"?>
<!--
Title: US_Realm_Header_Template
Revision History:
01/31/2011 bam created
07/29/2011 RWM modified
11/26/2011 RWM modified
08/12/2012 RWM modified
09/12/2012 BNR(Dragon) modified
03/27/2013 DRB added sdtc:dischargeDispositionCode for testing purposes
Note: The following are pre-existing errors in the document versus MU2 validation:
1670|Consol Immunization Medication Information SHALL contain exactly one [1..1] manufacturedMaterial (CONF:9006) manufacturedMaterial SHALL contain exactly one [1..1] code, where the @code SHALL be selected from ValueSet Vaccines administered (CVX) 2.16.840.1.114222.4.11.934 STATIC 7 (CONF:9007)
22|Mu2consol Social History Section SHALL contain at least one [1..*] entry Contains exactly one [1..1] Smoking Status Observation (templateId: 2.16.840.1.113883.10.20.22.4.78)
manufacturedMaterial SHALL contain exactly one [1..1] code, where the @code SHALL be selected from ValueSet Vaccines administered (CVX) 2.16.840.1.114222.4.11.934 STATIC 7 (CONF:9007)
04/10/2013 DRB added entire FAMILY HISTORY section to test sdtc:deceasedInd/sdtc:deceasedTime/sdtc:id
04/15/2013 DRB added sdtc:raceCode and sdtc:birthTime to the base model
04/22/2013 DRB adjusted sdtc:id to new schema sequence; adjusted raceCode to include valid code/codeSystem
10/30/2013 DRB adjusted sdtc:id to old schema sequence as the IG is planned to be changed back to it based on Errata 166 and 263
-->
<ClinicalDocument xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
xsi:schemaLocation="urn:hl7-org:v3 ../../org.eclipse.mdht.uml.cda/samples/C32_CDA.xsd"
xmlns="urn:hl7-org:v3"
xmlns:cda="urn:hl7-org:v3" xmlns:sdtc="urn:hl7-org:sdtc">
<!--
********************************************************
CDA Header
********************************************************
-->
<!-- CONF 16791 -->
<realmCode
code="US"/>
<!-- CONF 5361 -->
<typeId
root="2.16.840.1.113883.1.3"
extension="POCD_HD000040"/>
<!-- US General Header Template -->
<!-- CONF 5252 -->
<templateId
root="2.16.840.1.113883.10.20.22.1.1"/>
<!-- *** Note: The next templateId, code and title will differ depending on what type of document is being sent. *** -->
<!-- conforms to the document specific requirements -->
<templateId
root="2.16.840.1.113883.10.20.22.1.2"/>
<!-- CONF 5363 -->
<id
extension="Test CCDA"
root="1.1.1.1.1.1.1.1.1"/>
<!-- CONF 5253 "CCD document" -->
<code
codeSystem="2.16.840.1.113883.6.1"
codeSystemName="LOINC"
code="34133-9"
displayName="Summarization of Episode Note"/>
<!-- CONF 5254 -->
<title>Community Health and Hospitals: Health Summary</title>
<sdtc:statusCode code="STATUSCODE"/>
<!-- CONF 5256 -->
<effectiveTime
value="20120912000000-0000"/>
<!-- 5259 -->
<confidentialityCode
code="N"
codeSystem="2.16.840.1.113883.5.25"/>
<!-- 5372 -->
<languageCode
code="en-US"/>
<!-- CONF 5266 -->
<recordTarget>
<!-- CONF 5267 -->
<patientRole>
<!-- CONF 5268-->
<id
extension="1"
root="2.16.840.1.113883.4.6"/>
<!-- Fake ID using HL7 example OID. -->
<!-- Patient SSN recorded as an ID -->
<id
extension="123-101-5230"
root="2.16.840.1.113883.4.1"/>
<!-- CONF 5271 -->
<addr
use="HP">
<!-- HP is "primary home" from codeSystem 2.16.840.1.113883.5.1119 -->
<streetAddressLine>1357 Amber Drive</streetAddressLine>
<city>Beaverton</city>
<state>OR</state>
<postalCode>97006</postalCode>
<country>US</country>
<!-- US is "United States" from ISO 3166-1 Country Codes: 1.0.3166.1 -->
</addr>
<!-- CONF 5280 -->
<telecom
value="tel:(816)276-6909"
use="HP"/>
<!-- HP is "primary home" from HL7 AddressUse 2.16.840.1.113883.5.1119 -->
<!-- CONF 5283 -->
<patient xmlns:sdtc="urn:hl7-org:sdtc">
<!-- CONF 5284 -->
<name
use="L">
<!-- L is "Legal" from HL7 EntityNameUse 2.16.840.1.113883.5.45 -->
<given>Myra</given>
<!-- CL is "Call me" from HL7 EntityNamePartQualifier 2.16.840.1.113883.5.43 -->
<family>Jones</family>
</name>
<sdtc:desc>Description</sdtc:desc>
<administrativeGenderCode
code="F"
codeSystem="2.16.840.1.113883.5.1"
displayName="Female"/>
<birthTime
value="19470501"/>
<sdtc:deceasedInd value="true"/>
<sdtc:deceasedTime value="1967"/>
<maritalStatusCode
code="M"
displayName="Married"
codeSystem="2.16.840.1.113883.5.2"
codeSystemName="MaritalStatusCode"/>
<religiousAffiliationCode
code="1013"
displayName="Christian (non-Catholic, non-specific)"
codeSystemName="HL7 Religious Affiliation "
codeSystem="2.16.840.1.113883.5.1076"/>
<!-- Need to Fix the Race Code to be from the OMB Standards -->
<raceCode
code="2106-3"
displayName="White"
codeSystem="2.16.840.1.113883.6.238"
codeSystemName="Race and Ethnicity - CDC"/>
<sdtc:raceCode code="1002-5" codeSystem="2.16.840.1.113883.6.238" codeSystemName="RACE_CODESYSTEMNAME_VALUE"/>
<ethnicGroupCode
code="2186-5"
displayName="Not Hispanic or Latino"
codeSystem="2.16.840.1.113883.6.238"
codeSystemName="Race and Ethnicity - CDC"/>
<guardian>
<code
code="GPARNT"
displayName="Grandfather"
codeSystem="2.16.840.1.113883.5.111"
codeSystemName="HL7 Role code"/>
<addr
use="HP">
<!-- HP is "primary home" from codeSystem 2.16.840.1.113883.5.1119 -->
<streetAddressLine>1357 Amber Drive</streetAddressLine>
<city>Beaverton</city>
<state>OR</state>
<postalCode>97006</postalCode>
<country>US</country>
<!-- US is "United States" from ISO 3166-1 Country Codes: 1.0.3166.1 -->
</addr>
<telecom
value="tel:(816)276-6909"
use="HP"/>
<guardianPerson>
<name>
<given>Ralph</given>
<family>Jones</family>
</name>
</guardianPerson>
</guardian>
<birthplace>
<place>
<addr>
<city>Beaverton</city>
<state>OR</state>
<postalCode>97006</postalCode>
<country>US</country>
</addr>
</place>
</birthplace>
<!-- FIX the Code System to be 639.2 -->
<languageCommunication>
<languageCode
code="eng"/>
<modeCode
code="ESP"
displayName="Expressed spoken"
codeSystem="2.16.840.1.113883.5.60"
codeSystemName="LanguageAbilityMode"/>
<preferenceInd
value="true"/>
</languageCommunication>
</patient>
<providerOrganization>
<id
root="1.1.1.1.1.1.1.1.4"/>
<name>Community Health and Hospitals</name>
<telecom
use="WP"
value="tel: 555-555-5000"/>
<addr>
<streetAddressLine>1002 Healthcare Dr</streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>97266</postalCode>
<country>US</country>
</addr>
</providerOrganization>
</patientRole>
</recordTarget>
<author>
<time
value="20050813000000+0500"/>
<assignedAuthor>
<id
extension="111111"
root="2.16.840.1.113883.4.6"/>
<addr>
<streetAddressLine>1002 Healthcare Drive </streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>97266</postalCode>
<country>US</country>
</addr>
<telecom
use="WP"
value="tel:555-555-1002"/>
<assignedPerson xmlns:sdtc="urn:hl7-org:sdtc">
<name>
<prefix>Dr</prefix>
<given>Henry</given>
<family>Seven</family>
</name>
</assignedPerson>
</assignedAuthor>
</author>
<dataEnterer>
<assignedEntity>
<id
root="2.16.840.1.113883.4.6"
extension="999999943252"/>
<addr>
<streetAddressLine>1002 Healthcare Drive </streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>97266</postalCode>
<country>US</country>
</addr>
<telecom
use="WP"
value="tel:555-555-1002"/>
<assignedPerson>
<name>
<given>Mary</given>
<family>McDonald</family>
</name>
</assignedPerson>
</assignedEntity>
</dataEnterer>
<informant>
<assignedEntity>
<id
extension="KP00017"
root="2.16.840.1.113883.19.5"/>
<addr>
<streetAddressLine>1002 Healthcare Drive </streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>97266</postalCode>
<country>US</country>
</addr>
<telecom
use="WP"
value="tel:555-555-1002"/>
<assignedPerson>
<name>
<given>Henry</given>
<family>Seven</family>
</name>
</assignedPerson>
</assignedEntity>
</informant>
<informant>
<relatedEntity
classCode="PRS">
<!-- classCode PRS represents a person with personal relationship with the patient. -->
<code
code="SPS"
displayName="SPOUSE"
codeSystem="2.16.840.1.113883.1.11.19563"
codeSystemName="Personal Relationship Role Type Value Set"/>
<relatedPerson>
<name>
<given>Frank</given>
<family>Jones</family>
</name>
</relatedPerson>
</relatedEntity>
</informant>
<custodian>
<assignedCustodian>
<representedCustodianOrganization>
<id
extension="99999999"
root="2.16.840.1.113883.4.6"/>
<name>Community Health and Hospitals</name>
<telecom
value="tel: 555-555-1002"
use="WP"/>
<addr
use="WP">
<streetAddressLine>1002 Healthcare Drive </streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>97266</postalCode>
<country>US</country>
</addr>
</representedCustodianOrganization>
</assignedCustodian>
</custodian>
<informationRecipient>
<intendedRecipient>
<informationRecipient>
<name>
<given>Henry</given>
<family>Seven</family>
</name>
</informationRecipient>
<receivedOrganization>
<name>Community Health and Hospitals</name>
</receivedOrganization>
</intendedRecipient>
</informationRecipient>
<legalAuthenticator>
<time
value="20120813"/>
<signatureCode
code="S"/>
<assignedEntity>
<id
extension="999999999"
root="2.16.840.1.113883.4.6"/>
<addr>
<streetAddressLine>1002 Healthcare Drive </streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>97266</postalCode>
<country>US</country>
</addr>
<telecom
use="WP"
value="tel:555-555-1002"/>
<assignedPerson>
<name>
<given>Henry</given>
<family>Seven</family>
</name>
</assignedPerson>
</assignedEntity>
</legalAuthenticator>
<authenticator>
<time
value="20120813"/>
<signatureCode
code="S"/>
<assignedEntity>
<id
extension="999999999"
root="2.16.840.1.113883.4.6"/>
<addr>
<streetAddressLine>1002 Healthcare Drive </streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>97266</postalCode>
<country>US</country>
</addr>
<telecom
use="WP"
value="tel:555-555-1002"/>
<assignedPerson>
<name>
<given>Henry</given>
<family>Seven</family>
</name>
</assignedPerson>
</assignedEntity>
</authenticator>
<participant typeCode="IND">
<associatedEntity classCode="PRS">
<code
code="GPARNT"
displayName="Grand Parent"
codeSystem="2.16.840.1.113883.1.11.19563"
codeSystemName="Personal Relationship Role Type Value Set"/>
<addr
use="HP">
<!-- HP is "primary home" from codeSystem 2.16.840.1.113883.5.1119 -->
<streetAddressLine>1357 Amber Drive</streetAddressLine>
<city>Beaverton</city>
<state>OR</state>
<postalCode>97006</postalCode>
<country>US</country>
<!-- US is "United States" from ISO 3166-1 Country Codes: 1.0.3166.1 -->
</addr>
<telecom value='tel:(555)555-2006' use='WP'/>
<associatedPerson>
<name>
<prefix>Mr.</prefix>
<given>Ralph</given>
<family>Jones</family>
</name>
</associatedPerson>
</associatedEntity>
</participant>
<participant typeCode="IND">
<associatedEntity classCode="PRS">
<code
code="SPS"
displayName="SPOUSE"
codeSystem="2.16.840.1.113883.1.11.19563"
codeSystemName="Personal Relationship Role Type Value Set"/>
<addr
use="HP">
<!-- HP is "primary home" from codeSystem 2.16.840.1.113883.5.1119 -->
<streetAddressLine>1357 Amber Drive</streetAddressLine>
<city>Beaverton</city>
<state>OR</state>
<postalCode>97006</postalCode>
<country>US</country>
<!-- US is "United States" from ISO 3166-1 Country Codes: 1.0.3166.1 -->
</addr>
<telecom value='tel:(555)555-2006' use='WP'/>
<associatedPerson>
<name>
<prefix>Mr.</prefix>
<given>Frank</given>
<family>Jones</family>
</name>
</associatedPerson>
</associatedEntity>
</participant>
<documentationOf
typeCode="DOC">
<serviceEvent
classCode="PCPR">
<code
code="233604007"
codeSystem="2.16.840.1.113883.6.96"
codeSystemName="SNOMED-CT"
displayName="Pnuemonia"/>
<effectiveTime>
<low
value="20120806"/>
<high
value="20120813"/>
</effectiveTime>
<performer
typeCode="PRF">
<functionCode
code="PP"
displayName="Primary Care Provider"
codeSystem="2.16.840.1.113883.12.443"
codeSystemName="Provider Role">
<originalText>Primary Care Provider</originalText>
</functionCode>
<time>
<low
value="20120806"/>
<high
value="20120813"/>
</time>
<assignedEntity>
<id
extension="PseudoMD-1"
root="2.16.840.1.113883.4.6"/>
<code
code="208D00000X"
displayName="General Practice"
codeSystemName="Provider Codes"
codeSystem="2.16.840.1.113883.6.101"/>
<addr>
<streetAddressLine>1002 Healthcare Dr</streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>97266</postalCode>
<country>US</country>
</addr>
<telecom
value="tel:+1-555-555-5000"
use="WP"/>
<assignedPerson>
<name>
<prefix>Dr.</prefix>
<given>Henry</given>
<family>Seven</family>
</name>
</assignedPerson>
<representedOrganization>
<id
root="2.16.840.1.113883.19.5.9999.1393"/>
<name>Community Health and Hospitals</name>
<telecom
value="tel:+1-555-555-5000"
use="WP"/>
<addr>
<streetAddressLine>1002 Healthcare Drive </streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>97266</postalCode>
<country>US</country>
</addr>
</representedOrganization>
</assignedEntity>
</performer>
<performer
typeCode="PRF">
<functionCode
code="PP"
displayName="Primary Care Provider"
codeSystem="2.16.840.1.113883.12.443"
codeSystemName="Provider Role">
<originalText>Primary Care Provider</originalText>
</functionCode>
<time>
<low
value="20120806"/>
<high
value="20120813"/>
</time>
<assignedEntity>
<id
extension="PseudoMD-3"
root="2.16.840.1.113883.4.6"/>
<code
code="208D00000X"
displayName="General Practice"
codeSystemName="Provider Codes"
codeSystem="2.16.840.1.113883.6.101"/>
<addr>
<streetAddressLine>1002 Healthcare Dr</streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>97266</postalCode>
<country>US</country>
</addr>
<telecom
value="tel:+1-555-555-5000"
use="HP"/>
<assignedPerson>
<name>
<prefix>Dr.</prefix>
<given>Henry</given>
<family>Seven</family>
</name>
</assignedPerson>
<representedOrganization>
<id
root="2.16.840.1.113883.19.5.9999.1393"/>
<name>Community Health and Hospitals</name>
<telecom
value="tel:+1-555-555-5000"
use="HP"/>
<addr>
<streetAddressLine>1002 Healthcare Drive </streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>97266</postalCode>
<country>US</country>
</addr>
</representedOrganization>
</assignedEntity>
</performer>
</serviceEvent>
</documentationOf>
<componentOf>
<encompassingEncounter>
<id extension="1" root="2.16.840.1.113883.4.6"/>
<code
code="233604007"
codeSystem="2.16.840.1.113883.6.96"
codeSystemName="SNOMED-CT"
displayName="Pnuemonia"/>
<effectiveTime>
<low
value="20120806"/>
<high
value="20120813"/>
</effectiveTime>
<responsibleParty>
<assignedEntity>
<id root="2.16.840.1.113883.4.6"/>
<assignedPerson>
<name>
<prefix>Dr</prefix>
<given>Henry</given>
<family>Seven</family>
</name>
</assignedPerson>
</assignedEntity>
</responsibleParty>
<encounterParticipant typeCode="ATND">
<assignedEntity>
<id root="2.16.840.1.113883.4.6"/>
<assignedPerson>
<name>
<prefix>Dr</prefix>
<given>Henry</given>
<family>Seven</family>
</name>
</assignedPerson>
</assignedEntity>
</encounterParticipant>
<location>
<healthCareFacility>
<id root="2.16.840.1.113883.4.6"/>
</healthCareFacility>
</location>
</encompassingEncounter>
</componentOf>
<!-- ********************************************************
CDA Body
******************************************************** -->
<component>
<structuredBody>
<component>
<section>
<entry>
<observation>
<participant>
<participantRole>
<playingEntity>
<sdtc:birthTime value="19880907"/>
</playingEntity>
</participantRole>
</participant>
</observation>
</entry>
</section>
</component>
<!-- *********************** -->
<!--
********************************************************
Allergies, Adverse Reactions, Alerts
********************************************************
-->
<component>
<section>
<templateId
root="2.16.840.1.113883.10.20.22.2.6.1"/>
<!-- Alerts section template -->
<code
code="48765-2"
codeSystem="2.16.840.1.113883.6.1"/>
<title>ALLERGIES, ADVERSE REACTIONS, ALERTS</title>
<text>
<table
border="1"
width="100%">
<thead>
<tr>
<th>Substance</th>
<th>Reaction</th>
<th>Severity</th>
<th>Status</th>
</tr>
</thead>
<tbody>
<tr>
<td>Penicillin G benzathine</td>
<td><content
ID="reaction1">Hives</content></td>
<td><content
ID="severity1">Moderate to severe</content></td>
<td>Inactive</td>
</tr>
<tr>
<td>Codeine</td>
<td><content
ID="reaction2">Shortness of Breath</content></td>
<td><content
ID="severity2">Moderate</content></td>
<td>Active</td>
</tr>
<tr>
<td>Aspirin</td>
<td><content
ID="reaction3">Hives</content></td>
<td><content
ID="severity3">Mild to moderate</content></td>
<td>Active</td>
</tr>
</tbody>
</table>
</text>
<entry
typeCode="DRIV">
<act
classCode="ACT"
moodCode="EVN">
<templateId
root="2.16.840.1.113883.10.20.22.4.30"/>
<!-- ** Allergy problem act ** -->
<id
root="36e3e930-7b14-11db-9fe1-0800200c9a66"/>
<code
code="48765-2"
codeSystem="2.16.840.1.113883.6.1"
codeSystemName="LOINC"
displayName="Allergies, adverse reactions, alerts"/>
<statusCode
code="completed"/>
<effectiveTime
value="20070501">
<low
value="20070501"/>
<high
value="20120806"/>
</effectiveTime>
<entryRelationship
typeCode="SUBJ">
<observation
classCode="OBS"
moodCode="EVN">
<!-- allergy observation template -->
<templateId
root="2.16.840.1.113883.10.20.22.4.7"/>
<id
root="4adc1020-7b14-11db-9fe1-0800200c9a66"/>
<code
code="ASSERTION"
codeSystem="2.16.840.1.113883.5.4"/>
<statusCode
code="completed"/>
<effectiveTime>
<low nullFlavor="UNK"/>
<high value="20120806"/>
</effectiveTime>
<value
xsi:type="CD"
code="419511003"
displayName="Propensity to adverse reaction to drug"
codeSystem="2.16.840.1.113883.6.96"
codeSystemName="SNOMED CT">
<originalText>
<reference
value="#reaction1"/>
</originalText>
</value>
<participant
typeCode="CSM">
<participantRole
classCode="MANU">
<playingEntity
classCode="MMAT">
<code
code="7982"
displayName="Penicillin G benzathine"
codeSystem="2.16.840.1.113883.6.88"
codeSystemName="RxNorm">
<originalText>
<reference
value="#reaction1"/>
</originalText>
</code>
</playingEntity>
</participantRole>
</participant>
<entryRelationship
typeCode="SUBJ"
inversionInd="true">
<observation
classCode="OBS"
moodCode="EVN">
<templateId
root="2.16.840.1.113883.10.20.22.4.28"/>
<!-- Allergy status observation template -->
<code
code="33999-4"
codeSystem="2.16.840.1.113883.6.1"
codeSystemName="LOINC"
displayName="Status"/>
<statusCode
code="completed"/>
<value
xsi:type="CE"
code="73425007"
codeSystem="2.16.840.1.113883.6.96"
displayName="Inactive"/>
</observation>
</entryRelationship>
<entryRelationship
typeCode="MFST"
inversionInd="true">
<observation
classCode="OBS"
moodCode="EVN">
<templateId
root="2.16.840.1.113883.10.20.22.4.9"/>
<!-- Reaction observation template -->
<id
root="4adc1020-7b14-11db-9fe1-0800200c9a64"/>
<code
nullFlavor="NA"/>
<text>
<reference
value="#reaction1"/>
</text>
<statusCode
code="completed"/>
<effectiveTime>
<low
value="20070501"/>
</effectiveTime>
<value
xsi:type="CD"
code="247472004"
codeSystem="2.16.840.1.113883.6.96"
displayName="Hives"/>
</observation>
</entryRelationship>
<entryRelationship
typeCode="SUBJ"
inversionInd="true">
<observation
classCode="OBS"
moodCode="EVN">
<templateId
root="2.16.840.1.113883.10.20.22.4.8"/>
<!-- ** Severity observation template ** -->
<code xsi:type="CE"
code="SEV"
displayName="Severity Observation"
codeSystem="2.16.840.1.113883.5.4"
codeSystemName="ActCode"/>
<text>
<reference
value="#severity1"/>
</text>
<statusCode
code="completed"/>
<value
xsi:type="CD"
code="371924009"
displayName="Moderate to severe"
codeSystem="2.16.840.1.113883.6.96"
codeSystemName="SNOMED CT"/>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
</act>
</entry>
<entry
typeCode="DRIV">
<act
classCode="ACT"
moodCode="EVN">
<templateId
root="2.16.840.1.113883.10.20.22.4.30"/>
<!-- ** Allergy problem act ** -->
<id
root="36e3e930-7b14-11db-9fe1-0800200c9a66"/>
<code
code="48765-2"
codeSystem="2.16.840.1.113883.6.1"
codeSystemName="LOINC"
displayName="Allergies, adverse reactions, alerts"/>
<statusCode
code="completed"/>
<effectiveTime
value="20060501">
<low
value="20060501"/>
<high
value="20120806"/>
</effectiveTime>
<entryRelationship
typeCode="SUBJ">
<observation
classCode="OBS"
moodCode="EVN">
<!-- allergy observation template -->
<templateId
root="2.16.840.1.113883.10.20.22.4.7"/>
<id
root="4adc1020-7b14-11db-9fe1-0800200c9a66"/>
<code
code="ASSERTION"
codeSystem="2.16.840.1.113883.5.4"/>
<statusCode
code="completed"/>
<effectiveTime>
<low
value="20060501"/>
</effectiveTime>
<value
xsi:type="CD"
code="419511003"
displayName="Propensity to adverse reaction to drug"
codeSystem="2.16.840.1.113883.6.96"
codeSystemName="SNOMED CT">
<originalText>
<reference
value="#reaction2"/>
</originalText>
</value>
<participant
typeCode="CSM">
<participantRole
classCode="MANU">
<playingEntity
classCode="MMAT">
<code
code="2670"
displayName="Codeine"
codeSystem="2.16.840.1.113883.6.88"
codeSystemName="RxNorm">
<originalText>
<reference
value="#reaction2"/>
</originalText>
</code>
</playingEntity>
</participantRole>
</participant>
<entryRelationship
typeCode="SUBJ"
inversionInd="true">
<observation
classCode="OBS"
moodCode="EVN">
<templateId
root="2.16.840.1.113883.10.20.22.4.28"/>
<!-- Allergy status observation template -->
<code
code="33999-4"
codeSystem="2.16.840.1.113883.6.1"
codeSystemName="LOINC"
displayName="Status"/>
<statusCode
code="completed"/>
<value
xsi:type="CE"
code="55561003"
codeSystem="2.16.840.1.113883.6.96"
displayName="Active"/>
</observation>
</entryRelationship>
<entryRelationship
typeCode="MFST"
inversionInd="true">
<observation
classCode="OBS"
moodCode="EVN">
<templateId
root="2.16.840.1.113883.10.20.22.4.9"/>
<!-- Reaction observation template -->
<id
root="4adc1020-7b14-11db-9fe1-0800200c9a64"/>
<code
nullFlavor="NA"/>
<text>
<reference
value="#reaction2"/>
</text>
<statusCode
code="completed"/>
<effectiveTime>
<low
value="20060501"/>
</effectiveTime>
<value
xsi:type="CD"
code="267036007"
codeSystem="2.16.840.1.113883.6.96"
displayName="Shortness of Breath"/>
</observation>
</entryRelationship>
<entryRelationship
typeCode="SUBJ"
inversionInd="true">
<observation
classCode="OBS"
moodCode="EVN">
<templateId
root="2.16.840.1.113883.10.20.22.4.8"/>
<!-- ** Severity observation template ** -->
<code xsi:type="CE"
code="SEV"
displayName="Severity Observation"
codeSystem="2.16.840.1.113883.5.4"
codeSystemName="ActCode"/>
<text>
<reference
value="#severity2"/>
</text>
<statusCode
code="completed"/>
<value
xsi:type="CD"
code="6736007"
displayName="Moderate"
codeSystem="2.16.840.1.113883.6.96"
codeSystemName="SNOMED CT"/>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
</act>
</entry>
<entry
typeCode="DRIV">
<act
classCode="ACT"
moodCode="EVN">
<templateId
root="2.16.840.1.113883.10.20.22.4.30"/>
<!-- ** Allergy problem act ** -->
<id
root="36e3e930-7b14-11db-9fe1-0800200c9a66"/>
<code
code="48765-2"
codeSystem="2.16.840.1.113883.6.1"
codeSystemName="LOINC"
displayName="Allergies, adverse reactions, alerts"/>
<statusCode
code="completed"/>
<effectiveTime
value="20080501">
<low
value="20080501"/>
<high
value="20120806"/>
</effectiveTime>
<entryRelationship
typeCode="SUBJ">
<observation
classCode="OBS"
moodCode="EVN">
<!-- allergy observation template -->
<templateId
root="2.16.840.1.113883.10.20.22.4.7"/>
<id
root="4adc1020-7b14-11db-9fe1-0800200c9a66"/>
<code
code="ASSERTION"
codeSystem="2.16.840.1.113883.5.4"/>
<statusCode
code="completed"/>
<effectiveTime>
<low
value="20080501"/>
<high value="20120806"/>
</effectiveTime>
<value
xsi:type="CD"
code="419511003"
displayName="Propensity to adverse reaction to drug"
codeSystem="2.16.840.1.113883.6.96"
codeSystemName="SNOMED CT">
<originalText>
<reference
value="#reaction3"/>
</originalText>
</value>
<participant
typeCode="CSM">
<participantRole
classCode="MANU">
<playingEntity
classCode="MMAT">
<code
code="1191"
displayName="Aspirin"
codeSystem="2.16.840.1.113883.6.88"
codeSystemName="RxNorm">
<originalText>
<reference
value="#reaction3"/>
</originalText>
</code>
</playingEntity>
</participantRole>
</participant>
<entryRelationship
typeCode="SUBJ"
inversionInd="true">
<observation
classCode="OBS"
moodCode="EVN">
<templateId
root="2.16.840.1.113883.10.20.22.4.28"/>
<!-- Allergy status observation template -->
<code
code="33999-4"
codeSystem="2.16.840.1.113883.6.1"
codeSystemName="LOINC"
displayName="Status"/>
<statusCode
code="completed"/>
<value
xsi:type="CE"
code="55561003"
codeSystem="2.16.840.1.113883.6.96"
displayName="Active"/>
</observation>
</entryRelationship>
<entryRelationship
typeCode="MFST"
inversionInd="true">
<observation
classCode="OBS"
moodCode="EVN">
<templateId
root="2.16.840.1.113883.10.20.22.4.9"/>
<!-- Reaction observation template -->
<id
root="4adc1020-7b14-11db-9fe1-0800200c9a64"/>
<code
nullFlavor="NA"/>
<text>
<reference
value="#reaction3"/>
</text>
<statusCode
code="completed"/>
<effectiveTime>
<low
value="20080501"/>
</effectiveTime>
<value
xsi:type="CD"
code="247472004"
codeSystem="2.16.840.1.113883.6.96"
displayName="Hives"/>
</observation>
</entryRelationship>
<entryRelationship
typeCode="SUBJ"
inversionInd="true">
<observation
classCode="OBS"
moodCode="EVN">
<templateId
root="2.16.840.1.113883.10.20.22.4.8"/>
<!-- ** Severity observation template ** -->
<code xsi:type="CE"
code="SEV"
displayName="Severity Observation"
codeSystem="2.16.840.1.113883.5.4"
codeSystemName="ActCode"/>
<text>
<reference
value="#severity3"/>
</text>
<statusCode
code="completed"/>
<value
xsi:type="CD"
code="371923003"
displayName="Mild to moderate"
codeSystem="2.16.840.1.113883.6.96"
codeSystemName="SNOMED CT"/>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
</act>
</entry>
</section>
</component>
<!--
********************************************************
ENCOUNTERS
********************************************************
-->
<component>
<section>
<templateId
root="2.16.840.1.113883.10.20.22.2.22.1"/>
<!-- Encounters Section - required entries -->
<code
code="46240-8"
codeSystem="2.16.840.1.113883.6.1"
codeSystemName="LOINC"
displayName="History of encounters"/>
<title>ENCOUNTERS</title>
<text>
<table
border="1"
width="100%">
<thead>
<tr>
<th>Encounter</th>
<th>Performer</th>
<th>Location</th>
<th>Date</th>
</tr>
</thead>
<tbody>
<tr>
<td>
<content
ID="Encounter1"/> Pnuemonia</td>
<td>Dr Henry Seven</td>
<td>Community Health and Hospitals</td>
<td>20120806</td>
</tr>
</tbody>
</table>
</text>
<entry
typeCode="DRIV">
<encounter xmlns:sdtc="urn:hl7-org:sdtc" classCode="ENC" moodCode="EVN">
<templateId
root="2.16.840.1.113883.10.20.22.4.49"/>
<!-- Encounter Activities -->
<!-- ******** Encounter activity template ******** -->
<id
root="2a620155-9d11-439e-92b3-5d9815ff4de8"/>
<code
code="99222"
displayName="InPatient Admission"
codeSystemName="CPT"
codeSystem="2.16.840.1.113883.6.12"
codeSystemVersion="4">
<originalText>Mild Fever<reference
value="#Encounter1"/>
</originalText>
</code>
<effectiveTime
value="20120806"/>
<sdtc:dischargeDispositionCode code="42" codeSystem="2.16.840.1.113883.12.112" codeSystemName="HL7 Discharge Disposition"/>
<performer>
<assignedEntity>
<id
root="2a620155-9d11-439e-92a3-5d9815ff4de8"/>
<code
code="59058001"
codeSystem="2.16.840.1.113883.6.96"
codeSystemName="SNOMED CT"
displayName="General Physician"/>
</assignedEntity>
</performer>
<participant
typeCode="LOC">
<participantRole
classCode="SDLOC">
<templateId
root="2.16.840.1.113883.10.20.22.4.32"/>
<!-- Service Delivery Location template -->
<code
code="1160-1"
codeSystem="2.16.840.1.113883.6.259"
codeSystemName="HealthcareServiceLocation"
displayName="Urgent Care Center"/>
<addr>
<streetAddressLine>1002 Healthcare Dr</streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>97266</postalCode>
<country>US</country>
</addr>
<telecom
nullFlavor="UNK"/>
<playingEntity
classCode="PLC">
<name>Community Health and Hospitals</name>
</playingEntity>
</participantRole>
</participant>
<entryRelationship
typeCode="RSON">
<observation
classCode="OBS"
moodCode="EVN">
<templateId
root="2.16.840.1.113883.10.20.22.4.19"/>
<id
root="db734647-fc99-424c-a864-7e3cda82e703"
extension="45665"/>
<code
code="404684003"
displayName="Finding"
codeSystem="2.16.840.1.113883.6.96"
codeSystemName="SNOMED CT"/>
<statusCode
code="completed"/>
<effectiveTime>
<low
value="20120806"/>
</effectiveTime>
<value
xsi:type="CD"
code="233604007"
displayName="Pneumonia"
codeSystem="2.16.840.1.113883.6.96"/>
</observation>
</entryRelationship>
<entryRelationship
typeCode="SUBJ" inversionInd="false">
<act classCode="ACT" moodCode="EVN">
<!--Encounter diagnosis act -->
<templateId root="2.16.840.1.113883.10.20.22.4.80"/>
<id root="5a784260-6856-4f38-9638-80c751aff2fb"/>
<code xsi:type="CE"
code="29308-4"
codeSystem="2.16.840.1.113883.6.1"
codeSystemName="LOINC"
displayName="ENCOUNTER DIAGNOSIS"/>
<statusCode code="active"/>
<effectiveTime>
<low value="20120806"/>
</effectiveTime>
<entryRelationship typeCode="SUBJ" inversionInd="false">
<observation classCode="OBS" moodCode="EVN" negationInd="false">
<templateId root="2.16.840.1.113883.10.20.22.4.4"/>
<!-- Problem Observation -->
<id
root="ab1791b0-5c71-11db-b0de-0800200c9a66"/>
<code
code="409586006"
codeSystem="2.16.840.1.113883.6.96"
displayName="Complaint"/>
<statusCode
code="completed"/>
<effectiveTime>
<low
value="20120806"/>
</effectiveTime>
<value
xsi:type="CD"
code="233604007"
codeSystem="2.16.840.1.113883.6.96"
displayName="Pneumonia"/>
</observation>
</entryRelationship>
</act>
</entryRelationship>
</encounter>
</entry>
</section>
</component>
<!--
********************************************************
FAMILY HISTORY
********************************************************
-->
<component>
<section>
<templateId root="2.16.840.1.113883.10.20.22.2.15"/>
<!-- ******** Family history section template ******** -->
<code code="10157-6" codeSystem="2.16.840.1.113883.6.1"/>
<title>FAMILY HISTORY</title>
<text>
<paragraph>Father (deceased)</paragraph>
<table border="1" width="100%">
<thead>
<tr>
<th>Diagnosis</th>
<th>Age At Onset</th>
</tr>
</thead>
<tbody>
<tr>
<td>Myocardial Infarction (cause of death)</td>
<td>57</td>
</tr>
<tr>
<td>Diabetes</td>
<td>40</td>
</tr>
</tbody>
</table>
</text>
<entry typeCode="DRIV">
<organizer xmlns:sdtc="urn:hl7-org:sdtc" moodCode="EVN" classCode="CLUSTER">
<templateId root="2.16.840.1.113883.10.20.22.4.45"/>
<!-- ******** Family history organizer template ******** -->
<statusCode code="completed"/>
<subject>
<relatedSubject classCode="PRS">
<code code="FTH" displayName="Father"
codeSystemName="HL7 FamilyMember"
codeSystem="2.16.840.1.113883.5.111">
<translation code="9947008"
displayName="Biological father"
codeSystemName="SNOMED"
codeSystem="2.16.840.1.113883.6.96"/>
</code>
<subject>
<sdtc:id root="root" extension="extension" assigningAuthorityName="assigningAuthorityName" displayable="false"/>
<administrativeGenderCode code="M"
codeSystem="2.16.840.1.113883.5.1"
displayName="Male"/>
<birthTime value="1910"/>
<sdtc:deceasedInd value="true"/>
<sdtc:deceasedTime value="1967"/>
</subject>
</relatedSubject>
</subject>
<component>
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.46"/>
<!-- Family History Observation template -->
<id root="d42ebf70-5c89-11db-b0de-0800200c9a66"/>
<code code="55561003" displayName="Active"
codeSystemName="SNOMED CT"
codeSystem="2.16.840.1.113883.6.96"/>
<statusCode code="completed"/>
<effectiveTime value="1967"/>
<value xsi:type="CD" code="22298006"
codeSystem="2.16.840.1.113883.6.96"
displayName="Myocardial infarction"/>
<entryRelationship typeCode="CAUS">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.47"/>
<!-- ******** Family history death observation template ******** -->
<id root="6898fae0-5c8a-11db-b0de-0800200c9a66"/>
<code code="ASSERTION"
codeSystem="2.16.840.1.113883.5.4"/>
<statusCode code="completed"/>
<value xsi:type="CD" code="419099009"
codeSystem="2.16.840.1.113883.6.96"
displayName="Dead"/>
</observation>
</entryRelationship>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.31"/>
<!-- ******** Age observation template ******** -->
<code code="397659008" codeSystem="2.16.840.1.113883.6.96"
displayName="Age"/>
<statusCode code="completed"/>
<value xsi:type="PQ" value="57" unit="a"/>
</observation>
</entryRelationship>
</observation>
</component>
<component>
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.46"/>
<!-- ******** Family history observation template ******** -->
<id root="5bfe3ec0-5c8b-11db-b0de-0800200c9a66"/>
<code code="7087005" displayName="Intermittent"
codeSystemName="SNOMED CT"
codeSystem="2.16.840.1.113883.6.96"/>
<statusCode code="completed"/>
<effectiveTime value="1950"/>
<value xsi:type="CD" code="46635009"
codeSystem="2.16.840.1.113883.6.96"
displayName="Diabetes mellitus type 1"/>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.31"/>
<!-- ******** Age observation template ******** -->
<code code="397659008" codeSystem="2.16.840.1.113883.6.96"
displayName="Age"/>
<statusCode code="completed"/>
<value xsi:type="PQ" value="40" unit="a"/>
</observation>
</entryRelationship>
</observation>
</component>
</organizer>
</entry>
</section>
</component>
<!--
********************************************************
IMMUNIZATIONS
********************************************************
-->
<component>
<section>
<templateId
root="2.16.840.1.113883.10.20.22.2.2.1"/>
<!-- Entries Required -->
<!-- ******** Immunizations section template ******** -->
<code
code="11369-6"
codeSystem="2.16.840.1.113883.6.1"
codeSystemName="LOINC"
displayName="History of immunizations"/>
<title>IMMUNIZATIONS</title>
<text><content
ID="immunSect"/>
<table
border="1"
width="100%">
<thead>
<tr>
<th>Vaccine</th>
<th>Date</th>
<th>Status</th>
</tr>
</thead>
<tbody>
<tr>
<td><content
ID="immun2"/>Influenza virus vaccine, IM</td>
<td>May 2012</td>
<td>Completed</td>
</tr>
<tr>
<td><content
ID="immun4"/>Tetanus and diphtheria toxoids, IM</td>
<td>Aor 2012</td>
<td>Completed</td>
</tr>
</tbody>
</table>
</text>
<entry
typeCode="DRIV">
<substanceAdministration
classCode="SBADM"
moodCode="EVN"
negationInd="false">
<templateId
root="2.16.840.1.113883.10.20.22.4.52"/>
<!-- ******** Immunization activity template ******** -->
<id
root="e6f1ba43-c0ed-4b9b-9f12-f435d8ad8f92"/>
<text>
<reference
value="#immun2"/>
</text>
<statusCode
code="completed"/>
<effectiveTime
xsi:type="IVL_TS"
value="20120510"/>
<routeCode
code="C28161"
codeSystem="2.16.840.1.113883.3.26.1.1"
codeSystemName="National Cancer Institute (NCI) Thesaurus"
displayName="Intramuscular injection"/>
<doseQuantity
value="50"
unit="mcg"/>
<consumable>
<manufacturedProduct
classCode="MANU">
<templateId
root="2.16.840.1.113883.10.20.22.4.54"/>
<!-- ******** Immunization Medication Information ******** -->
<manufacturedMaterial>
<code
code="88"
codeSystem="2.16.840.1.113883.6.59"
displayName="Influenza virus vaccine"
codeSystemName="CVX">
<originalText>Influenza virus vaccine</originalText>
<translation
code="111"
displayName="influenza, live, intranasal"
codeSystemName="CVX"
codeSystem="2.16.840.1.113883.6.59"/>
</code>
</manufacturedMaterial>
<manufacturerOrganization>
<name>Health LS - Immuno Inc.</name>
</manufacturerOrganization>
</manufacturedProduct>
</consumable>
<entryRelationship
typeCode="SUBJ" inversionInd="true">
<act
classCode="ACT"
moodCode="INT">
<templateId
root="2.16.840.1.113883.10.20.22.4.20"/>
<!-- ** Instructions Template ** -->
<code xsi:type="CE"
code="171044003"
codeSystem="2.16.840.1.113883.6.96"
displayName="immunization education"/>
<text><reference
value="#immunSect"/>Possible flu-like symptoms for three days.</text>
<statusCode
code="completed"/>
</act>
</entryRelationship>
</substanceAdministration>
</entry>
<entry
typeCode="DRIV">
<substanceAdministration
classCode="SBADM"
moodCode="EVN"
negationInd="false">
<templateId
root="2.16.840.1.113883.10.20.22.4.52"/>
<!-- ******** Immunization activity template ******** -->
<id
root="e6f1ba43-c0ed-4b9b-9f12-f435d8ad8f92"/>
<text>
<reference
value="#immun4"/>
</text>
<statusCode
code="completed"/>
<effectiveTime
xsi:type="IVL_TS"
value="20120401"/>
<routeCode
code="C28161"
codeSystem="2.16.840.1.113883.3.26.1.1"
codeSystemName="National Cancer Institute (NCI) Thesaurus"
displayName="Intramuscular injection"/>
<doseQuantity
value="50"
unit="mcg"/>
<consumable>
<manufacturedProduct
classCode="MANU">
<templateId
root="2.16.840.1.113883.10.20.22.4.54"/>
<!-- ******** Immunization Medication Information ******** -->
<manufacturedMaterial>
<code
code="103"
codeSystem="2.16.840.1.113883.6.59"
displayName="Tetanus and diphtheria toxoids - preservative free"
codeSystemName="CVX">
<originalText>Tetanus and diphtheria toxoids - preservative free</originalText>
<translation
code="09"
displayName="Tetanus and diphtheria toxoids - preservative free"
codeSystemName="CVX"
codeSystem="2.16.840.1.113883.6.59"/>
</code>
</manufacturedMaterial>
<manufacturerOrganization>
<name>Health LS - Immuno Inc.</name>
</manufacturerOrganization>
</manufacturedProduct>
</consumable>
<entryRelationship
typeCode="SUBJ"
inversionInd="true">
<act
classCode="ACT"
moodCode="INT">
<templateId
root="2.16.840.1.113883.10.20.22.4.20"/>
<!-- ** Instructions Template ** -->
<code xsi:type="CE"
code="171044003"
codeSystem="2.16.840.1.113883.6.96"
displayName="immunization education"/>
<text><reference
value="#immunSect"/>Possible flu-like symptoms for three days.</text>
<statusCode
code="completed"/>
</act>
</entryRelationship>
</substanceAdministration>
</entry>
</section>
</component>
<!--
********************************************************
MEDICATIONS
********************************************************
-->
<component>
<section>
<templateId
root="2.16.840.1.113883.10.20.22.2.1.1"/>
<code
code="10160-0"
codeSystem="2.16.840.1.113883.6.1"
codeSystemName="LOINC"
displayName="HISTORY OF MEDICATION USE"/>
<title>Medications</title>
<text>
<table
border="1"
width="100%">
<thead>
<tr>
<th>Medication</th>
<th>Directions</th>
<th>Start Date</th>
<th>Status</th>
<th>Indications</th>
<th>Fill Instructions</th>
</tr>
</thead>
<tbody>
<tr>
<td><content
ID="Med1">Albuterol 0.09 MG/ACTUAT inhalant solution</content></td>
<td>0.09 MG/ACTUAT inhalant solution, 2 puffs once</td>
<td>20120806</td>
<td>Active</td>
<td>Pneumonia (233604007 SNOMED CT)</td>
<td><content ID="FillIns">Generic Substitition Allowed</content></td>
</tr>
</tbody>
</table>
</text>
<entry
typeCode="DRIV">
<substanceAdministration
classCode="SBADM"
moodCode="EVN">
<templateId
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<!-- ** MEDICATION ACTIVITY -->
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<!-- ** Medication Dispense Template ** -->
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<precondition
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<!--
********************************************************
CARE PLAN
********************************************************
-->
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<!-- **** Plan of Care section template **** -->
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<th>Planned Activity</th>
<th>Planned Date</th>
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<td>Consultation with Dr George Potomac for Asthma</td>
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<!-- **** Plan of Care Activity Encounter template **** -->
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<!-- ** Instructions Template ** -->
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<!-- Plan of Care Activity Observation template -->
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</component>
<!--
********************************************************
HOSPITAL DISCHARGE MEDICATIONS
********************************************************
-->
<component>
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<!-- Entries Required -->
<!-- Hospital Discharge Summary templateId -->
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<table
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<tr>
<th>Medication</th>
<th>Directions</th>
<th>Start Date</th>
<th>Status</th>
<th>Indications</th>
<th>Fill Instructions</th>
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</thead>
<tbody>
<tr>
<td><content ID="DM">120 ACTUAT Fluticasone propionate 0.11 MG/ACTUAT Metered Dose Inhaler</content></td>
<td><content ID="DM1">0.11 MG/ACTUAT Metered Dose Once Daily</content></td>
<td>20120813</td>
<td>Active</td>
<td>Bronchitis (32398004 SNOMED CT)</td>
<td><content ID="FillIns_DM">Generic Substitition Allowed</content></td>
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<!-- Discharge Medication Entry -->
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<!-- ** MEDICATION ACTIVITY -->
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<!-- ** Medication Dispense Template ** -->
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</component>
<!--
********************************************************
REASON FOR REFERRAL
********************************************************
-->
<component>
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<!-- ** Reason for Referral Section Template ** -->
<code
codeSystem="2.16.840.1.113883.6.1"
codeSystemName="LOINC"
code="42349-1"
displayName="REASON FOR REFERRAL"/>
<title>REASON FOR REFERRAL</title>
<text>
<paragraph>Follow up with Dr George Potomac for Asthma</paragraph>
</text>
</section>
</component>
<!--
********************************************************
PROBLEM LIST
********************************************************
-->
<component>
<section>
<templateId
root="2.16.840.1.113883.10.20.22.2.5.1"/>
<code
code="11450-4"
codeSystem="2.16.840.1.113883.6.1"
codeSystemName="LOINC"
displayName="PROBLEM LIST"/>
<title>PROBLEMS</title>
<text><content
ID="problems"/>
<list
listType="ordered">
<item><content
ID="problem1">Pneumonia : Status - Resolved</content></item>
<item><content
ID="problem2">Asthma : Status - Active</content></item>
</list>
</text>
<entry
typeCode="DRIV">
<act
classCode="ACT"
moodCode="EVN">
<!-- Problem act template -->
<templateId
root="2.16.840.1.113883.10.20.22.4.3"/>
<id
root="ec8a6ff8-ed4b-4f7e-82c3-e98e58b45de7"/>
<code
code="CONC"
codeSystem="2.16.840.1.113883.5.6"
displayName="Concern"/>
<statusCode
code="completed"/>
<effectiveTime>
<low
value="20120806"/>
<high
value="20120806"/>
</effectiveTime>
<entryRelationship
typeCode="SUBJ">
<observation
classCode="OBS"
moodCode="EVN">