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# Template Patient - recordTarget

Id | 2.16.756.5.30.1.1.10.2.1 ref hl7chcda- | Effective Date | 2022‑06‑21 13:45:28
Status | Draft | Version Label | 2022
Name | cdach_header_Patient | Display Name | Patient - recordTarget
Description | A human patient for whom this CDA document instance was created. All CDA-CH V2 derivatives, i.e. Swiss exchange formats MUST use this template by either reference or specialisation.
Context | Parent nodes of template element with id 2.16.756.5.30.1.1.10.2.1
Label | CDA‑CH V2
Classification | CDA Header Level Template
Open/Closed | Open (other than defined elements are allowed)
Used by / Uses |
Used by 6 transactions and 15 templates, Uses 5 templates
Used by | as | Name | Version
--- | --- | --- | ---
cdachemed-transaction-4 | Transaction | Medication Prescription document | 2018‑04‑04 15:33:29
cdachemed-transaction-9 | Transaction | Medication Treatment Plan document | 2019‑12‑12 14:11:31
cdachemed-transaction-5 | Transaction | Medication Dispense document | 2018‑04‑04 15:35:51
cdachemed-transaction-6 | Transaction | Pharmaceutical Advice document | 2018‑04‑04 15:36:35
cdachemed-transaction-7 | Transaction | Medication List document | 2018‑04‑04 15:37:19
cdachemed-transaction-8 | Transaction | Medication Card document (2022) | 2018‑04‑04 15:42:50
2.16.756.5.30.1.1.10.9.36 | Include | CDA-CH v2.0 Header Template Compilation (2017) | 2018‑04‑18
2.16.756.5.30.1.1.10.1.9 |  | CDA-CH v2.1 - structuredBody (2020) | 2019‑10‑17 15:22:41
2.16.756.5.30.1.1.10.9.41 | Include | Header Template Compilation Medication Dispense document (2019) | 2018‑01‑08 15:56:47
2.16.756.5.30.1.1.10.1.5 |  | Medication Dispense document (2020) | 2016‑05‑21
2.16.756.5.30.1.1.10.9.42 | Include | Header Template Compilation Medication Card document (2022) | 2019‑10‑17 13:58:45
2.16.756.5.30.1.1.10.1.3 |  | Medication Card document (2022) | 2016‑05‑13
2.16.756.5.30.1.1.10.9.42 | Include | Header Template Compilation Medication Card document (2017) | 2018‑01‑08 16:20:12
2.16.756.5.30.1.1.10.9.43 | Include | Header Template Compilation Pharmaceutical Advice document (2019) | 2018‑01‑08 16:23:16
2.16.756.5.30.1.1.10.1.6 |  | Pharmaceutical Advice document (2020) | 2016‑05‑21
2.16.756.5.30.1.1.10.9.44 | Include | Header Template Compilation MedicationTreatmentPlan (2019) | 2018‑01‑08 16:26:11
2.16.756.5.30.1.1.10.1.7 |  | Medication Treatment Plan document (2020) | 2017‑04‑12 13:57:31
2.16.756.5.30.1.1.10.9.45 | Include | Header Template Compilation Medication Prescription document (2021) | 2018‑01‑08 16:28:39
2.16.756.5.30.1.1.10.1.4 |  | Medication Prescription document (2020) | 2016‑05‑21
2.16.756.5.30.1.1.10.9.46 | Include | Header Template Compilation Medication List document (2019) | 2018‑01‑22 15:29:29
2.16.756.5.30.1.1.10.1.13 |  | Medication List document (2020) | 2018‑01‑22 15:17:26
Uses | as | Name | Version
2.16.756.5.30.1.1.10.9.35 | Containment | Address Information Compilation - eCH-0010 (2022) | DYNAMIC
2.16.756.5.30.1.1.10.9.34 | Containment | Person Name Information Compilation - eCH-0011 (2022) | DYNAMIC
2.16.756.5.30.1.1.10.9.49 | Include | Original Text Reference (2021) | DYNAMIC
2.16.756.5.30.1.1.10.9.24 | Containment | Organization Compilation with name (2017) | DYNAMIC
2.16.756.5.30.1.1.10.9.30 | Containment | Organization Compilation with GLN and name (2017) | DYNAMIC
Relationship | Version: template 2.16.756.5.30.1.1.10.2.1 Patient - recordTarget (2019‑09‑12 14:53:02) ref hl7chcda- Version: template 2.16.756.5.30.1.1.10.2.1 Patient - recordTarget (2018‑04‑18) ref hl7chcda- Specialization: template 2.16.840.1.113883.10.12.101 CDA recordTarget (2005‑09‑07) ref ad1bbr-
Example |
Sample patient
<recordTarget> <templateId root="2.16.756.5.30.1.1.10.2.1"/> <patientRole> <id root="2.999" extension="898989"/> <addr use="HP"> <streetName>Leidensweg</streetName> <houseNumber>10</houseNumber> <postalCode>9876</postalCode> <city>Specimendorf</city> <country>CH</country> </addr> <telecom use="HP" value="tel:+41.32.685.12.34"/> <telecom use="PUB" value="mailto:sesuna.tigrinja@sampledomain.ch"/> <patient> <name> <given>Sesuna</given> <family>Tigrinja</family> </name> <administrativeGenderCode code="F" codeSystem="2.16.840.1.113883.5.1" codeSystemName="AdministrativeGender" displayName="Female"/> <birthTime value="20000404"/> </patient> <providerOrganization> <id root="2.51.1.3" extension="7608888888888"/> <name>Gruppenpraxis CH, Dr. med. Allzeit Bereit</name> </providerOrganization> </patientRole></recordTarget>
Example |
Pseudonymizing with initials
<recordTarget> <templateId root="2.16.756.5.30.1.1.10.2.1"/> <patientRole> <id nullFlavor="MSK"/> <addr nullFlavor="MSK"/> <telecom nullFlavor="MSK"/> <patient> <name nullFlavor="MSK"> <family>(only first letter)</family> <given>(only first letter)</given> </name> <administrativeGenderCode nullFlavor="MSK"/> <birthTime nullFlavor="MSK"/> </patient> </patientRole></recordTarget>
Item | DT | Card | Conf | Description | Label
--- | --- | --- | --- | --- | ---
hl7:recordTarget |  | 1 … 1 | R | A human patient for whom this CDA document instance was created. Target patient The HL7 CDA R2 (2005) standard allows multiple patients. In order to ensure that the information in a CDA document is unambiguously assigned to one and only patient, a CDA-CH V2 based document MUST contain exactly one patient. Special cases: In exceptional cases (e.g., new-born twins, both having jaundice), multiple documents MUST be created (all of the same content, but each with a unique patient). Patient identifiers Multiple ids (patient identification number) MAY be declared. If multiple ids are known, it is highly recommended to declare all known ids. Especially in cases where the CDA document instance is kind of an answer to a preceding order (independent of its data format), all ids specified by the ordering system SHALL be declared in the CDA document instance. This allows the receiver to assign its internal patient identification. The patient identification number MUST be grouped with the OID of its assigning system. The patient identification number MUST be unique within the system identified by the OID. The declared OID MUST be found in one of the public OID registries, such as oid.refdata.ch (preferred), oid-info.com, hl7.org/oid, www.dimdi.de/static/de/klassi/oid/, gesundheit.gv.at/OID_Frontend/ etc. OIDs that can't be found in a public OID registry are NOT ALLOWED. Pseudonymizing In special cases, the demographic data of the patient are not allowed to be transmitted or they have to be pseudonymized. While HL7 CDA or its derivatives like CDA-CH or Swiss exchange formats nevertheless require these elements in the XML structure, the affected values MUST be replaced by a nullFlavor of type "MSK" (masked), in order to support the required data format structure and simultaneously to shield the real data. | CDA‑CH V2
hl7:templateId | II | 1 … 1 | M |  | CDA‑CH V2
@root | uid | 1 … 1 | F | 2.16.756.5.30.1.1.10.2.1
hl7:patientRole |  | 1 … 1 | R |  | CDA‑CH V2
hl7:id | II | 1 … * | R | The patient's id. | CDA‑CH V2
@root | uid | 1 … 1 | R | The OID of the system that issued the id. OIDs of code systems, which are published in a public OID registry are REQUIRED. Others are NOT ALLOWED.
@extension | st | 0 … 1 |  | The id itself. It MUST be unique within the issuing system.
hl7:addr | AD | 0 … * |  | The patient's address. Contains 2.16.756.5.30.1.1.10.9.35 Address Information Compilation - eCH-0010 (DYNAMIC) | CDA‑CH V2
hl7:telecom | TEL | 0 … * |  | The patient's means of communication (phone, eMail, ...). | CDA‑CH V2
hl7:patient |  | 1 … 1 | R | Contains 2.16.756.5.30.1.1.10.9.34 Person Name Information Compilation - eCH-0011 (DYNAMIC) | CDA‑CH V2
hl7:administrativeGenderCode | CE | 1 … 1 | R | The patient's gender | CDA‑CH V2
@code | cs | 0 … 1 |  |
@codeSystem | oid | 0 … 1 | F | 2.16.840.1.113883.5.1
@codeSystemName | st | 0 … 1 | F | HL7 AdministrativeGender
@displayName | st | 0 … 1 |  |
hl7:birthTime | TS.CH.TZ | 1 … 1 | R | The patient's birthdate. | CDA‑CH V2
hl7:maritalStatusCode | CE | 0 … 1 |  | The patient's marital status. | CDA‑CH V2
@code | cs | 1 … 1 | R |
@codeSystem | oid | 1 … 1 | F | 2.16.840.1.113883.5.2
@codeSystemName | st | 1 … 1 | F | HL7 MaritalStatus
@displayName | st | 1 … 1 | R |
| CONF |
The value of @code SHALL be drawn from value set 2.16.840.1.113883.1.11.12212 MaritalStatus (DYNAMIC)
hl7:translation |  | 0 … * |  | A translation of the code to another coding system | CDA‑CH V2
@code | cs | 1 … 1 | R |
@codeSystem | oid | 1 … 1 | R |
@codeSystemName | st | 1 … 1 | R |
@displayName | st | 1 … 1 | R |
hl7:religiousAffiliationCode | CE | 0 … 1 |  | The patient's religion. | CDA‑CH V2
@nullFlavor | cs | 0 … 1 | F | NAV
@code | cs | 0 … 1 |  |
@codeSystem | oid | 0 … 1 |  |
@codeSystemName | st | 0 … 1 |  |
@displayName | st | 0 … 1 |  |
Included | 0 … 1 | C | from 2.16.756.5.30.1.1.10.9.49 Original 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:originalText | ED | 0 … 1 | C |  | 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 | 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 | 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"/>'). |
| Schematron assert | role | error |
| test | parent::*/text()=ancestor::hl7:structuredBody//*[@ID=$idvalue]/text() |
| Message | The originalText content MUST be identical to the narrative text for this reference. |
| Schematron assert | role | error |
| test | (@nullFlavor='NAV' and originalText and not(@codeSystem or @codeSystemName or @code or @displayName)) or (@codeSystem and @codeSystemName and @code and @displayName) |
| Message | Either a code described by code, codeSystem, codeSystemName and displayName or originalText and nullFlavor="NAV" is REQUIRED. |
hl7:guardian |  | 0 … * |  | The patient's guardian. | CDA‑CH V2
hl7:id | II | 0 … * |  | The guardian's id. | CDA‑CH V2
@root | uid | 1 … 1 | R | The OID of the system that issued the id. OIDs of code systems, which are published in a public OID registry are REQUIRED. Others are NOT ALLOWED.
@extension | st | 0 … 1 |  | The id itself. It MUST be unique within the issuing system.
hl7:code | CE | 0 … 1 |  | The guardian's role. | CDA‑CH V2
@nullFlavor | cs | 0 … 1 |  |
@code | cs | 0 … 1 |  |
@codeSystem | oid | 0 … 1 | F | 2.16.840.1.113883.5.111
@codeSystemName | st | 0 … 1 | F | HL7RoleCode
@displayName | st | 0 … 1 |  |
| Schematron assert | role | error |
| test | (not(@nullFlavor) and @displayName and @code and @codeSystem and @codeSystemName) or (@nullFlavor and not(@displayName or @code or @codeSystem or @codeSystemName)) |
| Message | Either nullFlavor or a valid code is required. |
hl7:addr | AD | 0 … * |  | The guardian's address. Contains 2.16.756.5.30.1.1.10.9.35 Address Information Compilation - eCH-0010 (DYNAMIC) | CDA‑CH V2
hl7:telecom | TEL | 0 … * |  | The guardian's means of communication (phone, eMail, ...). | CDA‑CH V2
Choice | 1 … 1 |  | Elements to choose from: hl7:guardianPerson containing template 2.16.756.5.30.1.1.10.9.34 Person Name Information Compilation - eCH-0011 (DYNAMIC) hl7:guardianOrganization containing template 2.16.756.5.30.1.1.10.9.24 Organization Compilation with name (DYNAMIC)
hl7:guardianPerson |  |  |  | The guardian's as a person. Contains 2.16.756.5.30.1.1.10.9.34 Person Name Information Compilation - eCH-0011 (DYNAMIC) | CDA‑CH V2
hl7:guardianOrganization |  |  |  | The guardian's as an organization. Contains 2.16.756.5.30.1.1.10.9.24 Organization Compilation with name (DYNAMIC) | CDA‑CH V2
hl7:birthplace |  | 0 … 1 |  | The patient's birthplace. | CDA‑CH V2
hl7:place |  | 1 … 1 |  |  | CDA‑CH V2
hl7:name | EN | 0 … 1 |  | The patient's birthplace name. | CDA‑CH V2
hl7:addr | AD | 1 … 1 | R | The patient's birthplace address. Contains 2.16.756.5.30.1.1.10.9.35 Address Information Compilation - eCH-0010 (DYNAMIC) | CDA‑CH V2
hl7:languageCommunication |  | 0 … * |  | The patient's language skills. | CDA‑CH V2
hl7:languageCode | CS | 1 … 1 |  |  | CDA‑CH V2
| CONF |
The value of @code SHALL be drawn from value set 2.16.840.1.113883.1.11.11526 HumanLanguage (DYNAMIC)
hl7:modeCode | CE | 0 … 1 |  |  | CDA‑CH V2
| CONF |
The value of @code SHALL be drawn from value set 2.16.840.1.113883.1.11.12249 LanguageAbilityMode (DYNAMIC)
hl7:proficiencyLevelCode | CE | 0 … 1 |  |  | CDA‑CH V2
| CONF |
The value of @code SHALL be drawn from value set 2.16.840.1.113883.1.11.12199 LanguageAbilityProficiency (DYNAMIC)
hl7:preferenceInd | BL | 0 … 1 |  | In case of @value=true it is the patient's correspondence language. | CDA‑CH V2
hl7:providerOrganization |  | 0 … 1 |  | The organization who took care of the patient in the same context with the current CDA document. E.g. entry of the Medreg, FMH Index or the Health Organisation Index (HOI) of the Swiss EPR. Contains 2.16.756.5.30.1.1.10.9.30 Organization Compilation with GLN and name (DYNAMIC) | CDA‑CH V2