Model Attribute Description

The HL7 attribute classCode uses a code to describe this class as a role of patient.

Implementation in XML Instance

• The XML attribute classCode is fixed to "PAT".

Model Attribute Description

The HL7 attribute addr uses a set of addresses for the patient (this is limited to a maximum of 4 types to reduce display issues in rendering CDA documents).

The HL7 attribute addr allows structured and unstructured addresses to be carried. Only structured addresses are recommended to be used.

Implementation in XML Instance

There are a number of forms of structured address. The three shown here are the recommended formats for patient addresses, they are listed in no particular order.

The XML element addr is populated as follows:

When using the structured address in the style of PDS the XML element addr shall contain five XML elements streetAddressLine:

• The first XML element streetAddressLine shall contain the premises name
  
• The second XML element streetAddressLine shall contain the number and thoroughfare
• The third XML element streetAddressLine shall contain the locality
• The fourth XML element streetAddressLine shall contain the post town
• The fifth XML element streetAddressLine shall contain the county

The first XML element streetAddressLine or the second XML element streetAddressLine and the fourth XML element streetAddressLine are mandatory to be populated.

• The XML element postalCode can be used to carry a postcode
  
• The XML element addressKey can be used to carry a PAF key
  

When using the fully structured address format then the XML element addr shall be populated as follows:

• The XML element houseNumber shall contain the house/building number or name
  
• The XML element streetName shall contain the street name
  
• The XML element city shall contain the city name
  
• The XML element county shall contain the county
• The XML element country shall contain the country name
  
• The XML element postalCode shall contain the postcode
• The XML element addressKey shall contain the address key

Note that unpopulated XML elements should not be present.

Alternatively the structured address may contain just a series of XML elements streetAddressLine populated in the correct order to render as a postal address with as much information as available included.

• The first XML element streetAddressLine shall contain the first address line
  
• The second XML element streetAddressLine shall contain the second address line
• The third XML element streetAddressLine shall contain the third address line
• and so on ....

Note that unpopulated XML elements should not be present.

The XML element addr also allows an XML attribute use and this should be used to further define the patient address type when required. Only the use values listed below are recommended to be used for patient addresses.

When the XML attribute use of the XML element addr contains the value "PHYS" then the following two XML elements of the XML element addr may be populated.

• The XML element desc of the XML element addr may contain a description of the address; this may be used for things like directions for the address.
• The XML element additionalLocator of the XML element addr may contain additional location information such as longitude and latitude coordinates.
  

The XML element useablePeriod of XML element addr can be used to indicate some of the following types of valid times for an address:

• A point in time when the contact address details are valid
  
• A start and end time
• Just including hours and minutes to indicate opening hours of an office for a work address
  
• Using dates for indicating a contact address is only for a certain period of time.
  
• A start time only to indicate when the contact address is valid from.
• An end time only to indicate that the contact address is only valid until a certain date.

Model Attribute Description

The HL7 attribute id enables the identification of the patient using the NHS number, or a local identifier if the NHS number is not available. This attribute has been extended for NHS use to allow the status of the NHS number to also be stated.

Implementation in XML Instance

There must be either one or two instances of id.

• The first instance of id must contain information related to the patient's NHS Number
• The second instance of id may contain information related to a local patient identifier
  

For a verified NHS Number:

• The XML attribute root shall contain the OID "2.16.840.1.113883.2.1.4.1"
• The XML attribute extension shall contain the 10 digit NHS number.
• The XML attribute patientIdStatus shall contain the value "01".
  

For an unverified NHS Number:

• The XML attribute root shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.23"
• The XML attribute extension shall contain the 10 digit NHS number.
• The XML attribute patientIdStatus shall contain one of the following values to indicate the status of the included NHS number:

When the NHS Number is not included then:

• The XML attribute patientIdStatus shall contain the value "07"

A local identifier for the patient may also be included in the second instance of id as below:

• The XML attribute root shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.24"
• The XML attribute extension shall contain the local patient identifier
• The XML attribute assigningAuthorityName shall contain the assigning organisation in the format of ODSCode:ODSName,

A link to the patient class.

A link to the organisation class that provides the care.

Model Attribute Description

The HL7 attribute classCode describes this class as a person.

Implementation in XML Instance

• The XML attribute classCode is fixed to "PSN".

Model Attribute Description

The HL7 attribute determinerCode describes this class as an instance of a person.

Implementation in XML Instance

• The XML attribute determinerCode is fixed to "INSTANCE".

Model Attribute Description

The HL7 attribute administrativeGenderCode uses a code from the Sex vocabulary to indicate the gender of the patient.

This code is for administrative purposes only and does not imply a particular genetic or physical sex.

Implementation in XML Instance

The Coded Plain data type flavour of Coded Value (CV) shall be used to carry this information in the XML element administrativeGenderCode as follows:

• The XML attribute code shall contain a code from the Sex vocabulary
• The XML attribute codeSystem shall contain the fixed OID "2.16.840.1.113883.2.1.3.2.4.16.25"
  
• The XML attribute displayName shall carry the description associated with the code in the Sex vocabulary.

Model Attribute Description

The HL7 attribute birthTime specifies the patient's date of birth.

Implementation in XML Instance

The XML attribute value of the XML element birthTime shall be populated a time stamp in the format yyyymmddhhmm where:

• yyyy is the year
• mm is the month
• dd is the day
• hh is the hour
• mm is the minute

At least the year must be present.

The XML attribute value of the XML element birthTime should be populated to the level of detail that is available on the sending system.

Model Attribute Description

The HL7 attribute name provides names associated with the person who is the patient.

Implementation in XML Instance

The Person Name Structured with optional Use and optional Valid Time flavour of the PN data type is the recommended format for the patient's name. This information is carried in the XML element name as follows:

• The XML element prefix should contain the patient's title
• The XML element given should contain the patient's forenames; there can be as many occurrences of the XML element as required
  
• The XML element family should contain the patient's surname
• The XML element suffix may contain any suffix for the patient

Additionally the XML attribute use of the XML element name should be used to indicate the type of name; the recommended codes to be used are listed below:

Note some of the codes listed are NHS extensions, these are marked with an *

Additionally the XML element validTime of the XML element name may be used to indicate the time when the name is valid/was valid for the patient, some uses are shown below:

• A point in time when the name details are known to be valid
  
• A start and end time
• To represent the period of time the patient is/was known by this name
  
• A start time only to indicate when the name is/was valid from for the patient
  
• An end time only to indicate that the name is/was only valid for the patient until a certain date

When no patient name is available to the sending system to then an appropriate XML attribute nullFlavor may be used to populate the XML element name. The recommended values for the XML attribute nullFlavor are listed below:

The HL7 attribute templateId provides a unique identifier for the template and the class name within that template. This is used to identify how the CDA standard has been constrained for NHS use.

The Identifier External data type flavour is used to carry this information in the XML element templateId as follows:

• The root attribute is fixed to the OID "2.16.840.1.113883.2.1.3.2.4.18.2"
• The extension attribute is fixed to "COCD_TP145230GB02#patientPatient

Model Attribute Description

The HL7 attribute classCode describes this class as a guardian role.

Implementation in XML Instance

• The XML attribute classCode is fixed to "GUARD".

Model Attribute Description

The HL7 attribute addr uses a set of addresses for the patient's guardian (this is limited to a maximum of 4 types to reduce display issues in rendering CDA documents).

The HL7 attribute addr allows structured and unstructured addresses to be carried. Only structured addresses are recommended to be used.

Implementation in XML Instance

There are a number of forms of structured address. The three shown here are the recommended formats for patient addresses, they are listed in no particular order.

The XML element addr is populated as follows:

When using the structured address in the style of PDS the XML element addr shall contain five XML elements streetAddressLine:

• The first XML element streetAddressLine shall contain the premises name
  
• The second XML element streetAddressLine shall contain the number and thoroughfare
• The third XML element streetAddressLine shall contain the locality
• The fourth XML element streetAddressLine shall contain the post town
• The fifth XML element streetAddressLine shall contain the county

The first XML element streetAddressLine or the second XML element streetAddressLine and the fourth XML element streetAddressLine are mandatory to be populated.

• The XML element postalCode can be used to carry a postcode
  
• The XML element addressKey can be used to carry a PAF key
  

When using the fully structured address format then the XML element addr shall be populated as follows:

• The XML element houseNumber shall contain the house/building number or name
  
• The XML element streetName shall contain the street name
  
• The XML element city shall contain the city name
  
• The XML element county shall contain the county
• The XML element country shall contain the country name
  
• The XML element postalCode shall contain the postcode
• The XML element addressKey shall contain the address key

Note that unpopulated XML elements should not be present.

Alternatively the structured address may contain just a series of XML elements streetAddressLine populated in the correct order to render as a postal address with as much information as available included.

• The first XML element streetAddressLine shall contain the first address line
  
• The second XML element streetAddressLine shall contain the second address line
• The third XML element streetAddressLine shall contain the third address line
• and so on ....

Note that unpopulated XML elements should not be present.

The XML element addr also allows an XML attribute use and this should be used to further define the patient address type when required. Only the use values listed below are recommended to be used for patient addresses.

When the XML attribute use of the XML element addr contains the value "PHYS" then the following two XML elements of the XML element addr may be populated.

• The XML element desc of the XML element addr may contain a description of the address; this may be used for things like directions for the address.
• The XML element additionalLocator of the XML element addr may contain additional location information such as longitude and latitude coordinates.
  

The XML element useablePeriod of XML element addr can be used to indicate some of the following types of valid times for an address:

• A point in time when the contact address details are valid
  
• A start and end time
• Just including hours and minutes to indicate opening hours of an office for a work address
  
• Using dates for indicating a contact address is only for a certain period of time.
  
• A start time only to indicate when the contact address is valid from.
• An end time only to indicate that the contact address is only valid until a certain date.

Model Attribute Description

The HL7 attribute id enables the identification of the guardian using the NHS number, or a local identifier if the NHS number is not available. This attribute has been extended for NHS use to allow the status of the NHS number to also be stated.

Implementation in XML Instance

There must be either one or two instances of id.

• The first instance of id must contain information related to the patient's NHS Number
• The second instance of id may contain information related to a local patient identifier
  

For a verified NHS Number:

• The XML attribute root shall contain the OID "2.16.840.1.113883.2.1.4.1"
• The XML attribute extension shall contain the 10 digit NHS number.
• The XML attribute patientIdStatus shall contain the value "01".
  

For an unverified NHS Number:

• The XML attribute root shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.23"
• The XML attribute extension shall contain the 10 digit NHS number.
• The XML attribute patientIdStatus shall contain one of the following values to indicate the status of the included NHS number:

When the NHS Number is not included then:

• The XML attribute patientIdStatus shall contain the value "07"

A local identifier for the patient may also be included in the second instance of id as below:

• The XML attribute root shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.24"
• The XML attribute extension shall contain the local patient identifier
• The XML attribute assigningAuthorityName shall contain the assigning organisation in the format of ODSCode:ODSName,

Model Attribute Description

The HL7 Attribute telecom specifies contact details for the guardian in the form of telephone numbers, fax numbers and email addresses.

Implementation in XML Instance

The XML value attribute of the XML element telecom should contain the telephone / fax number or an email address prefixed by the type of contact and a colon.

• For a telephone number the actual telephone number would be prefixed with tel:
• For a fax number the actual fax number would be prefixed with fax:
• For an email address the actual email address would be prefixed with mailto:
  

The XML attribute use of the XML element telecom may be used to give further information about the type of contact details contained in the XML attribute value. Only the use values listed below are recommended to be used for the patient contact details:

The XML element useablePeriod of the XML element telecom may be used to indicate when the contact details given are valid, for example to indicate that a telephone number is only for office hours (9am to 5 pm). It can be used to indicate some of the following types of valid times:

• A point in time when the contact details are valid
  
• A start and end time
• Just including hours and minutes to indicate opening hours of an office for work contacts
  
• Using dates for indicating a contact is only for a certain period of time.
  
• A start time only to indicate when the contact details are valid from.
• An end time only to indicate that the contact details are only valid until a certain date.

Model Attribute Description

The HL7 attribute classCode describes this class as an organisation.

Implementation in XML Instance

• The XML attribute classCode is fixed to "ORG".
  

Model Attribute Description

The HL7 attribute determinerCode describes this class as an instance of an organisation.

Implementation in XML Instance

• The XML attribute determinerCode is fixed to "INSTANCE".

Model Attribute Description

The HL7 attribute name uses the description of the organisation associated with the ODS code.

Implementation in XML Instance

The XML element name will carry the description associated with the ODS code carried in the XML attribute extension of the XML element id.

Model Attribute Description

The HL7 attribute standardIndustryClassCode uses a code taken from the GuardianOrganisationType vocabulary to indicate the type of care provider.

The only use currently for this attribute is to indicate that the organisation is the patient's registered GP practice.

Implementation in XML Instance

The Coded Plain data type flavour of Coded Value (CV) shall be used to carry this information in the XML element standardIndustryClassCode as follows:

• The XML attribute code shall contain a code from the GuardianOrganisationType vocabulary
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.17.478"
• The XML attribute displayName shall carry the description associated with the code in the GuardianOrganisationType vocabulary.

The HL7 attribute telecom provides contact details for the organisation in the form of telephone numbers, fax numbers and email addresses.

Implementation in XML Instance

This XML element telecom should be populated as below:

The XML attribute value of the XML element telecom should contain the telephone / fax number or an email address prefixed by the type of contact and a colon.

• For a telephone number the actual telephone number would be prefixed with tel:
• For a fax number the actual fax number would be prefixed with fax:
• For an email address the actual email address would be prefixed with mailto:
  

The XML attribute use of the XML element telecom may be used to give further information about the type of contact details contained in the XML attribute value. Only the use values listed below are recommended for an organisation's contact details:

The XML element useablePeriod of XML element telecom may be used to indicate when the contact details given are valid, for example to indicate that a telephone number is only for office hours (9am to 5 pm). It can be used to indicate some of the following types of valid times:

• A point in time when the contact details are valid
  
• A start and end time
• Just including hours and minutes to indicate opening hours
• Using dates for indicating a contact is only for a certain period of time
  
• A start time only to indicate when the contact details are valid from
• An end time only to indicate that the contact details are only valid until a certain date

• The XML attribute root is fixed to the OID "2.16.840.1.113883.2.1.3.2.4.18.2"
• The XML attribute extension is fixed to "COCD_TP14530GB01#guardianOrganization"

Model Attribute Description

The HL7 attribute classCode describes this class as a person.

Implementation in XML Instance

• The XML attribute classCode is fixed to "PSN".

Model Attribute Description

The HL7 attribute determinerCode describes this class as an instance of a person.

Implementation in XML Instance

• The XML attribute determinerCode is fixed to "INSTANCE".

Model Attribute Description

The HL7 attribute name provides a name associated with the person who is the patient's guardian.

Implementation in XML Instance

The Person Name Structured with optional Use and optional Valid Time flavour of the PN data type is the recommended format for the guardian's name. This information is carried in the XML element name as follows:

• The XML element prefix should contain the guardian's title
• The XML element given should contain the guardian's forenames; there can be as many occurrences of the XML element as required.
  
• The XML element family should contain the guardian's surname
• The XML element suffix may contain any suffix for the guardian

Additionally the XML attribute use of the XML element name should be used to indicate the type of name; the recommended codes to be used are listed below:

Note some of the codes listed are NHS extensions, these are marked with an *

Additionally the XML element validTime of the XML element name may be used to indicate the time when the name is valid/was valid for the guardian, some uses are shown below:

• A point in time when the name details are known to be valid
  
• A start and end time
• To represent the period of time the guardian is/was known by this name.
  
• A start time only to indicate when the name is/was valid from for the guardian.
• An end time only to indicate that the name is/was only valid for the guardian until a certain date.

Model Attribute Description

The HL7 attribute classCode describes this class as an organisation.

Implementation in XML Instance

• The XML attribute classCode is fixed to "ORG".
  

Model Attribute Description

The HL7 attribute determinerCode describes this class as an instance of an organisation.

Implementation in XML Instance

• The XML attribute determinerCode is fixed to "INSTANCE".
  

Model Attribute Description

The HL7 attribute addr provides a contact address for the organisation.

The HL7 attribute addr allows structured and unstructured addresses to be carried in an instance. Only structured addresses are recommended to be used. There are a number of structured forms of addresses. The three shown here are the recommended formats for organisation addresses, they are listed in no particular order.

Implementation in XML Instance

When the structured address in the style of PDS is used then it shall contain five XML elements streetAddressLine:

• The first XML element streetAddressLine should contain the premises name
  
• The second XML element streetAddressLine should contain the number and thoroughfare
• The third XML element streetAddressLine should contain the locality
• The fourth XML element streetAddressLine should contain the post town
• The fifth XML element streetAddressLine should contain the county

The first XML element streetAddressLine or second XML element streetAddressLine and the fourth XML element streetAddressLine are mandated to be populated.

• The XML element postalCode may be used to carry a postcode
  
• The XML element addressKey may be used to carry a PAF key

or the address may use the fully structured address:

• The XML element houseNumber should contain the house/building number or name
  
• The XML element streetName should contain contains the street name
  
• The XML element city should contain the city name
  
• The XML element county should contain the county
• The XML element country should contain the country name
  
• The XML element postalCode should contain the post code
• The XML element addressKey should contain the address key

Alternatively the structured address may contain just a series of XML elements streetAddressLine populated in the correct order to render as a postal address with as much information as available included:

• The first XML element streetAddressLine contains the first address line
  
• The second XML element streetAddressLine contains the second address line
• The third XML element streetAddressLine contains the third address line
• and so on ....
  

The XML element addr allows an XML attribute use, this should be used to further define the organisation address when required. Only the use values listed below are recommended to be used for organisation addresses.

The XML element useablePeriod of XML element addr can be used to indicate some of the following types of valid times:

• A point in time when the contact address details are valid
  
• A start and end time
• Just including hours and minutes to indicate opening hours
• Using dates for indicating a contact address is only for a certain period of time
  
• A start time only to indicate when the contact address is valid from
• An end time only to indicate that the contact address is only valid until a certain date

Model Attribute Description

The HL7 attribute id uses an ODS code as an identifier that uniquely identifies the organisation which provides/provided care to the patient. The ODS code should identify the organisation at either the site level or organisation level. Where possible the organisation should be identified at the site level. ODS codes were formerly known as NACS codes.

Implementation in XML Instance

When ODS site code is used then the XML element id is populated in the following way:

• The XML attribute root shall contain an OID with the value "2.16.840.1.113883.2.1.3.2.4.19.2"
• The XML attribute extension shall contain the ODS site code.

When ODS organisation code is used then the XML element id is populated in the following way:

• The XML attribute root shall contain an OID with the value "2.16.840.1.113883.2.1.3.2.4.19.1"
• The XML attribute extension shall contain the ODS organisation code.

Model Attribute Description

The HL7 attribute name uses the description of the organisation associated with the ODS code.

Implementation in XML Instance

The XML element name will carry the description associated with the ODS code carried in the XML attribute extension of the XML element id.

Model Attribute Description

The HL7 attribute standardIndustryClassCode uses a code taken from the CDAOrganizationProviderType vocabulary to indicate the type of care provider.

The only use currently for this attribute is to indicate that the organisation is the patient's registered GP practice.

Implementation in XML Instance

The Coded Plain data type flavour of Coded Value (CV) shall be used to carry this information in the XML element standardIndustryClassCode as follows:

• The XML attribute code shall contain a code from the CDAOrganizationProviderType vocabulary
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.17.289"
• The XML attribute displayName shall carry the description associated with the code in the CDAOrganizationProviderType vocabulary.
  

Model Attribute Description

The HL7 attribute telecom provides contact details for the organisation in the form of telephone numbers, fax numbers and email addresses.

Implementation in XML Instance

This XML element telecom should be populated as below:

The XML attribute value of the XML element telecom should contain the telephone / fax number or an email address prefixed by the type of contact and a colon.

• For a telephone number the actual telephone number would be prefixed with tel:
• For a fax number the actual fax number would be prefixed with fax:
• For an email address the actual email address would be prefixed with mailto:
  

The XML attribute use of the XML element telecom may be used to give further information about the type of contact details contained in the XML attribute value. Only the use values listed below are recommended for an organisation's contact details:

The XML element useablePeriod of XML element telecom may be used to indicate when the contact details given are valid, for example to indicate that a telephone number is only for office hours (9am to 5 pm). It can be used to indicate some of the following types of valid times:

• A point in time when the contact details are valid
  
• A start and end time
• Just including hours and minutes to indicate opening hours
• Using dates for indicating a contact is only for a certain period of time
  
• A start time only to indicate when the contact details are valid from
• An end time only to indicate that the contact details are only valid until a certain date
  

Model Attribute Description

The HL7 attribute classCode describes this class as a part role.

Implementation in XML Instance

• The XML attribute classCode is fixed to "PART".

Model Attribute Description

The HL7 attribute id uses an ODS code as an identifier that uniquely identifies the organisation which provides/provided care to the patient. The ODS code should identify the organisation at either the site level or organisation level. Where possible the organisation should be identified at the site level. ODS codes were formerly known as NACS codes.

Implementation in XML Instance

When ODS site code is used then the XML element id is populated in the following way:

• The XML attribute root shall contain an OID with the value "2.16.840.1.113883.2.1.3.2.4.19.2"
• The XML attribute extension shall contain the ODS site code.

When ODS organisation code is used then the XML element id is populated in the following way:

• The XML attribute root shall contain an OID with the value "2.16.840.1.113883.2.1.3.2.4.19.1"
• The XML attribute extension shall contain the ODS organisation code.

When no identifier is available then this attribute show be nulled using a null flavor as below:

• The XML attribute nullFlavor shall contain the value "UNK"