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ref Template  Comment

Id 1.3.6.1.4.1.19376.1.5.3.1.4.2
ref
(from repository: epsos-)		 Effective Date valid from 2013‑12‑20

There are versions of templates with this id:
  • EntryComment as of 2013‑12‑20
  • AnnotationComment as of 2008‑08‑08
Status draft Draft Version Label
Name EntryComment Display Name Comment
Description
This entry allows for a comment to be supplied with each entry. For CDA this structure is usually included in the target act using the <entryRelationship> element defined in the CDA Schema, but can also be used in the <component> element when the comment appears within an <organizer>. The example below shows recording a comment for an <entry>, and is used as context for the following sections. For HL7 Version 3 Messages, this relationship is represented with the element <sourceOf>, although the remainder of the typecodes and semantics are unchanged.

Any condition or allergy may be the subject of a comment.
Context Parent nodes of template element with id 1.3.6.1.4.1.19376.1.5.3.1.4.2
Classification CDA Entry Level Template
Open/Closed Open (other than defined elements are allowed)
Used by / Uses
Used by 0 transactions and 7 templates, Uses 1 template
Used by as Name Version
2.16.756.5.30.1.127.10.4.29 Containment draft Blutgruppe 2016‑07‑02
2.16.756.5.30.1.127.10.3.11 link draft Blutgruppe Section 2016‑07‑02
2.16.756.5.30.1.127.10.1.3 link draft Laborbefund Transplantationsprozesss 2016‑07‑02
2.16.756.5.30.1.127.10.4.32 Containment draft Laborresultat (lrtp) 2016‑07‑20
2.16.756.5.30.1.127.10.4.31 link draft Resultatgruppe (lrtp) 2016‑07‑20
2.16.756.5.30.1.127.10.4.30 link draft Befundgruppe (lrtp) 2016‑07‑20
2.16.756.5.30.1.127.10.3.12 link draft Laborbefund Section (lrtp) 2016‑07‑02
Uses as Name Version
2.16.840.1.113883.3.1937.777.11.10.102 Include draft epSOS CDA author DYNAMIC
Example
Example
<act classCode="ACT" moodCode="EVN">
  <templateId root="2.16.840.1.113883.10.20.1.40"/>  <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.2"/>  <code code="48767-8" displayName="Annotation Comment" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>  <text>
    <reference value="#comment-2"/>  </text>  <statusCode code="completed"/>  <author>
    <time value=""/>    <assignedAuthor>
      <id root="" extension=""/>      <addr/>      <telecom value="" use=""/>      <assignedPerson>
        <name/>      </assignedPerson>      <representedOrganization>
        <name/>      </representedOrganization>    </assignedAuthor>  </author></act>
Item DT Card Conf Description Label
hl7:act
 R (EntryComment)
@classCode
 1 … 1 F ACT
@moodCode
 1 … 1 F EVN
hl7:templateId
 II 1 … 1 R (EntryComment)
@root
 1 … 1 F 2.16.840.1.113883.10.20.1.40
hl7:templateId
 II 1 … 1 R (EntryComment)
@root
 1 … 1 F 1.3.6.1.4.1.19376.1.5.3.1.4.2
hl7:code
 CD 1 … 1 R (EntryComment)
@code
 CONF 1 … 1 F 48767-8
@codeSystem
 1 … 1 F 2.16.840.1.113883.6.1 (Logical Observation Identifier Names and Codes)
hl7:statusCode
 CS 1 … 1 R (EntryComment)
@code
 CONF 1 … 1 F completed
hl7:text
 ED 1 … * R (EntryComment)
hl7:reference
 TEL 1 … 1 M (EntryComment)
@value
 1 … 1 R Reference pointing to the narrative, typically #{label}-{generated-id}, e.g. #xxx-1
Included 0 … * R from 2.16.840.1.113883.3.1937.777.11.10.102 epSOS CDA author (DYNAMIC)
hl7:author
 0 … * R (EntryComment)
@typeCode
 cs 0 … 1 F AUT
@contextControlCode
 cs 0 … 1 F OP
hl7:functionCode
 CE.EPSOS 0 … 1 R R1.10.6
  CONF
The value of @code shall be drawn from value set 1.3.6.1.4.1.12559.11.10.1.3.1.42.1 epSOSHealthcareProfessionalRoles (DYNAMIC)
hl7:time
 TS.EPSOS.TZ 1 … 1 R The author/time element represents the start time of the author’s participation in the creation of the clinical document. The author/time element SHALL be present. (EntryComment)
hl7:assignedAuthor
 1 … 1 R (EntryComment)
@classCode
 cs 0 … 1 F ASSIGNED
  Schematron assert role red error  
  test @nullFlavor or hl7:assignedPerson or hl7:assignedAuthoringDevice  
  Message If assignedAuthor has an associated representedOrganization with no assignedPerson or assignedAuthoringDevice, then the value for "ClinicalDocument/author/assignedAuthor/id/@nullFlavor" SHALL be "NA" "Not applicable" 2.16.840.1.113883.5.1008 NullFlavor STATIC.  
hl7:id
 II.EPSOS 1 … * R HP ID number R1.10.5
@nullFlavor
 cs 0 … 1 F NA
hl7:code
 CE.EPSOS 0 … 1 R HP Specialty R1.10.7
hl7:addr
 AD.EPSOS 1 … * R IHE PCC
hl7:telecom
 TEL.EPSOS 1 … * R Attribute @value SHALL contain a URI if element telecom is used. The URI scheme SHALL be one of URLScheme IHE PCC / R1.10.8 / R1.10.8.1 / R1.10.8.2
@use
 set_cs 0 … 1  
  CONF
The value of @use shall be drawn from value set 1.3.6.1.4.1.12559.11.10.1.3.1.42.40 epSOSTelecomAddress (DYNAMIC)
Choice 0 … 1 Elements to choose from:
hl7:assignedPerson
 R (EntryComment)
@classCode
 cs 0 … 1 F PSN
@determinerCode
 cs 0 … 1 F INSTANCE
hl7:name
 PN 1 … 1 R HP Name IHE PCC
  Example <name>
  <given>John</given>  <family>Español Smith</family></name>
hl7:family
 1 … * R HP Family Name/Surname R1.10.1
hl7:given
 1 … * R HP Given Name R1.10.2
hl7:prefix
 0 … * R HP Prefix R1.10.3
hl7:suffix
 0 … * R HP Suffix R1.10.4
hl7:assignedAuthoringDevice
 R Contains 2.16.840.1.113883.3.1937.777.11.10.129 CDA Device (DYNAMIC) (EntryComment)
hl7:representedOrganization
 1 … 1 R Contains 2.16.840.1.113883.3.1937.777.11.10.111 epSOS CDA Organization (DYNAMIC) R1.10.9