Structured Headings
Domain Message Specification

Discharge Tabular View

COCD_TP146067GB01
Discharge

This template class constrains the CDA Discharge entry class.

This class is the Patient Discharge encounter.

Used by:
[1..1] [M] classCode (CS { CNE: ActClass } )
{ Fixed="ENC" }

Model Attribute Description

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

Implementation in XML Instance

  • The XML attribute classCode is fixed to "ENC".
[1..1] [M] moodCode (CS { CNE: ActMood } )
{ Fixed="EVN" }

Model Attribute Description

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

Implementation in XML Instance

  • The XML attribute moodCode is fixed to "EVN".
[1..1] [M] code (CV { CNE:SnomedCT } )
{ Fixed="58000006" }

Model Attribute Description

The HL7 attribute code uses a code from SNOMED CT to describe this class as a patient discharge.

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 "58000006"
  • 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. It is recommended that the preferred term is used to populate this attribute.
The value attribute of the reference element within the originalText element may be used to link the coded information to the relevant text in the CDA section.
[1..1] [M] effectiveTime (TS)

Model Attribute Description

The HL7 attribute effectiveTime is used to define the time when the patient discharge took place.

Implementation in XML Instance

The XML attribute value of the XML element effectiveTime shall be populated with the time of the patient discharge 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.

[1..1] [M] id (II)

Model Attribute Description

The HL7 attribute id uses an identifier to identify the instance of the patient discharge.

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.
[1..1] [M] statusCode (CS { CNE:ActStatus } )
{ Fixed="completed" }
Model Attribute Description

The HL7 attribute code uses a code to describe the status of the patient discharge.

Implementation in XML Instance

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

  • The XML attribute code shall contain a fixed value of "completed".
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146067GB01#Discharge" }

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_TP146067GB01#Discharge".
[0..1] author

This template class constrains the CDA author class.

The author of this patient discharge information must be included if the author is different to the document (inherited) author.

If there is no known author for the information held on the source system then:

  • The information may be included and the document author will be deemed to be the author (by inheritance). The author should be asked to decide whether this is acceptable or not.
  • If the document author does not want to be considered as the author of the information then information must not be included in the document.
[1..1] [M] typeCode (CS { CNE: ParticipationType } )
{ Fixed="AUT" }

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".
[1..1] [M] contextControlCode (CS { CNE: ContextControl } )
{ Fixed="OP" }

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"
[1..1] [M] contentId (II) { "NPFIT-300001#Role" }

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.
[1..1] [M] functionCode (CV { CNE:AuthorFunctionType } )
{ Fixed="OA" }

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".
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146067GB01#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_TP146067GB01#author".
[1..1] [R] time (TS)

Model Attribute Description

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

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"
[1..1] participant (AuthorChoice)

A link to the choice of authors.

[0..1] entryRelationship

Refers to up to one coded entry to detail the discharge method.

[1..1] [M] typeCode (CS { CNE: ActRelationshipType } )
{ Fixed="COMP" }

Model Attribute Description

The HL7 attribute typeCode uses a code to describe this class as a component.

Implementation in XML Instance

  • The XML attribute typeCode is fixed to "COMP".
[1..1] [M] contextConductionInd (BL)
{ Fixed="true" }

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".
[1..1] [M] seperatableInd (BL)
{ Fixed="false" }

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".
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146067GB01#entryRelationship" }
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_TP146067GB01#entryRelationship".
[1..1] dischargeMethod (DischargeMethod)

A link to the discharge method observation.

[0..1] entryRelationship1

Refers to up to one coded entry to detail the discharge destination.

[1..1] [M] typeCode (CS { CNE: ActRelationshipType } )
{ Fixed="COMP" }

Model Attribute Description

The HL7 attribute typeCode uses a code to describe this class as a component.

Implementation in XML Instance

  • The XML attribute typeCode is fixed to "COMP".
[1..1] [M] contextConductionInd (BL)
{ Fixed="true" }

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".
[1..1] [M] seperatableInd (BL)
{ Fixed="false" }

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".
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146067GB01#entryRelationship1" }
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_TP146067GB01#entryRelationship1".
[1..1] dischargeDestination (DischargeDestination)

A link to the discharge destination observation.

[0..1] participant

This template class constrains the CDA participant class.

A class which is a participation of destination (the discharge destination location for the patient).

[1..1] [M] typeCode (CS { CNE: ParticipationType } )
{ Fixed="DST" }

Model Attribute Description

The HL7 attribute typeCode uses a code to describe this class as a destination.

Implementation in XML Instance

The XML attribute typeCode is fixed to " DST".

[1..1] [M] templateId (II)
{ Fixed="COCD_TP146067GB01#participant" }
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_TP146067GB01#participant".
[1..1] participantRole (ParticipantRole)

A link to the participant role.

[0..1] performer

Refers to the discharging specialty for the performer of the patient discharge.

[1..1] [M] typeCode (CS { CNE: ParticipationType } )
{ Fixed="PRF" }

Model Attribute Description

The HL7 attribute typeCode uses a code to describe this class as a performer participation.

Implementation in XML Instance

  • The XML attribute classCode is fixed to "PRF".
[1..1] [M] contentId (II) { "NPFIT-300004#Role" }

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.
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146067GB01#performer" }
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_TP146067GB01#performer".
[1..1] participant (DischargingSpecialtyChoice)

A link to the discharging specialty for the performer template.

ParticipantRole

This template class constrains the CDA participant role class.

The discharge destination.

Used by: Discharge
[1..1] [M] classCode (CS { CNE: RoleClass } )
{ Fixed="ROL" }

Model Attribute Description

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

Implementation in XML Instance

  • The XML attribute classCode is fixed to "ROL".
[1..1] [M] addr (AD)

Model Attribute Description

The HL7 attribute addr provides a contact address for the organisation or residential site where the role is based.

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 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 address when required. Only the use values listed below are recommended to be used for addresses.

Code
Definition
WP Work place - An office address. First choice for business related contacts during business hours. Used for organisation addresses.
TMP Temporary address - May be good for visit or mailing.
PHYS Physical visit address - Used primarily to visit an address.
PST
Postal address - Used to send mail.

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
[1..1] [M] code (CV { CNE:CDARoleType } )
{ Fixed="DischargeDestination" }

Model Attribute Description

The HL7 attribute code uses a code from the CDARoleType vocabulary the role of the address.

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 of "DischargeDestination"
  • The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.17.514"
  • The XML attribute displayName shall carry the description associated with the code.
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146067GB01#participantRole" }

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_TP146067GB01#participantRole".
DischargingSpecialtyChoice

Refers to a choice of discharging specialty.

Used by: Discharge
[1..1] : Template2

A link to the choice of discharging specialty.

DischargeDestination

This template class constrains the CDA observation class.

This class is an observation about the discharge destination of the patient post discharge.

Used by: Discharge
[1..1] [M] classCode (CS { CNE: ActClass } )
{ Fixed="OBS" }

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".
[1..1] [M] moodCode (CS { CNE: ActMood } )
{ Fixed="EVN" }

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"
[1..1] [M] code (CV { CNE:CDAObservationType } )
{ Fixed="DD" }

Model Attribute Description

The HL7 attribute code uses a code from the CDAObservationType vocabulary to describe the discharge destination.

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 of "DD"
  • The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.16.41"
  • The XML attribute displayName shall carry the description associated with the code.
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146067GB01#dischargeDestination" }
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_TP146067GB01#dischargeDestination".
[1..1] [M] value (CV { CNE:DischargeDestination } )

Model Attribute Description

The HL7 attribute code uses a code from the DischargeDestination vocabulary to describe the discharge destination.

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 xsi:type shall contain the value "CV"
  • The XML attribute code shall contain a value from the DischargeDestination vocabulary
  • The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.16.40"
  • The XML attribute displayName shall carry the description associated with the code.
DischargeMethod

This template class constrains the CDA observation class.

This class is an observation about the discharge method of the patient discharge.

Used by: Discharge
[1..1] [M] classCode (CS { CNE: ActClass } )
{ Fixed="OBS" }

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".
[1..1] [M] moodCode (CS { CNE: ActMood } )
{ Fixed="EVN" }

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"
[1..1] [M] code (CV { CNE:CDAObservationType } )
{ Fixed="DM" }

Model Attribute Description

The HL7 attribute code uses a code from the CDAObservationType vocabulary to describe the method of patient discharge.

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 of "DM"
  • 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.
[1..1] [M] templateId (II)
{ Fixed="COCD_TP146067GB01#dischargeMethod" }
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_TP146067GB01#dischargeMethod".
[1..1] [M] value (CV { CNE:DischargeMethod } )

Model Attribute Description

The HL7 attribute code uses a code from the DischargeMethod vocabulary to describe the method of patient discharge.

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 xsi:type shall contain the value "CV"
  • The XML attribute code shall contain a value from the DischargeMethod vocabulary
  • The XML attribute codeSystem shall contain the OID "2.16.840.1.113883.2.1.3.2.4.16.41"
  • The XML attribute displayName shall carry the description associated with the code.
AuthorChoice

Refers to the choice of authors of the discharge.

Used by: Discharge
[1..1] : Template1

A link to the choice of author templates.