Structured Headings
Domain Message Specification

Change History

Version: 1.0; Status: RC4

  • Fourth Release Candidate
    • Version 1.0 RC4 includes changes following a review of 1.0 RC3 by the Healthy London Partnership London Digital Programme End of Life Care Co-ordination project.
  • New Schema
    • COCD_TP146090GB01-CrisisCarePlan - to carry Plan Agreement Text and Planned Review Date.
  • Amended Schemas
    • COCD_TP146055GB02-PersonalCarePreference - changed to CD instead of CV to allow the qualifier in value for the personal care preference, and this allows for the recording of the patient's wishes that are not advance statements.
    • COCD_TP146058GB02-AuthoritytoLastingPowerofAttorney - changed effective time from TS to IVL_TS.
    • COCD_TP146059GB02-AdvanceDecisionToRefuseTreatment - the cardinality for the ADRTDocsLocation has been relaxed to 0..1.
    • COCD_TP000075GB02-ProblemsAndIssuesSection - added a Coded Problems and Issues Choice to carry ClinicalRisk (COCD_TP146086GB01).
    • COCD_TP146077GB02-EoLCarePlan - removed Plan Agreement Text and Planned Review Date.
    • COCD_TP000082GB02-IndividualRequirementsSection - added a Coded Individual Requirements Choice to carry Mobility (COCD_TP146076GB01).
    • COCD_TP146422GB03-DNACPRDecision - changed the cardinality of the act relationship to 0..* for InformedOfDecision.
    • POCD_MT000002UK01-NHS CDA RMIM - changed CD.NPfIT.CDA.Url to ED for Act.text.
  • Constraints
    • NPFIT-300008#Act, the Coded Crisis Care Plan Choice - has been amended to include the new COCD_TP146090GB01 template and the upversioned COCD_TP146422GB03.
    • NPFIT-300011#Act, the Coded Legal Information Choice - has been amended to include the upversioned COCD_TP146058GB02 and COCD_TP146059GB02 templates.
    • NPFIT-300014#Act, the Coded Safety Alerts Choice - removed ClinicalRisk (COCD_TP146086GB01)
    • NPFIT-300017#Act, the Coded End Of Life Choice - has been amended to include the upversioned COCD_TP146077GB02 template.
    • NPFIT-300015#Act, the Coded Social Context Choice - removed Mobility (COCD_TP146076GB01).
    • NPFIT-300022#Act ,the Person And Carer Concerns Expectations And Wishes Choice - has been amended to include the upversioned COCD_TP146055GB02 template.
    • NPFIT-300024#Act, the Coded Problems and Issues Choice - this is a new constraint for ProblemsAndIssuesSection (COCD_TP000075GB02) to carry ClinicalRisk (COCD_TP146086GB01).
    • NPFIT-300025#Act, the Coded Individual Requirements Choice - this is a new constraint for IndividualRequirementsSection (COCD_TP000082GB02) to carry Mobility (COCD_TP146076GB01).
    • NPFIT-500004#Section, the Section Choice - has been amended to include the upversioned ProblemsAndIssuesSection (COCD_TP000075GB02) and IndividualRequirementsSection (COCD_TP000082GB02).
  • Vocabulary
    • CDAObservationType - Added new enumerations for CCP (Crisis Care Plan) and CCPRD (Crisis Care Planned Review Date).

Version: 1.0; Status: RC3

  • Third Release Candidate
    • Version 1.0 RC3 includes changes to meet the requirements for sending discharge summaries to GP for mental health adult patients.
  • New Schemas for the Section Templates
    • COCD_TP000089GB01-InvestigationsResultsSection
    • COCD_TP000091GB01-ReferrerDetailsSection
    • COCD_TP000090GB01-PatientConcernsExpectationsAndWishesSection
    • COCD_TP000088GB01-InformationAndAdviceGivenSection
  • Amended Schemas following feedback from implementers
    • COCD_TP145243GB02-DischargingSpecialty - ID and code attributes are made required and also allowing orginalText in the code attribute. Note the GB01 version has been kept for backwards compatibility.
    • COCD_TP000084GB01-PersonAndCarerConcernsExpectationsAndWishesSection - removed the default code of TBA in the model for the SectionTypeSnCT vocabulary and corrected the tabular view.
  • Constraints
    • The Section Choice, NPFIT-500004#Section – has been amended to include the new section templates.
    • The Discharging Specialty Choice, NPFIT-300004#Role - has been amended to include COCD_TP145243GB02

Version: 1.0; Status: RC2

  • Schemas
    • Corrected a defect in the schema of COCD_TP146084GB01 (RiskToPerson), where the code attribute was incorrectly fixed to a 222701000000104. The model, tabular view and schema have been corrected, to allow the code attribute to take any value from the RiskToPersonSnCT subset.
    • Amended COCD_TP146422GB02 (DNACPRDecision), by removing entryRelationship4.ResuscitationStatus. The model, tabular view and schema have been corrected.
    • Amended RelevantPastMedicalSurgicalAndMentalHealthHistorySection (COCD_TP000083GB01), to include SignificantPastMedicalHistory (COCD_TP146083GB01) in the choice. The model, tabular view and schema have been corrected.
  • Constraints
    • Allergies And Adverse Reactions Section, NPFIT-300004#Act - has been corrected to include the old version of AllergicOrAdverseReactionEvent (COCD_TP146060GB01) for backwards compatibility.
    • Crisis Care Plan Section, NPFIT-300008#Act – EoLCarePlan (COCD_TP146077GB01) has been removed from the choice.
    • Crisis Care Plan Section, NPFIT-300008#Act – SignificantPastMedicalHistory (COCD_TP146083GB01) has been removed from the choice.
    • Person and Carers Concerns, Expectations and Wishes Section, NPFIT-300022#Act – PatientDeathInformation (COCD_TP146078GB01) has been removed from the choice.
    • Relevant Past Medical Surgical And Mental Health History Section, NPFIT-300023#Act – SignificantPastMedicalHistory (COCD_TP146083GB01) is included in the the choice.
  • Vocabulary
    • DNACPRprefSnCT - added a new value of 845151000000104, "Not aware of do not attempt cardiopulmonary resuscitation clinical decision (finding)". This vocabulary has changed to reflect the model change to COCD_TP146422GB02 (DNACPRDecision).

Version: 1.0; Status: RC1

  • First Release Candidate
    • Changes made following internal review and review comments from the Healthy London Partnership London Digital Programme End of Life Care Co-ordination project.
  • Main Model - ClinicalDocument.MessageType is no longer fixed to a particular value
    • POCD_RM000042GB01-StructuredHeadings.mif is a generic model and therefore the MessageType should not be fixed. The CDA Profile Specification document for the domain identifies which MessageType value should be used.
  • Templates
    • COCD_TP146073GB01-AnticipatoryMedicineBoxIssueProcedure.mif has changed, by linking this to a new template COCD_TP146088GB01-Medications-Supplied.
    • COCD_TP146056GB01-CrisisCareObservation.mif, improvements to the tabular view description.
    • COCD_TP146066GB02-Procedure.mif, has changed, by linking to AnatomicalSite and Laterality classes.
    • Correction to the description of the originalText in the value attribute across all template tabular views.
  • Constraint
    • NPFIT-300013#Act - RiskToPatient has been removed from the history section, NPFIT-300013#Act. However, COCD_TP146063GB02-Diagnosis.mif and COCD_TP146066GB01-Procedure.mif have been added to the history section, to cater for the needs of other domains.
    • NPFIT-300009#Act - remove AdvanceStatement, PatientDeathInformation and PersonalCarePreference from NPFIT-300009#Act (PatientAndCarerConcernsSection). Note, PatientAndCarerConcernsSection will be kept as this is a generic CDA model, and other domains may need this section, however PatientAndCarerConcernsSection will be disallowed in the NHS Digital End of Life Constraints Document.
    • NPFIT-300022#Act - A new constraint, has been added as a coded entry choice to COCD_TP000084GB01-PersonAndCarerConcernsExpectationsAndWishesSection.mif. This constraint carries a choice of AdvanceStatement, PatientDeathInformation and PersonalCarePreference.
    • NPFIT-300014#Act - Accommodation has been removed from the SafetyAlerts section choice.
  • Examples
    • Examples amended to ensure originalText is used.
    • Examples amended to ensure a number of data items which would normally be recorded in just the section text are recorded in a coded entry, for risks to patient/others, safeguarding issues, significant past medical history and mobility.
  • Data Types
    • References to an originalText XML attribute are changed to originalText XML element.
  • Cross References
    • These are included for ease of navigation for this release.

Version: 1.0; Status: Draft B

  • Second Draft
    • Second draft version (Version 1.0 Draft B) includes changes to meet the requirements for the Healthy London Partnership London Digital Programme End of Life Care Co-ordination project.
  • Section Templates - The following have been amended by the addition of Coded Entries:
    • COCD_TP000010GB01-PatientAndCarerConcernsSection.mif
    • COCD_TP000037GB01-DiagnosesSection.mif
    • COCD_TP000044GB01-LegalInformationSection.mif
    • COCD_TP000040GB01-MedicationsAndMedicalDevicesSection.mif
    • COCD_TP000064GB01-HistorySection.mif
    • COCD_TP000039GB01-SafetyAlertsSection.mif
    • COCD_TP000043GB01-SocialContextSection.mif
    • COCD_TP000083GB01-RelevantPastMedicalSurgicalAndMentalHealthHistorySection.mif
    • COCD_TP000085GB01-CrisisCarePlanSection.mif
    • COCD_TP000086GB01-EndOfLifeSection.mif
  • Templates - New templates included for this release:
    • COCD_TP145007UK04-RelatedEntity.mif
    • COCD_TP146052GB01-MedicationsAdministered.mif
    • COCD_TP146053GB01-DiscontinuedMedications.mif
    • COCD_TP146054GB01-MedicalDevices.mif
    • COCD_TP146055GB01-PersonalCarePreference.mif
    • COCD_TP146056GB01-CrisisCareObservation.mif
    • COCD_TP146057GB01-Prognosis.mif
    • COCD_TP146058GB01-AuthoritytoLastingPowerofAttorney.mif
    • COCD_TP146059GB01-AdvanceDecisionToRefuseTreatment.mif
    • COCD_TP146060GB02-AllergicOrAdverseReactionEvent.mif
    • COCD_TP146063GB02-Diagnosis.mif
    • COCD_TP146070GB01-TissueAndOrganDonation.mif
    • COCD_TP146071GB01-SafeGuarding.mif
    • COCD_TP146072GB01-PatientAndCarerConcerns.mif
    • COCD_TP146073GB01-AnticipatoryMedicineBoxIssueProcedure.mif
    • COCD_TP146074GB01-Accommodation.mif
    • COCD_TP146075GB01-Housing.mif
    • COCD_TP146076GB01-Mobility.mif
    • COCD_TP146077GB01-EoLCarePlan.mif
    • COCD_TP146078GB01-PatientDeathInformation.mif
    • COCD_TP146079GB01-SocialOrPersonalCircumstance.mif
    • COCD_TP146081GB01-RiskToPatient.mif
    • COCD_TP146083GB01-SignificantPastMedicalHistory.mif
    • COCD_TP146084GB01-RiskToPerson.mif
    • COCD_TP146085GB01-Service.mif
    • COCD_TP146086GB01-ClinicalRisk.mif
    • COCD_TP146087GB01-AdvanceStatement.mif
    • COCD_TP146093GB01-LegalStatus.mif
    • COCD_TP146422GB02-DNACPRDecision.mif
  • Templates - Some existing templates have been changed, for example tabular view amendments:
    • COCD_TP146060GB01-AllergicOrAdverseReactionEvent.mif
    • COCD_TP146062GB01-Admission.mif
    • COCD_TP146066GB01-Procedure.mif
    • COCD_TP146067GB01-Discharge.mif

Version: 1.0; Status: Draft A

  • First Draft
    • First draft version (Version 1.0 Draft A) developed to use all structured headings.