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 a substance administration event.

Implementation in XML Instance

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

Model Attribute Description

The HL7 attribute effectiveTime is used to record the date and time of the discontinuation of 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 discontinuation 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 id uses an identifier to identify each unique instance of a section.

Implementation in XML Instance

The Identifier Global data type flavour is used to carry the identifier 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 medication change. As this template describes discontinued medications only, this is fixed to aborted.

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 aborted

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_TP146053GB01#DiscontinuedMedication".

Model Attribute Description

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

Implementation in XML Instance

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

This template class constrains the CDA author class.

This class is a links 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 as the originating 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_TP146053GB01#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 discontinued medication or medical device.

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_TP146053GB01#consumable".

A link to the manufactured product.

This template class constrains the CDA reason class.

This class is a links to the indication for the discontinued medication entry.

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_TP146053GB01#entryRelationship".

A link to the justifying 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_TP146053GB01#manufacturedProduct".

A link to the manufactured material kind.

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 Kind of manufactured material.

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 discontinued 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_TP146053GB01#manufacturedManufacturedMaterialKind".

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 discontinuing a 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_TP146053GB01#justifyingIndication".

Model Attribute Description

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