46. EPMO Open Source Coordination Office Redaction File Detail Report

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1	cds.zip\cds\product\production\opencds\opencds-documentation\SourceMaterialAndNotes\Models	vMRLogicalDocumentation.pdf	Fri Jul 1 17:45:46 2016 UTC
2	cds.zip\cds\product\production\opencds\opencds-documentation\SourceMaterialAndNotes\Models	vMRLogicalDocumentation.pdf	Wed Sep 27 16:09:07 2017 UTC

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	1	HL7 vMR DA M - Sept 2 011 Page: 1
	2
	3
	4	Virtual Me dical Reco rd (vMR) f or Clinica l Decision Support
	5	– Domain A nalysis Mo del
	6
	7	Project Co ordinator and Docume nt Editor
	8	Kensaku Ka wamoto, MD , PhD, Uni versity of Utah
	9
	10	Collaborat ors
	11	David Shie lds, Unive rsity of U tah
	12	Andrew K. McIntyre, FRACP, MBB S, Medical -Objects
	13	Yongjian B ao, PhD, G E Healthca re
	14	Howard R. Strasberg, MD, MS, W olters Klu wer Health
	15	Peter R. T attam, Tat tam Softwa re Enterpr ises Pty L td
	16	Scott Bolt e, MS, GE Healthcare
	17	Peter Scot t, MBBS, M edical-Obj ects
	18	Keith Boon e, GE Heal thcare
	19	Zhijing Li u, PhD, Si emens Heal thcare
	20	Chris Melo , Philips Healthcare
	21	Nathan Hul se, PhD, I ntermounta in Healthc are
	22	Jim Basila kis, MBBS, MS, Unive rsity of W estern Syd ney
	23	Robert Wor den, Open Mapping So ftware, Li mited
	24	Daryl Cher tcoff, HLN Consultin g
	25	Clayton Cu rtis, MD, PhD, U.S. Veterans H ealth Admi nistration
	26	Guilherme Del Fiol, MD, PhD, U niversity of Utah
	27	Emory Fry, MD, Unifo rmed Servi ce Univers ity Health Sciences
	28	Jean-Charl es Dufour, MD, PhD, Université Aix-Marse ille
	29	Laurent CH ARLOIS, Un iversité d e la Médit erranée
	30
	31	Project Sp onsor
	32	HL7 Clinic al Decisio n Support
	33
	34	HL7 Projec t #184
	35	Informati ve Ballot
	36	September 2011
	37	HL7 vMR DA M - Sept 2 011 Page: 2
	38
	39	Table of C ontents
	40	Table of C ontents .. .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... ...... 2
	41	Executive Summary .. .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .. 5
	42	vMR DAM Sp ecificatio n ........ .......... .......... .......... .......... .......... .......... .......... .......... .......... . 6
	43	1. Modelin g Methodol ogy ...... .......... .......... .......... .......... .......... .......... .......... .......... ... 6
	44	2. Model A rtifacts a nd Example s ........ .......... .......... .......... .......... .......... .......... .......... 6
	45	3. Domain Analysis M odel ..... .......... .......... .......... .......... .......... .......... .......... .......... ... 7
	46	3.1 modelP arent .... .......... .......... .......... .......... .......... .......... .......... .......... .......... ...... 7
	47	3.1.1 cdsI nput ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... ...... 7
	48	3.1.1.1 CD SContext . .......... .......... .......... .......... .......... .......... .......... .......... .......... 8
	49	3.1.1.2 CD SInput ... .......... .......... .......... .......... .......... .......... .......... .......... .......... ... 8
	50	3.1.1.3 CD SResource .......... .......... .......... .......... .......... .......... .......... .......... ........ 9
	51	3.1.2 cdsO utput .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .. 10
	52	3.1.2.1 CD SOutput .. .......... .......... .......... .......... .......... .......... .......... .......... ......... 10
	53	3.1.3 cdsI nputSpecif ication .. .......... .......... .......... .......... .......... .......... .......... ....... 11
	54	3.1.3.1 CD SInputSpec ification .......... .......... .......... .......... .......... .......... .......... ... 11
	55	3.1.3.2 Cl inicalStat ementInput Specificat ion ...... .......... .......... .......... .......... ....... 12
	56	3.1.3.3 Co dedAttribu teRequirem ent ...... .......... .......... .......... .......... .......... ......... 12
	57	3.1.3.4 Ev aluatedPer sonInputSp ecificatio n ........ .......... .......... .......... .......... ...... 13
	58	3.1.3.5 Pa tientInput Specificat ion ...... .......... .......... .......... .......... .......... .......... .... 13
	59	3.1.3.6 Re latedEntit yInputSpec ification .......... .......... .......... .......... .......... .......... 14
	60	3.1.3.7 Re latedEvalu atedPerson InputSpeci fication . .......... .......... .......... .......... 15
	61	3.1.3.8 Ti meAttribut eRequireme nt........ .......... .......... .......... .......... .......... .......... 15
	62	3.1.4 vmr .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... ....... 17
	63	3.1.4.1 Ad ministrabl eSubstance ......... .......... .......... .......... .......... .......... .......... .. 27
	64	3.1.4.2 Ad verseEvent ......... .......... .......... .......... .......... .......... .......... .......... ........ 2 7
	65	3.1.4.3 Ad verseEvent Base ..... .......... .......... .......... .......... .......... .......... .......... .... 28
	66	3.1.4.4 Ap pointmentP roposal .. .......... .......... .......... .......... .......... .......... .......... ... 28
	67	3.1.4.5 Ap pointmentR equest ... .......... .......... .......... .......... .......... .......... .......... ... 29
	68	3.1.4.6 Bo dySite ... .......... .......... .......... .......... .......... .......... .......... .......... .......... .. 29
	69	3.1.4.7 Cl inicalStat ement .... .......... .......... .......... .......... .......... .......... .......... ....... 30
	70	3.1.4.8 Cl inicalStat ementEntit yInRoleRel ationship. .......... .......... .......... .......... .. 31
	71	3.1.4.9 Cl inicalStat ementRelat ionship .. .......... .......... .......... .......... .......... .......... 31
	72	3.1.4.10 D eniedAdver seEvent .. .......... .......... .......... .......... .......... .......... .......... .. 31
	73	3.1.4.11 D eniedProbl em ....... .......... .......... .......... .......... .......... .......... .......... ...... 32
	74	3.1.4.12 D oseRestric tion ..... .......... .......... .......... .......... .......... .......... .......... ....... 32
	75	3.1.4.13 E ncounterBa se ....... .......... .......... .......... .......... .......... .......... .......... ...... 32
	76	3.1.4.14 E ncounterEv ent ...... .......... .......... .......... .......... .......... .......... .......... ...... 33
	77	3.1.4.15 E ntity .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .... 33
	78	3.1.4.16 E ntityRelat ionship .. .......... .......... .......... .......... .......... .......... .......... ....... 33
	79	3.1.4.17 E valuatedPe rson ..... .......... .......... .......... .......... .......... .......... .......... ..... 34
	80	3.1.4.18 F acility .. .......... .......... .......... .......... .......... .......... .......... .......... .......... .... 34
	81	3.1.4.19 G oal ...... .......... .......... .......... .......... .......... .......... .......... .......... .......... .... 35
	82	3.1.4.20 G oalBase... .......... .......... .......... .......... .......... .......... .......... .......... ......... 35
	83	HL7 vMR DA M - Sept 2 011 Page: 3
	84
	85	3.1.4.21 G oalProposa l ........ .......... .......... .......... .......... .......... .......... .......... ........ 3 5
	86	3.1.4.22 M issedAppoi ntment ... .......... .......... .......... .......... .......... .......... .......... ... 36
	87	3.1.4.23 O bservation Base ..... .......... .......... .......... .......... .......... .......... .......... ..... 36
	88	3.1.4.24 O bservation Order .... .......... .......... .......... .......... .......... .......... .......... ..... 37
	89	3.1.4.25 O bservation Proposal . .......... .......... .......... .......... .......... .......... .......... ... 37
	90	3.1.4.26 O bservation Result ... .......... .......... .......... .......... .......... .......... .......... ..... 38
	91	3.1.4.27 O rganizatio n ........ .......... .......... .......... .......... .......... .......... .......... ......... 38
	92	3.1.4.28 P erson .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .. 39
	93	3.1.4.29 P roblem ... .......... .......... .......... .......... .......... .......... .......... .......... .......... . 39
	94	3.1.4.30 P roblemBase ......... .......... .......... .......... .......... .......... .......... .......... ....... 40
	95	3.1.4.31 P rocedureBa se ....... .......... .......... .......... .......... .......... .......... .......... ...... 40
	96	3.1.4.32 P rocedureEv ent ...... .......... .......... .......... .......... .......... .......... .......... ...... 41
	97	3.1.4.33 P rocedureOr der ...... .......... .......... .......... .......... .......... .......... .......... ...... 41
	98	3.1.4.34 P rocedurePr oposal ... .......... .......... .......... .......... .......... .......... .......... .... 42
	99	3.1.4.35 S cheduledAp pointment .......... .......... .......... .......... .......... .......... .......... 42
	100	3.1.4.36 S cheduledPr ocedure .. .......... .......... .......... .......... .......... .......... .......... .. 42
	101	3.1.4.37 S pecimen .. .......... .......... .......... .......... .......... .......... .......... .......... ......... 43
	102	3.1.4.38 S ubstanceAd ministrati onBase ... .......... .......... .......... .......... .......... ....... 43
	103	3.1.4.39 S ubstanceAd ministrati onEvent .. .......... .......... .......... .......... .......... ....... 44
	104	3.1.4.40 S ubstanceAd ministrati onOrder .. .......... .......... .......... .......... .......... ....... 44
	105	3.1.4.41 S ubstanceAd ministrati onProposal ......... .......... .......... .......... .......... ..... 45
	106	3.1.4.42 S ubstanceDi spensation Event .... .......... .......... .......... .......... .......... ....... 45
	107	3.1.4.43 S upplyBase .......... .......... .......... .......... .......... .......... .......... .......... ........ 4 6
	108	3.1.4.44 S upplyEvent ......... .......... .......... .......... .......... .......... .......... .......... ........ 4 6
	109	3.1.4.45 S upplyOrder ......... .......... .......... .......... .......... .......... .......... .......... ........ 4 6
	110	3.1.4.46 S upplyPropo sal ...... .......... .......... .......... .......... .......... .......... .......... ...... 47
	111	3.1.4.47 U nconducted Observatio n ........ .......... .......... .......... .......... .......... ......... 47
	112	3.1.4.48 U ndelivered Procedure .......... .......... .......... .......... .......... .......... .......... .. 47
	113	3.1.4.49 U ndelivered SubstanceA dministrat ion ...... .......... .......... .......... .......... ... 48
	114	3.1.4.50 U ndelivered Supply ... .......... .......... .......... .......... .......... .......... .......... .... 48
	115	3.1.4.51 V MR ....... .......... .......... .......... .......... .......... .......... .......... .......... .......... .. 49
	116	3.1.5 data Types .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .. 50
	117	3.1.5.1 is o-21090-da tatypes-si mplified-v mr ....... .......... .......... .......... .......... ....... 51
	118	3.1.5.1.1 AD ....... .......... .......... .......... .......... .......... .......... .......... .......... .......... .. 51
	119	3.1.5.1.2 ADXP ..... .......... .......... .......... .......... .......... .......... .......... .......... ......... 51
	120	3.1.5.1.3 ANY ...... .......... .......... .......... .......... .......... .......... .......... .......... .......... 52
	121	3.1.5.1.4 BL ....... .......... .......... .......... .......... .......... .......... .......... .......... .......... .. 52
	122	3.1.5.1.5 CD ....... .......... .......... .......... .......... .......... .......... .......... .......... .......... . 52
	123	3.1.5.1.6 CS ....... .......... .......... .......... .......... .......... .......... .......... .......... .......... .. 54
	124	3.1.5.1.7 EN ....... .......... .......... .......... .......... .......... .......... .......... .......... .......... .. 54
	125	3.1.5.1.8 ENXP ..... .......... .......... .......... .......... .......... .......... .......... .......... ......... 55
	126	3.1.5.1.9 II........ .......... .......... .......... .......... .......... .......... .......... .......... .......... .... 55
	127	3.1.5.1.10 INT ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... . 56
	128	3.1.5.1.11 IVL_INT . .......... .......... .......... .......... .......... .......... .......... .......... ....... 57
	129	3.1.5.1.12 IVL_PQ .. .......... .......... .......... .......... .......... .......... .......... .......... ....... 57
	130	3.1.5.1.13 IVL_REAL .......... .......... .......... .......... .......... .......... .......... .......... ..... 58
	131	HL7 vMR DA M - Sept 2 011 Page: 4
	132
	133	3.1.5.1.14 IVL_RTO . .......... .......... .......... .......... .......... .......... .......... .......... ...... 59
	134	3.1.5.1.15 IVL_TS .. .......... .......... .......... .......... .......... .......... .......... .......... ........ 5 9
	135	3.1.5.1.16 PQ ...... .......... .......... .......... .......... .......... .......... .......... .......... .......... 60
	136	3.1.5.1.17 QTY ..... .......... .......... .......... .......... .......... .......... .......... .......... ......... 61
	137	3.1.5.1.18 REAL .... .......... .......... .......... .......... .......... .......... .......... .......... ........ 6 1
	138	3.1.5.1.19 RTO ..... .......... .......... .......... .......... .......... .......... .......... .......... ......... 61
	139	3.1.5.1.20 ST ...... .......... .......... .......... .......... .......... .......... .......... .......... .......... . 61
	140	3.1.5.1.21 TEL ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... 62
	141	3.1.5.1.22 TS ...... .......... .......... .......... .......... .......... .......... .......... .......... .......... . 63
	142	3.1.5.1.23 XP ...... .......... .......... .......... .......... .......... .......... .......... .......... .......... . 63
	143
	144	HL7 vMR DA M - Sept 2 011 Page: 5
	145
	146	Executive Summary
	147	A Virtual Medical Re cord (vMR) for Clini cal Decisi on Support (CDS) is a data mod el for rep resenting
	148	clinical i nformation relevant to CDS. T he vMR enc ompasses d ata about a patient' s demograp hics and
	149	clinical h istory, as well as C DS inferen ces about the patien t (e.g., r ecommended clinical interventi ons).
	150
	151	This Domai n Analysis Model (DA M) include s the foll owing:
	152	• A specif ication of a vMR for CDS
	153	• Structur al specifi cations fo r inputs a nd outputs of CDS en gines, whi ch are com posed prim arily of v MR
	154	data
	155	• A struct ural speci fication f or identif ying input data requ irements f or specifi c CDS use cases
	156
	157	In additio n, example s are prov ided for c linical da ta represe nted using a vMR str ucture.
	158
	159	What is no t provided in this D AM, but wh ich are ex pected to be needed for specif ic CDS imp lementatio ns
	160	using the vMR includ e the foll owing:
	161	• Template s that con strain the vMR and i ts compone nts for sp ecific int eroperabil ity settin gs
	162	• Implemen tation gui des for pl atform-spe cific impl ementation approache s for the vMR
	163	• Mappings between H L7 ballote d informat ion struct ures and t he vMR
	164
	165	Of note, t he HL7 vMR project t eam plans on develop ing the ab ove requir ed resourc es and to contribute
	166	them throu gh HL7 and through o ther disse mination c hannels. In particu lar, OpenC DS
	167	(http://ww w.opencds. org) will be making many of th e above re sources av ailable as open-sour ce
	168	contributi ons.
	169
	170	The vMR DA M was init ially ball oted in Ma y 2010. S ince then, the comme nts from t hat ballot have been
	171	incorporat ed to deve lop a DAM that is mo re closely aligned w ith the HL 7 Referenc e Informat ion Model.
	172	In particu lar, the v MR DAM has been re-d esigned so that it c an be more easily po pulated fr om standar d
	173	HL7 artifa cts such a s the HL7 Continuity of Care D ocument (C CD). vMR project te am members have
	174	vetted and iterative ly refined the appro ach propos e


	175	HL7 vMR DA M - Sept 2 011 Page: 6
	176
	177	vMR DAM Sp ecificatio n
	178	1. Modelin g Methodol ogy
	179	The vMR DA M was deve loped in s everal sta ges.
	180
	181	As an impo rtant init ial step t he vMR pro ject team conducted a multi-in stitutiona l analysis of CDS da ta
	182	needs enco mpassing 2 0 CDS syst ems from 4 nations, which incl uded both large-scal e home-gro wn CDS
	183	systems (e .g., CDS s ystems of the Vetera ns Health Administra tion, Inte rmountain Healthcare , and
	184	Partners H ealthcare) as well a s a number of commer cial CDS s ystems (Si emens Soar ian, Eclip sys
	185	Sunrise, M edical-Obj ects CDS, Altos Onco EMR, Hughe s riskApps , Wolters Kluwer Hea lth Infobu tton API,
	186	and Medi-S pan). Thi s analysis identifie d the use of 131 ato mic data e lements ac ross the 2 0 CDS
	187	systems. A manuscri pt summari zing the f indings fr om this st udy is ava ilable at
	188	http://www .ncbi.nlm. nih.gov/pm c/articles /PMC304131 7/.
	189
	190	Using the results of this mult i-institut ional CDS data needs analysis as the fou ndation, a n initial DAM was
	191	developed using the following modeling g uidelines:
	192	• Encompas s all data elements identified as being used for C DS by the multi-inst itutional CDS data
	193	needs anal ysis
	194	• Use an e xtensible modeling a pproach, w ith the un derstandin g that the model can be restri cted later
	195	through im plementati on guides and profil es.
	196
	197	The result of the ab ove method ology was the initia l vMR DAM, which was balloted in May 201 0. The
	198	ballot did pass the informativ e guide ap proval vot e requirem ents. Sub sequently, the vMR p roject tea m
	199	sought to do the fol lowing: (i ) address the peer r eview comm ents and i nsights re ceived dur ing this
	200	process an d (ii) imp lement dra ft version s of the v MR specifi cation to ensure its usability . As some
	201	specific e nhancement s to the v MR resulti ng from th is process , the vMR now includ es concret e,
	202	constraine d data typ es derived from ISO 21090 data types, an d the vMR was more c losely ali gned with
	203	normative HL7 constr ucts to be tter enabl e semantic interoper ability wi th these m odels.
	204
	205	2. Model A rtifacts a nd Example s
	206	A separate file arch ive that a ccompanies this docu ment conta ins the fo llowing mo del artifa cts and
	207	examples:
	208	• The Ente rprise Arc hitect UML model (.E AP) contai ning the v MR DAM. O f note, th is ballot document
	209	wa auto-ge nerated fr om this En terprise A rchitect f ile using a custom r eporting t emplate in cluded in
	210	the file.
	211	• An XMI U ML file (. xmi) expor ted from E nterprise Architect
	212	• A set of XML Schem as (.xsd), primarily auto-gene rated from the Enter prise Arch itect mode l, to
	213	provide an example o f a potent ial platfo rm-specifi c implemen tation of the vMR.
	214	• XML exam ples of vM R instance s (.xml) c onformant with the a bove vMR X ML schemas .
	215
	216	Provided b elow is de tailed doc umentation of the vM R DAM.
	217
	218	HL7 vMR DA M - Sept 2 011 Page: 7
	219
	220	3. Domain Analysis M odel
	221	Details of the vMR D omain Anal ysis Model are provi ded below.
	222
	223	3.1 modelP arent
	224	Type: Pac kage
	225	Package: M odel
	226
	227	The modelP arent pack age is the parent pa ckage cont aining the following subsidiar y model pa ckages:
	228	- cdsInput : specifie s the data input use d by CDS s ystems.
	229	- cdsOutpu t: specifi es the dat a output g enerated b y CDS syst ems.
	230	- cdsInput Specificat ion: speci fies the s pecific CD S input da ta require d for a sp ecific CDS use case.
	231	- vmr: spe cifies inf ormation a bout a pat ient relev ant for CD S.
	232	- dataType s: specifi es data ty pes used; constraine d version of ISO 210 90 data ty pes.
	233
	234	Note that this is a platform-i ndependent , logical informatio n model fr om which p latform-sp ecific inf ormation
	235	models can be derive d.
	236
	237
	238	3.1.1 cdsI nput
	239	Type: Pac kage
	240	Package: m odelParent
	241
	242	Specifies input data used by C DS systems .
	243
	244
	245	cdsInput - (Class di agram)
	246	class cds Input
	247	CDSContext
	248	+ cdsSyste mUserType :CD [0..1 ]
	249	+ cdsSyste mUserPrefe rredLangua ge :CD [0 ..1]
	250	+ cdsInfor mationReci pientType :CD [0..1 ]
	251	+ cdsInfor mationReci pientPrefe rredLangua ge :CD [0 ..1]
	252	+ cdsSyste mUserTaskC ontext :C D [0..1]
	253	CDSInput
	254	+ template Id :II [0 ..*]
	255	CDSResourc e
	256	+ cdsResou rceType : CD
	257	+ resource Contents :anyType
	258	v mr::VMR
	259	+ template Id :II [1 ..*]
	260	+cdsContex t
	261	0..1
	262	+vmrInput 1 +cdsReso urce 0..*
	263
	264	Figure: 1
	265
	266
	267	HL7 vMR DA M - Sept 2 011 Page: 8
	268
	269	3.1.1.1 CD SContext
	270	Type: Cla ss
	271	Package: c dsInput
	272
	273	The situat ion or con text withi n which a CDS evalua tion is ma de. Inclu ded in CDS inputs fo r HL7 Cont ext-Aware
	274	Knowledge Retrieval (Infobutto n) Knowled ge Request standard. Used, fo r example, to genera te human-r eadable
	275	care guida nce in the end-user' s preferre d language .
	276
	277	Attributes
	278	Attribute Notes
	279	cdsSystemU serType
	280	CD [0. .1]
	281	The type o f individu al using t he CDS sys tem. E.g. , patient, healthcar e
	282	provider, or specifi c type of healthcare provider (physician , nurse, e tc.).
	283	cdsSystemU serPreferr edLanguage
	284	CD [0. .1]
	285	Preferred language o f the pers on who is using the system. U sed, for
	286	example, t o indicate the langu age in whi ch the use r interfac e should b e
	287	rendered. E.g., Eng lish, Span ish.
	288	cdsInforma tionRecipi entType
	289	CD [0. .1]
	290	The type o f individu al who con sumes the CDS conten t. May be
	291	different from CDS s ystem user type (e.g ., if clin ician is g etting dis ease
	292	management guidance for provis ion to a p atient). E.g., pati ent,
	293	healthcare provider, or specif ic type of healthcar e provider (physicia n,
	294	nurse, etc .).
	295	cdsInforma tionRecipi entPreferr edLa
	296	nguage
	297	CD [0. .1]
	298	Preferred language o f the pers on who wil l consume the CDS co ntent.
	299	Used, for example, t o indicate the langu age in whi ch the con tent shoul d
	300	be written . E.g., E nglish, Sp anish.
	301	cdsSystemU serTaskCon text
	302	CD [0. .1]
	303	The task t hat a CDS system use r is perfo rming. E. g., labora tory resul ts
	304	review, me dication l ist review . Can be used to ta ilor CDS o utputs,
	305	such as re commended informatio n resource s.
	306
	307
	308
	309	3.1.1.2 CD SInput
	310	Type: Cla ss
	311	Package: c dsInput
	312
	313	The parent class con taining th e data use d by a CDS system to generate inferences . Include s an input vMR and
	314	optionally CDS conte xt and/or CDS resour ce data.
	315
	316	Attributes
	317	Attribute Notes
	318	templateId
	319	II [0. .*]
	320	The identi fier of a set of con straints p laced on a CDS input .
	321
	322
	323	HL7 vMR DA M - Sept 2 011 Page: 9
	324
	325
	326	3.1.1.3 CD SResource
	327	Type: Cla ss
	328	Package: c dsInput
	329
	330	A resource independe nt of indi vidual pat ients, pro vided to a CDS engin e to facil itate pati ent evalua tion. Inc ludes,
	331	for exampl e, local a ntibiogram data (loc al suscept ibility pr ofile of m icrobes to different antimicro bial agent s), local
	332	formulary restrictio ns, or CDS system us er prefere nce on whi ch guideli nes to use for healt h maintena nce (e.g.,
	333	HEDIS vs. USPSTF).
	334
	335	Attributes
	336	Attribute Notes
	337	cdsResourc eType
	338	CD
	339	The type o f CDS reso urce, as d efined by a coded ta xonomy. A
	340	resource i ndependent of indivi dual patie nts, provi ded to a C DS engine
	341	to facilit ate patien t evaluati on. E.g., local ant ibiogram, local form ulary
	342	restrictio ns, CDS sy stem user preference on which guidelines to use fo r
	343	health mai ntenance ( e.g., HEDI S vs. USPS TF). The specified
	344	informatio n structur e used to convey the related r esourceCon tents must
	345	be identif iable from the cdsRe sourceType .
	346	resourceCo ntents
	347	anyType
	348	The inform ation stru cture of t he resourc e depends on the CDS resource
	349	type. E.g ., local a ntibiogram data, loc al formula ry restric tions, CDS
	350	system use r preferen ce on whic h guidelin es to use for health
	351	maintenanc e (e.g., H EDIS vs. U SPSTF).
	352
	353
	354
	355
	356	HL7 vMR DA M - Sept 2 011 Page: 10
	357
	358	3.1.2 cdsO utput
	359	Type: Pac kage
	360	Package: m odelParent
	361
	362	Specifies output dat a generate d by CDS s ystems.
	363
	364
	365	cdsOutput - (Class d iagram)
	366	class cds Output
	367	CDSOutput
	368	v mr::VMR
	369	+ template Id :II [1 ..*]
	370	dataTypes: :
	371	iso-21090- datatypes- simplified -vmr::ANY
	372	+simpleOut put 0..1+v mrOutput 0 ..1
	373
	374	Figure: 2
	375
	376
	377	3.1.2.1 CD SOutput
	378	Type: Cla ss
	379	Package: c dsOutput
	380
	381	The parent class con taining th e data use d by a CDS system to communica te inferen ces. Can use the vM R data
	382	structure or a base data type to communi cate the r esults.
	383
	384
	385
	386
	387	HL7 vMR DA M - Sept 2 011 Page: 11
	388
	389	3.1.3 cdsI nputSpecif ication
	390	Type: Pac kage
	391	Package: m odelParent
	392
	393	Specifies the specif ic CDS inp ut data re quired for a specifi c CDS use case.
	394
	395
	396	cdsInputSp ecificatio n - (Class diagram)
	397	class cds InputSpeci fication
	398	CDSInputSp ecificatio n
	399	+ required CdsResourc eType :CD [0..*]
	400	+ required CdsContext Attribute :CS [0..* ]
	401	+ required InputVmrTe mplate :I I [0..*]
	402	EvaluatedP ersonInput Specificat ion
	403	+ required EvaluatedP ersonAttri bute :CS [0..*]
	404	+ required EvaluatedP ersonTempl ate :II [ 0..*]
	405	PatientInp utSpecific ation Rela tedEv alua tedPersonI nputSpecif ication
	406	+ inclusio nScope :C D
	407	+ inclusio nScopeChai nDepth :i nt [0..1]
	408	+ inclusio nScopeDist ance :PQ [0..1]
	409	RelatedEnt ityInputSp ecificatio n
	410	+ required Relationsh ipType :C D
	411	+ required Relationsh ipSearchBa ckTimePeri od :PQ [0 ..1]
	412	+ required Relationsh ipSearchFo wardTimePe riod :PQ [0..1]
	413	+ required Enti tyTem plate :II [0..*]
	414	ClinicalSt atementInp utSpecific ation
	415	+ required ClinicalSt atementTem plate :II [0..*]
	416	+ required GeneralCli nicalState mentClass :CS
	417	+ required SpecificCl inicalStat ementClass :CS [0.. 1]
	418	CodedAttri buteRequir ement
	419	+ targetCo dedAttribu te :CS
	420	+ targetCo de :CD [1 ..*]
	421	TimeAttrib uteRequire ment
	422	+ targetTi meAttribut e :CS
	423	+ searchBa ckTimePeri od :PQ [0 ..1]
	424	+ searchFo rwardTimeP eriod :PQ [0..1]
	425	+clinicalS tatementIn putSpecifi cation
	426	0..*
	427	+relatedEn tityInputS pecificati on
	428	0..*
	429	+relatedEv aluatedPer sonInputSp ecificatio n
	430	0..1+patie ntInputSpe cification 0..1
	431	+timeAttri buteRequir ement0..+ codedAttri buteRequir ement 0..
	432
	433	Figure: 3
	434
	435
	436	3.1.3.1 CD SInputSpec ification
	437	Type: Cla ss
	438	Package: c dsInputSpe cification
	439
	440	The parent class con taining th e data req uired by a specific CDS use ca se. For e xample, th is class c an be used to
	441	specify th at the eva luation of a patient for the n eed for a mammogram requires t he followi ng data: ( i) gender; (ii)
	442	age; (iii) past mast ectomy his tory; and (iv) past mammogram history.
	443
	444	Can includ e a detail ed input s pecificati on for the focal pat ient as we ll as for related ev aluated pe rsons. No te that it
	445	is assumed that the superset o f data req uired for related ev aluated pe rsons are the same f or each of the relat ed
	446	HL7 vMR DA M - Sept 2 011 Page: 12
	447
	448	evaluated persons (e .g., relat ives). If input spe cification s are not provided r egarding p atients or other eva luated
	449	persons, t hen this s ignifies t hat no fur ther const raints are being pla ced on req uired data other tha n what is expressed
	450	through th e input da ta model a nd its exi sting temp late(s).
	451
	452	Attributes
	453	Attribute Notes
	454	requiredCd sResourceT ype
	455	CD [0. .*]
	456	The type o f CDS reso urce requi red. Requ ired input parameter s (e.g.,
	457	mammogram testing fr equency) c an be spec ified usin g this att ribute
	458	(e.g., wit h a CD rep resenting mammogram testing fr equency).
	459	requiredCd sContextAt tribute
	460	CS [0. .*]
	461	The CDS co ntext attr ibute (e.g ., CDS sys tem user p referred l anguage)
	462	required.
	463	requiredIn putVmrTemp late
	464	II [0. .*]
	465	Identifier of a set of constra ints that must be pl aced on th e input vM R.
	466
	467
	468
	469	3.1.3.2 Cl inicalStat ementInput Specificat ion
	470	Type: Cla ss
	471	Package: c dsInputSpe cification
	472
	473	Specifies the clinic al stateme nts requir ed regardi ng the eva luated per son of int erest. Ca n include
	474	CodedAttri buteRequir ements and TimeAttri buteRequir ements.
	475
	476	If no Code dAttribute Requiremen t specifie d, all rel evant clin ical state ments are required r egardless of their c oded
	477	attributes . If no T imeAttribu teRequirem ent specif ied, all r elevant cl inical sta tements ar e required regardles s of
	478	their time attribute s. All sp ecified Co dedAttribu teRequirem ents and T imeAttribu teRequirem ents shoul d be
	479	fulfilled in provide d Clinical Statements .
	480
	481	Attributes
	482	Attribute Notes
	483	requiredCl inicalStat ementTempl ate
	484	II [0. .*]
	485	Identifier of a set of constra ints that must be pl aced on th e
	486	ClinicalSt atement. Allows, fo r example, the speci fication o f required
	487	detailed c linical mo dels that correspond to templa tes.
	488	requiredGe neralClini calStateme ntCla
	489	ss
	490	CS
	491	The genera l class of clinical statement required. E.g., Pro cedure,
	492	Observatio n.
	493
	494	If only th e general clinical s tatement t ype is spe cified (i. e.,
	495	requiredSp ecificClin icalStatem entType is not speci fied), the n it will be
	496	assumed th at all mem bers of th e specifie d general clinical s tatement
	497	types are desired.
	498	requiredSp ecificClin icalStatem entCla
	499	ss
	500	CS [0. .1]
	501	The specif ic class o f clinical statement required. E.g., Pr ocedureOrd er,
	502	Observatio nEvent.
	503
	504
	505
	506	3.1.3.3 Co dedAttribu teRequirem ent
	507	Type: Cla ss
	508	Package: c dsInputSpe cification
	509
	510	A requirem ent for a coded attr ibute of a clinical statement. Specifie d in terms of the ta rget coded attribute and the
	511	code(s) fo r that att ribute tha t allow th e requirem ent to be fulfilled.
	512	HL7 vMR DA M - Sept 2 011 Page: 13
	513
	514
	515	Attributes
	516	Attribute Notes
	517	targetCode dAttribute
	518	CS
	519	The clinic al stateme nt's coded attribute that is t he subject of restri ction.
	520	E.g., prob lem code, problem st atus.
	521	targetCode
	522	CD [1. .*]
	523	A target c ode for th e target c oded attri bute. If a clinical statement has a
	524	target cod ed attribu te (e.g., problem co de) that m atches one of the ta rget
	525	codes (e.g ., ICD9CM 250.00), t hen the co ded attrib ute requir ement is
	526	met.
	527
	528
	529
	530	3.1.3.4 Ev aluatedPer sonInputSp ecificatio n
	531	Type: Cla ss
	532	Package: c dsInputSpe cification
	533
	534	Specifies the data r equired fo r an evalu ated perso n. Can in clude (i) a specific ation of t he person attributes (e.g.,
	535	gender) re quired; (i i) a speci fication o f the temp lates that must be a pplied; (i ii) a spec ification of the dat a required
	536	for relate d entities ; and (iv) a specifi cation of the clinic al stateme nts requir ed.
	537
	538	Attributes
	539	Attribute Notes
	540	requiredEv aluatedPer sonAttribu te
	541	CS [0. .*]
	542	Required a ttribute o f the Eval uatedPerso n. Note t hat if an attribute is
	543	required b y a specif ied templa te, it mus t be provi ded regard less of
	544	whether it s need is specified here.
	545	requiredEv aluatedPer sonTemplat e
	546	II [0. .*]
	547	Identifier of a set of constra ints that must be pl aced on th e
	548	EvaluatedP erson.
	549
	550
	551
	552	3.1.3.5 Pa tientInput Specificat ion
	553	Type: Cla ss Eval uatedPerso nInputSpec ification
	554	Package: c dsInputSpe cification
	555
	556	The data r equired fo r the pati ent. Is a specializ ation of t he Evaluat edPersonIn putSpecifi cation cla ss.
	557
	558
	559
	560	HL7 vMR DA M - Sept 2 011 Page: 14
	561
	562	3.1.3.6 Re latedEntit yInputSpec ification
	563	Type: Cla ss
	564	Package: c dsInputSpe cification
	565
	566	Specifies the data r equired re garding en tities rel ated to th e evaluate d person o f interest .
	567
	568	Attributes
	569	Attribute Notes
	570	requiredRe lationship Type
	571	CD
	572	Required t ype of rel ationship to Entitie s other th an Evaluat edPersons, if
	573	available. Note tha t requirem ents for o ther Evalu atedPerson s are
	574	specified separately within th e
	575	RelatedEva luatedPers onInputSpe cification class. E .g., prima ry care
	576	provider, health ins urance pro vider.
	577	requiredRe lationship SearchBack Time
	578	Period
	579	PQ [0. .1]
	580	This requi rement is met if the relations hip time i nterval ov erlaps wit h
	581	the time i nterval th at starts at (index evaluation time) and ends at ( index
	582	evaluation time + re quiredRela tionshipSe archForwar dTimePerio d). The
	583	earlier po int is con sidered to be exclus ive and th e ending p oint is
	584	considered to be inc lusive. E .g., if th e index ev aluation t ime is
	585	7/1/2011 a t 4pm and the
	586	requiredRe lationship SearchForw ardTimePer iod is 1 y ear, then this
	587	requiremen t is met i f the rela tionshipTi meInterval overlaps with any
	588	time after 4pm on 7/ 1/2011 and up to and including 7/1/2012 at 4pm.
	589	requiredRe lationship SearchFowa rdTi
	590	mePeriod
	591	PQ [0. .1]
	592	This requi rement is met if the relations hip time i nterval ov erlaps wit h
	593	the time i nterval th at starts at (index evaluation time -
	594	requiredRe lationship SearchBack TimePeriod ) and ends at (index
	595	evaluation time). Th e earlier point is c onsidered to be excl usive and the
	596	ending poi nt is cons idered to be inclusi ve. E.g., if the in dex evalua tion
	597	time is 7/ 1/2011 at 4pm and th e
	598	requiredRe lationship SearchBack TimePeriod is 1 year , then thi s
	599	requiremen t is met i f the rela tionshipTi meInterval overlaps with any
	600	time after 4pm on 7/ 1/2010 and up to and including 7/1/2011 at 4pm.
	601	requiredEn tityTempla te
	602	II [0. .*]
	603	Identifier of a set of constra ints that must be pl aced on th e related
	604	Entity.
	605
	606
	607
	608	HL7 vMR DA M - Sept 2 011 Page: 15
	609
	610	3.1.3.7 Re latedEvalu atedPerson InputSpeci fication
	611	Type: Cla ss Eval uatedPerso nInputSpec ification
	612	Package: c dsInputSpe cification
	613
	614	The data r equired fo r evaluate d persons related to the patie nt. Is a specializa tion of th e
	615	EvaluatedP ersonInput Specificat ion class. Includes a specifi cation of the scope of evaluat ed persons that are
	616	required.
	617
	618	Attributes
	619	Attribute Notes
	620	inclusionS cope
	621	CD
	622	The scope of evaluat ed persons to includ e. E.g., relative, sexual
	623	contacts, persons li ving in af fected geo graphic zo ne.
	624	inclusionS copeChainD epth
	625	int [0 ..1]
	626	The number of links to travers e to ident ify evalua ted person s within t he
	627	specific s cope. E.g ., 3 in co mbination with scope of relati ve would
	628	indicate u p to 3rd d egree rela tives. If neither
	629	inclusionS copeChainD epth nor i nclusionSc opeDistanc e are spec ified,
	630	then all a vailable e valuated p ersons wit h the indi cated scop e should b e
	631	included. E.g., if inclusion scope is s exual cont act and no scope
	632	depth/dist ance is sp ecified, t hen all se xual conta cts of the focal per son
	633	and of oth er persons related t hrough sex ual contac t should b e included .
	634	inclusionS copeDistan ce
	635	PQ [0. .1]
	636	The distan ce to trav erse to id entify eva luated per sons withi n the spec ific
	637	scope. E. g., 5 mile s in combi nation wit h scope of living in affected
	638	area would indicate people liv ing within a 5 mile radius of a location of
	639	interest. If neithe r inclusio nScopeChai nDepth nor
	640	inclusionS copeDistan ce are spe cified, th en all ava ilable eva luated
	641	persons wi th the ind icated sco pe should be include d. E.g., if inclusi on
	642	scope is s exual cont act and no scope dep th/distanc e is speci fied, then all
	643	sexual con tacts of t he focal p erson and of other p ersons rel ated throu gh
	644	sexual con tact shoul d be inclu ded.
	645
	646
	647	3.1.3.8 Ti meAttribut eRequireme nt
	648	Type: Cla ss
	649	Package: c dsInputSpe cification
	650
	651	A requirem ent for a time attri bute of a clinical s tatement. Specified in terms of the tar get time a ttribute a nd the
	652	required t ime interv al for tha t attribut e in relat ed to the index eval uation tim e. A sear chBackTime Period and /or a
	653	searchForw ardTimePer iod must b e provided .
	654
	655	Attributes
	656	Attribute Notes
	657	targetTime Attribute
	658	CS
	659	The time a ttribute t argeted fo r restrict ion. E.g. , procedur e time,
	660	substance dispensati on time.
	661	searchBack TimePeriod
	662	PQ [0. .1]
	663	The time a ttribute r equirement is met if the targe t time att ribute ove rlaps
	664	with the t ime interv al that st arts at (i ndex evalu ation time -
	665	searchBack TimePeriod ) and ends at (index evaluatio n time). The
	666	earlier po int is con sidered to be exclus ive and th e ending p oint is
	667	considered to be inc lusive. E .g., if th e index ev aluation t ime is
	668	7/1/2011 a t 4pm and the search BackTimePe riod is 1 year, then the time
	669	attribute requiremen t is met i f the targ etTimeAttr ibute has overlaps w ith
	670	anytime af ter 4pm on 7/1/2010 and up to and includ ing 7/1/20 11 at
	671	4pm.
	672	HL7 vMR DA M - Sept 2 011 Page: 16
	673
	674	Attribute Notes
	675	searchForw ardTimePer iod
	676	PQ [0. .1]
	677	The time a ttribute r equirement is met if the targe t time att ribute ove rlaps
	678	with the t ime interv al that st arts at (i ndex evalu ation time ) and ends at
	679	(index eva luation ti me + searc hForwardTi mePeriod). The earl ier point
	680	is conside red to be exclusive and the en ding point is consid ered to be
	681	inclusive. E.g., if the index evaluation time is 7 /1/2011 at 4pm and t he
	682	searchForw ardTimePer iod is 1 y ear, then the time a ttribute r equirement
	683	is met if the target TimeAttrib ute has ov erlaps wit h anytime after 4pm on
	684	7/1/2011 a nd up to a nd includi ng 7/1/201 2 at 4pm.
	685
	686
	687
	688
	689	HL7 vMR DA M - Sept 2 011 Page: 17
	690
	691	3.1.4 vmr
	692	Type: Pac kage
	693	Package: m odelParent
	694
	695	Specifies informatio n about a patient re levant for CDS.
	696
	697
	698	vmr - (Cla ss diagram )
	699	class v m r
	700	ClinicalSt atement
	701	+ id :II
	702	+ template Id :II [0 ..*]
	703	+ dataSour ceType :C D [0..1]
	704	Entity
	705	+ id :II
	706	+ template Id :II [0 ..*]
	707	+ entityTy pe :CD [0 ..1]
	708	ClinicalSt atementEnt ityInRoleR elationshi p
	709	+ role :C D
	710	ClinicalSt atementRel ationship
	711	+ targetRe lationship ToSource :CDEv alua tedPerson
	712	+ birthTim e :TS [0. .1]
	713	+ ethnici ty :CD [0 ..*]
	714	+ gender :CD [0..1]
	715	+ race :C D [0..*]
	716	+ preferre dLanguage :CD [0..1 ]
	717	+ age :PQ [0..1]
	718	+ isDeceas ed :BL [0 ..1]
	719	+ ageAtDea th :PQ [0 ..1]
	720	EntityRela tionship
	721	+ targetRo le :CD
	722	+ relation shipTimeIn terval :I VL_TS [0.. 1]
	723	VMR
	724	+ template Id :II [1 ..*]
	725	Person
	726	+ name :E N [0..*]
	727	+ address :AD [0..* ]
	728	+ telecom :TEL [0.. *]
	729	+patient 1
	730	+relatedEn tity
	731	0..*
	732	+relatedCl inicalStat ement
	733	0..*
	734	+clinicalS tatement
	735	0..*
	736	+relatedEn tityInRole
	737	0..*
	738
	739	Figure: 4
	740
	741
	742
	743	HL7 vMR DA M - Sept 2 011 Page: 18
	744
	745	entity - ( Class diag ram)
	746	class ent ity
	747	Facility
	748	+ name :E N [0..*]
	749	+ address :AD [0..* ]
	750	+ telecom :TEL [0.. *]
	751	Entity
	752	+ id :II
	753	+ template Id :II [0 ..*]
	754	+ entityTy pe :CD [0 ..1]
	755	EntityRela tionship
	756	+ targetRo le :CD
	757	+ relation shipTimeIn terval :I VL_TS [0.. 1]
	758	Ev aluated Person
	759	+ birthTim e :TS [0. .1]
	760	+ ethnicit y :CD [0. .*]
	761	+ gender :CD [0..1]
	762	+ race :C D [0..*]
	763	+ preferre dLanguage :CD [0..1 ]
	764	+ age :PQ [0..1]
	765	+ isDeceas ed :BL [0 ..1]
	766	+ ageAtDea th :PQ [0 ..1]
	767	Organizati on
	768	+ name :E N [0..*]
	769	+ address :AD [0..* ]
	770	+ telecom :TEL [0.. *]
	771	Person
	772	+ name :E N [0..*]
	773	+ address :AD [0..* ]
	774	+ telecom :TEL [0.. *]
	775	Administra bleSubstan ce
	776	+ substanc eCode :CD
	777	+ strength :RTO [0. .1]
	778	+ form :C D [0..1]
	779	+ substanc eBrandCode :CD [0.. 1]
	780	+ substanc eGenericCo de :CD [0 ..1]
	781	+ manufact urer :CD [0..1]
	782	+ lotNo : ST [0..1]
	783	Specimen
	784	+relatedEn tity 0..*
	785
	786	Figure: 5
	787
	788
	789	HL7 vMR DA M - Sept 2 011 Page: 19
	790
	791	clinicalSt atement - (Class dia gram)
	792	class cli nicalState ment
	793	Observatio nBase
	794	+ observat ionFocus :CD
	795	+ observat ionMethod :CD [0..1 ]
	796	+ targetBo dySite :B odySite [0 ..1]
	797	EncounterE v ent
	798	+ encounte rEventTime :IVL_TS
	799	Observ ati onResult
	800	+ observat ionEventTi me :IVL_T S
	801	+ observat ionValue :ANY
	802	+ interpre tation :C D [0..*]
	803	Problem
	804	+ importan ce :CD [0 ..1]
	805	+ severity :CD [0.. 1]
	806	+ problemS tatus :CD
	807	+ ageAtOns et :PQ [0 ..1]
	808	+ wasCause OfDeath : BL [0..1]
	809	Adv erseEv ent
	810	+ critical ity :CD [ 0..1]
	811	+ severity :CD [0.. 1]
	812	+ affected BodySite :BodySite [0..*]
	813	+ adverseE ventStatus :CD
	814	Unconducte dObserv at ion
	815	+ reason :CD [0..1]
	816	+ subjectE ffectiveTi me :IVL_T S [0..1]
	817	+ document ationTime :IVL_TS
	818	Undeliv er edProcedur e
	819	+ reason :CD [0..1]
	820	+ subjectE ffectiveTi me :IVL_T S [0..1]
	821	+ document ationTime :IVL_TS
	822	DoseRestri ction
	823	+ maxDoseF orInterval :PQ
	824	+ timeInte rval :PQ
	825	SubstanceA dministrat ionOrder
	826	+ critical ity :CD [ 0..1]
	827	+ doseRest riction : DoseRestri ction [0.. 1]
	828	+ administ rationTime Interval :IVL_TS
	829	+ dosingSi g :CD [0. .*]
	830	+ numberFi llsAllowed :INT [0. .1]
	831	+ orderEve ntTime :I VL_TS
	832	SubstanceD ispensatio nEv ent
	833	+ daysSupp ly :INT [ 0..1]
	834	+ dispensa tionQuanti ty :PQ [0 ..1]
	835	+ doseRest riction : DoseRestri ction [0.. 1]
	836	+ dispensa tionTime :IVL_TS
	837	+ fi l lNu mber :INT [0..1]
	838	+ fi l lsR emaining :INT [0..1 ]
	839	+ isValid :BL [0..1 ]
	840	SubstanceA dministrat ionEv ent
	841	+ doseNumb er :INT [ 0..1]
	842	+ administ rationTime Interval :IVL_TS [0 ..1]
	843	+ document ationTime :IVL_TS
	844	+ informat ionAttesta tionType :CD [0..1]
	845	ProcedureP roposal
	846	+ critical ity :CD [ 0..1]
	847	+ proposed ProcedureT ime :IVL_ TS [0..1]
	848	+ repeatNu mber :INT [0..1]
	849	ProcedureO rder
	850	+ critical ity :CD [ 0..1]
	851	+ orderEve ntTime :I VL_TS
	852	+ procedur eTime :IV L_TS [0..1 ]
	853	+ repeatNu mber :INT [0..1]
	854	ProcedureE v ent
	855	+ procedur eTime :IV L_TS
	856	BodySite
	857	+ bodySite Code :CD
	858	+ laterali ty :CD [0 ..1]
	859	ScheduledP rocedure
	860	+ procedur eTime :IV L_TS
	861	ScheduledA ppointment
	862	+ appointm entTime : IVL_TS
	863	Appointmen tRequest
	864	+ critical ity :CD [ 0..1]
	865	+ requeste dAppointme ntTime :I VL_TS
	866	+ requestI ssuanceTim e :IVL_TS
	867	+ repeatNu mber :INT [0..1]
	868	Appointmen tProposal
	869	+ critical ity :CD [ 0..1]
	870	+ proposed Appointmen tTime :IV L_TS [0..1 ]
	871	+ repeatNu mber :INT [0..1]
	872	SupplyEv e nt
	873	+ supplyTi me :IVL_T S
	874	SupplyProp osal
	875	+ proposed SupplyTime :IVL_TS [0..1]
	876	+ repeatNu mber :INT [0..1]
	877	SupplyOrde r
	878	+ supplyTi me :IVL_T S [0..1]
	879	+ orderEve ntTime :I VL_TS
	880	+ repeatNu mber :INT [0..1]
	881	Observ ati onProposal
	882	+ critical ity :CD [ 0..1]
	883	+ proposed Observatio nTime :IV L_TS [0..1 ]
	884	+ repeatNu mber :INT [0..1]
	885	Observ ati onOrder
	886	+ critical ity :CD [ 0..1]
	887	+ orderEve ntTime :I VL_TS
	888	+ observat ionTime : IVL_TS [0. .1]
	889	+ repeatNu mber :INT [0..1]
	890	DeniedProb lem
	891	DeniedAdv erseEv ent
	892	Undeliv er edSupply
	893	+ reason :CD [0..1]
	894	+ subjectE ffectiveTi me :IVL_T S [0..1]
	895	+ document ationTime :IVL_TS
	896	Undeliv er edSubstanc eAdministr ation
	897	+ reason :CD [0..1]
	898	+ subjectE ffectiveTi me :IVL_T S [0..1]
	899	+ document ationTime :IVL_TS
	900	EncounterB ase
	901	+ encounte rType :CD
	902	ProcedureB ase
	903	+ procedur eCode :CD
	904	+ procedur eMethod : CD [0..1]
	905	+ approach BodySite :BodySite [0..1]
	906	+ targetBo dySite :B odySite [0 ..1]
	907	SupplyBase
	908	+ supplyCo de :CD
	909	+ quantity :PQ [0.. 1]
	910	+ targetBo dySite :B odySite [0 ..1] Subst anceAdmini strationPr oposal
	911	+ critical ity :CD [ 0..1]
	912	+ doseRest riction : DoseRestri ction [0.. 1]
	913	+ proposed Administra tionTimeIn terval :I VL_TS [0.. 1]
	914	+ validAdm inistratio nTimeInter val :IVL_ TS [0..1]
	915	+ numberFi llsAllowed :INT [0. .1]
	916	ClinicalSt atement
	917	+ id :II
	918	+ template Id :II [0 ..*]
	919	+ dataSour ceType :C D [0..1]
	920	Entity
	921	Administra bleSubstan ce
	922	+ substanc eCode :CD
	923	+ strength :RTO [0. .1]
	924	+ form :C D [0..1]
	925	+ substanc eBrandCode :CD [0.. 1]
	926	+ substanc eGenericCo de :CD [0 ..1]
	927	+ manufact urer :CD [0..1]
	928	+ lotNo : ST [0..1]
	929	GoalBase
	930	+ goalFocu s :CD
	931	+ critical ity :CD [ 0..1]
	932	+ goalPurs uitEffecti veTime :I VL_TS [0.. 1]
	933	+ goalAchi evementTar getTime : IVL_TS [0. .1]
	934	+ targetBo dySite :B odySite [0 ..1]
	935	+ targetGo alValue : ANY [0..1]
	936	ProblemBas e
	937	+ problemC ode :CD
	938	+ problemE ffectiveTi me :IVL_T S [0..1]
	939	+ diagnost icEventTim e :IVL_TS
	940	+ affected BodySite :BodySite [0..*]
	941	AdverseEve ntBase
	942	+ adverseE ventCode :CD
	943	+ adverseE ventAgent :CD [0..1 ]
	944	+ adverseE ventTime :IVL_TS [0 ..1]
	945	+ document ationTime :IVL_TS
	946	SubstanceA dministrat ionBase
	947	+ substanc eAdministr ationGener alPurpose :CD
	948	+ substanc e :Admini strableSub stance
	949	+ delivery Method :C D [0..1]
	950	+ doseQuan tity :IVL _PQ [0..1]
	951	+ delivery Route :CD [0..1]
	952	+ approach BodySite :BodySite [0..1]
	953	+ targetBo dySite :B odySite [0 ..1]
	954	+ dosingPe riod :IVL _PQ [0..1]
	955	+ dosingPe riodInterv alIsImport ant :BL [ 0..1]
	956	+ delivery Rate :IVL _PQ [0..1]
	957	Overview d iagram of all clinic al stateme nt
	958	types. In dividual d iagrams ar e also ava ilable
	959	for specif ic types o f clinical statement s (e.g.,
	960	Problems, Procedures ).
	961	MissedAppo intment
	962	+ appointm entTime : IVL_TS
	963	Goal
	964	+ goalObse rverEventT ime :IVL_ TS
	965	+ goalStat us :CD
	966	GoalPropos al
	967	+relatedCl inicalStat ement 0..*
	968
	969	Figure: 6
	970	HL7 vMR DA M - Sept 2 011 Page: 20
	971
	972
	973	adverseEve nt - (Clas s diagram)
	974	class adv erseEv ent
	975	Adv erseEv ent
	976	+ cri tica lity :CD [0..1]
	977	+ severity :CD [0.. 1]
	978	+ affected BodySite :BodySite [0..*]
	979	+ adverseE ventStatus :CD
	980	DeniedAdv erseEv ent
	981	ClinicalSt atement
	982	+ id :II
	983	+ template Id :II [0 ..*]
	984	+ dataSour ceType :C D [0..1]
	985	AdverseEve ntBase
	986	+ adverseE ventCode :CD
	987	+ adverseE ventAgent :CD [0..1 ]
	988	+ adverseE ventTime :IVL_TS [0 ..1]
	989	+ document ationTime :IVL_TS
	990	BodySite
	991	+ bodySite Code :CD
	992	+ laterali ty :CD [0 ..1]
	993	+relatedCl inicalStat ement 0..*
	994
	995	Figure: 7
	996
	997
	998
	999	HL7 vMR DA M - Sept 2 011 Page: 21
	1000
	1001	encounter - (Class d iagram)
	1002	class enc ounter
	1003	EncounterE vent
	1004	+ encounte rEventTime :IVL_TS
	1005	ScheduledA ppointment
	1006	+ appointm entTime : IVL_TS
	1007	Appointmen tRequest
	1008	+ critical ity :CD [ 0..1]
	1009	+ requeste dAppointme ntTime :I VL_TS
	1010	+ requestI ssuanceTim e :IVL_TS
	1011	+ repeatNu mber :INT [0..1]
	1012	Appointmen tProposal
	1013	+ critical ity :CD [ 0..1]
	1014	+ proposed Appointmen tTime :IV L_TS [0..1 ]
	1015	+ repeatNu mber :INT [0..1]
	1016	EncounterB ase
	1017	+ encounte rType :CD
	1018	ClinicalSt atement
	1019	+ id :II
	1020	+ template Id :II [0 ..*]
	1021	+ dataSour ceType :C D [0..1]
	1022	MissedAppo intment
	1023	+ appointm entTime : IVL_TS+rel atedClinic alStatemen t 0..*
	1024
	1025	Figure: 8
	1026
	1027
	1028	goal - (Cl ass diagra m)
	1029	class goa l
	1030	ClinicalSt atement
	1031	+ id :II
	1032	+ template Id :II [0 ..*]
	1033	+ dataSour ceType :C D [0..1]
	1034	GoalBase
	1035	+ goalFocu s :CD
	1036	+ critical ity :CD [ 0..1]
	1037	+ goalPurs uitEffecti veTime :I VL_TS [0.. 1]
	1038	+ goalAchi evementTar getTime : IVL_TS [0. .1]
	1039	+ targetBo dySite :B odySite [0 ..1]
	1040	+ targetGo alValue : ANY [0..1]
	1041	BodySite
	1042	+ bodySite Code :CD
	1043	+ laterali ty :CD [0 ..1]
	1044	Goal
	1045	+ goalObse rverEventT ime :IVL_ TS
	1046	+ goalStat us :CD
	1047	GoalPropos al
	1048	+relatedCl inicalStat ement 0..*
	1049
	1050	Figure: 9
	1051	HL7 vMR DA M - Sept 2 011 Page: 22
	1052
	1053
	1054
	1055
	1056	observatio n - (Class diagram)
	1057	class obs erv ation
	1058	Observatio nBase
	1059	+ observat ionFocus :CD
	1060	+ observat ionMethod :CD [0..1 ]
	1061	+ targetBo dySite :B odySite [0 ..1]
	1062	Observ ati onResult
	1063	+ observat ionEventTi me :IVL_T S
	1064	+ observat ionValue :ANY
	1065	+ interpre tation :C D [0..*]
	1066	Unconducte dObserv at ion
	1067	+ reason :CD [0..1]
	1068	+ subjectE ffectiveTi me :IVL_T S [0..1]
	1069	+ document ationTime :IVL_TS
	1070	Observ ati onProposal
	1071	+ critical ity :CD [ 0..1]
	1072	+ proposed Observatio nTime :IV L_TS [0..1 ]
	1073	+ repeatNu mber :INT [0..1]
	1074	Observ ati onOrder
	1075	+ critical ity :CD [ 0..1]
	1076	+ orderEve ntTime :I VL_TS
	1077	+ observat ionTime : IVL_TS [0. .1]
	1078	+ repeatNu mber :INT [0..1]
	1079	ClinicalSt atement
	1080	+ id :II
	1081	+ template Id :II [0 ..*]
	1082	+ dataSour ceType :C D [0..1]
	1083	BodySite
	1084	+ bodySite Code :CD
	1085	+ laterali ty :CD [0 ..1]
	1086	+relatedCl inicalStat ement 0..*
	1087
	1088	Figure: 10
	1089
	1090
	1091
	1092	HL7 vMR DA M - Sept 2 011 Page: 23
	1093
	1094	problem - (Class dia gram)
	1095	class pro blem
	1096	Problem
	1097	+ importan ce :CD [0 ..1]
	1098	+ severity :CD [0.. 1]
	1099	+ problemS tatus :CD
	1100	+ ageAtOns et :PQ [0 ..1]
	1101	+ wasCause OfDeath : BL [0..1]
	1102	DeniedProb lem
	1103	ClinicalSt atement
	1104	+ id :II
	1105	+ template Id :II [0 ..*]
	1106	+ dataSour ceType :C D [0..1]
	1107	ProblemBas e
	1108	+ problemC ode :CD
	1109	+ problemE ffectiveTi me :IVL_T S [0..1]
	1110	+ diagnost icEventTim e :IVL_TS
	1111	+ affected BodySite :BodySite [0..*]
	1112	BodySite
	1113	+ bodySite Code :CD
	1114	+ laterali ty :CD [0 ..1]
	1115	+relatedCl inicalStat ement 0..*
	1116
	1117	Figure: 11
	1118
	1119
	1120
	1121	HL7 vMR DA M - Sept 2 011 Page: 24
	1122
	1123	procedure - (Class d iagram)
	1124	class pro cedure
	1125	Undelivere dProcedure
	1126	+ reason :CD [0..1]
	1127	+ subjectE ffectiveTi me :IVL_T S [0..1]
	1128	+ document ationTime :IVL_TS
	1129	ProcedureP roposal
	1130	+ critical i ty :CD [0..1]
	1131	+ proposed ProcedureT ime :IVL_ TS [0..1]
	1132	+ repeatNu mber :INT [0..1]
	1133	ProcedureO rder
	1134	+ critical i ty :CD [0..1]
	1135	+ orderEve ntTime :I VL_TS
	1136	+ procedur eTime :IV L_TS [0..1 ]
	1137	+ repeatNu mber :INT [0..1]
	1138	ProcedureE v ent
	1139	+ procedur eTime :IV L_TS
	1140	ScheduledP rocedure
	1141	+ procedur eTime :IV L_TS
	1142	ProcedureB ase
	1143	+ procedur eCode :CD
	1144	+ procedur eMethod : CD [0..1]
	1145	+ approach BodySite :BodySite [0..1]
	1146	+ targetBo dySite :B odySite [0 ..1]
	1147	ClinicalSt atement
	1148	+ id :II
	1149	+ template Id :II [0 ..*]
	1150	+ dataSour ceType :C D [0..1]
	1151	BodySite
	1152	+ bodySite Code :CD
	1153	+ laterali ty :CD [0 ..1]
	1154	+relatedCl inicalStat ement 0..*
	1155
	1156	Figure: 12
	1157
	1158
	1159
	1160	HL7 vMR DA M - Sept 2 011 Page: 25
	1161
	1162	substanceA dministrat ion - (Cla ss diagram )
	1163	class sub stanceAdmi nistration
	1164	DoseRestri ction
	1165	+ maxDoseF orInterval :PQ
	1166	+ timeInte rval :PQ
	1167	SubstanceA dministrat ionOrder
	1168	+ critical ity :CD [ 0..1]
	1169	+ doseRest riction : DoseRestri ction [0.. 1]
	1170	+ administ rationTime Interval :IVL_TS
	1171	+ dosingSi g :CD [0. .*]
	1172	+ numberFi llsAllowed :INT [0. .1]
	1173	+ orderEve ntTime :I VL_TS
	1174	SubstanceD ispensatio nEvent
	1175	+ daysSupp ly :INT [ 0..1]
	1176	+ dispensa tionQuanti ty :PQ [0 ..1]
	1177	+ doseRest riction : DoseRestri ction [0.. 1]
	1178	+ dispensa tionTime :IVL_TS
	1179	+ fi l lNu mber :INT [0..1]
	1180	+ fi l lsR emaining :INT [0..1 ]
	1181	+ isValid :BL [0..1 ]
	1182	SubstanceA dministrat ionEvent
	1183	+ doseNumb er :INT [ 0..1]
	1184	+ administ rationTime Interval :IVL_TS [0 ..1]
	1185	+ document ationTime :IVL_TS
	1186	+ informat ionAttesta tionType :CD [0..1]
	1187	Undelivere dSubstance Administra tion
	1188	+ reason :CD [0..1]
	1189	+ subjectE ffectiveTi me :IVL_T S [0..1]
	1190	+ document ationTime :IVL_TS
	1191	SubstanceA dministrat ionProposa l
	1192	+ critical ity :CD [ 0..1]
	1193	+ doseRest riction : DoseRestri ction [0.. 1]
	1194	+ proposed Administra tionTimeIn terval :I VL_TS [0.. 1]
	1195	+ validAdm inistratio nTimeInter val :IVL_ TS [0..1]
	1196	+ numberFi llsAllowed :INT [0. .1]
	1197	ClinicalSt atement
	1198	+ id :II
	1199	+ template Id :II [0 ..*]
	1200	+ dataSour ceType :C D [0..1]
	1201	Entity
	1202	Administra bleSubstan ce
	1203	+ substanc eCode :CD
	1204	+ strength :RTO [0. .1]
	1205	+ form :C D [0..1]
	1206	+ substanc eBrandCode :CD [0.. 1]
	1207	+ substanc eGenericCo de :CD [0 ..1]
	1208	+ manufact urer :CD [0..1]
	1209	+ lotNo : ST [0..1]
	1210	SubstanceA dministrat ionBase
	1211	+ substanc eAdministr ationGener alPurpose :CD
	1212	+ substanc e :Admini strableSub stance
	1213	+ delivery Method :C D [0..1]
	1214	+ doseQuan tity :IVL _PQ [0..1]
	1215	+ delivery Route :CD [0..1]
	1216	+ approach BodySite :BodySite [0..1]
	1217	+ targetBo dySite :B odySite [0 ..1]
	1218	+ dosingPe riod :IVL _PQ [0..1]
	1219	+ dosingPe riodInterv alIsImport ant :BL [ 0..1]
	1220	+ delivery Rate :IVL _PQ [0..1]
	1221	BodySite
	1222	+ bodySite Code :CD
	1223	+ laterali ty :CD [0 ..1]
	1224	+relatedCl inicalStat ement 0..*
	1225
	1226	Figure: 13
	1227
	1228
	1229
	1230	HL7 vMR DA M - Sept 2 011 Page: 26
	1231
	1232	supply - ( Class diag ram)
	1233	class sup ply
	1234	SupplyEv e nt
	1235	+ supplyTi me :IVL_T S
	1236	SupplyProp osal
	1237	+ proposed SupplyTime :IVL_TS [0..1]
	1238	+ repeatNu mber :INT [0..1]
	1239	SupplyOrde r
	1240	+ supplyTi me :IVL_T S [0..1]
	1241	+ orderEve ntTime :I VL_TS
	1242	+ repeatNu mber :INT [0..1]
	1243	Undeliv er edSupply
	1244	+ reason :CD [0..1]
	1245	+ subjectE ffectiveTi me :IVL_T S [0..1]
	1246	+ document ationTime :IVL_TS
	1247	SupplyBase
	1248	+ supplyCo de :CD
	1249	+ quantity :PQ [0.. 1]
	1250	+ targetBo dySite :B odySite [0 ..1]
	1251	ClinicalSt atement
	1252	+ id :II
	1253	+ template Id :II [0 ..*]
	1254	+ dataSour ceType :C D [0..1]
	1255	BodySite
	1256	+ bodySite Code :CD
	1257	+ lateral ity :CD [ 0..1]
	1258	+relatedCl inicalStat ement 0..*
	1259
	1260	Figure: 14
	1261
	1262
	1263	HL7 vMR DA M - Sept 2 011 Page: 27
	1264
	1265	3.1.4.1 Ad ministrabl eSubstance
	1266	Type: Cla ss Enti ty
	1267	Package: v mr
	1268
	1269	A material of a part icular con stitution that can b e given to a person to enable a clinical effect. It can hav e
	1270	component administra ble substa nces.
	1271
	1272	Attributes
	1273	Attribute Notes
	1274	substanceC ode
	1275	CD
	1276	The code t hat identi fies the s ubstance w ith as muc h specific ity as
	1277	appropriat e, or as r equired by a templat e. E.g., aspirin, l isinopril. May
	1278	be either a generic or brand c ode, unles s otherwis e restrict ed by a
	1279	template.
	1280	strength
	1281	RTO [0 ..1]
	1282	The concen tration of the subst ance. E.g ., 250 mg per 5 ml.
	1283	form
	1284	CD [0. .1]
	1285	The physic al form of the subst ance as pr esented to the subje ct. E.g.,
	1286	tablet, pa tch, injec table, inh alent.
	1287	substanceB randCode
	1288	CD [0. .1]
	1289	A code des cribing th e product as a brand ed or trad emarked en tity from a
	1290	controlled vocabular y.
	1291	substanceG enericCode
	1292	CD [0. .1]
	1293	A code des cribing th e product as a subst ance produ ced and di stributed
	1294	without pa tent prote ction.
	1295	manufactur er
	1296	CD [0. .1]
	1297	The organi zation tha t produces the subst ance. Thi s is a CD and not an
	1298	II because there are managed c ode system s for manu facturers.
	1299	lotNo
	1300	ST [0. .1]
	1301	The number assigned by the man ufacturer to the bat ch of manu factured
	1302	substances in which this subst ance insta nce belong s. Used f or quality
	1303	control pu rposes.
	1304
	1305
	1306
	1307	3.1.4.2 Ad verseEvent
	1308	Type: Cla ss Adve rseEventBa se
	1309	Package: v mr
	1310
	1311	unfavorabl e healthca re event ( e.g., deat h, rash, d ifficulty breathing) that is t hought to have been caused by some
	1312	agent (e.g ., a medic ation, imm unization, food, or environmen tal agent) .
	1313
	1314	Attributes
	1315	Attribute Notes
	1316	criticalit y
	1317	CD [0. .1]
	1318	The clinic al importa nce or ser iousness o f the adve rse event. E.g.,
	1319	life-threa tening, po tentially requires h ospitaliza tion, self -resolving .
	1320	Different from sever ity in tha t a modera te subarac hnoid hemo rrhage is
	1321	likely to be highly critical, whereas a moderate h eadache is not.
	1322	severity
	1323	CD [0. .1]
	1324	The intens ity of the adverse e vent. E.g ., severe, moderate. If the
	1325	adverseEve ntCode is rash and s everity is moderate, it means that the
	1326	adverse ev ent was a moderate r ash.
	1327	affectedBo dySite
	1328	BodySite [0..*]
	1329	A body sit e affected by the ad verse even t.
	1330	adverseEve ntStatus
	1331	CD
	1332	The state of the eff ects of th is adverse event. E .g., activ e, inactiv e,
	1333	resolved.
	1334
	1335
	1336
	1337	HL7 vMR DA M - Sept 2 011 Page: 28
	1338
	1339	3.1.4.3 Ad verseEvent Base
	1340	Type: Cla ss Clin icalStatem ent
	1341	Package: v mr
	1342
	1343	Abstract b ase class for advers e events, which are unfavorabl e healthca re events (e.g., dea th, rash, difficulty
	1344	breathing) that are thought to have been caused by some agen t (e.g., a medicatio n, immuniz ation, foo d, or
	1345	environmen tal agent) . If a giv en agent i s thought to cause m ultiple re actions, t hese react ions shoul d be repre sented
	1346	using mult iple adver se events.
	1347
	1348	Attributes
	1349	Attribute Notes
	1350	adverseEve ntCode
	1351	CD
	1352	Coded natu re of the effects of the adver se event; maps to th e "value" of
	1353	an adverse event obs ervation. For an ad verse even t due to a n identifi ed
	1354	agent, thi s is the r eaction co de. E.g., hives, di fficulty b reathing.
	1355	adverseEve ntAgent
	1356	CD [0. .1]
	1357	The causat ive agent of the adv erse event , identifi ed with as much
	1358	specificit y as avail able, or a s required by a temp late. E.g ., penicil lin,
	1359	peanuts.
	1360	adverseEve ntTime
	1361	IVL_TS [0..1]
	1362	The time t hat reflec ts when th e subject experience d the adve rse event
	1363	(in the ca se of Adve rseEvent) or when th e subject did not ex perience t he
	1364	adverse ev ent (in th e case of DeniedAdve rseEvent).
	1365	documentat ionTime
	1366	IVL_TS
	1367	The time w hen the ad verse even t was docu mented (e. g., entere d into an
	1368	electronic health re cord syste m by a car e provider ).
	1369
	1370
	1371
	1372	3.1.4.4 Ap pointmentP roposal
	1373	Type: Cla ss Enco unterBase
	1374	Package: v mr
	1375
	1376	Proposal, e.g., by a CDS syste m, for an Encounter to take pl ace.
	1377
	1378	Attributes
	1379	Attribute Notes
	1380	criticalit y
	1381	CD [0. .1]
	1382	The urgenc y or impor tance of t he propose d encounte r.
	1383	proposedAp pointmentT ime
	1384	IVL_TS [0..1]
	1385	Proposed t ime for ap pointment. Optional , as the p roposer (e .g., a CDS
	1386	system) ma y wish to simply pro pose an ap pointment of a type (e.g.,
	1387	encounter with eye p rofessiona l) without specifyin g a specif ic
	1388	appointmen t time int erval.
	1389
	1390	If repeatN umber >= 2 , then spe cifies pro posed peri od within which the
	1391	appointmen ts should take place . In thes e cases, i t is assum ed that th e
	1392	appointmen ts should be evenly distribute d within t he timefra me. E.g.,
	1393	if propose d time is 1/1/2011 t o 12/31/20 11, and re peatNumber is 3,
	1394	ideal appo intment ti mes would be 1/1/201 1, 12/31/2 011, and i n the
	1395	middle of the year.
	1396	repeatNumb er
	1397	INT [0 ..1]
	1398	The propos ed number of appoint ment to ma ke.
	1399
	1400
	1401
	1402	HL7 vMR DA M - Sept 2 011 Page: 29
	1403
	1404	3.1.4.5 Ap pointmentR equest
	1405	Type: Cla ss Enco unterBase
	1406	Package: v mr
	1407
	1408	A request by a provi der to sch edule an a ppointment .
	1409
	1410	Attributes
	1411	Attribute Notes
	1412	criticalit y
	1413	CD [0. .1]
	1414	The urgenc y or impor tance of t he request ed encount er.
	1415	requestedA ppointment Time
	1416	IVL_TS
	1417	Requested time for a ppointment .
	1418
	1419	If repeatN umber >= 2 , then spe cifies req uested per iod within which the
	1420	appointmen ts should take place . In thes e cases, i t is assum ed that th e
	1421	appointmen ts should be evenly distribute d within t he timefra me. E.g.,
	1422	if request ed time is 1/1/2011 to 12/31/2 011, and r epeatNumbe r is 3,
	1423	ideal appo intment ti mes would be 1/1/201 1, 12/31/2 011, and i n the
	1424	middle of the year.
	1425	requestIss uanceTime
	1426	IVL_TS
	1427	Time when the encoun ter appoin tment was requested by the pro vider, as
	1428	opposed to the time it was req uested for .
	1429	repeatNumb er
	1430	INT [0 ..1]
	1431	The reques ted number of appoin tment to m ake.
	1432
	1433
	1434
	1435	3.1.4.6 Bo dySite
	1436	Type: Cla ss
	1437	Package: v mr
	1438
	1439	A location on an Eva luatedPers on's body. E.g., le ft breast, heart.
	1440
	1441	Attributes
	1442	Attribute Notes
	1443	bodySiteCo de
	1444	CD
	1445	A location on an Eva luatedPers on's body. May or m ay not enc ompass
	1446	laterality . E.g., l ung, left lung.
	1447	laterality
	1448	CD [0. .1]
	1449	The side o f the body , from the Evaluated Person's p erspective . E.g., le ft,
	1450	right, bil ateral.
	1451
	1452
	1453
	1454	HL7 vMR DA M - Sept 2 011 Page: 30
	1455
	1456	3.1.4.7 Cl inicalStat ement
	1457	Type: Cla ss
	1458	Package: v mr
	1459
	1460	A record o f somethin g of clini cal releva nce that i s being do ne, has be en done, c an be done , or is in tended or
	1461	requested to be done . An abst ract base class that serves as the basis for concr ete clinic al stateme nts, such as
	1462	Observatio nEvent and Procedure Proposal.
	1463
	1464	Naming and modeling convention s:
	1465	• in gener al, attrib ute names end in 'Co de' if and only if t he name of the attri bute overl aps with t he name of the
	1466	parent cla ss
	1467	• times ar e named as follows: Time is th e default suffix for these att ributes. EventTime is used to distingui sh
	1468	the time a n order is placed vs . when the ordered a ct should take place . Effectiv eTime and TimeInterv al are
	1469	used when there is a desire to emphasize that a pr olonged ti me interva l (e.g., > 1 day) ca n be used rather tha n a
	1470	point in t ime or a s hort time interval. Note that regardles s of the n aming conv ention, IV L_TS attri butes allo w
	1471	time inter vals of an y length.
	1472	• subjectE ffectiveTi me is the time that is primari ly related to the su bject's ex perience o f disease or treatme nt
	1473	events (or durations ), rather than when those even ts were re ported or recorded b y the perf ormer
	1474	• performe rEventTime is the ev ent time t hat is pri marily rel ated to th e performe r, rather than the s ubject.
	1475	• the stat e between ordering a nd the ord ered event occurring is modele d only in cases of p rocedures and
	1476	encounters , due to t he substan tial rate at which o rders do n ot result in events.
	1477
	1478	Approaches to repres enting spe cific stat ements:
	1479	• No known allergies --> Denie dAdverseEv ent with a dverseEven tAgentCode that is t he generic root-leve l code
	1480	for substa nces and a dverseEven tCode that its the g eneric roo t-level co de for adv erse event s.
	1481	• No known drug alle rgies --> DeniedAdve rseEvent w ith advers eEventAgen tCode that is the ro ot-level c ode for
	1482	medication s and adve rseEventCo de that it s the gene ric root-l evel code for advers e events.
	1483	• No known food alle rgies --> DeniedAdve rseEvent w ith advers eEventAgen tCode that is the ro ot-level c ode for
	1484	food and a dverseEven tCode that its the g eneric roo t-level co de for adv erse event s.
	1485	• No known medicatio ns --> Und eliveredSu bstanceAdm inistratio n with sub stance tha t is the r oot-level code for
	1486	medication s.
	1487	• No known problems --> Denied Problem wi th problem Code that is the roo t-level co de for pro blems or
	1488	conditions .
	1489	• Patient takes an u nknown dru g --> Subs tanceAdmin istrationE vent where code for substance represents
	1490	"unknown m edication" .
	1491
	1492
	1493	Attributes
	1494	Attribute Notes
	1495	id
	1496	II
	1497	A unique I D of this clinical s tatement f or referen ce purpose s. Does n ot
	1498	need to be the actua l ID of th e source s ystem.
	1499	templateId
	1500	II [0. .*]
	1501	The identi fier of a set of con straints p laced on a clinical statement.
	1502	dataSource Type
	1503	CD [0. .1]
	1504	A categori zation of the type o f informat ion source making th e clinical
	1505	statement. Can be u sed, for e xample, to provide r elevant in formation
	1506	regarding the reliab ility of i nput data or to mark specific pieces of data
	1507	as having been gener ated by a CDS system . E.g., ad ministrati ve system,
	1508	clinical s ystem, pat ient or fa mily membe r, externa l CDS syst em, this
	1509	CDS system . Optiona l in the b ase vMR, b ut should consider p roviding
	1510	when avail able.
	1511
	1512
	1513	HL7 vMR DA M - Sept 2 011 Page: 31
	1514
	1515
	1516	3.1.4.8 Cl inicalStat ementEntit yInRoleRel ationship
	1517	Type: Ass ociationCl ass
	1518	Package: v mr
	1519
	1520	The relati onship bet ween a Cli nicalState ment and a n Entity s erving the indicated function or positio n.
	1521
	1522	Attributes
	1523	Attribute Notes
	1524	role
	1525	CD
	1526	The functi on or posi tion of th e Entity i n relation ship to th e
	1527	ClinicalSt atement. E.g., heal thcare pro vider, lab oratory sp ecimen,
	1528	subject of procedure .
	1529
	1530
	1531
	1532	3.1.4.9 Cl inicalStat ementRelat ionship
	1533	Type: Cla ss
	1534	Package: v mr
	1535
	1536	The relati onship bet ween two C linicalSta tements.
	1537
	1538	Attributes
	1539	Attribute Notes
	1540	targetRela tionshipTo Source
	1541	CD
	1542	The target clinical statement' s relation ship to th e source c linical
	1543	statement. E.g., if relations hip is "pa rt of", th en target clinical
	1544	statement is part of source cl inical sta tement. I n an XML c ontext, th e
	1545	target cli nical stat ement woul d be the o ne that is enclosed within the
	1546	source cli nical stat ement.
	1547
	1548
	1549
	1550	3.1.4.10 D eniedAdver seEvent
	1551	Type: Cla ss Adve rseEventBa se
	1552	Package: v mr
	1553
	1554	A denial t hat the su bject has or had the specified adverse e vent. E.g ., if adve rseEventCo de is hive s, adverse event
	1555	agent is p enicillin, and docum entation t ime is 201 1-05-01, a n assertio n was made on 2011-0 5-01 that the subjec t
	1556	does not g et hives a s a reacti on to peni cillin.
	1557
	1558	Common den ials of ad verse even ts to a cl ass of age nts can be expressed as follow s:
	1559	• No known allergies --> Denie dAdverseEv ent with a dverseEven tAgentCode that is t he generic root-leve l code
	1560	for substa nces and a dverseEven tCode that its the g eneric roo t-level co de for adv erse event s.
	1561	• No known drug alle rgies --> DeniedAdve rseEvent w ith advers eEventAgen tCode that is the ro ot-level c ode for
	1562	medication s and adve rseEventCo de that it s the gene ric root-l evel code for advers e events.
	1563	• No known food alle rgies --> DeniedAdve rseEvent w ith advers eEventAgen tCode that is the ro ot-level c ode for
	1564	food and a dverseEven tCode that its the g eneric roo t-level co de for adv erse event s.
	1565
	1566
	1567
	1568
	1569	HL7 vMR DA M - Sept 2 011 Page: 32
	1570
	1571	3.1.4.11 D eniedProbl em
	1572	Type: Cla ss Prob lemBase
	1573	Package: v mr
	1574
	1575	An asserti on that th e subject did not ha ve the pro blem speci fied. For example, if problem Code is di abetes and
	1576	diagnostic EventTime is 2011-05 -01, then an asserti on was mad e on 2011- 05-01 that the subje ct does no t have
	1577	diabetes.
	1578
	1579	To assert that the s ubject has no known problems, a DeniedPr oblem can be asserte d with a p roblemCode that is t he
	1580	root-level code for problems o r conditio ns. E.g., if for a DeniedProb lem, probl emCode is the root-l evel code for
	1581	problems o r conditio nsand diag nosticEven tTime is 2 011-05-01, then an a ssertion w as made on 2011-05-0 1 that the
	1582	subject ha s no known problems as of that date.
	1583
	1584
	1585
	1586	3.1.4.12 D oseRestric tion
	1587	Type: Cla ss
	1588	Package: v mr
	1589
	1590	Referred t o in CDA r elease 2 a s maxDoseQ uantity. Specifies the maximu m dose tha t can be g iven in a specified
	1591	time inter val.
	1592
	1593	Attributes
	1594	Attribute Notes
	1595	maxDoseFor Interval
	1596	PQ
	1597	Maximum am ount of su bstance th at can be given with in the spe cified
	1598	time inter val.
	1599	timeInterv al
	1600	PQ
	1601	The time i nterval du ring which the dose specified is the max imum
	1602	amount tha t should b e administ ered.
	1603
	1604
	1605
	1606	3.1.4.13 E ncounterBa se
	1607	Type: Cla ss Clin icalStatem ent
	1608	Package: v mr
	1609
	1610	The abstra ct base cl ass for an encounter of an Eva luatedPers on with th e healthca re system. If an en counter or
	1611	appointmen t has been canceled, it should simply no t be provi ded using this model . This al lows the e ncounter a nd
	1612	appointmen t classes to be used without a n explicit encounter status ch eck.
	1613
	1614	Attributes
	1615	Attribute Notes
	1616	encounterT ype
	1617	CD
	1618	Identifies the type of encount er with as much spec ificity as available , or
	1619	as require d by a tem plate. E. g., outpat ient encou nter, outp atient
	1620	cardiology encounter .
	1621
	1622
	1623
	1624	HL7 vMR DA M - Sept 2 011 Page: 33
	1625
	1626	3.1.4.14 E ncounterEv ent
	1627	Type: Cla ss Enco unterBase
	1628	Package: v mr
	1629
	1630	EncounterE vent is th e record o f an inter action bet ween an Ev aluatedPer son and th e healthca re system. It can b e
	1631	used to gr oup observ ations and intervent ions perfo rmed durin g that int eraction, through th e use of
	1632	relatedCli nicalState ments.
	1633
	1634	Attributes
	1635	Attribute Notes
	1636	encounterE ventTime
	1637	IVL_TS
	1638	The time o f the enco unter.
	1639
	1640
	1641
	1642	3.1.4.15 E ntity
	1643	Type: Cla ss
	1644	Package: v mr
	1645
	1646	A physical thing, gr oup of phy sical thin gs or an o rganizatio n.
	1647
	1648	Attributes
	1649	Attribute Notes
	1650	id
	1651	II
	1652	The entity 's unique identifier . Used fo r internal tracking purposes;
	1653	must be pr ovided. D oes not ne ed to be t he entity' s "real" i dentifier.
	1654	templateId
	1655	II [0. .*]
	1656	The identi fier of a set of con straints p laced on a n Entity.
	1657	entityType
	1658	CD [0. .1]
	1659	The specif ic type of entity. E.g., heal tchare org anization, medical
	1660	facility, pacemaker.
	1661
	1662
	1663
	1664	3.1.4.16 E ntityRelat ionship
	1665	Type: Ass ociationCl ass
	1666	Package: v mr
	1667
	1668	The relati onship bet ween one E ntity and another En tity.
	1669
	1670	Attributes
	1671	Attribute Notes
	1672	targetRole
	1673	CD
	1674	The functi on or posi tion serve d by the t arget Enti ty in rela tion to th e
	1675	source Ent ity. E.g. , primary care provi der, healt h insuranc e provider .
	1676	relationsh ipTimeInte rval
	1677	IVL_TS [0..1]
	1678	The timefr ame in whi ch the rel ationship existed. E.g., time frame when
	1679	a Person s erved as t he primary care prov ider for a n Evaluate dPerson.
	1680
	1681
	1682
	1683	HL7 vMR DA M - Sept 2 011 Page: 34
	1684
	1685	3.1.4.17 E valuatedPe rson
	1686	Type: Cla ss Pers on
	1687	Package: v mr
	1688
	1689	A person w ho is the subject of evaluatio n by a CDS system. May be the focal pat ient or so me other r elevant pe rson
	1690	(e.g., a r elative or a sexual contact). Includes d emographic attribute s, clinica l statemen ts, and re lated enti ties.
	1691
	1692	Attributes
	1693	Attribute Notes
	1694	birthTime
	1695	TS [0. .1]
	1696	The date o n which th e person w as born.
	1697	ethnicity
	1698	CD [0. .*]
	1699	The person 's ethnici ty. An et hnicity or ethnic gr oup is a g roup of
	1700	people who se members identify with each other thro ugh a comm on
	1701	heritage. E.g., His panic.
	1702	gender
	1703	CD [0. .1]
	1704	The person 's gender. E.g., ma le, female . Typical ly will co nsist of
	1705	administra tive gende r, with cl inical gen der noted using
	1706	Observatio nEvents.
	1707	race
	1708	CD [0. .*]
	1709	The person 's race. Race is a classifica tion of hu mans into large grou ps
	1710	by various factors, such as he ritable ph enotypic c haracteris tics or
	1711	geographic ancestry. E.g., Wh ite, Asian .
	1712	preferredL anguage
	1713	CD [0. .1]
	1714	The person 's languag e of prefe rence. E. g., Englis h.
	1715	age
	1716	PQ [0. .1]
	1717	The person 's age at the time o f CDS eval uation. M ay potenti ally be
	1718	provided i nstead of birthTime when birth Time is no t availabl e. E.g., 3 .5
	1719	months, 63 years.
	1720	isDeceased
	1721	BL [0. .1]
	1722	Whether th e person i s deceased .
	1723
	1724	Included t o support family his tory-based inferenci ng.
	1725	ageAtDeath
	1726	PQ [0. .1]
	1727	The age at which the person di ed.
	1728
	1729	Included t o support family his tory-based inferenci ng.
	1730
	1731
	1732
	1733	3.1.4.18 F acility
	1734	Type: Cla ss Enti ty
	1735	Package: v mr
	1736
	1737	A property such as a building that has b een establ ished to e nable the performanc e of speci fic activi ties, typi cally be
	1738	organizati ons. E.g. , a hospit al or clin ic.
	1739
	1740	Attributes
	1741	Attribute Notes
	1742	name
	1743	EN [0. .*]
	1744	A word or a combinat ion of wor ds by whic h a facili ty is know n.
	1745	address
	1746	AD [0. .*]
	1747	The place or the nam e of the p lace where a facilit y is locat ed or may be
	1748	reached.
	1749	telecom
	1750	TEL [0 ..*]
	1751	A locatabl e resource of a faci lity that is identif ied by a U RI, such a s a
	1752	web page, a telephon e number ( voice, fax or some o ther resou rce
	1753	mediated b y telecomm unication equipment) , an e-mai l address, or any
	1754	other loca table reso urce that can be spe cified by a URL.
	1755
	1756	HL7 vMR DA M - Sept 2 011 Page: 35
	1757
	1758
	1759	3.1.4.19 G oal
	1760	Type: Cla ss Goal Base
	1761	Package: v mr
	1762
	1763	A clinical end or ai m towards which effo rt is dire cted.
	1764
	1765	Attributes
	1766	Attribute Notes
	1767	goalObserv erEventTim e
	1768	IVL_TS
	1769	The time t hat the ob server mad e a note o f the goal . It is p rimarily
	1770	related to the creat or or obse rver of th e goal, ra ther than the subjec t.
	1771	goalStatus
	1772	CD
	1773	State of t he attempt to reach this goal. E.g., ac tive, inac tive.
	1774
	1775
	1776
	1777	3.1.4.20 G oalBase
	1778	Type: Cla ss Clin icalStatem ent
	1779	Package: v mr
	1780
	1781	Abstract b ase class for a goal , which is a clinica l end or a im towards which eff ort is dir ected.
	1782
	1783	Attributes
	1784	Attribute Notes
	1785	goalFocus
	1786	CD
	1787	This is th e code tha t identifi es the met ric that i s the clin ical subje ct of
	1788	the goal w ith as muc h specific ity as ava ilable, or as requir ed by a
	1789	template. Typically a measura ble clinic al attribu te of the subject.
	1790	E.g., weig ht, blood pressure, hemoglobin A1c level .
	1791	criticalit y
	1792	CD [0. .1]
	1793	Urgency or importanc e of the g oal. May reflect th e threat t o the
	1794	patient's health tha t this goa l addresse s. E.g., critical, moderately
	1795	important.
	1796	goalPursui tEffective Time
	1797	IVL_TS [0..1]
	1798	The time i n which th e subject pursues th e goal. T his includ es pursuin g
	1799	maintenanc e of a goa l that has already b een achiev ed.
	1800	The end ti me of the interval m ay be "ope n" or not stated, if the goal is
	1801	being inde finitely p ursued. T his time i s optional , as, for example, a
	1802	CDS system may simpl y wish to propose we ight loss without sp ecifying
	1803	a pursuit effective time.
	1804	goalAchiev ementTarge tTime
	1805	IVL_TS [0..1]
	1806	The time t hat is tar geted for the goal t o be attai ned. For example, t here
	1807	may be a g oal to rea ch a weigh t of X pou nds by a p articular date.
	1808	targetBody Site
	1809	BodySite [0..1]
	1810	The body s ite that s erves as t he target of the goa l. E.g., waist.
	1811	targetGoal Value
	1812	ANY [0 ..1]
	1813	The metric whose ach ievement w ould signi fy the ful fillment o f the goal .
	1814	E.g., 150 pounds, 7. 0%.
	1815
	1816
	1817	3.1.4.21 G oalProposa l
	1818	Type: Cla ss Goal Base
	1819	Package: v mr
	1820
	1821	Proposal, e.g., by a CDS syste m, for est ablishing the goal s pecified.
	1822	HL7 vMR DA M - Sept 2 011 Page: 36
	1823
	1824
	1825	3.1.4.22 M issedAppoi ntment
	1826	Type: Cla ss Enco unterBase
	1827	Package: v mr
	1828
	1829	An appoint ment that was (i) sc heduled, ( ii) not re scheduled or cancele d, and (ii i) for whi ch the Eva luatedPers on did
	1830	not show u p.
	1831
	1832	Attributes
	1833	Attribute Notes
	1834	appointmen tTime
	1835	IVL_TS
	1836	The time o f the sche duled appo intment th at was mis sed.
	1837
	1838
	1839
	1840	3.1.4.23 O bservation Base
	1841	Type: Cla ss Clin icalStatem ent
	1842	Package: v mr
	1843
	1844	The abstra ct base cl ass for an observati on, which is the act of recogn izing and noting a f act.
	1845
	1846	Attributes
	1847	Attribute Notes
	1848	observatio nFocus
	1849	CD
	1850	This is th e code tha t identifi es the foc us of the observatio n with as much
	1851	specificit y as avail able, or a s required by a temp late. E.g ., serum
	1852	potassium level, hem oglobin A1 c level, s moking sta tus.
	1853	observatio nMethod
	1854	CD [0. .1]
	1855	The approa ch used to make the observatio n. E.g., direct mea surement,
	1856	indirect c alculation , Enzyme-L inked Immu nosorbent Assay.
	1857	targetBody Site
	1858	BodySite [0..1]
	1859	The body s ite where the observ ation is b eing made. E.g., le ft lung.
	1860
	1861
	1862
	1863	HL7 vMR DA M - Sept 2 011 Page: 37
	1864
	1865	3.1.4.24 O bservation Order
	1866	Type: Cla ss Obse rvationBas e
	1867	Package: v mr
	1868
	1869	An order b y a provid er to cond uct an obs ervation, such as a laboratory test.
	1870
	1871	Attributes
	1872	Attribute Notes
	1873	criticalit y
	1874	CD [0. .1]
	1875	Urgency or importanc e of obser vation. M ay be code s for the threat to
	1876	the patien t's health causing t he need fo r the obse rvation, o r other co ding
	1877	system val ues indica ting the u rgency of a requeste d or propo sed
	1878	observatio n (eg, ple ase do thi s CBC, STA T).
	1879	orderEvent Time
	1880	IVL_TS
	1881	Time when the order was create d.
	1882	observatio nTime
	1883	IVL_TS [0..1]
	1884	Time when the observ ation shou ld be perf ormed.
	1885
	1886	If repeatN umber >= 2 , then spe cifies per iod within which the
	1887	observatio ns should take place . In thes e cases, i t is assum ed that th e
	1888	observatio ns should be evenly distribute d within t he timefra me. E.g., if
	1889	proposed t ime is 1/1 /2011 to 1 2/31/2011, and repea tNumber is 3, ideal
	1890	observatio n times wo uld be 1/1 /2011, 12/ 31/2011, a nd in the middle of
	1891	the year.
	1892	repeatNumb er
	1893	INT [0 ..1]
	1894	The number of times the observ ation shou ld be made .
	1895
	1896
	1897
	1898	3.1.4.25 O bservation Proposal
	1899	Type: Cla ss Obse rvationBas e
	1900	Package: v mr
	1901
	1902	Proposal, e.g., by a CDS syste m, for an Observatio n to take place.
	1903
	1904	Attributes
	1905	Attribute Notes
	1906	criticalit y
	1907	CD [0. .1]
	1908	Urgency or importanc e of obser vation. M ay be code s for the threat to
	1909	the patien t's health causing t he need fo r the obse rvation, o r other co ding
	1910	system val ues indica ting the u rgency of a requeste d or propo sed
	1911	observatio n (e.g., p lease do t his CBC, S TAT).
	1912	proposedOb servationT ime
	1913	IVL_TS [0..1]
	1914	Time when it is prop osed to do the obser vation.
	1915
	1916	If repeatN umber >= 2 , then spe cifies pro posed peri od within which the
	1917	observatio ns should take place . In thes e cases, i t is assum ed that th e
	1918	observatio ns should be evenly distribute d within t he timefra me. E.g., if
	1919	proposed t ime is 1/1 /2011 to 1 2/31/2011, and repea tNumber is 3, ideal
	1920	observatio n times wo uld be 1/1 /2011, 12/ 31/2011, a nd in the middle of
	1921	the year.
	1922	repeatNumb er
	1923	INT [0 ..1]
	1924	The number of times the observ ation shou ld be made .
	1925
	1926
	1927
	1928	HL7 vMR DA M - Sept 2 011 Page: 38
	1929
	1930	3.1.4.26 O bservation Result
	1931	Type: Cla ss Obse rvationBas e
	1932	Package: v mr
	1933
	1934	The findin gs from an observati on.
	1935
	1936	Attributes
	1937	Attribute Notes
	1938	observatio nEventTime
	1939	IVL_TS
	1940	Time for t he complet ion of the observati on, includ ing the in terpretati on.
	1941	observatio nValue
	1942	ANY
	1943	Actual obs erved resu lts. E.g. , 6.5 mg/d L, 5.7%.
	1944	interpreta tion
	1945	CD [0. .*]
	1946	Explanatio n of the r esults. E .g., high, low, with in normal limits.
	1947
	1948
	1949
	1950	3.1.4.27 O rganizatio n
	1951	Type: Cla ss Enti ty
	1952	Package: v mr
	1953
	1954	An Entity representi ng a forma lized grou p of perso ns or othe r organiza tions with a common purpose an d the
	1955	infrastruc ture to ca rry out th at purpose . E.g., a healthcar e delivery organizat ion.
	1956
	1957	Attributes
	1958	Attribute Notes
	1959	name
	1960	EN [0. .*]
	1961	A word or a combinat ion of wor ds by whic h an organ ization is known.
	1962	address
	1963	AD [0. .*]
	1964	The place or the nam e of the p lace where an organi zation is located or
	1965	may be rea ched.
	1966	telecom
	1967	TEL [0 ..*]
	1968	A locatabl e resource of an org anization that is id entified b y a URI, s uch
	1969	as a web p age, a tel ephone num ber (voice , fax or s ome other resource
	1970	mediated b y telecomm unication equipment) , an e-mai l address, or any
	1971	other loca table reso urce that can be spe cified by a URL.
	1972
	1973
	1974
	1975	HL7 vMR DA M - Sept 2 011 Page: 39
	1976
	1977	3.1.4.28 P erson
	1978	Type: Cla ss Enti ty
	1979	Package: v mr
	1980
	1981	A human be ing.
	1982
	1983	Attributes
	1984	Attribute Notes
	1985	name
	1986	EN [0. .*]
	1987	A word or a combinat ion of wor ds by whic h a person is known.
	1988	address
	1989	AD [0. .*]
	1990	The place or the nam e of the p lace where a person is located or may be
	1991	reached.
	1992	telecom
	1993	TEL [0 ..*]
	1994	A locatabl e resource of a pers on that is identifie d by a URI , such as a
	1995	web page, a telephon e number ( voice, fax or some o ther resou rce
	1996	mediated b y telecomm unication equipment) , an e-mai l address, or any
	1997	other loca table reso urce that can be spe cified by a URL.
	1998
	1999
	2000
	2001	3.1.4.29 P roblem
	2002	Type: Cla ss Prob lemBase
	2003	Package: v mr
	2004
	2005	An asserti on regardi ng a clini cal condit ion of the subject t hat needs to be trea ted or man aged.
	2006
	2007	Attributes
	2008	Attribute Notes
	2009	importance
	2010	CD [0. .1]
	2011	Urgency or importanc e of probl em. E.g., may be co des for pr imary,
	2012	secondary as applies to an enc ounter dia gnosis fro m administ rative dat a,
	2013	or codes f or the deg ree of thr eat to the patient's health ca used by th e
	2014	problem (e .g., life- threatenin g, require s hospital ization).
	2015	severity
	2016	CD [0. .1]
	2017	The intens ity of the problem. E.g., sev ere, moder ate.
	2018	problemSta tus
	2019	CD
	2020	State of t he problem . E.g., a ctive, ina ctive, res olved.
	2021	ageAtOnset
	2022	PQ [0. .1]
	2023	The subjec t's age wh en the pro blem began .
	2024	wasCauseOf Death
	2025	BL [0. .1]
	2026	Whether th e problem was the ca use of the subject's death.
	2027
	2028
	2029
	2030	HL7 vMR DA M - Sept 2 011 Page: 40
	2031
	2032	3.1.4.30 P roblemBase
	2033	Type: Cla ss Clin icalStatem ent
	2034	Package: v mr
	2035
	2036	Abstract b ase class for proble ms, which are clinic al conditi ons that n eed to be treated or managed.
	2037
	2038	Attributes
	2039	Attribute Notes
	2040	problemCod e
	2041	CD
	2042	This is th e code tha t identifi es the pro blem or co ndition wi th as much
	2043	specificit y as avail able, or a s required by a temp late. It might be a n
	2044	ICD9 or SN OMED code, or whatev er vocabul aries are appropriat e to
	2045	describe t he problem or condit ion. E.g. , diabetes mellitus, congestiv e
	2046	heart fail ure.
	2047	problemEff ectiveTime
	2048	IVL_TS [0..1]
	2049	The time t hat is pri marily rel ated to th e subject' s experien ce of the
	2050	disease or condition , rather t han when t hose event s were rep orted or
	2051	recorded b y the eval uater.
	2052	diagnostic EventTime
	2053	IVL_TS
	2054	The time w hen the ev aluater id entified t he subject as having the
	2055	condition (in the ca se of Prob lem) or as not havin g the cond ition (in the
	2056	case of De niedProble m).
	2057	affectedBo dySite
	2058	BodySite [0..*]
	2059	A body sit e affected by the pr oblem (in the case o f Problem) or not
	2060	affected b y the prob lem (in th e case of DeniedProb lem).
	2061
	2062
	2063
	2064	3.1.4.31 P rocedureBa se
	2065	Type: Cla ss Clin icalStatem ent
	2066	Package: v mr
	2067
	2068	Abstract b ase class for a proc edure, whi ch is a se ries of st eps taken on a subje ct to acco mplish a c linical go al.
	2069
	2070	Attributes
	2071	Attribute Notes
	2072	procedureC ode
	2073	CD
	2074	This is th e code tha t identifi es the pro cedure wit h as much specificit y as
	2075	available, or as req uired by a template. E.g., ap pendectomy , coronary
	2076	artery byp ass graft surgery.
	2077	procedureM ethod
	2078	CD [0. .1]
	2079	The method ology used for the p rocedure. E.g., lap roscopic s urgery,
	2080	robotic su rgery.
	2081	approachBo dySite
	2082	BodySite [0..1]
	2083	The body s ite used f or gaining access to the targe t body sit e. E.g.,
	2084	femoral ar tery for a coronary angiograph y.
	2085	targetBody Site
	2086	BodySite [0..1]
	2087	The body s ite where the proced ure takes place. E. g., corona ry blood
	2088	vessels fo r coronary angiograp hy.
	2089
	2090
	2091
	2092	HL7 vMR DA M - Sept 2 011 Page: 41
	2093
	2094	3.1.4.32 P rocedureEv ent
	2095	Type: Cla ss Proc edureBase
	2096	Package: v mr
	2097
	2098	The actual event of performing a procedu re.
	2099
	2100	Attributes
	2101	Attribute Notes
	2102	procedureT ime
	2103	IVL_TS
	2104	Time when procedure was done.
	2105
	2106
	2107
	2108	3.1.4.33 P rocedureOr der
	2109	Type: Cla ss Proc edureBase
	2110	Package: v mr
	2111
	2112	An order f or procedu re to be d one.
	2113
	2114	Attributes
	2115	Attribute Notes
	2116	criticalit y
	2117	CD [0. .1]
	2118	Urgency or importanc e of the p rocedure.
	2119	orderEvent Time
	2120	IVL_TS
	2121	The time w hen the or der was ma de.
	2122	procedureT ime
	2123	IVL_TS [0..1]
	2124	Ordered ti me for pro cedure.
	2125
	2126	If repeatN umber >= 2 , then spe cifies per iod within which the
	2127	procedures should ta ke place. In these cases, it is assumed that the
	2128	procedures should be evenly di stributed within the timeframe . E.g., i f
	2129	ordered ti me is 1/1/ 2011 to 12 /31/2011, and repeat Number is 3, ideal
	2130	procedure times woul d be 1/1/2 011, 12/31 /2011, and in the mi ddle of
	2131	the year.
	2132	repeatNumb er
	2133	INT [0 ..1]
	2134	Number of times the procedure should tak e place.
	2135
	2136
	2137
	2138	HL7 vMR DA M - Sept 2 011 Page: 42
	2139
	2140	3.1.4.34 P rocedurePr oposal
	2141	Type: Cla ss Proc edureBase
	2142	Package: v mr
	2143
	2144	Proposals for a proc edure to t ake place, e.g., gen erated by a CDS syst em or by a consultin g clinicia n.
	2145
	2146	Attributes
	2147	Attribute Notes
	2148	criticalit y
	2149	CD [0. .1]
	2150	Urgency or importanc e of the p roposed pr ocedure.
	2151	proposedPr ocedureTim e
	2152	IVL_TS [0..1]
	2153	Requested time for p rocedure.
	2154
	2155	If repeatN umber >= 2 , then spe cifies req uested per iod within which the
	2156	procedures should ta ke place. In these cases, it is assumed that the
	2157	procedures should be evenly di stributed within the timeframe . E.g., i f
	2158	requested time is 1/ 1/2011 to 12/31/2011 , and repe atNumber i s 3, ideal
	2159	procedure times woul d be 1/1/2 011, 12/31 /2011, and in the mi ddle of
	2160	the year.
	2161	repeatNumb er
	2162	INT [0 ..1]
	2163	Number of times the procedure is request ed.
	2164
	2165
	2166
	2167	3.1.4.35 S cheduledAp pointment
	2168	Type: Cla ss Enco unterBase
	2169	Package: v mr
	2170
	2171	A clinical appointme nt that ha s been sch eduled. I f reschedu led, the a ppointment Time may c hange.
	2172
	2173	Attributes
	2174	Attribute Notes
	2175	appointmen tTime
	2176	IVL_TS
	2177	The time o f the sche duled appo intment.
	2178
	2179
	2180
	2181	3.1.4.36 S cheduledPr ocedure
	2182	Type: Cla ss Proc edureBase
	2183	Package: v mr
	2184
	2185	A procedur e that has been sche duled to t ake place.
	2186
	2187	Attributes
	2188	Attribute Notes
	2189	procedureT ime
	2190	IVL_TS
	2191
	2192
	2193
	2194
	2195	HL7 vMR DA M - Sept 2 011 Page: 43
	2196
	2197	3.1.4.37 S pecimen
	2198	Type: Cla ss Enti ty
	2199	Package: v mr
	2200
	2201	A sample o f tissue, blood, uri ne, water, air, etc. , taken fo r the purp oses of di agnostic e xamination or evalua tion.
	2202
	2203
	2204
	2205	3.1.4.38 S ubstanceAd ministrati onBase
	2206	Type: Cla ss Clin icalStatem ent
	2207	Package: v mr
	2208
	2209	Abstract b ase class for giving a materia l of a par ticular co nstitution to a pers on to enab le a clini cal effect .
	2210
	2211	Attributes
	2212	Attribute Notes
	2213	substanceA dministrat ionGeneral Purp
	2214	ose
	2215	CD
	2216	The genera l purpose for the su bstance ad ministrati on. E.g., medicatio n,
	2217	immunizati on.
	2218	substance
	2219	Administr ableSubsta nce
	2220	A material of a part icular con stitution that can b e given to a person to
	2221	enable a c linical ef fect.
	2222	deliveryMe thod
	2223	CD [0. .1]
	2224	Methodolog y used to administer the subst ance. E.g ., gastric feeding
	2225	tube, gast rostomy.
	2226	doseQuanti ty
	2227	IVL_PQ [0..1]
	2228	The amount of substa nce. E.g. , 1 tab, 3 25 mg, 1-2 tabs.
	2229	deliveryRo ute
	2230	CD [0. .1]
	2231	The physic al route t hrough whi ch the sub stance is administer ed. E.g.,
	2232	IV, PO.
	2233	approachBo dySite
	2234	BodySite [0..1]
	2235	The body s ite used f or gaining access to the targe t body sit e for the
	2236	purposes o f the subs tance admi nistration .
	2237	targetBody Site
	2238	BodySite [0..1]
	2239	The body s ite where the substa nce is del ivered.
	2240	dosingPeri od
	2241	IVL_PQ [0..1]
	2242	Together w ith dosing PeriodInte rvalIsImpo rtant, ide ntifies th e frequenc y
	2243	of substan ce adminis tration. dosingPeri od identif ies the pe riodicity of
	2244	doses with in a 24 ho ur timefra me. E.g., a dosingP eriod of 8 hr would
	2245	signify q8 h if dosin gPeriodInt ervalIsImp ortant is true, and TID if
	2246	dosingPeri odInterval IsImportan t is false .
	2247	dosingPeri odInterval IsImportan t
	2248	BL [0. .1]
	2249	Together w ith dosing Period, id entifies t he frequen cy of subs tance
	2250	administra tion. dos ingPeriod identifies the perio dicity of doses with in
	2251	a 24 hour timeframe, whereas d osingPerio dIntervalI sImportant
	2252	identifies whether d oses shoul d be equal ly spaced within tha t 24 hour
	2253	period. E .g., a dos ingPeriod of 8 hr wo uld signif y q8h if
	2254	dosingPeri odInterval IsImportan t is true, and TID i f
	2255	dosingPeri odInterval IsImportan t is false .
	2256	deliveryRa te
	2257	IVL_PQ [0..1]
	2258	Rate of su bstance ad ministrati on. E.g., 1000 mL/h r.
	2259
	2260
	2261
	2262	HL7 vMR DA M - Sept 2 011 Page: 44
	2263
	2264	3.1.4.39 S ubstanceAd ministrati onEvent
	2265	Type: Cla ss Subs tanceAdmin istrationB ase
	2266	Package: v mr
	2267
	2268	The actual administr ation of t he substan ce.
	2269
	2270	Handling o f entries in "curren t medicati on list" w ith no oth er informa tion than current me dications would be a s
	2271	follows:
	2272	- Substanc eAdministr ationEvent with docu mentationT ime = time when snap shot was t aken of cu rrent medi cation
	2273	list, admi nistration EventTime = null if no informa tion provi ded on whe n medicati on was sta rted or st opped,
	2274	administra tionTime w ith specif ied Low bu t null Hig h if infor mation onl y provided on when m edication was starte d.
	2275
	2276	To specify "patient takes an u nknown dru g", use a code for s ubstance t hat repres ents "unkn own medica tion".
	2277
	2278	Attributes
	2279	Attribute Notes
	2280	doseNumber
	2281	INT [0 ..1]
	2282	Identifies which dos e this sub stance adm inistratio n represen ts within a
	2283	series of doses. Mo st commonl y used for immunizat ions.
	2284	administra tionTimeIn terval
	2285	IVL_TS [0..1]
	2286	The time w hen the su bstance is administe red. An u nspecified high
	2287	time inter val signif ies that t he adminis tration is ongoing. Left opti onal
	2288	to allow u se for a m edication list that does not h ave this i nformation .
	2289	documentat ionTime
	2290	IVL_TS
	2291	The time w hen the su bstance ad ministrati on is docu mented.
	2292	informatio nAttestati onType
	2293	CD [0. .1]
	2294	How the su bstance ad ministrati on was cla imed or ve rified. E .g.,
	2295	patient-re ported, ob served by care provi der, perfo rmed by ca re provide r.
	2296	Can be use d as a gau ge of reli ability, o r when ver ified subs tance
	2297	administra tion (e.g. , for tube rculosis t reatment) is require d.
	2298
	2299	3.1.4.40 S ubstanceAd ministrati onOrder
	2300	Type: Cla ss Subs tanceAdmin istrationB ase
	2301	Package: v mr
	2302
	2303	A clinical order for a substan ce adminis tration. Includes m edication prescripti ons.
	2304
	2305	Attributes
	2306	Attribute Notes
	2307	criticalit y
	2308	CD [0. .1]
	2309	Urgency or importanc e of the s ubstance a dministrat ion. May be codes
	2310	for the th reat to th e patient' s health c ausing the need for the substa nce
	2311	administra tion, or o ther codin g system v alues indi cating the urgency o f
	2312	an ordered substance administr ation (e.g ., please give Vitam in K,
	2313	STAT).
	2314	doseRestri ction
	2315	DoseRestr iction [0..1]
	2316	Specifies the maximu m dose tha t can be g iven in a specified time
	2317	interval.
	2318	administra tionTimeIn terval
	2319	IVL_TS
	2320	Ordered ti me for adm inistering the subst ance.
	2321	dosingSig
	2322	CD [0. .*]
	2323	Directions for the s ubstance a dministrat ion as ide ntified in Sig codes .
	2324	E.g., qam, qhs, prn.
	2325	numberFill sAllowed
	2326	INT [0 ..1]
	2327	The number of fills allowed. M ust be 1 o r greater.
	2328	orderEvent Time
	2329	IVL_TS
	2330	Time when order was made.
	2331
	2332	HL7 vMR DA M - Sept 2 011 Page: 45
	2333
	2334	3.1.4.41 S ubstanceAd ministrati onProposal
	2335	Type: Cla ss Subs tanceAdmin istrationB ase
	2336	Package: v mr
	2337
	2338	Proposal f or a subst ance admin istration. Used, fo r example, when a CD S system p roposes th at a medic ation or
	2339	vaccinatio n be given .
	2340
	2341	Attributes
	2342	Attribute Notes
	2343	criticalit y
	2344	CD [0. .1]
	2345	Urgency or importanc e of the s ubstance a dministrat ion. May be codes
	2346	for the th reat to th e patient' s health c ausing the need for the substa nce
	2347	administra tion, or o ther codin g system v alues indi cating the urgency o f
	2348	a proposed substance administr ation (e.g ., please give Vitam in K,
	2349	STAT).
	2350	doseRestri ction
	2351	DoseRestr iction [0..1]
	2352	Specifies the maximu m dose tha t can be g iven in a specified time
	2353	interval.
	2354	proposedAd ministrati onTimeInte rval
	2355	IVL_TS [0..1]
	2356	Proposed t ime for ad ministerin g the subs tance.
	2357	validAdmin istrationT imeInterva l
	2358	IVL_TS [0..1]
	2359	Acceptable time for administer ing the su bstance. Distinct f rom
	2360	proposedAd ministrati onTimeInte rval that this time includes a cceptable
	2361	but subopt imal admin istration times. Th is is an i mportant a spect of
	2362	immunizati ons, which have reco mmended an d acceptab le/valid
	2363	timeframes for admin istration that can d iffer.
	2364	numberFill sAllowed
	2365	INT [0 ..1]
	2366	The number of fills allowed. M ust be 1 o r greater.
	2367
	2368	3.1.4.42 S ubstanceDi spensation Event
	2369	Type: Cla ss Subs tanceAdmin istrationB ase
	2370	Package: v mr
	2371
	2372	This is th e Event of a pharmac y filling a prescrip tion.
	2373
	2374	Attributes
	2375	Attribute Notes
	2376	daysSupply
	2377	INT [0 ..1]
	2378	The number of days t his dispen sation sho uld last.
	2379	dispensati onQuantity
	2380	PQ [0. .1]
	2381	The amount of substa nce provid ed.
	2382	doseRestri ction
	2383	DoseRestr iction [0..1]
	2384	Specifies the maximu m dose tha t can be g iven in a specified time
	2385	interval.
	2386	dispensati onTime
	2387	IVL_TS
	2388	Time when substance was dispen sed.
	2389	fillNumber
	2390	INT [0 ..1]
	2391	The curren t fill num ber. 1 if it is the first fill on this p rescriptio n, 2 if it
	2392	is the sec ond, etc. Must be 1 or greate r.
	2393	fillsRemai ning
	2394	INT [0 ..1]
	2395	The number of fills remaining on prescri ption.
	2396	isValid
	2397	BL [0. .1]
	2398	Primarily designed t o support analysis o f previous immunizat ions
	2399
	2400
	2401
	2402	HL7 vMR DA M - Sept 2 011 Page: 46
	2403
	2404	3.1.4.43 S upplyBase
	2405	Type: Cla ss Clin icalStatem ent
	2406	Package: v mr
	2407
	2408	Abstract b ase class for the pr ovision of some clin ical mater ial or equ ipment to the subjec t, such as a wheelch air.
	2409
	2410	Attributes
	2411	Attribute Notes
	2412	supplyCode
	2413	CD
	2414	This is th e code tha t identifi es the mat erial supp lied with as much
	2415	specificit y as avail able, or a s required by a temp late. E.g ., wheelch air,
	2416	bandages.
	2417	quantity
	2418	PQ [0. .1]
	2419	Amount of material d escribed b y the supp lyCode.
	2420	targetBody Site
	2421	BodySite [0..1]
	2422	Body site where supp ly is to b e used.
	2423
	2424
	2425
	2426	3.1.4.44 S upplyEvent
	2427	Type: Cla ss Supp lyBase
	2428	Package: v mr
	2429
	2430	The provis ion of som e clinical material or equipme nt to the subject, s uch as a w heelchair.
	2431
	2432	Attributes
	2433	Attribute Notes
	2434	supplyTime
	2435	IVL_TS
	2436	When the s upply was delivered.
	2437
	2438
	2439
	2440	3.1.4.45 S upplyOrder
	2441	Type: Cla ss Supp lyBase
	2442	Package: v mr
	2443
	2444	A provider 's order t o deliver the supply .
	2445
	2446	Attributes
	2447	Attribute Notes
	2448	supplyTime
	2449	IVL_TS [0..1]
	2450	Ordered ti me for sup ply.
	2451
	2452	If repeatN umber >= 2 , then spe cifies per iod within which the supplies
	2453	should tak e place. In these c ases, it i s assumed that the s upplies sh ould
	2454	be evenly distribute d within t he timefra me. E.g., if ordered time is
	2455	1/1/2011 t o 12/31/20 11, and re peatNumber is 3, ide al supply times
	2456	would be 1 /1/2011, 1 2/31/2011, and in th e middle o f the year .
	2457	orderEvent Time
	2458	IVL_TS
	2459
	2460	repeatNumb er
	2461	INT [0 ..1]
	2462	Number of times supp ly should be deliver ed.
	2463
	2464	HL7 vMR DA M - Sept 2 011 Page: 47
	2465
	2466	3.1.4.46 S upplyPropo sal
	2467	Type: Cla ss Supp lyBase
	2468	Package: v mr
	2469
	2470	Proposal, e.g., by a CDS syste m, for a S upply to b e delivere d.
	2471
	2472	Attributes
	2473	Attribute Notes
	2474	proposedSu pplyTime
	2475	IVL_TS [0..1]
	2476	Requested time for s upply.
	2477
	2478	If repeatN umber >= 2 , then spe cifies req uested per iod within which the
	2479	supplies s hould take place. I n these ca ses, it is assumed t hat the
	2480	supplies s hould be e venly dist ributed wi thin the t imeframe. E.g., if
	2481	requested time is 1/ 1/2011 to 12/31/2011 , and repe atNumber i s 3, ideal
	2482	supply tim es would b e 1/1/2011 , 12/31/20 11, and in the middl e of the
	2483	year.
	2484	repeatNumb er
	2485	INT [0 ..1]
	2486	Number of times supp ly should be deliver ed.
	2487
	2488
	2489
	2490	3.1.4.47 U nconducted Observatio n
	2491	Type: Cla ss Obse rvationBas e
	2492	Package: v mr
	2493
	2494	A statemen t that an observatio n was not made. E.g ., a state ment that smoking st atus was n ot assesse d.
	2495
	2496	Attributes
	2497	Attribute Notes
	2498	reason
	2499	CD [0. .1]
	2500	The reason the obser vation was not made. E.g., in adequate t ime,
	2501	patient re fused.
	2502	subjectEff ectiveTime
	2503	IVL_TS [0..1]
	2504	Time when the observ ation migh t have bee n done, bu t was not.
	2505	Optional, as may wis h to simpl y note tha t an obser vation was never
	2506	done.
	2507	documentat ionTime
	2508	IVL_TS
	2509	Time when the provid er noted t hat the ob servation was not ma de.
	2510
	2511
	2512
	2513	3.1.4.48 U ndelivered Procedure
	2514	Type: Cla ss Proc edureBase
	2515	Package: v mr
	2516
	2517	Documentat ion that a procedure was not d elivered. E.g., doc umentation that a su rgery was not perfor med becaus e
	2518	the patien t refused.
	2519
	2520	Attributes
	2521	Attribute Notes
	2522	reason
	2523	CD [0. .1]
	2524	The reason the proce dure was n ot perform ed. E.g., patient r efused,
	2525	inadequate time.
	2526	HL7 vMR DA M - Sept 2 011 Page: 48
	2527
	2528	Attribute Notes
	2529	subjectEff ectiveTime
	2530	IVL_TS [0..1]
	2531	Time when procedure might have been done , but was not. Optio nal, as
	2532	may simply want to n ote that a procedure was never done.
	2533	documentat ionTime
	2534	IVL_TS
	2535	Time when the non-de livery of the proced ure was do cumented.
	2536
	2537
	2538
	2539	3.1.4.49 U ndelivered SubstanceA dministrat ion
	2540	Type: Cla ss Subs tanceAdmin istrationB ase
	2541	Package: v mr
	2542
	2543	Documents the non-de livery of a substanc e. E.g., documents that an in fluenza im munization was not g iven becau se
	2544	the patien t refused or had an adverse re action to a previous flu vacci ne.
	2545
	2546	Attributes
	2547	Attribute Notes
	2548	reason
	2549	CD [0. .1]
	2550	Reason why the subst ance was n ot adminis tered.
	2551	subjectEff ectiveTime
	2552	IVL_TS [0..1]
	2553	Time inter val when s ubject did not recei ve substan ce. Optio nal, as ma y
	2554	simply wan t to note that a par ticular su bstance wa s never ad ministered .
	2555	documentat ionTime
	2556	IVL_TS
	2557	Time time when the n on-deliver y of the s ubstance w as documen ted.
	2558
	2559
	2560
	2561	3.1.4.50 U ndelivered Supply
	2562	Type: Cla ss Supp lyBase
	2563	Package: v mr
	2564
	2565	Documentat ion that t he indicat ed materia l was not provided t o the subj ect.
	2566
	2567	Attributes
	2568	Attribute Notes
	2569	reason
	2570	CD [0. .1]
	2571	The reason the suppl y was not provided. E.g., pat ient refus ed,
	2572	inadequate time.
	2573	subjectEff ectiveTime
	2574	IVL_TS [0..1]
	2575	Time when the supply should ha ve been de livered, b ut was not .
	2576	Optional, as may sim ply want t o note tha t a supply was never done.
	2577	documentat ionTime
	2578	IVL_TS
	2579	Time when the non-de livery of the supply was docum ented.
	2580
	2581
	2582
	2583	HL7 vMR DA M - Sept 2 011 Page: 49
	2584
	2585	3.1.4.51 V MR
	2586	Type: Cla ss
	2587	Package: v mr
	2588
	2589	A virtual medical re cord (vMR) contains informatio n about a patient re levant for CDS, eith er with re gard to th e data
	2590	used for g enerating inferences (input) o r the conc lusions re ached as a result of analyzing the data (output). A vMR
	2591	may contai n, for exa mple, prob lems and m edications or CDS-ge nerated as sessments and recomm ended acti ons.
	2592	Note that CDS-genera ted assess ments and recommende d actions would typi cally be c onsidered a CDS outp ut but
	2593	could also be used a s a CDS in put as wel l (e.g., p rior CDS s ystem reco mmendation s could in fluence cu rrent CDS
	2594	system rec ommendatio ns).
	2595
	2596	This model does allo w for the presence o f informat ion belong ing to rel ated perso ns (such a s in the c ase of fam ily
	2597	history, o r public h ealth infe ctious dis ease cases ) for a si ngle patie nt. These related p ersons are modeled a s
	2598	EvaluatedP ersons who have asso ciated Cli nicalState ments. No te that th is model i s not desi gned to be an
	2599	informatio n model fo r providin g CDS for a large po pulation.
	2600
	2601	Note that enumeratio ns and val ue domains are antic ipated to be specifi ed in prof iles in ad ditional b allots.
	2602
	2603	Attributes
	2604	Attribute Notes
	2605	templateId
	2606	II [1. .*]
	2607	The identi fier of a set of con straints p laced on a vMR.
	2608
	2609
	2610
	2611
	2612	HL7 vMR DA M - Sept 2 011 Page: 50
	2613
	2614	3.1.5 data Types
	2615	Type: Pac kage
	2616	Package: m odelParent
	2617
	2618	Specifies data types used. Th e data typ es are a s implified/ constraine d version of ISO 210 90 data ty pes, which is an
	2619	implementa ble specif ication ba sed on the abstract HL7 versio n 3 data t ypes speci fication, release 2.
	2620
	2621
	2622	dataTypes - (Class d iagram)
	2623	class dat aTypes
	2624	iso-21090- datatypes- simplified -vmr::
	2625	ANY
	2626	iso-21090- datatypes- simplified -v mr::XP
	2627	+ value : string
	2628	iso-21090- datatypes- simplified -vmr::ADXP
	2629	+ type :C S
	2630	iso-21090- datatypes- simplified -v mr::ENX P
	2631	+ type :C S
	2632	+ qualifie r :CS [0. .*]
	2633	iso-21090- datatypes- simplified -v mr::AD
	2634	+ part :A DXP [1..*]
	2635	+ use :CS [0..*]
	2636	iso-21090- datatypes- simplified -vmr::CD
	2637	+ code :s tring
	2638	+ codeSyst em :strin g
	2639	+ displayN ame :ST [ 0..1]
	2640	iso-21090- datatypes- simplified -vmr::CS
	2641	+ code :s tring
	2642	iso-21090- datatypes- simplified -v mr::EN
	2643	+ part :E NXP [1..*]
	2644	+ use :CS [0..*]
	2645	iso-21090- datatypes- simplified -v mr::II
	2646	+ root :s tring
	2647	+ extensio n :string [0..1]
	2648	iso-21090- datatypes- simplified -v mr::IVL _INT
	2649	+ low :IN T [0..1]
	2650	+ high :I NT [0..1]
	2651	+ lowIsInc lusive :b oolean [0. .1]
	2652	+ highIsIn clusive : boolean [0 ..1]
	2653	iso-21090- datatypes- simplified -v mr::IVL _PQ
	2654	+ low :PQ [0..1]
	2655	+ high :P Q [0..1]
	2656	+ lowIsInc lusive :b oolean [0. .1]
	2657	+ highIsIn clusive : boolean [0 ..1]
	2658	iso-21090- datatypes- simplified -v mr::IVL _RTO
	2659	+ low :RT O [0..1]
	2660	+ high :R TO [0..1]
	2661	+ lowIsInc lusive :b oolean [0. .1]
	2662	+ highIsIn clusive : boolean [0 ..1]
	2663	iso-21090- datatypes- simplified -v mr::IVL _REAL
	2664	+ low :RE AL [0..1]
	2665	+ high :R EAL [0..1]
	2666	+ lowIsInc lusive :b oolean [0. .1]
	2667	+ highIsIn clusive : boolean [0 ..1]
	2668	iso-21090- datatypes- simplified -v mr::INT
	2669	+ value : int
	2670	iso-21090- datatypes- simplified -v mr::IVL _TS
	2671	+ low :TS [0..1]
	2672	+ high :T S [0..1]
	2673	+ lowIsInc lusive :b oolean [0. .1]
	2674	+ highIsIn clusive : boolean [0 ..1]
	2675	iso-21090- datatypes- simplified -v mr::PQ
	2676	+ value : decimal
	2677	+ unit :s tring
	2678	iso-21090- datatypes- simplified -vmr::
	2679	QTY
	2680	iso-21090- datatypes- simplified -v mr::
	2681	REAL
	2682	+ value : decimal
	2683	iso-21090- datatypes- simplified -v mr::
	2684	RTO
	2685	+ numerato r :PQ
	2686	+ denomina tor :PQ
	2687	iso-21090- datatypes- simplified -v mr::ST
	2688	+ value : string
	2689	iso-21090- datatypes- simplified -v mr::TEL
	2690	+ useableP eriodOrigi nalText : string [0. .1]
	2691	+ value : string
	2692	+ use :CS [0..*]
	2693	+ capabili ties :CS [0..*]
	2694	iso-21090- datatypes- simplified -v mr::TS
	2695	+ value : string
	2696	iso-21090- datatypes- simplified -vmr::
	2697	BL
	2698	+ value : boolean
	2699
	2700	Figure: 15
	2701
	2702	HL7 vMR DA M - Sept 2 011 Page: 51
	2703
	2704
	2705	3.1.5.1 is o-21090-da tatypes-si mplified-v mr
	2706	Type: Cla ss
	2707	Package: d ataTypes
	2708
	2709
	2710
	2711
	2712	3.1.5.1.1 AD
	2713	Type: Cla ss ANY
	2714	Package: d ataTypes
	2715
	2716	Mailing an d home or office add resses.
	2717
	2718	AD is prim arily used to commun icate data that will allow pri nting mail labels, o r that wil l allow a person to
	2719	physically visit tha t address. The posta l address datatype i s not supp osed to be a contain er for add itional in formation
	2720	that might be useful for findi ng geograp hic locati ons (e.g., GPS coord inates) or for perfo rming epid emiologica l
	2721	studies. S uch additi onal infor mation sho uld be cap tured by o ther, more appropria te data st ructures.
	2722
	2723	Addresses are essent ially sequ ences of a ddress par ts, but ad d a "use" code and a valid tim e range fo r informat ion
	2724	about if a nd when th e address can be use d for a gi ven purpos e.
	2725
	2726	Attributes
	2727	Attribute Notes
	2728	part
	2729	ADXP [ 1..*]
	2730	A sequence of addres s parts, s uch as str eet or pos t office B ox, city,
	2731	postal cod e, country , etc.
	2732	use
	2733	CS [0. .*]
	2734	A set of c odes advis ing a syst em or user which add ress in a set of lik e
	2735	addresses to select for a give n purpose.
	2736	An address without s pecific us e code mig ht be a de fault addr ess useful
	2737	for any pu rpose, but an addres s with a s pecific us e code wou ld be
	2738	preferred for that r espective purpose.
	2739	If populat ed, the va lues conta ined in th is attribu te SHALL b e taken
	2740	from the H L7 PostalA ddressUse code syste m.
	2741
	2742
	2743
	2744	3.1.5.1.2 ADXP
	2745	Type: Cla ss XP
	2746	Package: d ataTypes
	2747
	2748	A part wit h a type-t ag signify ing its ro le in the address. T ypical par ts that ex ist in abo ut every a ddress are street,
	2749	house numb er, or pos t box, pos tal code, city, coun try but ot her roles may be def ined regio nally, nat ionally, o r on an
	2750	enterprise level (e. g. in mili tary addre sses).
	2751
	2752	Attributes
	2753	Attribute Notes
	2754	type
	2755	CS
	2756	Whether an address p art names the street , city, co untry, pos tal code,
	2757	post box, address li ne 1, etc.
	2758	The value of this at tribute SH ALL be tak en from th e HL7
	2759	AddressPar tType code system.
	2760
	2761	HL7 vMR DA M - Sept 2 011 Page: 52
	2762
	2763
	2764
	2765	3.1.5.1.3 ANY
	2766	Type: Cla ss
	2767	Package: d ataTypes
	2768
	2769	Defines th e basic pr operties o f every da ta value. This is co nceptually an abstra ct type, m eaning tha t no prope r value
	2770	can be jus t a data v alue witho ut belongi ng to any concrete t ype. Every public co ncrete typ e is a spe cializatio n of this
	2771	general ab stract Dat aValue typ e.
	2772
	2773	This class is mainta ined despi te the lac k of attri butes to m aintain co mpatibilit y with the ISO 21090 data stru cture.
	2774
	2775
	2776
	2777	3.1.5.1.4 BL
	2778	Type: Cla ss ANY
	2779	Package: d ataTypes
	2780
	2781	BL stands for the va lues of tw o-valued l ogic. A BL value can be either true or f alse.
	2782
	2783	Attributes
	2784	Attribute Notes
	2785	value
	2786	boolean
	2787	The value of the BL.
	2788
	2789
	2790
	2791	3.1.5.1.5 CD
	2792	Type: Cla ss ANY
	2793	Package: d ataTypes
	2794
	2795	A CD is a reference to a conce pt defined in an ext ernal code system, t erminology , or ontol ogy.
	2796
	2797	Attributes
	2798	Attribute Notes
	2799	code
	2800	string
	2801	The plain code symbo l defined by the cod e system, or an expr ession in a
	2802	syntax def ined by th e code sys tem which describes the concep t.
	2803	Code SHALL be an exa ct match t o a plain code symbo l or expre ssion
	2804	defined by the code system. If the code system def ines a cod e or
	2805	expression that incl udes white space, the code SHAL L include the
	2806	whitespace . An expre ssion can only be us ed where t he codeSys tem
	2807	either def ines an ex pression s yntax, or there is a generally accepted
	2808	syntax for the codeS ystem. A c ode system may be de fined that only
	2809	defines an expressio n syntax w ith bindin gs to othe r code Sys tems for
	2810	the elemen ts of the expression .
	2811	It is at t he discret ion of the interpret ing system whether t o check fo r an
	2812	expression instead o f a simple code and evaluate t he express ion instea d
	2813	of treatin g the expr ession as a code. In some case s, it may be unclear or
	2814	ambiguous whether th e code rep resents a single sym bol or an
	2815	expression . This usu ally arise s where th e code sys tem define s an
	2816	expression language and then d efines pre -coordinat ed concept s with
	2817	HL7 vMR DA M - Sept 2 011 Page: 53
	2818
	2819	Attribute Notes
	2820	symbols wh ich match their expr ession, e. g. UCUM. I n other ca ses, it is
	2821	safe to tr eat the ex pression a s a symbol . There is no guaran tee that t his
	2822	is always safe: the definition s of the c odeSystem should alw ays be
	2823	consulted to determi ne how to handle pot ential exp ressions.
	2824	codeSystem
	2825	string
	2826	The code s ystem that defines t he code, o r if no co de was fou nd, the
	2827	codeSystem in which no code wa s found.
	2828	Code syste ms SHALL b e referred to by a U ID, which allows
	2829	unambiguou s referenc e to stand ard code s ystems and other loc al
	2830	codesystem s. Where e ither ISO or HL7 hav e assigned UID to co de
	2831	Systems, t hen these UIDs SHALL be used. Otherwise implementa tions
	2832	SHALL use an appropr iate ISO O bject Iden tifier (OI D) or UUID to
	2833	construct a globally unique lo cal coding system id entifier.
	2834	displayNam e
	2835	ST [0. .1]
	2836	A name, ti tle, or re presentati on for the code or e xpression as it exis ts in
	2837	the code s ystem.
	2838	If populat ed, the di splayName SHALL be a valid hum an readabl e
	2839	representa tion of th e concept as defined by the co de system at the tim e
	2840	of data en try. The d isplayName SHALL con form to an y rules de fined
	2841	by the cod ingSystem; if the co deSystem d oes not de fine a hum an
	2842	representa tion for t he code or expressio n, then no ne can be provided.
	2843	displayNam e is inclu ded both a s a courte sy to an u naided hum an
	2844	interprete r of a cod e value an d as a doc umentation of the na me used to
	2845	display th e concept to the use r. The dis play name has no fun ctional
	2846	meaning; i t SHALL ne ver exist without a code; and it SHALL n ever
	2847	modify the meaning o f the code . A displa y name may not be pr esent if
	2848	the code i s an expre ssion for which no d isplay nam e has been assigned
	2849	or can be derived. I nformation Processin g Entities claiming direct or
	2850	indirect c onformance MAY choos e not to i mplement d isplayName but
	2851	SHALL NOT reject ins tances bec ause displ ayName is present.
	2852	Display na mes SHALL not alter the meanin g of the c ode value.
	2853	Therefore, display n ames SHOUL D NOT be p resented t o the user on a
	2854	receiving applicatio n system w ithout asc ertaining that the d isplay nam e
	2855	adequately represent s the conc ept referr ed to by t he code va lue.
	2856	Communicat ion SHALL NOT simply rely on t he display name. The
	2857	display na me's main purpose is to suppor t implemen tation deb ugging.
	2858
	2859
	2860
	2861	HL7 vMR DA M - Sept 2 011 Page: 54
	2862
	2863	3.1.5.1.6 CS
	2864	Type: Cla ss ANY
	2865	Package: d ataTypes
	2866
	2867	Coded data in its si mplest for m, where o nly the co de is not predetermi ned.
	2868
	2869	The code s ystem and code syste m version are implie d and fixe d by the c ontext in which the CS value o ccurs.
	2870
	2871	Due to its highly re stricted f unctionali ty, CS SHA LL only be used for simple str uctural at tributes w ith highly
	2872	controlled and stabl e terminol ogies wher e:
	2873	- all code s come fro m a single code syst em
	2874	- codes ar e not reus ed if thei r concept is depreca ted
	2875	- the publ ication an d extensib ility prop erties of the code s ystem are well descr ibed and u nderstood
	2876
	2877	Attributes
	2878	Attribute Notes
	2879	code
	2880	string
	2881	The plain code symbo l defined by the cod e system. If the co de value i s
	2882	empty or n ull, then there is n o code in the code s ystem that represent s
	2883	the concep t.
	2884	Code SHALL only cont ain charac ters that are either a letter, a digit, or
	2885	one of '.' , '-', '_' or ':'. C ode system s that are used with CS SHALL NOT
	2886	define cod e symbols or express ion syntax es that co ntain whit espace or
	2887	any other characters not in th is list.
	2888
	2889
	2890
	2891	3.1.5.1.7 EN
	2892	Type: Cla ss ANY
	2893	Package: d ataTypes
	2894
	2895	A name for a person, organizat ion, place or thing.
	2896
	2897	Examples: Jim Bob Walton, Jr ., Health Level Seve n, Inc., L ake Tahoe, etc. An e ntity name may be as simple as a
	2898	character string or may consis t of sever al entity name parts , such as, Jim, Bob, Walton, a nd Jr., He alth Level Seven,
	2899	and Inc.
	2900
	2901	Entity nam es are ess entially s equences o f entity n ame parts, but add a "use" cod e.
	2902
	2903	Attributes
	2904	Attribute Notes
	2905	part
	2906	ENXP [ 1..*]
	2907	A sequence of name p arts, such as given name or fa mily name, prefix,
	2908	suffix, et c.
	2909	use
	2910	CS [0. .*]
	2911	A set of c odes advis ing a syst em or user which nam e in a set of names
	2912	to select for a give n purpose.
	2913	A name wit hout speci fic use co de might b e a defaul t name use ful for
	2914	any purpos e, but a n ame with a specific use code w ould be pr eferred fo r
	2915	that respe ctive purp ose. Names SHOULD no t be colle cted witho ut at
	2916	least one use code, but names MAY exist without u se code,
	2917	particular ly for leg acy data.
	2918	If populat ed, the va lues conta ined in th is attribu te SHALL b e taken
	2919	from the H L7 EntityN ameUse2 co de system
	2920
	2921	HL7 vMR DA M - Sept 2 011 Page: 55
	2922
	2923
	2924
	2925	3.1.5.1.8 ENXP
	2926	Type: Cla ss XP
	2927	Package: d ataTypes
	2928
	2929	A part wit h a type c ode signif ying the r ole of the part in t he whole e ntity name , and qual ifier code s for more detail
	2930	about the name part type. (Typ ical name parts for person nam es are giv en names, and family names, ti tles, etc. ).
	2931
	2932	Attributes
	2933	Attribute Notes
	2934	type
	2935	CS
	2936	Indicates whether th e name par t is a giv en name, f amily name , prefix,
	2937	suffix, et c.
	2938	The value of this at tribute SH ALL be tak en from th e HL7
	2939	EntityName PartType2 code syste m.
	2940	qualifier
	2941	CS [0. .*]
	2942	The qualif ier is a s et of code s each of which spec ifies a ce rtain
	2943	subcategor y of the n ame part i n addition to the ma in name pa rt type.
	2944	For exampl e, a given name may be flagged as a nick name (CL), a
	2945	family nam e may be a name acqu ired by ma rriage (SP ) or a nam e from
	2946	birth (BR) .
	2947	If populat ed, the va lues conta ined in th is attribu te SHALL b e taken
	2948	from the H L7 EntityN amePartQua lifier2 co de system.
	2949
	2950
	2951
	2952	3.1.5.1.9 II
	2953	Type: Cla ss ANY
	2954	Package: d ataTypes
	2955
	2956	An identif ier that u niquely id entifies a thing or object.
	2957
	2958	Examples a re object identifier for HL7 R IM objects , medical record num ber, order id, servi ce catalog item id,
	2959	Vehicle Id entificati on Number (VIN), etc . Instance identifie rs are usu ally defin ed based o n ISO obje ct identif iers.
	2960
	2961	An identif ier allows someone t o select o ne record, object or thing fro m a set of candidate s. Usually an identi fier
	2962	alone with out any co ntext is n ot usable. Identifie rs are dis tinguished from conc ept descri ptors as c oncept des criptors
	2963	never iden tify an in dividual t hing, alth ough there may somet imes be an individua l record o r object t hat repres ents
	2964	the concep t.
	2965
	2966	Informatio n Processi ng Entitie s claiming direct or indirect conformanc e SHALL ne ver assume that rece iving
	2967	applicatio ns can inf er the ide ntity of i ssuing aut hority or the type o f the iden tifier fro m the iden tifier or components
	2968	thereof.
	2969
	2970	Attributes
	2971	Attribute Notes
	2972	root
	2973	string
	2974	A unique i dentifier that guara ntees the global uni queness of the insta nce
	2975	identifier .
	2976	If root is populated , and ther e is no ex tension, t hen the ro ot is a gl obally
	2977	unique ide ntifier in its own r ight. In t he presenc e of a non -null
	2978	extension, the root is the uni que identi fier for t he "namesp ace" of th e
	2979	identifier in the ex tension. N ote that t his does N OT necessa rily corre late
	2980	with the o rganizatio n that man ages the i ssuing of the identi fiers. A
	2981	HL7 vMR DA M - Sept 2 011 Page: 56
	2982
	2983	Attribute Notes
	2984	given orga nization m ay manage multiple i dentifier namespaces , and
	2985	control ov er a given namespace may trans fer from o rganizatio n to
	2986	organizati on over ti me while t he root re mains the same.
	2987	This field can be ei ther a DCE UUID, an Object Ide ntifier (O ID), or a
	2988	special id entifier t aken from lists that may be pu blished by ISO or HL 7.
	2989	Comparison of root v alues is a lways case sensitive . UUID's S HALL be
	2990	represente d in upper case, so UUID case should alw ays be pre served.
	2991	The root S HALL not b e used to carry sema ntic meani ng - all i t does is
	2992	ensure glo bal comput ational un iqueness.
	2993	extension
	2994	string [0..1]
	2995	A characte r string a s a unique identifie r within t he scope o f the
	2996	identifier root.
	2997	The root a nd extensi on scheme means that the conca tenation o f root and
	2998	extension SHALL be a globally unique ide ntifier fo r the item that this II
	2999	value iden tifies.
	3000	Some ident ifier sche mes define certain s tyle optio ns to thei r code
	3001	values. Fo r example, the U.S. Social Sec urity Numb er (SSN) i s
	3002	normally w ritten wit h dashes t hat group the digits into a pa ttern
	3003	"123-12-12 34". Howev er, the da shes are n ot meaning ful and a SSN can
	3004	also be re presented as "123121 234" witho ut the das hes. In th e case
	3005	where iden tifier sch emes provi de for mul tiple repr esentation s, HL7 or
	3006	ISO may ma ke a rulin g about wh ich is the preferred form and document
	3007	that rulin g where th at respect ive extern al identif ier scheme is
	3008	recognized .
	3009	If no exte nsion attr ibute is p rovided in a non-nul l II, then the root is the
	3010	complete u nique iden tifier.
	3011
	3012
	3013
	3014	3.1.5.1.10 INT
	3015	Type: Cla ss QTY
	3016	Package: d ataTypes
	3017
	3018	Integer nu mbers (-1, 0,1,2, 100 , 3398129, etc.) are precise n umbers tha t are resu lts of cou nting and enumeratin g.
	3019	Integer nu mbers are discrete, the set of integers is infinit e but coun table. No arbitrary limit is i mposed on the range
	3020	of integer numbers.
	3021
	3022	Attributes
	3023	Attribute Notes
	3024	value
	3025	int
	3026	The value of the INT . Note tha t this spe cification imposes n o limitati ons
	3027	on the siz e of integ er, but mo st impleme ntations w ill map th is to a 32 or
	3028	64 bit int eger.
	3029
	3030
	3031
	3032	HL7 vMR DA M - Sept 2 011 Page: 57
	3033
	3034	3.1.5.1.11 IVL_INT
	3035	Type: Cla ss ANY
	3036	Package: d ataTypes
	3037
	3038	A set of c onsecutive values of an ordere d base dat atype.
	3039
	3040	Any ordere d type can be the ba sis of an IVL; it do es not mat ter whethe r the base type is d iscrete or continuou s. If
	3041	the base d atatype is only part ially orde red, all e lements of the IVL m ust be ele ments of a totally o rdered sub set of
	3042	the partia lly ordere d datatype . For exam ple, PQ is considere d ordered. However t he orderin g of PQs i s only par tial;
	3043	a total or der is onl y defined among comp arable qua ntities (q uantities of the sam e physical dimension ). While I VLs
	3044	between 2 and 4 mete r exists, there is n o IVL betw een 2 mete rs and 4 s econds.
	3045
	3046	Attributes
	3047	Attribute Notes
	3048	low
	3049	INT [0 ..1]
	3050	This is th e low limi t. If the low limit is not kno wn, it may be null.
	3051	The low li mit SHALL NOT be pos itive infi nity.
	3052	high
	3053	INT [0 ..1]
	3054	This is th e high lim it. If the high limi t is not k nown, it m ay be null .
	3055	The high l imit SHALL NOT be ne gative inf inity, and SHALL be higher
	3056	than the l ow limit i f one exis ts.
	3057	lowIsInclu sive
	3058	boolean [0..1]
	3059	This attri bute is ca lled lowIs Closed in the ISO 21 090 specif ication.
	3060
	3061	Whether lo w is inclu ded in the IVL (is c losed) or excluded f rom the
	3062	IVL (is op en).
	3063	highIsIncl usive
	3064	boolean [0..1]
	3065	This attri bute is ca lled highI sClosed in the ISO 2 1090 speci fication.
	3066
	3067	Whether hi gh is incl uded in th e IVL (is closed) or excluded from the
	3068	IVL (is op en).
	3069
	3070
	3071	3.1.5.1.12 IVL_PQ
	3072	Type: Cla ss ANY
	3073	Package: d ataTypes
	3074
	3075	A set of c onsecutive values of an ordere d base dat atype.
	3076
	3077	Any ordere d type can be the ba sis of an IVL; it do es not mat ter whethe r the base type is d iscrete or continuou s. If
	3078	the base d atatype is only part ially orde red, all e lements of the IVL m ust be ele ments of a totally o rdered sub set of
	3079	the partia lly ordere d datatype . For exam ple, PQ is considere d ordered. However t he orderin g of PQs i s only par tial;
	3080	a total or der is onl y defined among comp arable qua ntities (q uantities of the sam e physical dimension ). While I VLs
	3081	between 2 and 4 mete r exists, there is n o IVL betw een 2 mete rs and 4 s econds.
	3082
	3083	Attributes
	3084	Attribute Notes
	3085	low
	3086	PQ [0. .1]
	3087	This is th e low limi t. If the low limit is not kno wn, it may be null.
	3088	The low li mit SHALL NOT be pos itive infi nity.
	3089	high
	3090	PQ [0. .1]
	3091	This is th e high lim it. If the high limi t is not k nown, it m ay be null .
	3092	The high l imit SHALL NOT be ne gative inf inity, and SHALL be higher
	3093	than the l ow limit i f one exis ts.
	3094	lowIsInclu sive
	3095	boolean [0..1]
	3096	This attri bute is ca lled lowIs Closed in the ISO 21 090 specif ication.
	3097
	3098	Whether lo w is inclu ded in the IVL (is c losed) or excluded f rom the
	3099	IVL (is op en).
	3100	HL7 vMR DA M - Sept 2 011 Page: 58
	3101
	3102	Attribute Notes
	3103	highIsIncl usive
	3104	boolean [0..1]
	3105	This attri bute is ca lled highI sClosed in the ISO 2 1090 speci fication.
	3106
	3107	Whether hi gh is incl uded in th e IVL (is closed) or excluded from the
	3108	IVL (is op en).
	3109
	3110
	3111
	3112	3.1.5.1.13 IVL_REAL
	3113	Type: Cla ss ANY
	3114	Package: d ataTypes
	3115
	3116	A set of c onsecutive values of an ordere d base dat atype.
	3117
	3118	Any ordere d type can be the ba sis of an IVL; it do es not mat ter whethe r the base type is d iscrete or continuou s. If
	3119	the base d atatype is only part ially orde red, all e lements of the IVL m ust be ele ments of a totally o rdered sub set of
	3120	the partia lly ordere d datatype . For exam ple, PQ is considere d ordered. However t he orderin g of PQs i s only par tial;
	3121	a total or der is onl y defined among comp arable qua ntities (q uantities of the sam e physical dimension ). While I VLs
	3122	between 2 and 4 mete r exists, there is n o IVL betw een 2 mete rs and 4 s econds.
	3123
	3124	Attributes
	3125	Attribute Notes
	3126	low
	3127	REAL [ 0..1]
	3128	This is th e low limi t. If the low limit is not kno wn, it may be null.
	3129	The low li mit SHALL NOT be pos itive infi nity.
	3130	high
	3131	REAL [ 0..1]
	3132	This is th e high lim it. If the high limi t is not k nown, it m ay be null .
	3133	The high l imit SHALL NOT be ne gative inf inity, and SHALL be higher
	3134	than the l ow limit i f one exis ts.
	3135	lowIsInclu sive
	3136	boolean [0..1]
	3137	This attri bute is ca lled lowIs Closed in the ISO 21 090 specif ication.
	3138
	3139	Whether lo w is inclu ded in the IVL (is c losed) or excluded f rom the
	3140	IVL (is op en).
	3141	highIsIncl usive
	3142	boolean [0..1]
	3143	This attri bute is ca lled highI sClosed in the ISO 2 1090 speci fication.
	3144
	3145	Whether hi gh is incl uded in th e IVL (is closed) or excluded from the
	3146	IVL (is op en).
	3147
	3148
	3149
	3150	HL7 vMR DA M - Sept 2 011 Page: 59
	3151
	3152	3.1.5.1.14 IVL_RTO
	3153	Type: Cla ss ANY
	3154	Package: d ataTypes
	3155
	3156	A set of c onsecutive values of an ordere d base dat atype.
	3157
	3158	Any ordere d type can be the ba sis of an IVL; it do es not mat ter whethe r the base type is d iscrete or continuou s. If
	3159	the base d atatype is only part ially orde red, all e lements of the IVL m ust be ele ments of a totally o rdered sub set of
	3160	the partia lly ordere d datatype . For exam ple, PQ is considere d ordered. However t he orderin g of PQs i s only par tial;
	3161	a total or der is onl y defined among comp arable qua ntities (q uantities of the sam e physical dimension ). While I VLs
	3162	between 2 and 4 mete r exists, there is n o IVL betw een 2 mete rs and 4 s econds
	3163
	3164	Attributes
	3165	Attribute Notes
	3166	low
	3167	RTO [0 ..1]
	3168	This is th e low limi t. If the low limit is not kno wn, it may be null.
	3169	The low li mit SHALL NOT be pos itive infi nity.
	3170	high
	3171	RTO [0 ..1]
	3172	This is th e high lim it. If the high limi t is not k nown, it m ay be null .
	3173	The high l imit SHALL NOT be ne gative inf inity, and SHALL be higher
	3174	than the l ow limit i f one exis ts.
	3175	lowIsInclu sive
	3176	boolean [0..1]
	3177	This attri bute is ca lled lowIs Closed in the ISO 21 090 specif ication.
	3178
	3179	Whether lo w is inclu ded in the IVL (is c losed) or excluded f rom the
	3180	IVL (is op en).
	3181	highIsIncl usive
	3182	boolean [0..1]
	3183	This attri bute is ca lled highI sClosed in the ISO 2 1090 speci fication.
	3184
	3185	Whether hi gh is incl uded in th e IVL (is closed) or excluded from the
	3186	IVL (is op en).
	3187
	3188
	3189	3.1.5.1.15 IVL_TS
	3190	Type: Cla ss ANY
	3191	Package: d ataTypes
	3192
	3193	A set of c onsecutive values of an ordere d base dat atype.
	3194
	3195	Any ordere d type can be the ba sis of an IVL; it do es not mat ter whethe r the base type is d iscrete or continuou s. If
	3196	the base d atatype is only part ially orde red, all e lements of the IVL m ust be ele ments of a totally o rdered sub set of
	3197	the partia lly ordere d datatype . For exam ple, PQ is considere d ordered. However t he orderin g of PQs i s only par tial;
	3198	a total or der is onl y defined among comp arable qua ntities (q uantities of the sam e physical dimension ). While I VLs
	3199	between 2 and 4 mete r exists, there is n o IVL betw een 2 mete rs and 4 s econds.
	3200
	3201	Attributes
	3202	Attribute Notes
	3203	low
	3204	TS [0. .1]
	3205	This is th e low limi t. If the low limit is not kno wn, it may be null.
	3206	The low li mit SHALL NOT be pos itive infi nity.
	3207	high
	3208	TS [0. .1]
	3209	This is th e high lim it. If the high limi t is not k nown, it m ay be null .
	3210	The high l imit SHALL NOT be ne gative inf inity, and SHALL be higher
	3211	than the l ow limit i f one exis ts.
	3212	lowIsInclu sive
	3213	boolean [0..1]
	3214	This attri bute is ca lled lowIs Closed in the ISO 21 090 specif ication.
	3215
	3216	Whether lo w is inclu ded in the IVL (is c losed) or excluded f rom the
	3217	IVL (is op en).
	3218	HL7 vMR DA M - Sept 2 011 Page: 60
	3219
	3220	Attribute Notes
	3221	highIsIncl usive
	3222	boolean [0..1]
	3223	This attri bute is ca lled highI sClosed in the ISO 2 1090 speci fication.
	3224
	3225	Whether hi gh is incl uded in th e IVL (is closed) or excluded from the
	3226	IVL (is op en).
	3227
	3228	3.1.5.1.16 PQ
	3229	Type: Cla ss QTY
	3230	Package: d ataTypes
	3231
	3232	A dimensio ned quanti ty express ing the re sult of me asuring.
	3233
	3234	Attributes
	3235	Attribute Notes
	3236	value
	3237	decimal
	3238	The number which is multiplied by the un it to make the PQ.
	3239	unit
	3240	string
	3241	The unit o f measure specified in the Uni fied Code for Units of Measure
	3242	(UCUM).
	3243	UCUM defin es two for ms of expr ession, ca se sensiti ve and cas e
	3244	insensitiv e. PQ uses the case sensitive codes. The codeSyste m OID for
	3245	the case s ensitive f orm is 2.1 6.840.1.11 3883.6.8. The defaul t value fo r
	3246	unit is th e UCUM cod e "1" (uni ty).
	3247	Equality o f physical quantitie s does not require t he values and units to
	3248	be equal i ndependent ly. Value and unit i s only how we repres ent
	3249	physical q uantities. For examp le, 1 m eq uals 100 c m. Althoug h the unit s
	3250	are differ ent and th e values a re differe nt, the ph ysical qua ntities ar e
	3251	equal. The refore one should ne ver expect a particu lar unit f or a physi cal
	3252	quantity b ut instead allow for automated conversio n between different
	3253	comparable units.
	3254	The unit S HALL come from UCUM, which onl y specifie s unambigu ous
	3255	measuremen t units. S ometimes i t is not c lear how s ome measur ements
	3256	in healthc are map to UCUM code s.
	3257	Note: The general pa ttern for a measurem ent is va lue unit o f Thing. I n
	3258	this schem e, the PQ represents the valu e and the unit, and the Thing is
	3259	described by some co ded concep t that is linked to the PQ by the contex t
	3260	of use. Th is maps ob viously to some meas urements, such as Pa tient
	3261	Body Tempe rature of 37 Celsius , and 250 mg/day of Salicylate .
	3262	However fo r some mea surements that arise in health care, the scheme is
	3263	not so obv ious. Two classic ex amples are 5 Drinks of Beer, a nd 3
	3264	Acetominop hen tablet s. At firs t glance i t is tempt ing to cla ssify thes e
	3265	measurment s like thi s: 5 drink s of Beer and 3 Acet ominophen tablets.
	3266	The proble m with thi s is that UCUM does not suppor t units of "beer",
	3267	"tablets" or "scoops ".
	3268	The reason for this is that ne ither tabl ets or sco ops are pr oper units .
	3269	What kind of tablets ? How big is the gla ss? In the se kinds o f cases, t he
	3270	concept th at appears to be a u nit needs to further specified before
	3271	interopera bility is establishe d. If a co rrect amou nt is requ ired, then it is
	3272	generally appropriat e to speci fy an exac t measurem ent with a n
	3273	appropriat e UCUM uni t. If this is not po ssible, th en the con cept is no t
	3274	part of th e measurem ent. UCUM provides a unit call ed unity f or use in
	3275	these case s. The pro per way to understan d these me asurements as 3 1
	3276	Acetominop hen tablet s, where 1 is the UC UM unit fo r unity, a nd the
	3277	Thing has a qualifie r. The con text of us e will nee d to provi de the ext ra
	3278	qualifying informati on.
	3279	HL7 vMR DA M - Sept 2 011 Page: 61
	3280
	3281	3.1.5.1.17 QTY
	3282	Type: Cla ss ANY
	3283	Package: d ataTypes
	3284
	3285	The quanti ty datatyp e is an ab stract gen eralizatio n for all datatypes whose doma in values has an ord er relatio n
	3286	(less-or-e qual) and where diff erence is defined in all of th e datatype 's totally ordered v alue subse ts.
	3287
	3288
	3289
	3290	3.1.5.1.18 REAL
	3291	Type: Cla ss QTY
	3292	Package: d ataTypes
	3293
	3294	Fractional numbers. Typically used whene ver quanti ties are m easured, e stimated, or compute d from oth er real
	3295	numbers. T he typical represent ation is d ecimal, wh ere the nu mber of si gnificant decimal di gits is kn own as the
	3296	precision.
	3297
	3298	Attributes
	3299	Attribute Notes
	3300	value
	3301	decimal
	3302	The value of the REA L.
	3303
	3304
	3305
	3306	3.1.5.1.19 RTO
	3307	Type: Cla ss QTY
	3308	Package: d ataTypes
	3309
	3310	A quantity construct ed as the quotient o f a numera tor quanti ty divided by a deno minator qu antity.
	3311	Common fac tors in th e numerato r and deno minator ar e not auto matically cancelled out.
	3312	The RTO da tatype sup ports tite rs (e.g., 1:128) and other qua ntities pr oduced by laboratori es that tr uly repres ent
	3313	ratios. Ra tios are n ot simply structured numerics, particula rly blood pressure m easurement s (e.g. 12 0/60) are not
	3314	ratios.
	3315	Notes:
	3316	1. Rati os are dif ferent fro m rational numbers, i.e., in r atios comm on factors in the nu merator an d denomina tor
	3317	never canc el out. A ratio of t wo real or integer n umbers is not automa tically re duced to a real numb er. This d atatype
	3318	is not def ined to ge nerally re present ra tional num bers. It i s used onl y if commo n factors in numerat or and
	3319	denominato r are not supposed t o cancel o ut. This i s only rar ely the ca se. For ob servation values, ra tios occur almost
	3320	exclusivel y with tit ers. In mo st other c ases, REAL should be used inst ead of the RTO.
	3321
	3322	Attributes
	3323	Attribute Notes
	3324	numerator
	3325	PQ
	3326	The quanti ty that is being div ided in th e ratio
	3327	denominato r
	3328	PQ
	3329	The quanti ty that di vides the numerator in the rat io.
	3330	The denomi nator SHAL L not be z ero.
	3331
	3332
	3333
	3334	3.1.5.1.20 ST
	3335	HL7 vMR DA M - Sept 2 011 Page: 62
	3336
	3337	Type: Cla ss ANY
	3338	Package: d ataTypes
	3339
	3340	The charac ter string datatype stands for text data , primaril y intended for machi ne process ing (e.g., sorting, querying,
	3341	indexing, etc.) or d irect disp lay. Used for names, symbols, presentati on and for mal expres sions.
	3342
	3343	A ST SHALL have at l east one c haracter o r else be null.
	3344
	3345	Attributes
	3346	Attribute Notes
	3347	value
	3348	string
	3349	The actual content o f the stri ng.
	3350
	3351
	3352	3.1.5.1.21 TEL
	3353	Type: Cla ss ANY
	3354	Package: d ataTypes
	3355
	3356	A locatabl e resource that is i dentified by a URI, such as a web page, a telephon e number ( voice, fax or some o ther
	3357	resource m ediated by telecommu nication e quipment), an e-mail address, or any oth er locatab le resourc e that can be
	3358	specified by a URL.
	3359
	3360	The addres s is speci fied as a Universal Resource L ocator (UR L) qualifi ed by time specifica tion and u se codes t hat
	3361	help in de ciding whi ch address to use fo r a given time and p urpose.
	3362
	3363	The value attribute is constra ined to be a uniform resource locator sp ecified ac cording to IETF RFCs 1738 and 2806
	3364	when used in this da tatype.
	3365
	3366	Note: The intent of this data type is to be a loca tor, not a n identifi er; this d atatype is used to r efer to a locatable
	3367	resource u sing a URL , and know ing the UR L allows o ne to loca te the obj ect. Howev er some us e cases ha ve arisen
	3368	where a UR I is used to refer t o a locata ble resour ce. Though this data type allow s for URIs to be use d, the res ource
	3369	identified SHOULD al ways be lo catable. A common us e of locat able URIs is to refe r to SOAP attachment s.
	3370
	3371	Attributes
	3372	Attribute Notes
	3373	useablePer iodOrigina lText
	3374	string [0..1]
	3375	This attri bute is eq uivalent t o the orig inalText a ttribute w ithin the
	3376	useablePer iod attrib ute of thi s class in the ISO 2 1090 speci fication.
	3377
	3378	The period s of time during whi ch the tel ecommunica tion addre ss can be
	3379	used.
	3380
	3381	For a tele phone numb er, this c an indicat e the time of day in which the
	3382	party can be reached on that t elephone. For a web address, i t may
	3383	specify a time range in which the web co ntent is p romised to be
	3384	available under the given addr ess.
	3385	value
	3386	string
	3387	A uniform resource i dentifier specified according to IETF RF C 2396.
	3388	The URI sp ecifies th e protocol and the c ontact poi nt defined by that
	3389	protocol f or the res ource.
	3390	Examples: Notable u ses of the telecommu nication a ddress dat atype are
	3391	for teleph one and te lefax numb ers, e-mai l addresse s, Hyperte xt
	3392	references , FTP refe rences, et c.
	3393	use
	3394	CS [0. .*]
	3395	One or mor e codes ad vising sys tem or use r which te lecommunic ation
	3396	address in a set of like addre sses to se lect for a given tel ecommunica tion
	3397	need.
	3398	HL7 vMR DA M - Sept 2 011 Page: 63
	3399
	3400	Attribute Notes
	3401	The teleco mmunicatio n use code is not a complete c lassificat ion for
	3402	equipment types or l ocations. Its main p urpose is to suggest or
	3403	discourage the use o f a partic ular telec ommunicati on address . There ar e
	3404	no easily defined ru les that g overn the selection of a telec ommunicati on
	3405	address. C onformance statement s may clar ify what r ules may a pply or
	3406	how additi onal rules are appli ed.
	3407	If populat ed, the va lues conta ined in th is attribu te SHALL b e taken
	3408	from the H L7 Telecom munication AddressUse code syst em
	3409	capabiliti es
	3410	CS [0. .*]
	3411	One or mor e codes ad vising a s ystem or u ser what t elecommuni cation
	3412	capabiliti es are kno wn to be a ssociated with the t elecommuni cation
	3413	address.
	3414	If populat ed, the va lues conta ined in th is attribu te SHALL b e taken
	3415	from the H L7 Telecom munication Capability code syst em
	3416
	3417
	3418
	3419	3.1.5.1.22 TS
	3420	Type: Cla ss QTY
	3421	Package: d ataTypes
	3422
	3423	A quantity specifyin g a point on the axi s of natur al time. A point in time is mo st often r epresented as a cale ndar
	3424	expression .
	3425
	3426	Attributes
	3427	Attribute Notes
	3428	value
	3429	string
	3430	The value of the TS. value is a string w ith the fo rmat
	3431	"YYYY[MM[D D[HH[MM[SS [.U[U[U[U] ]]]]]]]][+ \|-ZZzz]" t hat
	3432	conforms t o the cons trained IS O 8601 def ined in IS O 8824 (AS N.1)
	3433	under clau se 32 (gen eralized t ime). The format sho uld be use d to the
	3434	degree of precision that is ap propriate.
	3435
	3436
	3437
	3438	3.1.5.1.23 XP
	3439	Type: Cla ss
	3440	Package: d ataTypes
	3441
	3442	A part of a name or address. E ach part i s a charac ter string .
	3443
	3444	Attributes
	3445	Attribute Notes
	3446	value
	3447	string
	3448	The actual string va lue of the part.
	3449
	3450
	3451
	3452
	3453
	3454