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ref Template  Laboratory Observation

Id 2.16.756.5.30.1.1.10.4.3
ref
ch-palm-
 		Effective Date 2017‑06‑21
Status pending Under pre-publication review Version Label 2017
Name chpalm_entry_LaboratoryObservation Display Name Laboratory Observation
Description

Laboratory reports MUST contain at least one laboratory result which is declared using this element. Each laboratory result consists of code, value and interpretation of the result.

Code

For laboratory reports in Switzerland, primarly LOINC and where necessary, additional SNOMED CT codes MUST be used. At least one laboratory result for a specimen MUST thus contain a LOINC code.

Certain microbiology pathogen detection can not be uniquely identified with LOINC (e.g., Campylobacter coli). Such pathogen detection must be specified in a second observation in the same Laboratory Battery Organizer with a corresponding code from another code system (e.g., SNOMED CT).

For examinations according to the Swiss analysis list (AL), a translation element CAN be specified to establish the reference to the corresponding AL position.

Further translation elements may be added to make reference to other codes, e.g. the locally used code in the laboratory.

Value

The concrete values measured MUST be specified in observation elements as follows (data types according to HL7 CDA):

  • Text findings are declared as free text in the narrative portion of the corresponding section, and the text element MUST contain the corresponding reference to the narrative text. In this case, the observation MAY NOT contain the value element.
  • True / False values are declared using the data type BL.
  • Encoded values are declared using the data type CD.
  • Numeric results are declared using data type PQ in combination with internationally standardized units (UCUM), according to the value set.
  • Ratios are declared with data type RTO.

Interpretation

The interpretation code specifies AT LEAST whether it is a normal result or a result outside the normal range. Further interpretation codes CAN be used.

Context Parent nodes of template element with id 2.16.756.5.30.1.1.10.4.3
Label IHE PalM TF3 Rev.8, 6.3.4.13
Classification CDA Entry Level Template
Open/Closed Open (other than defined elements are allowed)
Used by / Uses
Used by 0 transactions and 10 templates, Uses 12 templates
Used by as Name Version
2.16.756.5.30.1.1.10.4.11 Containment pending Specimen Collection (2017) 2017‑06‑21
notice Circular reference found with 2.16.756.5.30.1.1.10.4.11, please check
2.16.756.5.30.1.1.10.4.17 link pending Laboratory Isolate Organizer (2017) 2017‑06‑21
2.16.756.5.30.1.1.10.4.4 link pending Laboratory Report Data Processing Entry (2017) 2017‑06‑21
2.16.756.5.30.1.1.10.3.3 link pending Laboratory Speciality Section - coded (2017) 2017‑06‑21
2.16.756.5.30.1.1.10.1.17 link pending Immunization Recommendation Request (2018) 2018‑04‑19
2.16.756.5.30.1.1.10.1.18 link pending Immunization Recommendation Response (2018) 2018‑04‑19
2.16.756.5.30.1.1.10.1.19 link pending Vaccination Record (2018) 2018‑04‑19
2.16.756.5.30.1.1.10.3.5 link pending Laboratory Report Item Section - coded (2017) 2017‑06‑21
2.16.756.5.30.1.1.10.4.19 link pending Laboratory Battery Organizer (2017) 2017‑06‑21
2.16.756.5.30.1.1.10.4.3 link pending Laboratory Observation (2017) 2017‑06‑21
Uses as Name Version
2.16.756.5.30.1.1.10.9.14 Include active Narrative Text Reference (2017) DYNAMIC
2.16.756.5.30.1.1.10.4.5 Containment pending Non-Human Subject - subject Containment (2017) DYNAMIC
2.16.756.5.30.1.1.10.4.6 Containment pending Human Patient with Non-Human Subject - subject Containment (2017) DYNAMIC
2.16.756.5.30.1.1.10.4.7 Containment pending Laboratory Performer - performer Containment (2017) DYNAMIC
2.16.756.5.30.1.1.10.9.16 Containment active Author Compilation with name, addr and telecom (2017) DYNAMIC
2.16.756.5.30.1.1.10.4.8 Containment pending Laboratory Results Validator - authenticator/participant Containment (2017) DYNAMIC
2.16.756.5.30.1.1.10.4.9 Containment pending Responsible Party - participant Containment (2017) DYNAMIC
2.16.756.5.30.1.1.10.4.10 Containment pending Device - participant Containment (2017) DYNAMIC
2.16.756.5.30.1.1.10.4.11 Containment pending Specimen Collection (2017) DYNAMIC
2.16.756.5.30.1.1.10.4.2 Containment pending Annotation Comments (2016) DYNAMIC
2.16.756.5.30.1.1.10.4.22 Containment pending Previous Observation (2017) DYNAMIC
2.16.756.5.30.1.1.10.4.29 Containment pending External document (2017) DYNAMIC
Relationship Specialization: template 2.16.840.1.113883.10.12.303 (2005‑09‑07)
Specialization: template 1.3.6.1.4.1.19376.1.3.1.6 (DYNAMIC)
Example
Example
<observation classCode="OBS" moodCode="EVN">
  <templateId root="2.16.756.5.30.1.1.10.4.3"/>  <templateId root="1.3.6.1.4.1.19376.1.3.1.6"/>  <code code="2951-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Sodium [Moles/volume] in Serum or Plasma">
    <translation code="1574.00" codeSystemName="Swiss analysis list (AL)" codeSystem="2.16.756.5.30.1.129.1.3" displayName="Natrium, Blut/Plasma/Serum"/>  </code>  <text>
    <reference value="#nartext1"/>  </text>  <statusCode code="completed"/>  <effectiveTime value="20180311202253"/>  <value xsi:type="PQ" value="137" unit="mmol/L"/>  <interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"/>  <referenceRange typeCode="REFV">
    <observationRange classCode="OBS" moodCode="EVN.CRT">
      <value xsi:type="IVL_PQ">
        <low value="135" unit="mmol/L"/>        <high value="147" unit="mmol/L"/>      </value>      <interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"/>    </observationRange>  </referenceRange></observation>
Item DT Card Conf Description Label
hl7:observation
 Laboratory result with interpretation, related previous results, reference range, participants (persons and devices) as well as comments. IHE PalM TF3 Rev.8, 6.3.4.13
@classCode
 cs 1 … 1 F OBS
@moodCode
 cs 1 … 1 F EVN
hl7:templateId
 II 1 … 1 M IHE PalM TF3 Rev.8, 6.3.4.13
@root
 uid 1 … 1 F 1.3.6.1.4.1.19376.1.3.1.6
hl7:templateId
 II 1 … 1 M IHE PalM TF3 Rev.8, 6.3.4.13
@root
 uid 1 … 1 F 2.16.756.5.30.1.1.10.4.3
hl7:id
 II 0 … 1 An ID for this item MAY be filled for traceability. IHE PalM TF3 Rev.8, 6.3.4.13
@root
 uid 1 … 1 R MUST contain the OID of the system that issued the ID. OIDs of code systems, which are published in the public OID registry for the Swiss health care system (oid.refdata.ch) are REQUIRED. Others are NOT ALLOWED.
@extension
 st 0 … 1   Contains the ID itself. The ID MUST be unique within the system that issued the ID.
hl7:code
 CD 1 … 1 R A unique code for this result MUST be specified. IHE PalM TF3 Rev.8, 6.3.4.13
@nullFlavor
 st 0 … 1 F NAV
@code
 cs 0 … 1   The code MUST be specified.
@codeSystem
 oid 0 … 1   The OID of the code system MUST be specified.
@codeSystemName
 st 0 … 1   The name of the code system MUST be specified for tracking purposes. However, processing is NOT ALLOWED.
@displayName
 st 0 … 1   The displayName of the code MUST be specified for tracking purposes. However, processing is NOT ALLOWED. Instead, a processing system is to display a user readable language translation of the code from the value set.
hl7:translation
 CD 0 … * Makes reference to the corresponding position of the Swiss analysis list (AL). Multiple references (translation elements) are allowed. IHE PalM TF3 Rev.8, 6.3.4.13
@code
 cs 1 … 1 R The position number of the Swiss Analysis list MUST be declared.
@codeSystem
 oid 1 … 1 F 2.16.756.5.30.1.129.1.3
  The OID of the Swiss analysis list (AL) MUST be specified.
@codeSystemName
 st 1 … 1 F Swiss analysis list (AL)
  The name of the code system MUST be specified for tracking purposes. However, processing is NOT ALLOWED.
@displayName
 st 1 … 1 R The displayName of the code MUST be specified for tracking purposes. It MUST correspond to one of the available languages of the Swiss analysis list (AL). However, processing is NOT ALLOWED. Instead, a processing system is to display a user readable language translation of the code from the Swiss analysis list (AL).
hl7:translation
 CD 0 … * Makes reference to other codes, e.g. the locally used code in the laboratory. Multiple references (translation elements) are allowed. IHE PalM TF3 Rev.8, 6.3.4.13
@code
 cs 1 … 1 R The code MUST be specified.
@codeSystem
 oid 1 … 1 R The OID of the code system MUST be specified.
@codeSystemName
 st 1 … 1 R The name of the code system MUST be specified for tracking purposes. However, processing is NOT ALLOWED.
@displayName
 st 1 … 1 R The displayName of the code MUST be specified for tracking purposes. However, processing is NOT ALLOWED. Instead, a processing system is to display a user readable language translation of the code from the value set.
  Schematron assert role red error  
  test (@code and @codeSystem=('2.16.840.1.113883.6.1','2.16.840.1.113883.6.96')) or (@nullFlavor='NAV')  
  Message Either a LOINC or SNOMED CT code or nullFlavor='NAV' is required.  
Included 1 … 1 from 2.16.756.5.30.1.1.10.9.14 Narrative Text Reference (DYNAMIC)
The human-readable text MUST be generated automatically from the structured information of this element. The text element MUST contain the reference to the corresponding text in the human readable part, ONLY.
hl7:text
 ED 1 … 1 M CDA‑CH V2
hl7:reference
 TEL 1 … 1 M The reference to the corresponding text in the human readable part must be specified by reference to content[@ID]: reference[@value='#xxx'] CDA‑CH V2
@value
 1 … 1 R Reference to the narrative part of the section in the format '#xxx', where xxx is the ID of the corresponding element.
  Schematron assert role red error  
  test starts-with(@value,'#')  
  Message The @value attribute content MUST conform to the format '#xxx', where xxx is the ID of the corresponding <content/> element.  
  Variable let Name idvalue  
  Value substring-after(@value,'#')  
  Schematron assert role red error  
  test ancestor::hl7:structuredBody//*[@ID=$idvalue]  
  Message No narrative text found for this reference (no content element within this document has an ID that corresponds to '<value-of select="$idvalue"/>').  
hl7:statusCode
 CS 1 … 1 M

The status 'completed' means that the result is final.

The status 'aborted' means that the examination could not be performed.

 IHE PalM TF3 Rev.8, 6.3.4.13
  CONF
The value of @code shall be drawn from value set 1.3.6.1.4.1.19376.1.3.11.2 ActStatusAbortedCompleted (DYNAMIC)
hl7:effectiveTime
 IVL_TS.CH.TZ 0 … 1 C

Timestamp of the finding (physiologically relevant time of this observation). Accuracy of the value: Date and time with hour and minute

This information is ALLOWED for results within an isolate group, ONLY. For all other results, the time specified in the Laboratory Battery Organizer is to be used.

IHE PalM TF3 Rev.8, 6.3.4.13
  Schematron assert role red error  
  test string-length(@value)>11  
  Message A precision of date and time of day with at least hour and minute is required.  
  Schematron assert role red error  
  test ancestor::*[hl7:templateId/@root='1.3.6.1.4.1.19376.1.3.1.5']  
  Message The effectiveTime information is ALLOWED for results within an isolate group, ONLY. For all other results, the time specified in the Laboratory Battery Organizer is to be used.  
Choice 0 … *

The result of the examination MUST be specified for all elements with status 'completed'. One of the following data types MUST be used. For elements with status 'aborted', the result of the test is NOT ALLOWED.

In the case of microbiological or infection-serological detection of pathogens, NO value element is PERMITTED. Instead, declare using the interpretationCode whether the pathogen was detected in the sample (POS) or not (NEG).

Elements to choose from:
  • hl7:value[(local-name-from-QName(resolve-QName(@xsi:type,.))='BL' and namespace-uri-from-QName(resolve-QName(@xsi:type,.))='urn:hl7-org:v3')]
  • hl7:value[(local-name-from-QName(resolve-QName(@xsi:type,.))='CD' and namespace-uri-from-QName(resolve-QName(@xsi:type,.))='urn:hl7-org:v3')]
  • hl7:value[(local-name-from-QName(resolve-QName(@xsi:type,.))='ED' and namespace-uri-from-QName(resolve-QName(@xsi:type,.))='urn:hl7-org:v3')]
  • hl7:value[(local-name-from-QName(resolve-QName(@xsi:type,.))='PQ' and namespace-uri-from-QName(resolve-QName(@xsi:type,.))='urn:hl7-org:v3')]
  • hl7:value[(local-name-from-QName(resolve-QName(@xsi:type,.))='RTO' and namespace-uri-from-QName(resolve-QName(@xsi:type,.))='urn:hl7-org:v3')]
hl7:value
 BL 0 … 1 True / False or Yes / No Result. If the observation value can not be determined, @value is NOT ALLOWED. Instead, @nullFlavor='NA' MUST be used in combination with interpretationCode that declares whether the result is below (Low of scale) or above (High of scale) of the reference range. IHE PalM TF3 Rev.8, 6.3.4.13
@xsi:type
 1 … 1 F BL
@nullFlavor
 cs 0 … 1 F NA
  Observation value could not be determined.
@value
 bl 0 … 1   true or false.
  Example <value xsi:type="BL" value="false"/>
  Schematron assert role red error  
  test @value or (@nullFlavor='NA' and parent::*/hl7:interpretationCode[@code=('>','<')])  
  Message If the observation value can not be determined, @value is NOT ALLOWED. Instead, @nullFlavor='NA' MUST be used in combination with interpretationCode that declares whether the result is below (Low of scale) or above (High of scale) of the reference range..  
hl7:value
 CD 0 … 1 Coded result. If the observation value can not be determined, @code, @codeSystem, @codeSystemName and @displayName are NOT ALLOWED. Instead, @nullFlavor='NA' MUST be used in combination with interpretationCode that declares whether the result is below (Low of scale) or above (High of scale) of the reference range. IHE PalM TF3 Rev.8, 6.3.4.13
@xsi:type
 1 … 1 F CD
@nullFlavor
 cs 0 … 1 F NA
  Observation value could not be determined.
@code
 cs 0 … 1   The code MUST be specified.
@codeSystem
 oid 0 … 1   The OID of the code system MUST be specified.
@codeSystemName
 st 0 … 1   The name of the code system MUST be specified for tracking purposes. However, processing is NOT ALLOWED.
@displayName
 st 0 … 1   The displayName of the code MUST be specified for tracking purposes. However, processing is NOT ALLOWED. Instead, a processing system is to display a user readable language translation of the code from the value set.
  Example <value xsi:type="CD" code="N" codeSystem="2.16.756.5.30.2.1.1.3.1"/>
  Schematron assert role red error  
  test (@code and @codeSystem and @codeSystemName and @displayName) or (@nullFlavor='NA' and parent::*/hl7:interpretationCode[@code=('>','<')])  
  Message If the observation value can not be determined, @code, @codeSystem, @codeSystemName and @displayName are NOT ALLOWED. Instead, @nullFlavor='NA' MUST be used in combination with interpretationCode that declares whether the result is below (Low of scale) or above (High of scale) of the reference range.  
hl7:value
 ED 0 … 1 Text result. IHE PalM TF3 Rev.8, 6.3.4.13
@xsi:type
 1 … 1 F ED
  Example <value xsi:type="ED">
  <reference value="#l1"/></value>
hl7:reference
 TEL 1 … 1 M The reference to the corresponding text in the human readable part must be specified by reference to content[@ID]: reference [@value = '#xxx'] IHE PalM TF3 Rev.8, 6.3.4.13
@value
 1 … 1 R Reference to the narrative part of the section in the format '#xxx', where xxx is the ID of the corresponding Element.
hl7:value
 PQ 0 … 1 Numeric result with unit. If the observation value can not be determined, @value and @unit are NOT ALLOWED. Instead, @nullFlavor='NA' MUST be used in combination with interpretationCode that declares whether the result is below (Low of scale) or above (High of scale) of the reference range. IHE PalM TF3 Rev.8, 6.3.4.13
@xsi:type
 1 … 1 F PQ
@nullFlavor
 cs 0 … 1 F NA
  Observation value could not be determined.
@unit
 cs 0 … 1   Valid UCUM unit.
@value
 real 0 … 1   Numeric observation result
  Example <value xsi:type="PQ" value="6.4" unit="mg/dL"/>
  Schematron assert role red error  
  test (@unit and @value) or (@nullFlavor='NA' and parent::*/hl7:interpretationCode[@code=('>','<')])  
  Message If the observation value can not be determined, @value and @unit are NOT ALLOWED. Instead, @nullFlavor='NA' MUST be used in combination with interpretationCode that declares whether the result is below (Low of scale) or above (High of scale) of the reference range.  
hl7:value
 RTO 0 … 1 Ratio results. If the observation value can not be determined, numerator and denominator are NOT ALLOWED. Instead, @nullFlavor='NA' MUST be used in combination with interpretationCode that declares whether the result is below (Low of scale) or above (High of scale) of the reference range. IHE PalM TF3 Rev.8, 6.3.4.13
@xsi:type
 1 … 1 F RTO
@nullFlavor
 cs 0 … 1 F NA
  Observation value could not be determined.
  Example
Titer
<value xsi:type="RTO">
  <numerator xsi:type="INT" value="1"/>  <denominator xsi:type="INT" value="64"/></value>
hl7:numerator
 QTY 0 … 1 IHE PalM TF3 Rev.8, 6.3.4.13
@value
 1 … 1 R Numerator of the ratio.
hl7:denominator
 QTY 0 … 1 IHE PalM TF3 Rev.8, 6.3.4.13
@value
 1 … 1 R Denominator of the ratio.
  Schematron assert role red error  
  test (hl7:numerator[@value] and hl7:denominator[@value]) or (@nullFlavor='NA' and parent::*/hl7:interpretationCode[@code=('>','<')])  
  Message If the observation value can not be determined, numerator and denominator are NOT ALLOWED. Instead, @nullFlavor='NA' MUST be used in combination with interpretationCode that declares whether the result is below (Low of scale) or above (High of scale) of the reference range.  
hl7:interpretationCode
 CE 0 … 1

At least one interpretation of the result MUST be declared. For this purpose, a code from the HL7 Observation Interpretation vocabulary MUST be used.

Examples of normal results:

  • N: Normal

Examples of pathogen detection:

  • POS: pathogen found in the specimen
  • NEG: pathogen not found in the specimen (No evidence or no growth). Note: Negative does not necessarily imply the complete absence of the specified item.

Examples abnormal results with numeric values:

  • H: High - Above reference range
  • HH: High alert - Above reference range (critical value)
  • L: Low - Below reference range
  • LL: Low alert - Below reference range (critical value)

Examples of non-determinable results:

  • >: High off scale - Above analytical limit
  • <: Low off scale - Below analytical limit

Examples of antimicrobial susceptibility tests in microbiology:

  • S: susceptible
  • R: resistant
  • I: intermediate
  • SDD: Susceptible-dose dependent
 IHE PalM TF3 Rev.8, 6.3.4.13
  CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.78 ObservationInterpretation (DYNAMIC)
Choice 0 … 1
IF this result is based on a specimen of a non-human material, this MUST be declared with the subject element.
Elements to choose from:
hl7:subject
 0 … 1 Contains 2.16.756.5.30.1.1.10.4.5 Non-Human Subject - subject Containment (DYNAMIC) IHE PalM TF3 Rev.8, 6.3.4.13
treeblank treeblank where [hl7:templateId [@root='2.16.756.5.30.1.1.10.4.5'] and hl7:templateId [@root='1.3.6.1.4.1.19376.1.3.3.1.2.1']]
hl7:subject
 0 … 1 Contains 2.16.756.5.30.1.1.10.4.6 Human Patient with Non-Human Subject - subject Containment (DYNAMIC) IHE PalM TF3 Rev.8, 6.3.4.13
treeblank treeblank where [hl7:templateId [@root='1.3.6.1.4.1.19376.1.3.3.1.3.1']]
hl7:performer
 0 … * This CAN be used to indicate who has performed the test. This information supersedes any information recorded at higher level.
Contains 2.16.756.5.30.1.1.10.4.7 Laboratory Performer - performer Containment (DYNAMIC) 		IHE PalM TF3 Rev.8, 6.3.4.13
treeblank where [@typeCode='PRF'] [hl7:templateId [@root='2.16.756.5.30.1.1.10.4.7'] and hl7:templateId [@root='1.3.6.1.4.1.19376.1.3.3.1.7']]
hl7:author
 0 … * This MAY be used to indicate who has documented the result. This information supersedes any information recorded at higher level.
Contains 2.16.756.5.30.1.1.10.9.16 Author Compilation with name, addr and telecom (DYNAMIC) 		IHE PalM TF3 Rev.8, 6.3.4.13
treeblank where [hl7:functionCode [concat(@code,@codeSystem)=doc('include/voc-2.16.756.5.30.1.127.3.10.1.1.3-DYNAMIC.xml')//valueSet [1]/conceptList/concept/concat(@code,@codeSystem) or @nullFlavor]]
Choice 0 … *
This CAN be used to identify other parties:
  • Who has verified the result (AUTHEN).
  • Which external laboratory has delivered the result (RESP).
  • Which device (analyzer) was used to determine the result (DEV).
Elements to choose from:
hl7:participant
 0 … * Who has verified the result (AUTHEN). This information supersedes any information recorded at higher level.
Contains 2.16.756.5.30.1.1.10.4.8 Laboratory Results Validator - authenticator/participant Containment (DYNAMIC) 		IHE PalM TF3 Rev.8, 6.3.4.13
treeblank treeblank where [@typeCode='AUTHEN'] [hl7:templateId [@root='2.16.756.5.30.1.1.10.4.8'] and hl7:templateId [@root='1.3.6.1.4.1.19376.1.3.3.1.5']]
hl7:participant
 0 … * Which external laboratory has delivered the result (RESP). This information supersedes any information recorded at higher level.
Contains 2.16.756.5.30.1.1.10.4.9 Responsible Party - participant Containment (DYNAMIC) 		IHE PalM TF3 Rev.8, 6.3.4.13
treeblank treeblank where [@typeCode='RESP']
hl7:participant
 0 … * Which device (analyzer) was used to determine the result (DEV). This information supersedes any information recorded at higher level.
Contains 2.16.756.5.30.1.1.10.4.10 Device - participant Containment (DYNAMIC) 		IHE PalM TF3 Rev.8, 6.3.4.13
treeblank treeblank where [@typeCode='DEV']
hl7:entryRelationship
 0 … * Information on specimen collection for this Observation. This information supersedes any information recorded at higher level.
Contains 2.16.756.5.30.1.1.10.4.11 Specimen Collection (DYNAMIC) 		IHE PalM TF3 Rev.8, 6.3.4.13
treeblank where [@typeCode='COMP'] [hl7:procedure [hl7:templateId [@root='1.3.6.1.4.1.19376.1.3.1.2'] and hl7:templateId [@root='2.16.756.5.30.1.1.10.4.11']]]
@typeCode
 cs 1 … 1 F COMP
hl7:entryRelationship
 0 … * Comment on this Observation.
Contains 2.16.756.5.30.1.1.10.4.2 Annotation Comments (DYNAMIC) 		IHE PalM TF3 Rev.8, 6.3.4.13
treeblank where [@typeCode='SUBJ'] [hl7:act [hl7:templateId [@root='2.16.756.5.30.1.1.10.4.2'] and hl7:templateId [@root='2.16.840.1.113883.10.20.1.40'] and hl7:templateId [@root='1.3.6.1.4.1.19376.1.5.3.1.4.2']]]
@typeCode
 cs 1 … 1 F SUBJ
@inversionInd
 bl 1 … 1 F true
hl7:entryRelationship
 0 … * This CAN be used to indicate previous observation for the same test code on a previous specimen.
Contains 2.16.756.5.30.1.1.10.4.22 Previous Observation (DYNAMIC) 		IHE PalM TF3 Rev.8, 6.3.4.13
treeblank where [@typeCode='REFR'] [hl7:observation [hl7:templateId [@root='2.16.756.5.30.1.1.10.4.22']]]
@typeCode
 cs 1 … 1 F REFR
hl7:sequenceNumber
 INT 0 … 1 In case there is more than one previous result, the entryRelationship elements are sorted in reverse chronological order, and numbered from 1 to n by sequenceNumber. IHE PalM TF3 Rev.8, 6.3.4.13
@value
 int 0 … 1   Contains the sequence number.
hl7:reference
 0 … * This CAN be used to make reference to an external document.
Contains 2.16.756.5.30.1.1.10.4.29 External document (DYNAMIC) 		IHE PalM TF3 Rev.8, 6.3.4.13
treeblank where [@typeCode='REFR'] [hl7:externalDocument [hl7:templateId [@root='2.16.756.5.30.1.1.10.4.29']]]
@typeCode
 cs 1 … 1 F REFR
hl7:referenceRange
 0 … 1 The reference range SHALL be specified for the range of normal values for the data types PQ and INT. The following applies:
  • Upper limit: [R]
  • Lower limit: [R]
  • interpretationCode containing code=N: [M]

The reference range CAN be omitted for other data types. If only an upper or lower limit is meaningful, the unused limit MUST be declared using nullFlavor.

IHE PalM TF3 Rev.8, 6.3.4.13
@typeCode
 cs 1 … 1 F REFV
hl7:observationRange
 1 … 1 M IHE PalM TF3 Rev.8, 6.3.4.13
@classCode
 cs 1 … 1 F OBS
@moodCode
 cs 1 … 1 F EVN.CRT
Choice 0 … 1 Elements to choose from:
  • hl7:value[@xsi:type='IVL_PQ']
  • hl7:value[@xsi:type='IVL_INT']
hl7:value
 IVL_PQ 0 … 1 R Reference range for PQ data types IHE PalM TF3 Rev.8, 6.3.4.13
treeblank treeblank treeblank treeblank where [@xsi:type='IVL_PQ']
@xsi:type
 1 … 1 F IVL_PQ
hl7:low
 IVXB_PQ 1 … 1 Lower limit of the reference range IHE PalM TF3 Rev.8, 6.3.4.13
@nullFlavor
 cs 0 … 1 F NA
  Unused limit MUST be declared using nullFlavor.
@value
 real 0 … 1   Lower limit value of the reference range
@unit
 cs 0 … 1   Valid UCUM Unit of the lower limit of the reference range
  Schematron assert role red error  
  test (parent::hl7:value/@unit and @value) or (@unit and @value) or (@nullFlavor='NA')  
  Message Unused limit MUST be declared using nullFlavor='NA'.  
hl7:high
 IVXB_PQ 1 … 1 Upper limit of the reference range IHE PalM TF3 Rev.8, 6.3.4.13
@nullFlavor
 cs 0 … 1 F NA
  Unused limit MUST be declared using nullFlavor.
@value
 real 0 … 1   Upper limit value of the reference range
@unit
 cs 0 … 1   Valid UCUM Unit of the upper limit of the reference range
  Schematron assert role red error  
  test (parent::hl7:value/@unit and @value) or (@unit and @value) or (@nullFlavor='NA')  
  Message Unused limit MUST be declared using nullFlavor='NA'.  
hl7:value
 IVL_INT 0 … 1 R Reference range for INT data types IHE PalM TF3 Rev.8, 6.3.4.13
treeblank treeblank treeblank treeblank where [@xsi:type='IVL_INT']
@xsi:type
 1 … 1 F IVL_INT
hl7:low
 IVXB_INT 1 … 1 Lower limit of the reference range IHE PalM TF3 Rev.8, 6.3.4.13
@nullFlavor
 cs 0 … 1 F NA
  Unused limit MUST be declared using nullFlavor.
@value
 int 0 … 1   Lower limit value of the reference range
@unit
 cs 0 … 1   Valid UCUM Unit of the lower limit of the reference range
  Schematron assert role red error  
  test (parent::hl7:value/@unit and @value) or (@unit and @value) or (@nullFlavor='NA')  
  Message Unused limit MUST be declared using nullFlavor='NA'.  
hl7:high
 IVXB_INT 1 … 1 Upper limit of the reference range IHE PalM TF3 Rev.8, 6.3.4.13
@nullFlavor
 cs 0 … 1 F NA
  Unused limit MUST be declared using nullFlavor.
@value
 int 0 … 1   Upper limit value of the reference range
@unit
 cs 0 … 1   Valid UCUM Unit of the upper limit of the reference range
  Schematron assert role red error  
  test (parent::hl7:value/@unit and @value) or (@unit and @value) or (@nullFlavor='NA')  
  Message Unused limit MUST be declared using nullFlavor='NA'.  
hl7:interpretationCode
 CE 1 … 1 M This reference range defines normal values. IHE PalM TF3 Rev.8, 6.3.4.13
@code
 CONF 1 … 1 F N