Model Attribute Description

The HL7 attribute classCode uses a code to describe this class as a substance administration.

Implementation in XML Instance

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

Model Attribute Description

The HL7 attribute moodCode uses a code to describe this class as an observation event.

Implementation in XML Instance

• The XML attribute moodCode is fixed to "EVN".

Model Attribute Description

The HL7 attribute administrationUnitCode uses a concept from the SNOMED CT terminology, constrained by the NHSdm+dDoseFormSnCT vocabulary, to describe the form of the medication taken by the patient.

Implementation in XML Instance

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

• The XML attribute code shall contain a concept from the vocabulary NHSdm+dDoseFormSnCT.
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.15".
• The XML attribute displayName shall carry the description associated with the concept.

Model Attribute Description

The HL7 attribute approachSiteCode uses a concept from the SNOMED CT terminology, constrained by the SiteOfMedicationAdministrationSnCT vocabulary, (or a text representation) to describe the anatomical site at which the medication is to be administered.

Implementation in XML Instance

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

If using a concept from SNOMED CT then

• The XML attribute code shall contain a concept from the SiteOfMedicationAdministrationSnCT vocabulary.
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.15".
• The XML attribute displayName shall carry the description associated with the concept.

If not using a concept from SNOMED CT then

• The XML element originalText should be used to record the medicine.
  

Model Attribute Description

The HL7 attribute code uses a fixed concept from the SNOMED CT terminology to identify this class as being the medication item.

Implementation in XML Instance

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

• The XML attribute code shall contain the value "18629005".
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.15"
• The XML attribute displayName shall carry the description associated with the code.

Model Attribute Description

The HL7 attribute effectiveTime records the time stamp when the medication course should begin, and end time stamp when the medication course should finish.

Implementation in XML Instance

The Interval of Points in Time data type flavour is used to carry this information in the XML element effectiveTime using the value attributes of the of the XML elements low and high.

The date range shall be carried as follows:

The XML attribute value of the XML elements low and high, may be populated with a time stamp in the format yyyymmddhhmmss[+|-ZZzz] where:

• yyyy is the year
• mm is the month
• dd is the day
• hh is the hour
• mm is the minute
• ss is seconds
• [+|-ZZzz] is the time zone offset in hours and minutes

Sections from the right of this representation may be left off when the sending system does not record to this level of accuracy. When hours are present, the time zone offset must also be present.

• If known, the XML attribute value of the XML element low shall be populated with a 'start date' time stamp to indicate when the medication course should begin.
• If known, the XML attribute value of the XML element high shall be populated with an 'end date' time stamp to indicate when the medication course should finish.
  

Model Attribute Description

The HL7 attribute id uses an identifier to identify the instance of a medication entry.

Implementation in XML Instance

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

• The XML attribute root shall contain a DCE UUID.

Model Attribute Description

The HL7 attribute statusCode uses a code from the ActStatus vocabulary to describes the status of the medication item. As this template describes post event information, it records completed events, and so is fixed to completed.

Implementation in XML Instance

The Coded Only datatype flavour is used to carry this information as follows:

• The XML attribute code of the XML element statusCode is fixed to completed

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#MedicationItem".

Model Attribute Description

The HL7 attribute text is used to hold the dose directions description. This should be a single plain text phrase describing the entire medication dosage and administration directions, including dose quantity and medication frequency.

Implementation in XML Instance

• The ST data type is used to carry this information in the XML element text

For example
1 tablet at night
20mg at 10pm

This template class constrains the CDA author class.

This class is a link to the author of the medication entry.

Model Attribute Description

The HL7 attribute typeCode describes this class as an author participation.

Implementation in XML Instance

• The XML attribute typeCode is fixed to "AUT".

Model Attribute Description

The HL7 attribute contextControlCode uses a set of codes from the HL7 vocabulary ContextControl to determine whether participations associated with the parent act are conducted across to the child act (also associated with the child act). This set of codes also determine how these participations conduct.

The conduction can only take place if the contextConductionInd in the actRelationships is set to "true".

The value of this attribute is fixed in the HL7 model to "OP":

• "O" (Overriding) - the author replaces any author that has been conducted from any previous acts.
• "P" (Propagating) - the author is conducted to all child acts where the contextConductionInd is set to "true".

Implementation in XML Instance

• The XML attribute contextControlCode shall contain the value "OP"

Model Attribute Description

The HL7 (NHS localisation) attribute contentId, when valued in an instance, provides a unique forward pointing identifier for the template which constrains the classes and attributes which follow, for NHS use.

The attribute is intended simply as a structural navigational aid and should not be relied upon as an indicator of semantic meaning. The contentId is populated at run time with a value from the allowed list contained in the model.

Implementation in XML Instance

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

• The XML attribute root is fixed to the OID "2.16.840.1.113883.2.1.3.2.4.18.16"
• The XML attribute extension shall contain one of the allowed template artefact identifiers.

Model Attribute Description

The HL7 attribute functionCode uses a code from the vocabulary AuthorFunctionType to describe the function of the author

Implementation in XML Instance

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

• The XML attribute code is fixed to "OA"
• The XML attribute codeSystem is fixed to the OID "2.16.840.1.113883.2.1.3.2.4.17.178"
• The XML attribute displayName is fixed to the author's function name "Originating Author".

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#author".

Model Attribute Description

The HL7 attribute time is used to define the time the author originally recorded the medication.

Implementation in XML Instance

The XML attribute value of the XML element time shall be populated with the time that author recorded the information using a time stamp in the format yyyymmddhhmmss[+|-ZZzz] where:

• yyyy is the year
• mm is the month
• dd is the day
• hh is the hour
• mm is the minutes
• ss is the seconds
• [+|-ZZzz] is the time zone offset in hours and minutes

Sections from the right of this representation may be left off when the sending system does not record to this level of accuracy. When hours are present, the time zone offset must also be present.

Where no time is recorded or available then:

• The XML attribute nullFlavor of the XML element time shall contain the value "UNK"
  

A link to the choice of author templates.

This template class constrains the CDA consumable class.

This class is a links to the medication or medical device to the manufactured product.

Model Attribute Description

The HL7 attribute typeCode describes this class as a consumable participation.

Implementation in XML Instance

• The XML attribute typeCode is fixed to "CSM".

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#consumable".

A link to the manufactured product.

This template class constrains the CDA component class.

This class is a component that connects the medication item to the dose amount.

Model Attribute Description

The HL7 attribute typeCode describes this class as a component.

Implementation in XML Instance

• The XML attribute typeCode is fixed to "COMP".

Model Attribute Description

The HL7 attribute contextConductionInd uses a Boolean value (true or false) to determine whether information associated with the parent act is conducted across to the child act (also associated with the child act).

Implementation in XML Instance

• The XML attribute contextConductionInd is fixed to "true".

Model Attribute Description

The HL7 attribute seperatableInd uses a Boolean (true or false) to indicate whether two pieces of information can be interpreted separately.

Implementation in XML Instance

• The XML attribute seperatableInd is fixed to "false".

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#entryRelationship".

A link to the dose amount.

This template class constrains the CDA component class.

This class is a component that connects the medication item to the total daily dose.

Model Attribute Description

The HL7 attribute typeCode describes this class as a component.

Implementation in XML Instance

• The XML attribute typeCode is fixed to "COMP".

Model Attribute Description

The HL7 attribute contextConductionInd uses a Boolean value (true or false) to determine whether information associated with the parent act is conducted across to the child act (also associated with the child act).

Implementation in XML Instance

• The XML attribute contextConductionInd is fixed to "true".

Model Attribute Description

The HL7 attribute seperatableInd uses a Boolean (true or false) to indicate whether two pieces of information can be interpreted separately.

Implementation in XML Instance

• The XML attribute seperatableInd is fixed to "false".

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#entryRelationship10".

A link to the total daily dose.

This template class constrains the CDA reason class.

This class is a reason class that connects the medication item to its indication.

Model Attribute Description

The HL7 attribute typeCode describes this class as a reason.

Implementation in XML Instance

• The XML attribute typeCode is fixed to "RSON".

Model Attribute Description

The HL7 attribute contextConductionInd uses a Boolean value (true or false) to determine whether information associated with the parent act is conducted across to the child act (also associated with the child act).

Implementation in XML Instance

• The XML attribute contextConductionInd is fixed to "true".

Model Attribute Description

The HL7 attribute seperatableInd uses a Boolean (true or false) to indicate whether two pieces of information can be interpreted separately.

Implementation in XML Instance

• The XML attribute seperatableInd is fixed to "false".

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#entryRelationship12".

A link to the reason for ordering the medication.

This template class constrains the CDA reason class.

This class is a reason class that connects the medication item to its indication choice.

Model Attribute Description

The HL7 attribute typeCode describes this class as a reason.

Implementation in XML Instance

• The XML attribute typeCode is fixed to "RSON".

Model Attribute Description

The HL7 attribute contextConductionInd uses a Boolean value (true or false) to determine whether information associated with the parent act is conducted across to the child act (also associated with the child act).

Implementation in XML Instance

• The XML attribute contextConductionInd is fixed to "false".

Model Attribute Description

The HL7 (NHS localisation) attribute contentId, when valued in an instance, provides a unique forward pointing identifier for the template which constrains the classes and attributes which follow, for NHS use.

The attribute is intended simply as a structural navigational aid and should not be relied upon as an indicator of semantic meaning. The contentId is populated at run time with a value from the allowed list contained in the model.

Implementation in XML Instance

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

• The XML attribute root is fixed to the OID "2.16.840.1.113883.2.1.3.2.4.18.16"
• The XML attribute extension shall contain one of the allowed template artefact identifiers.

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#entryRelationship13".

A link to the Indication link Choice.

This template class constrains the CDA support class.

This class is a support class that connects the medication item to the medication change summary.

Model Attribute Description

The HL7 attribute typeCode describes this class as supporting information.

Implementation in XML Instance

• The XML attribute typeCode is fixed to "SPRT".

Model Attribute Description

The HL7 attribute contextConductionInd uses a Boolean value (true or false) to determine whether information associated with the parent act is conducted across to the child act (also associated with the child act).

Implementation in XML Instance

• The XML attribute contextConductionInd is fixed to "true".

Model Attribute Description

The HL7 attribute seperatableInd uses a Boolean (true or false) to indicate whether two pieces of information can be interpreted separately.

Implementation in XML Instance

• The XML attribute seperatableInd is fixed to "false".

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#entryRelationship15".

A link to the medication change summary.

This template class constrains the CDA component class.

This class is a component that connects the medication item to the administration method.

Model Attribute Description

The HL7 attribute typeCode describes this class as a component.

Implementation in XML Instance

• The XML attribute typeCode is fixed to "COMP".

Model Attribute Description

The HL7 attribute contextConductionInd uses a Boolean value (true or false) to determine whether information associated with the parent act is conducted across to the child act (also associated with the child act).

Implementation in XML Instance

• The XML attribute contextConductionInd is fixed to "true".

Model Attribute Description

The HL7 attribute seperatableInd uses a Boolean (true or false) to indicate whether two pieces of information can be interpreted separately.

Implementation in XML Instance

• The XML attribute seperatableInd is fixed to "false".

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#entryRelationship2".

A link to the administration method.

This template class constrains the CDA component class.

This class is a component that connects the medication item to the dose timing.

Model Attribute Description

The HL7 attribute typeCode describes this class as a component.

Implementation in XML Instance

• The XML attribute typeCode is fixed to "COMP".

Model Attribute Description

The HL7 attribute contextConductionInd uses a Boolean value (true or false) to determine whether information associated with the parent act is conducted across to the child act (also associated with the child act).

Implementation in XML Instance

• The XML attribute contextConductionInd is fixed to "true".

Model Attribute Description

The HL7 attribute seperatableInd uses a Boolean (true or false) to indicate whether two pieces of information can be interpreted separately.

Implementation in XML Instance

• The XML attribute seperatableInd is fixed to "false".

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#entryRelationship3".

A link to the dose timing.

This template class constrains the CDA component class.

This class is a component that connects the medication item to additional instructions.

Model Attribute Description

The HL7 attribute typeCode describes this class as a component.

Implementation in XML Instance

• The XML attribute typeCode is fixed to "COMP".

Model Attribute Description

The HL7 attribute contextConductionInd uses a Boolean value (true or false) to determine whether information associated with the parent act is conducted across to the child act (also associated with the child act).

Implementation in XML Instance

• The XML attribute contextConductionInd is fixed to "true".

Model Attribute Description

The HL7 attribute seperatableInd uses a Boolean (true or false) to indicate whether two pieces of information can be interpreted separately.

Implementation in XML Instance

• The XML attribute seperatableInd is fixed to "false".

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#entryRelationship5".

A link to the additional instructions

This template class constrains the CDA component class.

This class is a component that connects the medication item to the course status.

Model Attribute Description

The HL7 attribute typeCode describes this class as a component.

Implementation in XML Instance

• The XML attribute typeCode is fixed to "COMP".

Model Attribute Description

The HL7 attribute contextConductionInd uses a Boolean value (true or false) to determine whether information associated with the parent act is conducted across to the child act (also associated with the child act).

Implementation in XML Instance

• The XML attribute contextConductionInd is fixed to "true".

Model Attribute Description

The HL7 attribute seperatableInd uses a Boolean (true or false) to indicate whether two pieces of information can be interpreted separately.

Implementation in XML Instance

• The XML attribute seperatableInd is fixed to "false".

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#entryRelationship6".

A link to the course status.

This template class constrains the CDA component class.

This class is a component that connects the medication item to the routes of administration.

Model Attribute Description

The HL7 attribute typeCode describes this class as a component.

Implementation in XML Instance

• The XML attribute typeCode is fixed to "COMP".

Model Attribute Description

The HL7 attribute contextConductionInd uses a Boolean value (true or false) to determine whether information associated with the parent act is conducted across to the child act (also associated with the child act).

Implementation in XML Instance

• The XML attribute contextConductionInd is fixed to "true".

Model Attribute Description

The HL7 attribute seperatableInd uses a Boolean (true or false) to indicate whether two pieces of information can be interpreted separately.

Implementation in XML Instance

• The XML attribute seperatableInd is fixed to "false".

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#entryRelationship7".

A link to the route of administration.

This template class constrains the CDA component class.

This class is a component that connects the medication item to the dose direction duration.

Model Attribute Description

The HL7 attribute typeCode describes this class as a component.

Implementation in XML Instance

• The XML attribute typeCode is fixed to "COMP".

Model Attribute Description

The HL7 attribute contextConductionInd uses a Boolean value (true or false) to determine whether information associated with the parent act is conducted across to the child act (also associated with the child act).

Implementation in XML Instance

• The XML attribute contextConductionInd is fixed to "true".

Model Attribute Description

The HL7 attribute seperatableInd uses a Boolean (true or false) to indicate whether two pieces of information can be interpreted separately.

Implementation in XML Instance

• The XML attribute seperatableInd is fixed to "false".

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#entryRelationship8".

A link to the dose direction duration.

Model Attribute Description

The HL7 attribute classCode uses a code to describe this class as an observation.

Implementation in XML Instance

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

Model Attribute Description

The HL7 attribute moodCode uses a code to describe this class as an observation event.

Implementation in XML Instance

• The XML attribute moodCode is fixed to "EVN".

Model Attribute Description

The HL7 attribute code uses a code from a vocabulary to describe the values carried in the value attribute of this class. The vocabulary AdditionalInstructionType is used to define the type of additional instructions being conveyed.

Implementation in XML Instance

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

• The XML attribute code shall contain a value from the vocabulary AdditionalInstructionType.
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.17.537".
• The XML attribute displayName shall carry the description associated with the code.

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#additionalInstructions".

Model Attribute Description

The HL7 attribute value is used to carry the text of the additional instructions associated with the medication item. The type of additional instruction being conveyed is given by the code attribute of this class.

Implementation in XML Instance

• The XML attribute xsi:type shall contain the value "ST".
  
• The String (ST) data type shall be used to carry the additional instructions in the XML element value.

Model Attribute Description

The HL7 attribute classCode uses a code to describe this class as an observation.

Implementation in XML Instance

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

Model Attribute Description

The HL7 attribute moodCode uses a code to describe this class as an observation event.

Implementation in XML Instance

• The XML attribute moodCode is fixed to "EVN".

Model Attribute Description

The HL7 attribute code uses a code from the CDAObservationType vocabulary to describe this class as a total daily dose amount directive.

Implementation in XML Instance

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

• The XML attribute code shall contain the fixed value "DOSTOTD"
  
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.17.220"
• The XML attribute displayName shall carry the description associated with the code.

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#totalDailyDose".

Model Attribute Description

The HL7 attribute value uses a string to hold the total daily dose of medication. This may be computed from product/dose and frequency, or entered manually. The value must include the units of the dose.

Implementation in XML Instance

• The XML attribute xsi:type shall contain the value "ST".
• The String (ST) data type shall be used to carry the total daily dose in the XML element value.

Model Attribute Description

The HL7 attribute classCode uses a code to describe this class as an observation.

Implementation in XML Instance

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

Model Attribute Description

The HL7 attribute moodCode uses a code to describe this class as an observation event.

Implementation in XML Instance

• The XML attribute moodCode is fixed to "EVN".

Model Attribute Description

The HL7 attribute code uses a fixed concept from the SNOMED CT terminology to indicate that the value attribute of this class carries the route of adninistration.

Implementation in XML Instance

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

• The XML attribute code shall contain the value "410675002".
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.15"
• The XML attribute displayName shall carry the description associated with the code.

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#routeOfAdministration".

Model Attribute Description

The HL7 attribute value uses a concept from the SNOMED CT terminology, constrained by the NHSe-PrescribingRouteOfAdministrationSnCT vocabulary, (or a text representation) to describe the routes of administration.

Implementation in XML Instance

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

If using a concept from SNOMED CT then

• The XML attribute code shall contain a concept from the NHSe-PrescribingRouteOfAdministrationSnCT vocabulary.
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.15".
• The XML attribute displayName shall carry the description associated with the concept.

If not using a concept from SNOMED CT then

• The XML element originalText should be used to record the medicine.
  

Model Attribute Description

The HL7 attribute classCode uses a code to describe this class as an observation.

Implementation in XML Instance

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

Model Attribute Description

The HL7 attribute moodCode uses a code to describe this class as an observation event.

Implementation in XML Instance

• The XML attribute moodCode is fixed to "EVN".

Model Attribute Description

The HL7 attribute code uses a fixed concept from the SNOMED CT terminology to indicate that the value attribute of this class carries the medication change summary details.

Implementation in XML Instance

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

• The XML attribute code shall contain the value "182838006".
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.15"
• The XML attribute displayName shall carry the description associated with the code.

Model Attribute Description

The HL7 attribute effectiveTime is used to record the date and time of the change to the medication.

Implementation in XML Instance

The Timestamp datatype is used to carry this information as follows:

• The XML attribute value of the XML element effectiveTime shall be populated with the time the medication was changed using a time stamp in the format yyyymmddhhmmss[+|-ZZzz] where:
  

• yyyy is the year
• mm is the month
• dd is the day
• hh is the hour
• mm is the minutes
• ss is the seconds
• [+|-ZZzz] is the time zone offset in hours and minutes

Sections from the right of this representation may be left off when the sending system does not record to this level of accuracy. When hours are present, the time zone offset must also be present.

Model Attribute Description

The HL7 attribute statusCode uses a code from the ActStatus vocabulary to describes the status of medication change. As this template describes actual changes (not proposed changes), this is fixed to completed.

Implementation in XML Instance

The Coded Only datatype flavour is used to carry this information as follows:

• The XML attribute code of the XML element statusCode is fixed to completed

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#supportingMedicationChangeSummary".

Model Attribute Description

The HL7 attribute text is used to carry the description of the medication amendment.

Implementation in XML Instance

• The text element shall contain the description of the medication amendment.

This template class constrains the CDA component class.

This class is a component that connects the medication change summary to the medication change status.

Model Attribute Description

The HL7 attribute typeCode describes this class as a component.

Implementation in XML Instance

• The XML attribute typeCode is fixed to "COMP".

Model Attribute Description

The HL7 attribute contextConductionInd uses a Boolean value (true or false) to determine whether information associated with the parent act is conducted across to the child act (also associated with the child act).

Implementation in XML Instance

• The XML attribute contextConductionInd is fixed to "true".

Model Attribute Description

The HL7 attribute seperatableInd uses a Boolean (true or false) to indicate whether two pieces of information can be interpreted separately.

Implementation in XML Instance

• The XML attribute seperatableInd is fixed to "false".

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#entryRelationship11".

A link to the medication change status

This template class constrains the CDA component class.

This class is a component that connects the medication change summary to the medication change indication.

Model Attribute Description

The HL7 attribute typeCode describes this class as a component.

Implementation in XML Instance

• The XML attribute typeCode is fixed to "COMP".

Model Attribute Description

The HL7 attribute contextConductionInd uses a Boolean value (true or false) to determine whether information associated with the parent act is conducted across to the child act (also associated with the child act).

Implementation in XML Instance

• The XML attribute contextConductionInd is fixed to "true".

Model Attribute Description

The HL7 attribute seperatableInd uses a Boolean (true or false) to indicate whether two pieces of information can be interpreted separately.

Implementation in XML Instance

• The XML attribute seperatableInd is fixed to "false".

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#entryRelationship9".

A link to the change indication.

Model Attribute Description

The HL7 attribute classCode uses a code to describe this class as an observation.

Implementation in XML Instance

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

Model Attribute Description

The HL7 attribute moodCode uses a code to describe this class as an observation event.

Implementation in XML Instance

• The XML attribute moodCode is fixed to "EVN".

Model Attribute Description

The HL7 attribute code uses a code from the CDAObservationType vocabulary to describe this class as a medication change finding.

Implementation in XML Instance

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

• The XML attribute code shall contain the fixed value "MEDCHT"
  
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.17.220"
• The XML attribute displayName shall carry the description associated with the code.

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#medicationChangeStatus".

Model Attribute Description

The HL7 attribute value uses a code from the MedicationChangeType vocabulary to describe the change to the medication item as a result of this episode of care.

Implementation in XML Instance

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

• The XML attribute xsi:type shall contain the value "CV".
• The XML attribute code shall contain a value from the MedicationChangeType vocabulary.
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.17.534".
• The XML attribute displayName shall carry the description associated with the code.

Model Attribute Description

The HL7 attribute classCode uses a code to describe this class as an observation.

Implementation in XML Instance

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

Model Attribute Description

The HL7 attribute moodCode uses a code to describe this class as an observation event.

Implementation in XML Instance

• The XML attribute moodCode is fixed to "EVN".

Model Attribute Description

The HL7 attribute code uses a fixed concept from the SNOMED CT terminology to indicate that the concept being carried in the value attribute of this class is an indication for medication change.

Implementation in XML Instance

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

• The XML attribute code shall contain the value "410665000".
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.15"
• The XML attribute displayName shall carry the description associated with the code.

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#changeIndication".

Model Attribute Description

The HL7 attribute value uses a concept from the SNOMED CT terminology, or a text representation, to describe the medication change indication.

Implementation in XML Instance

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

If using a concept from the SNOMED CT terminology

• The XML attribute xsi:type shall contain the value "CV".
• The XML attribute code shall contain a value from the FindingTypeSnCT vocabulary.
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.15".
• The XML attribute displayName shall carry the description associated with the code.

If using text

• The XML element originalText of the value element may be used to convey the indication.
  

Model Attribute Description

The HL7 attribute classCode uses a code to describe this class as a manufactured product.

Implementation in XML Instance

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

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#manufacturedProduct".

A link to the Manufactured Material.

Model Attribute Description

The HL7 attribute classCode uses a code to describe this class as a manufactured material.

Implementation in XML Instance

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

Model Attribute Description

The HL7 attribute determinerCode uses a code to describe this class as an instance.

Implementation in XML Instance

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

Model Attribute Description

The HL7 attribute code uses a concept from the Dictionary of Medicines and Devices (dm+d) to identify the medicine or device being prescribed for the patient. If the medicine being recorded does not appear on dm+d (for example for historical reasons, patient reported items, extemporaneous preparations, or simply not appearing on dm+d), the originalText element of code should be used to record these medicines.

Implementation in XML Instance

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

If the medicine or device is a dm+d concept

• The XML attribute code shall contain a value from the vocabulary MedicationItemSnCT.
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.15".
• The XML attribute displayName shall carry the description associated with the code.

If the medicine is not a dm+d concept (note that devices that are not part of dm+d are recorded separately)

• The XML element originalText should be used to record the medicine.
  

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#manufacturedManufacturedMaterial".

A link to the author templates.

Model Attribute Description

The HL7 attribute classCode uses a code to describe this class as an observation.

Implementation in XML Instance

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

Model Attribute Description

The HL7 attribute moodCode uses a code to describe this class as an observation event.

Implementation in XML Instance

• The XML attribute moodCode is fixed to "EVN".

Model Attribute Description

The HL7 attribute code uses a code from the CDAObservationType vocabulary to describe this class as a dose direction duration direction.

Implementation in XML Instance

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

• The XML attribute code shall contain the fixed value "DOSDUR"
  
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.17.220"
• The XML attribute displayName shall carry the description associated with the code.

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#doseDirectionDuration".

Model Attribute Description

The HL7 attribute text is used to carry the duration of the medication dosage, where "Dosage" has been selected as the DoseDirectionDurationType.

Implementation in XML Instance

The text element shall contain the duration of the medication dosage. Correct units should be supplied to the duration, allowing for

• years
• months
• weeks
• days
• hours

When expressing duration, full unit text should be used for clarity.

For example
6 years
3 months
1 week 4 days

Model Attribute Description

The HL7 attribute value uses a code from the DoseDirectionDurationType vocabulary to describe the medication dose duration. If a dose duration type of "Duration" is chosen, the actual duration must be specified in the text attribute of this class.

Implementation in XML Instance

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

• The XML attribute xsi:type shall contain the value "CV".
• The XML attribute code shall contain a value from the DoseDirectionDurationType vocabulary.
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.17.535".
• The XML attribute displayName shall carry the description associated with the code.

Model Attribute Description

The HL7 attribute classCode uses a code to describe this class as an observation.

Implementation in XML Instance

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

Model Attribute Description

The HL7 attribute moodCode uses a code to describe this class as an observation event.

Implementation in XML Instance

• The XML attribute moodCode is fixed to "EVN".

Model Attribute Description

The HL7 attribute code uses a code from the CDAObservationType vocabulary to describe this class as a dose timing direction.

Implementation in XML Instance

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

• The XML attribute code shall contain the fixed value "DOSTIM"
  
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.17.220"
• The XML attribute displayName shall carry the description associated with the code.

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#doseTiming".

Model Attribute Description

The HL7 attribute value is used to carry the text of the dose timing associated with the medication item.

Implementation in XML Instance

• The XML attribute xsi:type shall contain the value "ST".
• The String (ST) data type shall be used to carry a text representation of the dose timing in the XML element value.

For example
Twice a day
At 8am 2pm and 10pm

Model Attribute Description

The HL7 attribute classCode uses a code to describe this class as an observation.

Implementation in XML Instance

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

Model Attribute Description

The HL7 attribute moodCode uses a code to describe this class as an observation event.

Implementation in XML Instance

• The XML attribute moodCode is fixed to "EVN".

Model Attribute Description

The HL7 attribute code uses a fixed concept from the SNOMED CT terminology to indicate that the value attribute of this class carries the dose amount.

Implementation in XML Instance

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

• The XML attribute code shall contain the value "408102007".
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.15"
• The XML attribute displayName shall carry the description associated with the code.

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#doseAmount".

Model Attribute Description

The HL7 attribute value is used to carry the text of the dose amount associated with the medication item.

Implementation in XML Instance

• The XML attribute xsi:type shall contain the value "ST".
• The String (ST) data type shall be used to carry a text representation of the dose amount in the XML element value.

Model Attribute Description

The HL7 attribute classCode uses a code to describe this class as an observation.

Implementation in XML Instance

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

Model Attribute Description

The HL7 attribute moodCode uses a code to describe this class as an observation event.

Implementation in XML Instance

• The XML attribute moodCode is fixed to "EVN".

Model Attribute Description

The HL7 attribute code uses a fixed concept from the SNOMED CT terminology to label the text being carried in the value attribute of this class as an administration method description.

Implementation in XML Instance

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

• The XML attribute code shall contain the value "447487007".
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.15"
• The XML attribute displayName shall carry the description associated with the code.

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#administrationMethod".

Model Attribute Description

The HL7 attribute value is used to carry the text of the administration method associated with the medication item.

Implementation in XML Instance

• The XML attribute xsi:type shall contain the value "ST".
• The String (ST) data type shall be used to carry the administration method in the XML element value.

Model Attribute Description

The HL7 attribute classCode uses a code to describe this class as an observation.

Implementation in XML Instance

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

Model Attribute Description

The HL7 attribute moodCode uses a code to describe this class as an observation event.

Implementation in XML Instance

• The XML attribute moodCode is fixed to "EVN".

Model Attribute Description

The HL7 attribute code uses a fixed concept from the SNOMED CT terminology to indicate that the concept being carried in the value attribute of this class is an indication for a course of medication.

Implementation in XML Instance

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

• The XML attribute code shall contain the value "410665000".
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.15"
• The XML attribute displayName shall carry the description associated with the code.

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#justifyingIndication".

Model Attribute Description

The HL7 attribute value uses a concept from the SNOMED CT terminology, or a text representation, to describe the medication course indication.

Implementation in XML Instance

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

If using a concept from the SNOMED CT terminology

• The XML attribute xsi:type shall contain the value "CV".
• The XML attribute code shall contain a value from the FindingTypeSnCT vocabulary.
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.15".
• The XML attribute displayName shall carry the description associated with the code.

If using text

• The XML element originalText of the value element may be used to convey the indication.
  

Model Attribute Description

The HL7 attribute classCode uses a code to describe this class as an observation.

Implementation in XML Instance

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

Model Attribute Description

The HL7 attribute moodCode uses a code to describe this class as an observation event.

Implementation in XML Instance

• The XML attribute moodCode is fixed to "EVN".

Model Attribute Description

The HL7 attribute code uses a code from the CDAObservationType vocabulary to describe this class as a medication course status finding.

Implementation in XML Instance

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

• The XML attribute code shall contain the fixed value "MEDCS"
  
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.17.220"
• The XML attribute displayName shall carry the description associated with the code.

Model Attribute Description

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.

Implementation in XML Instance

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

• 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_TP146052GB01#courseStatus".

Model Attribute Description

The HL7 attribute value uses a code from the CourseStatus vocabulary to describe the medication course status.

Implementation in XML Instance

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

• The XML attribute xsi:type shall contain the value "CV".
• The XML attribute code shall contain a value from the CourseStatus vocabulary.
• The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.17.536".
• The XML attribute displayName shall carry the description associated with the code.

A link to the indication choice.